The PS 1767 form serves as a pivotal document within organizations, ensuring a structured process for employees to report potential safety hazards, thereby safeguarding their welfare and fostering a secure work environment. It outlines procedural steps that start with the employee's initial report and extend through various organizational levels—namely immediate supervisors, approving officials, and maintenance supervisors—to guarantee the hazard's timely and effective abatement. This form, emblematic of a commitment to safety, offers employees the choice to remain anonymous, thereby encouraging more open and frequent reporting of safety concerns without fear of retribution. It meticulously defines the roles and responsibilities at each stage, including the investigation of reported hazards, the implementation of corrective measures, and the documentation and communication of actions taken, all aimed at mitigating risks promptly. The form not only embodies an organization's adherence to safety protocols but also reinforces a culture of transparency and accountability, ensuring every reported hazard is addressed systematically and efficiently. By detailing the course of action from the report's submission to the final resolution, the PS 1767 form appears as a cornerstone of workplace safety management, advocating for a proactive stance on hazard prevention and employee protection.
| Question | Answer |
|---|---|
| Form Name | Ps Form 1767 Fillable |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | ps form 1767 usps, ps form 1767, usps form 1767 instructions, 1767 usps |
INSTRUCTIONS
I.EMPLOYEE
a.Complete section I. and file it with your immediate supervisor.
b.If you desire anonymity, complete section I. (including your name) and file the report with the Safety Office. Safety personnel will immediately return the form to your supervisor for necessary action, and will delete your name from
the form to ensure your anonymity.
II.SUPERVISOR
a.Investigate the alleged hazard during the same tour of duty in which the report was received.
b.Abate the hazard if it is within the scope of your authority to do so.
c.Record the action taken to eliminate the hazard or record recommendation for corrective action in section II. and sign your name.
d.Forward the original and yellow copy to your immediate supervisor (approving official); send the pink copy to the Safety Office; and give the employee the remaining blue copy as a receipt. It is your responsibility to monitor the
status of the report, at all times, until the hazard is abated.
III.ApPROVING OFFICIAL
a.Initiate action to eliminate or minimize the hazard. If this results in the submission of a work order, attach the original of this form, and forward through channels, to the manager, Plant Maintenance.
b.If you determine that there are no reasonable grounds to believe a hazard exists, notify the employee in writing within 15 calendar days. Safety personnel will assist you in this determination when requested.
c.If the hazard was abated by the first line supervisor or when it has been abated through your actions, notify the employee in writing, and send the original of this form to the Safety Office.
IV. MAINTENANCE SUPERVISOR
When the work order has been completed, sign, date, and return the original of this form to the approving official who will then forward it to the Safety Office.
PS Form 1767, Dec. 1982, (Reverse)