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OSHA METHOD- 330 Incidents - 29 Minor Injuries-1 Major or Loss-Time Accident
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? () (Elimination, substitution, Engineering Control, Administration, PPE)
Name Of Observer
Emp No
LocationDetails of the Dangerous / Near Miss :
Suggestions By the Observer : Reported to
Ingestion by
Reviewed By Possible Actions :Corrective Action:
Time Line :
Review by Management :
Awards / Rewards for Observer :
Near Miss / Dangerous Occurrence Report S.NO:
Date :