North Carolina Safety or Health Hazards Report Form

State:
Multi-State
Control #:
US-AHI-287
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is used to report any safety or health hazards that have occurred within a workplace.

North Carolina Safety or Health Hazards Report Form is a crucial tool used to report and document safety and health hazards in various environments such as workplaces, public areas, or residential properties. This form allows individuals to notify authorities or responsible parties about hazardous conditions that may pose risks to people's safety and well-being. The North Carolina Safety or Health Hazards Report Form typically includes fields and sections to gather relevant information about the hazard, the location where it was identified, and the person reporting it. The form may require the following details: 1. Contact Information: This section collects the personal details of the person reporting the hazard, including their name, address, contact number, and email. 2. Date and Time: Here, the individual provides the specific date and time when the hazard was observed or discovered. 3. Hazard Description: In this field, the person provides a detailed description of the safety or health hazard encountered. This could include information about the nature of the hazard (e.g., chemical spill, exposed wiring, malfunctioning equipment), its location, and any potential risks or injuries it may cause. 4. Location: This section requires specific details about the hazard's location, including the address, floor, room number, or specific area where it was found. Providing accurate location information helps authorities locate and resolve the issue promptly. 5. Witness Information: If there were any witnesses to the hazard, their names, contact details, and statements may be included in this section. Witnesses play a crucial role in validating the reported hazard and providing additional information if required. 6. Attachments: The form may allow the person reporting the hazard to attach supporting evidence such as photographs, videos, or any relevant documents that can help authorities understand and address the situation effectively. It is also worth mentioning that there might be different types of North Carolina Safety or Health Hazards Report Forms, specific to particular industries or sectors. For example, there may be specialized forms for workplace hazards, construction site hazards, chemical spill hazards, or public health hazards. Having various forms tailored to different contexts ensures that all potential safety or health hazards can be accurately identified, reported, and handled accordingly. This flexibility allows authorities and responsible entities to address hazards promptly, preventing accidents, injuries, or any adverse effects on public health and safety. Overall, the North Carolina Safety or Health Hazards Report Form serves as a vital document in promoting and maintaining a safe and healthy environment for residents, employees, and visitors in the state. It facilitates effective communication and collaboration between the public and relevant authorities to promptly address and mitigate potential dangers.

How to fill out Safety Or Health Hazards Report Form?

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FAQ

North Carolina operates an OSHA-approved State Plan covering most private sector workers and all state and local government workers.

North Carolina is an OSHA-approved State Plan that covers both private and state and local government workers. With certain exceptions, the N.C. Department of Labor adopts federal OSHA standards verbatim.

Report to the OSH Division within 24 hours of the incident. Call 1-800-625-2267 or 919-779-8560.

File a complaint online. Contact the OSH Complaint Desk by phone at 919-779-8560 or 1-800-NC-LABOR (1-800-625-2267) (in-state only).

All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported within 24 hours.

Submit your complaint online to OSHA. Complete the complaint form or letter, and then fax, mail, or email it back to your local OSHA office. OSHA staff can discuss your complaint with you and respond to any questions you may have. OSHA staff can discuss your complaint with you and respond to any questions you may have.

If you are still worried or feel that your supervisor hasn't taken your concerns seriously, report to your health and safety manager, or directly to your employer. Employers also have health and safety responsibilities. They must make sure that your work can be carried out safely.

A whistleblower complaint filed with OSHA cannot be filed anonymously. If OSHA proceeds with an investigation, OSHA will notify your employer of your complaint and provide the employer with an opportunity to respond.

Region 4 Occupational Safety and Health Administration.

Contact InformationOccupational Safety and Health Division, 111 Hillsborough Street.Raleigh, North Carolina 27601-1092.North Carolina Department of Labor Occupational Safety and Health Division, 1101 Mail Service Center.Raleigh, North Carolina 27699-1101.(919) 707-7806.Josh Dobson, Commissioner.(919) 707-7701.

More info

Form Details: Released on July 1, 2018;; The latest edition currently provided by the North Carolina Department of Labor;; Ready to use and print; ... Facilities above the threshold quantity can find guidance on completing hazard assessments andFor more information on Chemical Safety and Reporting.13, 263.13, 264.5 and 265.5 to notify the South Carolina Department of Health and Environmental Control (SCDHEC) that they are involved in hazardous waste ... To register with the State of North Carolina, complete an Application for Income Tax Withholding (Form NC-BR), apply online or contact the Department of Revenue ... You can file a complaint online OR you can download the MIOSHA Complaint Form, complete and sign the form, then mail or fax it to MIOSHA. Be sure to include ... A. By encouraging employers and employees in their effort to reduce the number of occupational safety and health hazards at the place of employment, and to ... Employees can also file a report if employer retaliation occurs after a complaint.Materials associated with health and safety risks must be labeled, ... All employees should seek medical treatment immediately after an injury occurs.Complete the North Carolina Employee Incident Report Form (Appendix A) ... To file a child care complaint or report a child care health and safety violation in North Dakota, contact a licensing specialist in your county. Back to States ... Use a hazard report form template to make your document workflow moresend a copy of the document to the workplace Health & Safety Office each field has ...

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North Carolina Safety or Health Hazards Report Form