For the General
Public
Section 95-136(d)(1)
of the North Carolina Safety and Health Act, provides
as follows: any employee or representative
of employees who believe that a violation of a safety
or health standard exists that threatens physical
harm, or that imminent danger exists, may
request an inspection by giving notice of such violation
or danger to the Commissioner or Director.
Any such notice shall be reduced to writing, shall
set forth with reasonable particularity the grounds
for the notice, and then shall be signed by the
employee or representative of employees, and a copy
shall be provided the employer or his agent no later
than at the time of inspection. Upon request
of the person giving such notice, his name and the
names of individual employees referred to therein
shall not appear in such copy or on any record published,
released, or made available pursuant to subsection
(e) of this section. If upon receipt of such
notification the Commissioner or Director determines
there are reasonable grounds to believe that such
violation or danger exists, the Commissioner or
Director shall make a special investigation in accordance
with the provisions of this section as soon as practicable
to determine if such violation or danger exists. If the Commissioner
or Director determines there are not reasonable grounds to believe
that a violation
or danger exists, he shall notify the employee or
representative of the employees in writing of such
determination.
NOTE: The
Retaliatory Employment Discrimination Act provides
that no person shall discharge or discriminate against
any employee because that employee has filed a complaint.
Instructions:
Fill in the form as
accurately and completely as possible. Describe
each hazard you think exists in as much detail as
you can. If the hazards described in your
complaint are not all in the same area, please identify
where each hazard can be found at the worksite. If there is any particular
evidence that supports your suspicion that a hazard exists (for instance,
a recent accident or physical symptoms of employees
at your site) include the information in your description.
Punishment
for unlawful statements
Potential complainants
should keep in mind that it is unlawful to make
false statements, representations, or certifications
associated with any complaint (NCGS §95-139).
Violations of this statute are a Class 2 misdemeanor
in the state of North Carolina and are punishable
by a fine of up to $10,000.
Return to
Complaint Form
