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City of Wagga Wagga Office Use Only Near Miss / Incident Notification Form Incident Number: Claim Number: Important This notification must be completed and submitted via email to safety ragga.NSW.gov.AU
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How to fill out council incidentnear miss notification

How to Fill out Council Incident/Near Miss Notification:
01
Start by clearly identifying the incident or near miss that occurred. Provide a brief description of what happened and where it took place.
02
Include the date and time of the incident or near miss. It is important to be as accurate as possible to ensure proper documentation.
03
Describe the immediate actions taken after the incident or near miss. This may include providing first aid, contacting emergency services, or implementing safety measures to prevent further incidents.
04
Identify any individuals involved in the incident or near miss. Include their names, job titles, and any other relevant information. This will help in conducting further investigations or follow-up actions.
05
Explain the potential causes or contributing factors that led to the incident or near miss. This could include unsafe work practices, equipment malfunctions, or environmental hazards. Be as detailed as possible to aid in preventing similar incidents in the future.
06
Provide any witness statements or evidence that supports your account of the incident or near miss. This may include photographs, videos, or written statements from individuals who were present at the time.
07
Outline any corrective actions taken or recommended to address the incident or near miss. This could involve implementing new safety protocols, conducting training sessions, or fixing faulty equipment.
Who Needs Council Incident/Near Miss Notification:
01
Employees: It is crucial for all employees to be aware of incident and near miss reporting procedures. They should promptly report any incidents or near misses to their supervisors or the designated council authority.
02
Supervisors and Managers: These individuals play a key role in ensuring that all incidents and near misses are properly reported and investigated. They need to be knowledgeable about the notification process and capable of guiding employees through it.
03
Council Authorities: The council or relevant authorities need to be informed of incidents and near misses that occur within their jurisdiction. This allows them to take appropriate actions, such as implementing safety measures or conducting inspections.
04
Health and Safety Professionals: Individuals responsible for health and safety in the council or organization should be notified of incidents and near misses. They can analyze trends, identify potential risks, and implement preventive measures to protect employees and the public.
In summary, anyone involved in or affected by incidents and near misses within a council or organization needs to be aware of the notification process. From employees to supervisors/managers, council authorities, and health and safety professionals, all play a vital role in maintaining a safe and accident-free environment.
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What is council incident near miss notification?
Council incident near miss notification is a report that is submitted to a council to inform them about any incidents or near misses that have occurred.
Who is required to file council incident near miss notification?
Any individual or organization that experiences an incident or near miss that is required to be reported to the council must file a council incident near miss notification.
How to fill out council incident near miss notification?
To fill out a council incident near miss notification, you need to provide details about the incident or near miss, including the date, time, location, description, and any other relevant information requested by the council.
What is the purpose of council incident near miss notification?
The purpose of council incident near miss notification is to ensure that the council is informed about any incidents or near misses that have occurred within their jurisdiction, allowing them to take appropriate actions to address and prevent similar situations in the future.
What information must be reported on council incident near miss notification?
The council incident near miss notification may require reporting of information such as the date, time, location, description of the incident or near miss, any injuries or damages incurred, steps taken to address the situation, and any other information deemed necessary by the council.
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