Hazard Report Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Reported by:FirstLastContact Email:Contact Phone:You may remain anonymous when reporting a hazard. However, by providing your contact information, you will receive follow-up updates and a close-out report regarding the status and resolution of the hazard you reported. NextHazard Date: *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Hazard Time: *Weather at Time of Hazard: *--- Select Choice ---ClearCloudyFogIceRainSnowThunderstormWindVisibility at Time of Hazard: *--- Select Choice ---DawnDaylightDuskNightlight (256) Hazard: Hazard Location Area: *--- Select Choice ---RunwayTaxiwayAir Carrier RampGeneral Aviation RampCargo RampFuel FarmHazard: *--- Select Choice ---Injury or DamageNear Miss: Unplanned event that did not result in injury or damage but had the potentialUnsafe Condition: Something in the environment that could cause someone to get hurtUnsafe Behavior: Something that could lead to an accident or injuryHazard Type: *--- Select Choice ---Airside DiscrepancyAirside OperationConstructionFacility DiscrepancyForeign Object DebrisMarkings (Non-Movement)Markings (Movement)Spill or Hazardous MaterialWeatherWildlife ReportOtherReport Active Spills to (256) 461-1116If other, please describe the Hazard Type:Priority: *--- Select Choice ---LowMediumHighIf this is an emergency, call the Comm Center at (256) 461-1116.SMS is not intended for immediate attention, such as injury or active incidents. NextDescription of Hazard: *Recommendations:Location of Hazard in Detail: *Photo of Hazard (If Available): Drag & Drop Files, Choose Files to Upload You can upload up to 4 files. Hazard Reporting Submissions:All hazard reports are treated as confidential and will only be shared with those necessary to address and resolve the issue. Confidentiality will be maintained to the fullest extent possible, except where disclosure is required by law.Submit
