OSHA Compliance Group, Inc

Custom made to your State’s OSHA Specific Requirements

Federal or local State OSHA - required Safety Manual or Injury & Illness Prevention Plan

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Please fill out the form below in order to complete your order. If you already filled out this customization form once - you do not need to fill it out again.

What is your Safety Manual order number? (not required)	From the invoice we emailed you. (not required)
What is the full name of your organization or company as you want it to print?
Please enter the name and email address of the person who is filling out this information.	Full Name: Email:
At which phone number you can be reached?
Alternate phone number that you can be reached?
Fax Number
How many employees does your company have?
Number of Company Vehicles?
Number of Forklifts?
Number of Supervisors?
What is your industry?	Other:
Please give a brief description of what your company or business does.	(500 characters max)
Does your company require a pre-employment physical or drug screen?
If you have an eyewash where is it located?
Where will all the safety notices be posted?	Examples: in the break room, on the bulletin board, next to the time clock, in the job site trailer, in the office.
Do you have a 1st Aid Kit?
Where is the First Aid Kit located?
Where will the "Material Safety Data Sheets" be kept?	(Example: on the bulletin board)
How many employees are on the safety committee?
How often does the safety committee meet:
How much time between routine safety checks?	Other:
How much time between safety meetings with all of the employees?	Other:
If Tailgate Safety Meetings or Toolbox Talks are performed, how often are they done?	Other:
Where will the emergency phone numbers be kept?	Examples: in the break room, on the posters, next to the time clock, in the job site trailer, in the office, next to each phone location.
What is the name of the RSO? (Responsible Safety Officer)	Who is the person that will be responsible to implement the company safety program. OSHA wants to have a specific name of an individual.
What is the title of the person who will be conducting the safety meetings?	Other:
What is the physical address of your company? This address will appear on the cover of your Safety Manual.	NO P.O. BOXES Address City State Zip
Are there any special considerations or concerns you have that need to be addressed in your safety manual?	(500 characters max)
Please tell us how did you find out about SafetyManual.com's web site?	Other:

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