OSHA Log Information
INCIDENT REPORT FORM -
editable pdf
PLEASE NOTIFY THE STATEWIDE OFFICE OF RISK MANAGEMENT, ANCHORAGE or FAIRBANKS, IF ANY OF THE FOLLOWING OCCUR:
IMMEDIATELY:
-
Any
occurrence affecting the UA system resulting in a loss of life or requiring
the hospitalization of 1 or more people
-
Any declared
disaster within the UA system at any campus or facility
-
Any
situation requiring the implementation of either a campus or UA Emergency
Operations Plan, and use of public response agencies
WITHIN 8 HOURS:
- Property damage or loss
expected to result in a claim over $10,000
- Any environmental release
that is reportable to either a Federal, State or Local regulatory agency
WITHIN 24 HOURS
- All injuries to third
parties (anyone who is not an employee)
- Employee injuries requiring
a doctor visit or time off work
- All motor vehicle accidents
involving UA and a third party
- Any other situation
that may give rise to an adverse claim against the UA
- Any
official visit by a regulatory agency that involves either a compliance
audit or a documented Notice of Violation from that agency
If you have questions or comments about this page,email SDRISK |