安全隐患我发现之表格

校园及校园周边“安全隐患我发现”情况汇总表

 

学校：        班级：               日期：2011年03月29日

 

校园内安全隐患排查：

1、  班级教室：                                                                   

                                                                                 

                                                                                      

2、  班级内部：                                                                   

                                                                                 

                                                                                  

3、  年段矛盾：                                                                   

                                                                                 

                                                                                  

4、  校园内部：                                                                   

                                                                                 

                                                                                  

 

 

校园周边安全隐患排查：

1、  网吧名称：                                                                   

                                                                                 

                                                                                  

2、  水塘：                                                                   

                                                                                  

                                                                                  

3、  废弃石窟：                                                                   

                                                                                 

                                                                                  

4、  危险水域：                                                                   

                                                                                 

                                                                                  

5、  那些同学经常在校外进行赌博？

                                                                                 

                                                                               

                                                                                 

                                                                                   

6、校外不良青年经常在校园周边哪里出没？与学校那些同学频繁接触？