Wet Floor Hazard Report Form
Report and document wet floor hazards to ensure workplace and public safety.
Reporter Name
*
First Name
Last Name
Reporter Contact Information
*
Date and Time of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Exact Location of Wet Floor
*
Brief Description of the Hazard and How It Happened
*
Were warning signs or barriers already in place?
*
Yes
No
Not Sure
Immediate Actions Taken
*
Current Status of the Area
*
Please Select
Area secured and warning signs in place
Area cleaned and hazard removed
Hazard remains, awaiting cleanup
Other
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