- Rm. 255 Tel 914 997-9514 FAX 914 997-9528 PESH 7 1-11 Complaint Number Establishment Name Site Address Mailing Address Management Official Type of Business Site Phone Site FAX Mail Phone Mail FAX Telephone Hazard Description/Location. Describe the hazard s which you believe exist be specific. New York State Department of Labor Public Employee Safety and Health Bureau Notice of Alleged Safety or Health Hazards For the General Public This form is provided for the assistance of any complainant...
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