POST EVENT ANALYSIS – REPORT TEMPLATE – [Insert Council Name]

Incident Date: _____________ Council Ref. No: ___________________ Location: _____________________________ Loss Type: _____________________

Brief Summary (What, where, how) ____________________________________________________________________________________________________________

Identified Issues Contributors/Causes Control Measures/Remedial Actions Risk Rating Resp. Person

ACCOUNTABILITIES
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AWARENESS/ …………………
TRAINING ../../.. ../../..

INSPECTIONS/ …………………
MAINTENANCE ../../.. ../../..

DESIGN
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PRIOR HISTORY
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CONSEQUENCE
LEGEND
Insignificant Minor Moderate Major Catastrophic
LIKELIHOOD
Dept:………………………….…………. 1 2 3 4 5
E: Extreme risk, immediate action required
A(Almost Certain) M H H E E H: High risk, senior management attention
Branch:………………………………….. B (Likely) M M H H E required
M: Moderate risk; specific management
C (Possible) L M H H H responsibility
Sub Branch:……….…………………… D (Unlikely) L L M M H
L: Low risk; No immediate action
required/managed by routine procedures
E (Rare) L L M M H

Comments.
Participants; ___________________________________________________________________ Date; __________________