Professional Documents
Culture Documents
ACCIDENT/INCIDENT REPORT
Details of Person Making This Report:
DECAGON
Project / Location &
SCAFFOLDING AND Date of Event 25/05/2020
Plot no:
ENGINEERING CO
L.L.C / 5320167
Date Reported Reported By Jubin Thomas
26/05/2020
Event Type:-
Type of Treatment:-
Fatality / Major / 3 Day /
Minor or 1st aid /Major/
st
(1 aid / Doctor / Hospital) Dangerous Occurrence / PROPERTY DAMAGE
Vehicle Accident / Near
Miss) / Property Damage &
Environmental
Disturbance(Strong wind)
wind)
IP Name & ID no - __
IP (Injured Party)
Details Date of Joining & Position - __
Due to strong wind that hit our project site on 25-05-2020, boundary sheets of 24 running
meters and project signboard has been damaged.
- Area has been immediately barricaded where the fencing has been damaged.
A Treading on nails etc E Collapse of excavation I Trapped by machinery M Burns or scalds Q Welding flash
B Falls from height F Falling objects J Use of hand tools N Strains or sprains R Road accident
C Falls into excavation G Striking fixed object K Handling materials O Electric shock S Horse play suspected
D Falls on level ground H Struck by moving plant L Foreign bodies in eye P Heat exhaustion T Other unclassified
Root Cause
Unforeseen Act /
Unsafe Act Lack of Information Lack of Competence Environmental
Disturbance
Others
Management system
Unsafe Condition Lack of Training Poor Supervison
failure
Report Distribution: