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WASTEFUL ACTIONS AT ALLIANT ENERGY

IT IS ILLEGAL AND A VIOLATION OF SEC.8 OF THE NLRA FOR AN EMPLOYER TO INTERFERE WITH,

RESTRAIN, OR COERCE ACTIVITIES SUCH AS FILLING OUT THIS FORM.

NAME:

WORK LOCATION:

HOME E-MAIL ADDRESS:

HOME PHONE NUMBER:

WHEN: DATE & TIME INCIDENT HAPPENED:

WHERE: EXAMPLE:OFFICE,FIELD,OR ADDRESS:

WHO: EXAMPLE: CONTRACTOR, OR SALARIED MANAGER WHO WAS AWARE, INVOLVED, OR APPROVED THIS DECISION:

CHECK ALL THE BOXES THAT PERTAIN TO THIS INCIDENT

WAS THIS A WASTEFUL ACTION THAT AFFECTED:

CONFIDENTIALITY

ENVIRONMENT

SERVICE RELIABILITY

SAFETY

COST

QUALITY

OTHER PLEASE EXPLAIN:

WHO DOES THIS WASTEFUL ACTION AFFECT:

CUSTOMER

EMPLOYER

CONTRACTOR

PLEASE GIVE A BRIEF EXPLANATION ON ALL CHECKED BOXES:

IS THIS PROBLEM ONGOING

COULD THIS HAVE BEEN PREVENTED

DO YOU WISH TO HAVE YOUR NAME WITHHELD

MAY WE CONTACT YOU FOR A FOLLOW UP