Hazard Reporting
Instructions: Use this form to identify any unsafe conditions and/or practices. The fields with an asterisk (*) are required to be completed. Please note that this form is not to be used to report emergencies or imminent danger. Call 911 to report emergencies.
For assistance with this form, please contact us by email or phone (951) 827-5528.
Employees are advised that it would be illegal for an employer to take any action against an employee in reprisal for exercising rights to participate in reporting safety issues.