Document M49wbG99mkkkzyMOybGY9mnL

CHEMICAL MANUFACTURERS ASSOCIATION -< February 12, 1985 To: Subject: Occupational Safety and Health Contacts Occupational Injury and Illness Report Signers Application for Certificates of Achievement and Honor I am enclosing an application form and cover sheet for CMAJIertificates-of Achievement and Honor. The accuracy in submission of the application form Is essential. WKat you enter on this form will be copied on the finished Certificate. Please enter the name of the installation on the first line, followed by the Division, and the Company precisely as it should appear on the Certificate. Directions for completing your application are on the back of the application form. Please call me (202/887-1275) or Melissa Winter (202/887-1283) if there are any questions. If you are no longer responsible for such matters, please forward this correspondence to the appropriate person as soon as possible. Your cooperation in forwarding the application and cover sheet to CMA by March 15, 1985, will be greatly appreciated. I will attempt to process and return the Certificates to you as soon as possible. Sinrprftlv Milton Freifeld 1/ Associate Director Health, Safety and Chemical Regulations MF :mw cc: Safety Standards Task Group Safety Statistics Work Group received FEB 1 5 il'35 QP ^ c r' BOR 007676 Formeily Manufacturing Chemists Association--Serving the Chemical Industry Since 1872. 2501 M Street, NW Washington, DC 20037 Telephone 202/887*1100 Telex 89617 (CMA WSH) CHEMICAL MANUFACTURERS ASSOCIATION Cover Sheet CERTIFICATES OF HONOR/ACHIEVEMENT TO: FROM: TDatel CHEMICAL MANUFACTURERS ASSOCIATION Attn: Milton Freifeld 2501 M Street, NW Washington, DC 20037 (Name of Organization) (Person Submitting Report) (Street or POB Mailing Address) (City, State and Zip Code) ( ) (Area Code, Phone Number, and Extension) Attached is a list (in triplicate) of our facilities which merit either a CMA Certificate of Honor or Certificate of Achievement for the previous calendar year. We have submitted the previous calendar-year's injury and illness statistics to CMA by separate mail in accordance with eligibility requirements. In addition, each of the facilities listed on the attached form(s) worked a minimum of 20,000 employee hours during the year. Units such as company office, sales office, and others not directly associated with an operating plant or laboratory were not included. Parts or divisions of a plant or sections of a laboratory also were not included. Those facilities meriting the Certificate of Honor had zero deaths and zero lost workday cases (away from work or restricted activity) according to current OSHA guidelines. The Certificates of Achievement are for those facilities with zero deaths and zero lost workday cases involving days away from work. The attached forms were prepared in triplicate according to the instructions on the reverse side of the application form. I understand that incorrect applications will be returned without further action. The listing is true and correct to the best of my knowledge. Attachment(s) MUST BE RECEIVED AT CMA BY March 15, 1984 2/85 (rev) (Signature) BOR 007677 SUBMIT IN TRIPLICATE CHEMICAL MANUFACTURERS ASSOCIATION APPLICATION FOR FACILITY CERTIFICATES OF HONOR/ACHIEVEMENT _______________________________ (Company Name) (Date) Full Facility Identification to Appear on Certificate____________ City & State Page_____of TYPE OF CERTIFICATE (Check One Only) Honor Achievement 2/85 BOR 007678 I CHEMICAL MANUFACTURERS ASSOCIATION APPLICATION FOR FACILITY CERTIFICATES OF HONOR/ACHIEVEMENT INSTRUCTIONS Form is to be submitted in triplicate. First copy is used to prepare certificate. Second copy is used for national publicity. The final copy is retained for reference purposes. First Column: Enter the full identification of the facility EXACTLY AS IT IS TO APPEAR ON CERTIFICATE. The identification should be limited to 3 lines. One cop/ of the application will be used for preparation of the certificates. Therefore, PLEASE BE SURE THAT SPELLING, PUNCTUATION, AND FORM ARE CORRECT. ERRORS WILL BE REFLECTED IN THE FINISHED CERTIFICATES. Examples: Brownwood Laboratories Industrial Chemicals Division XYZ Industries, Inc. Jonesboro Plant Smith-Frank Chemical Company A Division of The Smith-Frank Company Second Column: Enter the location of the facility by city and state. This will be used to prepare a press release for each state. Third Column: Indicate the type of certificate earned by the facility (Honor or Achievement). 2/85 BOR 007679