Request of Protection for Trade Secrets

This Notice is provided pursuant to Section 15 (“Confidentiality of Trade Secrets”) of the Occupational Safety and Health Act of 1970 (hereinafter referred to as the “Act”).

[Company name] is hereby notifying OSHA Inspector [print inspector’s name] (hereinafter referred to as “Inspector”) that it deems the materials listed below that were provided to Inspector in the course of the inspection as being or related to company trade secrets and requests that in accordance with the above-referenced Section of the Act, that said materials be held in confidence and not released in any way to the public. The Company intends to invoke and exercise all of the rights and protections afforded to it under the Act in order to ensure the confidentiality of said trade secrets.

Trade Secrets Provided

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Company Representative Signature: ___________________________
Date: ___________________________________________________

OSHA Inspector Signature: _______________________________________
Date: _________________________________________________________

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