Minnesota Safety Council: Governor's Award Application

Examples of How to Distinguish By Location and By Function
Example 1 – how to distinguish by location
My Company, Anoka
My Company, Fridley
My Company, St. Paul

Example 2 – how to distinguish by function:
My Company, Parts Manufacturing
My Company, Adhesives
My Company, Final Production

Choosing an NAICS Code
Your reporting code will be a North American Industry Classification System (NAICS) code chosen from the drop-down menu on the application form. Please choose a reporting code that corresponds to an industry that has a hazard exposure that is similar to yours.

Years of Data Required
Please submit annual information for the past three years. Report Minnesota figures only for calendar years 2005, 2006, and 2007. NOTE: If you submitted data last year, check that box on the application. You will then only be required to enter last year’s data.

Definition of DART Cases and OSHA Recordable Cases
For purposes of this awards program, DART (Days Away Restricted Transferred) cases are cases which involve days away from work, days of restricted work activity, and/or days of job transfer.

OSHA recordable injury and illness cases are those which require recording on your OSHA Log of Work-Related Injuries and Illnesses (300 Log). Criteria for deciding whether to record cases on your OSHA 300 Log can be found by clicking the "Regulatory Text" link at www.osha.gov/recordkeeping/index.html. The Minnesota Safety Council also presents a workshop on OSHA recordkeeping. Information can be found at www.minnesotasafetycouncil.org/courses/courses.cfm.

Formulas Used to Calculate Incidence Rates
Rates will be automatically calculated for you based on the data you enter. For reference, here are the formulas that are used.

Recordable Case Incidence Rate:
Total number of entries on 300 log, multiplied by 200,000, then divided by the total hours worked by all employees during the year covered.

DART (Days Away Restricted Transferred) Rate
Number of CASES with days away from work or job transfer or restrictions (cases on 300 log with either column H or I checked) multiplied by 200,000, then divided by total hours worked by all employees during the year covered.

Award Categories
These are the categories of awards for which your organization may be eligible:

• Meritorious Achievement—Based on better than average incidence rates, and answers to screening questions.
• Outstanding Achievement—For continuing improvement and/or a continuing outstanding record.
• Award of Honor—Highest level of award; presented for exceptional accomplishment in reduction of injuries and illnesses in the workplace.