M/S SAMIR SINHA & CO. DOC NO- SSC-CSMS/NM/1.

2-J/R-01

NEARMISS INVESTIGATION REPORT

Department: Vendor Code:

Name of Person/Equipment Affected: Reported By-

Location- Date –
Time -
DESCRIBE THE EVENT OCCURRED –
During tighting process of overflow bend bolt with using spanner at hydrocyclone(jig plant) area at
that time bolt slipped from thread and our employee Pravesh Gope got jerk but fortunately he
managed himself and avoid from falling hazard.

Initial/Immediate action taken:

Stop work and told that to not using that bolt and keep that on a safe place.

Corrective Actions proposed to prevent reoccurrence of such incidents(s):

Instructed to replace that defective bolt and use a new or good bolt.

Root Cause Analysis:

Why- Damage thread of bolt
Why- Due to old bolt
Why- Infrequent Schedule Maintenance
Why- Irresponsible behavior of maintenance in-charge
Why-
Preventive Actions Proposed to prevent reoccurrence of such incident(s):

- Training should be needed about “BBS”.

Name & Sign of Safety Supervisor Follow Up Action / Date (s)

Status-Closed
BEFORE