Pallet Disposal Incident Report Form
Use this form to report and document any pallet disposal incidents accurately and efficiently.
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
Location of incident
*
Pallet type or ID
*
Number of pallets involved
*
Describe the incident
*
Possible cause of incident
Please Select
Improper handling
Equipment malfunction
Obstructed path
Incorrect disposal procedure
Other
Immediate actions taken
Was a supervisor notified?
Yes
No
Your full name
*
First Name
Last Name
Upload photo or file (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit Report
Should be Empty: