Report a Safety Hazard

* = Required
Question	Response
Note: Safety hazards that pose an imminent danger to life and health should be reported immediately to your supervisor, County Director, Regional Director, Center Director or to EH&S at (530) 752-6024. Use this form to report less serious hazards.
* ANR Office/Location
* Location of Hazard (building, room, other description)
* Description of Hazard (include information about physical, chemical, biological, etc)
* Recommended Corrective Actions
* Has this hazard been reported to your supervisor?	Yes No
Optional Information (this will be kept confidential, but can help us investigate your report and respond)
Name
Location
Telephone
e-mail