F416 093 000 2025

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The document is a witness statement form from the Washington State Department of Labor and Industries, specifically for reporting incidents related to occupational safety and health. It collects information about the accident, including details about the witness, victim, employer, and nature of the occurrence. The form also includes sections for the witness's observations, opinions on how the incident occurred and could be prevented, and options for confidentiality regarding their identity.

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2006	4 Satisfied (27 Votes)

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