Download as pptx, pdf, or txt
Download as pptx, pdf, or txt
You are on page 1of 1

Hazard Report Hazard Report

Date: Project Name: Date: Project Name:

Section 1: Reporting Person Information Section 1: Reporting Person Information


1. Name: ……………………………………………………………………………………………………. 1. Name: …………………………………………………………………………………………………….

2. Position/Title: 2. Position/Title:
…………………………………………………………………………………........... …………………………………………………………………………………...........

3. Contact Number: …………………………………………………………………………….... 3. Contact Number: ……………………………………………………………………………....

Section 2: Hazard Information Section 2: Hazard Information


4. Hazard Details: 4. Hazard Details:
……………………………………………………………………………………………………………… ………………………………………………………………………………………………………………
……………………………………………………………………………………………………………… ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………….

5. Location of Hazard: 5. Location of Hazard:


……………………………………………………………………………………………………………… ………………………………………………………………………………………………………………

Section 3: Action Taken Section 3: Action Taken


6. Immediate Actions Taken: 6. Immediate Actions Taken:
………………………………………………………………………………………………………… …………………………………………………………………………………………………………
………………………………………………………………………………………………………… …………………………………………………………………………………………………………
…………………………………………………………………………………………………………. ………………………………………………………………………………………………………….
7. Follow-up Actions Required: 7. Follow-up Actions Required:
………………………………………………………………………………………………………… …………………………………………………………………………………………………………
………………………………………………………………………………………………………… …………………………………………………………………………………………………………
…………………………………………………………………………………………………………. ………………………………………………………………………………………………………….

You might also like