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Contact the H S Office for more details. A sample of Form PM-S-0066 REPORT OF MINOR INCIDENT is included at the end of this chapter. 10-5 Upon receiving notification of a minor injury or illness the supervisor shall do the following Give a Form PM-S-0066 Report of Minor Incident to the injured or ill employee to complete. Ca.gov/hr/HEALTHSAFETY/ra/ra.shtml 10. 08 REPORT OF MINOR INCIDENT PM-S-0066 A minor injury or illness is broadly defined as a.

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