Burlington System Division
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    Feb 03, 2023
    Sammy's Pizza, 445 99th Ave NW, Coon Rapids, MN
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    Feb 25, 2023
    Pizza Hut, 811 US-83, McCook, NE 69001
  • Witness Statement Online
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    First name:
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    Email Address:
    Employee Number:
    Position at Time of Statement:
    Is this regarding a Claim? YES                NO
    If YES, what Claim?

    Location of Witnessed or Discovered 

    Work or Violation

    Detailed Description of what you Witnessed

    What was done?

    Who was there?

    When did it happen, and for how long?


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