Monthly incident summary form

Choose one of the options below

Option 1: Log New Monthly Incident Summary Report

If you just want to create a new Monthly Incident Summary Report, start here.

Summary Period
Hours Worked this Period

up to 7 digit number e.g. 1234567.12

up to 7 digit number e.g. 1234567.12
Average Number of Workers

up to 7 digit number e.g. 1234567.12
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up to 7 digit number e.g. 1234567.12
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Option 2: Retrieve Existing Monthly Incident Summary Report
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Notes:

  • All fields are compulsory, unless otherwise stated.
  • If the mine code you enter does not match a valid code in our records, you will not be able to submit this form
  • This form does not replace the need for the site senior executive to notify an inspector of a serious accident or high potential incident.
  • Mining industry incident report manual (PDF, 222 kB) - instructions/definitions for completion of this on-line incident report form