Description of hazard

  • What is the hazard ?

  • Take a photo showing what the hazard is

  • Where is the hazard ?

  • Take a photo showing here the hazard is

  • Type of hazard

  • Explain the hazard & the context in how the hazard poses a risk

  • Add photo of hazard

  • What could happen as a result of the hazard?

  • What have you or others done now to reduce the risk ?

  • Take a picture of your completed actions

  • Is the risk from the hazard now acceptable ?

  • Your ideas on how to permanently fix the hazard:

  • Please give this report to the Account Manager and or the Manager or Supervisor where the hazard is located. You will be notified within 2 working days of either the action taken or to be taken

Manager or Supervisor to complete this section

  • Corrective Action Taken:

  • Is the risk from the hazard now acceptable ?

  • Situation Corrected:

  • Employee Notified ?

  • Date Employee Notified

  • Signed:

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