Get Appendix D - Red Tag Hazard Report Form - Ehs Uci

This guide provides a clear, step-by-step approach to completing the Appendix D - Red Tag Hazard Report Form online. By following these instructions, you will efficiently provide necessary information related to hazards and ensure compliance with safety protocols.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the 'Reported by' section with your name and contact details. Include your position or title if applicable.
3. Enter the 'Red Tag Incident #' which is a unique identifier for this report, followed by the 'Location/Building' where the hazard was noted.
4. Indicate if the location is a laboratory by choosing 'Yes' or 'No' in the corresponding field.
5. Attach a photo of the hazard if available by selecting 'Yes' or 'No' for the photo attached section.
6. Fill in the 'Area/Room' where the hazard was identified, providing specific details.
7. In the 'Details of Hazard & Recommended Corrective Actions' section, describe the hazard and propose necessary corrective actions.
8. Use the 'Risk Priority/Rating' section to classify the hazard using the Appendix A reference. Choose from Very High, High, Medium, Low, Resolved, or Not Found.
9. Document whether the operation was shut down and if a Red Tag was attached. Provide the date and time of this action.
10. Indicate if a notification of the shutdown was made to the Supervisor and other relevant persons. Choose 'Yes' or 'No' as applicable.
11. If injuries occurred due to the hazard, answer 'Yes' and provide details, including any incident report number.
12. Complete the 'Corrective actions taken by' section with the name of the responsible person and describe the actions taken.
13. State whether the corrective actions have been completed and reviewed by EH&S. Enter the date and time.
14. Indicate if the EH&S removed the Red Tag and whether activity may resume, providing the date and time of this action.
15. Specify if further actions are required by choosing 'Yes' or 'No' and provide any necessary details for corrective actions required.
16. Assess and prioritize any further corrective actions as either URGENT, Semi-Urgent, Non-Urgent, Programmed, or Agreed.
17. Obtain signatures and dates from the Lab/Department Representative and EH&S Representative to finalize the report.
18. Once you have completed all sections, save your changes, download, print, or share the form as needed.

Complete the Appendix D - Red Tag Hazard Report Form online today to ensure proper hazard reporting and compliance.