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Accident/Incident Investigation Form
Part 1???????Accident/Incident general data ???Name?
????? ???CAPA????
Jabil Inc. Proprietary -All rights reserved Printed copies are Reference Only File level: ???????? ??????? ?????
Jabil Inc. Proprietary -All rights reserved Printed copies are Reference Only File level: ???????? ??????? ?????
Part 2????????Accident/Incident Improvement Measures: Jabil Inc. Proprietary -All rights reserved Printed copies are Reference Only File level:
???????? ??????? ?????
Jabil Inc. Proprietary -All rights reserved Printed copies are Reference Only File level: ???????? ??????? ?????
????????????????????
Please identify the accident/incident grades and the handling condition
1.??????Accident type?
???????: ?????????????????????????Lost Time Injury: Recordable injury or illness that results in one (1) or more days away from work after the day on which the incident occurred
?????:??????2500??Real property damage of more than $2500 USD
????: ??????????????????????????????????Occupational Illness: Any abnormal condition or disorder, other than one resulting from an occupational injury, caused by exposure to environmental factors associated with employment.
???????????????????????????????????External Site Inquiry initiated by a complaint, follow-up to an incident, a non-compliance, or on-site visit
?????: ??5??(19?)?????????Hazardous Material Spill or release greater than 5 gallons (19 liters)
????????????????????????????????????????Significant environmental incidents requiring reporting to a government agency.
??????????,????????????????????, ???????????????Significant Near Miss: An event that could have resulted in an injury or illness, property damage, spill or
????????Checking the handling condition
2.?????????
Please check the accuracy for the handling condition of accident/incident.
???OK ????NG
(?????,??3?????) (If the handle results is not appropriately, please make solutions )
3. ?????? Solutions?
???????????/????/??????????3??????????????
(????EHS????Jabil Inc. Proprietary -All rights reserved Printed copies are Reference Only File level: ???????? ??????? ?????
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