Scribd Logo
Upload

Welcome to Scribd!

  • As PLN Ssoma 01 Plan Ssoma As

    Uploaded by

    Nirutnac Canturin
    4 views1 page

    Original Title

    As Pln Ssoma 01 Plan Ssoma As

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views1 page

    As PLN Ssoma 01 Plan Ssoma As

    Uploaded by

    Nirutnac Canturin

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    INFORME DE REPORTE PRELIMINAR

    AS.FRM.SSOMA.30 (Rev. 01 / Oct.21)

    PROYECTO :

    Incidente Accidente Leve 1° Auxilio Moderado Grave Fatal

    Potencial de Riesgo Bajo Medio Alto Extremo

    Personal Ambiental Material Tránsito Operativo No Operativo

    INFORMACIÓN DEL ACONTECIMIENTO

    Lugar: Hora: Fecha:

    Nombre del Involucrado:

    Descripción:

    Posibles causas:

    Consecuencias:

    Fotografía

    Acción Correctiva Inmediata:

    GRAVEDAD Nombre de los testigos


    PROBABILIDAD

    1°:
    2°:

    REPORTADO POR (Jefe directo del accidentado)

    Nombres y Apellidos:

    Ocupación:

    Firma: Fecha: Hora:

    You might also like