Environmental Engineering Reference
In-Depth Information
AccIdent dAtA, hAnd tools
.(1). Type.of.tool:.._____________________________________________________________________
.(2). Manufacturer:.___________________________.Model:._____________________________.Size:..___________
.(3). _________.Left.Handed.
_________.Right.Handed.Tool.
Weight:._________.oz./lb
.(4). Type.of.handle:._________.Wood.
_________.Rubber.
_________.Plastic.
_________.Metal
.(5). Was.handle.slippery?.
.Yes.
.No.
If.so,.why?.. _____________________________________
.(6). Was.tool.designed.for.the.job?.
.Yes.
.No.
If.not,.explain.(screwdriver.being.used.for.punch.
or.chisel,.etc.):
. . ________________________________________________________________________________
.(7). Was.there.a.material.failure.of.tool?. .Yes. .No. If.so,.describe:.._______________________
. . ________________________________________________________________________________
.(8). Condition.of.tool.prior.to.the.accident:. _________.Good. _________.Poor. Describe:..___________
. . ________________________________________________________________________________
.(9). Describe.exactly.how.tool.inlicted.injury:.. _____________________________________________
. . ________________________________________________________________________________
. . ________________________________________________________________________________
. . ________________________________________________________________________________
(10). If.electrical.shock.was.involved,.was.tool.insulated?.
.Yes.
.No
.
.
Complete.Accident.Data,.Electrical.Form.if.appropriate..Recover.tool.for.analysis.
 
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