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OSHA - Notice of Alleged Safety Violation Mobile App

"OSHA inspections for occupational safety can reveal health hazards and even imminent danger. This mobile app for the complainant can make work and health hazard reporting easier, using federal OSHA report standards, right from a smartphone or tablet.
This digital form, provided for the assistance of any complainant, is not intended to constitute the exclusive means by which a complaint may be registered with the U.S. Department of Labor. It is a helpful digital tool or employees, subcontractor employees and company safety officers to report occupational safety hazards in the OSHA standard, in order for company representatives to take corrective action.
Prevent physical harm with high standards of workplace safety and by reporting potential hazards. Save, share, send and document hazards with the GoCanvas Cloud. "

  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

Take a peek inside the OSHA - Notice of Alleged Safety Violation Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    First Name

  • Ico textbox

    Last Name

  • Ico textbox

    Email

  • Ico gps

    Current Location

  • Ico textbox

    Type of Business:

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    Site Address

  • Ico textbox

    Management Official:

  • Ico textbox

    Establishment Name

  • Ico multiline

    Mailing Address (if different)

  • Ico textbox

    Telephone

  • Ico multiline

    Describe briefly the hazards(s) which you believe exist.

  • Ico multiline

    Hazard Location Specify the particular building or worksite where the alleged violation exists:

  • Ico multiline

    This condition has been brought to the attention of: (Enter all that apply)

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    I am a(n):

  • Ico checkbox

    Employee

  • Ico checkbox

    Federal Safety and Health Committee

  • Ico checkbox

    Representative of Employees

  • Ico textbox

    Other: (specify)

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    The OSH Act gives complainants the right to request that their names not be revealed to their employer.

  • Ico dropdown

    Please indicate your desire:

  • Ico textbox

    Complainant name

  • Ico multiline

    Complainant address

  • Ico textbox

    Complainant telephone

  • Ico textbox

    Complainant email address

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    If you are an authorized representative of employees affected by this complaint, please state the name of the organization that you represent and your title:

  • Ico statictext

    Potential complainants also should keep in mind that it is unlawful to make any false statement, representation, or certification in any complaint.

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    Public reporting burden for this voluntary collection of information is estimated to vary from 15 to 25 minutes per response with an average of 17 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

  • Ico date

    Date

  • ...and More!

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