Mr Haza5Rd

Section A: Incident / Hazard Report SERIOUS INCIDENTS must BE REPORTED BY PHONE IMMEDIATELY TO THE OH& group A;S CONSULTANT 0404 xxxxxx (Speed dial 3188) SECTIONS A & B OF THIS REPORT MUST BE FAXED TO HR WITHIN 48 HOURS ON: 03 9214 8xxx IF A MANAGEMENT RESPONSE IS NOT set up AT TIME - FAX SECTION C AS SOON AS POSSIBLE 1. PERSON INVOLVED DETAILS fore TO YOUR TEAM LEADER / MANAGER WITHIN 24 HOURS| effrontery name: JOHNFamily name: ?????| Position Title: MAINTENANCE doer| Employee Visiting Student Agency Personnel Visitor declarer| | Employee number / Student ID: ?????| | Address: 26 HENLEY BEACH ROAD, TORRENSVILLE SA| theatrical role: ?????| | | Management unit of measurement: ?????| | | TAFE Unit / Sub Management Unit: ?????| | DOB: 26/05/1986| Gender: MALE | Contact details: BH ?????AH: ?????| | come you reported this to your Team Leader / Manager / Teacher? YES date stamp notified: 28/08/2012Name ( please Print): JASON MAILO Contact no: 0413712XXX| 2.

DETAILS OF INCIDENT / opine| Act of Violence Injury / Illness* YES Incident / proficient Miss Hazard Property Damage *If you are coverage a work related injury / illness please also complete Section B of this form| Campus: ????? stadium: (building / room): ????? Date hazard observed / incident occured: ?????Off-Site (specify location): ????? succession: ?????| What were you doing? Describe the activity undertaken at the time| MAINTENANCE give AT THE BUILDING.| What happened unexpectedly? Describe the hazard / incident as it occurred| LADDER SLIP OVER.| What did you do? Describe what happened next| feral OVER THE FLOOR AND BREAK MY ARMS| What factors do you tone caused this hazard / incident? | RAINY WEATHER, SLIPPERY... If you want to get a full essay, order it on our website: Ordercustompaper.com

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