CfA Safety: Reporting Procedures
 
REPORT OF UNSAFE OR UNHEALTHFUL CONDITIONS

(Print, fill-out, and send to Karen Lawley, Safety Office, MS17; phone: 5-7478; email: klawley@cfa.harvard.edu



Classification of Hazard (Please check one):

Imminent Danger........... Serious Hazard............ Other.............

Location of Condition:...............................................................................................................................................

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Description of Condition:..........................................................................................................................................

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Signature:............................................

Extension:................................Date:.....................................
 


(To be completed by Safety Officer)

Date/Nature of Action Taken:...............................................................................................................................

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Complainant Notified: Orally.................................. In Writing...........................................................................

Date of Notification:................................................................................................................................................

Routing:....................................................................................................................................................................



 

 
 

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