This form is to report any potential safety or health hazards that could cause injury or damage to City employees, the public or to... More… This form is to report any potential safety or health hazards that could cause injury or damage to City employees, the public or to City property. This form may also be used to submit safety suggestions.Less…
Complete this form and submit to the Risk Management department within 72 hours of any accident involving City vehicles, equipment,... More… Complete this form and submit to the Risk Management department within 72 hours of any accident involving City vehicles, equipment, property, private person(s) or private property, this also includes theft and vandalism. If a City employee is injured, obtain, and complete a Supervisor's Report of Work-Related Near Miss, Injury, Illness, or Exposure Form online. An incident form should be completed for ALL incidents, accidents and emergencies. This form must be completed immediately after the incident or accident occurs. Please provide as much detail as possible. Attach additional pages if necessary. A separate incident form should be completed for each injured individual. Less…
Witness Statements should be completed for ALL incidents, accidents and emergencies. This form must be completed immediately after the... More… Witness Statements should be completed for ALL incidents, accidents and emergencies. This form must be completed immediately after the incident or accident occurs. Please provide as much detail as possible. Attach additional pages if necessary. The Witness Statement is a Confidential report to City Attorney for defense of claims.Less…
Complete this form and submit to the Risk Management department within 72 hours of any accident involving City vehicles, equipment,... More… Complete this form and submit to the Risk Management department within 72 hours of any accident involving City vehicles, equipment, property, private person(s) or private property, this also includes theft and vandalism. If a City employee is injured, obtain, and complete a Supervisor's Report of Work-Related Near Miss, Injury, Illness, or Exposure Form online.Less…
This form is to be filled out by all City of Napa employees.
