iAuditor Mobile App Preview

Audit

Number of Cases

Total number of deaths (G)

Total number of cases with days away from work (H)

Total number of cases with job transfer or restriction (I)

Total number of other recordable cases (J)

Number of Days

Total number of days away from work (K)

Total number of days of job transfer or restriction (L)

Injury and Illness Types

Total number of Injury

Total number of Skin Disorder

Total number of Respiratory Condition

Total number of Poisoning

Total number of Hearing Loss

Total number of All Other Illnesses

Establishment Information

Your establishment name

Address

Industry description

Standard Industrial Classification (SIC) if known

North American Industrial Classification (NAICS) if known

Employment Information

Annual average number of employees

Total hours worked by all employees last year

Sign here
Company executive

OSHA Form 300A Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 25

This OSHA Form 300A Summary of Work-Related Injuries and Illnesses has been converted into an iAuditor digital template. This form should be completed as an annual record of total injury case and type information as well as time lost.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

Browse for other checklists


iauditor logo

The World's #1 Cloud-Based Inspection Software and App

chevron logo
coles logo
emirates logo
overground logo
tesla logo
toyota logo

Audit

Number of Cases

Total number of deaths (G)

Total number of cases with days away from work (H)

Total number of cases with job transfer or restriction (I)

Total number of other recordable cases (J)

Number of Days

Total number of days away from work (K)

Total number of days of job transfer or restriction (L)

Injury and Illness Types

Total number of Injury

Total number of Skin Disorder

Total number of Respiratory Condition

Total number of Poisoning

Total number of Hearing Loss

Total number of All Other Illnesses

Establishment Information

Your establishment name

Address

Industry description

Standard Industrial Classification (SIC) if known

North American Industrial Classification (NAICS) if known

Employment Information

Annual average number of employees

Total hours worked by all employees last year

Sign here
Company executive