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  • F-13 IMS-PR-04 Near Miss Report

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    F-13 IMS-PR-04 Near Miss Report

    Uploaded by

    SyedTalha

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    SHIBH AL JAZIRA CONTRACTING CO.

    Reference: F-13/IMS-PR-04

    QHSE DEPARTMENT Rev: 00

    Accident / Incident Reporting Dated: July 15th, 2018

    NEAR MISS REPORT


    Reporting Date Company

    Date & Time of Near miss happened Location

    Brief Description of the Near Miss/incident

    What could have resulted?

    Immediate Cause of Incident?

    Was this hazard noticed before and informed to the Concerned Person?

    What was the immediate action taken?

    Image/Drawing of incident

    Reported by : Noted by : Noted by :

    Attachments:

    F-13/IMS-PR-04, Rev. 00

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