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Section 1
Section Navigation Bar
Near miss incident report
Please use this form to report near misses on North Lincolnshire's roads.
Date of incident
*
Date of incident
Month
MM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Time of incident
*
Hours
hh
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Minutes
mm
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Location of incident
*
Type of vehicle(s) involved (e.g. car, bus, cycle, etc.)
Direction of travel
*
e.g. towards Ashby
Condition of road surface
*
Please select ...
Dry
Wet
Ice
Snow
Light conditions
*
Please select ...
Daylight
Dark - with streetlights
Dark - no streetlights
Fog
Street furniture damaged?
Lamp post
Property boundary
Service pole
Sign pole
Signal pole
Tree
Other
If Other, please specify
Please describe exactly what happened?
*
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