Template

Initial ESV Incident Attendance Report

by Lachlan Coulson, from the Community

Document initial attendance details for incidents involving electrical hazards and ESV involvement. Record call and arrival times, site location, site contacts, and incident identifiers. Capture WorkSafe and MEC involvement, details of patrons, and a structured summary of evidence including photos, items seized, and observations such as arcing marks or equipment damage. Add preliminary findings, recommended next steps, and notes to support root cause analysis and regulatory compliance.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

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This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
ESV Incident Attendance Report
This ESV Incident Attendance Report template helps investigators document attendance and key facts following electrical incidents or near misses. Capture call and arrival times, site location, contacts including MEC, site and emergency services, WorkSafe involvement, evidence found and seized, and details of people on site. Record preliminary findings, next steps and recommendations to support compliance with electricity safety regulations and streamline root cause analysis.
by Lachlan Coulson, from the Community
Downloads: 0
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Template
ESV Initial Incident Investigation Attendance v2
Use this ESV initial incident investigation attendance form to document first response details for energy incidents. Capture incident location, notifications, site contacts, energy type, gas readings, appliances and vehicles, and responsible authorities. Log scene summaries, sketches, exhibits, and witness details. Follow the included checklist for scene preservation, evidence collection, and post-event actions, including CIMS or PEGA entry and debriefs.
by Zerub Roberts Muthyala, from the Community
Downloads: 0
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Template
ESV Incident Investigation (Updated)
This updated ESV Incident Investigation checklist supports investigations of gas or electrical events. Record incident date, time, location, site contacts, and notifications (police, fire, WorkSafe). Log ESV attendance and required resources. Capture appliance and vehicle details, gas readings, meters, serials, and registration numbers. Document onsite personnel, witness details, and a summary of the event and scene. Follow the investigation checklist: preserve the scene, identify breaches, collect and label exhibits, take readings, sketch and photograph the scene. Classify form of energy (gas, electricity) and incident type (e.g., electric shock, explosion, fire). Complete post-event actions: CIMS/PEGA entry, create files, obtain statements, compile BOE and FIR, submit for review, and upload to IMS.
by Lachlan Coulson, from the Community
Downloads: 0
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Template
Contractor Preliminary Incident Report
Use this contractor preliminary incident report template to document workplace events on site. Capture contractor and foreman details, incident date, time and location, type of incident, weather and site conditions, equipment involved, employee statement and investigator observations. Record utility damage with 811 locate info, medical details and injured body parts, attach photos of the incident and damage, and collect EHS director and participant signatures.
by Jamie Taylor, from the Community
Downloads: 10+
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ESV Incident Attendance Report

This ESV Incident Attendance Report template helps investigators document attendance and key facts following electrical incidents or near misses. Capture call and arrival times, site location, contacts including MEC, site and emergency services, WorkSafe involvement, evidence found and seized, and details of people on site. Record preliminary findings, next steps and recommendations to support compliance with electricity safety regulations and streamline root cause analysis.

by Lachlan Coulson, from the Community

Get

Template

ESV Initial Incident Investigation Attendance v2

Use this ESV initial incident investigation attendance form to document first response details for energy incidents. Capture incident location, notifications, site contacts, energy type, gas readings, appliances and vehicles, and responsible authorities. Log scene summaries, sketches, exhibits, and witness details. Follow the included checklist for scene preservation, evidence collection, and post-event actions, including CIMS or PEGA entry and debriefs.

by Zerub Roberts Muthyala, from the Community

Get

Template

ESV Incident Investigation (Updated)

This updated ESV Incident Investigation checklist supports investigations of gas or electrical events. Record incident date, time, location, site contacts, and notifications (police, fire, WorkSafe). Log ESV attendance and required resources. Capture appliance and vehicle details, gas readings, meters, serials, and registration numbers. Document onsite personnel, witness details, and a summary of the event and scene. Follow the investigation checklist: preserve the scene, identify breaches, collect and label exhibits, take readings, sketch and photograph the scene. Classify form of energy (gas, electricity) and incident type (e.g., electric shock, explosion, fire). Complete post-event actions: CIMS/PEGA entry, create files, obtain statements, compile BOE and FIR, submit for review, and upload to IMS.

by Lachlan Coulson, from the Community

Get

Template

Contractor Preliminary Incident Report

Use this contractor preliminary incident report template to document workplace events on site. Capture contractor and foreman details, incident date, time and location, type of incident, weather and site conditions, equipment involved, employee statement and investigator observations. Record utility damage with 811 locate info, medical details and injured body parts, attach photos of the incident and damage, and collect EHS director and participant signatures.

by Jamie Taylor, from the Community

10+

Get

Initial ESV Incident Attendance Report

About author

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ESV Incident Attendance Report

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