Notice of Alleged Safety or Health Hazard

This is to be completed only for businesses or employers in North Carolina.

Describe briefly the hazard(s) which you believe exist. Include the approximate number of employees exposed to or threatened by each hazard.
Specify the particular building or work site where the alleged violation exists.

It is the policy of OSH not to reveal the names of complainants to the employer.  However, providing your name and telephone number to our department will enable us to provide you with inspection/investigation findings, and assist you if questions arise.

The OSH Act gives complainants the right to request that their names not be revealed to their employer. Providing your name and address, will only allow NCDOL staff communicate with you regarding your complaint.