Environmental Engineering Reference
In-Depth Information
AccIdent dAtA, other
This.form.is.used.only.for.“last.resort”.accident.classiication..It.relates.to.very.unusual.accident.
phenomena.not.covered.by.one.or.more.of.the.others.
.(1).Is.this.accident.unique.in.experience.of.investigator,.witnesses,.and.the.operations'.oficials?
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.Yes.
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.No
. . If.not,.state.other.known.occurrences:..__________________________________________________
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.(2).Explain.objects.and.conditions.involved;.how.accident.happened.and.what.inlicted.injury(ies):..
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.(3).Was.task.being.performed,.a.normal.task.in.the.operation?.
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.Yes.
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.No
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.Yes.
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.No
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. Normal.for.job.of.victim(s)?.
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. Was.there.an.established.safe.job.for.this.task.in.this.mine?.
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.Yes.
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.No
. . Was.victim(s).trained.to.do.task?.
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.Yes.
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.No
.(4).Other.pertinent.data:.. _______________________________________________________________
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