Add Incident Report

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  • Submitted By

  • Project Name

  • Client

  • Work Order #

  • UCC #

  • District & Region

  • Address

  • Circuit & Substation

  • Date & Time

  • Type of Incident

  • Description of Incident

  • Related vehicle

  • Vehicle Type

     

  • vehicle - Make/Model

     

  • Related vehicle2

  • Related vehicle2 - Vehicle Type

     

  • Related vehicle2 - Make/Model

     

  • Name & Contact of Injured

  • Nature of Injury

  • Injured's Current Condition

  • Immediate Actions Taken

  • Corrective Actions

  • Attachment 1

  • Attachment 2

  • Attachment 3

  • Attachment 4

  • Attachment 5

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