Safety Observations/Near Misses If this situation requires additional attention please call Landwehr Construction’s Safety AND COMPLIANCE DIRECTOR at 320-248-7164 Safety Observations/Near Misses Would you like to submit a Safety Idea or a Safety Oberservation/Near Miss?* Safety Idea Safety Observation/Near Miss Name - Optional First Last Name - Optional First Last Date MM slash DD slash YYYY Date - When did the incident take place? MM slash DD slash YYYY Job - Where did the incident take place? What type of observation?* Positive Negative Not sure Describe the incidentWas anyone hurt? Yes No Please describe the nature of the injuryWas anything damaged? Yes No Please list the damaged equipment and damage details.Please describe your Safety Idea below:Would you like a follow up call? Yes No Would you like a follow up call? Yes No Name First Last Name First Last PhonePhoneCAPTCHA
