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Safety Reporting Form
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Please Fully Describe The Event Or Identified Hazard. Include Your Suggestions On How To Prevent Similar Occurrences. *
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In Your Opinion, What Is The Likelihood Of Such An Event Or Similar Happening Again?
Extremely Improbable
Improbable
Remote
Occasional
Frequent
What Do You Consider Could Be The Worst Possible Consequence If This Event Did Happen, Or Happen Again?
Negligible
Minor
Major
Hazardous
Catastrophic
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