Free Emergency Incident Report Template
Emergency Incident Report
Report Prepared by: |
[Your Name] |
Position: |
Safety Officer |
Date of Report: |
[December 10, 2050] |
Report Number: |
EIR-20501210 |
Incident Overview
Incident ID: |
20501210-01 |
Date and Time of Incident: |
December 7, 2050, at 2:45 PM |
Location: |
[Your Company Address] |
Type of Incident: |
Electrical Fire |
Reported by: |
John Smith, Maintenance Supervisor |
Incident Description
At approximately 2:45 PM on December 7, 2050, a fire broke out in the server room located on the second floor of the [Your Company Name] building. The fire was initially detected by the automated fire alarm system, and visual confirmation was provided by John Smith. The fire was categorized as an electrical fire, originating from an overloaded power outlet.
Response Actions
Time |
Action Taken |
Personnel Involved |
2:46 PM |
Fire alarm activation |
Automated System |
2:47 PM |
Evacuation initiated |
John Smith |
2:50 PM |
Local fire department notified |
Jane Doe, Receptionist |
2:55 PM |
Fire department arrives on site |
City Fire Brigade |
3:10 PM |
Fire contained |
City Fire Brigade |
3:30 PM |
All clear given, re-entry permitted |
City Fire Brigade |
Impact Assessment
A. Personnel Injuries: None reported
B. Property Damage:
-
Server Room: Extensive damage to server equipment and electrical installations.
-
Estimated Cost: $150,000
C. Data Loss:
-
Approximately 4 TB of data lost
-
Backup systems initiated recovery; estimated restoration time is 72 hours.
D. Operational Impact:
-
Server downtime impacted [Your Company Name]'s online services.
-
Estimated downtime: 6 hours
Root Cause Analysis
Initial investigation suggests that the fire was caused by an overload in one of the power outlets, which was used beyond its capacity. Contributing factors include:
-
Insufficient regular maintenance checks
-
Lack of adherence to safety protocols for electrical equipment
Preventive Measures
In response to this incident, the following preventive measures are proposed:
-
Regular Maintenance Checks: Increase the frequency of electrical system inspections from bi-annually to quarterly.
-
Safety Training: Conduct mandatory electrical safety training for all maintenance staff.
-
Equipment Upgrade: Replace all outdated electrical outlets with newer, safer models that include overload protection.
This report serves as a comprehensive record of the emergency incident that occurred on December 7, 2050, at [Your Company Name]. It aims to provide a clear understanding of the events, the response actions taken, and recommendations for future prevention.
For further inquiries or additional information, please contact [Your Name] at [Your Email].