HAZARD NOTIFICATION FORM
Ocean Blue Sports
Name
First Name
Last Name
Date Observed
/
Month
/
Day
Year
Date
Location
Description of hazard including significance in your opinion
Note any immediate action taken to mitigate:
Signature of person reporting hazard
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Health and safety representative report including analysis and action taken
Your recommendations to control or eliminate the hazard
Health and Safety Representative
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Submit
Should be Empty: