Safety Event Form

This form is intended for Transpower staff, and contractors/consultants who do not have access to Maximo HSE, to report injuries and near misses related to Transpower activities. All Transpower staff and contractors/consultants may use this form to report general safety observations.

If you have any questions about the information needed to complete the form, or for assistance completing the form, please contact the Safety Team

If you are a member of the public who would like to tell us about a safety concern, please use the Public Safety Submission form.

Please note: all fields marked with an * are required.

Whom
Name of the person reporting the incident / observation.
When
Please enter the date and time of the incident / observation that you are reporting.
On which day did your make the observation?
:
What time of day did you make the observation?
Where
Please let us know where the event / observation took place, using either the map or site list below.
Click on the map to set a marker. Click on the marker to delete it. Or you can fill an address in the location field below.
What
Please let us know if your report is about a safety observation, a near miss, or an injury.
For injury or near miss, it's the employer of the affected party. If it's an observation or environmental event, it's the Service Provider responsible for the activity.
Does the incident or observation you are reporting have the potential to impact the environment? (i.e. an oil spill or gas leak)
Please provide a description of what happened or what was observed.
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png.
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png.
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png.
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png.
Whom Involved/Affected