Log it once. Post the 300A on time.

Enter each recordable incident. The 300 log fills in. The 300A summary and TRIR/DART calculate.

Recordable cases

Days away

TRIR

—

DART rate

—

Establishment

Company name

Establishment name

NAICS

Address

City

State / ZIP

Reporting year

Avg # employees

Total hours worked (year)

Executive name

Executive title

Phone

No incidents entered.

OSHA Form 300 — Log of Work-Related Injuries and Illnesses

[Company]

Year: 1970

NAICS: —

Case #	Employee	Job title	Date	Location	Description / body part	Outcome	Days away	Days rest.
No incidents to display.

OSHA Form 300A — Summary of Work-Related Injuries and Illnesses

Annual Summary · 1970

Total deaths	0
Cases with days away from work	0
Cases with restricted / transfer	0
Other recordable cases	0

Total days away from work	0
Total days of restriction	0

Annual avg. employees	0
Total hours worked	0
TRIR (recordable × 200,000 / hrs)	—
DART (days-away + restricted × 200,000 / hrs)	—

I certify that I have examined this document and that to the best of my knowledge the entries aretrue, accurate, and complete.

[Name] · [Title]

Date · Phone: —