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This notification can be utilized to identify potential hazards, before they create a safety mishap. We do ask that you notify your superivsor to try and fix the safety hazard prior to submission, but it is not required.
Location of hazard. (Please be specific, so the hazard can be located):
Please provide the details of the hazard. Try to be as specific as possible, to ensure we can locate it.:
Severity of hazard:
Low Impact
Moderate
Severe
Catastrophic
Would you like to be notified of the results?
Yes
No
If you answered Yes to the above question, how may we contact you?
All reported hazards will be investigated as soon as practicle. If you wish to be notified of the results, please let us know.