Agency Schedule Detail

Authorization Number : 800-0848

Agency Series No. : 51-05

Status : Active

Agency Web Link :

Agency : COM

Confidential Description : This report is generated by the hospital or treatment facility for persons who are burned or killed in a fire or explosion.

Division : COMOFA1

Vital Description :

Section : COMOFA1INVB

Record Title : OHIO BURN INJURY REPORT – COM 5146

Revision : 0

Record Description : ORC 2921.22 - Requires hospital personnel to complete this report and send to the Division of State Fire Marshal within three working days after treating a victim of a suspicious burn.

Retention Period	Retention Justification	Media Code	Method of Disposal
If report is affiliated with an open investigation, incorporate electronic copy with case file and apply appropriate schedule thereafter. Retain all other electronic records indefinitely.	This report is generated by the hospital or treatment facility for persons who are burned or killed in a fire or explosion. Information and data contained therein may be used as an investigatory and case intelligence tool for future case reference. Injuries reported on this form are cross referenced with other cases. Due to the low quantity received annually, digital resource usage is limited.	Electronic	Delete
Enter data in computer system, scan original document into machine readable format. Upon confirmation scanned copy has been checked for quality and completeness, destroy paper copy		Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Holly Johnston	Records Officer	7/12/2024 10:10:03 AM
Approved	Terri Dittmar	Record Administrator	7/15/2024 12:10:28 PM
Approved	Martin Meeks	State Auditor	7/16/2024 8:26:57 AM
Approved	Fred Previts	State Archivist	7/16/2024 4:32:02 PM

Notes

Date	Reason	User