Good Catch - Near Miss Reporting Form

Good Catch, Near Miss

A good catch is a potential hazard or incident that has not resulted in any personal injury or property damage. Some good examples of good catches are unsafe conditions, improper use of equipment, use of faulty equipment, or not following proper procedures. It is everyone’s responsibility to report and correct any of these potential hazards immediately. Please use this form to report Good Catches and assist in preventing future incidents and making O6 ENV a safer place to work.

Location:

Date

Time

Tyle of Concern (Check All That Apply)

At Risk Behavior

Unsafe Equipment

Unsafe Use of Equipment

Unsafe Condition

Safety Success

Positive Recognition

Other

Description of Good Catch Condition and Possible Outcome:

Safety Suggestion / Corrective Action Taken:

Post Image

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Name

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