Appendix E - Required Elements for the Cal/OSHA Form 300A,
Annual Summary of Work-Related Injuries and Illnesses Equivalent
Form  A. Employers who are required to complete the Cal/OSHA
Form 300A may use an equivalent form that provides all of the
following information:  1. The number of cases:  (G) The total
number of deaths  (H) The total number of cases with days away
from work  (I) The total number of cases with job transfers or
restriction  (J) The total number of other recordable cases  2.
The number of days:  (K) The total number of days of job
transfer or restriction  (L) The total number of days away from
work  (M) Injury and Illness Types, the total numbers of:  1.
Injuries  2. Skin disorders  3. Respiratory conditions  4.
Poisonings  5. All other illnesses  3. Posting requirement
statement: "Post this Annual Summary from February 1 to April 30
of the year following the year covered by the form."  4.
Establishment information:  The establishment name  Street
address  City, State, Zip  Industry descri