0567-2806-MTDC: Accident Investigation Guide 2005, Exhibit 1-5

Accident Investigation Guide: 2005 Edition

Exhibit 1-5

File Code:	6730	Date:
Route To:
Subject:	Expanded (72-hour—after the team arrives) Briefing (Location of accident) (Date of accident)
To:	(Official authorizing the investigation)

THE FOLLOWING INFORMATION IS PRELIMINARY AND SUBJECT TO CHANGE

Name of injured or deceased (if the next of kin have been notified):

Preliminary factual findings:

Narrative:

/s/ Team leader

cc:
Safety Manager (at the level authorizing the investigation)

Visitor

since July 21, 2005