Title Page

  • Location
  • Date hazard reported

  • Person reporting hazard

Details

  • Hazard: A hazard is something that has potential to cause harm. Please report this hazard immediately to Human Resources.

  • Have you identified a Hazard?

  • Hazard category

  • Please specify

  • Name of person who reported hazard

  • Hazard Mechanism

  • Specify

  • Description of Hazard

  • Risk Level

  • Immediate Action/s taken to control risk

  • Has this hazard been fixed and closed out?

  • Generate action. Close out the hazard so this is a safety gain.

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