Incident Report Slip
Incident Details
Date of Incident: | [December 10, 2050] |
Time of Incident: | [2:15 PM] |
Location of Incident: | Main Office Building, Conference Room 3 |
Type of Incident: | Fire Emergency |
Description of Incident: | A small fire erupted due to an electrical short circuit in the projector. The fire was contained within 10 minutes with minimal damage. |
Affected Parties
Number of Injured Persons: | 0 |
Number of Affected Employees: | 5 |
Names of Affected Employees: | John Doe Jane Smith Michael Johnson Emily Davis Richard Brown
|
Response and Actions Taken
Immediate Actions Taken: | |
Emergency Services Contacted: | Local Fire Department |
Time of Response by Emergency Services: | [2:25 PM] |
Further Actions Taken: | Electrical system inspection Repair and replacement of damaged equipment Debriefing and counseling session for affected employees
|
Approval and Sign-Off
Prepared By: [Your Name]
Reviewed By: [Your Supervisor Name]
Date: December 11, 2050
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