New Incident Report

Reported By*

Category* Select Category... H&S Accident H&S Incident H&S Near Miss H&S Safety Concern H&S Positive Observation H&S Observation Marine Accident Marine Incident Marine Near Miss Marine Safety Concern Marine Safety Observation Environmental Incident Environmental Near Miss Environmental Concern Environmental Observation Marine Spill

Severity N/A 1 - Critical 2 - Major 3 - Moderate 4 - Minor

Record Injured Persons details? No Yes

About the injured person

Name

Job Title

Address 1

Address 2

Address 3

Town

County

Post code

Gender Male Female Other

Age

Status Employee of company Employed by someone else On a Training Scheme On work experience Self employed at work Member of the Public

Has this person given consent for their employer to disclose their personal information and details of the accident to safety representatives for them to carry out safety functions required by law? No Yes

Injured Area

	Abdomen		Ankle		Arm
	Back		Chest		Ear
	Elbow		Eye		Face
	Fingers		Foot		Groin
	Hand		Head		Hip
	Knee		Leg		Mouth
	Neck		Nose		Shoulder
	Toes		Wrist

Incident date*

Incident time*

Area* 16 Regent Quay Albert Basin Albert Quay 1- 5 Albert Quay Bunker Berth Atlantic Quay Balmoral Quay Blaikies Quay Castlegate Quay Central roadway Clipper Quay Commercial Quay East Commercial Quay West Crathes Quay Crown Wall Cut Dockgates Dry Dock Area Dunnottar Quay Duthies Quay Eurolink Linkspan Eurolink pontoon Gregness Breakwater Halls Quay Harbour Vessels Installation Berth Jamiesons Quay Maintenance Workshops Marine Operations Centre Matthews Cross Berth Matthews Quay Mearns Quay 1 - 3 Navigation Channel Nord Centre North Breakwater (NH) North Harbour Approaches Pacific Quay Palmerston Fish market Pocra Base Pocra Quay Point Law Cross Berth Regent Quay 1-4 Regent Road River Dee Russells Quay Shed 1 Shed 2 Shed 4 Shed 5 Shed 6 Shed 8 Shed 9 South Breakwater (NH) South Harbour Approaches South Harbour Basin Telford Dock The Silver Darling Tidal Harbour Torry Quay 1 - 6 Trinity Quay Turning Basin Upper Dock Upper Dock Cross Berth Victoria Dock Waterloo Goods Yard Weighbridge A Weighbridge B Other

Location*

Weather conditions (if applicable)

Incident type* Other Act of violence Contact with electricity or electrical discharge Contact with moving machinery Contact- Fixed object Contact/Collision with Vehicle Contamination of land, flora, fauna Diving incident Drowning or asphyxiation Emission to air of gas, dust, fumes or other pollutants Environmental Concern Exposure to an explosion Exposure to fire Exposure to, or contact with, a harmful substance Failure to comply with site rules Fall from height Fall into water Fire/Explosion Incident First Aid Case Fly tipping (Illegal waste dumping ) GDPR Grounding Injured by an animal Injured while handling, lifting or carrying IT Failure IT Failure Machinery/Hull Failure Marine Collision Marine Contact (Allision) Marine Fire /Explosion Marine Incident (Near Miss) Marine Less Serious Casualty Marine Machine Failure Marine Other Onboard Incident Marine Pollution Marine safety Observation Marine Serious Casualty Marine Very Serious Casualty Medical Treatment (MTC) Noise, light, odour, vibration or other nuisance Object Overboard Other Onboard Incident Other type of incident Person Overboard Pilot ladder damage PoA LTI (Lost Time Injury ) Pollution of water courses, surface water drains, foul water sewers Positive Observation -Action/ Condition Restricted Work Days Safety Concern Slip, Trip and Fall on same level Spillage, leakage, or uncontrolled discharge of substance Strike against something fixed/stationary Struck by moving vehicle Struck by moving, including flying/falling, object Traffic Issue Trapped by something collapsing/overturning trespass/ theft Trespassing

Description of Incident*

Action taken at the time*

Root cause category* Other Crew failed to utilise the correct type of fairlead for the tugs line. Crew Fatigue Defective tools or machinery Environmental Factors (e.g., currents, visibility) Equipment failure /Equipment Malfunction External Factors Failure of Port Infrastructure Failure to comply with Port regulations Failure to follow standard operating procedures (SOPs) Failure to maintain Failure to provide suitable and sufficient risk assessment Failure to tend lines, incorrect procedures GDPR Breach Human error - Lapse Human error - Violation Human error process failure Inadequate coordination between different teams or departments Inadequate design of workplace and equipment (Unsafe work environment) Inadequate Emergency Response Procedures Inadequate implementation of safety management system Inadequate Inspection of Vessels or Equipment Inadequate Lighting Inadequate Maintenance of Equipment or Infrastructure Inadequate Risk Assessment or Risk Management Inadequate Training of Crew Members Incorrect maneuvering procedures Incorrect Navigation Insufficient training on specific equipment or procedures Lack of adequate supervision Lack of co-operation Lack of communication Lack of competence Lack of oversight or supervision Lapse error whilst manoeuvring Medical Emergencies Misunderstandings or unclear instructions Overloading or Improper Loading Poor Communication Between Crew Members or with Port Authorities Poor Weather Conditions Security breaches or unauthorized access Structural deficiencies or weaknesses Structural Failure of Equipment Supply Chain Disruptions Training and familiarisation. Underwater Infrastructure Damage Unfamiliarity with maritime environment Unfamiliarly with Maritime environment. Unsafe Practices (e.g., shortcuts, ignoring safety protocols) Violation

Details of root cause of the incident (if known)

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