SD-FORM-003 Near Miss-Good Catch Report

Near Miss / Good Catch Report
Environmental Construction Service: ☐ MAS ☐ SAS ☐ SPS ☐ SLC
☐ Near Miss
☐ Good Catch
Date of Event:
Date Submitted:
Location of Event: Brief Description of Event:
Contributing Factors:
What changes, modifications, or actions will be implemented?
How will you implement these corrective actions?
Office Use Only: Date Received: ☐ Logged
☐
Statistics Documented
Document Title
NEAR MISS-GOOD CATCH REPORT
Approving Authority:
Joe Snorek
Origination Date:
March 12, 2015
Owner / Author:
Joe Snorek
Document Number:
SD-FORM-003
Revision Level / Date:
REV 3 / August 30, 2018
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Near Miss and Good Catch Reporting Instructions
Definitions:
Good Catch – An unsafe condition or act was recognized, which if let unaddressed, could have resulted in an
injury, property damage, or outage. This could also be a positive recognition of a good work practice or behavior
which helped create a safer environment.
Near Miss – An incident occurred where no property was damaged, and no personal injury was sustained, but
where, given a slight shift in time or position, damage and/or injury could have occurred.
Intent:
The intent of this document is to capture the Good Catch/Near Miss Event reports received from multiple
contractors on one standard document. This document is not intended to replace the contractor's own Good
Catch/Near Miss reporting process or documentation.
Procedure:
1. Once a Near Miss has occurred, or an unsafe condition or act has been recognized, an employee should
report it to their Supervisor or Safety & Compliance Representative per the guidelines of their own company's
reporting policy.
2. The Supervisor or Safety & Compliance Representative will record the Near Miss/Good Catch on the
company Good Catch and Near Miss Report and submit the form to: safety.field@sterlingsolutions.com
3. Please fill out the form in its entirety. The report should include the following:
1. Date of Near Miss/Good Catch
2. Location of Near Miss/Good Catch
3. Contributing Factors (states, critical errors, other)
4. Also, it is highly important that suggestions or recommendations be made regarding what actions
will be taken
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