Get Da Form 5480 Fillable

The Da Form 5480 Fillable is essential for contractor employees who wish to report occupational safety or health complaints. This guide provides a clear and user-friendly approach to filling out the form online, ensuring that all necessary details are accurately submitted.

Follow the steps to successfully complete the Da Form 5480 Fillable online.

1. Press the ‘Get Form’ button to access the form and launch it in your preferred digital editor.
2. In Item 1A, select the appropriate box to indicate your status. If applicable, check 'Other' for visitors or subcontractors.
3. Assess the severity of your complaint in Item 1B and check the box that corresponds to the required immediacy of action.
4. Enter the contractor's name, which is SANDIA NATIONAL LABORATORIES, in Item 2.
5. Complete the address field in Item 3 with the relevant location details.
6. Input the phone number in Item 4 using the contacts provided: 844-5250 or 845-8316 for the Safety Engineering Division, and 294-2303 for the Health and Safety Division.
7. In Item 5, specify the building and room number where the issue is occurring. If applicable, mention the nearest identifiable location if outside a building.
8. Describe the ongoing work at the location from Item 5 in Item 6.
9. In Item 7, provide the name and contact number of the supervisor or the designated person responsible for operations in that area.
10. Detail the specifics of your complaint in Item 8, ensuring to include as much pertinent information as possible.
11. In Item 9, list any OSHA standards or DOE orders that you believe have been violated in relation to your complaint.
12. Answer Item 10A and 10B, assessing if there has been any action taken regarding your complaint.
13. In Item 11, select your preference regarding anonymity on the submission of your complaint.
14. Finally, transmit the completed form to the appropriate address listed at the bottom, ensuring accurate submission.
15. Once all sections are filled out, remember to save your changes, download, print, or share the completed form as necessary.

Ensure your safety concerns are addressed by completing the Da Form 5480 Fillable online today.