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UTTAM GALVA METALLICS LIMITED

BHUGAON LINK ROAD, WARDHA-442001


REPORT OF NEAR MISS INCIDENT

Name: Amar Totade Emp. No/Contractor


Department: Coke Oven (conveyor) Date & Time: 11/08/18 03:00 AM
Description of Near Miss:
While Amar Totade was going to check regular job of coke 2 tail end
surrounding area,His leg slipped as the area was filled with slurry of coke fines
.May be injury occur
Remedial measures suggested:
1.Regular cleaning of area required during rainy season
2.Spillage to be controlled

Signature (Optional):-Amar totade


(For safety Department official use only)

Received on ………../……../20 Sr. No……………………………………………………………….

Investigated by Mr. ……………………………………………………………………. On ……………………………………………

Investigation Report attached.

Signature of HOS (Safety) HOD of Concerned Department

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