Hazard Report Form
Date
-
Day
-
Month
Year
Date
Reported By
First Name
Last Name
Location
Please Select
Main Beach Tourist Park
Jacobs Well Tourist Park
Other
Reported to
Hazard Type
*
Incident
Near Miss
Workplace Hazard
Hazardous Work Practice
Other
Description of Hazard
*
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How would you rate the Hazard?
*
Insignificant
Minor
Moderate
Major
Catastrophic
Almost Certain
Likely
Possible
Unlikely
Rare
For more information on Risk Rating please click here
HIGH RISK - Do not proceed with work unless approved by manager
MEDIUM RISK - Ensure you take nessary precautions
LOW RISK - Proceed with your work with caution
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