OSHA 10 and 30-Hour Card Verification Log

Per-employee log for verifying OSHA 10 or 30-Hour Outreach card details, including card number, trainer ID, issue date, and replacement window for jobsite credential checks.

Employee Identification

• Employee Name
• Employee ID
  Optional internal ID for matching records without collecting additional PII.
• Job Title
• Worksite or Project

OSHA Outreach Card Details

• OSHA Outreach Course Level
• Card Number
  Enter the OSHA Outreach card number exactly as shown on the card.
• Trainer ID
  Trainer ID printed on the card or training record.
• Card Issue Date
  Use the date printed on the card or the official issue date from the training record.
• Replacement Window
  Select the current replacement status if the card is lost, damaged, or nearing expiration for site policy purposes.

Verification and Jobsite Status

• Verification Status
• Verified By
  Optional verifier name or department for internal audit trail.
• Verification Date
• Jobsite Access Notes
  Use this field for exceptions, follow-up items, or site-specific credential requirements.

Consent and Submission

• Consent to collect and store this information for jobsite credential verification
  This form collects limited PII for compliance and audit trail purposes only. Information will be used to verify OSHA Outreach card details and manage jobsite access.
• I confirm the information entered is accurate to the best of my knowledge