Free Non Injury Incident Report Template
Non-Injury Incident Report
I. Incident Overview
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Incident Date: |
May 25, 2054 |
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Incident Time: |
09:30 AM |
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Location: |
[YOUR COMPANY ADDRESS] |
II. Description of the Incident
On May 25, 2054, at approximately 09:30 AM, an incident occurred at the [YOUR COMPANY ADDRESS]. The incident involved a small fire breaking out near the assembly line due to a malfunctioning welding machine.
A. Details
During routine production activities, a welding machine overheated and sparked, igniting nearby flammable materials. The fire was quickly contained by the plant's fire suppression system, but there was minor damage to equipment and a temporary halt in production.
III. Contributing Factors
The primary contributing factor to the incident was the malfunction of the welding machine, which had not been properly maintained according to the manufacturer's recommendations. Additionally, a buildup of combustible dust in the area exacerbated the fire risk.
IV. Witness Statements
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Witness Name: John Smith
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Statement: "I was working nearby when I heard a loud popping sound, followed by the smell of smoke. I saw flames coming from the welding machine and immediately activated the fire alarm."
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Witness Name: Emily Johnson
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Statement: "I noticed that the welding machine had been acting up for a few days, but I didn't report it because I thought it was a minor issue. I didn't realize it could lead to a fire."
V. Immediate Actions Taken
Upon discovering the fire, the production supervisor activated the fire alarm and evacuated all personnel from the area. The plant's fire suppression system was activated, and the fire was extinguished within minutes. Maintenance personnel inspected the welding machine and isolated it from the power source to prevent further incidents.
VI. Preventive Measures and Recommendations
To prevent similar incidents in the future, the following measures are recommended:
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Implement a more rigorous preventive maintenance schedule for all equipment, including regular inspections and servicing of welding machines.
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Conduct regular training sessions for employees on fire safety procedures, including how to properly report equipment malfunctions and respond to fire emergencies.
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Improve housekeeping practices to reduce the accumulation of combustible dust and other flammable materials in production areas.
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Review and update emergency response protocols to ensure swift and effective action in the event of a fire or other emergency.
VII. Follow-Up Actions
Following the incident, a comprehensive review of the plant's safety protocols and procedures will be conducted by the safety committee. Any necessary updates or revisions to safety protocols will be implemented, and additional training sessions will be scheduled for all employees.
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Report Prepared By: [YOUR NAME]
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Position: Safety Manager
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Date Report Prepared: June 1, 2054
