建設(shè)工程職工傷亡事故調(diào)查報(bào)告書

建設(shè)工程職工傷亡事故調(diào)查報(bào)告書1．企業(yè)詳細(xì)名稱：地址：電話：2．經(jīng)濟(jì)類型：直接主管部門：3．事故發(fā)生時(shí)間：年月日班時(shí)分4．工程概況：結(jié)構(gòu)：層/幢：面積：m25．事故類別：6．事故級別：7．事故詳細(xì)經(jīng)過：（填寫不下可另附紙）------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------8．事故原因分析（以專家分析為準(zhǔn)）（1）直接原因：------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------（2）主要原因：----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------（3）間接原因：-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------9.事故搶救過程：（包括哪些部門、領(lǐng)導(dǎo)參加）----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------10.傷亡人員情況：姓名性別年齡文化程度用工形式工種級別本工種工齡安全教育情況傷害原因傷害部位傷害程度損失工作日備注11.本次事故損失工作日總數(shù)：12.本次事故經(jīng)濟(jì)損失（元）：其中直接經(jīng)濟(jì)（元）：13.事故的教訓(xùn)和預(yù)防事故重復(fù)發(fā)生的措施：----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------14.事故責(zé)任分析和對責(zé)任者處理意見：（以法律、法規(guī)、規(guī)章為依據(jù)，劃分單位和有關(guān)人員應(yīng)負(fù)的行政責(zé)任和經(jīng)濟(jì)責(zé)任）--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------15.附件（事故現(xiàn)場照片、傷亡者照片、技術(shù)鑒定圖示、旁證等資料）16.參加調(diào)查人員：負(fù)責(zé)人簽名：