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This version of the form is not currently in use and is provided for reference only. Download this version of
Form ADOSH ICA2213
for the current year.
Form ADOSH ICA2213 Notice of Alleged Safety or Health Hazards - Arizona
What Is Form ADOSH ICA2213?
This is a legal form that was released by the Industrial Commission of Arizona - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ADOSH ICA2213?
A: Form ADOSH ICA2213 is a Notice of Alleged Safety or Health Hazards that is specific to the state of Arizona.
Q: What is the purpose of Form ADOSH ICA2213?
A: The purpose of Form ADOSH ICA2213 is to report any alleged safety or health hazards in a workplace in Arizona.
Q: Who should fill out Form ADOSH ICA2213?
A: Form ADOSH ICA2213 should be filled out by any individual who wants to report or notify ADOSH about alleged safety or health hazards in a workplace.
Q: What information is required on Form ADOSH ICA2213?
A: Form ADOSH ICA2213 requires information such as the name and address of the employer, description of the alleged hazard, and contact information of the person reporting the hazard.
Q: Is there a deadline to submit Form ADOSH ICA2213?
A: Yes, Form ADOSH ICA2213 should be submitted within 15 days of the alleged hazard being observed or discovered.
Q: What happens after I submit Form ADOSH ICA2213?
A: Once Form ADOSH ICA2213 is submitted, ADOSH will review the information and conduct an investigation if necessary, to determine if any safety or health hazards exist.
Q: Can I remain anonymous when submitting Form ADOSH ICA2213?
A: Yes, you have the option to remain anonymous when submitting Form ADOSH ICA2213.
Q: Are there any penalties for false or misleading information on Form ADOSH ICA2213?
A: Yes, providing false or misleading information on Form ADOSH ICA2213 is subject to penalties and legal consequences.
Q: Can I contact ADOSH directly for more information about Form ADOSH ICA2213?
A: Yes, you can contact the Arizona Division of Occupational Safety and Health (ADOSH) directly for more information about Form ADOSH ICA2213.
Form Details:
- Released on August 1, 2016;
- The latest edition provided by the Industrial Commission of Arizona;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form ADOSH ICA2213 by clicking the link below or browse more documents and templates provided by the Industrial Commission of Arizona.
