Unsafe Condition Report - UNIDIL PACKAGING LIMITED

Report Unsafe Condition

Please fill out this form to report any unsafe conditions in the workplace. All fields marked with are required.

1. Report Details

Reported By (Full Name)

Employee ID

Department / Section

Shift

Morning

Afternoon

Night

2. Unsafe Condition Information

Exact Location

Type of Unsafe Condition (Select all that apply)

Mechanical (e.g., moving parts without guards)

Electrical (e.g., exposed wires)

Housekeeping (e.g., blocked aisles, slippery floor)

Material Handling (e.g., unstable stacking, pallet damage)

Fire Safety (e.g., blocked extinguisher)

Chemical / Adhesive Hazard

Others

Please specify other condition type:

Description of Unsafe Condition

Photo Attachment (Optional) Supported formats: JPG, PNG, GIF (Max size: 5MB)

3. Potential Risk / Consequences

Select all potential risks (Select all that apply)

Injury to person

Damage to machinery

Production downtime

Fire risk

Environmental hazard