Protocol for inspection of the accident site (filling sample)

If an accident occurs at work, it is urgently necessary to create a commission that will conduct an investigation and write an appropriate report.

But first, the commission members must draw up a protocol for interviewing victims, witnesses and a protocol for examining the scene of the incident.

It is carried out by all members of the commission, but the responsibility for this lies with the chairman of the commission, who is indicated in the document.

Who draws up the NS in the event of an incident at work?

Immediately after the incident, a commission is formed that must inspect the accident site. The protocol indicates that the procedure is carried out by the chairman of the commission.

When checking the scene of an accident, video and photography are allowed to record all the details of the incident.

This way, during the investigation, it will be easier to establish the causes and assess the consequences of the accident.

What should the employer and the victim do after an accident?

Accident site inspection protocol

Form 7

PROTOCOL of inspection of the scene of an accident that occurred

Me, the chairman (member) of the commission to investigate an industrial accident,

During the inspection it was established:

2) description of the workplace (unit, machine, machine tool, vehicle and other equipment), where

3) description of a piece of equipment (building, structure), material, tool, fixture and others

	in the wardrobe room there are no defects in the flooring, things that contribute to
no injury was detected

Compilation deadlines

The protocol must be drawn up during the inspection of the scene of the incident or immediately after it. A special commission must inspect the scene of the incident, but it is created after the issuance of an order from the head.

This order is then indicated in the protocol as the basis. The investigation itself in most cases lasts no more than 3 days.

Based on the entire investigation and the inspection of the scene of the event, an act is drawn up in Form N 1, which indicates the causes, as well as the consequences of the incident and the perpetrators.

Also, every production organization has a journal in which information is recorded. The magazine is stored in production for 45 years.

How is Form 7 completed?

According to the law, there is a clearly established Form 7, which allows for a proper inspection of the scene of the incident.

Filling it out begins with indicating the name of the document, that this is a protocol of an accident that occurred with a certain employee, then fill in the date and full name of the victim.

The next point is where the protocol will be drawn up.

Then the exact time, down to the minute, for the start and end of the inspection is indicated.

The next point is that the chairman writes his data and refers to the order, according to which the investigation is being conducted.

This line indicates the full name of the employer or production manager, the name of the organization, as well as the date the order was left.

The next paragraph of Form 7 is a list of all persons participating in the inspection. Their initials and positions are indicated.

The main part of the Form 7 protocol contains a description of the scene of the incident. It should contain the following information:

• The situation at the scene of the accident at the time of inspection and comparison with the testimony of the victim.
• Accurate description of the workplace. This is usually a machine, machine, power tool, platform, vehicle or moving mechanism. Here the data and characteristics of the machine are indicated, as well as its number.
• Information about the assessment of working conditions, the certification number, as well as the organization that conducted the certification is recorded.
• A description of the piece of equipment that caused the injury or injury to the employee.
• Availability of protective fences, safety equipment, protective screens, and interlocks.
• Availability of personal protective equipment, including whether the employee was wearing it at the time of the incident or not.
• Description of ventilation, as well as lighting devices, level of illumination of the workplace.
• As a result, Form 7 describes what was seized during the inspection, as well as confirmation that photographs or video were taken at the scene of the incident during the inspection. All data must be attached to the document.
• Also, a diagram of the scene of the incident should be attached to the protocol and this should be recorded in Form 7.

The final part indicates whether the inspection participants had any complaints; if so, they are also included in the document.

This is followed by signatures with the full initials and indication of the position of the persons who left the protocol, read it aloud, as well as the persons familiar with it.

A separate inspection report can be drawn up for the machines and mechanisms that caused the accident.

This act indicates the owner of the device, as well as the name, brand, model, availability of operating documents and passports.

Mandatory check of all main components and functionality of the unit.

and sample filling

accident scene inspection protocol form 7 – word.

filling out the protocol in form 7 – word.

SOWY.RU

Appendix No. 1 to the resolution of the Ministry of Labor of the Russian Federation of October 24, 2002 No. 73

Form 7

Protocol of inspection of the accident site that occurred “...”……………20...

With …………………. (surname, initials, profession (position) of the victim) …………………. “…………….. 20… (place of drawing up the protocol)

The inspection began at ... o'clock. ... min. The inspection ended at... o'clock. ... min.

By me, the chairman /member/ of the commission to investigate an industrial accident, formed by order …………………. (surname, initials of the employer - an individual or name of the organization) ………………… from “…”………….. 20... N …., ………………… (position, surname, initials Chairman /member of the commission/ who carried out the survey) the site of the accident was inspected, which occurred in ………………… (name of the organization and its structural unit or the surname and initials of the employer - an individual; date of the accident) from …………… …… (profession (position), surname, initials of the victim) The inspection was carried out in the presence of ………………… (procedural position, surnames, initials of other persons participating in the inspection: other members of the accident investigation commission, the victim’s authorized representative, lawyer, etc.) During the inspection, it was established: 1) the situation and condition of the accident scene at the time of inspection ………………… (whether it has changed or not according to the testimony of the victim or eyewitnesses of the accident, a brief summary of the essence of the changes); 2) description of the workplace (unit, machine, machine tool, vehicle and other equipment) where the accident occurred……………… (exact indication of the workplace, type (brand), inventory number of the unit, machine, machine, vehicle and other equipment) 2.1. Information on conducting a special assessment of working conditions (certification of workplaces according to working conditions) indicating the individual number of the workplace and class (subclass) of working conditions …………………*; 2.2. Information about the organization that carried out the special assessment of working conditions (certification of workplaces based on working conditions) (name, Taxpayer Identification Number) …………………*; 3) description of a piece of equipment (building, structure), material, tool, device and other items that caused the injury……………… (indicate specifically their presence and condition) 4) presence and condition of protective fences and other safety equipment ………………… (locks, alarms, protective screens, casings, grounding / grounding /, wire insulation, etc.) 5) availability and condition of personal protective equipment used by the victim ………………… (availability of certified workwear, safety footwear and other personal protective equipment, their compliance with regulatory requirements) 6) availability of general and local ventilation and its condition ………………… 7) state of lighting and temperature ………………… (availability of devices lighting and heating of premises and their condition) ………………… During the inspection, ………………… (photography, video recording, etc.) were taken from the scene of the incident ………………… (list and individual characteristics of the seized items) Attached to the inspection protocol are ………………… (diagram of the scene of the incident, photographs, etc.) Before, during or at the end of the inspection from the persons participating in the inspection ………………… ( their procedural status, surnames, initials) applications ………………… Contents of applications: ………………… (received, not received)

…………………

…………………

…………………

(signature, surname, initials of the person who inspected the scene of the incident)

………………… (signatures, surnames, initials of other persons who participated in the inspection of the scene of the incident)

This protocol has been reviewed by ………………… (signatures, surnames, initials of the persons participating in the inspection, date);

The protocol was read aloud ………………… (signature, surname, initials of the person who conducted the inspection, date) Comments to the protocol ………………… (content of comments or an indication of their absence) The protocol was drawn up ……………… ... (position, surname, initials of the chairman / member / commission who conducted the inspection, signature, date)

*If a special assessment of working conditions (certification of workplaces for working conditions) was not carried out, clause 2.1 indicates “not carried out”, clause 2.2 is not completed

Source - Resolution of the Ministry of Labor of the Russian Federation of October 24, 2002 N 73 “On approval of the forms of documents necessary for the investigation and recording of industrial accidents, and the Regulations on the peculiarities of the investigation of industrial accidents in certain industries and organizations” (with amendments and additions) . With changes and additions from February 20, 2014, November 14, 2021

conclusions

After an emergency at work, the manager is obliged to notify all necessary authorities and then begin an investigation.

The investigation report is drawn up on the basis of several protocols, including the inspection of the incident, interviews with witnesses, the victim himself and those involved.

All protocols are completed on approved forms. Sample forms can be downloaded on the Internet or compiled and stored in the organization in advance.

All documents related to an industrial accident must be stored at the enterprise for at least 45 years, and according to some sources - all the time.

Accident site inspection protocol

(Appendix to the Resolution of the Ministry of Labor and Social Development of the Russian Federation dated October 24, 2002 N 73) Form 7 PROTOCOL OF INSPECTION OF THE SITE OF AN ACCIDENT THAT OCCURRED “__” _________ 200_ G. S _________________________________________ (last name, initials, profession (position) of the victim) _____________________________ “ __" ____________ 200_ (place of drawing up the protocol) The inspection began at __ o'clock. __ min. The inspection ended at __ o'clock. __ min. By me, the chairman (member) of the commission to investigate an industrial accident, formed by order ________ ___________________________________________________________________ (surname, initials of the employer - an individual or name _________________________________ dated "__" __________ 200_ N __, organization) ___________________________________________________________________ (position, surname, initials of the chairman (member of the commission) who carried out the survey) an inspection was carried out of the site of the accident that occurred in _______ ___________________________________________________________________ (name of the organization and its structural unit or the surname and initials of the employer - an individual; date of the accident) from ________________________________________________________________ (profession (position), surname, initials of the victim ) ___________________________________________________________________ The inspection was carried out in the presence of ___________________________________ (procedural position, surnames, initials of other persons participating in the inspection: ___________________________________________________________________ other members of the commission for the investigation of the accident, the victim’s proxy, lawyer, etc.) ___________________________________________________________________ During the inspection, the following was established: 1) the situation and condition the scene of the accident at the time of inspection ___________________________________________________________________ (has changed or not according to the testimony of the victim or eyewitnesses of the accident, brief summary _________________________________________________________________; essence of the changes) 2) description of the workplace (unit, machine, machine tool, vehicle and other equipment) where the accident occurred ________________________________________________ (exact indication of the workplace, type (brand), ___________________________________________________________________ inventory business number of the unit, machine, machine tool, vehicle and other equipment) _________________________________________________________________; 3) description of a piece of equipment (building, structure), material, tool, device and other items that caused the injury ___________________________________________________________________ (indicate specifically their presence and condition) ___________________________________________________________________; 4) the presence and condition of protective fences and other safety equipment _____________________________________________________ (locks, means of _________________________________________________________________; alarms, protective screens, casings, grounding (grounding), wire insulation, etc.) 5) the presence and condition of personal protective equipment used by the victim ___________________________________________________________________ (availability of certified workwear, safety footwear and other personal protective equipment, their compliance with ___________________________________________________________________ regulatory requirements) ___________________________________________________________________; 6) the presence of general and local ventilation and its condition ______ ___________________________________________________________________ _________________________________________________________________; 7) state of illumination and temperature __________________________ (availability of lighting and heating devices and their condition) ___________________________________________________________________ _________________________________________________________________; ______________________________________________________________ ______________________________________________________________ During the inspection, _______________________________________ was carried out (photography, video recording, etc.) _____________________________________________ were confiscated from the scene of the incident (list and individual characteristics of the seized items) ___________________________________ (diagram of the scene of the incident, photographs, etc.) are attached to the inspection protocol. during or at the end of the inspection from the persons participating in the inspection _________________________________________________________ __________________________________________________________________ (their procedural position, surname, initials) statements _________________________. Contents of the applications: _______ (received, not received) __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ _______________________________________ (signature, surname, initials of the person who inspected the scene of the incident) _______________________________________ (signatures, surnames, initials of other persons who participated in the inspection of the scene of the incident) _______________________________________ _________________________________ have been familiarized with this protocol ( signatures, surnames, initials of the persons participating in the inspection, date) The protocol was read aloud ___________________________________________ (signature, surname, initials of the person who conducted the inspection, date) Comments to the protocol _________________________________________________ (the content of the comments or an indication of their absence) ___________________________________________________________________ ___________________________________________________________________ The protocol was drawn up _______________________________________________ (position, surname, initials of the chairman (member) of the commission who conducted the inspection, signature, date)

Documentation

Here is a list of investigation materials on industrial accidents :

1. Order for collection of commission.
2. Protocols and graphic materials from the inspection site.
3. Documents about the condition of the injured person’s workplace.
4. Extracts from registration journals.
5. Recorded data from witness interviews.
6. Medical reports on the nature and severity of injuries.

Standard form 2 of an industrial accident report.

Forms of the report – 2-4, the appropriate option is determined taking into account the severity of the emergency and the professional affiliation of the affected persons. The act must be drawn up in two or three copies (the third is provided to the insurer). The document is drawn up for each victim individually. If the accident occurred at work, but has nothing to do with the performance of work duties, two copies of the report will be sufficient.

The exact list of materials of the SB investigation depends on the circumstances of a particular case. It is determined by the chairman of the commission.

Filling out a form in case of an accident

Road traffic accidents are one of the most unexpected accidents, where there may be not only one or two victims, but also a number exceeding dozens of victims. The crime scene inspection form is drawn up taking into account not only the Criminal Code of the Russian Federation, but also the Code of Administrative Offenses and Traffic Regulations. Attention is paid to the regulation of this area of ​​traffic, the distance to the curb is measured. The time of day, season, road surface, weather and driver condition are indicated. The road markings, the presence of signs, a traffic light and its signal (if it works) are specifically discussed.

A diagram of the scene of the accident is drawn up even by the participants in the incident in the insurance policy - there is a place there to indicate the position of the cars in the event of a collision. In the event that no physical harm was caused to the health of any of the participants in the accident, the drivers can disperse without waiting for an investigation (if one of the victims is a pedestrian, then the chance of physical harm increases significantly). Then they themselves schematically depict their vehicles, ignoring nearby objects.

What is the commission

A special commission, the formation of which is regulated by Art. 229 Labor Code of the Russian Federation. The commission is approved by order of the employer. It includes:

• employer representatives;
• occupational safety specialist;
• union workers.

We recommend that you read about voluntary accident insurance in this material.

The head of the commission is the employer himself or his representative, in some cases an official from the supervisory authorities. In the event of death or serious injury, other persons may be included in the commission. The number of members must be even. The investigation is carried out in stages - the participants in the accident are identified, the degree of damage caused to them is assessed, and the persons who allowed the accident to occur at work are assessed.

The composition of the commission and its compliance with accepted standards are carefully checked by representatives of the labor inspectorate.