Help with SAFENET Form Fields

Agency Response

• Agency Response Narrative
  

  This field is a required field. Please describe what corrective actions were taken.

• Corrective action taken by
  

  This is a required field. Please supply the position title who took corrective action on this SAFENET.

• Date Submitted
  

  This field is a required field. Please supply the date the corrective action was taken.

• Email Address
  

  This field is a required field.

• Originator Notified by
  

  This field is an optional field. Please supply who if anyone notified the originator of the SAFENET that corrective action had been taken.

• Originator Notified Date
  

  This is an optional field. If you know the date the originator was notified please supply us with it.

• Supplemental Corrective Action
  

  The Supplemental Corrective Action form is used to supply corrective action to existing SAFENET's.

SAFENET

• Actions Taken
  

  This is a required field. Please describe actions you took to correct or mitigate the unsafe/unhealthful event.

• Agency/Organization
  

  The "Agency/Organization" field is a required field. Your choices are BIA, BLM, FWS, NPS, USFS, State, Other.

• Contributing Factors Checkboxes
  

  The "Contributing Factors" checkboxes are required fields.

• Corrective Action
  

  The Corrective Action field is an optional field.

• Date Reported
  

  This field is computed for display.

• EMail
  

  The "EMail" field is an optional field.

• Event Date
  

  The "Event Date" is a required field. Please supply the date the event occurred in the MM/DD/YY format.

• Human Factors Checkboxes
  

  The "Human Factors" checkboxes are required fields if "Human Factors" is checked in the "Contributing Factors" fields.

• Incident Activity
  

  The "Incident Activity" checkbox fields are required fields, you must choose at least one.

• Incident Name
  

  The "Incident Name" is a required field. Please supply the Name of the Incident where the event occurred. If this field is not applicable please enter N/A.

• Fire Number
  

  The "Fire Number" is an optional field. Please supply the Fire Number of the Incident where the event occurred. If this field is not applicable please enter N/A.

• Incident Type
  

  The "Incident Type" checkbox fields are required fields, you must choose at least one.

• Jurisdiction
  

  The "Jurisdiction" field is a required field. Your choices are BIA, BLM, FWS, NPS, USFS, State, Other, Unknown.

• Local Time
  

  The "Event Time" is an optional field Please supply the approximate time the event occurred in the 03:00 PM format.

• Local Unit
  

  The "Local Unit" Field is an optional field.

• Name
  

  The "Name" field is an optional field.

• Narrative
  

  The "Narrative" field is a required field. Use this field to describe in detail what happened and the resulting safety/health issues.

• Other Agency
  

  If "Other" was selected in the "Agency/Organization" field further describe "other" in this field (e.g. Eagle Fire Department).

• Other Factors
  

  The "Other Factors" field is a required field if "Other Factors" is checked in the "Contributing Factors" fields.

• Phone
  

  The "Phone" field is an optional field.

• Position Title
  

  The "Position Title" field is an optional field.