New Safety Report

For emergencies, call 911

For non-emergency medical assistance, contact:
Justin Yohn at 601-966-6853 or your Supervisor.

This employee has already submitted 3 safety reports today. Please contact your Health and Safety department directly if you need to report an immediate safety concern.

Score

Safety Report Type

Description

Submitted By

Immediate Corrective Action

Long Term Corrective Action

Incident Photo 1

Incident Photo 2

Incident Photo 3

Incident Photo 4

Incident Photo 5

Corrective Action Photo

Check the checkbox below to acknowledge you have reviewed the safety checklist, and marked any applicable action items.

Acknowledge

PPE

Satisfactory
Action Required

Tools & Equipment

Satisfactory
Action Required

Slips, Trips, & Falls

Satisfactory
Action Required

Material Handling

Satisfactory
Action Required

Safety Glasses

Satisfactory
Action Required

Hard Hat

Satisfactory
Action Required

Hearing Protection

Satisfactory
Action Required

Appropriate Footwear

Satisfactory
Action Required

Proper Gloves

Satisfactory
Action Required

Proper Suit/Clothing

Satisfactory
Action Required

Goggles

Satisfactory
Action Required

Face Shield

Satisfactory
Action Required

Respirator

Satisfactory
Action Required

Metatarsals

Satisfactory
Action Required

Harness

Satisfactory
Action Required

Personal Flotation Device (PFD)

Satisfactory
Action Required

Proper Tool

Satisfactory
Action Required

Proper Use

Satisfactory
Action Required

Proper Condition

Satisfactory
Action Required

Air Monitoring

Satisfactory
Action Required

LO/TO

Satisfactory
Action Required

Grounding / Bonding

Satisfactory
Action Required

Ladders

Satisfactory
Action Required

Open Holes

Satisfactory
Action Required

Barricades / Handrails

Satisfactory
Action Required

Housekeeping

Satisfactory
Action Required

Walkways

Satisfactory
Action Required

Hoses

Satisfactory
Action Required

Stairs/Steps

Satisfactory
Action Required

Manual Lifting

Satisfactory
Action Required

Mechanical Lifting

Satisfactory
Action Required

Body Positioning

Satisfactory
Action Required

Pinch Points

Satisfactory
Action Required

Safety Manager E-Mail

Steps to Final Outcome

Final Outcome

Final Outcome Photo

Report Status

Closed By

Date Closed

Injury Report Type

Injury Report Status

E3 Safety Observations

ERROR MESSAGES

Initial Report

Photos

Safety Checklist

Personal Protective Equipment

Tools & Equipment

Slips, Trips & Falls

Material Handling

Safety Office

System Columns