Incident Reporting and Investigation Policy

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Incident Reporting and Investigation Policy

Management Statement: (Your Organization) realizes the importance of accurate and timely reporting of incidents and
injuries. (Your Organization) Management understands that unless incidents and injuries are reported, we will lose the
opportunity to learn and improve our Health, Safety and Environmental program. (Your Organization) strives to foster an
atmosphere of management and perso9nal accountability relative to reporting and investigating incidents and injuries. Our
motto is:” You will never get into trouble for reporting event, but not reporting an HSE event as described below is breaking
company policy and will lead to disciplinary action”. All incidents occurring on a (Your Organization) worksite, no matter
how small, must be reported.

Definitions:
• A Health or Safety Event is any event which has or may lead to:
• Harm to one or more persons including:
o Near miss or near hit: Level 1
o First Aid Injury as described in OSHA 300: Level 2
o OSHA Recordable Injury :Level 3
o Days Away From Work Case: Level 4
o Hospitalization of one employee: Level 4
o Fatality: Level 4
Note: Hospitalization of two or more employees overnight or one or more fatalities must be reported to
OSHA within 24 hours.
• Vehicle Event is any event which has or may lead to:
o Near Miss or near hit: Level 1
o Damage to a vehicle, < $500.00: Level 2
o Damage to a vehicle, > $500.00: Level 3
• Environmental Event is any event which has or may lead to:
o Minor release of chemical fluids or hydrocarbons, <2 liters: Level 2
o Damage to an environmental containment, < $1000.00: Level 2
o Environmental damage: Level 3
▪ 2 liters – 10 liters of chemical, fluids or hydrocarbons
▪ $1000.00 - $5000.00 damage to an environmental containment
▪ Major Environmental Damage: Level 4 Any environmental event > those listed as Level 3

Reporting Responsibilities:
• All (Your Organization) Employees, Contractors and Sub-Contractors shall Report any event listed above as
soon as safely possible, but always within one hour of the event. (Your Organization) Clients Shall be notified
immediately of any incidents occurring on their property or in their operations.

Investigation of Incidents:
• Incidents listed as Level 1 or Level 2 will de investigated at the discretion of the local management and
(Your Organization) HSE staff.
• Incidents listed as Level 3 or above will be investigated by a team of HSE, supervision and management, and
led by a trained (Your Organization) Root Cause Analysis Specialist. A Root Cause Analysis will be performed to
better understand the incident and avoid reoccurrence
• Incidents listed as Level 4 will be investigated in coordination with (Your Organization) President or the President’s
Delegate, and will be led by a trained (Your Organization) Root Cause Analysis Specialist. A Root Cause Analysis
will be performed to better understand the incident and avoid reoccurrence
• Information gathered in any investigation will be summarized and shared throughout (Your Organization) to avoid a
repeat of the incident.

Signed: (Your Organization)


President Date: 1/1/06
Co-Signed: (Your Organization) VP
of HSE Date: 1/1/06
Revised: ________

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