Safety and Occupational 

Health Program 

For Managers and 

Supervisors

What YOU Should Know
U.S. Nuclear Regulatory Commission
Safety and Occupational Health Program for Managers and Supervisors—What You Should Know

Purpose 1

Objectives 1

References 1

U.S. NRC Safety and Occupational Health Program Overview 1

Objectives 1

Basic Organizational Responsibilities 1

Summary of the Responsibilities of Line Management 3

Most Common NRC Work Hazards and Applicable Standards 3

Employee Rights and Responsibilities . . . . . . . . . . . . . . . . 4

Hazard Reporting 4

How to Abate Workplace Hazards 5

You and Your Workplace Inspection. . . . . . . . . . . . . . . . . 6

What to Do in Case of an Injury or Illness . . . . . . . . . . . . . . 7

Automobile Accidents 7

Contents:
U.S. Nuclear Regulatory Commission
Safety and Occupational Health Program For Managers and Supervisors—What You Should Know | 1

Purpose:

The purpose of U.S. NRC NUREG/BR-0098, 

Revision 7, is to inform managers and 

supervisors of actions they are responsible 

for to maintain agency compliance with 

the NRC Safety and Occupational Health 

Program.

Objectives:

The objectives of this NRC regulation are 

to ensure that managers and supervisors 

perform the following activities:

1. Identify their responsibilities

2. Recognize and abate hazards in their 

specific work area

3. Respond correctly when occupational 

injuries or illnesses occur

4. Ensure employee rights under the 

program

References:

1. U.S. NRC Management Directive (MD) 

10.130, “Safety and Occupatinal Health 

Program.” March 2015

2. U.S. NRC MD 7.1, “Tort Claims Against 

the United States,” May 21, 2010 (for 

reporting motor vehicle accidents)

3. Occupational Safety and Health Act (OSH 

Act) of 1970 (Public Law 91-596, 91st 

Congress, S.2193), December 29, 1970

4. Executive Order (EO) 12196, 

“Occupational Safety and Health 

Programs for Federal Employees,” 

February 26, 1980

5. “Basic Program Elements for Federal 

Employee Occupational and Safety 

Health Programs and Related Matters,” 

Title 29 Code of Federal Regulations

(CFR) Part 1960, November 2004

6. “Recording and Reporting Occupational 

Injuries and Illnesses,” Title 29 CFR Part 

1904, June 2003

7. “Claims for Compensation Under the 

Federal Employees’ Compensation Act,” 

20 CFR Part 10, June 2011

8. National Safety Council, “Accident 

Prevention Manual for Business 

and Industry: Administration and 

Programs,” 13th edition, 2009

9. “Occupational Injury and Illness 

Recording and Reporting Requirements: 

North American Industry Classification 

System Update and Reporting 

Revisions,” 79 Federal Register 181, 

September 18, 2014, pp. 56130-56183, 

available at http://www.regulations.

gov/#!documentDetail;

D=OSHA-2010-0019-0127.

Objectives:

The basic objectives of the NRC Safety and 

Occupational Health Program under the 

OSH Act are as follows:

1. To furnish all NRC employees with 

places and conditions of employment 

that are free from recognized hazards 

likely to cause injuries or illnesses

2. To ensure compliance with standards 

issued under Section 6 of the OSH Act 

of 1970, EO 12196, Title 29 CFR Part 

1960, and Part 1904

3. To ensure prompt abatement of unsafe 

or unhealthful working conditions or 

development of abatement plans that 

include a timetable for abatement 

and interim protective measures for 

affected employees

4. To ensure that no employee is subject 

to restraint, interference, coercion, 

discrimination, or reprisal for filing 

a report of unsafe or unhealthful 

working conditions

Executive Director for Operations:

Provides oversight of the NRC’s Safety and 

Occupational Health Program.

Deputy Executive Director for 

Corporate Management:

1. Provides general direction on issues 

involving the NRC’s Safety and 

Occupational Health Program

2. Delegates authority to the Director, 

Office of Administration, to act as the 

Designated Agency Safety and Health 

Official (DASHO) for the management 

and administration of the NRC’s Safety 

and Occupational Health Program

Director, Office of Administration:

1. Serves as the NRC’s DASHO

2. Implements provisions of the OSH Act 

of 1970, EO 12196, Title 29 CFR Part 

1960 and Part 1904

3. Establishes the NRC’s safety and health 

policies

4. Reviews and submits the NRC’s Annual 

Report of Occupational Safety and 

Health to the Secretary of Labor

5. Appoints the agency’s Safety and 

Occupational Health Program Manager

U.S. NRC Occupational 

Safety and Health 

Program

What You Should Know

U.S. NRC Safety and 

Occupational Health 

Program Overview

Basic Organizational 

Responsibilities
2 | U.S. Nuclear Regulatory Commission

Safety and Occupational Health 

Program Manager:

1. Manages and administers the NRC Safety 

and Occupational Health Program

2. Assesses NRC safety and occupational 

health training needs, develops training 

requirements, and coordinates course 

development through the Office of the 

Chief Human Capital Officer, Human 

Resources Training and Development

3. Conducts annual safety inspections of 

Headquarters, Regional, and Technical 

 Training Center (TTC) facilities 

4. Provides technical support to the 

Regional and TTC Collateral Duty Safety 

Officers (CDSO)

5. Maintains injury and illness statistics in 

accordance with Title 29 CFR Part 1904

Regional and TTC Collateral Duty 

Safety Officers:

1. Manage and administer the NRC 

Regional and TTC Safety and 

Occupational Health Program under 

the guidance of the NRC Safety and 

Occupational Health Program Manager

2. Provide counsel to their management 

officials to assist them in carrying out 

their safety and occupational health 

duties and responsibilities as required by 

the OSH Act, EO 12196, Title 29 CFR 1960 

and NRC MD 10.130 

3. Act on reports of hazards or alleged 

hazards, maintaining confidentiality 

when requested and correcting 

hazardous conditions when discovered

4. Conduct annual safety and occupational 

health inspections

5. Investigate all workplace injuries and 

illnesses and maintain related forms, 

records and reports in accordance with 

Title 29 CFR Part 1904

Chief Human Capital Officer:

Establishes and offers safety and 

occupational health training courses to 

support the requirements of Title 29 CFR 1960.

Managers and Supervisors:

1. Inform employees of the NRC Safety and 

Occupational Health Program and of 

protection afforded employees under 

the program

2. Provide active and aggressive leadership 

that maintains safety and occupational 

health in all operations

3. Ensure the safety of employees 

under their supervision by identifying 

hazardous conditions, informing 

employees of them, and correcting the 

conditions as promptly as possible

4. Give immediate attention to employee 

reports of alleged unsafe or unhealthful 

working conditions and request 

assistance from the NRC Safety and 

Occupational Health Program Manager 

and the CDSOs, when necessary

5. Investigate promptly all accidents 

occurring in workplaces under their 

jurisdiction and submit accurate and 

timely accident reports

6. Ensure that no employee is subject 

to restraint, interference, coercion, 

discrimination, or reprisal for filing 

a report of an unsafe or unhealthful 

working condition

7. Provide special personal protective 

equipment (PPE) and require their use, 

when necessary, to protect employees 

from identified hazards that cannot 

be eliminated through substitution, 

administrative, or engineering controls

8. Ensure employee compliance with 

the occupational safety and health 

standards applicable to the activity 

being performed and with all rules, 

regulations, and orders issued 

with respect to the NRC Safety and 

Occupational Health Program

Employees:

1. Comply with the standards, rules, 

regulations, procedures, and orders 

issued by the NRC that are applicable to 

their own actions and conduct

2. Participate in safety and occupational 

health training as prescribed by the NRC 

Safety and Occupational Health Program 

requirements

3. Use PPE and other safety devices and 

procedures provided or directed by 

the NRC that are necessary for their 

protection 

4. Use correct and safe procedures in all 

official activities

5. Report observed hazards to a supervisor, 

a union representative, a safety official 

or directly to the Occupational Safety 

and Health Administration (OSHA)

6. Ensure that no employee is subject 

to restraint, interference, coercion, 

discrimination, or reprisal for filing 

a report of an unsafe or unhealthful 

working condition 

7. Report workplace injuries and illnesses 

to their supervisors, document injuries 

or illness on the appropriate forms, and 

forward the information to the NRC 

Safety and Occupational Health Program 

Manager or CDSO

Basic Organizational 

Responsibilities (cont.)
Safety and Occupational Health Program For Managers and Supervisors—What You Should Know | 3

Accident Prevention:

1. Provide special protective clothing and 

equipment at no cost to the employee 

and require their use, when necessary, 

to ensure protection of the employee 

from identified hazards that cannot be 

eliminated

2. Ensure that employees receive 

appropriate and required information 

and training related to their particular 

position

3. Ensure the compliance of employees 

with safety and occupational health 

requirements through monitoring and 

motivation

4. Conduct periodic walk-through safety 

inspections to ensure a workplace free 

of recognized hazards

Identification and Abatement of 

Recognized Hazards

1. Promptly report identified hazards 

to the Office of Administration, the 

NRC Safety and Occupational Health 

Program Manager, or the CDSO for 

abatement

2. Promptly abate identified workplace 

hazards that can be resolved safely.

3. Promptly attend to employees’ reports 

of workplace hazards

4. Promptly investigate and report all 

occupational accidents and illnesses

Respect Employee Rights

1. Ensure freedom from reprisal for 

reporting hazards in the workplace.

2. Ensure employees’ right to refuse 

hazardous work

3. Ensure the right to participate in the 

NRC Safety and Occupational Health 

Program

With the majority of NRC employees 

working in an office environment, the 

agency’s injury and illness statistics basically 

reflect the effects of office hazards, such as 

slips, trips, and falls. According to OSHA’s 

nationwide statistics, on-the-job office 

accidents amount to about 40,000 disabling 

injuries each year at a direct cost (indemnity 

benefits and medical expenses) of about 

$100 million. This figure does not include 

any indirect costs for employers, workers, or 

the nation. Examples of indirect workplace 

injury and illness costs include damages to 

equipment, loss of employee services, and 

the hiring and training of replacement 

workers. Employee costs such as injury, pain 

and discomfort, delay in wages, and the 

inability to perform daily functions also 

affect any organization.

The National Safety Council’s “Accident 

Prevention Manual for Business and 

Industry, Administration and Programs,” 

13th edition, states that complacency— 

the attitude that office accidents do not 

amount to much—is one of the prime 

causes of office accidents. The average 

office worker gives little thought to safety 

because office work is not perceived as 

hazardous. 

Common Hazards in Office Setting 

Workplaces Include:

1. Obstructed or cluttered walkways

2. Open file cabinets and desk drawers

3. Damaged electrical cords and 

overloaded outlets

4. Poor storage facilities

5. Sharp instruments

6. Poor ergonomic workstation design

Leading Types of Office Accidents Are:

1. Slips, trips, or falls

2. Strains or overexertion 

3. Injuries from falling objects or striking 

against objects

4. Being caught in or between furniture, 

doors, cabinets, etc.

5. Musculoskeletal disorders (repetitive motion 

injuries, carpal tunnel syndrome, etc.)

Applicable Standards

To ensure that the NRC provides its 

employees with a safe and healthful 

working environment free from recognized 

hazards, the agency has adopted standards, 

codes, and criteria that are consistent with 

Section 6 of the OSH Act of 1970 and 

Title 29 CFR Part 1960. Those standards that 

the NRC adopted are listed in NRC MD 10.130.

Summary of the 

Responsibilities of 

Line Management

Most Common 

U.S. NRC Work Hazards 

and Applicable Standards
4 | U.S. Nuclear Regulatory Commission

Employee rights and responsibilities are 

described in detail in NRC MD 10.130. The 

following summarizes employee rights:

Employees Have a Right to:

1. A safe and healthful workplace

2. Personal protective equipment (PPE): 

• Employees shall be provided with

 PPE at no cost 

• Employees shall be trained in the

 proper use of PPE 

3. Training: 

	 	 • Employees have a right to be

provided with appropriate safety 

and occupational health training, 

including specialized job safety and 

health training appropriate to the 

work performed by the employee.

4. Report hazardous (unsafe or 

unhealthful) working conditions: 

	 	 • Employees have the responsibility

to report hazardous workplace 

conditions and have the right to 

request and assist with inspections

5. Anonymity and freedom from reprisal 

for reporting workplace hazards:

	 	 • Employees have the right to

request that their names not be 

disclosed except, when necessary, 

to representatives of the Secretary 

of Labor and an inspector, in case 

assistance is needed from the 

employee making the report

6. Refuse hazardous work:

	 • Employees have the right to decline

to perform his or her assigned task 

because of a reasonable belief 

that under the circumstances, 

the task poses an imminent risk 

of death or serious bodily harm, 

coupled with a reasonable belief 

that there is insufficient time to 

seek effective redress through 

normal hazard reporting and 

abatement procedures established 

in accordance with Title 29 CFR 

Part 1960.

7. Program participation:

	 • Employees are responsibile to

comply with the NRC Safety and 

Occupational Health Program 

and the safety instructions of 

management. Employees may 

also be represented on safety and 

occupational health committees.

Employee Rights and 

Responsibilities

A workable definition of “hazard” is 

any existing or potential condition in the 

workplace that by itself or by interacting 

with other variables can result in deaths, 

injury, property damage, and other losses. 

(Firenze, 1978, National Safety Council 

Accident Prevention Manual for Business and 

Industry, 10th edition.)

Anyone in the agency can make written 

or oral reports of hazards. Many safety 

and occupational health problems can be 

eliminated as soon as they are identified and 

brought to the attention of the supervisor. 

However, an employee does not have to wait 

for the outcome of an oral report before 

filing a written report. Hazard reporting is 

described in detail in NRC MD 10.130.

An employee or an employee representative 

(i.e., National Treasury Employees Union 

steward), a supervisor, or another co-worker 

may request an inspection of the workplace 

if he or she believes that an unsafe or 

unhealthful working condition exists. The 

report should:

1. Be made in writing on NRC Form 14, 

“Report of Unsafety or Unhealthful 

Working Conditions.” The NRC Form 14 

is located on the NRC Forms Library Web 

site, http://fusion.nrc.gov/nrcformsportal/

default.aspx 

2. Give particular grounds for the report

3. Can be made anonymously

4. Be addressed to the NRC DASHO, his or 

her representative, or the appropriate 

regional administrator. A copy of the 

report should be sent to the appropriate 

safety and occupational health committee

An inspection will be conducted within 

24 hours for conditions of imminent danger, 

within 3 working days for potentially serious 

conditions, and within 20 working days 

for other than serious safety and health 

conditions.

“Imminent danger” is any condition or 

practice in any workplace that could 

reasonably be expected to cause death or 

serious physical harm immediately or before 

the imminence of such danger can be 

eliminated through normal procedures.

“Serious,” as in “serious hazard,” “serious 

violation,” or “serious condition,” means 

hazard, violation, or condition for which 

there is a substantial probability that death 

or severe physical harm could result.

Hazard Reporting
Safety and Occupational Health Program For Managers and Supervisors—What You Should Know | 5

The manager or supervisor in charge of an 

operation is responsible for initiating the 

action to correct unsafe or unhealthful 

working conditions brought to his or her 

attention. He or she shall also ensure 

that employees are not exposed to undue 

risk or injury or illness during the period 

required to abate the hazard. Abatement 

must be accomplished through normal 

administrative channels, when practicable.

The first step in hazard abatement is for the 

first line supervisor to report a workplace 

hazard to the NRC Safety and Occupational 

Health Manager or appropriate CDSO who 

will then post a notice of the hazard in the 

work area. Hazard information entered 

on NRC Form 219, “Notice of Unsafe or 

Unhealthful Working Conditions,” shall be 

conspicuously posted near the affected area. 

Notices shall not be removed for 3 workdays 

or until the hazard is abated, whichever is 

later. The NRC Form 219 is located on the 

NRC Forms Library Web site, http://fusion.

nrc.gov/nrcformsportal/default.aspx. 

General Principles of Hazard 

Abatement:

1. Eliminate the source of the hazard

2. Reduce the severity of the hazard

3. Reduce the number of employees 

exposed to the hazard or duration of 

exposure

Specific Approaches and Techniques:

1. Recognize or identify hazards through 

walk-through safety inspections.

2. Evaluate or measure hazards to 

determine their criticality.

 a. What are the potential risks of 

exposure?

 b.How many people are affected?

 c. What are the feasible alternatives 

for abating the hazards?

3. Control or abate hazards by one or more 

of the following means:

 a. Administrative:

 1) Contact the Office of the Chief 

Human Capital Officer for 

relocation of affected personnel.

 2) Monitoring

 3) Limited worker exposure

 4) Training and education

 5) Housekeeping and maintenance

 b.Engineering Controls:

 1) Isolation of source

 2) Lockout procedures

 3) Design modifications

 4) Process of procedural changes

 5) Monitoring and warning 

equipment

 6) Chemical or material substitution

 c. Personal Protective Equipment

PPE may be selected for use 

when there is no immediate way 

to control the hazard by either 

administrative or engineering 

means or when it is used as a 

temporary measure while more 

effective solutions are being 

installed. PPE is provided to 

employees at no cost.

 1) Select the proper 

equipment for the 

job and the hazards 

involved

 2) Fit and maintain the 

equipment on a regular 

basis

 3) Train and monitor 

employees in their use 

of the equipment

How to Abate 

Workplace Hazards
6 | U.S. Nuclear Regulatory Commission

What is an Inspection?

 An inspection is a comprehensive survey 

of all or part of a workplace to detect 

safety and occupational health hazards. It 

does not include routine day-to-day visits 

by agency safety and occupational health 

personnel or routine workplace surveillance 

of occupational health conditions.

Who Makes Inspections?

The agency’s Safety and Occupational Health 

Program Manager, the CDSOs, safety and 

occupational health committee members, 

or contracted safety and health inspectors, 

as needed. A work area supervisor and an 

employee representative may accompany the 

inspector.

When Do Inspections Occur?

Inspections occur at least annually and 

more frequently in workplaces where there 

is an increased risk of accidents, injury, or 

illness. Inspections are performed during 

normal business hours, without disrupting 

normal operations. Deficiencies cited will 

be reported to the supervisor responsible for 

the work area, along with recommended 

corrective actions.

The responsible director or regional 

administrator shall give the DASHO, or his or 

her representative, a plan for abatement of 

any unsafe or unhealthful condition within 

15 workdays of receipt of the inspection 

findings.

Neither initial nor followup inspections will 

be announced

Why Are Inspections Needed?

Inspections are needed to ensure safe 

working conditions and practices through 

early detection and abatement of hazards.

What Can Be Done in Advance to 

Avoid Inspection Problems?

Supervisors should stay abreast of hazard 

reports and corrective actions. Informal 

walk-through inspections can be performed 

to identify potential hazards and initiate 

corrective actions through appropriate 

channels. Additionally, safety issues can be 

brought up for discussion in staff meetings 

or safety committees, where appropriate.

You and Your 

Workplace Inspection
Safety and Occupational Health Program For Managers and Supervisors—What You Should Know | 7

Injury or Illness

1. In the case of an on-the-job injury or 

illness, ensure that the employee obtains 

first aid care from the Health Center 

or medical treatment from the nearest 

medical facility, even if the injury is minor. 

Although many minor injuries heal 

without treatment, a few do not. Seek 

medical treatment for every injury as 

soon as possible.

 Medical treatment means the 

management and care of a patient to 

combat disease or disorder by a physician 

or other licensed health care professional.

 Medical treatment does not include visits 

to a physician or other licensed health 

care professional solely for observation 

or counseling, the conduct of diagnostic 

procedures, such as x-rays and blood 

tests, including the administration of 

prescription medications used solely 

for diagnostic purposes (e.g., eye drops 

to dilate pupils) or first aid (one-time 

treatment).

2. In case of serious injury or illness, 

nonmedical personnel should not move 

the victim except to avoid further risk. 

Wait for emergency personnel to arrive.

3. The supervisor should promptly notify 

the NRC Safety Manager or CDSO that an 

injury or illness has occured.

4. The supervisor and the injured employee 

complete NRC Form 436, “Report of 

Work-Related Injuries and Illness,” as 

soon as possible. This report should 

promptly be forwarded to the Safety and 

Occupational Health Program Manager 

or the appropriate CDSO as soon as 

possible. Form 436 is located on the NRC 

Forms Library Web site, http://fusion.nrc.

gov/nrcformsportal/default.aspx

Fatality and Severe Injury Reporting

1. The Director of ADM, as the DASHO, 

reports any work-related fatality to 

OSHA within 8 hours of the event 

by calling the OSHA Area Office 

that is nearest to the site of the 

incident; by calling the OSHA toll-free 

central telephone hotline number, 

1-800-321-OSHA (1-800-321-6742); or by 

electronically submitting the reporting 

application located on OSHA’s public Web 

site at www.osha.gov.www.osha.gov.

2. The Director of ADM, as the DASHO, 

reports all work-related in-patient 

hospitalizations, amputations, and losses 

of an eye to OSHA within 24 hours of 

the event by calling the OSHA Area 

Office that is nearest to the site of the 

incident; by calling the OSHA toll-free 

central telephone hotline number, 

1-800-321-OSHA (1-800-321-6742); or by 

electronically submitting the reporting 

application located on OSHA’s public Web 

site at www.osha.gov.www.osha.gov.

3. Within 24-hours, the supervisor should 

investigate the cause(s) of the incident 

and may request assistance from the 

Safety and Occupational Health Manager 

or local Collateral Duty Safety Officer 

(CDSO). A Form 436, “Report of WorkRelated Injuries and Illnesses,” must be 

submitted within seven days to the Safety 

and Occupational Health Manager or 

local CDSO.

Automobile Accidents

Procedures and responsibilities for reporting 

automobile accidents are found in 

MD 7.1, “Tort Claims Against the United 

States”. 

What to Do in Case of 

an Injury
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15&)250 Page 3 of 3
REPORT OF UNSAFE OR 

UNHEALTHFUL WORKING CONDITIONS

NRC FORM 14

(09-2012)

NRCMD 10.130

U.S. NUCLEAR REGULATORY COMMISSION 

NRC FORM 14 (09-2012)

2. Person Completing Form (Check one) 4. Specific Location of alleged violation

5. Name of Supervisor at site of violation

6. Have you reported this condition to your supervisor? Yes No

7. Describe the hazard. Include materials and equipment involved and the approximate number of employees exposed or threatened 

 by the condition. 

9. Has anyone attempted to correct the condition? If yes, give details. Yes No

10. Has anyone been hurt, or has property been destroyed as a result of this condition? If yes, give details. Yes No

11. May your name be revealed? Yes No

If no is checked, the safety officer will detach the bottom portion of this form before distribution is made.

Employee's Name Employee's Work Telephone number (Include area code)

Employee's Signature Date of Employee's Signature

Representative of employee believes 

that a condition in the workplace violates 

safety and occupational health standards.

Employee

3. Name of Facility 

8. Forward to:

NRC Occupational Safety and Health Manager Regional/TTC Safety Officer

PAGE 1

1. Assigned Report Number
PROCEDURES

Every effort should be made to correct identified hazards as soon as possible. Hazards should first be 

reported to your immediate supervisor, since it is usually the most expedient means of abatement. However, 

hazards may also be reported either verbally or in writing to the local collateral duty safety officer, safety and 

health committee, or the the NRC Safety and Occupational Health Manager at Headquarters. You also have 

the right to report workplace hazards to the Occupational Safety and Health Administration (OSHA), although 

it is preferred that hazards be reported to the NRC Safety Office first, so they can be promptly investigated and 

abated.

When submitting a report of unsafe or unhealthful working conditions, you have the right to request that your 

name not be disclosed to anyone except an authorized representative of the Secretary of Labor (OSHA).

Upon receipt of a report of unsafe or unhealthful working conditions, the manager or collateral duty safety 

officer will:

A. Assign a report number and enter the report on the Hazard Report Log.

B. Detach the employee's name from the bottom of the form, if anonymity is requested.

C. Investigate alleged hazards within the appropriate time frame.

24 hours - for imminent danger conditions •

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3 working days - for serious conditions

20 working days - for other than serious conditions

D. Forward the inspection report to the individual responsible for abatement.

E. Forward the completed inspection report to the local safety and health committee for review.

F. Notify the employee of the results of the inspection, in writing, within 15 days after completion of the 

 inspection, for safety violations or within 30 days for health violations.

G. Retain a copy of the completed form on file for 5 years.

H. Notify the local safety and health committee when necessary corrective actions or interim protective 

 measures are not taken in a timely manner.

NRC FORM 14 (09-2012) PAGE 2
NOTICE OF UNSAFE OR UNHEALTHFUL 

WORKPLACE CONDITIONS

NRC FORM 219

(07-2012)

NRCMD 10.130

U.S. NUCLEAR REGULATORY COMMISSION 

NRC FORM 219 (07-2012)

LOCATION DATE OBSERVED (MM/DD/YYYY)

29 CFR 1960.26(c) and NRC MD 10.130 Handbook, Required this notice remain posted in a 

conspicuous place at or near each place the condition shown exists until the unsafe or unhealthful 

working condition has been abated or for 3 working days, whichever is later. This notice shall 

remain on file at this establishment for a period of five years after abatement.

NAME OF SAFETY OFFICER:

SIGNATURE DATE

DATE POSTED (MM/DD/YYYY)

HAZARDOUS CONDITION OBSERVED:

HAZARDOUS CLASSIFICATION:

IMMINENT DANGER SERIOUS

OTHER

STANDARD VIOLATION:

INTERIM CONTROL MEASURES IMPLEMENTED:

RECOMMENDATION FOR ABATEMENT:

TELEPHONE NUMBER OF SAFETY OFFICER: 

(Include area code) 

EXPECTED ABATEMENT DATE: 

(mm/dd/yyyy)

PAGE 1

ASSIGNED REPORT NUMBER
INSTRUCTIONS

In accordance with OSHA regulation 29 CFR 1960.26(c), the safety officer shall issue a "Notice of Unsafe 

or Unhealthful Conditions" following an inspection of the workplace that results in the determination that a 

hazardous condition is present in the workplace. The purpose of the Notice is to advise employees and 

visitors about a hazard that could potentially result in injury or illness, and to inform them of any measures 

taken to protect them from the hazardous condition.

The Notice shall contain the following information:

Specific location of the unsafe or unhealthful working condition.

Date the condition was first observed and the date this Notice was posted.

Description of the hazardous condition, including materials and equipment involved and the means 

by which employees may be harmed by the condition.

Hazard classification (imminent danger, serious, or other). Imminent danger hazard is defined as a 

condition that could reasonably be expected to cause death or serious physical harm immediately or 

before the hazard can be eliminated. A serious hazard is defined as a condition in which there is a 

substantial probability that death or serious harm could occur. Another type of hazard is a condition 

that violates a safety or health standard but does not have a direct impact on worker safety.

Specific safety and health standard that the condition violates.

Safeguards or actions taken to protect employees from harm before the condition can be corrected.

Actions that will be taken to correct or eliminate the hazardous condition and the date when such 

corrective measures are expected to be completed.

The safety officer shall:

Issue the Notice within 15 days following the inspection for a safety violation and with 30 days for a 

health violation.

Send a copy of the Notice to the official in charge of the workplace, the employee representative, 

and the safety and health committee.

Post the Notice near the place of the condition or in a prominent location where all affected 

employees will be able to see the Notice. The Notice shall remain posted until the hazard has been 

abated or for 3 working days, whichever is later.

Retain a copy of the Notice on file for 5 years following the end of the fiscal year in which the 

condition is corrected.

NRC FORM 219 (07-2012) PAGE 2

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United States 

Nuclear Regulatory Commission

NUREG/BR-0098, Rev. 7

March 2015