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OSHA 300 Log
Establishment name
Street
City
State
Zip
Industry description (e.g., Manufacture of motor truck trailers)
Standard Industrial Classification (SIC), if known (e.g., 3715)
Employment information
Log of Work-Related Injuries and Illnesses
Case No.
Employee's Name
Job Title (e.g., Welder)
Date of Injury or Onset of Illness (mm/dd)
Where the event occurred (e.g., Loading dock north end)
Describe injury or illness, parts of body affected, and object/substance that directly injured or made person ill (e.g., Second degree burns on right forearm from acetylene torch)
Death
Days away from work
Days of restricted work activity or job transfer
Other recordable cases
Away From Work Cases
Case No.
Employee's Name
Job Title
Date of Injury or Onset of Illness
Date returned to work (mm/dd/yyyy)
Number of calendar days away from work
Injury and Illness Types
Injury
Skin Disorder
Respiratory Condition
Poisoning
Hearing Loss
All Other Illnesses