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Cal/OSHA Form 300-Log of Work-Related Injuries …

Attention: This form contains information relating to employee health and must be used in a manner that protects the confidentiality of Cal/OSHA form 300 (Rev. 7/2007) Appendix A employees to the extent possible while the information is being used Year 20__ __. for occupational safety and health purposes. Log of Work-Related Injuries and illnesses See CCR Title 8 (b)(6)-(10). Department of Industrial Relations Division of Occupational Safety and Health You must record information about every Work-Related death and 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.

Department of Industrial Relations Division of Occupational Safety and Health Cal/OSHA Form 300 (Rev. 7/2007) Appendix A Year 20__ __ Log of Work-Related Injuries and Illnesses

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