Dawson Mine Hazard Report

• Name:

• Work Area:
  Address

• Hazard Location:

• Date and Time:

  Date

• Supervisor:

• Impact Type:

  Select Safety Environment Equipment Damage Reputation Health Legal/Regulatory Social Material Losses/Business Interruption

  • Safety
  • Environment
  • Equipment Damage
  • Reputation
  • Health
  • Legal/Regulatory
  • Social
  • Material Losses/Business Interruption

Hazard Description

• Details:

• Add Photos:

  Media

Immediate action taken:

• Detail:

• Add Photos:

  Media

Additional Controls Required:

• Further action required?

  YES

  NO

• Add comment where required.

Additional Comments:

• Add comment where required.

• Enablon No: