Oil and Gas Field Incident Report Form
Date of Report
Date of Incident
Time of Incident
Location/Site
Field Name/Well Number
Reported By
Contact Information
Designation
Department
Type of Incident
Injury
Fatality
Near Miss
Fire/Explosion
Spill/Leak
Equipment Failure
Other
Description of Incident
Immediate Action Taken
Persons Involved (Name & Role)
Witnesses (Name & Contact Info)
Recommended Next Steps