HAZARD REPORTING

Zambia Airports Corporation Limited

This form supports anonymous reporting. Providing your name is optional.

Name (Optional)

Email (Optional - for feedback)

Phone Number (Optional - for feedback)

Station/Location *

Source of Hazard *

Equipment Person Process Environment

Nature of Hazard *

Landside Operations Terminal Operations Airside Operations

Description of Hazard *

Associated Risks *

Suggested Corrective Action/Immediate Action Taken

Digital Signature (Optional)