Document MGBNNXnXYnpXjRBQXB0K0Gjyk
PISptor Uhit
Empl^'s Name
Classification
HEALTH AHD SAFETY COMPUIHT FORM H/SNo. A 163658
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Department/Location:
t__________________________ aift
3
-
Statement of Complaint:
to the an unsafe in asnaeiol omto a health
la Dept* 1810 at J<4?
Adjustment Requested:
ao oarinesrt space < be need instead at
Otalco
Results of Discussion with Foreman:
stated that ^f not Jeopardise aagr
District Committeeman:
_
that thla esbsetae bo itarai elaabae, jnfeMUj la Another alternative lo that a substitute
v (Signature)
this prdfcian and tMO ho fait did
/-/Z--79 (Date)
Unit Health and Safety Representative Discussion
with Supervision:__________________________
(Name)
(Date)
Asbestos Is used In various applications throughout the Bavsonville Plant.
Result Local Management has failed to initiate any controls concerning the safe handling
and use of this notarial.
The Union demands that the Company comply vith Pule 1910.1001 of the fWQA
Standards.
Unit Health & Safety Representative.
(Signature)
(Data)'
Company Safety Representative:i:
Company Disposition.
&***
u>/lL A,
r
~Sj (Signature)
Fom F10
HFM- 003778
(Signature)
A
8007 1656
(Date Received) I**'
/-7J-7? (Date of Disposition)
PRINTED IN URA
SCF-FORD-1658