Holmes Area Safety Council Semi-Annual Report Co-sponsored by BWC's Division of Safety and Hygiene Reporting Period 1st - Due by July 15 for the current period January 1–June 30, 2020 2nd - due by January 15 for the current period July 1–December 31, 2020 Safety Council Account Number Company Name Phone Fax Address Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Submitted by Most Recent Injury or Illness Resulting in Day(s) Away from Work Report all information below for CURRENT SIX-MONTH PERIOD ONLY (corresponds with period identified above) Average Number of Employees Total Hours Worked (entire six-month period, all employees) The following items are based on the Recordkeeping Requirements under the Occupational Safety & Health Act of 1970 (rev. 1/2/02). The columns listed below correspond to the columns in the OSHA 300 Log. Number of Deaths (column G in OSHA 300 Log) Number of occupational injuries and/or illnesses resulting in days away from work (column H in OSHA 300 Log) Number of days away from work as a result of occupational injuries and/or illnesses (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, the most recent date of death, injury, or illness must correspond with the date provided above.
