Belte r r a Cor p or at ion S afety M an ual D oc I D C H S M BE L 2 0 1 7 Pa g e 5 20 of 53 8 Doc u m e n t Identif icat ion F R M 047 P age Nu m b e r 2 of 2 Doc u m e n t C r e ation Dat e S e ptembe r 15 2014 Im p le m e n tat ion Dat e S e ptembe r 30 2014 S ugges tions fo r I mpr o v ing S a fet y I do not w a nt m y n a me r e ve a led to a n y one other t ha n the supe rvisor o r sa f e t y r e pr e se ntative I do not h a ve a n y p roble ms re ve a li n g m y na me to B e lt e r ra e mpl o y e e s Empl o y e e Na me Da te R e c e ived b y Na me of su pe rvisor or sa fe t y r e pre s e ntative De sig n a ti on Da te f orm r e c e ived Tha nk y o u for takin g the ti me to r e port y ou r c onc e rn s a bout s a fe t y Your s upe rvisor or the s a fe t y re pre s e ntative w il l do a f oll ow up a nd ge t bac k to y ou in a tim e l y manne r