Health and Safety Online Forms (Responses)
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TimestampI would like toYour NameDate of hazardTime hazard was foundLocation
Description of hazard including significance in your opinion.
Any immediate action taken to mitigate: (please describe)
Your recommendations to control or to eliminate the hazard
Your NameDate of IncidentType of incident
Names and contacts of affected people
Incident / issue description
Action(s) takenOutcome(s) if knownIs this type incidentIs this type incident
Is this type incident been increasing
Have appropriate steps been taken to address this situation
Time of incident
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Form Responses 1
 
 
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