Get Report Of Injury To Employee Operating A Mechanical Power Press

Filling out the Report Of Injury To Employee Operating A Mechanical Power Press is an important step in documenting workplace incidents. This guide provides clear and supportive instructions to help you complete the form accurately and efficiently online.

Follow the steps to complete the form online.

1. Press the ‘Get Form’ button to access the form and open it in your editing tool.
2. In the employer and establishment information section, fill in the employer’s name, workplace location, city, state, and ZIP code. Ensure all details are accurate for proper reporting.
3. Under incident information, enter the employee's name, the date of the injury, and describe the injury sustained with specific body parts and nature of the injury.
4. Detail the task that was being performed at the time of the incident by selecting the appropriate operation from the options provided.
5. Indicate the type of clutch used on the press. Choose from options like full revolution or part revolution, and provide additional description if necessary.
6. Describe the type of safeguard(s) that were in use during the operation, selecting from options such as two-hand trips or two-hand controls. If not listed, provide a complete description separately.
7. Identify the cause of the accident by selecting the applicable choice from options such as 'safeguard failure' or 'no safeguard provided.' Include comments if necessary.
8. Specify the type of feeding method used, indicating if it was manual with hands in or out of dies. Additional comments can be included as needed.
9. Fill in the means used to actuate the press stroke from options like foot trip or hand control, providing comments if applicable.
10. Indicate the number of operators required for the operation and the number provided with controls and safeguards.
11. Certify the accuracy of the entries by including the company executive’s signature, title, and the date.
12. Once you have completed the form, you may save changes, download, print, or share the form as needed.

Complete your Report Of Injury To Employee Operating A Mechanical Power Press online to ensure proper documentation.