Simply replace the unfilled areas such as "" and "[date]" with your information.
Dear [facilities manager],
I would like to report a possibly hazardous condition in [location of condition]. I was in this area at approximately [time] today and noticed that [describe the possible hazard]. Several of the employees working in this area expressed concerns regarding this condition as well.
As this could cause possible hazardous situations for our employees that work in this area, I would appreciate if you would investigate this immediately. Should you require any assistance or further information regarding this issue, please let me know.
If you are not the correct person to notify regarding these issues, please let me know immediately so that I can notify the correct person in a timely manner.