PROJECT LEADER INCIDENT BRIEFING Form # HSEQ - PLIB Rev 2 -.docx
1. Project Information: Project Name: Click here to enter text. Report No.: Click here to enter text. Project Location: Click here to enter text. Property No.: Click here to enter text. Fatality Major Injury Minor Injury Property Damage Environmental Other 2. Describe the Incident in detail: Answer who, what, why, where, when & how in this section: (Attach additional pages if required) 3. Incident Root Causes: Describe direct, indirect & root cause: (Attach additional pages if required) 4. Key Corrections Taken Immediately after the Incident: Attach additional pages if more space is required: 5. Key Corrective Actions to Prevent Recurrence: Describe the corrective actions with timeframe: (Attach additional pages if required) Corporate Office Remarks:
PROJECT LEADER INCIDENT BRIEFING Form # HSEQ - PLIB Rev 2 -.docx
- 1. PROJECT LEADER INCIDENT BRIEFING (To be submitted to the HSEQ Corporate Office 1 week before SMT Safety Meeting) Page 1 of 1 Form # PLIB (Rev 2 - Mar 23) 1. Project Information: Project Name: Click here to enter text. Report No.: Click here to enter text. Project Location: Click here to enter text. Property No.: Click here to enter text. Fatality Major Injury Minor Injury Property Damage Environmental Other 2. Describe the Incident in detail: Answer who, what, why, where, when & how in this section: (Attach additional pages if required) 3. Incident Root Causes: Describe direct, indirect & root cause: (Attach additional pages if required) 4. Key Corrections Taken Immediately after the Incident: Attach additional pages if more space is required: 5. Key Corrective Actions to Prevent Recurrence: Describe the corrective actions with timeframe: (Attach additional pages if required) Corporate Office Remarks: