Christchurch City Council - Contractor Health, Safety & Wellbeing Statistics

Monthly Health and Safety Reporting

Please submit this form by the 10th of the month
If you require support, please contact hswsupport@ccc.govt.nz
Reporting Group*
Function*
Project / Site*
Project*
Name of Submitter*
Company*
E-mail address of submitter*
my.name@example.co.nz
Contract No.*
CCC Project Manager*
Email address of CCC Project Manager*
firstname.surname@ccc.govt.nz
CCC Engineers Rep / Contracts Engineer*
firstname.surname@ccc.govt.nz
Lag Indicators

Accident / Injury Statistics
Reporting month*
Reporting year*
Incidents*
Near Misses*
First Aid Injuries*
Medical Treatment Injuries*
Lost Time Injuries*
No. of Days Lost to LTIs*
No. of notifiable events to WorkSafe*
No. of Hours Worked*
Lead Indicators

Please complete the number of the following that have occurred in the reporting period.
Inductions completed*
Toolbox Meetings*
Internal Inspection*
Safety Observations*
Shared Learnings*
Visits from WorkSafe*
Monthly Health & Safety Report

Browse Files

Cancelof
Internal Inspection Report (Optional)

Browse Files

Cancelof
Attach Monthly Health & Safety Report OLD

Browse Files

Cancelof
CCC Engineers Rep / Engineer to Contract OLD
firstname.surname@ccc.govt.nz
Should be Empty:

Lag Indicators