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Incident Investigation Form
"I need an Incident Investigation Form for our manufacturing facility in Manila that includes bilingual sections in English and Tagalog, with specific focus on machinery accidents and chemical spills, compliant with latest DOLE regulations effective January 2025."
1. Incident Basic Information: Essential details including date, time, location, and type of incident
2. Reporter Information: Details of the person reporting the incident, including name, position, and contact information
3. Incident Description: Detailed narrative of what occurred, including sequence of events and immediate actions taken
4. Affected Persons: Information about all persons involved in or affected by the incident, including employees, contractors, or visitors
5. Witness Information: Details of witnesses, including names, contact information, and initial statements
6. Environmental Conditions: Description of workplace conditions at the time of incident (lighting, weather, equipment status, etc.)
7. Root Cause Analysis: Investigation findings on direct and underlying causes of the incident
8. Immediate Actions Taken: Description of immediate response actions and emergency measures implemented
9. Corrective Actions: Detailed preventive and corrective measures to be implemented to prevent recurrence
10. Investigation Team: Names and roles of personnel conducting the investigation
1. Medical Report Section: Detailed medical information and treatment details when incident results in injury
2. Property Damage Assessment: Detailed evaluation of damage to equipment, facilities, or materials when applicable
3. Environmental Impact: Assessment of environmental effects for incidents involving spills, emissions, or other environmental concerns
4. Third Party Involvement: Additional section for incidents involving external parties or contractors
5. Cost Impact Analysis: Financial assessment of incident impact when significant costs are involved
6. Legal Compliance Review: Additional section for incidents requiring specific regulatory reporting or legal review
1. Appendix A - Photographic Evidence: Photographs, diagrams, or sketches of the incident scene and relevant details
2. Appendix B - Witness Statements: Detailed written statements from witnesses
3. Appendix C - Related Documents: Relevant documentation such as maintenance records, training records, or procedures
4. Appendix D - Risk Assessment: Pre-incident risk assessments and post-incident risk evaluation
5. Appendix E - Medical Reports: Copies of medical certificates or reports if applicable
6. Appendix F - Investigation Timeline: Detailed timeline of events before, during, and after the incident
7. Appendix G - Action Tracking Sheet: Template for tracking implementation of corrective actions
Authors
Manufacturing
Construction
Mining
Healthcare
Transportation
Logistics
Agriculture
Food Processing
Chemical Industry
Retail
Hospitality
Education
Energy
Telecommunications
Maritime
Aviation
Health and Safety
Human Resources
Operations
Quality Assurance
Risk Management
Compliance
Security
Facilities Management
Production
Maintenance
Environmental Health
Legal
Emergency Response
Occupational Health
Safety Officer
Health and Safety Manager
Facility Manager
Operations Manager
Human Resources Manager
Risk Manager
Department Supervisor
Quality Assurance Manager
Compliance Officer
Security Manager
Plant Manager
Site Supervisor
Environmental Health Officer
Occupational Health Nurse
Production Manager
Maintenance Manager
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