Sample Hazard Correction Form

Review Date Plan of Action Next Review Date 

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Many companies use forms that document hazards identified for the purpose of developing a corrective action plan. Inspection reports include discussions about hazard correction along with the information about the hazard. Forms that employees use to report hazards and incidents should provide a space for description of the action plan. Refer to Chapter 11 and Appendix B for more detail. Notice that each of these forms has a line for corrective actions [2], Refer to Table 11-6 for a sample pohcy for employees to report hazards. Appendix C provides other forms for employees to report various hazards. 

Sample Forms for Employee Reporting of Hazards, Tracking Hazard Corrections, Follow-Up Documentation... 

The hazard reports that work best are a set of customized checklist for a specific workplace and operation. Appendix B provides several sample reporting forms, Sample Forms for Employee Reporting of Hazards,Tracking Hazard Correction, and Follow-Up Documentation. 

Self-Inspections. Describe your worksite safety and health inspection procedures. Include information about inspection schedules and industrial hygiene sanqiling and monitoring. Indicate who performs inspections and how any necessary corrections are tracked. (You may attach sample forms and internal time frames for correction.) Where applicable to health hazards, summarize the testing and analysis procedures used and qualifications of personnel who conduct them. 

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