INCIDENT REPORT – EMPLOYEE STATEMENT AND MEETING

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DETAILS OF INCIDENT

DATE OF INCIDENT*

NAME OF EMPLOYEE*

First Name Last Name

LOCATION OF INCIDENT*

Street Address Town/City County Postal Code Country

DATE OF INVESTIGATION MEETING*

START TIME OF INVESTIGATION MEETING*

END TIME OF INVESTIGATION MEETING*

LOCATION OF INVESTIGATION MEETING*

Street Address Town/City County Postal Code Country

NAME OF MEETING CHAIR*

First Name Last Name Position

NAME OF MINUTE TAKER*

First Name Last Name Position

INCIDENT DESCRIPTION AND STATEMENT*

SIGNATURE OF MEETING CHAIR*

Telephone: 01270 529200
Out of Hours: 01270 529200

Email

enquiries@lynchtankers.co.uk

Address

James Lynch & Sons (Transport) Ltd.
Norton Way,
Moss Lane Industrial Estate,
Sandbach,
Cheshire,
CW11 3YT