2019 SCMA Safety Performance Recognition Application

    NOTE: IN ORDER TO RECEIVE A PLAQUE A REPRESENTATIVE FROM EACH FACILITY MUST BE PRESENT OTHER WISE A CERTIFICATE WILL BE GIVEN
  • 2019 OSHA Form 300A must be used to complete this form.
  • Hours
  • H
  • I
  • (Total # of Cases (H+I) X 200,000) / (Total # of Hours Worked during 2019)

Incident rate table used: http://www.scosha.llronline.com/BLS/injuryinlless/2018/2018%20I&I%20Table%201.pdf

Please complete by February 14, 2020

**Please note this is not a registration form to attend the conference, you must register on our website www.myscma.com**
Email: watts@myscma.com Phone: 803-799-9695 Fax: 803-771-8738