Cal OSHA: Investigation / Corrective Action Report


Cal OSHA: Investigation / Corrective Action Report

    Date and Time of Incident / Exposure


    Employees Involved

    Detailed Incident / Exposure Description

    Ultimate cause of incident/exposure (I.e. "who, what, when, where, how" and the "5 ways" the root cause)

    Options for elimination or control of the root cause(s)


    Investigated By:


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