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A North American Rail Solutions Company
(855) 920-8722
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(855) 920-8722
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Careers
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Services
Engineering
Maintenance
Construction
Operations
Emergency Services
Locations
Denver, CO
Dillsburg, PA
Fort Worth, TX
Gillette, WY
Henderson, NV
Houston, TX
Lexington, NC
Mulberry, FL
Pensacola, FL
Salt Lake City, UT
Tomahawk, WI
Tulsa, OK
Vancouver, WA
Case Studies
Overview
Home Improvement Client
Limestone Client
Petroleum Client
Glass Manufacturer Client
Proppant Client
Careers
Safety
News
REQUEST INFORMATION
24-Hour Emergency Service
(855) 920-8722
Safety Share/Observation Report
***All submissions are 100% anonymous
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1. Check all appropriate conditions:
*
a. Safety Share
b. Safety Recognition
c. Near Miss
d. Safety Concern
e. Safety Suggestion
f. Other:
Other Conditions
2. Type of Condition:
*
a. Safety Share
b. Safety Recognition
c. Unsafe Act
d. Unsafe Condition
e. Unsafe Equipment
f. Unsafe Use of Equipment
g. Other:
Other Conditions
3. Date
*
4. Time
*
5. American Track Location:
6. Job Name
7. Reporting Person (Name)
8. Has supervisor been made aware of this?
*
Yes
No
9. Are there any witnesses who can provide additional details? If so, please list.
10. Describe the condition/potential incident/hazard/concern (possible effects, etc):
*
11. What corrective action steps were taken to prevent Near Miss/Incident?
*
12. What steps can be taken to reduce the potential for similar accidents/incidents in the future?
*
13. Please provide photos of the condition/incident.
Click or drag files to this area to upload.
You can upload up to 5 files.
Submit
