Hazard Report HAZARD/INCIDENT REPORTWorkplace/Venue *Date *Reported ByName: *Time of Hazard/Incident *Reported toName: *Place of Hazard/Incident: *1. Describe the Hazard/Incident in detail: Include area and task, equipment, tools and people involved2. Possible Solutions/ how to prevent recurrence: Do you have any suggestions for fixing problems or preventing a repeat?3. Results of Investigation. Determine whether the hazard/incident is likely to cause an injury4. Action Taken: Supervisors to identify actions to prevent injury or illness.To be completed by Risk Management Team:Resolved: YesNoSigned Name: Date File Upload hand written report VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
