Incident Report – Full Investigation & Report

This checklist is used to report incidents, accidents and injuries at the construction site. It records the vital details of the incident like date, time, evidence and causes so that a thorough investigation can be performed. It ensures that the right steps can be taken to remediate the action. 

Details of further investigation needed:
Name of reporter:
Signature of reporter:
Details of people involved
Name of person
Job role type
Designation
Employee ID number
Contact number
How is the person related to the incident?
Details of involvement
Are there photos available?
Damage details
Describe the scope of damage in details
Does the person want to log a statement?
Are there any injuries?
Type of injury
Cause of injury
Equipment details
Type of equipment
Make and model of equipment
Photos available
Equipement ID number
Any corrective actions required pertaining to incidence?
Contributing factors to the incident
Has the root cause of the issue been identified?
Evidence and details
Is evidence available?
Describe the evidence
Type of evidence
Are photos available?
Incident report
Project Name :
Description of incident:
Type of incident:
Date :
Time :
Location :
What is the incident priority? (urgent/high/medium/low)
Weather conditions at the time of incident
Name of supervisor on duty
Details of incident
Describe the incidence
Was any first aid/medical attention given if people involved?
Is a timeline of incidents needed?
If yes, prepare a brief timeline
Vehicle details
Vehicle registration number
Vehicle make
Vehicle model
Name of driver on duty
Further information regarding vehicle
Type of damage
Describe the damage in detail
Photos of damage available?
Item
Type of item
Description of item
ID number of item
Further information regarding item damage

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