Form 5A - Queensland Mining Industry Incident Report Form
Choose one of the options below
- 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 - online forms (PDF, 222 kB) - instructions/definitions for completion of this on-line incident report form