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Tips for Completing the OSHA-7 Form, Study notes of Construction

The University of Science and Arts of Oklahoma (USAO)Construction

INSTRUCTIONS Provided on the Form: Open the form and complete the front page as accurately and completely as possible. Describe each hazard you think exists ...

Typology: Study notes

2021/2022

Uploaded on 09/27/2022

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HANDOUT #12b
Filing an OSHA Complaint – Tips for Completing the OSHA-7 Form
INSTRUCTIONS Provided on the Form:
Open the form and complete the front page as accurately and completely as possible.
Describe each hazard you think exists in as much detail as you can. If the hazards
described in your complaint are not all in the same area, please identify where each
hazard can be found at the worksite. If there is any particular evidence that supports
your suspicion that a hazard exists (for instance, a recent accident or physical
symptoms of employees at your site) include the information in your description. If you
need more space than is provided on the form, continue on any other sheet of paper.
After you have completed the form, return it to your local OSHA office.
Herearetipsforcompletingtheform:
1. Be specific and include appropriate
details: The information on the
complaint form may be the only
description of the hazard that the
inspector will see before the
inspection. The inspector will base
his or her research and planning on
this information.
2. Establishment Name, Address, &
Type of Business: Be thorough and
specific. The inspector’s research
on the company and the industry’s
hazards will be based on this
information.
3. Hazard Description/Location: The
hazard description is the most
important part of the form. Your
answer should explain the hazards
clearly. If your complaint is about
chemicals, identify them whenever
possible and attach copies of labels
or MSDSs if you can. Identif y the
location so the inspector will know
where to look.
4. Has this condition been brought to
the attention of the employer or
another government agency? You
should indicate on the form if you
have tried to get the employer to fix
the hazard before filing the
complaint. Also, if another agency,
such as a local fire or building
department, has been notified of
these hazards, OSHA may want to
consult with them.
5. Do NOT reveal my name: OSHA will keep your name off the complaint, if you wish. Remember that
discrimination for health and safety activity is illegal. If you are a union representative, you may
wish to have your name on the complaint.
6. Signature and address: It is important to sign the complaint if you want OSHA to conduct an onsite
inspection. Also, your address will allow OSHA to send copies of inspection related materials to
you.
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Download Tips for Completing the OSHA-7 Form and more Study notes Construction in PDF only on Docsity!

Filing an OSHA Complaint – Tips for Completing the OSHA-7 Form

INSTRUCTIONS Provided on the Form:

Open the form and complete the front page as accurately and completely as possible.

Describe each hazard you think exists in as much detail as you can. If the hazards

described in your complaint are not all in the same area, please identify where each

hazard can be found at the worksite. If there is any particular evidence that supports

your suspicion that a hazard exists (for instance, a recent accident or physical

symptoms of employees at your site) include the information in your description. If you

need more space than is provided on the form, continue on any other sheet of paper.

After you have completed the form, return it to your local OSHA office.

Here are tips for completing the form:

  1. Be specific and include appropriate details: The information on the complaint form may be the only description of the hazard that the inspector will see before the inspection. The inspector will base his or her research and planning on this information.
  2. Establishment Name, Address, & Type of Business: Be thorough and specific. The inspector’s research on the company and the industry’s hazards will be based on this information.
  3. Hazard Description/Location: The hazard description is the most important part of the form. Your answer should explain the hazards clearly. If your complaint is about chemicals, identify them whenever possible and attach copies of labels or MSDSs if you can. Identify the location so the inspector will know where to look.
  4. Has this condition been brought to the attention of the employer or another government agency? You should indicate on the form if you have tried to get the employer to fix the hazard before filing the complaint. Also, if another agency, such as a local fire or building department, has been notified of these hazards, OSHA may want to consult with them.
  5. Do NOT reveal my name: OSHA will keep your name off the complaint, if you wish. Remember that discrimination for health and safety activity is illegal. If you are a union representative, you may wish to have your name on the complaint.
  6. Signature and address: It is important to sign the complaint if you want OSHA to conduct an onsite inspection. Also, your address will allow OSHA to send copies of inspection related materials to you.

Construction Complaint Scenario

Use the following scenario to determine what information should be

put on an OSHA complaint form. Is any additional information

needed?

You are a construction worker for ABC, Inc, 1000 Sweet Road, Anytown,

USA, 40001. ABC does non-residential plumbing, heating and air-

conditioning work. You have worked for ABC for 3 years. You, along with 7

co-workers, have been installing sheetmetal ductwork in the lower level of

the Anytown Shopping Mall, which is undergoing renovation, for the past few

weeks. The site is located in the Northwest quadrant, in the basement of the

anchor store, located at 555 Times Drive, in Anytown. One of your co-

workers has been operating a 65-horsepower concrete cutting saw in the

same area. The saw is being run in the propane mode. You and several co-

workers get headaches from the fumes whenever the saw is used and have

told your supervisor about the problem. The supervisor said that nothing

could be done, because the General Contractor, CAB Management, has

control over the site and this job will be complete in another month. You did

some research and found out that exposure to propane in a confined,

unventilated area can cause headaches, dizziness, difficulty breathing and

unconsciousness. There is no ventilation or monitoring of the air in the area.

After talking to your union representative, you decide to file a complaint with

OSHA.

NOTES:

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U. S. Department of Labor

Occupational Safety and Health Administration

Notice of Alleged Safety or Health Hazards

Complaint Number

Establishment Name

Site Address Site Phone Site FAX Mailing Address Mail Phone Mail FAX Management Official Telephone Type of Business HAZARD DESCRIPTION/LOCATION. Describe briefly the hazard(s) which you believe exist. Include the approximate number of employees exposed to or threatened by each hazard. Specify the particular building or worksite where the alleged violation exists.

Has this condition been brought to the attention of:

 Employer  Other Government Agency(specify)

Please Indicate Your Desire:  Do NOT reveal my name to my Employer  My name may be revealed to the Employer The Undersigned believes that a violation of an Occupational Safety or Health standard exists which is a job safety or health hazard at the establishment named on this form.

(Mark "X" in ONE box)

 Employee  Federal Safety and Health Committee  Representative of Employees  Other (specify) ___________________

Complainant Name Telephone Address(Street,City,State,Zip)

Signature Date

If you are an authorized representative of employees affected by this complaint, please state the name of the organization that you represent and your title: Organization Name: Your Title:

2 OSHA-7(Rev. 3/96)

Handout #12b