This document is a report of damages to property from an event. It provides details of the event such as the location, operator, supervisor, and damages. It also includes descriptions of the event from the operator and maintenance, safety, and resident engineers. The administration section indicates follow up and compliance measures taken.

1. INFORME N°______________
DAÑOS A LA PROPIEDAD
Nombre del Operador: __________________________________________________ Fecha evento: _____/_____/____
Lugar del Evento: _______________________________ Cod. Unidad: ___________ Guardia: _______ Turno________
Supervisor a cargo: ______________________________________________________________________________
Daños al equipo: ____________________________________________________________________________________
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Descripción del Evento: ______________________________________________________________________________
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Firma del Operador
Nº D.N.I.: Fecha presentación: ____/____/_____
Informe de Mantenimiento: __________________________________________________________________________
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Firma Jefe de Taller
Nombres: Fecha presentación: ____/____/_____

2. Informe de Seguridad: _______________________________________________________________________________
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Firma de Ingeniero de Seguridad
Nombres: Fecha presentación: ____/____/_____
Conclusiones Residencia: _____________________________________________________________________________
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Sello y VºBº Ingeniero Residente
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VºBº Operador
Fecha presentación: ____/____/_____
Seguimiento y Conformidad Administración: _____________________________________________________________
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Firma del Administrador
Nombres: Fecha archivo: ____/____/_____