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
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    First name:
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    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?

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    When did it happen, and for how long?

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