NearMissIncidentReportNewForm(EN-CN).docVIP

Near Miss Report 未遂事故报告 Events that resulted incident report or could have resulted near miss in injury to people, or damage to property, process or the environment includes road accidents and spills 此表用途： 导致（事故）或可能导致（未遂事故）人员伤亡、财产、工艺或环境损坏的事件。包括道路交通事故和泄漏。 Reported by报告人 : Performance Unit/ Department执行单位/部门 : Date of Incident事故发生日期 : Time of Incident事故发生时间 : Shift Time倒班时间 : Location of incident事故地点 : Mark any that apply标注出适用项目： Health Exposure健康: Environmental环境: Safety Incident安全事故: Security Incident保安事故: Quality Issue质量问题: Other其它: Did the incident result in any of the following: 事故是否导致下列任何情况的发生： Mark all that are applicable标注出所有适用项目: Occupational Injury or Illness职业伤害或职业病: Road or vehicle Incident道路交通或车辆安全事故: Material Release物料泄漏: Loss or damage损失或损坏: Complaint抱怨: Quality Issue质量问题: Primary company involved涉及的主要公司: BP/Castrol Contractor承包商 Customer/Third Party用户/第三方 Incident Description: Briefly describe what happened 事故描述：简要描述所发生的情况 Potential Consequences: What do you think could have been the result? 潜在的后果： 你认为可能导致什么后果 Have you suggestions for improvement - to prevent this from happening again or to prevent the potential consequences 你有什么改进的建议- 以防止该事件再次发生或避免潜在的后果 If appropriate, have any actions been taken? If so, please state them. List any actions to be taken for improvement. 是否采取了任何措施？如果有，请列举。 另外，列出将来拟采取的改进措施。 A copy of this form should be e-mailed or sent to: Line Management, HSSE Manager and local Traction co-ordinator All reports should be entered into the Traction HSSE reporting database Type of Incident 事故类型 Basic Details 基本情况 Incident Description 事故描述