Personal information of the Person/Staff completing the incident report form | Name |
Title/Position | |
Job Description | |
Date and Signature | |
Names of Witnesses (if any) |
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INCIDENT DESCRIPTION | |
Date and time the incident occurred | Date: Time: |
Location of the incident |
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Component/System affected |
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Safety classification of the component/system (SSCs) | Safety Class 1 Safety Class 2 Safety Class 3 Safety Class 4 |
Description of the incident |
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Immediate actions taken to contain the incident or secure the incident area |
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Can the incidence be resolved within three (3) working days? | Yes, the incident can be resolved No, the incident cannot be resolved |
Actions taken to resolve the incident (or Actions to be taken to resolve the incident if the resolution is not possible within 3 working days). |
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Number of day(s) taken to resolve the incident |
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Can the Reactor be operated without resolving the incident? | Yes, the Reactor can be operated No, the Reactor cannot be operated |
INCIDENT REPORTING (REPORT THE INCIDENT WITHIN 7 WORKING DAYS) | |
Date and Time the incident reported to the Manager |
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Date and Time the Manager reported the incident to the: | |
Director |
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Reactor Safety Committee |
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GAEC Security |
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Director General |
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NRA |
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