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0 <br /> 0 <br /> c <br /> to <br /> cam' <br /> M <br /> m <br /> 0 <br /> -a <br /> m <br /> N <br /> OSHA's Form 300A (Rev.01/2004) <br /> Year 2013_ <br /> Summary of Work-Belated Injuries and illnesses U.S.Safety—dHreaffh labor <br /> eoermatbn+r Syfery and HeetHs 6eim1n/ctraKfon m <br /> W <br /> Farmappmved OMBno.1218-0176 (7 <br /> Ol <br /> Ol <br /> All estabilshmants covered by Part 1904 must compiele this Summary page,even lfno work-related injuries or illnesses occurred during the year.Remember to review the Log w <br /> to verify that the entries are complete and accurate before completing this summary Establishment information m <br /> Using the Log,count the individual entries you made foreach category.Then write the totals below,making sure you ve added the entries from every page of ffle Log.If you <br /> m <br /> had no cases,write"0." r�rw„wrt.�naRe�o Racanelli Construction South W <br /> Emp oyees,former employees,and their eprese lahves have the right to review the OSHA Form 300 in is entirety.They also have l tuned access to the OSHA Form 301 or Em er On H111 WS e <br /> ds equivalent See 29 CFR Part 1904.35,In OSHA's rocordkeeping rule,for further details on the access provisions for these forms. Strcec to <br /> v <br /> Cif, Apex state NC zip 27502 to <br /> W <br /> _ w <br /> • fndusny description(eg.,MwufaGUre of nwtor truck rmilen) v <br /> Total number of Total number of Total number of Total number of General Contractors Commercial Construction M <br /> m <br /> deaths cases with days cases with job other recordable M <br /> away front vwrk transfer or restriction cases Standard Industrial Chssifimdoa(SIC),Tk�novm(eg,3715) <br /> 0 0 0 0 1 5 4 2 w <br /> OR <br /> (G) (M O) (�) <br /> North Aincrican Industrial Classif7mtion(NAICS),if novan(c.g.,336212) <br /> —6—-2——1-� <br /> Number of Days <br /> Total number of days away Total umnbcr of days oEjob Employment information(Ifyou don't ham 1f sefigurer,see hie <br /> W.Eni rheet nn du hark ofdcr p{Qr to et*wte.) <br /> from work transfer or restriction <br /> 0 Ar7ntral average number ofemployms 5 <br /> 0 680Q <br /> (�1 CL) <br /> 0 Total ho=worked by all employees last year <br /> Sign here <br /> Injury and Illness Types <br /> Knowingly falsifying this document may result in a fine. <br /> Total number of... <br /> (M) 0 0 <br /> (1)Injuries (4)Poisonings f certify that I have examined this document and that to the best ofmy <br /> (5)Hearing loss 0 laowled n entrile rate,tru u and complete. <br /> (2)Skin disorders 0 (6)All other lllne58es <br /> (3)Respiratory conditions 0 <br /> {919 363-3600 4V 2/5/14 <br /> post this Summary page from February 7 to April 30 of the year following the year covered by the form <br /> r'uhlic repordngb,A=for this collection or tal'muation is estimated to average 58 mvmlu per,respooso,tndnding time w revt-the ivatracUcara,eevch end gntiher the dhua Headed,and <br /> complere and twin"the echoed..diorormhdiHO.'Panona am not xegf=d m,espead to the c&,,U mHrinfonn don emcee tt displays acuannOY v Bd OMB eomtrol mmbeclfyouhave y <br /> comments about lbeme vkrualoa or any odra aspects orthis data collectloa,contact:U5 Depunmeal of Lehor,OSHA Olt.ofSta M..l Anslytls,R000 N-36J4,200 Caastitutian.4veaoe,Iv'W, <br /> Was}dHgton,DC 20250.Do Hat srnd Nc wmplMad fomra eo Ibis u(Bc.r. <br /> .... .......... ..........._........................................... ........... ..._.. <br />