Sample Student Accident Report

Accident Report

United Water
103 Wilson Avenue
Manalapan Township NJ 07726

From: Jim Mastrokalos

To: All employees of United Water

Date: January 18, 2018

On January 17, 2018 at 7:05 a.m., the morning crew was doing their rounds when they heard a noise coming out of the water treatment plant’s decommissioned outflow pipe. When they arrived at the site, they discovered there was someone in the pipe and called 911. The county police dispatcher notified the fire department, paramedics, and confined space rescue units.

Ken Genieczko, assistant fire chief and incident commander and his crew, along with the confined space rescue unit used cameras to find the victim. They began by disassembling the 20-inch overflow pipe one piece at a time until they found the victim 10-feet down at the bottom of the pipe.

The victim, employee John Andrews, was alert and talking with the rescue crew. Genieczko explained to Andrews how to put on the harness so they could pull him from the pipe.

He was extracted at 10:58 am and the paramedics took over and transported Andrews to Johnson Medical Center in New Brunswick. At this time Andrews is stable but has suffered a head injury.

Rich Henning will be reviewing the security cameras to get the facts on this incident.

My concerns and recommendations for the staff here at United Water are:

  1. Why was there not a lock on holding tank lid?
  2. Why was Andrews in the pipe in the first place?
  3. All staff will participate in a mandatory safety training session.
  4. Evaluations of this incident will be discussed at a staff meeting after all surveillance videos have been reviewed.

Thank you all for your continued hard work. Please put your and your co-workers’ safety first.




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Technical Writing for Technicians Copyright © 2019 by Will Fleming is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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