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John Smith is a mechanic who works at sample auto parts incorporated in Keizer Oregon on Thursday August 19th he experienced lightheadedness in the maintenance shop and was provided a medical evaluation by physician the doctor discovered John had been exposed to carbon monoxide based on the physicians recommendation John didn't return to work until Wednesday August 25th so this is something we should enter into our 300 log first thing we need to do with any incident is to assign it a case number this is a number the employer or whoever is filling out the case assigns you don't need to get this from anyone else it's the number you give it will call this case number one so for every instance you'll have an employee's name now this is a privacy concern case you would not put a name here you would put a reference number or something you could tie this back to another OSHA 300 log where you could have the person's name kept confidential so it's only releasable to certain people the next block is a job title it doesn't have to be super complicated it could be welder painter support or secretary so if this person works in a maintenance shop we could label them as a maintenance worker the date of the injury is the date the incident happened or if you don't know when the incident happened you could put in the date it was diagnosed or the date when you found out about it always go back to the earliest possible time of when it actually happened in this instance we have a date listed of when the incident occurred so that's a date we'll put in August 19th the next block is where the event happened so we're in the premises was John Smith was seeing a loading dock the maintenance shop or the warehouse where did it actually happen sometimes you may not know especially if it's an exposure to something like carbon monoxide it could have been everywhere inside the facility in a case like that where you can't nail down precisely where the person was especially if it's everywhere just put where he normally is in this case it's a maintenance shop in the next block briefly describe the illness we don't have to get super complex here and you don't have to put a whole lot of detail just enough so it gives you an idea of what actually happened in this case you would put carbon monoxide poisoning the reason you don't have to get so complicated in this one is that we would be filling out an 801 form and that gives you a lot more space to flush out what actually happened in the 300 log it's less critical to have a lot of information about the incident because the 801 form will have that info in the next block we need to classify the case this is the most serious.