Preventiebeleidsverklaring - GO! onderwijs van de Vlaamse ...
Preventiebeleidsverklaring - GO! onderwijs van de Vlaamse ...
Preventiebeleidsverklaring - GO! onderwijs van de Vlaamse ...
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Beschrijving <strong>van</strong> het ongeval<br />
(in te vullen door <strong>de</strong> verantwoor<strong>de</strong>lijke <strong>van</strong><br />
<strong>de</strong> af<strong>de</strong>ling)<br />
Voorbehou<strong>de</strong>n<br />
preventiedienst:<br />
• Datum - uur - dag:..........................................<br />
• Plaats:............................................................<br />
• Verslag:..........................................................<br />
.......................................................................<br />
.......................................................................<br />
.......................................................................<br />
.......................................................................<br />
.......................................................................<br />
......................................................................<br />
• Oorzaak:.........................................................<br />
.......................................................................<br />
.......................................................................<br />
• Voorkomingsmaatregelen:..............................<br />
.......................................................................<br />
.......................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
............................................................................<br />
Datum verslag:...................<br />
Handtekening verantwoor<strong>de</strong>lijke<br />
af<strong>de</strong>ling:.............................................<br />
Visum preventiedienst:....................<br />
Ongevallenverslag<br />
Document 35