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Near Miss Report

This near miss report describes an incident that occurred at an unspecified project location. While no actual injuries, damage, or losses were sustained, the report estimates what could have occurred and analyzes the contributing factors. It recommends corrective actions to prevent future recurrence. The supervisor reviewed the report, which aims to document and learn from near misses to enhance safety.

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adil khan
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191 views1 page

Near Miss Report

This near miss report describes an incident that occurred at an unspecified project location. While no actual injuries, damage, or losses were sustained, the report estimates what could have occurred and analyzes the contributing factors. It recommends corrective actions to prevent future recurrence. The supervisor reviewed the report, which aims to document and learn from near misses to enhance safety.

Uploaded by

adil khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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NEAR MISS REPORT

INCIDENT DETAILS

Project:

Date: Time: Location/Plant/Equipment:

Near Miss Description (Explain What happened – Use attachment if needed.

ESTIMATE OF LOSS POTENTIAL (What injuries or losses might have occurred)

Injuries:

Property/Equipment Damage:

Environmental Damage:

Other:
ANALYSIS (Why did it happen (List unsafe acts, unsafe conditions, wrong procedures/equipment or other factors)

CORRECTIVE ACTION (What must be done to prevent recurrence – List recommendations)

REVIEWER INFORMATION
Reviewed by Supervisor or above (Name / Title / Badge):

Page – 1 of 1 NP/HSE/24/00

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