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.
Your full name
Your Email address
Retype Email address
Position
Mine ID
Summary Period
Month/Year	N/A Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec N/A 2022 2023 2024
Hours Worked this Period
By employees up to 7 digit number e.g. 1234567.12
By contractors up to 7 digit number e.g. 1234567.12
Average Number of Workers
Employees up to 7 digit number e.g. 1234567.12
Contractors up to 7 digit number e.g. 1234567.12

Option 2: Retrieve Existing Monthly Incident Summary Report
Report No
Password

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, 1 MB) - instructions/definitions for completion of this on-line incident report form