Hazard, Risk and Maintenance Report
Use this form to promptly report any hazards, maintenance issues, or repair needs identified at Project Epic. Timely reporting ensures safety and compliance of all staff and participants.
Name
*
First Name
Last Name
Date
*
/
Day
/
Month
Year
Date
Location
*
Type of Report
*
Please Select
Hazard
Maintenance
Repair
Description of Issue
*
Urgency Level
*
Please Select
Low
Medium
High
Critical
Is the Area Safe to Use?
*
Yes
No
Has the area been blocked off or made safe?
Yes
No
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