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protection Unit F, 47 Blackborough Road, Reigate, Surrey RH2 7BU


Tel: +44 (0) 1737 226622 • Fax: +44 (0) 1737 242442 • Email: info@sbes.co.uk www.sbes.co.uk


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A proven management tool to help keep track, allocate and improve efficiency


How we can help


• Information at a glance • Keep track of current and up and coming projects easily


• Improve your department’s performance • Manage resources more efficiently • Standard or tailor made


Special Offer System only £95.00


inc 200 T Cards + P&P and VAT


Other Standard boards include:


• Maintenance Requests


• Continuous Improvement


• Staff In/out • Weekly Planners


tel 01732 871 417 web www.tcardsdirect.com


NEAR MISS / HAZARD ACTION PERSON TAKING RESPONSIBILITY FOR ACTION


ESTIMATED COMPLETION DATE DETAIL OF ACTION TAKEN


PLANT NAME


NEAR MISS / HAZARD LOCATION


REPORT A B C 0002


REF.


BRIEF DESCRIPTION OF NEAR MISS / HAZARD


DATE REPORTED BY


SUGGESTIONS FOR IMPROVEMENT


CONFIRM FEEDBACK PROVIDED TO EMPLOYEE YES CONFIRM ACTION AS COMPLETED AND CLOSED YES


TIME DATE SHIFT WORK REQUEST No. (IF APPLICABLE) TIME


A = CRITICAL B = MAJOR C = MINOR NEAR MISS:


(LIKELIHOOD OF FATALITY, LOSS OF BODY PART OR SIGNIFICANT LOSS OF STRUCTURE/EQUIPMENT/MATERIAL


(LIKELIHOOD OF SERIOUS INJURY/DAMAGE/LOSS). (LIKELIHOOD OF MINOR INJURY/DAMAGE/LOSS).


AN EVENT WITH POTENTIAL TO HAVE RESULTED IN INJURY DAMAGE OR LOSS T Cards Direct. Tel. 01732 871417 Re Order Ref: 13-407-4


PLANT NAME


NEAR MISS / HAZARD LOCATION


REPORT A B C 0003


REF.


BRIEF DESCRIPTION OF NEAR MISS / HAZARD


DATE REPORTED BY


SUGGESTIONS FOR IMPROVEMENT


TIME SHIFT


A = CRITICAL B = MAJOR C = MINOR NEAR MISS:


(LIKELIHOOD OF FATALITY, LOSS OF BODY PART OR SIGNIFICANT LOSS OF STRUCTURE/EQUIPMENT/MATERIAL


(LIKELIHOOD OF SERIOUS INJURY/DAMAGE/LOSS). (LIKELIHOOD OF MINOR INJURY/DAMAGE/LOSS).


AN EVENT WITH POTENTIAL TO HAVE RESULTED IN INJURY DAMAGE OR LOSS T Cards Direct. Tel. 01732 871417 Re Order Ref: 13-407-4


PLANT NAME


NEAR MISS / HAZARD LOCATION


REPORT A B C 0001


REF.


BRIEF DESCRIPTION OF NEAR MISS / HAZARD


DATE REPORTED BY


SUGGESTIONS FOR IMPROVEMENT


TIME SHIFT


A = CRITICAL B = MAJOR C = MINOR NEAR MISS:


(LIKELIHOOD OF FATALITY, LOSS OF BODY PART OR SIGNIFICANT LOSS OF STRUCTURE/EQUIPMENT/MATERIAL


(LIKELIHOOD OF SERIOUS INJURY/DAMAGE/LOSS). (LIKELIHOOD OF MINOR INJURY/DAMAGE/LOSS).


AN EVENT WITH POTENTIAL TO HAVE RESULTED IN INJURY DAMAGE OR LOSS T Cards Direct. Tel. 01732 871417 Re Order Ref: 13-407-4


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