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News
About
Services
Engineering
Maintenance
Construction
Operations
Emergency Services
Locations
Case Studies
Overview
Home Improvement Client
Limestone Client
Petroleum Client
Glass Manufacturer Client
Proppant Client
Careers
About Careers
Veteran Opportunities
Contact
Safety
News
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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.
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