Free osha 300 log excel

Excel OSHA 300 LOG Form And Memo

The objective of this assignment is to familiarize students with the OSHA 300 log and 300A by applying existing Part 1904 Recordkeeping rules. Students will prepare the required OSHA 300 log, and 300 A summary reports for the incidents contained herein. You will have to review OSHA Part 1904 in its entirety to learn how to properly record and complete the OSHA injury records. Download a copy of the excel OSHA 300 log, 300A summary provided in the Module 3 OSHA Recordkeeping Materials folder in Moodle. Note you do not have to complete the 301 injury supplement. A listing of incident facts is provided below for your analysis in this assignment. You will need to determine if each incident meets the recordability criteria of OSHA and properly record the incident on the OSHA 300 log and complete the annual 300A summary.

ASSIGNMENT

You are working for a safety consulting firm that contracts compliance services to small businesses. Your mission is to help ABC Roofing Company comply with Part 1904 OSHA recordkeeping rules for the year ending 2018. The company office is located at 1234 Park Ave, Houma, LA 70360. There are 100 full time workers and the company has a total of 200,000 work hours logged for the calendar year ending 12/31/2018. The NAICS code for this company is 23816 Roofing Contractors. You will need this to look up the industry TRIR and DART rates. The company has provided a listing of all incidents that have occurred during 2018 but is not sure which should be recorded on the OSHA logs. All incidents occurred in OSHA jurisdiction for recordkeeping purposes. You duty is to comply with the 1904 recordkeeping rules and complete the OSHA 300 and 300A summary accurately for the client.

In addition, Mr. Tim Smith, ABC Construction Company President, has asked you to compare ABC Roofing’s OSHA incident rates to the industry average for Total Recordable Rates and Cases with days away from work, job restriction or transfer (DART Rate) using the latest available BLS data. For purposes of this assignment, use the following link to the bureau of Labor Statistics for injury and illness rates published as of 2017. https://www.bls.gov/web/osh/summ1_00.htm

Look up NAICS code in second column for roofing contractors and locate the total recordable cases column and Total column for days away from work, rob restriction or transfer. This is what you will benchmark ABC Roofing’s experience to as described herein.

Note the incident rate represent the number of injuries and illnesses per 100 full-time workers and were calculated as: (N/EH) x 200,000, where
N = number of injuries and illnesses
EH = total hours worked by all employees during the calendar year
200,000 = base for 100 equivalent full-time workers (working 40 hours per week, 50 weeks per year)

In your memo you must specifically include a table and or chart of Total Recordable Incident Rates and Days Away Restricted and Transfer (DART) rates and compare it to benchmark information. From this you should clearly be able to conclude it the company experience is the same, better or worse than industry. You may need to do some research to learn how to calculate incident rates. Refer to Incident Rate Calculator and Comparison Tool handout in Moodle for additional guidance. https://safetymanagementgroup.com/resources/incident-rate-calculator/

You will ultimately produce the OSHA 300 log, 300A Summary and create a memo using MS WORD for Mr. Smith that explains OSHA record posting requirements and document retention rules for the 300 log, 300 A summary and 301 Incident report including time frame if any that you have to keep these records.

Here are the cases that occurred. You must determine if the meet the recordability requirements of Part 1904 and correctly record these on the OSHA 300 and 300A logs. Refer to OSHA website for additional guidance and letters of interpretation to accurate determine recordability of the following 10 incidents.

1. 1/21/18– Tom Jones, carpenter hurt his back lifting plywood in the shop and was admitted to ER. The doctor prescribed pain killers. He could not return to work for 20 days and the doctor then placed him on restricted duty for 20 days.

2. 2/14/18 – James Jones, a receiving clerk was cutting plastic banding straps on a bundle of 2 by 4 with knife in shop. Mr. Jones was not wearing the proper gloves which resulted in a cut on the left top of hand. The safety coordinator treated the cut with butterfly band aid. Mr. Jones returned to normal duty without future incident.

Note: The determination of medical treatment and first aid is always difficult to determine. For this case, refer to OSHA Interpretations to verify your answer here.

3. 3/8/18 – Susie Smith, Office manager was making bank deposit in her personal vehicle for the company and was involved in car accident in route to the bank and broke her neck. She spent 14 days in the hospital and then could not return to work for another 260 days.

4. 4/20/18 –Billy Bob, construction superintend was walking down a set of stairs at the shop and slipped on the stairs and twisted his ankle. The doctor checked him out and x-rayed his ankle. He was then released to go back to work but doctor prescribed that he wear a ridged boot to support his ankle for 30 days. Billy Bob decided not to wear the boot and resumed normal duties.

5. 5/18/18 – Thomas O’Malley was working at jobsite on the roof and slipped and fell about 10 feet to the ground landing on his back. He was hospitalized with severe back pain for 3 days and then underwent extensive pain management, rehab but never returned to work. He obtained a lawyer and the case has been making it way through the workers compensation courts.

6. 6/10/18 – Peter Pan, is a helper and was on a jobsite. He was cutting some wood with a skill saw and got wood dust in his eye. The supervisor flushed his eye with eye wash solutions but his eye was severely irritated. So supervisor took his to doctor’s office. The Company Doctor had to remove the wood dust from his eye using irrigation, performed an x ray to ensure all trash was removed from the eye and Peter Pan was able to returned to work the same day.

Mike Mars, a rig mechanic, slipped and fell on a wet floor while walking through the galley of Rig 2260 and sprained his right ankle in the fall. He was seen by the doctor who prescribed an anti-inflammatory. The doctor placed him on restricted duty for 10 days but Mike decided he could return to full duty, and he did so without any problems. While this is recordable how do you count the days. Be accurate on the OSHA log.

7. 7/10/2018 – Mike Nicholls, was a new hire on the job and during his first day on the job he got over-heated had to be taken to hospital for heat stress. He was treated with and fluid IV and doctor put him on restriction because of the heat stress incident for 10 days. The employee was embarrassed and quite the same day and never returned to work.

8. 8/4/18 -Paul Brown was climbing down an extension ladder on the jobsite and missed a step. He fell and landed on his right side and was seriously injured. An ambulance was called to take him to the hospital. He was treated for a broken hip, prescribed pain meds and sent home for 180 days. He never returned to work.

9. 9/25/18 – Marcus Brown, was a laborer and was on the jobsite helping a deliver driver unload roofing shingles. He climbed up onto the delivery truck trailer and unstrapping the load. He accidently stepped backwards and fell off the truck bed and broke his right hand. Brown was seen by the doctor and placed his hand in a cast. The doctor put Mr. Brown on restricted duty for 30 days.

10. 12/10/2018– Eugene Atabanks, shop Forman was driving to work in his personal car and crossed the center lane resulting in a head on collision. He was pronounced dead on the scene by responding authorities.

Use the Excel spreadsheet found in Module 3 Assignment - OSHA Recordkeeping Materials Folder to complete the OSHA 300 and 300A log.

OSHA Form 300
Attention: This form contains information relating to employee health and must be used in a manner that protects the confidentiality of employees to the extent possible while the information is being used for occupational safety and health purposes.
OSHA's Form 300 (Rev. 01/2004) Year
Log of Work-Related Injuries and Illnesses U.S. Department of Labor
Occupational Safety and Health Administration
You must record information about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid. You must also record significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional. You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR 1904.8 through 1904.12. Feel free to use two lines for a single case if you need to. You must complete an injury and illness incident report (OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If you're not sure whether a case is recordable, call your local OSHA office for help. Form approved OMB no. 1218-0176
Establishment name
City State
Identify the person Describe the case Classify the case
CHECK ONLY ONE box for each case based on the most serious outcome for that case: Enter the number of days the injured or ill worker was: Check the "injury" column or choose one type of illness:
(A) (B) (C) (D) (E) (F)
Case No. Employee's Name Job Title (e.g., Welder) Date of injury or onset of illness 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)
(M) Skin Disorder Respiratory Condition Poisoning Hearing Loss All other illnesses
Death Days away from work Remained at work Away From Work (days) On job transfer or restriction (days) Injury
(mo./day)
Job transfer or restriction Other record- able cases
(G) (H) (I) (J) (K) (L) (1) (2) (3) (4) (5) (6)
Page totals 0 0 0 0 0 0 0 0 0 0 0 0
Be sure to transfer these totals to the Summary page (Form 300A) before you post it. Injury Skin Disorder Respiratory Condition Poisoning Hearing Loss All other illnesses
Public reporting burden for this collection of information is estimated to average 14 minutes per response, including time to review the instruction, search and gather the data needed, and complete and review the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments about these estimates or any aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistics, Room N-3644, 200 Constitution Ave, NW, Washington, DC 20210. Do not send the completed forms to this office.
Page 1 of 1 (1) (2) (3) (4) (5) (6)
OSHA Form 300A
OSHA's Form 300A (Rev. 01/2004) Year
Summary of Work-Related Injuries and Illnesses U.S. Department of Labor
Occupational Safety and Health Administration
Form approved OMB no. 1218-0176
All establishments covered by Part 1904 must complete this Summary page, even if no injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary.
Using the Log, count the individual entries you made for each category. Then write the totals below, making sure you've added the entries from every page of the log. If you had no cases write "0." Establishment information
Employees former employees, and their representatives have the right to review the OSHA Form 300 in its entirety. They also have limited access to the OSHA Form 301 or its equivalent. See 29 CFR 1904.35, in OSHA's Recordkeeping rule, for further details on the access provisions for these forms. Your establishment name
Street
Number of Cases City State Zip
Industry description (e.g., Manufacture of motor truck trailers)
Total number of deaths Total number of cases with days away from work Total number of cases with job transfer or restriction Total number of other recordable cases
Standard Industrial Classification (SIC), if known (e.g., SIC 3715)
0 0 0 0
(G) (H) (I) (J) OR North American Industrial Classification (NAICS), if known (e.g., 336212)
Number of Days Employment information
Total number of days away from work Total number of days of job transfer or restriction
Annual average number of employees
0 0 Total hours worked by all employees last year
(K) (L)
Injury and Illness Types
Sign here
Total number of… Knowingly falsifying this document may result in a fine.
(M)
(1) Injury 0 (4) Poisoning 0
(2) Skin Disorder 0 (5) Hearing Loss 0 I certify that I have examined this document and that to the best of my knowledge the entries are true, accurate, and complete.
(3) Respiratory Condition 0 (6) All Other Illnesses 0
Company executive Title
Post this Summary page from February 1 to April 30 of the year following the year covered by the form Phone Date
Public reporting burden for this collection of information is estimated to average 50 minutes per response, including time to review the instruction, search and gather the data needed, and complete and review the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments about these estimates or any aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistics, Room N-3644, 200 Constitution Ave, NW, Washington, DC 20210. Do not send the completed forms to this office.