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ELEMENTAL

Ref: 1
NEAR MISS CASE INVESTIGATION REPORT

1. Details of the Project


Name of the Project: Elemental village Job No:1 Business Unit:

2. Description of the Incident


Date & Time of the incident: 22-2-2024. 12:00 PM Exact Location where the incident occurred: model
villa

Describe briefly how the incident occurred (Add sketches & additional sheets to support the description):

3. Causes of the Incident


Direct Causes:

Root Causes:

4. Precautionary Measures
What are the precautions taken / being taken to prevent similar occurrence?

5. Any other information

Names & Designation of the Investigation Team:

___________________
ENGINEER

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