Good Catch Report Company * HARLAN McPHEE NORTH MCPHEE SOUTH RICHARDS RAVEX SYSTEMS Please Select the Type of Report Good Catch Near Miss New Option This form is used to report and communicate occurrences which under slightly different circumstances, would have resulted in an incident (for example: an injury, a fire, a release, property damage, trip out, etc.) This form is used to identify/communicate a "Good Catch" was made where a potential hazard was recognized and addressed before it became an issue. Your Name * Job Site Date of Good Catch: * Please Check The Appropriate Boxes Below This Form Describes A Good Catch From: Industrial Substation Commercial Civil Wireless T&D Warehouse/Office Other Issue Related To (Check All That Apply) Equipment Procedure Actions Safety Reliability Environment Incident Outcome Potential Struck By Struck Against Stepped On Caught In/Under/Between Slip/Trip/Fall Material Handling Contact With/By Exposure To Inhalation/Ingestion/Absorbtion Vehicle Accident Other Did this incident or injury have the potential for a serious injury or fatality (SIF)? * YES NO This form will not generate a repair or modification. If further action is required, please notify a supervisor. There will be no repercussions of discipline as a result of submitting this report. What immediate action was taken to protect others from the hazard (Hazard repaired/removed, Notified Supervisor, Hazard barricaded, etc.)? Describe the "Good Catch" What could be the worst outcome if this were not caught? File Upload Drop a file here or click to upload Choose File Maximum upload size: 52.43MB reCAPTCHA If you are human, leave this field blank. Submit Δ
