Number of employee hours worked
Number of fatalities (Column 1 & 8)
If numbers are shown (attach explanation)
Number of restricted and lost workday
cases (Column 2 & 9)
Number of cases involving lost workdays
(Column 3 & 10 of OSHA log)
Number of cases defined as recordable
but without lost workdays (Column 6 &13)
Total number of cases for C, D, and
(not workdays)
“OSHA Incidence Rate” Formula:
Total Recordable Injuries x 200,000
Total number of work-hours
Number of citations by OSHA in past
three years (provide details of each)