Get the free OSHA's Form 300A (Rev

OSHA's Form 300A (Rev. 01/2004) Year Summary of Correlated Injuries and Illnesses U.S. Department of Labor Occupational Safety and Health Administration Form approved OMB no. 12180176 All establishments

How to fill out oshas form 300a rev

How to fill out OSHA's Form 300A Rev:

1. Obtain the Form: Start by obtaining a copy of OSHA's Form 300A Rev, which is the summary of work-related injuries and illnesses for a specific year. This form can be downloaded from OSHA's official website or obtained from your local OSHA office.
2. Compile the Data: Gather all relevant data for the reporting year, which typically spans from January 1st to December 31st. This includes information about each work-related injury or illness that occurred during this period.
3. Enter Establishment Information: Fill in the establishment name, address, industry classification (NAICS code), and other basic identifying details at the top of the form.
4. Total Hours and Employment: Calculate the total number of hours worked by all employees during the reporting year, as well as the average number of employees. These figures will be used to calculate the incidence rates later on.
5. Calculate Days Away, Restricted, or Transferred (DART): Determine the total number of cases that involved days away from work, job restrictions, or transfers to another job. Enter this number in the appropriate box on the form.
6. Calculate Total Number of Cases: Determine the total number of cases that resulted in days away from work, job restrictions, or transfers, and those that were other recordable cases (such as medical treatment beyond first aid). Enter these numbers in the corresponding boxes.
7. Calculate Injury and Illness Incidence Rates: Use the provided formulas on the form to calculate the injury and illness incidence rates for the establishment. These rates help identify the safety performance of the workplace.
8. Certification: The form must be certified by a company executive to validate that it has been completed accurately and truthfully. Sign and date the form accordingly.

Who needs OSHA's Form 300A Rev:

1. Employers: All employers who had more than ten employees at any point during the previous calendar year, and are not exempt from OSHA's recordkeeping requirements, need to fill out OSHA's Form 300A Rev.
2. Covered Industries: This form is applicable to employers in various industries, including construction, manufacturing, healthcare, retail, and any other industry that falls under OSHA's jurisdiction.
3. Recordkeeping Obligations: Employers subject to OSHA's recordkeeping requirements must maintain this form at their establishment for a period of at least five years. This helps ensure access to historical injury and illness data for regulatory compliance and safety improvement purposes.

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