Scaffold Collapse Incident Documentation
Incident Details
Date of Incident
Time of Incident
Location
Reported By
Contact Information
Description of Incident
Describe the sequence of events
Scaffold Details
Type of Scaffold
Height (m)
Width (m)
Length (m)
Purpose of Scaffold
Personnel Involved
Names and Roles
Number of People Involved
Injuries and Damages
Details of Injuries (if any)
Damage to Property/Equipment
Immediate Response
Actions Taken
Emergency Services Contacted
Witness Statements
Witnesses (names and contact info)
Witness Statements
Investigation and Analysis
Findings / Probable Cause
Contributing Factors
Corrective Actions
Recommendations
Actions Implemented