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There is no specific OSHA form named "5020." However, it is possible that you may be referring to a different form or there may be a typographical error in the form number provided.

The OSHA 5020 form, also known as the "OSHA Injury and Illness Incident Report," is required to be filed by employers who are covered under the Occupational Safety and Health Administration (OSHA) regulations. It must be filled out by employers who have knowledge of any work-related injury, illness, or fatality that occurs in their workplace.

The OSHA 5020 form, also known as the OSHA On-Site Consultation Program Employee's Request for Safety and Health Consultation, is used to request a safety and health consultation from OSHA's On-Site Consultation Program. Here are the steps to fill out the form: 1. Start by providing your personal information in the designated section, including your name, address, phone number, and email address. 2. Next, indicate whether you are an employee or employer requesting the consultation services. 3. In the "Employer Information" section, enter your employer's name, address, phone number, and email address. 4. Specify the type of industry your employer is involved in by selecting the appropriate option from the provided list. 5. If you have a specific concern or issue that you would like OSHA to address, describe it in detail in the "Description of Hazard" section. Provide specific information about the nature of the hazard and its potential impact on employee safety and health. 6. Indicate the type of consultation you are requesting by checking the corresponding box. You can choose from either a comprehensive consultation or a focused consultation. 7. If you have any special needs or requirements, such as the need for language interpretation services, mobility assistance, or other accommodations, note them in the "Special Remarks" section. 8. Review the certification statement at the bottom of the form and sign and date it to confirm that the information provided is accurate. 9. Keep a copy of the completed form for your records before submitting it to OSHA. Record the date of submission for future reference. 10. Submit the form to the appropriate OSHA On-Site Consultation Program office either by mail, email, fax, or by hand delivery, as specified by your local office. Remember to consult the specific instructions provided by the OSHA On-Site Consultation Program office in your state or region, as they may have variations in their procedures.

The purpose of OSHA Form 5020 is to report a complaint or referral to the Occupational Safety and Health Administration (OSHA). This form is used by individuals or employees who believe their workplace is not in compliance with OSHA regulations or presents hazards that could cause serious harm or death. The form allows individuals to provide detailed information about the alleged violation, the employer, and the worksite, enabling OSHA to investigate the complaint and take appropriate actions to ensure workplace safety.

The OSHA Form 5020, also known as the OSHA Log of Work-Related Injuries and Illnesses, must include the following information: 1. Employee demographics: Name, job title, department, and other relevant employee information. 2. Description of injury or illness: Detailed information about the nature of the injury or illness, including body part affected, cause of the incident, and whether the employee was hospitalized or required medical treatment beyond first aid. 3. Date of injury or illness: The date when the incident occurred or when the employee first became aware of the illness. 4. Duration of the employee's job transfer or restriction: If the employee was temporarily transferred to another job position or assigned work restrictions due to the injury or illness, the dates of such job transfer or restriction should be recorded. 5. Days away from work: The number of calendar days the employee was unable to work due to the injury or illness. 6. Death: If the incident results in the death of the employee, the date of death must be recorded. 7. Occupational Safety and Health Administration (OSHA) classification: The OSHA recordkeeping criteria may require the classification of the injury or illness as either "injury" or "illness" and "significant" or "non-significant." 8. Other relevant information: Additional information related to the incident, such as the treatment facility or other medical professionals involved, may be included if necessary. It is important to note that OSHA regulations and reporting requirements may vary based on the specific circumstances and industry. Employers should consult the appropriate OSHA guidelines and standards for complete and accurate reporting.

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