Employee Name:

[Your Name]

Job Title:

[Position]

Department:

[Operations]

Date:

[Month Day, Year]

Location/Department:

[Production Area]

Description of Observation:

Noticed a loose electrical wire hanging near Machine #3.

Date and Time of Observation:

[Month Day, Year], [Time]

Nature of Recommendation:

Hazard

Recommended Action:

Secure and repair the loose electrical wire to prevent potential electrical hazards.

Priority Level:

High

Actions Taken:

Safety team notified; electrical maintenance scheduled for [Month Day, Year].

Responsible Person:

Maintenance Supervisor

Target Completion Date:

[Month Day, Year]

Reviewed by:

[Name, Job Title]

Review Date:

[Month Day, Year]

Approval Status:

Approved

Comments (if any):

Ensure to conduct a follow-up inspection after the maintenance.