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Safety & Risk Management

Hazard Report Form


The CSUB Hazard Report forms are to be used by employees or students to report safety concerns through their supervisor, instructor, or anonymously.

Always verbally report dangers to life and limb to your supervisor or instructor immediately. If corrective action is not taken at once, complete the hazard report form. Submit it to a Campus Safety Committee Member, the EH&S Coordinator or Safety and Risk Director at as soon as possible. The EH&S Coordinator's office is located in the Public Safety Building. The Safety and Risk Director's phone ext. is 2066.
PROCEDURES:
  1. Verbally notify your supervisor or instructor of any hazards you know about or safety concerns that you may have.
  2. If you have the following information, please provide it to your supervisor. Include this information under "Reason for Report" if you complete the hazard report form.
    • Length of time hazard has been present.
    • Safety codes that the hazard is known to violate.
  3. If corrective action is not taken or if your concerns remain unresolved, complete the CSUB Safety / Hazard Report Form. Press firmly so all copies will be legible (for paper form).
  4. Give your supervisor the top two copies, keep the gold copy, and give the pink copy to a Campus Safety Committee Member or CSUB Hazardous Materials Coordinator. Your supervisor will use the yellow reply copy to inforrn you of the results of the hazard investigation (for paper form).
  5. To report a hazard anonymously, complete the form. Deliver it to the Environmental Health & Safety Office or send it via campus mail (for paper form).
It is advisable to print out your completed online hazard report form before submitting.


Last modified on: Tue., Mar. 01, 2011 - 08:20:57 AM
Your local time: Thu., Mar. 21, 2013 - 04:07:29 AM

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Last modified on: Tue., Mar. 01, 2011 - 08:20:57 AM
Your local time: Thu., Mar. 21, 2013 - 04:07:29 AM