Unsafe Condition & Unsafe Acts (UCUA) Form
Safety, Health & Environment (SHE)
Kindly fill in the following form
Contact Detail *
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Location/Area/Level spot of Unsafe Act or Unsafe Condition *
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Unsafe Conditions *
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Unsafe Acts *
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Only choose Other if any of the above unsafe act/condition does not meet your observation
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Picture Attachment *
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Kindly attach pictures as evidence / Sila sertakan gambar sebagai bukti
Total max size of pictures must be less than 10MB / Jumlah saiz maksimum gambar mestilah kurang daripada 10MB
File(s)
Description *
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Please explain the issue in detail / Sila jelaskan isu ini secara terperinci
Immediate Action Taken by Observer / Tindakan Segera Diambil oleh Pemerhati *
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Please state if there is any action taken immediately / Sila nyatakan sekiranya terdapat sebarang tindakan diambil dengan segera
If no action taken, please state none / Jika tiada tindakan diambil, sila nyatakan tiada