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Weekly Incident Report

This weekly incident report summarizes injuries, incidents, traffic violations, and man-hours for a project over a one week period. There was one loss time injury reported due to an unspecified cause of injury. Several incidents were reported including property damage, motor vehicle accidents, and heavy equipment damage. Traffic violations reported included speeding. A total of x man-hours were worked during the week.

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Borislav Vulić
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130 views

Weekly Incident Report

This weekly incident report summarizes injuries, incidents, traffic violations, and man-hours for a project over a one week period. There was one loss time injury reported due to an unspecified cause of injury. Several incidents were reported including property damage, motor vehicle accidents, and heavy equipment damage. Traffic violations reported included speeding. A total of x man-hours were worked during the week.

Uploaded by

Borislav Vulić
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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WEEKLY INCIDENT REPORT

Project / Div. / Dept. / Office: ________________________________________________ CRC: _________________________ Date: From _______________To _______________

INJURIES
Injury Type Non-
Project/ Work Risk Matrix
Date Emp. No. LTIC RWDC MTC FAC Cause of the Injury Action Taken Work
Support CRC Related Categorisation
Related

LTI – Loss Time Injury RWDC – Restricted Work Day Case MTC – Medical Treatment Case FAC – First Aid Case
INCIDENTS
EQP / Incident Type
Project / Vehicle Work Non-Work
Date Cause of the Incident Action Taken
Support CRC No. / Emp. PD MVA HED FE NM Related Related
No.

PD – Property Damage MVA – Motor Vehicle Accident HED – Heavy Equipment Damage FE – Fire and Explosion NM – Near Miss
TRAFFIC VIOLATIONS
Project / Emp. No. / Reported by
Date Nature of Violations / Penalty Action Taken
Support CRC Vehicle No SAHER SAUDI ARAMCO SIS OTHER AFFILIATES

MAN-HOURS
Week (Thursday - Wednesday): Cumulative:

Prepared by: _______________________ Concurred by: ________________________________________________


Name & Signature of HSE Staff Name & Signature of PM / PIC / Div. / Dept. / Office

Revision No. 05 Page No. 1 of 1 Doc. No. IS-HSE-R47


Prepared by: Management Representative Issued Date: 21st January 2018
Reviewed by: General Manager Approved by: Chief Executive Officer
DISTRIBUTION: HSE Department Originator
NOTE: 1. Week coverage (Thursday – Wednesday) 2. To be completed and sent weekly – every Wednesday (afternoon / evening)

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