FIELD ACCIDENT / PROPERTY DAMAGE REPORT - MANAGEMENT SECTION

Management Response

You are completing a Management Response for Field Accident Report # {field_id="35"}.

Was this accident preventable?

Was the driver following company procedures at the time?

Any violations identified (company policy, DOT, OSHA, etc.)?

Immediate corrective actions ( what was done right after the event):

Long-term corrective actions (repairs, changes to route/site, etc.):

Preventive actions (training, policy changes, engineering controls):

Incident reviewed with driver?

Customer involved?

Service disruption?

Customer notified by:

Date / Time

Date

Time

Customer feedback / complaint number (if any):

Driver Manager name

Fleet manager Name

the this Customer

HR Manager (if involved) Name