Get the free OSHA's Form 3004

OSHA\'s Form 3004 Annual Summary of Correlated injuries and illnesses Year:2019 Establishment Name: UC Santa BarbaraUNIVERSITYOFCATIFORNIAand accurate before completing this summary.in Cause\'S record

How to fill out oshas form 3004

How to Fill Out OSHA's Form 3004:

1. Begin by obtaining a copy of OSHA's Form 3004. This form is typically available for download on the official OSHA website.
2. Familiarize yourself with the purpose and requirements of Form 3004. This form is used to report each injury to a federal or contract employee at a U.S. Government job site.
3. Start by entering the name of the injured employee in the designated field. Include any additional identification details requested, such as employee number or social security number.
4. Provide the date and time of the injury in the appropriate section of the form. Be as specific as possible to ensure accuracy.
5. Describe the nature of the injury in detail. Include information such as the body part affected, the cause of the injury, and any contributing factors.
6. Indicate whether the employee was treated at the job site, transported to a hospital, or received medical attention elsewhere. Include the name and contact information of the medical facility if applicable.
7. If the injury resulted in the need for restricted work or job transfer, document the details in the corresponding section. Specify the date range and any changes in duties or work requirements.
8. In case of a fatality, provide the date, time, and location of the incident. Include a brief description of the circumstances surrounding the fatality.
9. Complete any additional fields on the form as required. This may include providing contact information for witnesses or any other relevant details.
10. Keep a copy of the completed Form 3004 for your records and submit the original to the appropriate authority within the specified timeframe.

Who Needs OSHA's Form 3004:

1. U.S. Government job site employers are generally required to fill out OSHA's Form 3004. This includes federal agencies and contractors working on federal projects.
2. Employers who have federal or contract employees who suffer work-related injuries at U.S. Government job sites are also required to complete Form 3004.
3. It is important for employers to familiarize themselves with the specific regulations and requirements for Form 3004 to ensure compliance with OSHA guidelines.

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What is oshas form 3004?

The OSHA form 3004 is the Summary of Work-Related Injuries and Illnesses.

Who is required to file oshas form 3004?

Employers with more than 10 employees are required to file OSHA's Form 3004.

How to fill out oshas form 3004?

Employers must fill out OSHA Form 3004 by documenting all work-related injuries and illnesses that occurred during the calendar year.

What is the purpose of oshas form 3004?

The purpose of OSHA Form 3004 is to provide a summary of work-related injuries and illnesses for analysis and prevention purposes.

What information must be reported on oshas form 3004?

Information such as the nature of the injury or illness, the affected body part, the date of the incident, and the days away from work must be reported on OSHA Form 3004.