Accident Prevention Plan(Sami Al.docx

Accident Prevention Plan
(Sami Almalki)
TECH 462 –Industrial Safety Engineering
March 18, 2013
Table of Contents
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
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:
Coordinator or the
• 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:
Coordinator or the
• 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:________________________________
Name/Location:________________________________
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
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.
Unsatisfactory

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:
_________________________
Unsatisfactory

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:
_________________________
Unsatisfactory

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 SubstancesEmployee 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
Accident Prevention Plan
(Ghanim Alzaria)

TECH 462 –Industrial Safety Engineering
March 18, 2013
TABLE OF CONTENTS
INTRODUCTION4
Company President Statement5
Purpose and Intention6
MANAGEMENT RESPONSIBILITITES7
A.Management8
B.Supervisors9
C.All Employees11
EMPLOYEE ORIENTATION13
SAFETY & HEALTH COMMITTEE14
SAFETY BULLETIN BOARD17
SAFETY ORIENTATION19
ACCIDENT INVESTIGATION AND REPORTING20
SAFETY AND HEALTH EDUCATION TRAINING25
INJURY AND ILLNESS PROCEDURES28
Injury and Illness Reporting30
Injury and Illness COMMUNICATIONS PROGRAM 31
Hazard Communication Program (HAZCOM)32
List of hazardous chemicals32
Material Safety Data Sheets (MSDS)32
Container Labeling33
Employee information and Training34
Safety Guidelines36
1. Building Administrators and Supervisors37
2. Supervisors37
3. MSDS manager38
4. Human Resources38
6. Subcontractors39
7. Science Teachers40
8. All Employees.40
EMERGENCY ACTIONS41
HAZARDOUS ENERGY CONTROL PROGRAM (lockout/tag
out)42
Lockout/Tag out Program43

PERSONAL PROTECTIVE EQUIPMENT48
Personal Protective Equipment (PPE) PROGRAM49
FIRST AID52
HEARING CONSERVATION PROGRAM56
CONFINED SPACE PROGRAM62
Sample Safety Assurance Forms68
JOB SAFETY ANALYSIS FORM69
JOB SAFETY ANALYSIS70
ORIENTATION/JOB SAFETY CHECK LIST71
Record of hazard observed72
Safety Committee Meeting Minutes73
REPORT OF ACCIDENT/INCIDENT75
ACCIDENT CAUSATION GUIDE77
ABBREVIATIONS78
Appendix A: Material Safety Data Sheet (Sample)79
Appendix B: State and Federal Posters85
Appendix C: OSHA Forms89
OSHA FORM 30091
OSHA Form 30091
Log of Work-Related Injuries and Illnesses91
Year 2091
OSHA FORM 300A93
OSHA Form 300A93
Summary of Work-Related Injuries and Illnesses93
Year 2093
OSHA FORM 301 - Injuries and Illnesses Incident Report95

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.

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, 4x8 inches
(b) 16 adhesive bandages, 1x3 inches
(c) 1 adhesive tape, 5 yards long
(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, 3x3 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, 2x2 inches, 3x3 inches and 5x5
inches
(b) Self-activating cold packs, 4x5 inches
(c) Roller bandages, 6 yards long
(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
Personal Protective Equipment:
Item
If
Issued
If Available
In Work Location
Employee'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 SignatureRecord 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

Accident Prevention Plan(Sami Al.docx

Accident Prevention Plan(Sami Al.docx

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