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Norco College students, staff, faculty or visitors may use this form to report any unrecognized or uncontrolled safety issue to the Risk Management Department
or their local College Safety Representative. The safety issue will then be investigated to determine if mitigations are needed.
The form can be submitted anonymously if desired.
College / District Location Where Unsafe Conditions Exist:
UNSAFE ACT DESCRIPTION or SAFETY HAZARD (Describe sequence of events. Provide all of the facts you can remember)
Suggestion for improving safety: