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If you currently have a pending IOSHA inspection, please do not submit a request for consultation until you have received either: A) A letter from IOSHA confirming you are free from violations or B) A safety order detailing any violations.
Required Company Name:
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(Found on OSHA 300A Log)
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Required Company Mailing Address:
Required City:
Required State:
Required Zip:
Ex: 12345-6789 or 12345
Is the site of the actual
inspection different from
the site above?

Company Web Site:
(If Available)
Required Contact First Name:
Required Contact Last Name:
Title:
Required Contact Phone:
Ex: (317) 555-1234 or 555-1234
Contact Fax:
Ex: (317) 555-1234 or 317-555-1234
Required Contact's Email:
Ex: someone@somewhere.com
Type of Business:
Required Please describe your
business activities:


Number of Employees
At This Site:
Total Number of Employees Company Wide:
Scope of Consultation:



Attach Your OSHA 300 Logs Here

File types accepted: Microsoft Word and Excel, PDF, and Word Perfect. Maximum file size is 5MB. If you have more than one file to attach or your file exceeds 5MB, please zip your file(s) to reduce the size to under 5MB. If the files are too large to be uploaded when zipped, please email them to insafe@dol.in.gov.
2012 OSHA 300 Log
2012 OSHA 300A
Summary Sheet
2011 OSHA 300 Log
2011 OSHA 300A
Summary Sheet
2010 OSHA 300 Log
2010 OSHA 300A
Summary Sheet
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