Safety Concer’ &Nédr'Miss Form - myCority

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This form should be only used for reporting near miss, safety concerns, and unsafe acts, events, or

situations that did not result in an injury or illness.

Near Miss - Incidents that resulted in no injury (inclusive of psychological), but had the potential for

causing serious injury

Safety Concern -— Any condition or practice that may cause a substantial probability of physical (or
psychological) harm, property loss and/or environmental impact

Unsafe Act - Actions/behaviours that may result in accidents, property loss, or harm to the environment,
putting the life, health, or safety of another person directly in danger

Employee Reporting
Holand, Mark (E21987)

Employee Job Type
Control Operator 80 (BU023)

Please provide your contact email address

mark_holand@bcrtc.bc.ca

Organization
BC Rapid Transit Co. Ltd (BCR)

Home Location
Operations & Maintenance Centre 1 (070)

Date of Incident

2026/01/22
YYYY/MM/DD

Self Reporting Number
75625

Employee - Supervisor (please ensure that this is
your current supervisor)

Wainwright, Ronald (£14033)

Employee Contact Phone Number
236-994-3376

Department
Control Operations (74300)

Incident Time

06:30
HH:MM (24H)