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Industrial Safety Engineering

75 pages and I need it in 14 days …

TECH462 Industrial Safety Engineering

Department of Engineering and Design

Eastern Washington University

Winter Quarter 2013

Accident Prevention Plan (150 points)

Assignment:

You are to complete an accident prevention plan for a company. The Complete list of content/sections to be covered is listed in the contents section below. The company profile, which you need to match to the content/sections, is listed in the company profile section below. The expected finished length of this assignment is from 75 to 100 pages.

Formatting:

Body Text Size: All of the body text in this assignment needs to be set in 12-point size. Please resist the temptation to mix and match point sizes.

Header Text Size: All of the header text in this assignment can be set in 14-point or 16-point size. Please resist the temptation to mix and match point sizes. Pick your text size and use it consistently throughout the assignment.

Double Spacing: For this assignment select all of your text and set it for double spacing. This includes the headers and body of your work. This allows space for marking up or making notes while I am reviewing what you have written. This also helps to make the document more readable. (The exception to the double spacing is the text on the title page.)

Page Margins: Set your pages to one-inch margins. One-inch margins mean one (1”) on all sides. The only text that ends up on the outside of the one-inch margin is the page number.

Title Page: This page will contain the title, “Accident Prevention Plan”, and the name block. Place the title in the center, right to left and about one-third the way down the page.

Name Block: Place the name block in the center, right to left and about two- thirds the way down the page. Put your
name first
, then the
class title
and then the
date
. Example:

Your Name

TECH 462 –Industrial Safety Engineering

March 18, 2013

Spelling/Grammar Checking: Remember to do your spelling and grammar checking before turning your assignments in. When doing the spelling/grammar checking keep in mind that some words such as mush and must, woods and words, or here and cow, will not be caught by either check. To correct these problems, you will need to proofread your work.

Page Numbers: Any assignment that has more than one page, needs to have page numbers on it. Please place your page numbers on the bottom of the page. In MS Word, use the footer selection and place the page number
in
the
bottom

center
or
bottom right
of the page.

Content: (Major Contents/Sections Check-Off List)

___ 1. Title Page

___ 2. Table of Contents Page

___ 3. Divider Pages

___ 4. Introduction

A. Purpose & Intentions

B. Company Presidents Statement

___ 5. Management Responsibilities

A. Manager Responsibilities

B. Supervisors Responsibilities

___ 6. Employee Orientation

A. How and When

B. Emergency Action Plan

C. Emergency Shutdown Procedures

___ 7. Injury and Illness Procedures

A. Procedures

B. Record Keeping

C. Supervisor Responsibilities

D. Report Form

___ 8. Incident/Accident Investigation Procedures

A. Procedure Steps

B. Worksheet Form

C. Incident/Accident Table

___ 9. Safety Guidelines

A. General Guidelines

B. Equipment Specific

C. Individual Specific

___ 10. Safety Disciplinary Policy

___ 11. Safety Awareness Program

A. Safety Committee

B. Safety Meetings

C. Safety Training and Forms

D. Safety Award Program

___ 12. Appendices

A. MSDS

B. State & Federal Posters

C. OSHA Forms and Instructions

Company Profile:

Company Size: 350 employees

Company Product: Custom manufacture of industrial hardened computers (CPU, Keyboards, etc)

Processes at factory include:

Circuit board assembly

Circuit board production

Metal case production

Plastic forming processes

Plastic pellet storage and transport to machines

Shipping/receiving

Specific equipment in factory:

Air compressor

Conveyors

Electric forklift

Hoists

Metal punch presses

Metal bending and cutting machines

Plastic injection molding machines

Plastic sheet forming equipment

Shearing machine for sheet plastic

Safety Promotion Budget: $8,000 annually

Saving/Naming Your File:

When you save your file, make sure that your name and the project number are included in it.

Example: YourName462APP

Because of problems with Blackboard, please use only letters, numbers and no spaces in the file name.

Due Date: Monday, March 18, 2013 no later than 11:59 p.m. on the due date.

(Late work for this assignment will be accepted up to March 22, 2013 (Last day of the quarter) with a 10% reduction in value.)

Revised 1/7/13 JM

Accident Prevention Plan

(Your Name)

TECH 462 –Industrial Safety Engineering

March 18, 2013

Table of Contents

Introduction

Purpose & Intentions Page x

Company Presidents Statement Page x

Management Responsibilities

Manager Responsibilities Page x

Supervisors Responsibilities Page x

Employee Orientation

How and When Page x

Emergency Action Plan Page x

Emergency Shutdown Procedures Page x

Injury and Illness Procedures

Procedures Page x

Record Keeping Page x

Supervisor Responsibilities Page x

Report Form Page x

Incident/Accident Investigation Procedures

Procedure Steps Page x

Worksheet Form Page x

Incident/accident Table Page x

Safety Guidelines

General Guidelines Page x

Equipment Specific Page x

Individual Specific Page x

Safety Disciplinary Policy

Safety Disciplinary Policy Page x

Safety Awareness Program

Safety Committee Page x

Safety Meetings Page x

Safety Training and Forms Page x

Safety Award Program Page x

Appendix A: Material Safety Data Sheet

(Insert Name of Product) MSDS Page x

Appendix B: State and Federal Posters

(Insert Name of Poster) Page x

(Insert Name of Poster) Page x
(Insert Name of Poster) Page x
(Insert Name of Poster) Page x
(Insert Name of Poster) Page x
(Insert Name of Poster) Page x

Appendix C: OSHA Forms and Instructions

OSHA Form Instructions Page x

OSHA Form 300 Page x

OSHA Form 300A Page x

OSHA Form 301 Page x

Introduction

(Insert your text here)

Management Responsibilities

(Insert your text here)

Employee Orientation

(Insert your text here)

Injury & Illness Procedures

(Insert your text here)

Incident/Accident

Investigation Procedures

(Insert your text here)

Safety Guidelines

(Insert your text here)

Safety Disciplinary Policy

(Insert your text here)

Safety Awareness Program

(Insert your text here)

Appendix A:

Material Safety Data Sheet

(Insert your text here)

Appendix B:

Material Safety Data Sheet

(Insert your text here)

Appendix C:

Material Safety Data Sheet

(Insert your text here)

AccidentPrevention Plan

(Ghanim Alzaria)

TECH

2 –Industrial Safety Engineering

March 1

TABLE OF CONTENTS

INTRODUCTION

Company President Statement

Purpose and Intention

MANAGEMENT RESPONSIBILITITES

Management

Supervisors

All Employees

EMPLOYEE ORIENTATION

SAFETY & HEALTH COMMITTEE

SAFETY BULLETIN BOARD

SAFETY ORIENTATION

ACCIDENT INVESTIGATION AND REPORTING

SAFETY AND HEALTH EDUCATION TRAINING

INJURY AND ILLNESS PROCEDURES

Injury and Illness Reporting

Injury and Illness COMMUNICATIONS PROGRAM 31

Hazard Communication Program (HAZCOM)

List of hazardous chemicals

Material Safety Data Sheets (MSDS)

Container Labeling

Employee information and Training

Safety Guidelines

1. Building Administrators and Supervisors

2. Supervisors

3. MSDS manager

4. Human Resources

6. Subcontractors

7. Science Teachers

8. All Employees.

EMERGENCY ACTIONS

HAZARDOUS ENERGY CONTROL PROGRAM (lockout/tag out)

Lockout/Tag out Program

PERSONAL PROTECTIVE EQUIPMENT

Personal Protective Equipment (PPE) PROGRAM

FIRST AID

HEARING CONSERVATION PROGRAM

CONFINED SPACE PROGRAM

Sample Safety Assurance Forms

JOB SAFETY ANALYSIS

FORM

JOB SAFETY ANALYSIS

ORIENTATION/JOB SAFETY CHECK LIST

Record of hazard observed

Safety Committee Meeting Minutes

REPORT OF ACCIDENT/INCIDENT

ACCIDENT CAUSATION GUIDE

ABBREVIATIONS

Appendix A: Material Safety Data Sheet (Sample)

Appendix B: State and Federal Posters

Appendix C: OSHA Forms

OSHA FORM 300

OSHA Form 300

Log of Work-Related Injuries and Illnesses

Year 20

OSHA FORM 300A

OSHA Form 300A

Summary of Work-Related Injuries and Illnesses

Year 20

OSHA FORM 301 – Injuries and Illnesses Incident Report

INTRODUCTION

Company President Statement

There has always been a policy for the provision and promotion of safety in the district, best practices that are medically perfect for the employees in a workplace. Focus of our major responsibilities is on the health and safety factor.

Employees would be fully introduced to our safety policies, given complete set of information on it and also would be trained in order to fulfill our safety policy for their prosperity. Prevention is the best recommendation that is the solution to all health and safety issues which is focus of our policy.

It is the sole duty of administration to ensure the initiation of an efficient program for health and safety measures.

Our district has regulated some laws that define a premises in which performance could be given under safe circumstances while using the tools that are possession of the district We try with our best efforts for the welfare of our personnel and for the development of the district, by agreeing and undertaking this dual responsibility of safest and best practices in our operations.

SUPERINTENDENT

Purpose and Intention

The main purpose to cultivate this accident control program is that so it could deploy the policies and regulations for the health and safety precautions of the district. The components of this program are designed in that manner so they shelter a wide range of precautionary measures for accidents and subsequent damages. If we observe these components, might have a very minor impact. But if it is examined as a complete solution package, it can minimize the quantity and the consequential damages that occur while doing a job and face by the employees of the district, and only could be realized if there is a support from all levels of district employees.

MANAGEMENT RESPONSIBILITITES

A. Management

It is the sole duty of every administrator to deploy the appropriate health and safety measures within the allotted territory. Some of the duties are given below:

1. Assigning the supervisors and auditing them for the precautionary measures for accidents, also to evaluate the reporting methodologies that are prescribed.

2. Surety about the completion of the introductory exercise to safety program, also the running safety training program in their territories.

3. Check whether the vehicle safety program is in process or not in their region.

4. Confirm the compatibility with WAC296-800-32005, which deals with the reporting of the mortalities or various accidents that are hospitalized.

5. Privately provision of the safety toolkit so a task could be completed without any medical risk.

B. Supervisors

It is the sole duty of every supervisor to administer the safety and health problems for their employees. In order to fulfill this duty they should:

1. Confirmation on the complete evaluation on all regulations for safety and health, the benchmarks and practices involved.

2. Employees familiarity and training provision under best practices and safe environment, evaluate that they have learnt accurately.

3. Plan to accept feedback from the employees and the committee that deals with safety, also an aptitude to involve suggestion in practice.

4. In order to eliminate dangerous issues, monthly audits of workplaces and surroundings should be conducted. Safety committee should receive reports from them with their recommendations.

5. With a little heed all accidents should be interrogated. A final report on the “Supervisors Report of Investigation” should be delivered to the committee and the coordinator who deals with the claims, along with the precautionary recommendations. Deadline for this report should be 24hours or it could be the next working day right after the information about the accident primarily came to the supervisor.

6. While the task is going on, availability and possession of private precautionary toolkits are on them or not.

7. Whenever on requirement basis a Safety Analysis should be piloted.

C. All Employees

It is the duty of employees to:

1. Show their presence in the primary introductory programs, also the training programs of relevant job skills.

2. They should be aware and capable to obey all regulations based on safety measures.

3. In order to provide support in mishaps, they should support and liaise with the other employees, their supervisors and the safety committee

4. Must find and tell the relevant people about the major threats.

5. On duty supervisors should be instantly reported in any case of accident, it doesn’t matter what the type or the level of accident. (Note: In case of failure of delivery of the report about the industrial injury, occupational illness, vehicle accident or equipment damage may result in a disciplinary action)

6. The deadline of any accident report is 24 hours or upcoming working day, within that time it should be completed and delivered on the table of the supervisor.

7. When a safety committee is in action or is being elected, they should cooperate with them fully.

8. A safe should be maintained in which the toolkit for precautionary measures and safety should be always ready so could be used anytime and worn when the task is allotted.

9. Mandatory to cooperate and work out in safety exercises.

10. A safe methodology should be designed to carry out all given tasks so they might night get into any hazardous condition along with other employees.

EMPLOYEE ORIENTATION

SAFETY & HEALTH COMMITTEE

1. The members of the Safety Committee will be selected on the decisions based on selection from employer and the employees. (WAC 296-800-13020).

(a) The member elected by the vote of employees can stay maximum for one year. In case when a new empty position is originated in the committee, a new member would be chosen before the upcoming meeting is scheduled.

(b) There would be an equilibrium in quantity of posts that are elected by the employer and the employees.

2. A chairperson would be elected for the Safety Committee.

3. It is the duty of the safety committee to decide the number of meetings in a year, minimum number is four in a year held after every three months.

(a) It is the role of the committee to decide the date, time and venue of the meeting.

(b) Unless the majority of the members vote, the time for a meeting would not cross more than an hour.

4. After the completion of the notes and the message to be delivered in a meeting, its file would be available to be reviewed by the noncompliance members from the Division of Industry Safety and Health for minimum of one year.

5. In the meetings of Safety and Health following would be discussed:

(a) In finding the effective unsafe points and practices, the summary of the safety and health report assist a lot.

(b) An evaluation of the accident investigations conducted since the last meeting to determine if the cause of the unsafe acts or unsafe condition involved was properly identified and corrected. Review and investigate any hazard reports received either orally or in writing.

(c) The interrogation made on any mishap would also be audited in relevance to the previous meeting so that it could be found that the mishap happened due to any unsafe act or not. Any danger identified tin that report should be verified and researched properly either in verbally or in documentation.

(d) Feedback given by employees on safety would be judged too.

(e) Presence and absence of members will be recorded on a sheet.

(f) Documentation would be done for every point that is discussed.

6. The notes of the meeting will be delivered to each bulletin board where it is necessary.

SAFETY BULLETIN BOARD

A. Purpose: In order to boost the level of awareness about the subject of safety and health problems, to set a platform where management could deliver information collectively, among the employees a bulletin board is placed physically.

B. Procedure Following steps should be followed while making a bulletin board effective source of communication:

a. On a bulletin board, there should be a specific portion reserved specifically only for the data to be displayed in relevance to safety issues.

b. Information should be displayed in such manner that they look attractive to employees.

c. Occasionally the board should be checked that it should not display the information like posters or notes from the safety committee that are out of date.

d. The board should be planted on that point in the workplace where it can grab the attention of maximum people just like the café, time office, etc.

e. In relevance to above statements, every spot should have a separate bulletin board.

C. The following will be posted:

1. WISHA poster P-416-081-000 (Job Safety and Health Protection)

2. Industrial Insurance poster F207-037-999 (Notice to Employees Self-Insured)

3. Reference and Notice (as applicable)

4. A list of all valid first aid cardholders and location(s) of first aid kit(s)

5. Most current safety committee meeting minutes

6. Hazard reporting form

SAFETY ORIENTATION

Purpose: Introduction of new employees, re-employs, part-time employees, substitutes, temporaries and those exchanged from an additional department inside the district will happen the first day of employment on the new job. This system will give a presentation of district policies and regulations, and will incorporate assessing the district’s composed safety and claims management techniques. The introduction may as well incorporate a tour of the facilities to familiarize the representative with the whole processing. The worker can additionally be informed regarding their job performance adequacy level.

Procedure: The working on-duty supervisor of the employee will furnish job particular security training, coating all parts of the security project as it identifies with every employee and their appointed duties. The relevant training can be commented on a “Safety Orientation” checklist. Both the employee and supervisor will attest, demonstrating that introduction was done effectively. The definitive sign-off sheet could be sent to the office for document position and supervisors will hold a duplicate for their bureau documents.

ACCIDENT INVESTIGATION AND REPORTING

A. Purpose: If we observe the situation of any accident, we’ll be able to find that it was a due to a sequel of interconnected reasons, and there is also a sign of possibility that if we identify this series of consequential reasons, we could reduce accidents. Even if we try to vanish a single reason, we might be able to halt the whole event. All possibilities of such evolving reasons and consequences must be extracted in any interrogation that is being conducted by the supervisor and after that appropriate steps should be taken in order to eliminate all such conditions. (i.e., investigate, report, correct, etc.)

B. Medical Emergency Procedure: In any case when the employees need any sort of assistance and support in such condition, an aid car will be there for them. All just they have to do is to dial
9-911
. There will be an officer from the district who’ll take the employee to nearest doctor or hospital.

C. Documentation Procedures:

1. Report of Accident/ Incident form is a document that records very information about the accident, even when anyone receives minor bruises in any accident or even “near-misses”. Following this form, when the Supervisor’s Report of Investigation is accomplished, only then a supervisor will interrogate the scenario.

2. Minor Injuries – (Requiring doctor/outpatient care.) It is the sole duty of the n duty supervisor to interrogate the accident and search for the on the spot witnesses after the taking emergency actions for that accident, so the main cause of accident could be found. All gathered results would be noted down on that Supervisor’s Report of Investigation form. Accomplished forms will be distributed in given manner:

a) Copy to the District Liaison

b) Copy to the Safety Committee Chairperson

c) Copy to Puget Sound Workers’ Compensation Trust

C. Documentation Procedures: (continued)

3. Major Injuries – (Fatality or multiple hospitalizations)

a. It is the duty of the on duty officer to report and tell the supervisor and the contact of the district urgently and the process of interrogation should be conducted under the regulations specified by the district. The team who’ll interrogate will not only include the district investigator, but also comprise of claims manager, a supervisor who deals in the case of injured people, is also a member who represent from the side of safety committee (supervisor-staff), also a member who is current employee.

b. On account of a casualty, or depending on if one or more employees are hospitalized, the supervisor will urgently report the accident to the closest office of the Department of Labor and Industries, telephone number 1-800-423-7233 within a deadline of eight hours after the mishap has happened. The accomplished report ought to identify the conditions, the number of fatalities and the degree of any damages. Note: If there is some sort of gear included in an accident bringing about a prompt casualty is not to be moved until an agent of the Department of Labor and Industries researches the accident and authorizes its evacuation. In the event that, be that as it may, it is essential to move the gear to avert extra accidents or to evacuate the one who faced the situation, the gear may be moved as needed.

4. “Near Misses” – (likelihood of personal injury or property damage) to the maximum limit in real, every single “near-miss” mishaps should be researched by the administrator/supervisor or safety committee agent. Documentation can be made on the
Supervisor’s Report of Investigation form
. A “near-miss” mishap is characterized as an unplanned occasion where harm came, yet there was no private injury to workers, or where harm did not come about however the probability of private injury to the worker was extraordinary. In such event, the conditions that allowed the “near-miss” or “close-call” to exist are not halted, they can further press on to be an issue, which might bring about mishaps or alternately private injury to the employee(s) in coming period.

SAFETY AND HEALTH EDUCATION TRAINING

A. Purpose: In order to enhance the level of responsiveness or the workers and employees in relevance to the mishaps based on routine issues, the provision of currently running modules on safety and health awareness will be ensured. This activity will not only boost the self-esteem of the employees through underlying mission of the management at personal level but also assists in agreeing to control and taking precautionary steps towards mishaps, perceiving these steps as a good and necessary point in every program.

B. Procedure: A properly designed precautionary training will be delivered on all sorts of mishaps by the institution district for the welfare of workers. In workplaces, a specialized on-the-job training will be delivered to workers under this module that will assist to acquaint every worker with the prescribed regulations of the district’s health and safety program.

C. General Safety and Health Training:

Back Injury Prevention

Blood borne Pathogens

Slip and Fall Prevention

Repetitive Trauma/Ergonomics

Fall Protection and Ladder Safety

Personal Protective Equipment

Eye Safety/Hand Safety

Respiratory Protection

Hearing Conservation

Machinery

Sprain/Strain Prevention

Hazardous Chemical Safety

Confined Space

Lockout/Tag out

D. Specific Safety and Health Training:

AHERA required Designated Person course (8 hours)

AHERA Custodial and Maintenance Worker course (2 hours)

L & I Asbestos Worker certification course (30 hours)

OSHA/WISHA Forklift Operator course

DOE Hazardous Material Handler course

WISHA Hazard Communication Standard and MSDS training

EPA Pesticide Applicator course

Chemical Hygiene Officers training

INJURY AND ILLNESS PROCEDURES

Purpose: Under the principles of federal & state that have been accepted, notes about the work-related harms and medical issues are recorded. On yearly basis they’re dispatched so the employees and the workers could be notified about the various types of disorders and the harms that could occur at certain workplaces.

Procedure: A fractional exclusion has been provided to educational institutes in maintaining the accounts on necessity of controlling the job-relevant physical mishaps and medical issues. There might be a chance that the district is nominated to intrude in a feedback program based on statistics collection. In this scenario, US dept. of Labor will inform the district about the nomination of the previous year in relevance to the survey conducted for the purpose of acquiring the information.

Injury and Illness Reporting

Purpose: In order to provide every worker a chance to inform and record without any tension of indirect punishment, about any action that is not good for others or similar situations too.

Procedure: It is to inform that workers are required to provide information to the on-duty supervisor or directly to the safety committee. Information about any danger should be delivered in any form whether it is written or even verbal. On specific harms, it is the duty of the supervisor along their safety committee to analyze, check a then take relevant step to eliminate it. In case of battement for the harm, the originator will be reported about every step for that purpose. In the notes of meeting done by the safety committee, all those steps taken for eliminating any harm would be codified.

Injury and Illness COMMUNICATIONS PROGRAM

Purpose: The reason to initiate a Program for District Hazard Communications is to ensure all the workers are reported about the harms that could be caused due to chemicals and relevant products that are utilized in the workplaces.

Procedure: It is must for the workers to get trained in their initial introductory training session under the District Hazard Communication Program that is to be conducted by a supervisor. Employees and workers would be reported frequently on the harms and dangers because of any contact with the products that are being utilized in the production process. In order to present the major hazards that can be dangerous medically, including the ailment provided by first aid, the necessary elements and tools required for personal precautionary measures and all those steps to control a mishap; a Material Safety Data Sheets (MSDSs) would be utilized. A session of training would be delivered by the victims and specialized personnels whenever a new item is to be introduced in the workplace. In that specific workplace all data regarding the MSDS sheets would be stored and updated.

Hazard Communication Program (HAZCOM)

This district is dedicated to the avoidance of exposures that bring about harm or alternately sickness; and to follow all appropriate state health and safety standards. To verify that workers ponder informative data concerning the dangers of all risky chemicals utilized by the district, the accompanying dangerous chemical communication program has been made.

List of hazardous chemicals

A record of afflict unsafe chemicals is kept in the front of the MSDS folder at every destination. There must be enough informative content on the record to match every substance to its MSDS. The record is upgraded every year, and old records are continued record at the area office. Chronicled records for every destination could be documented by year or in other case, demonstrate dates of utilization of every substance. 30 years is the duration of storage for stored data.

Material Safety Data Sheets (MSDS)

In case for each unsafe chemical during that time frame the chemical is gotten, an MSDS could be acquired. No chemical could be collected for storage or utilized without an MSDS.

Duplicates of MSDS for all risky chemicals in utilization could be kept in the locale MSDS manual and at the office of the district. Depending on if any vehicle customarily conveys a perilous chemical (for support, cleaning, and so forth.) an MSDS could be upheld in the vehicle for the perilous chemical conveyed. MSDS could be ready to all workers throughout every work movement.

The regional office will keep a duplicate of all MSDS for no less than thirty years. The aforementioned records are cushion of the presentation records. The records, which incorporate the chemical record by year, must portion the chemical, where it was utilized and when it was within utilization.

Container Labeling

There should be easily understandable tags and labels on the containers of the dangerous chemicals. Labels must have:

1. The name of the chemical or common name (adequate information for finding the MSDS) and

2. General information regarding the health and physical vulnerabilities of the chemical.

Whenever it would be probable, only the originally labeled container will be utilized. In a condition if it is not possible to read the original label, it would be changed and replaced.

Whenever an amount of material is moved into a non-labeled container for utilization, it ought to be just in an amount that could be utilized throughout the movement by the individual making the exchange. In the event that the chemical is kept in the compartment till the shift ends, it must be labeled.

Assuming that amounts of materials are to be utilized as a part of compartments other than the definitive labeled container they must be plainly labeled.

No containers can be kept without a name precisely portraying the elements.

Employee information and Training

It would be ensured by the supervisor that every worker and employee should show his or her presence in the introductory program of safety and health before they get to work, they should also be delivered the necessary information about every chemical that relevantly they might get exposed to at the location of work:

· An overview of the requirements contained in the Hazard Communication Standard;

· Hazardous chemicals present at his or her work places;

· Physical and health risks of the hazardous chemical; The symptoms of overexposure;

· How to determine the presence or release of hazardous chemicals in his or her work area;

· How to reduce or prevent exposure to hazardous chemicals through use of control procedures, work practices, and personal protective equipment;

· Steps the employer has taken to reduce or prevent exposure to hazardous chemicals;

· Procedures to follow if employees are overexposed to hazardous chemicals;

· How to read labels and review MSDS to obtain hazard information; and

· The location of the MSDS binder and written hazard communication program.

It would be ensured by the Supervisor that every employee should receive the updated training session in case of change in the usage of chemicals.

Safety Guidelines

1. Building Administrators and Supervisors

a. Maintain a list of hazardous chemicals used or stored in their work area.

b. Submit new material safety data sheets (MSDS) to the MSDS manager for database inclusion.

c. Obtain/maintain copies of (MSDS), as required, for each hazardous chemical used or stored I work areas and make the accessible to employees during each work shift.

d. Review MSDS received to make sure it is current and complete. If an MSDS appears to be outdated or incomplete, send a letter to the manufacturer requesting a current and complete MSDS.

e. Make this written Hazard Communication Program available, upon request, to all employees.

2. Supervisors

a. Ensure hazardous chemicals are properly labeled.

b. Ensure that all new chemicals introduced or used in work areas under their responsibility have MSDSs readily accessible and inform employees of these locations.

c. Ensure that employees under their supervision who work with hazardous chemicals and/or whose work area contains hazardous chemicals receive the general hazard communication training when hired, and receive work area specific training prior to their initial assignment of working with and/or being exposed to hazardous chemical(s) in work area. This includes any new chemical hazards introduced in the work area subsequent to initial training, those associated with non-routine tasks, and those introduced by non-District personnel (subcontractors, vendors, etc.).

d. Ensure that employees are training in use of any recommended PPE and they use it as instructed.

3. MSDS manager

a. Maintains a district-wide file of material safety data sheets (i.e., the master file) for all hazardous chemicals on each site (see also Subcontractors).

b. Maintains a list of all hazardous chemicals (i.e., the master list) used and stored on site in a central computer file (see also Subcontractors).

c. Provides a summary of this Hazard Communication Program to subcontractors who will perform work onsite. This may be accomplished by attachment to the contract or at pre-construction meetings.

d. Archives the chemical lists and MSDS from prior years, so that the district has records, which include the chemical list by year and which detail the chemical, where it was used and when it was in use.

4. Human Resources

a. Develops and presents general hazard communication training material.

b. Provides all new employees with general hazard communication training.

5. MSDS Manager, Building Administrators and Supervisors

a. Ensures containers of chemicals received, distributed, or transferred to other containers have the appropriate hazard communication labeling.

b. Forwards MSDSs received with shipments to MSDS manager for further distribution.

6. Subcontractors

a. Because the district uses and stores hazardous chemicals on-site in a way that the employees of other employer(s) may be exposed (for example, employees of a construction subcontractor working on-site), the program manager shall enclose a summary of this Hazard Communication Program in subcontracts involving work on site. Alternatively, this summary may be provided to subcontractors in pre- construction meetings.

b. Contractors performing work on-site shall include a copy of their hazard communication program in their site safety and health plan if they intend to bring any hazardous chemicals to the premises. MSDSs for these hazardous chemicals shall be maintained by the subcontractor and be made available to district staff upon request.

7. Science Teachers

a. Science teachers shall follow procedures in this policy as it applies to an inventory and MSDS for chemicals in their classrooms. In addition, they shall be provided general Hazard Communication and operation specific training if, as a part of their job, they use hazardous chemicals and/or are exposed to hazardous chemicals. Training shall be coordinated by their Building Administrator.

b. If applicable, science teachers will comply with the Laboratory Chemical Hygiene Plan.

8. All Employees.

a. All employees shall attend district Hazard Communication training and become familiar with the program and the location of the chemical list and material safety data sheets. Employees will become familiar with the hazards of chemicals they work with and will not use new chemicals until they have reviewed the MSDS and reviewed the hazards with their supervisor.

EMERGENCY ACTIONS

Purpose: In order to provide notification to all employees regarding the appropriate activities that should be done in case of crisis.

Procedure: Supervisors will accompany a training session in the beginning that will comprise a learning session on all the recommended activities required in a state of crisis. The policies that are developed for state of crisis will be delivered to employees in reference to every position in the workplace.

At the principal site or at the coordinator of office operations, all relevant plan programs that could assist in emergency in relevance to specific location, are found.

HAZARDOUS ENERGY CONTROL PROGRAM (lockout/tag out)

Purpose: The main reason to develop this module is check the all necessary things in case of exclusion or tag out of all resources that provide energy. In order to evaluate all the machineries and equipments, that they don’t emit energy that is dangerous and is also tagged out before they are brought in use by the workers, especially during maintenance procedure, in such scenario it is ensured machine might not emit the stored form of energy that could be dangerous, keeping in view such module is developed.

Procedure: In the training session to be delivered under the control of supervisor in the beginning, all the workers would be trained well about all practices regarding the lockout and tag out so they could be aware of its importance. This program is designed for every new or transferred employee who has to deal especially in that relevant machinery area, so would be informed and trained about the lockout and tag out practices.

Lockout/Tag out Program

Purpose

The main goal of enabling this program is to diminish or tag out those machineries that emit energy. Especially it will evaluate and guarantee that there is no dangerous quantum of energy emitting form any kind of tool of machine working around, and also would check that those machines and tools are locked or tag out before they are been repaired or tunes by the employees as that energy could be injurious at igniting point or from emitted from the storage even.

Responsibility

It is our duty to inform all the employees about the necessity of to be secure by lockout or any tag out practice. A training for the purpose of informing about the lockout or tag out program would be delivered to all employees that are new to this workspace whether they are recently hired or transferred including the current one also.

Preparation for Lockout or Tag out

In order to carry this program an analysis needs to be conducted that will spot and detect all those equipment, levers and valves that emit energy and that are need to be locked out or tagged out. In this process there might be more than one energy sources be involved as electrical, mechanical, etc.

Sequence of Lockout or Tag out Procedure

· Inform all the working employees about the usage and the linked motive about the lockout or tag out module. It is the ole duty of the authorized employees to recognize the category and quantum of energy that is emitted by a specific machinery or any equipment that is in use, so they could also be aware about its dangers.

· Such machine should be turned off in normal way, if it is found to be working. In such condition all the levers, valves or relevant equipment should be powered down so it remains disconnected from its power supply. Changing the position, blocking or bleeding is a safe methodology for stored energy in (springs, elevated machine members, rotating flywheels, hydraulic systems, and air, gas, steam or water pressure) so that they could be degenerated or halted.

· Individually locks and tags should be applied to Lockout or tag out, those devices that emit quantum of energy.

· A push button or any normal operating method should be deployed to check that the energy supply is turned off and so that the employees also not get exposed to such energy. CAUTION:

All operating controls should be neutralized to off side after the evaluation period.

· Now the energy is unable to reach the machinery.

Restoring Machines or Equipment to Normal Production

· After the fixing or tuning are done right and supplies are prepared for typical production practices, area around the machine should be evaluated in order to guarantee that no one is exposed to that.

· After all apparatuses have been evacuated from the machine or supplies, guards should be placed as per requirement and employees are free to move, eliminate all lockout/tag out mechanisms to again regulate the supply of energy to the machine or gears.

Procedure Involving More Than One Person

In the former steps, if more than one person is solicited for the purpose of lockout or tag-out the gears, every should spot and place their particular private lockout unit on the supply of energy that distinguishes for the device(s.) In case if a quantum of energy secluding apparatus can’t receive various locks or tags, a different lockout or tag-out gadget (hasp) may be utilized. Provided that lockout is utilized, only one lock might be utilized to lockout the machine or gear with the crux being set inside the lockout box or cabin that permits the utilization of many different bolts to secure it. Every employee will then use their particular bolt to provide security to the crate or the cabin. As every individual no longer should support their single lockout security, that individual will uproot their lock from the crate or the cabin.

Lost Key Procedure

In case of losing or forgetting the placement of the key that is designed for the lockout, the in charge officer should be informed instantly. There are two keys, one that would be with the machine and the other is the master one that is under the possession of the in charge officer. The key should be always with those employees who work in lock out service.

Removal of Lockout Tag out Equipment by Others

In case of neglecting done by the individual who locks out the apparatus in the beginning but forgets about the padlock before he leaves the workplace, following should be done:

· A complete assessment of the work area by the in-charge or the administration to protect the individuals who did introductory lock out/tag out techniques should be protected and uninjured.

· In the state of urgency, contact the representative’s habitation to verify their well-being and the area, and also verification should be done to check depending on if they did or did not finish the allotted undertaking or assuming that they unintentionally spurned to uproot the lock out signs and padlock.

· These two steps need to be finished when the in-charge officer accountable for the master key might uproot the lock out marks or padlock(s.)

· A record of this event ought to be kept and the lock out/tag out systems evaluated by the worker. Ongoing disciplinary activity ought to be taken if i seems to be necessary.

Basic Rules for Using Lockout or Tag out System

All supplies might be locked out or tagged out to ensure the possibility of any accident or coincidental injurious operation, when such operation might damage our personnel. DO NOT ATTEMPT to manage any lever, valve, or other power isolating equipment, when it is locked or tagged out.

Personnel Authorized to Lockout Tag out

All Facilities Maintenance personnel with Lockout/Tag out training

Training

· In the effective deployment of this complete module, all of the working employees should be taught in best practices.

· All the trained employees would be certified along a manifest with their names and date of training.

Periodic Review

These practices would be evaluated and audited after each year.

PERSONAL PROTECTIVE EQUIPMENT

Purpose: In order to keep employees equipped with the protection toolkit, while they are working in such place that could be harmful physically.

Procedure: Under the control of on duty in charge officer, the necessary personal protective equipment (PPE) will be given to all employees if required, while they are under the starter introductory lesson and the safety training. The lesson would include the issuing, necessity of utilizing, how to handle with care and finally tuning of PPE. In order to evaluate the necessity of PPE in the workplace a survey would be conducted and its results would be stored in a file.

Personal Protective Equipment (PPE) PROGRAM

It is the sole duty of the administrators to evaluate the dangers prevalent in each task and the required PPE for those dangers required on the job. A formal verbal certification should be narrated after the survey of dangers and required PPE for them, should contain the location and name of the site of work, authorized person assigning and he date of issue. Whenever any task is about to start or there is any variation in the terms or conditions, required tools or practices, this certification should be prepared. Hazard Assessment Certification form should be evaluated then and its duplicate will also be delivered to the relevant employee.

· Under the lesson given by the in charge officer, it is necessary to wear PPE so work could be done safely.

· There would be no expenses on the employee side of furnishing the PPE to them.

· Under the instruction provided by the vendor, it is the duty of the employees to tune and maintain the PPE, check them before any usage and on certain condition new equipment of PPE could be claimed.

· The availability of required PPE to the workers, they know how to handle and use that equipment with care and the PPE usage is must for them, is to be ensured by the in charge officer.

Hand Protection – (Glove Policy)

The most known form of PPE is Hand Gloves.

All employees are outfitted for single-use disposable nitrile or vinyl gloves on the off chance that they ought to be solicited to furnish emergency treatment or tidy up after damage.

Supervisory, service, and yard crews are outfitted suitable gloves to ensure the safety from materials they handle and for the security opposite chemicals and cleaning fuses which might harm employees “skin”.

Kitchen laborers are outfitted to use suitable gloves to be safe from cuts when utilizing blades and fire while cooking.

Service department employees who are deployed in or very near to the electric supplies (i.e. testing, troubleshooting), can be outfitted to wear electrical gloves and defenders. Employees are to accompany with the Electrical Safety Program.

Eye & Face Protection

Before the start of work here with a potential presentation to unsafe materials/chemicals, the closest eyewash might be distinguished and informed about that to all.

Protection glasses (ANSI Z87.1approved) could be worn whenever doing errands where particles might hit the eyes. Exceptional eye danger work ranges (such as welding, torch work, lasers etc.) ought to be known by the administration and proper eye protection should be ensured. American National Standards Institute (ANSI) affirmed that proper eye wear ought to be worn over prescribed glasses for access to task work zones until permanent protective eye-wear could be acquired.

Goggles ought to be worn if there’s possibility of fine particles or chemical based dangers. Guests entertained at our client dealing zones where eye insurance is needed, should be given verified goggles or glasses.

Face shields ought to be worn while grinding process and using acids, various dangerous industrial chemicals, or even in case of molten liquids/grease that might sprinkle.

Face shields could also be kept in use while doing cleansing of the slicks of blood or on those apparatus that might have risk of getting sprinkle on face.

FIRST AID

A.
Purpose: In order to ensure that every employee is made an immediate and right first aid treatment in case of an injury that is on duty.

B.
Procedure:

1. First Aid Training

It is necessary for all the supervisors and any individual who is directly leading others, should attain the training of First aid and its accreditation. In order to ensure the presence of an authorized employee who knows first aid is present around the site of working, a learning session would be delivered to adequate number of employees. The training session that is given to other relevant institutional employees is inclusive of:

It is the employee’s responsibility to attend first aid certification training if selected by the supervisor.

2. First Aid Kits

On every facilitation point, the kits that contain equipment for first aid will be conserved and the Safety Bulletin Board would show the notifications about these points, and while the introductory session would be going on these notifications would be shown to all employees. In order to signify the point were the first aid kit would be provided a board will be placed if their presence is not clearly seen by employees.

If we don’t mention the previously considered cases, where some other individual is assigned, the construction principal or the administrator of the site is assigned to check and verify that the first aid kits are legitimately retained and supplied.

The phone numbers required in situation of crisis and practical approach for emergency could be deliberately displayed, for example on the first aid kit, at telephones, on the safety bulletin board and at different zones where it is suitable.

WAC 296-800-150 First-aid kit guidance

SAMPLE: First-aid Kit Contents

(a) 1 absorbent compress, 4×8 inches

(b) 16 adhesive bandages, 1×3 inches

(d) 10 antiseptic single-use packages, 0.5g application

(e) 6 burn treatment single-use packages, 0.5g application

(f) 1 eye covering (for two eyes)

(g) 1 eye wash, 1 fluid ounce

(h) 4 sterile pads, 3×3 inches

(i) 2 pair of medical exam gloves

(j) 1 triangular bandage, 39x39x55 inches

(k) Disposable rubber (vinyl) gloves

(l) CPR Micro-shield (sterile, disposable)

Optional First-aid Kit Contents

(a) Bandage compresses, 2×2 inches, 3×3 inches and 5×5 inches

(b) Self-activating cold packs, 4×5 inches

(d) Mouth-to-mouth barrier for CPR

Note: ASTM (American Society for Testing and Materials) and ANSI (American National Standards Institute) or other consensus national standard kits will meet these requirements. Employers should consider the type of hazards at each work site (physical, chemical, biological, number of employees, and local emergency response providers to determine the quantities of first aid supplies.

In each kit that is used for first aid purpose, two additional items i.e. a CPR Micro-shield which should be antiseptic and made to dispose after single-use, and a pair of single-use gloves made from vinyl should be retained.

In order to defend the institutional employees from the fluids leaking from certain bodies like blood, urine, vomit, mucus, vaginal discharge, etc. , pair of gloves that are for single-use should be supplied to them.

The people who provide assistance the students in those locations where there is less probability of first aid kits presence like Play Ground in charges, crossing Guards, bus drivers, mentors & coaches, Club advisors, etc. In order to retain and evaluate the first kit, the safety provided by gloves should be utilized. If the situation is demanding the usage of additional tools that provide further safety like aprons and eye splash protector, should be arranged. (e.g., day care workers, bus drivers and handicapped student instructors and aides).

It is the duty of school supervisors that these tools are for the usage of employees only.

HEARING CONSERVATION PROGRAM

Purpose: In order to provide safety to employees at those levels where there noise is disturbing and dangerous for their hearing capability and to save them from permanent hearing loss. Under the prescription of OSHA and the Washington State Department of Industrial Safety and Health, this module is developed only to deliver safety to those employees who have to get job done in those regions where the level of noise is disturbing for them.

Procedure: In order to distinguish any zone or the task assigned that might enhance the Time Weighted Average (TWA) of 85db, the frequency level of noise more than 115db or any spontaneous or even the effect of the frequency that was determined to be more than 140db should be evaluated through an analysis of that district facilitation point and the task assigned, under the WAC 296-62 Part K.

Getting beyond the limit set by the standards by listening to a noise for a frequent time period could be dangerous for the sense of hearing. The distinguishing of points and regions where the frequency of noise increases and the monitoring of the regulations, is inclusive in our strategy, which also includes the reduction of the facing to these levels of sound through mechanical and managerial practices. The mechanical and managerial practices directly never reduce these level effectively, but the provision of PPE inclusive of tools that are for safety for the hearing can do this and would be subsequently delivered on necessity.

Job Hazard Assessment and Sound Level Surveys

It is the sole duty of the administrators to evaluate the dangers in the working sites and to pass solutions for them. A research analysis to document the results with the deployment of a sound level meter is recommended for those areas where the level of noise is disturbing for the employees ((where you would need to raise your voice to be heard at a 3 foot distance). On the basis of hearing Conservation Program and the audiometric testing, the employees working at these regions would be admitted in relevance to the analysis concluded from the survey.

It is must to inform the employees about the survey that is being conducted for them and for others to practically face that situation. After the consequences are developed from the survey, it would be delivered to the employees within 5 working days.

The area would be declared by displaying notice or employees would be delivered and enforced to wear the protective tools for hearing under TWA8, if the observation tells that the workspace has sound level continuously above than 85db, at 115db it would not be a rapid reaction but on 140db it could be. Those employees who got an impact of such sound would be admitted in the Hearing Conservation Program.

Employees

It is the sole duty of all the relevant employees to inform about the locations and tasks that are the cause of the production of loud noise frequency and as a safety they should wear PPE as prescribed by their in charge officer.

Preventing Hearing Loss

Frequent hearing to such noise can result in the loss of hearing ability, which could also be prohibited. If an adequate hearing conservation program is managed, could be beneficial in those scenarios where level and frequency of the sound is more than 85db.

Engineering Controls

Management control is deployed in scenarios when the employees have to work in situations where level of sound is more than 85db. It is inclusive of:

· Maintenance of machinery to reduce noise level.

· Modification of equipment.

· Substitution of equipment.

· Isolation from the noise source.

· Installation of acoustical material to absorb noise.

If the above given practices are unable to diminish the frequency of the sound, PPE and relevant practices can be deployed and utilized.

Administrative Controls

Management controls are deployed and utilized whenever the level and frequency of the sound is found more than 85db, which is inclusive of:

· Rotation of employees.

· Limitation of time for exposure to operation.

· Restricted area of work operation.

Types of Hearing Protection

There are several types of hearing protection available:

· Disposable ear plugs.

· Reusable ear plugs, custom fit.

· Ear canals.

· Ear muffs.

The goal behind the usage of these tools is not to eliminate the sound at all, it only prevents the ear to listen the disturbing level of frequency, in other words the sound that is not required to hear. If the cumulative frequency of the sound is reduced, the vocals and the precautionary signs could be easily perceived. With the assistance of environment of the workspace and the individual demands, the safety for hearing is devised. The equipment that is desired should be worn effectively and frequently in order to make hearing safe.

It is prescribed to carry two types of hearing protection devices when the employee has to get the task done on various sites or with different tools which have differentiating level of sound.

· Disposable foam ear plugs.

· Ear muffs.

It depends that the employee working should use foam plugs only or should wear the ear muffs, when the two levels of safety equipment for hearing are present, and if in such scenario the level of sound is very harsh both equipment can be utilized. This is useful as it delivers the employee a safety for hearing in variety of workspaces.

Hearing Protection Training and Record Keeping

The presence of those employees is necessary in the hearing conservation program and the learning session in relevance to safety for hearing, whose working in noisy environment of more than 85db is more than 8-hour time-weighted average (TWAB).

On the requisition of a presenter from the side of the employee to the Specialist of Worker’s Compensation the essential learning and training guide including the safety equipment from the noise level would be delivered. Inside the Human resources department the record of the audiogram and experience to the sound as a Performa of the employee, and this would be delivered to the representative or the employee himself on a request.

The data from observation about the sound levels and their evaluations, consequences of the research made on sound level, any extra ordinary practice involved and the deployment of mechanical controls would be recorded and will updated frequently.

Audiometric Testing and Oversight

It is the sole duty of the district to arrange a verified audiologist, otolaryngologist, or even any well-educated medical specialist for all the employees in the relevant hearing conservation program for the evaluation of the audiometric and to analyze the whole module. Only an authorized medical specialist or any engineer verified by the Council of Accreditation in Occupational Hearing Conservation (CAOHC) to test all the audiograms along with a well-educated analyst.

CONFINED SPACE PROGRAM

Purpose: In order to develop the safety and the health of all institutional employees, this program is designed, and it also focuses on those who have to do tasks in restricted zones especially for maintenance, tune-ups and such relevant causes.

The Washington Administrative Code WAC 296-62 Part M administers the regulations for working at restricted zones, Its goal is to define some limits and standards that could be followed while entering the restricted zones and also become practice for the protection, task completion and leaving that zone.

These restricted zones are distinguished and signaled as “permit-required,” “controlled hazards only” or “non-permit-required” confined space.

Procedures: In order to administer, develop, going inside or being present in those restricted zones, it is the duty of the personnel in the district so that the employees would be given a learning session which would be inclusive in their assignment but more preferable than it.

It is the responsibility of the district to distinguish and signal the cautionary indications at all restricted zones within the premises of the institutions.

Included in this policy there is a list which distinguishes those regions that are defined as permit-required zones and their positions inside the district premises, and along with the dangers at each restricted region.

Definitions

A restricted zone is a region that is limited as:

· Is large enough for an employee to enter;

· Has limited or restricted means of entry or exit (for example, tanks, vaults, wells, Tunnels, pits, manholes, catch basins); and

· Is not designed for continuous human occupancy.

A permit-required confined space (PRCS) is a restricted space that:

· Contains or has the potential to contain a hazardous atmosphere;

· Contains a material that has the potential for engulfing an entrant;

· Has an inside configuration such that an entrant could be trapped or asphyxiated by inwardly converging walls, or a floor which slopes downward and tapers to a smaller cross-section;

· Contains any other recognized serious hazards.

The point from which an individual appointed passes through into a region that is restricted and required a license is known as an Entry.

An entry permit is the written or printed document that is provided to allow and control entry into a permit space.

Engulfment is the surrounding, capturing, or both, of an entrant by divided particulate matter or liquid.

A hazardous atmosphere is one that may expose employees to risk of death or incapacitation, injury or illness by reason of oxygen deficiency or enrichment (less than 1 9.5o/o or greater than 23o/o oxygen by volume), flammability, explosive, or toxicity.

The zone that has specifications that seems to be like of a restricted region but if any research is analyzed done on it narrates that it is not harmful to the environment, even it is not dangerous in physical terms, is known as a Non-Permit Confined Space.

All Supervisors and employees will follow these rules:

· Supervisors shall ensure that all employees who may enter or work around confined spaces have confined space awareness training

· Prior to any entry of a permit or non-permit confined space a hazards assessment will be made and the space classified.

· To conduct an evaluation of the space identify hazards, consider the scope of hazard exposure; magnitude of hazard; likelihood and consequences of hazard occurrence; changing conditions/activities; impact on the need for emergency response; testing will be conducted in the presence of entrants.

· Based on the evaluation of hazards, classify and list confined spaces as either permit-required or non-permit confined spaces.

· lf a permit is required; complete in detail the Confined Space Entry Permit.

· Expired and completed permits will be saved for 1 year and used to evaluate the confined space programs effectiveness.

Periodic Evaluation of Hazards

In relevance to the practical variations in the restricted region or any bodily or even any atmospheric situations that could impact the workspace heavily, a periodic re-evaluation would be done. In this case the information from the expired and finalized Confined Space Entry Permits would be utilized.

Marking of Confined Spaces

In order to make the employees working at restricted region fully aware, indications would be delivered or some other relevant cautionary signs would be utilized. “Danger. Permit-Required Confined Space. Do Not Enter” are the indicating narrations or stop signs or relevant means so that the non-verified personnel stay away from the permit required region.

Entry into Confined Spaces

EXCEPT UNDER APPROVED PERMIT, NO EMPLOYEE WILL BE ALLOWED TO ENTER A PRCS.

In relevance to the Roadway and Traffic Design Standards and other Safety Standards an adequate control of the traffic, indicating signs and guards would be deployed so that they can be espoused in order to indicate those areas which are known as public passing regions.

If it is noticed by the Supervisor at Entry that the distinguished danger in the restricted zone is in relevance of environmental and air, and it can administer the dangers individually, in that scenario the passing into this region should be verified. In this scenario the practices prescribed by the other relevant safety should also be utilized.

Close enough to any open gutter, cable hose, sewerage, it should be tried to never bring any burning fire, torch or even lighted smoke equipment, in those regions especially, even is the analysis of that region clear that this region is not having any burnable gases, vapor or even fumes. Unless that region has been analyzed adequately with the detecting tools for the presence of volatile gases, oxygen deficiency and hydrogen sulfide, no employee should pass shortly from it.

Use of Safety Harness and Life Lines

It is necessary for all the workers who are assigned to enter the manholes, cable vaults, sewers or mines should wear some protection attachment or carry any life line. This life lie would be in connection to an adequate tool that could serve for the safety and also permits the retaining without any entry into that region. In those regions where the depth is more than four feet, a hard hat should always be worn. In order to release or call back the life line and to ensure the provision of support in state of crisis when entry is banned on requirement at any time when someone is working deep in the region, there should always be and expert outside.

These professionals who are in release or call back of the life line, should always keep effective communicating devices or even they should be able to communicate with those who are passing into it, even they should be able to get to them for providing them protection support or calling some assistance.

Sample Safety Assurance Forms

JOB SAFETY ANALYSIS FORM

DATE:

JOB:

ANALYSIS BY:

JOB SAFETY ANALYSIS

TITLE OF OPERATOR

REVIEWED BY:

DEPARTMENT

SECTION/UNIT in DEPARTMENT:

APPROVED BY:

REQUIRED OR RECOMMENDED

PERSONAL PROTECTIVE EQUIPMENT: Safety glasses, hand and foot protection

SEQUENCE OF BASIC JOB STEPS

POTENTIAL ACCIDENTS OR HAZARDS

RECOMMENDED SAFE JOB PROCEDURE

1. Place Raw Stock Blank In Lathe Chuck

1. Sharp edges of stock blank

1. Wear gloves or protect against sharp edges as required when handling raw stock.

2. Stock and lathe

2. Watch position of hands, arms and body to keep clear of pinch point.

3. Lifting raw stock blank

3. Use proper lifting procedures. Get help if blank is too large for one worker.

4. Moving parts while rotating blank

4. Keep hands clear when rotating chuck to position part. Use jogging control to slow speed. Wear short sleeves. Do not wear gloves or rings.

5. Falling objects

5. Wear foot protection.

2. Fabricate and/or Install Template On Stylus Platen

1. Slips on oily surface at same or different level. Climbing for access to elevated controls of equipment

1. Wipe up oil spills. Apply non-skid material to elevated steps. Use work platform engineered for job, including handrail protection.

3. Select And Install Tool Cutter

1. Falling objects, oily surfaces

1. Keep parts free of oil when handing. Wear foot protection.

2. Sharp tools

2. Be aware of handling sharp objects.

4. Select Machine Mode

1. Electrical controls

1. Be sure machine is properly grounded and all electrical controls are in good repair.

5. Machine Part

1. Metal particles

1. Wear eye protection.

6. Remove Turnings And Chips As Machining Progresses

1. Turnings and chips

1. Wear eye protection. Use correct tools to clean turnings from table.

2. Turnings

2. Break turnings before they become unwieldy. Do not wear long sleeve work clothes.

JOB SAFETY ANALYSIS

DATE:

JOB:

ANALYSIS BY:

JOB SAFETY ANALYSIS:

TITLE OF OPERATOR:

REVIEWED BY:

DEPARTMENT:

SECTION/UNIT inc. DEPARTMENT:

APPROVED BY:

REQUIRED OR RECOMMENDED

PERSONAL PROTECTIVE EQUIPMENT:

SEQUENCE OF BASIC JOB STEPS

POTENTIAL ACCIDENTS OR HAZARDS

RECOMMENDED SAFE JOB PROCEDURES

ORIENTATION/JOB SAFETY CHECK LIST

Employee’s Name

Employee’s Assignment

Supervisor’s Name

Location

Status (Circle One):

New Employee

Transfer

Rehire

Subject

Employee’s Initials

Supervisor’s Initials

1. Purpose of Orientation

2. District Policy

3. Accident (Injury) Reporting/Investigation

4. First Aid Requirements

5. Safety Committee

6. Emergency Actions

7. Hazard Reporting

8. Hazardous Communication Program

9. Lockout/Tagout Program

10. Personal Protective Equipment

11. Safety Rules

12. Operation of Machinery

13. Safety Bulletin Boards

14. Responsibilities

List machinery employee is authorized to operate:

Item

Employee’s Initials

Supervisor’s Initials

Personal Protective Equipment:

Item

Issued

If Available

In Work Location

Employee’s Initials

Supervisor’s Initials

I have instructed the employee on the items initialed above and believe he/she can perform assigned duties in a safe manner.

Date

Supervisor’s Signature

I have received orientation on the items initialed above.

I have received training on and understand the items initialed above.

Date

Employee’s Signature

Record of hazard observed

Reported By: (Optional)

Date:

Reported To:

Date:

Nature of Hazard: (Describe-Act, Equipment Situation, etc.)

Location of Hazard: (Be specific, i.e., custodial closet, West Wing, XYZ Elementary School)

Action Taken: (By Supervisor)

Signature Date

Forward to Safety Committee for review:

Safety Committee Review Date

Safety Committee Chairperson Date

Safety Committee Meeting Minutes

School District

Meeting Date

School Building

Chairperson

Elected Employee Members Present

Appointed Management Members Present

Members Absent

(Use additional pages if necessary to describe events fully)

1. Read, approve, and correct minutes from the previous meeting.

2. Old business (progress report on items and/or uncorrected hazards from previous meetings.)

3. New business (assign someone to research and follow-up, on each hazard and/or item listed.)

(continued on back)

4. Review accident and inspection records and reported hazards.

5. Other business, including student and visitor safety issues (describe.)

6. Items referred to Safety Director/Management with recommendations.

7. Comments on the overall effectiveness of the school district’s safety program.

Date next meeting

Time

Place

Secretary

Chairperson

REPORT OF ACCIDENT/INCIDENT

DISTRICT SCHOOL

NAME OF EMPLOYEE

DATE OF ACCIDENT TIME OF ACCIDENT

WHEN REPORTED

JOB POSITION DATE OF HIRE

HOURS USUALLY WORKED PER DAY PER WEEK

SPECIFIC BODY PART INJURED

TYPE OF INJURY (Puncture, sprain, etc.)

WAS FIRST AID REQUIRED? Y N

LOST TIME INVOLVED? Y N

PROPERTY DAMAGE INVOLVED? Y N DESCRIBE

HOW DID ACCIDENT OCCUR? (Object, activity or substance involved?)

WAS PERSONAL PROTECTIVE EQUIPMENT NEEDED? Y N USED? Y N

IN YOUR OPINION, HOW COULD THIS ACCIDENT HAVE BEEN PREVENTED?

WHAT UNSAFE CONDITIONS CONTRIBUTED TO THE ACCIDENT?

HAD THIS CONDITION BEEN REPORTED PREVIOUSLY? Y N NOT SURE

IF SO, TO WHOM?

CORRECTIVE ACTION TO BE TAKEN FOR UNSAFE CONDITION:

WITNESSES? Y N NAMES

WITNESS STATEMENT:

Signature of Employee Date

*To be completed within 24 hours and routed to the immediate supervisor and District Safety Committee

SUPERVISOR’S REPORT OF INVESTIGATION

SCHOOL DISTRICT School

WHO

Person injured/ill

Address Telephone No.

Social Security No. Marital Status Number of Dependent Children

Occupation Immediate Supervisor

Witnesses

Was the injury or exposure caused by someone other than an employee of the district? Y N

Please identify

WHERE

Exact Location of Incident

WHEN

Time/Date of Incident or Exposure Date Investigated

Time/Date Reported To Whom?

Last Day Worked Date expected to return to work

WHAT

Describe the event(s) leading up to the incident

Describe the type of injury/illness and body parts affected

Describe the object/exposure or activity that inflicted injury, illness or damage

Describe any personal protective equipment required Used? Y N

Describe any property damage

WHY (Use guide to identify)

Direct causes

Indirect causes

Basic causes

Explain why causes exist

Had this condition/procedure been reported previously? Y N Not Sure

When? To Whom?

HOW

Explain action you have taken or recommended to prevent recurrence

Identify other departments that may benefit from similar corrective actions

SIGN AND DATE

Immediate Administrator/Supervisor Date

Employee Representative Date

Claims Manager Date

Superintendent Date

White: District Claims Liaison Yellow: Safety Committee Pink: Puget Sound Workers’ Compensation Trust

ACCIDENT CAUSATION GUIDE

DIRECT CAUSES OF ACCIDENTS

INDIRECT CAUSES OF ACCIDENTS

Energy Sources

Unsafe Acts

1. Mechanical:

1. Failing to use personal protective equipment

machinery, compressed gases, moving objects, tools

2. Failing to warn co-workers or to secure equipment

explosives, strain (self)

3. Engaging in horseplay

2. Electrical:

4. Lifting improperly

uninsulated conductors, high voltage sources

5. Loading or placing equipment or supplies improperly

3. Chemical:

6. Rendering safety devices inoperable

acids, fuels, bases, reactive materials

7. Operating equipment at improper speeds

4. Thermal

8. Operating equipment without authority

5. Radiation:

9. Servicing equipment in motion

noise, x-rays, lasers, microwave, radioactive materials

10. Improper work position

Hazardous Materials

11. Using alcoholic beverages

1. Compressed or liquefied gases:

12. Using drugs

flames, hot surfaces

13. Using defective equipment

2. Corrosive material

14. Using equipment improperly

3. Flammable material:

Unsafe Conditions

solid, liquid, gas

1. Congestion of workplace

4. Oxidizing material

2. Defective tools, equipment, or supplies

5. Poison

3. Excessive noise

6. Radioactive material

4. Fire and explosion hazards

7. Etiological agent

5. Hazardous atmospheric conditions:

8. Dust

gases, dusts, fumes, vapors

9. Explosives

6. Inadequate supports or guards

7. Inadequate warning system

8. Poor housekeeping

9. Poor illumination

10. Poor ventilation

11. Radiation exposure

BASIC CAUSES OF ACCIDENTS

Management Safety Policies and Decisions

Personal Factors

1. Health and safety policy is not:

1. Behavior factors:

in writing, reviewed periodically; signed by top

frequent accidents; risk taking; lack of hazard awareness

management; distributed to each employee

2. Experience factors:

2. Health and Safety procedures do not provide for:

insufficient knowledge; accident record

a written manual; accident investigation

inadequate skills; unsafe practices

safety meetings; job safety analysis;

3. Physical factors:

adequate housekeeping; medical surveillance;

size; strength; stamina

preventive maintenance; reports; safety inspections

4. Mental factors:

3. Health and safety not considered in procurement of:

emotional; alcoholism; depression; drug use

supplies; equipment; services

5. Motivational factors:

4. Inadequate personnel practices regarding:

needs; capabilities

employee selection; communication; training;

6. Attitude factors:

assigned responsibility; assignment;

people; company; job

accountability; job observation

Environmental Factors

1. Unsafe facility designs:
mechanical layout; access ways; electrical systems

material handling; hydraulic systems; illumination

air conditioning; noise

2. Unsafe operating procedures

3. Unsafe projections:

physical plant; equipment; procedures; supplies

4. Unsafe location factors:

geographic area; surroundings; terrain; weather

ABBREVIATIONS

AHERA-Asbestos Hazard Emergency Response Act

ANSI-American National Standards Institute

ASTM-American Society for Testing and Materials

DOE-Department of Energy

EPA-Environmental Protection Agency

L&I-Department of Labor and Industries

MSDS-Material Safety Data Sheets

OSHA-Occupational Safety and Health Administration

OSPI-Office of Superintendent of Public Instruction

WAC-Washington Administrative Code

WIAA-Washington Interscholastic Athletic Association

WISHA-Washington Industrial Safety and Health Act

Appendix A: Material Safety Data Sheet (Sample)

Appendix B: State and Federal Posters

Appendix C: OSHA Forms

OSHA FORM 300

OSHA Form 300

Log of Work-Related Injuries and Illnesses

Year 20

Attention: This form contains information relating to employee health and must be used in a manner that protects the confidentiality of employees to the extent possible while the information is being used for occupational safety and health purposes

Department of Consumer & Business Services
Oregon Occupational Safety &
Health Division (OR-OSHA)

You must record information about every work- related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity, job transfer, days away from work, or medical treatment beyond first aid. You must also record significant work-related illnesses that are diagnosed by a physician or licensed health-care professional. You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in OAR 437-001-0700. Use more lines for each case if needed. You must complete an Injury and Illness Incident Report (DCBS form 801) or equivalent form for each injury or illness recorded on this form. If you’re not sure whether a case is recordable, call your local OR-OSHA office for help.

Establishment name:

City:

State:

Identify the person

Describe the case

Classify the case

(A)
Case no.

(B)
Employee’s name

(D)
Date of injury or illness

(E)
Where the event occurred (e.g., “loading dock – north end”

(F)
Describe Injury/Illness, parts of body affected, and object/substance that directly injured or made person ill (e.g., “second degree burns on right forearm from acetylene torch”)

Using these 4 categories, enter “1” in only the most serious result for each case:*

Enter the number of days the injured / worker was:

Enter “1” in the “injury” column or choose one type of illness:*
(M)

Death

Days away from work

Remained at work

Injury

Skin disorder

Respiratory condition

Poisoning

Hearing Loss

All other illnesses

Job transfer or restriction

Other record-able cases

Away from work

On job transfer or restriction

(G)

(H)

(I)

(J)

(K)

(L)

(1)

(2)

(3)

(4)

(5)

(6)

days

Page Totals

0 days

Be sure to transfer these totals to the Summary (OSHA Form 300A) before you post it
* Using “1” instead of an “x” allows the columns to total automatically.

Injury

Skin disorder

Respiratory condition

Poisoning

Hearing Loss

All other illnesses

Page of

(1)

(2)

(3)

(4)

(5)

(6)

OSHA FORM 300A

OSHA Form 300A

Summary of Work-Related Injuries and Illnesses

Year 20

Department of Consumer & Business Services
Oregon Occupational Safety &
Health Division (OR-OSHA)

Form approved OMB no. 1218-0176

All establishments covered by OAR 437-001-0700 must complete this Summary, even if no work-related injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary.
Using the Log: count the individual entries you made for each category, write the totals below, make sure you’ve added the entries from every page of the Log. If you haven’t had any cases, write “0”.
Employees, former employees, and their representatives, have the right to review the OSHA Form 300 in its entirety. They also have limited access to the DCBS Form 801 or its equivalent. See OAR 437-001-0700(20)

Establishment Information

Your establishment name

Street

City State ZIP

Industry description (e.g., Manufacturer of motor truck trailers)

Standard Industrial Classification (NAICS), if known (e.g.,336212)

Employment Information (If you don’t have these figures, see the worksheet on the back of this page to estimate.)
Annual average number of employees

Total hours worked by all employees last year

Sign here
Knowingly falsifying this document may result in a fine.
I certify that I have examined this document and that , to the best of my knowledge, the entries are true, accurate, and complete.

Company Executive Title

Phone: ( ) Date: / /

Number of Cases

Total number of deaths

Total number of cases
with days away from work

Total number of cases with job transfer or restriction

Total number of
other recordable cases

(G)

(H)

(I)

(J)

Number of Days

Total number of days away from work

Total number of days
of job transfer or restriction

(K)

(L)

Injury and Illness Types

Total number of…

(M)
(1) Injuries

(4) Poisonings

(2) Skin disorders

(5) Hearing Loss

(3) Respiratory conditions

(6) All other illnesses

Keep this Summary posted from February 1 to April 30 of the year following the year covered by this form.

OSHA FORM 301 – Injuries and Illnesses Incident Report

This form helps the employer and OSHA develop a picture of the extent and severity of work-related incidents.

File this report if the doctor has you off work or on restricted duty due to the injury.

Employee & Case Information:

Employee Name_____________________________
Case Number_________________ (Work Comp Dept will assign Case Number)

Street_________________________City_________________State__________Zip __________

Date of Birth_________________Date Hired_________________Male_________ Female_________

Date of Injury or Illness________________Time Employee began work_______AM_____PM_____

Time of Incident__________ AM____ PM____ Time Cannot Be Determined__________

Information about the physician or other health care professional:

Name of physician or health care professional who treated you (If Known)_______________________________

If treatment was given away from the worksite, where was it given?___________________________________

Was employee treated in an emergency room? Yes_____ No_____

Was employee hospitalized overnight as an in-patient: Yes_____ No_____

Information about the Incident:

What was the employee doing just before the incident occurred? Describe the activity, as well as the tools, equipment or material the employee was using. Examples: “Climbing a ladder while carrying roofing materials”; “Spraying chlorine from hand sprayer”; “daily computer key-entry.”

What happened?
Tell us how the injury occurred. Example: “When ladder slipped on wet floor, worker fell 20 feet”; “Worker was sprayed with chlorine when gasket broke during replacement”; “Worker developed soreness in wrist over time; etc.”

What was the injury or illness? Tell us the part of the body that was affected. Be more specific than “hurt, pain, or sore”. Examples: “Strained Back”; “Chemical burn to hand”; “Carpal Tunnel”.

What object or substance directly harmed the employee?
Examples: “Concrete floor”; “Chlorine”;”radial arm saw”. If this question does not apply to the accident, leave it blank.

If the employee died, when did death occur? Date of Death_____________________

(Return This Form to Jon Glick in Parsons Hall Room 109–Call Extension 7951 if you

have any questions.

PLEASE ANSWER ALL QUESTIONS AS COMPLETELY AS POSSIBLE. OSHA REQUIRES

EXPLANATION OF ALL ACCIDENTS AND HOW THEY HAPPENED.

AccidentPrevention Plan

(Sami Almalki)

TECH 462 –Industrial Safety Engineering

March 18, 2013

Introduction

Purpose & Intentions Page 5

Company Presidents Statement Page 6

Management Responsibilities

Manager Responsibilities Page 8

Supervisors Responsibilities Page 8-9

Employee Orientation

How

and

When Page 11

Emergency Action Plan Page 12-24

Emergency Shutdown Procedures Page 25

Injury and Illness Procedures

Procedures Page 27

Record Keeping Page 27

Supervisor Responsibilities Page 28

Report Form Page 29

Incident/Accident Investigation Procedures

Procedure Steps Page 31

Worksheet Form Page 32

Incident/accident Table Page 33

Safety Guidelines

General Guidelines Page 35-36

Equipment Specific Page 37

Individual Specific Page 38

Safety Disciplinary Policy

Safety Disciplinary Policy Page 40

Safety Awareness Program

Safety Committee Page 42

Safety Meetings Page 43

Safety Training Forms Page 43-44

Safety Award Program Page 45

Appendix A: Material Safety Data Sheet

(ACETOPHENONE) MSDS Page 47

(CALCIUM CARBONATE) MSDS Page 48

Appendix B: State and Federal Posters

(Job and Safety It’s the Law) Page 50

(In Case of Injury At Work) Page 51

(Fire Safety) Page 52

(Health and Safety at Work) Page 53

(Speak Up For Safety) Page 54

(Please Use Your Safety Gear) Page 55

Appendix C: OSHA Forms and Instructions

OSHA Form Instructions Page 57

OSHA Form 300 Page 58

OSHA Form 300A Page 59

OSHA Form 301 Page 60

ADDITIONAL FORMS Page 61-73

Introduction

SAFETY AND HEALTH POLICY FOR XYZ COMPANY

XYZ COMPANY places a high value on the safety of its employees. XYZ COMPANY is committed to providing a safe workplace for all employees and has developed this program for injury prevention to involve management, supervisors, and employees in identifying and eliminating hazards that may develop during our work process.

It is the basic safety policy of this company that no task is so important that an employee must violate a safety rule or take a risk of injury or illness in order to get the job done. The time during which employees are participating in training and education activities shall be considered as hours worked for purposes of wages, benefits, and other terms and conditions of employment. The training and education shall be provided at no cost to the employees. Members of the Safety/Health Committee will be allowed reasonable time to exercise the rights of the committee without any loss of pay or benefits.

Employees are required to comply with all company safety rules and are encouraged to actively participate in identifying ways to make our company a safer place to work. Supervisors are responsible for the safety of their employees and as a part of their daily duties must check the workplace for unsafe conditions, watch employees for unsafe actions and take prompt action to eliminate any hazards.

Management will do its part by devoting the resources necessary to form a safety committee composed of management and elected employees. We will develop a system for identifying and correcting hazards. We will plan for foreseeable emergencies. We will provide initial and ongoing training for employees and supervisors. And, we will establish a disciplinary policy to insure that company safety policies are followed.

Letter From The President

The purpose of this policy is to create a high criterion of safety all the way through operations of XYZ Company, and to make certain that no employee is expected to work under any conditions, which are risky or unhygienic.

We know that each employee has the right to obtain personal satisfaction from their job and the prevention of occupational injury and illness is of such significance to this belief that it will be given top priority at all times.

It is our goal here at ZYX Company to begin and maintain complete accident prevention and safety training programs. Each distinct individual from upper management to the working person is accountable for the safety and health of those persons that are in charge and their coworkers around them, our employee’s.

Signed,

The Company President

Management Responsibilities

Responsibilities for safety and health include the establishment and maintenance of an effective communication system among workers, supervisors and management

officials.

To this end, all personnel are responsible to assure that their messages are received and understood by the intended receiver. Specific safety and health responsibilities for company personnel are as follows:

1.
Management Officials

Active participation in and support of safety and health programs is essential. Management officials will display their interest in safety and health matters at every opportunity. At least one manager (as designated) will participate in the safety and health committee meetings, incident investigations and inspections. Each manager will establish realistic goals for implementing instructions for meeting the goals. Goals and implementing instructions shall be within the framework established by this document. Incentives will be included as part of the instructions.

1.
Supervisors

The safety and health of the employees they supervise is a primary responsibility of the supervisors. To accomplish this obligation, supervisors will:

1.

Assure that all safety and health rules, regulations, policies and procedures are understood and observed.

2.

Require the proper care and use of all required personal protective equipment.

3.

Identify and eliminate job hazards quickly through job safety analysis procedures. (See the sample Job Safety Analysis form attached to this document.)

4.

Inform and train employees on the hazardous chemicals and/or procedures they MAY encounter under normal working conditions or during an emergency situation. (See the sample hazard communication program.)

5.

Receive and take initial action on employee suggestions, awards or disciplinary measures.

6.

Train employees (new and experienced) in the safe and efficient methods of accomplishing each job or task as necessary.

7.

Review injury trends and establish prevention measures.

8.

Participate in incident investigations and inspections.

9.

Promote employee participation in the safety and health program.

10.

Actively follow the progress of injured workers and display an interest in their rapid recovery and return to work.

Employee Orientation

How and When

Safety is everyone’s job at Small Business Notes. Small Business Notes provides a clean, hazard free, healthy, safe environment in which to work in accordance with the Occupational Safety and Health Act of 1970. As an employee, you are expected to take an active part in maintaining this environment. You should observe all posted safety rules, adhere to all safety instructions provided by your supervisor and use safety equipment where

required.

Your workspace should be kept neat, clean and orderly.

EMERGENCY ACTION PLAN for: XYZ COMPANY

Facility Name: ____________________

Facility Address: ___________________

DATE PREPARED: ___/_____/______

EMERGENCY PERSONNEL NAMES AND PHONE NUMBERS

DESIGNATED RESPONSIBLE OFFICIAL (Highest Ranking Manager at

_____________site, such as __________, ___________, or ____________):

Name: Phone: (________________)

EMERGENCY COORDINATOR:

Name: Phone: (______________)

AREA/FLOOR MONITORS (If applicable):

Area/Floor:

Name: Phone: (_______________)

Area/Floor: Name: Phone: (_______________)

ASSISTANTS TO PHYSICALLY CHALLENGED (If applicable):

Name: Phone: (_______________)
Name: Phone: (________________)

Date ____/____/____

EVACUATION ROUTES

• Evacuation route maps have been posted in each work

area.

The

following information is marked on evacuation maps:

1. Emergency exits

2. Primary and secondary evacuation routes

3. Locations of fire extinguishers

4. Fire alarm pull stations’ location

a. Assembly points

• Site personnel should know at least two evacuation routes.

EMERGENCY PHONE NUMBERS

FIRE DEPARTMENT: ________________

PARAMEDICS: _______________

AMBULANCE: _______________

POLICE: ________________

FEDERAL PROTECTIVE SERVICE: ________________

SECURITY (If applicable): _________________

BUILDING MANAGER (If applicable): ________________

UTILITY COMPANY EMERGENCY CONTACTS

(Specify name of the company, phone number and point of contact)

ELECTRIC: _____________________

WATER: _______________________

GAS (if applicable): __________________________

TELEPHONE COMPANY: _______________________

Date: ___/____/_____

EMERGENCY REPORTING AND EVACUATION PROCEDURES

Types of emergencies to be reported by site personnel are:

• MEDICAL

• FIRE

• SEVERE WEATHER

• BOMB THREAT

• CHEMICAL SPILL

• STRUCTURE CLIMBING/DESCENDING

• EXTENDED POWER LOSS

• OTHER (specify)___________________________________

MEDICAL EMERGENCY

• Call medical emergency phone number (check applicable):

􀂆 Paramedics

􀂆 Ambulance

􀂆 Fire Department

􀂆 Other

Provide the following information:

a. Nature of medical emergency,

b. Location of the emergency (address, building, room number),

and

c. Your name and phone number from which you are calling.

• Do not move victim unless absolutely necessary.

• Call the following personnel trained in CPR and First Aid to provide the

required assistance prior to the arrival of the professional medical help:

Name: Phone:_______________________

Name: Phone: ________________________

• If personnel trained in First Aid are not available, as a minimum, attempt to

provide the following assistance:

1. Stop the bleeding with firm pressure on the wounds (note: avoid

contact with blood or other bodily fluids).

2. Clear the air passages using the Heimlich Maneuver in case of

choking.

• In case of rendering assistance to personnel exposed to hazardous materials,

consult the Material Safety Data Sheet (MSDS) and wear the appropriate personal

protective equipment. Attempt first aid ONLY if trained and qualified.

Date___/___/___

FIRE EMERGENCY

When fire is discovered:

• Activate the nearest fire alarm (if installed)

• Notify the local Fire Department by calling .

• If the fire alarm is not available, notify the site personnel about the fire

emergency by the following means (check applicable):

􀂆 Voice

Communication

􀂆 Phone Paging

􀂆 Radio

􀂆 Other (specify)

Fight the fire ONLY if:

• The Fire Department has been notified.

• The fire is small and is not spreading to other areas.

• Escaping the area is possible by backing up to the nearest exit.

• The fire extinguisher is in working condition and personnel are trained to

use it.

Upon being notified about the fire emergency, occupants must:

• Leave the building using the designated escape routes.

• Assemble in the designated area (specify location):

• Remain outside until the competent authority (Designated Official or

designee) announces that it is safe to reenter.

Designated Official, Emergency Coordinator or supervisors must (underline one):

• Disconnect utilities and equipment unless doing so jeopardizes his/her

safety.

• Coordinate an orderly evacuation of personnel.

• Perform an accurate head count of personnel reported to the designated

area.

• Determine a rescue method to locate missing personnel.

• Provide the Fire Department personnel with the necessary information

about the facility.

• Perform assessment and coordinate weather forecast office emergency

closing procedures

Area/Floor Monitors must:

• Ensure that all employees have evacuated the area/floor.

• Report any problems to the Emergency Coordinator at the assembly area.

Assistants to Physically Challenged should:

• Assist all physically challenged employees in emergency evacuation.

Date___/___/___

EXTENDED POWER LOSS

In the event of extended power loss to a facility certain precautionary measures should

be taken depending on the geographical location and environment of the facility:

• Unnecessary electrical equipment and appliances should be turned off in

the event that power restoration would surge causing damage to

electronics and effecting sensitive equipment.

• Facilities with freezing temperatures should turn off and drain the following

lines in the event of a long term power loss.

· Fire sprinkler system

· Standpipes

· Potable water lines

· Toilets

• Add propylene-glycol to drains to prevent traps from freezing

• Equipment that contain fluids that may freeze due to long term exposure

to freezing temperatures should be moved to heated areas, drained of

liquids, or provided with auxiliary heat sources.

Upon Restoration of heat and power:

• Electronic equipment should be brought up to ambient temperatures

before energizing to prevent condensate from forming on circuitry.

• Fire and potable water piping should be checked for leaks from freeze

damage after the heat has been restored to the facility and water turned

back on.

CHEMICAL SPILL

The following are the locations of:

Spill Containment and Security Equipment: ___________________________

Personal Protective Equipment (PPE):

MSDS:_____________________________________________________

When a Large Chemical Spill has occurred:

• Immediately notify the designated official and Emergency Coordinator.

• Contain the spill with available equipment (e.g., pads, booms, absorbent

powder, etc.).

• Secure the area and alert other site personnel.

• Do not attempt to clean the spill unless trained to do so.

• Attend to injured personnel and call the medical emergency number, if

required.

• Call a local spill cleanup company or the Fire Department (if arrangement

has been made) to perform a large chemical (e.g., mercury) spill cleanup.

Name of Spill Cleanup Company:_______________________________

Phone Number:_____________________________________________

• Evacuate building as necessary

When a Small Chemical Spill has occurred:

• Notify the Emergency Coordinator and/or supervisor (select one).

• If toxic fumes are present, secure the area (with caution tapes or cones) to

prevent other personnel from entering.

• Deal with the spill in accordance with the instructions described in the

MSDS.

• Small spills must be handled in a safe manner, while wearing the proper

PPE.

• Review the general spill cleanup procedures.

SEVERE WEATHER AND NATURAL DISASTERS

Tornado:

• When a warning is issued by sirens or other means, seek inside shelter.

Consider the following:

– Small interior rooms on the lowest floor and without windows,

– Hallways on the lowest floor away from doors and windows, and

– Rooms constructed with reinforced concrete, brick, or block with no

windows.

• Stay away from outside walls and windows.

• Use arms to protect head and neck.

• Remain sheltered until the tornado threat is announced to be over.

Earthquake:

• Stay calm and await instructions from the Emergency Coordinator or the

designated official.

• Keep away from overhead fixtures, windows, filing cabinets, and electrical

power.

• Assist people with disabilities in finding a safe place.

• Evacuate as instructed by the Emergency Coordinator and/or the

designated official.

Flood:

If indoors:

• Be ready to evacuate as directed by the Emergency Coordinator and/or

the designated official.

• Follow the recommended primary or secondary evacuation routes.

If outdoors:

• Climb to high ground and stay there.

• Avoid walking or driving through flood water.

• If car stalls, abandon it immediately and climb to a higher ground.

Hurricane

:

• The nature of a hurricane provides for more warning than other natural

and weather disasters. A hurricane watch issued when a hurricane

becomes a threat to a coastal area. A hurricane warning is issued when

hurricane winds of 74 mph or higher, or a combination of dangerously high

water and rough seas, are expected in the area within 24 hours.

Once a hurricane watch has been issued:

• Stay calm and await instructions from the Emergency Coordinator or the
designated official.

• Moor any boats securely, or move to a safe place if time allows.

• Continue to monitor local TV and radio stations for instructions.

• Move early out of low-lying areas or from the coast, at the request of

officials.

• If you are on high ground, away from the coast and plan to stay, secure

the building, moving all loose items indoors and boarding up windows and

openings.

• Collect drinking water in appropriate containers.

Once a hurricane warning has been issued:

• Be ready to evacuate as directed by the Emergency Coordinator and/or
the designated official.

• Leave areas that might be affected by storm tide or stream flooding.

During a hurricane:

• Remain indoors and consider the following:

– Small interior rooms on the lowest floor and without windows,
– Hallways on the lowest floor away from doors and windows, and
– Rooms constructed with reinforced concrete, brick, or block with no
windows.

Blizzard:

If indoors:
• Stay calm and await instructions from the Emergency Coordinator or the
designated official.

• Stay indoors!

• If there is no heat:

– Close off unneeded rooms or areas.

– Stuff towels or rags in cracks under doors.

– Cover windows at night.

• Eat and drink. Food provides the body with energy and heat. Fluids

prevent dehydration.

• Wear layers of loose-fitting, light-weight, warm clothing, if available.

If outdoors:

• Find a dry shelter. Cover all exposed parts of the body.

• If shelter is not available:

– Prepare a lean-to, wind break, or snow cave for protection from the

wind.

– Build a fire for heat and to attract attention. Place rocks around the

fire to absorb and reflect heat.

– Do not eat snow. It will lower your body temperature. Melt it first.

If stranded in a car or truck:

• Stay in the vehicle!

• Run the motor about ten minutes each hour. Open the windows a little for

fresh air to avoid carbon monoxide poisoning. Make

sure the exhaust pipe is not blocked.

• Make yourself visible to rescuers.

– Turn on the dome light at night when running the engine.

– Tie a colored cloth to your antenna or door.

– Raise the hood after the snow stops falling.

• Exercise to keep blood circulating and to keep warm.

CRITICAL OPERATIONS

During some emergency situations, it will be necessary for some specially

assigned personnel to remain at the work areas to perform critical operations.

Assignments:

Work Area Name Job Title Description of Assignment

• Personnel involved in critical operations may remain on the site upon the

permission of the site designated official or Emergency Coordinator.

• In case emergency situation will not permit any of the personnel to remain

at the facility, the designated official or other assigned personnel shall

notify the appropriate _______________ offices to initiate backups. This

information can be obtained from the Emergency Evacuation Procedures

included in the ___________________ Manual.

The following offices should be contacted:

Name/Location:________________________________

Telephone Number:_____________________________

Name/Location:________________________________
Telephone Number:_____________________________
Name/Location:________________________________
Telephone Number:_____________________________

TRAINING

The following personnel have been trained to ensure a safe and orderly

emergency evacuation of other employees:

Facility:

Name Title Responsibility Date

Emergency Shutdown Procedures

What is the first step in an emergency shutdown?

A.

Place pressure on switch to NO. 1 located in break room and release.

B.

Notify all personnel to evacuate the building.

C.

Pull fire control handle.

D.

Run to the outside warehouse.

Injury & Illness Procedures

Procedures

This document contains guidance for safety procedures to be followed and forms to be used. Supervisors are expected to integrate the procedures into the appropriate work activity and employees are expected to apply them on the job. The sample forms are to be used if they apply to the job concerned.

Record Keeping

1. Minor injuries – requiring doctor or outpatient care: After the emergency actions following an injury, an investigation of the incident will be conducted by the immediate supervisor and any witness to determine the causes. The findings must be documented on our investigation form.

1. Major injuries – fatality or one or more hospitalizations: Top management must see that the Department of Labor and Industries is notified as soon as possible, but at least within 8 hours of the incident. Call or contact in person the nearest office of the Department or call the OSHA toll free central number (1-800-321-6742). Top management will then assist the Department in the investigation.

1. The findings must be documented on our incident investigation report form and recorded on the OSHA 300 log, if applicable.

Supervisor’s Responsibilities

1. Supervise and administer first aid as you wish (Good Samaritan Law applies).

1. Arrange for transportation (ambulance, helicopter, company vehicle, etc.), depending on the seriousness of the injury. Protect the injured person from further injury.

1. Notify owner or top management, if not already present.

1. Do not move anything unless necessary, pending investigation of the incident.

1. Accompany or take injured person(s) to doctor, hospital, home etc. (depending on the extent of injuries).

1. Take injured person to family doctor, if available.

1. Remain with the injured person until relieved by other authorized persons (manager, EMT, doctor, etc.).

1. When the injured person’s immediately family is known, the owner or supervisor should properly notify family members, preferable in person, or have an appropriate person do so.

Report Form

Incident/Accident

Investigation Procedures

Procedure Steps

Observe the items of responsibility established in this document as well as job safety rules which may apply to specific task assignments.
1 Follow safety rules described in this program, OSHA safety standards and training or receive.
2. Report unsafe conditions or actions to your supervisor or safety committee representative
right away.
3. Report all injuries to your supervisor promptly regardless of how serious.
4. Report all near-miss incidents to your supervisor promptly.
5. Always use personal protective equipment (PPE) in good working condition where it is required.
6. Do not remove or defeat any safety device or safeguard provided for employee protection.
7. Encourage co-workers by your words and example to use safe work practices on the job.
8. Make suggestions to your supervisor, safety committee representative or management about changes you believe will improve employee safety.
Worksheet Form

Incident/Accident Table

Safety Guidelines

General Guidlines
Learn ways store materials in a safe manner. Tie down or support piles if necessary to prevent falling, rolling, or shifting.
1. Shavings, dust scraps, oil or grease should not be allowed to accumulate. Good housekeeping is a part of the job.
1. Trash piles must be removed as soon as possible. Trash is a safety and fire hazard.
1. Remove or bend over the nails in lumber that has been used or removed from a structure.
1. Immediately remove all loose materials from stairs, walkways, ramps, platforms, etc.
1. Do not block aisles, traffic lanes, fire exits, gangways, or stairs.
1. Avoid shortcuts – use ramps, stairs, walkways, ladders, etc.
1. Standard guardrails must be erected around all floor openings and excavations must be barricaded. Contact your supervisor for the correct specifications.
1. Do not remove, deface or destroy any warning, danger sign, or barricade, or interfere with any form of protective device or practice provided for your use or that is being used by other workers.
1. Get help with heavy or bulky materials to avoid injury to yourself or damage to material.
1. Keep all tools away from the edges of scaffolding, platforms, shaft openings, etc.
1. Do not use tools with split, broken, or loose handles, or burred or mushroomed heads. Keep cutting tools sharp and carry all tools in a container.
1. Know the correct use of hand and power tools. Use the right tool for the job.
1. Know the location and use of fire extinguishing equipment and the procedure for sounding a fire alarm.

Equipment Specific

The following equipment will be operated, and will require training beforehand:

Specific equipment in factory:
Air compressor
Conveyors
Electric forklift
Hoists
Metal punch presses
Metal bending and cutting machines
Plastic injection molding machines
Plastic sheet forming equipment
Shearing machine for sheet plastic

Individual Specific

Processes at factory include:
Circuit board assembly
Circuit board production
Metal case production
Plastic forming processes
Plastic pellet storage and transport to machines
Shipping/receiving

Safety Disciplinary Policy

Safety Disciplinary Policy

XYZ COMPANY believes that a safety and health Accident Prevention Program is unenforceable without some type of disciplinary policy. Our company believes that in order to maintain a safe and healthful workplace, the employees must be cognizant and aware of all company, State, and Federal safety and health regulations as they apply to the specific job duties required. The following disciplinary policy is in effect and will be applied to all safety and health violations.
The following steps will be followed unless the seriousness of the violation would dictate going directly to Step 2 or Step 3.
1. A first time violation will be discussed orally between company supervision and the employee. This will be done as soon as possible.
1. A second time offense will be followed up in written form and a copy of this written documentation will be entered into the employee’s personnel folder.
1. A third time violation will result in time off or possible termination, depending on the seriousness of the violation.

Safety Awareness Program

Safety Committee

We believe that hard work and perseverance are required for the prevention of injuries, with an active safety committee being the key to a successful result. The committee is made up of management-designated representatives and employee-elected representatives. Employees in each division will elect a representative from among themselves to be on the committee. At no time will there be more management-designated representatives than employee-elected representatives.
A. Purpose: To assist in the detection and elimination of unsafe conditions and work procedures.
B. Procedures:
The following guidelines will be followed:
0. The committee will elect a chairperson by majority vote.
0. The attendance and subjects discussed shall be documented and maintained on file for one year.
0. Copies of the minutes should be made available to the employees by posting or other means.

Safety Meetings

The regularly scheduled meeting time is at 12:50 pm on the first Tuesday of every third

month, at the break room. This may be changed by vote of the committee.

Safety Training Form

1.

Explain the company safety program, including:

Orientation

______

______

On-the-job training

______

______

Safety meetings

______

______

Incident investigation

______

______

Disciplinary action

______

______

2.

Use and care of personal protective equipment (Hard hat, fall protection, eye protection, etc.)

______

______

3.

Line of communication and responsibility for immediately reporting injuries.

A.

When to report an injury

______

______

B.

How to report an injury

______

______

C.

Who to report an injury to

______

______

D.

Filling out incident report forms

______

______

4.

General overview of operation, procedures, methods and hazards as they relate to the specific job

______

______

5.

Pertinent safety rules of the company and WISHA

______

______

6.

First aid supplies, equipment and training

A.

Obtaining treatment

______

______

B.

Location of Facilities

______

______

C.

Location and names of First-aid trained personnel

______

______

7.

Emergency plan

A.

Exit location and evacuation routes

______

______

B.

Use of fire fighting equipment (extinguishers, hose)

______

______

C.

Specific procedures (medical, chemical, etc.)

______

______

8.

Vehicle safety

______

______

9.

Personal work habits

A.

Serious consequences of horseplay

______

______

B.

Fighting

______

______

C.

Inattention

______

______

D.

Smoking policy

______

______

E.

Good housekeeping practices

______

______

F.

Proper lifting techniques

______

______

Safety Award Program

Appendix A:

Material Safety Data Sheet

Appendix B:

State and Federal Posters

Appendix C:

OSHA Forms and Instructions

OSHA Form Instructions

OSHA Form 300

OSHA Form 300A

OSHA Form 301

Safety and Health Inspection Check List

Job site: _____________________________________ Date: _________________________

This format is intended only as a reminder to look for unsafe practices, potential and/or near miss incidents.

(S) indicates Satisfactory (U) indicates Unsatisfactory

Date of inspection/walk around

Machinery

Point of operation guard

Belts, pulleys, gears, shafts, etc.

Oiling, cleaning, and adjusting

Maintenance and oil leaks

Pressure equipment

Steam equipment

Air Receivers and Compressors

Gas cylinders and hoses

Unsafe Practices

Excessive speed of vehicles

Improper lifting

Smoking in dangerous places

Horseplay

Running in aisles or on stairs

Improper use of air hoses

Removing machine guards

Job site: _____________________________________ Date: _________________________

This format is intended only as a reminder to look for unsafe practices, potential and/or near miss incidents.

(S) indicates Satisfactory (U) indicates Unsatisfactory

Date of inspection/walk around

Machinery

Point of operation guard

Belts, pulleys, gears, shafts, etc.

Oiling, cleaning, and adjusting

Maintenance and oil leaks

Pressure equipment

Steam equipment

Air Receivers and Compressors

Gas cylinders and hoses

Unsafe Practices

Excessive speed of vehicles

Improper lifting

Smoking in dangerous places

Horseplay

Running in aisles or on stairs

Improper use of air hoses

Removing machine guards

Working under suspended loads

Working on machines in motion

First aid

First aid kits

Stretchers and fire blankets

Emergency showers

Eyewash stations

All injuries and illnesses reported

Hazard Communications

Acids and caustics

Solvents

Dusts, vapors, or fumes

Radiation

Safety and Health Inspection Check List – continued
Job site: _____________________________________ Date: _________________________
(S) indicates Satisfactory (U) indicates Unsatisfactory

Date of inspection/walk around

Tools

Power tools, wiring and grounding

Hand tools (condition)

Use and storage of tools

Personal protective equipment

Goggles or face shield

Substantial footwear

Working under suspended loads

Working on machines in motion

First aid

First aid kits

Stretchers and fire blankets

Emergency showers

Eyewash stations

All injuries and illnesses reported

Hazard Communications

Acids and caustics

Solvents

Dusts, vapors, or fumes

Radiation

Safety and Health Inspection Check List – continued
Job site: _____________________________________ Date: _________________________
(S) indicates Satisfactory (U) indicates Unsatisfactory

Date of inspection/walk around

Tools

Power tools, wiring and grounding

Hand tools (condition)

Use and storage of tools

Personal protective equipment

Goggles or face shield

Substantial footwear

Hard hats

Gloves

Respirators

Fall protection equipment

Other protective clothing

Fire protection

Extinguishing equipment

Exits, stairs, and signs

Storage of flammable materials

Material Handling Equipment

Power trucks and hand trucks

Elevators

Cranes and hoists

Conveyors

Cables, ropes, chains, slings

Housekeeping

Aisles, stairs and floors

Storage and piling of materials

Wash and locker rooms

Light and ventilation

Disposal of water

Yards and parking lots

Bulletin boards

Only safety and health materials posted

Neat and attractive

Display regularly changed

Well-illuminated

Equipment Safety Inspection Checklist
Date: __________________________________________
Project: _________________________________________
Equipment: ______________________________________

All guards and fenders

_____

OK

_____

Needs Repair

Brakes

_____

OK

_____

Needs Repair

Lights – front, rear, side, dash

_____

OK

_____

Needs Repair

Back-up alarm – horn

_____

OK

_____

Needs Repair

Ladders, stairs, hand holds

_____

OK

_____

Needs Repair

ROPS (Roll-over protection)

_____

OK

_____

Needs Repair

Seat belts

_____

OK

_____

Needs Repair

Fire extinguisher

_____

OK

_____

Needs Repair

Glass

_____

OK

_____

Needs Repair

Tires

_____

OK

_____

Needs Repair

Electrical cords

_____

OK

_____

Needs Repair

Ground fault circuit interrupters

_____

OK

_____

Needs Repair

Electrical hand tools

_____

OK

_____

Needs Repair

Powder actuated tools

_____

OK

_____

Needs Repair

Pneumatic condition of all hand tools

_____

OK

_____

Needs Repair

Other Items Checked:

Oil level and leaks

___

OK

___

Needs Repair

___

Add

___

Change

Hydraulic oil level and leaks

___

OK

___

Needs Repair

___

Add

___

Change

Anti-freeze level and leaks

___

OK

___

Needs Repair

___

Add

___

Change

Fuel level and leaks

___

OK

___

Needs Repair

___

Add

___

Change

First aid kit

___

OK

___

Needs Repair

___

Add

___

Change

Repaired by: _________________________________________

Checked by: __________________________________________
52
JOB SAFETY ANALYSIS WORKSHEET

TITLE OF JOB OPERATION: _______________________________

Date: ______________

Title of person who does job: _____________________________________________________

Employee observed: _________________________

Location: ________________________

Analysis made by: ___________________________

Analysis approved by: ______________

Sequence of basic job steps

Potential injuries or hazards

Recommended safe job procedures

Hazardous Substances
Employee Orientation Checklist
Employee Name:
(Add Name of Employee here)

Title:
(Add title of employee here)
Date hired:
(Add Date Hired here)

Trainer Name:
(Add name of person conducting training here)

This checklist is to inform employees of
(Add company name here)
of its Hazard Communication Program. Place a check in each box to indicate that the subject has been covered.
The supervisor has reviewed the following information with the employee:
1. The purpose of the hazard communication standard is to require chemical manufacturers or importers to assess the hazards of chemicals they produce or import. All employers must provide information to their employees about the hazardous chemicals to which they may be exposed.
Employees must be informed about the hazard communication program, labels and other forms of warning, and material safety data sheets, and they must have training on the hazardous substances they may encounter.
2. The supervisor has reviewed the hazardous chemical list with the employee.
3. The supervisor has shown the employee the following:
Location of hazardous chemicals within the employee’s work site.
Location of the written Hazard Communication Program.
Location of the material safety data sheets for all hazardous chemicals in the employee’s assigned work area.
Location of the list of person(s) trained and authorized to handle the hazardous chemicals.
The signature below documents that the appropriate elements have been talked over to the satisfaction of both parties and that both the supervisor and employee accept responsibility for maintaining a safe and healthful work environment.
Date:
(Enter date of orientation)
Supervisor’s signature: _______________________
Date:
(Enter date of orientation)
Employee’s signature: ________________________

73

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1.	Assure that all safety and health rules, regulations, policies and procedures are understood and observed.
2.	Require the proper care and use of all required personal protective equipment.
3.	Identify and eliminate job hazards quickly through job safety analysis procedures. (See the sample Job Safety Analysis form attached to this document.)
4.	Inform and train employees on the hazardous chemicals and/or procedures they MAY encounter under normal working conditions or during an emergency situation. (See the sample hazard communication program.)
5.	Receive and take initial action on employee suggestions, awards or disciplinary measures.
6.	Train employees (new and experienced) in the safe and efficient methods of accomplishing each job or task as necessary.
7.	Review injury trends and establish prevention measures.
8.	Participate in incident investigations and inspections.
9.	Promote employee participation in the safety and health program.
10.	Actively follow the progress of injured workers and display an interest in their rapid recovery and return to work.