Republic of the Philippines

ZAMBOANGA CITY WATER DISTRICT

LEGAL DEPARTMENT
Pilar Street, Zamboanga City
Telephone Numbers: (062) 991-1556 Loc. 8104

Incident Report
Particulars of incident:
Date: APRIL 2018 Time: UNKNOWN Location: ZCWD Motorpool Office Ground
Type of incident (please circle below):
Theft/Loss of 8” Pipe Wrench

Reported by: Roderick O. Solis Phone: 991-1556(8104)

Role in the event: Driver of Vehicle Email:
The injured person:
Name: NONE Address:
Age: Phone:
Witness(s):
Name: NONE Phone:
Name: NONE Phone:
Name: NONE Phone:
Describe the incident: (space overleaf for diagram if needed)
Sometime in April of 2018, the Legal Department Vehicle with Plate No. SGD 125, Isuzu Van Type, was taken in
for repair of its air conditioning system with the Transport Operations & Equipment Maintenance Division at its
main office grounds at Motorpool, Pasonanca. The same vehicle was repaired for a period of more or less two
(2) weeks. That after the repair, Mr. Roderick O. Solis, the designated driver of the vehicle, with Job Order
position at the Legal Department (LD), noticed that the hinge of the toolbos was already damaged that the said
toolbox could already be opened with any unlocking. And afterwards, Mr. Solis observed that the Pipe Wrench
with 8” size was already missing. He has no awareness or knowledge as to how or who have taken the said pipe
wrench.

Thereafter, during the ICIU meeting in the morning of May 22, 2018, at around 8:45 a.m., Mr. Roderick O. Solis
informed ICIU Chief Benjamin A. Buenaflor of the said incident, thus this incident report was prepared.

Describe any property damage: What damage was caused and how?
Hinge of toolbox was already damaged.

Analysis: What do you think caused or contributed to the incident?

UNCERTAIN

Prevention: What action has been taken to prevent a reoccurrence?

Plan to repair the hinge of the toolbox with new parts.

LD Personnel/ICIU Team II Leader

Name & Signature: YUSOP B. MASDAL Date completed: MAY 22, 2018
Legal Assistant II
Investigation conducted by: (No formal investigation yet) Date: