Aviation Occupational Health and Safety Regulations (SOR/2011-87)
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Regulations are current to 2025-05-27 and last amended on 2025-03-26. Previous Versions
SCHEDULE 1(Subsection 10.6(1))
![]() | Employment and Social Development Canada | Emploi et Développement social Canada |
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HAZARDOUS OCCURRENCE INVESTIGATION REPORT
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| Business number | |
Telephone number | ||
Site of hazardous occurrence | Date and time of hazardous occurrence | |
Weather (if applicable) | ||
Witnesses | Supervisor's name | |
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Brief description of property damage and the estimated cost of repair | ||
| Age | Occupation |
Years of experience in occupation | ||
Description of injury or illness | Gender | Direct cause of injury or illness |
Was training in accident prevention given to the employee in relation to duties performed at the time of the hazardous occurrence? ☐ Yes | ||
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Reasons for not taking corrective measures | ||
Supplementary preventive measures | ||
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Last name | First name | Telephone number |
Title | ||
Signature | Date | |
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Last name | First name | Telephone number |
Title | ||
Work place committee's or health and safety representative's comments | ||
Signature | Date |
ESDC LAB1070 E | ![]() |
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