A Maharatna Company

NTPC Limited
Tanda Super Thermal Power Station

Form – III-A

(NEARMISS INCIDENT REPORT FORMAT)

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Report No Project Person Affected

Date of Incident Name of witness
Time of Incident Incidents
classification
Area of Incident
Agency Name

Direct / Indirect Cause of incident

Whether incident took place due to unsafe
condition or unsafe act (Give details)
How many similar incidents took place in
the plant
Direct / Indirect Losses

Incident Description (where, when what, how, who)

Immediate actions taken

Place: Signature of Head of the Department

Date: Name, Designation & Department.

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 A Maharatna Company

CC to : 1. Head of Safety
2. Head of O & M / Project
3. Head of Plant– For kind information

Note:
1. All near miss accident are to be reported to Head of Safety by the head of
the Department immediately or within 24 hrs.
2. Head of Safety should investigation all near miss accidents and circulate the
enquiry report along with remedial measures at the Project / Station with a
copy to Corporate Safety Department.

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