Ocean Blue Hazard Form

HAZARD NOTIFICATION FORM

Ocean Blue Sports
Name

First NameLast Name
Date Observed

MonthDayYear
Date
Location
Description of hazard including significance in your opinion
Note any immediate action taken to mitigate:
Signature of person reporting hazard
Health and safety representative report including analysis and action taken
Your recommendations to control or eliminate the hazard
Health and Safety Representative
Should be Empty: