APPENDIX “3”

SIGN DESIGN & FABRICATION, INC.

SAFETY OR PROCESS IMPROVEMENT

SUGGESTION FORM

NAME: _______________________________________ DATE: ________ (OPTIONAL BUT PREFERRED)

DESCRIPTION OF UNSAFE CONDITION OR PRACTICE or PROCESS IMPROVEMENT:

_________________________.

CAUSE(S) OR CONTRIBUTING FACTORS THAT SHOULD BE TAKEN INTO CONSIDERATION:

__________________________. SUGGESTION FOR IMPROVING SAFETY OR PROCESS:

_______________________________________________________. (If Helpful to you please draw a picture or diagram to describe situation)

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