Near Miss Report

Topscan Inspections Limited — HSE Safety Management System

All near misses, unsafe acts and unsafe conditions must be reported immediately. Early reporting helps prevent serious injuries.

Date of Occurrence

Time of Occurrence

Name of Personnel

Report Type

Work Group

Location

Job Execution Period

Department

No. of People Involved

What Happened?

Immediate Action Taken

Further Action Required

Reported By

Supervisor / Line Manager

Status

Your report is submitted securely to the Topscan HSE System.