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Event Notification Form


This is an initial notification to Energy Safety of an accident or incident. Submission of this form will go directly into the Energy Safety Intelligence (ESI) database system. You may later be asked to provide additional details.

If you are reporting an electrical or gas accident that resulted in serious injury or death and/or significant damage to property, an Energy Safety Technical Officer on call will contact you shortly for more information as your notification will page them directly. Other notifications will be responded to during business hours.

Please note that if an energy worker is notifying Energy Safety about an installation that presents an immediate danger to life or property, they must also notify the owner or occupier where the danger exists. There is an Installation Fault Notice form available for this.

Notification

First Name *
Last Name *
 
Phone *
Mobile
 
Email
Please select the most appropriate role that applies to you? *
 
What organisation do you represent? *
 
What Type of Event are you Notifying Energy Safety about? *
 
When and Where did the Event occur?
Event Date(dd/mm/yyyy)
Event Time
Town/City
Briefly describe what happened *
 
What is the Energy Type related to this Notification? *
 
Were there any Injuries Requiring Medical Attention? *
 
 
Were there any Fatalities? *
 
Was there Property Loss or Damage? *
 

 

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