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semi-annual reports


Choose which report you are submitting: Jan. 1 - June 30           July 1 - Dec. 31 




City:    State:   Zip:


Full Name:




1.) Date of most recent injury/illness resulting in day(s) away from work: (mm/dd/yyyy)


Report all information below for current six month period only
(corresponds with period identified above)

2.) Average Number of Employees:

3.) Total Hours Worked (entire six month period, all employees):


Items 4, 5 and 6 are based on the Recordkeeping Requirements under the Occupational Safety & Health Act of 1970 (rev. 1/1/02). The columns listed below correspond to the columns in the OSHA 300 log.

4.) Number of Deaths (column G in OSHA 300 Log):

5.) Number of occupational injuries and/or illnesses resulting in days away from work
                                 (column H in OSHA 300 Log):

6.) Number of days away from work as a result of occupational injuries and/or illness
                                 (column K in OSHA 300 Log):

Note: If you report a death, injury or illness resulting in days away from work in the current six month period (item 4 or 5), the most recent date of the death, injury or illness must correspond with item 1.

  • Note: Please only hit the "Submit" button once, and allow time for processing.


Safety Council of Greater Columbus | 1175 Dublin Rd. |  Columbus, OH 43215 |  PH 614.486.9521  |  FX 614.486.7620  

Last updated: 6/28/2018
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