Hazard Identification &Safety Suggestion Form

This form may be used by any employee of the District to report hazardous conditions that exist in their workplace and/or to make suggestions that will improve safety. Please be as specific as possible. All submissions will be discussed at the next Health and Safety Committee meeting in your building. It is not necessary to identify yourself, but additional information may be required for the committee to respond effectively "An employee who is discharged or otherwise discriminated against because the employee has reported a safety hazard to the Safety and Health Committee, is subject to the protection afforded under MN Statutes, Section 182.669"
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