Appendix — Forms

Safety Manual · 2026 Edition · Rev 2.0 · Effective August 2026 · Owner DF

The following master forms support this program. Photocopy or reprint as needed; do not use the master. Completed forms are returned to the Safety Coordinator / HR as indicated. (This edition consolidates the duplicate form copies from the prior manual into a single master of each.)

• Appendix A — Employee Acknowledgment of Safety Program

• Appendix B — Employee Warning Notice

• Appendix C — Supervisor's Report of Injury or Illness

• Appendix D — First Aid Treatment Form

• Appendix E — Employee Hazard Report

• Appendix F — New-Hire Safety Orientation Checklist

• Appendix G — Toolbox Talk / Safety Meeting Record

• Appendix H — Jobsite Safety Inspection Checklist

OSHA Forms 300, 300A, and 301: current fillable versions are downloaded from osha.gov/recordkeeping/forms and kept by the Safety Coordinator. Insert the current year's forms behind Appendix H.