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Annapurna Helicopters
Safety Manual Image SAFETY MANAGEMENT SYSTEM MANUAL Chapter 8
APPENDICES

APPENDIX 1 VOLUNTARY HAZARD REPORT

The information supplied in this form will only be used to enhance safety. You may choose to not provide your name. If you do provide your name, upon receipt of this form your name and position will be removed and discarded. Under no circumstances will your identity be disclosed to any person in the organization without your express permission.

When you have completed your part of the form, it should be given to the safety manager of the company. It may also be dropped in the drop box provided in various locations of the organization.

1. Name (optional)
2. Position (optional)
Email
Phone Number

(Name and position, if provided, to be discarded by the safety manager before processing this form further)

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PART A - TO BE COMPLETED BY THE PERSON IDENTIFYING HAZARD

Please fully describe the hazard.