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Get OSHA 300 2004

_ (H) ____ days ____ days month/day _____ (G) On job transfer or restriction Hearing loss ____________ __ ____/___ _______ Other recordable cases Away from work Poisoning ________________________ Days away Job transfer from work or restriction Check the “Injury” column or choose one type of illness: (M) Remained at Work Death _____ Enter the number of days the injured or ill worker was: Poisoning CHECK ONLY ONE box for each case based on the most serious outcome for that.

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