The Fidlar Companies
Corporate Safety Manual
December, 2004
The Fidlar Companies
This is a product of the Molyneaux Insurance Loss Control Department. All materials are
provided to enhance our client's risk management control. Recommendations are purely advisory
and intended for the purpose of assisting our clients in loss control and safety procedures.
Implementing and complying with local, state, and federal regulatory laws are the sole
responsibility of the client.
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The Fidlar Companies
1 INTRODUCTION ..................................................................................................... 6
2 STATEMENT OF POLICY ....................................................................................... 8
3 JOB DESCRIPTIONS ............................................................................................. 10
President .................................................................................................... 11
Supervisor .................................................................................................. 12
Employee .................................................................................................... 13
4 MEDICAL EMERGENCY RESPONSE PLAN .......................................................... 18
Routine Transportation of Employees to the Doctor ........................................... 19
Emergency Transportation .............................................................................. 19
Medical Release/Return to Work Authorization Forms ....................................... 20
Preferred Medical Clinic Location ................................................................... 20
First Aid Equipment and Supplies .................................................................... 20
Medical Procedure ......................................................................................... 21
5 ACCIDENT REPORTING AND INVESTIGATION PROCEDURES ........................... 22
Incident Reporting ......................................................................................... 23
Home Injuries ................................................................................................ 23
Incident Investigation ..................................................................................... 23
Employee Accident Form Requirements ............................................. 24
Home Injury Status Report ....................................................................... 25
Supervisor's Incident Investigation Report Form ..................................... 26
Witness/Injured Incident Report Form ..................................................... 28
Employee Accident/Incident Report Form ................................................ 30
Photo Mount Display ................................................................................. 31
6 HAZARD COMMUNICATION PROGRAM ............................................................. 32
Policy ........................................................................................................... 33
Hazard Communication Program Coordinator ................................................... 33
Hazardous Substances or Materials List ............................................................ 34
Labels and Forms of Warning.......................................................................... 37
Material Safety Data Sheets (MSDS) ............................................................... 37
Employee Information And Training ................................................................ 37
Hazard Communication Training Program Form .................................... 40
7 OSHA INSPECTION PROCEDURE......................................................................... 41
Guidelines for OSHA Inspections .................................................................... 42
Inspection Scheduling and Prioritization ........................................................... 42
OSHA Inspector Arrival ................................................................................. 43
Records Reviewed ......................................................................................... 43
Standard Procedures for an OSHA Inspection ................................................... 44
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TABLE OF CONTENTS
Section Page
8 MATERIAL HANDLING AND STORAGE .............................................................. 47
General Precautions ....................................................................................... 48
Manual Lifting Techniques: ............................................................................ 48
Squat Lifting ........................................................................................ 48
Assisted One-Hand Lift ......................................................................... 48
Team Lifting and Carrying ..................................................................... 49
Handling Specific Shapes: ..................................................................... 49
Boxes, Cartons, and Sacks ............................................................ 49
Barrels and Drums ....................................................................... 49
Hand Trucks, Carts, and Dollies: ..................................................................... 50
Safe Procedures for Using Two-Wheeled Trucks or Carts ................................... 50
Four-Wheel Trucks or Cart ............................................................................. 50
9 FIRE PROTECTION AND FIRE PREVENTION ....................................................... 51
Fire Protection ............................................................................................... 52
Fire Extinguisher Use ..................................................................................... 52
Fire Prevention .............................................................................................. 52
10 LOCKOUT/TAGOUT PROGRAM........................................................................... 54
Introduction................................................................................................... 55
Purpose ......................................................................................................... 55
Scope and Application .................................................................................... 55
Definitions .................................................................................................... 56
Energy Control Program ................................................................................. 57
Energy Control Procedures.............................................................................. 57
Group Lockout .............................................................................................. 59
Energy Isolating Devices ................................................................................ 59
Requirements for Lockout/Tagout Devices ....................................................... 60
Employee Training ......................................................................................... 61
Periodic Inspection......................................................................................... 61
Additional Safety Requirements ...................................................................... 62
11 EMERGENCY ACTION AND FIRE PREVENTION PLAN ....................................... 69
12 RESPIRATORY PROTECTION PROGRAM ............................................................ 79
13 DRUG AND ALCOHOL PROGRAM ..................................................................... 105
Policy Statement .......................................................................................... 106
Definitions .................................................................................................. 106
Confidentiality............................................................................................. 107
Rules, Disciplinary Actions ........................................................................... 108
Drug and Alcohol Testing ............................................................................. 109
Rehabilitation and Employee Assistance Program ............................................ 110
4
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TABLE OF CONTENTS
Section Page
14 POWERED INDUSTRIAL TRUCK .................................................................. 111
Objective ................................................................................................... 112
Applicability/Scope ................................................................................... 112
Accountability .......................................................................................... 112
Training .................................................................................................... 116
15 CRISIS MANAGEMENT ...................................................................................... 121
Introduction.............................................................................................. 122
Preparation .............................................................................................. 123
16 WRITTEN PERSONAL PROTECTIVE EQUIPMENT PROGRAM .......................... 155
17 VEHICLE FLEET SAFETY POLICY ..................................................................... 161
Objective ...................................................................................................................... 162
Applicability/Scope ...................................................................................................... 162
Accountability .............................................................................................................. 162
Driver Eligibility .......................................................................................................... 162
Defensive Safety Rules ................................................................................................ 164
Defensive Driving Rules .............................................................................................. 164
What to Do In Case of An Accident ............................................................................. 165
Vehicle Fleet Safety Rules ........................................................................................... 168
APPENDIX PPE HAZARD ASSESMENT ....................................................................... 169
Hazard Assessment Guide ................................................................................................ 170
Eye and Face Protection Selection Chart ................................................................... 170
Selection Guidelines for Head Protection ................................................................... 172
Selection Guidelines for Foot Protection .................................................................... 173
Selection Guidelines for Hand Protection ................................................................... 174
Guidelines for Cleaning and Maintenance ................................................................. 174
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The Fidlar Companies
SECTION 1
INTRODUCTION
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The Fidlar Companies
This manual establishes procedures that provide a safe and healthful working environment for all
employees. These procedures apply to all work performed at any Fidlar Companies location that is
managed, or operated by The Fidlar Companies.
The objectives are as follows:
To provide guidelines for implementing a safety plan that will direct safety and health
programs at The Fidlar Companies and to maintain compliance with federal, state and/or
local statutory requirements or regulations.
To minimize occupational injury and illnesses, reduce equipment and property damage,
and eliminate recurrences.
To establish responsibility and accountability for the safety program at the facility.
This manual is intended to list some of the policies, procedures, and practices of The Fidlar Companies
and is subject to change, revision, or revocation at any time without notice. It is not to be construed
either as an employment contract or a guaranty of employment.
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The Fidlar Companies
SECTION 2
STATEMENT OF POLICY
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The Fidlar Companies
The well being of all employees working at The Fidlar Companies is our highest priority. While we must
provide quality work at a fair price for our customers in order to survive as a business, we refuse to
accept that anyone must be injured in the process. We believe that productive work habits and safe work
habits are one in the same.
Many accidents occur when people are in a hurry to get something done, or when they get into habits and
think that it won't happen to them. None of us have the ability to predict when, where, or how an
accident will happen. The tragedy is that most accidents would take but a few seconds to avoid. No
matter how busy or experienced you feel you are, you MUST consistently take that little bit of time to do
it safely. You cannot coast; you have got to do it everyday. Victims of accidents wish they had.
1. Avoid accidents and other unplanned occurrences that result in injury to employees,
interruption of production, or damage to equipment and property.
2. Take all action necessary in engineering, planning, designing, assigning and supervising
work operations to establish and maintain safe and healthful working conditions on all
projects.
This booklet outlines the minimum requirements for a safe work environment. Certain jobs will require
additional protections. It is extremely important that you understand HOW each task is to be done in a
safe manner. If you do not know, STOP and ASK before you begin to work. Your safety and well being,
as well as the safety of those around you, can be accomplished only through your constant, sincere effort.
Merely talking about safety is not sufficient. It is everyone's responsibilities to act, think, and perform
safely.
We must work together to maintain a safe work environment. Together we can achieve our goal of an
accident-free workplace.
____________________________, President
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The Fidlar Companies
SECTION 3
JOB DESCRIPTIONS
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The Fidlar Companies
TITLE
(as related to safety): President
SUMMARY: The President of The Fidlar Companies shall demonstrate a positive attitude toward
the achievement of a strong safety program, with the objective of preventing
personal injury and property damage through direct and active support.
PRIMARY SAFETY RESPONSIBILITY:
1. Communicate about safety in the same way you communicate about costs and schedules.
2. Include the discussion of safety programs at staff meetings.
3. Request status reports (monthly) on safety activities and progress within The Fidlar
Companies.
4. Insist newly hired employees receive training in safe work methods.
5. Make the necessary appropriations to meet the requirements of an effective safety
program.
6. Continually support and enforce the The Fidlar Companies Safety Program.
7. Practice safety through good example.
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SECTION 3 JOB DESCRIPTIONS
TITLE
(as related to safety): Supervisor
SUMMARY: Supervisors are directly responsible for the control and activities of their employees.
They play a key role in the implementation and maintenance of an effective safety
program.
Supervisors must plan their safety activity with the same care and effort as they do
other portions of their work.
PRIMARY SAFETY RESPONSIBILITY:
1. Provide, and require the use of, all personal protective equipment deemed necessary by
the process, equipment or materials.
2. Perform work site safety inspections and hazard corrections on a daily basis.
3. Hold safety meetings with their crews on as needed basis.
4. Provide all accident reports to the management the day of the accident.
6. Assist with accident investigations to ensure proper reporting and documentation.
Follow up accidents with prompt corrections to eliminate recurrences.
7. Insist on compliance with the all safety programs and compliance regulations.
8. Monitor compliance with safety programs when applicable.
9. Ensure prompt first aid is administered to injured employees and that necessary medical
treatment is pursued.
10. Practice safety through good example.
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SECTION 3 JOB DESCRIPTIONS
TITLE
(as related to safety): Employee
SUMMARY: Good safety practices and accident prevention is the responsibility of every The
Fidlar Companies employee. Each employee is responsible to know and to follow
the general provisions of the The Fidlar Companies Safety Policy, the specific rules
of their job and the rules enumerated below.
ALL EMPLOYEES WILL ABIDE BY THE FOLLOWING RULES:
1. Report unsafe conditions and "near misses" to a supervisor.
2. Immediately report all injuries to a supervisor.
3. Employees who will miss work must report by calling the office by 9:00 A.M. of the day
missed. Employees failing to report any absence after the third missed day are presumed
to have abandoned their job.
4. Employees involved in a work related accident, regardless of injury, are required to fill
out and sign an Accident/Incident Report Form.
5. Wear designated PPE according to company policy.
6. Wear appropriate work clothes as designated by The Fidlar Companies
7. Properly care and be responsible for all personal and company protective equipment.
Report lost or damaged equipment.
8. During an emergency evacuation, employees are to report to their supervisor at the
designated assembly area.
9. The use of, or being under the influence of intoxicating beverages or illegal drugs while
on company premises is prohibited. Prescription drugs, which may cause drowsiness,
must be reported to your supervisor.
10. Horseplay or practical jokes shall not be permitted. Fighting is grounds for dismissal.
12. Good housekeeping shall be practiced by all employees working at The Fidlar
Companies. Excess material shall be properly stacked and stored. Debris shall not be
allowed to accumulate in aisles and will be frequently removed.
13. Flammable liquids must be stored and securely transported in proper safety containers
with a self-closing lid and flash arresters in place. Engines must be shut off when
refueling. No smoking anywhere near flammable liquids.
14. Compressed gas cylinders (Propane, Oxygen, Acetylene, etc.) must be secured in an
upright position. When not in use, caps must be securely on. Oxygen and Acetylene
shall not be stored together.
13
SECTION 3 JOB DESCRIPTIONS
15. Never operate any machines or equipment unless all guards and safety devices are in
place and in proper operating condition.
16. Keep all tools in safe working condition. Never use defective tools or equipment.
Report all defective equipment to your supervisor.
17. Machinery shall be properly oiled, cleaned, adjusted, refueled and operated only by
authorized operators. Shut off and lock out equipment under repair.
18. No person (other than the operator) shall ride any forklift or material handling
equipment.
19. Ladders shall be used only in the open and locked position. The last step prior to the top
will never be used. Place ladders on a substantial base and do not use ladders with
broken, split or missing rungs or rails. All access ladders are to extend at least three feet
above the landing platform and be securely fastened. Proper ladder placement is: 1/4
base/height.
20. Lift correctly, using your legs to take the strain. Turn by placing the proper foot into
direction of the turn (do not twist with the back). Lock your lower back curve; tighten
stomach muscles before you lift. Stretch your muscles before lifting.
21. Running on the job is always prohibited. Jumping off any ladder or height is grounds for
dismissal. While ascending any ladder the three point contact rule (2 hands - 1 foot; 2
feet - 1 hand) must be used. Use a rope to lift tools.
22. The Fidlar Companies has a Hazard Communication Program (HCP). The purpose of
this program is to inform you of the hazards of the chemicals we work with in order to
reduce chemical source injuries and illness. If you have a question about any chemical
you work with see your supervisor.
23. You must understand the supervisor's instruction. If you do not know how to do the job
safely, ask your supervisor.
24. Never seek medical attention concerning a work related injury or illness after work hours
without first attempting to notify a supervisor.
25. If you are injured away from the job, notify your supervisor; it may affect your job
performance or worsen the injury.
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SECTION 3 JOB DESCRIPTIONS
EMPLOYEE ACKNOWLEDGMENT
I, the undersigned, acknowledge receipt of the The Fidlar Companies Employee Safety Manual and Drug
and Alcohol Policy, and an orientation on its contents.
I agree to read and abide by the regulations contained in the Safety Manual and Drug and Alcohol Policy,
as well as all other company policies. I UNDERSTAND THAT MY FAILURE TO ADHERE TO
THESE POLICIES MAY RESULT IN THE TERMINATION OF MY EMPLOYMENT.
________________________________________________________________
Employee Signature
________________________________________________________________
Print Name
________________________________________________________________
Date
I have delivered an Employee Safety Manual to the employee shown above and have given an orientation
on the contents of the manual and other safety rules and company regulations which may apply.
________________________________________________________________
The Fidlar Companies Representative Signature
________________________________________________________________
Print Name
________________________________________________________________
Date
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The Fidlar Companies
DISCIPLINE AND ENFORCEMENT OF SAFETY RULES
This procedure is established to provide a mechanism for the discipline of employees who repeatedly
violate safety rules. Safety rules are written and enforced to protect employees from injury and provide a
"safe and healthful place of employment."
Supervisors are responsible for the enforcement of the safety and health program at The Fidlar
Companies In order to accomplish this, they must ensure that each employee is properly instructed in the
use of safety equipment and safe work practices, warn employees when they violate a safety rule.
When an employee violates a safety rule, the employer will follow the discipline procedure below as the
employer may deem appropriate:
1. First offense – verbal/written warning
2. Second offense – written warning
3. Third offense – unpaid time off or possible termination
The listing of infractions and penalties above is intended only as a general guideline, and The Fidlar
Companies specifically retains the right to modify the penalties and/or impose the appropriate
disciplinary action or other forms of discipline, based upon the specific circumstances involved in each
individual case, including discipline or termination on the first offense.
Each written warning will advise the employee of the nature of the violation and the correct safe practice
and procedure.
A copy of the violation will be provided to the employee.
NOTE: DOCUMENTATION OF THE ABOVE ACTION IS NECESSARY TO COMPLY WITH
GOVERNMENT REGULATIONS AND LABOR LAWS.
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The Fidlar Companies
EMPLOYEE WARNING RECORD Verbal
Written
Employee's Name ______________________________________________ Clock or Payroll No. ___________________
Date of Warning _________________________ Department ______________________________ Shift ___________
VIOLATION REASON FOR WARNING
Date Absence Substandard Work Disobedience
Time Tardiness Carelessness Safety
Place Other
COMPANY REMARKS - Explain pertinent facts in detail ____________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
EMPLOYEE REMARKS - Absence of statement by EMPLOYEE indicates agreement with this report. _______________
____________________________________________________________________________________________________
I have entered my version of the matter above
Employee's Signature ___________________________________________________ Date ________________________
ACTION TO BE TAKEN _____________________________________________________________________________
____________________________________________________________________________________________________
PREVIOUS WARNINGS I have read this "Warning Record" and understand it.
When and By Whom
1st Warning Employee's Signature Date
Date_________________________
Verbal Written
By Whom_____________________ Signature of person who prepared warning - Title Date
2nd Warning
Date_________________________ Supervisor's Signature Date
Verbal Written
By Whom_____________________
Signature of witness if employee refuses to sign
3rd Warning
Date_________________________ DISTRIBUTION
Verbal Written Original - Personnel File
By Whom_____________________ 2nd Copy - Employee
3rd Copy - Supervisor
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The Fidlar Companies
SECTION 4
MEDICAL EMERGENCY RESPONSE PLAN
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The Fidlar Companies
This section describes the first aid, medical services, and emergency transportation provided for
employees who incur occupational injuries arising out and in the course of employment with The Fidlar
Companies.
ROUTINE TRANSPORTATION OF
EMPLOYEES TO THE DOCTOR
Employees should not be permitted to leave the property without their Supervisor‟s approval. Employees
shall not be permitted to provide their own transportation for the initial visit to the doctor for a job-
related injury.
EMERGENCY TRANSPORTATION
The following guidelines should be followed for emergency transportation:
1. Supervision within The Fidlar Companies will decide what type of transportation will be
used. If medical attention is necessary during transport, the ambulance will be used. If
there is any doubt, the ambulance will always be the first choice. The ambulance phone
number is _______________________ or call 911.
2. The hospital emergency room or the clinic will be notified when the transportation
vehicle leaves the property. All available information regarding the nature and extent of
the injury should be given to the emergency room staff.
3. The injured employee will be accompanied by their Supervisor or a designee when being
transported to a clinic or hospital (non-ambulance).
4. The injured employee's nearest relative must be notified by their Supervisor or designee
after first aid has been rendered and he/she is on their way to the hospital.
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SECTION 4 MEDICAL EMERGENCY RESPONSE PLAN
MEDICAL RELEASE/RETURN TO
WORK AUTHORIZATION FORMS
When an employee returns from the physician, hospital, or clinic, he/she must present a Medical
Release/Return to Work Authorization form.
PREFERRED MEDICAL CLINIC
LOCATION
A medical clinic should be selected within the immediate area for treatment of non-life threatening work-
related injuries. A protocol should also be established with the selected clinic to ensure prompt and
accurate communication of medical treatment. It is The Fidlar Companies‟ primary objective to hasten
the recovery of employees injured on the job so that they may return to work as quickly as possible.
The medical clinic selected for this facility is
(Name of Clinic) at (Address and Phone Number of Selected Medical Clinic).
FIRST AID EQUIPMENT AND
SUPPLIES
Every major area within the facility will be equipped with a first aid kit. The size and the contents of the
first aid kit will be determined by The Fidlar Companies and the consulting physician. Other medical
and first aid supplies will be ordered as necessary for the employees' safety.
Personnel of The Fidlar Companies shall not dispense medication.
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SECTION 4 MEDICAL EMERGENCY RESPONSE PLAN
MEDICAL PROCEDURE
ALL MAJOR ACCIDENTS INVOLVING UNCONSCIOUSNESS OR MAJOR TRAUMA REQUIRE
PARAMEDICS!!!!
MAJOR ACCIDENTS
1. Secure the injured person: DO NOT MOVE SERIOUSLY INJURED OR UNCONSCIOUS
PERSONS unless he/she is in further danger.
2. KNOW THIS INFORMATION AND TELL THE PARAMEDICS:
a. Location of the facility.
b. Location at the facility of the injured employee (what floor, etc.).
c. General nature of the injury: shock, amputation, fall, etc.
3. Send for HELP: 'Anyone' available should make a call for help. Send someone to wait at the
facility entrance to direct the paramedics.
MINOR ACCIDENTS
Minor accidents such as cuts and muscle strains that do not impair the ability to work, should receive
first aid on the job. All such incidents must be reported to a supervisor.
All job injuries, which restrict work or cause the employee to stop work, must be directed to a supervisor.
1. CALL ( ) CLINIC at ( ).
Eye injuries are to be sent to this clinic as well. Hours: 8:00 a.m. to 4:30 p.m.
2. OFF-HOUR ACCIDENTS AND WEEKEND ACCIDENTS: Injured employees must be
accompanied to the nearest emergency room only.
3. After securing the injured, contact ( ), the General Manager and
immediately investigate: WHO, WHAT, WHEN, WHERE, AND WHY according to the
Accident Investigation procedures established by The Fidlar Companies
4. A written investigation form signed by the Supervisor should be turned in to the management
office. Witness statement forms located in section 5 of this manual should be filled out at the
time of the accident.
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The Fidlar Companies
SECTION 5
ACCIDENT REPORTING AND
INVESTIGATION PROCEDURES
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The Fidlar Companies
REPORTING AND INVESTIGATING ACCIDENTS
INCIDENT REPORTING
All incidents, however minor they may be, must be reported to the Workers‟ Compensation insurance
company. Sometimes minor injuries can develop into serious injuries. If a minor injury is reported, and
will not be submitted as a claim, then that report should read “FOR REPORTING PURPOSES ONLY.”
HOME INJURIES
When an employee arrives for work with an injury that occurred outside of work, a “HOME INJURY
STATUS REPORT” must be completed. Home injuries can prevent employees from performing the
essential functions of their jobs and working with a home injury may result in an aggravation of such an
injury.
If such a situation occurs, the employee should be sent home and directed to see a physician who can
complete the “HOME INJURY STATUS REPORT.” Employees should not be allowed to return to work
until they have a full release from their physician based on the essential functions of their job.
INCIDENT INVESTIGATION
The Incident Investigation must be completed as soon as possible after the scene is secured and all
injured parties are treated. By completing the investigation as soon as possible, you are ensuring that the
facts gathered are as accurate as possible.
Incident investigation must be fact-finding, not fault finding. The purpose is to learn the true cause so
that similar incidents can be prevented and determine facts bearing on legal liability. Another purpose of
the investigation or fact-finding is to prepare accurate documentation in case of possible litigation. From
the investigation, a written report will be completed for all serious incidents. The report should be
completed by the Supervisor who has investigated the incident. The report should contain the following:
1. Detailed description of the incident, including answers to the following:
a. What happened?
b. Who (individuals and companies) was involved?
c. When did the incident occur?
d. What injuries/property damage resulted?
2. Photographs taken.
3. Diagrams drawn of the scene.
4. Statement(s) from witness(es).
5. Conclusions should be developed regarding the physical cause of the incident, but should
not deal with the placement of legal liability upon any party.
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SECTION 5 INCIDENT REPORTING AND INVESTIGATION PROCEDURES
Only supervisory employees trained in incident investigation procedures should take witness statements
as part of the investigation.
No part of the report shall be given to any party, including the injured employee unless authorized by the
The Fidlar Companies management or legal counsel.
KEY POINTS TO REMEMBER
1. Get medical attention for all injured parties and notify the management office
immediately.
2. Protect the scene's physical evidence.
3. Confiscate all faulty equipment or materials.
4. Take photographs of incident scene.
5. Obtain the names, addresses, and phone numbers of all witnesses.
6. Discourage all The Fidlar Companies personnel from making any statements to the
media.
EMPLOYEE ACCIDENT FORM REQUIREMENTS
The employee accident form (Employer's First Report) shall be prepared by the Supervisor or his
designee the day of the accident. It is very important that all pertinent information be provided on the
accident report. The following information is of the greatest value:
1. The employee's full name
2. The employee's complete address
a. Street
b. City
c. Zip Code
d. Telephone Number
3. Whether the accident resulted in lost time from work
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HOME INJURY STATUS REPORT
DATE: NAME: COMPANY:
INITIAL VISIT: FOLLOW-UP VISIT:
WORK STATUS
Return to work - NO Return to work on
restriction on with the following restriction:
Unable to return to work No frequent lifting, bending, or twisting of
(See below) the trunk.
Lifting restriction of ______ lbs.
Keep wound clean and dry.
Must use protective device.
No repetitive motion of affected area.
No prolonged standing or walking limit to
_____hours per day.
No overhead work.
Other
No use of ladders.
No kneeling.
ESTIMATED DURATION OF RESTRICTED DUTY
At least until visit when we will reevaluate and notify of changes in restrictions.
Until
****NOTE: These restrictions are based on medical criteria only. If such restricted duty is not available, the
company may at their option send the employee home until the next evaluation at our office.
Physician‟s Signature
25
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The Fidlar Companies
SUPERVISOR'S INCIDENT INVESTIGATION REPORT
1. COMPANY OR BRANCH 2. DEPARTMENT
3. EXACT LOCATION 4. DATE OF 5. TIME AM 6. DATE
OCCURRENCE PM REPORTED
INJURY OR ILLNESS PROPERTY DAMAGE OTHER INCIDENT
7. INJURED'S NAME 13. PROPERTY DAMAGED 19. PERSON REPORTING INCIDENT
8. OCCUPATION 9. PART OF BODY 14. ESTIMATED 15. ACTUAL COSTS 20. OCCUPATION 21. COST (if
AFFECTED? COSTS $ $ applicable) $
10. NATURE OF INJURY/ILLNESS 16. NATURE OF DAMAGE 22. NATURE OF INCIDENT
11. OBJECT/EQUIPMENT/SUBSTANCE 17. OBJECT/EQUIPMENT/SUBSTANCE 23. OBJECT/EQUIPMENT/SUBSTANCE
INFLICTING INJURY/ILLNESS INFLICTING DAMAGE RELATED
12. PERSON WITH MOST CONTROL OF 18. PERSON WITH MOST CONTROL OF 24. PERSON WITH MOST CONTROL OF
ITEM 11. ITEM 17. ITEM 23.
D 25. DESCRIBE CLEARLY HOW THE INCIDENT OCCURRED.
E
S
C
R
I
P
T
I
O
N
Date: Supervisor: Reviewed by:
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EVALUATION: 26. LOSS SEVERITY POTENTIAL 27. PROBABLE RECURRENCE RATE
Major Serious Minor Frequent Occasional Rare
28. WHAT ACTS, FAILURES TO ACT, AND/OR CONDITIONS CONTRIBUTED MOST DIRECTLY TO THIS INCIDENT?
A
N
A
L 29. WHAT ARE THE BASIC OR FUNDAMENTAL REASONS FOR THE EXISTENCE OF THESE ACTS AND/OR CONDITIONS?
Y
S
I
S
Date: Supervisor: Reviewed by:
27
The Fidlar Companies
WITNESS/INJURED INCIDENT REPORT
_________________________________________________ is vitally interested in the health
and safety of all employees. We, therefore, request your assistance in completing this report to
help us prevent future incidents to yourself or your fellow employees.
Name of Injured Person: ____________________________________________________________
Date of Incident: ________________________________ Hour: _________________________
Witness: ______________________________________ Job Title: ______________________
Department: ____________________________________ Supervisor: _____________________
How Did You First Learn of This Incident: _____________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________ _____________________________________________
(Date) (Witness/Injured Signature)
All reports must be signed.
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The Fidlar Companies
EMPLOYEE ACCIDENT/INCIDENT
REPORT FORM
The Fidlar Companies is committed to safety. Your cooperation in providing an accurate description of the event helps the safety department to prevent future incidents. Your
cooperation in filling out and signing this form is required under the The Fidlar Companies Safety Policy you have signed.
Name Date of Occurrence Time AM Date Reported Exact Location
PM
Nature of Incident Please indicate with a () Witnesses Nature of Injury Part of Body Source of Injury
Personal injury Property damage only
Personal injury and Near accidentCould have Nature of Damage Source of Damage (object/equipment causing damage) Equipment #
property damage resulted in personal injury or
property damage
Describe the event: (Step 1)
(Step 2)
(Step 3)
(Step 4)
(Step 5)
Names of persons/places/objects in diagram: (mark on the diagram) (note your location) Draw a diagram of the event:
A.
B.
C.
D.
E.
F.
Reasons you refuse to complete this form:
Signature Date Reviewed by Date Reviewed by Date
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The Fidlar Companies
PHOTO MOUNT
DISPLAY
Insured Claimant Claim #
Date Taken
Time
By
Location
Description
Date Taken
Time
By
Location
Description
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The Fidlar Companies
SECTION 6
HAZARD COMMUNICATION PROGRAM
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The Fidlar Companies
POLICY
The Fidlar Companies has developed a Hazard Communication Program to ensure that all our employees
are informed of hazardous chemicals known to be present at our property. We will make every effort to
provide our employees with a reasonably safe work place. We also intend to instruct our people in
proper techniques for handling these chemicals.
It will be the responsibility of management to ensure that the proper information is obtained and
disseminated to the appropriate employees. It will be the employees' responsibility to follow safe
practices as outlined in the Material Safety Data Sheets.
A copy of this program will be kept on file in the management office.
HAZARD COMMUNICATION
PROGRAM COORDINATOR
The Coordinator's responsibilities are:
1. Providing Material Safety Data Sheets (MSDS) to employees if requested.
2. Ensuring that all employees have been trained in the proper use of hazardous substances
used in everyday (routine) and infrequent (non-routine) tasks.
3. Ensuring that all employees have been trained:
a. How to read MSDS
b. How to read labels
4. Verify that all employees under their supervision have received the proper training prior
to working with hazardous substances on the job site.
5. Identifying all jobs that require the use of hazardous substances.
6. Provide the required personal protective equipment.
7. Make routine surveys of the work area to ensure that safe practices are being followed.
8. Review the MSDS for the hazardous substance with the employees involved before the
non-routine task begins.
9. Ensure that required labeling practices are being followed.
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SECTION 6 HAZARD COMMUNICATION PROGRAM
The employees' responsibilities are:
1. Obey established rules.
2. Use personal protective equipment as required by company procedures.
3. Inform your Supervisor of:
a. Any symptoms of overexposure that may possibly be related to hazardous
substances
b. Missing labels on containers
c. Any questions you may have before starting a task with hazardous materials.
HAZARDOUS SUBSTANCES OR
MATERIALS LIST
A list of hazardous substances or materials at each property will be maintained. If an employee finds a
chemical or material that is not on the list, they should report it immediately. A copy of this list will be
supplied to employees upon request.
34
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The Fidlar Companies
CHEMICAL INVENTORY
DATE: ________________________________
Hazardous Chemicals Operation/Area Used MSDS on File
-35-
CHEMICAL INVENTORY FORM
Company: _______________________________________________________ Date:____________________________________________________________
Department: _____________________________________________________ Verified By: ______________________________________________________
Unit/Location: ____________________________________________________
Hazard Routes of Entry
Chemical Product Chemical Name Class * PPE (S)kin (I)ngestion MSDS Storage/Comments
No. Trade Name Major Components 1-800- # H F R C Required (L)ungs (I)njection Onsite Sat. Or Unsat.
* Hazard Class Rating NFPA (H) Health, (F) Flammability, (R) Reactivity, (C) Corrosivity on a 0-4 scale.
36
The Fidlar Companies
LABELS AND FORMS OF WARNING
Since chemical manufacturers are required to label their containers of hazardous chemicals, The Fidlar
Companies will use these labels as our primary means of warning employees about the products.
All employees are responsible for ensuring that all containers are labeled. Labels are not to be removed
from any container or defaced in any manner. If a label is missing or defaced beyond recognition, notify
a supervisor.
If a label is needed, the HCPC will audit the MSDS for the proper information and a Hazardous Material
Information System (HMIS) label will be applied.
MATERIAL SAFETY DATA SHEETS
(MSDS)
Material Safety Data Sheets are intended to outline the special precautions and controls necessary for
handling hazardous materials. Copies of the MSDS sheets will be maintained for hazardous materials
used by The Fidlar Companies
If an MSDS is not furnished with the initial shipment from the supplier, the MSDS will be requested
from that supplier. This request should be made in writing and a copy of this request should be kept on
file until the MSDS is received.
EMPLOYEE INFORMATION AND
TRAINING
Training and disseminating information to The Fidlar Companies employees relating to the Hazard
Communication Standard is the responsibility of each supervisor. At no time will any of our employees
be expected to perform any non-routine tasks involving exposure to hazardous substances without proper
instruction. Training will be conducted at the property through video training sessions or safety talks
prior to using the hazardous substance.
-37-
SECTION 6 HAZARD COMMUNICATION PROGRAM
Information provided to the employees shall include:
1. Training requirements of the Hazard Communication Standard
2. Any operations in their work area where hazardous substances are known to be present
3. Location and availability of The Fidlar Companies Hazard Communication Program,
including the required lists of hazardous substances and MSDS.
Training provided to the employees shall include:
1. Methods and observations that can be used to detect the presence of hazardous materials
on the job site:
a. visual appearance
b. odor
c. air monitoring
2. Physical hazards
a. Hydraulic oil
b. Acetylene
c. Oxygen
d. Welders
3. Health hazards
a. Carcinogen
b. Toxic
c. Corrosives
e. Agents that damage lungs, skin, eyes, or mucous membranes
4. Measures for protection
a. Appropriate work practices
(1) Ventilation
(2) No smoking
b. Emergency procedures
(1) Spill procedures
(2) Emergency numbers
5. Personal protective equipment
a. Gloves
b. Goggles
c. Rubber boots
d. Respirators
e. Disposable clothing
6. Interpretations of MSDS
a. Common name and manufacturer's name
b. Physical and chemical characteristics
1ww2085a 38
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SECTION 6 HAZARD COMMUNICATION PROGRAM
c. Fire and explosion data
d. Reactivity data
e. Health hazard data
f. Precautions for safe handling
g. Control measures
h. First aid procedures
7. Explanation of labeling system
a. Health hazard
b. Fire hazard
c. Reactivity
d. Numbering system (0-4)
e. Personal protection
8. The Fidlar Companies labeling system
a. HMIS (Hazardous Material Information System)
b. NFPA
Training sessions will be documented to show date, subject matter, and the name of the employees attending. A
copy of the attendance sheet will be kept by The Fidlar Companies ' HCPC. The Fidlar Companies will provide
contractors working at our facilities with a list of the hazardous materials used on the premises if requested.
Precautionary measures that are needed to protect other employees will be discussed at a pre-job meeting. If there
are any questions, be sure to direct them to The Fidlar Companies management for immediate attention.
1ww2085a 39
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The Fidlar Companies
HAZARD COMMUNICATION TRAINING PROGRAM
ATTENDANCE ROSTER
Date Accomplished:
Non-Routine Task
Employee Name ID No. Part I Part II Part III Part IV List Substance Date MSDS Used
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Superintendent: Date:
-40-
The Fidlar Companies
SECTION 7
OSHA INSPECTION PROCEDURE
-41-
The Fidlar Companies
GUIDELINES FOR OSHA
INSPECTIONS
I. INSPECTION SCHEDULING AND
PRIORITIZATION
A. Imminent Danger - An “imminent danger” is considered to be the most serious situation,
and OSHA will assign top priority to these inspections.
B. Fatality/Catastrophe Investigations - Any accident that results in the injury of three or
more employees or the death of one or more employees must be reported to OSHA
within 8 hours.
C. Complaints and referrals - OSHA can follow up on employee complaints in the following
manner:
1. Presently, OSHA can perform an inspection if the employee insists that an
inspection be made. This will take place only if that employee signs a
complaint form stating the exact reason for the inspection.
2. Presently OSHA will call the employer to follow up on unsigned complaints.
When this happens, the employer must respond in the following manner:
a. Write a response that includes how the condition(s) was
abated.
b. Responses should include the following:
i. How you measured the exposure(s) and what
engineering controls were or were not selected.
ii. What administrative controls were or were not
selected based on the exposure(s).
iii. What PPE was or was not selected based on the
exposure(s).
D. Programmed inspections - The routine “surprise” inspections carried out by OSHA are
considered important, but less pressing than focused inspections on serious, repeated or
willful violators.
-42-
SECTION 7 OSHA INSPECTION PROCEDURE
II. OSHA INSPECTOR ARRIVAL
A. You have the right to refuse entry until a warrant is issued, however, it is not
recommended that you do so. In most cases, when entry is refused, a simple or focused
inspection can turn into a comprehensive inspection, resulting in many violations and
fines. The only time you want to refuse entry is when an inspection occurs at an
extremely bad time (i.e. production involvement is essential at that moment and stopping
it for an inspection could result in a detrimental loss). If this is the case, explain the
situation and ask the inspector if he could come back at a later time or date that is more
feasible.
B. The inspection will start with an opening conference. Throughout the opening
conference, remain cordial and professional, NEVER lose your temper or your
professionalism.
C. Photocopy the inspector‟s credentials and verify the inspector‟s employment and his
assignment to your facility.
D. Confirm the type of inspection, a brief explanation of the purpose, and a request for
employer and employee representatives.
E. The inspector will begin the opening conference. You will be asked about your safety
program. You should be prepared to tell the inspector how it is communicated and
enforced. NEVER VOLUNTEER INFORMATION OR LOSS CONTROL REPORTS.
III. RECORDS REVIEWED
A. Lost workday injury rate
B. OSHA 300 and 300a forms and posting requirements. See notes.
A file should be created for all recordable accidents. This file must include.
1. A completed OSHA 300 log and 300a summary for the current year.
2. Completed OSHA 300 logs and 300a summaries for each of the 4 years prior
to the current year.
3. First report of injury forms (i.e. OSHA 301 or equivalent)
4. Copy of medical release forms pertaining to full duty or number of restricted
days.
C. General safety and health management program/Safety Manual
*NOTES: All entries into the OSHA 300 log must be made within 6 working days of
the injury/illness. This log must also be posted in a prominent area for the
from February 1 to April 30.
43
SECTION 7 OSHA INSPECTION PROCEDURE
IV. STANDARD PROCEDURES FOR
AN OSHA INSPECTION
A. Preparation for Inspection
1. Request to see the inspector's credentials and write down his name.
2. Inquire as to the reason for the visit.
a. Employee complaint
b. General or scheduled inspection
c. Referral
d. Fatality or catastrophe investigation
B. Inspection Procedures
1. Opening Conference
a. The purpose of the opening conference is to inform management of their
purpose and outline inspection plans.
b. A Fidlar Companies representative should begin taking notes.
c. Be prepared to show the inspector the OSHA 300 Log and OSHA poster.
2. Walkaround
a. Try to correct the violation immediately, if possible
b. Walk the facility with the inspector and take notes
c. Take pictures every time the inspector takes pictures
3. Closing Conference
a. The inspector will review all violations
b. Take good notes pertaining to alleged violations
c. Do not argue with the inspector
44
SECTION 7 OSHA INSPECTION PROCEDURE
C. Other Precautions
1. Be knowledgeable of what is contained in the Safety Manual.
2. Note in what areas pictures were taken.
3. Be certain as to the time allowed for abatement of the alleged violation.
45
SECTION 7 OSHA INSPECTION PROCEDURE
46
The Fidlar Companies
SECTION 8
MATERIAL HANDLING AND STORAGE
-47-
SECTION 8 MATERIAL HANDLING AND STORAGE
GENERAL PRECAUTIONS
General precautions that must be followed to prevent injuries while handling materials are:
1. Inspect materials for slivers, jagged, or sharp edges, burns, rough, or slippery surface.
2. Grasp the object with a firm grip.
3. Keep fingers away from pinch and shear points, especially when setting down materials.
4. Wipe off greasy, wet, slippery, or dirty objects before trying to handle them.
MANUAL LIFTING TECHNIQUES
SQUAT LIFTING
1. Keep feet apart - one alongside, one behind the object.
2. Keep back straight, nearly vertical
3. Tuck elbows and arms in, and hold load close to body.
4. Grasp the object with the whole hand.
5. Tuck your chin in.
6. Keep body weight directly over feet.
ASSISTED ONE-HAND LIFT
In this method, the worker rests one hand on top of the container, bends over to grasp an object in the
container, and then pushes down with the non-lifting hand resting on top of the container to force the
upper body back to a vertical position.
The basic techniques are:
1. Place the non-lifting hand on the container top, bend over container and assume lift
position.
2. While bending over, back the foot on the same side as the non-lifting hand rearward to
provide body balance.
3. Reach and grasp object to be lifted.
4. Push down with the non-lifting hand on the container top, raising the upper body to a
vertical position.
-48-
SECTION 8 MATERIAL HANDLING AND STORAGE
5. Be sure to let the non-lifting hand, not the back, do the work.
TEAM LIFTING AND CARRYING
When two or more people carry one object:
1. They should adjust the load so that it rides level so that each person carries an equal part
of the load.
2. Test lifts should be made before proceeding.
3. When carrying long sections of pipe, lumber, or steel they should carry them on the same
shoulder.
HANDLING SPECIFIC SHAPES
Boxes, Cartons, and Sacks
1. Grasp the alternate top and bottom corner.
2. Draw a corner between the legs.
3. Sacked materials should be grasped at opposite corners.
4. Upon reaching an erect position:
a. Let the sack rest against the hip and belly
b. Then swing the sack to one shoulder
5. As the sack reaches the shoulder, the worker should stoop slightly, put a hand on the hip
so that the sack rests partly on the shoulder and partly on the arm and back.
Barrels and Drums
1. When handling a drum, one should request assistance or use a drum tilter or other
mechanical assistance (two-wheeled dolly equipped for drums).
2. If necessary to roll a barrel or drum, the worker should push against the sides with the
hands.
-49-
SECTION 8 MATERIAL HANDLING AND STORAGE
HAND TRUCKS, CARTS, AND
DOLLIES
SAFE PROCEDURES FOR USING TWO-WHEELED TRUCKS OR CARTS
1. Tip the load to be lifted forward slightly so that the tongue of the truck goes under the
load.
2. Push the truck all the way under the load to be moved.
3. Keep the center of gravity of the load as low as possible. Place heavy objects below
lighter objects.
4. Place the load well forward so the weight will be carried by the axle, not by the handles.
5. Place the load so it will not slip, shift, or fall.
6. Load only to a height that will allow a clear view ahead.
7. Let the truck carry the load. The operator should only balance and push.
8. Never walk backwards with a hand truck.
9. For extremely bulky items or pressurized items, such as gas cylinders, strap or chain the
item to the truck.
10. When going down an incline, keep the truck ahead so that it can be observed at all times.
FOUR-WHEEL TRUCKS OR CART
1. Trucks or carts should be evenly loaded to prevent tipping.
2. Trucks should be pushed rather than pulled.
3. They should be loaded so that the operators can see where they are going.
4. Contents of load should be arranged so that they will not fall.
-50-
The Fidlar Companies
SECTION 9
FIRE PROTECTION AND FIRE PREVENTION
-51-
The Fidlar Companies
This section describes the requirements for Fire Protection and Prevention.
FIRE PROTECTION
1. Fire extinguishers will be provided in various locations at each property pursuant to local
fire codes. These fire extinguishers shall be conspicuously posted with signs indicating
their location.
2. Fire extinguishers should be updated yearly and inspected monthly to ensure that they
are in their designated locations, and not blocked, and are working properly.
3. All employees will be trained in the correct use of fire extinguishers.
FIRE EXTINGUISHER USE
FIRE (Small and Contained)
If a small, contained fire is discovered:
1. If you wish to do so, use a fire extinguisher to put it out; remember that you are
not required to fight fires.
2. If you do not wish to use an extinguisher, notify your supervisor immediately.
FIRE (Uncontrolled/Not Readily Extinguished)
If a fire cannot be extinguished quickly by a hand extinguisher, the following steps should be followed to
ensure your safety:
1. Leave the area immediately
2. Notify your immediate supervisor
3. If alarm is sounded, walk to the designated assembly area outside of the building.
4. Stay in the designated assembly area until further notice from your supervisor.
FIRE PREVENTION
1. All electrical wiring and equipment for light, heat or power shall be installed in
compliance with applicable codes.
2. Smoking shall be prohibited in the vicinity of operations that constitute a fire hazard and
shall be posted "No Smoking or Open Flame"
3. Good housekeeping is critical in fire prevention. Dispose of refuse in appropriate
containers. Metal garbage cans are to be used in maintenance areas.
4. Be aware of fire extinguisher locations at all times.
-52-
SECTION 9 FIRE PROTECTION AND FIRE PREVENTION
5. Only approved containers and portable tanks shall be used for storage of and handling of
flammable and combustible liquids.
6. No more than 25 gallons of flammable or combustible liquids shall be stored in a room
outside an approved storage cabinet. No more than 60 gallons of flammable or 120
gallons of combustible liquids shall be stored in any one-storage cabinet. No more than
three storage cabinets may be located in a single storage area.
7. Inside storage rooms shall be constructed to meet the required fire-resistive rating for
their se. Where an automatic extinguishing system is provided, the system shall be
designed and installed in an approved manner. Materials, which react with water and
create a fire hazard shall not be stored in the same room with flammable or combustible
liquids. Electrical wiring and equipment located in inside storage rooms shall be
approved for Class 1, Hazardous Locations. Every inside storage room shall be provided
with either a gravity or mechanical exhausting system. In every inside room, a clear
aisle, at least three feet wide, shall be maintained.
8. Storage of containers (not more than 60 gallons each) shall not exceed 1,100 gallons in
any one pile or area. The storage area shall be graded to divert possible spills away from
buildings or other exposures, or shall be surrounded by a curb or earth dike. Storage
areas shall be free from weeds, debris, and other combustible material not necessary to
the storage.
9. Flammable liquids shall be kept in closed containers when not actually in use.
53
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SECTION 10 LOCKOUT/TAGOUT PROGRAM
SECTION 10
LOCKOUT/TAGOUT PROGRAM
54
SECTION 10 LOCKOUT/TAGOUT PROGRAM
INTRODUCTION
This program is used to identify the practices and procedures necessary to shut down and lock
out or tag out machines and equipment, requires that employees of THE FIDLAR COMPANIES
receive training in their role in the lockout/tagout program, and mandates that periodic
inspections be conducted to maintain or enhance the energy control program.
PURPOSE
The purpose of this program is to protect employees of THE FIDLAR COMPANIES from
hazardous energy while they are performing servicing or maintenance on machines and
equipment. This program also allows THE FIDLAR COMPANIES to be in compliance with 29
CFR 1910.147. It requires that, in general, before servicing or maintenance is performed on
machinery or equipment, the machinery or equipment must be turned off and disconnected from
the energy source, and the energy-isolating device must be either locked or tagged out.
SCOPE AND APPLICATION
The lockout/tagout standard applies to general industry employment and covers the servicing and
maintenance of machines and equipment in which the unexpected startup or the release of stored
energy could cause injury to employees.
The standard does not apply to maintenance tasks that do not expose them to the unexpected
release of hazardous energy.
If a servicing activity, such as lubricating, cleaning, or unjamming the production equipment,
takes place during production, the employee performing the servicing may be subjected to
hazards that are not encountered as part of the production operation itself. Workers engaged in
these operations are covered by lockout/tagout when any of the following conditions occur:
1. The employee must either remove or bypass machine guards or other safety
devices, resulting in exposure to hazards at the point of operation
2. The employee is required to place any part of his or her body in contact with the
point of operation of the operational machine or piece of equipment
3. The employee is required to place any part of his or her body into a danger zone
associated with a machine operating cycle.
In the above situations, the equipment must be de energized and locks and/or tags
must be applied to the energy-isolating devices.
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SECTION 10 LOCKOUT/TAGOUT PROGRAM
Minor Servicing Tasks - Employees performing minor tool changes and adjustments and/or other
minor servicing activities during normal production operations that are routine, repetitive, and
integral to the use of the production equipment are not covered by the lockout/tagout program,
provided the work is performed using alternative measures that give effective protection.
DEFINITIONS
Affected Employee - An employee who performs the duties of his or her job in an area in which
the energy control procedure is implemented and servicing or maintenance operations are
performed. An affected employee does not perform servicing or maintenance on machines or
equipment and, consequently, is not responsible for implementing the energy control procedure.
An affected employee becomes an "authorized" employee whenever he or she performs servicing
or maintenance functions on machines or equipment that must be locked or tagged.
Authorized Employee - An employee who performs servicing or maintenance on machines and
equipment. Lockout or tagout is used by these employees for their own protection.
Capable of Being Locked Out - An energy-isolating device is considered capable of being
locked out if it meet one of the following requirements.
It is designed with a hasp to which a lock can be attached.
It is designed with any other integral part through which a lock can be affixed.
It has a locking mechanism built into it.
It can be locked without dismantling, rebuilding, or replacing the energy isolating device or
permanently altering its energy control capability.
Energized - Machines and equipment are energized when they are connected to an energy source
or they contain residual or stored energy
Energy-Isolating Device - Any mechanical device that physically prevents the transmission or
release of energy. These include, but are not limited to, manually operated electrical circuit
breakers, disconnect switches, line valves, and blocks.
Energy Source - Any source of electrical, mechanical, hydraulic, pneumatic, chemical, thermal,
or other energy.
Energy Control Procedure - A written document that contains those items of information an
authorized employee needs to know in order to safely control hazardous energy during servicing
or maintenance of machines or equipment.
Energy Control Program - A program intended to prevent the unexpected energizing of the
release of stored energy in machines or equipment. The program consists of energy control
procedure(s), an employee training program, and periodic inspection.
56
SECTION 10 LOCKOUT/TAGOUT PROGRAM
Lockout - The placement of a lockout device on an energy-isolating device, in accordance with
an established procedure, ensuring that the energy-isolating device and the equipment being
controlled cannot be operated until the lockout device is removed.
Lockout Device - Any device that uses positive means such as a lock, either key or combination
type, to hold an energy-isolating device in a safe position, thereby preventing the energizing of
machinery or equipment. When properly installed, a blank flange or bolted slip blind are
considered equivalent to lockout devices.
Tagout - The placement of a tagout device on an energy-isolating device, in accordance with an
established procedure, to indicate that the energy-isolating device and the equipment being
controlled may not be operated until the tagout device is removed.
Tagout Device - Any prominent warning device, such as a tag and a means of attachment, that
can be securely fastened to an energy-isolating device in accordance with an established
procedure. The tag indicates that the machine or equipment to which it is attached is not to be
operated until the tagout device is removed in accordance with the energy control procedure.
ENERGY CONTROL PROGRAM
The lockout/tagout rule requires that the employer establish an energy control program that
includes the following:
1. Documented energy control procedures.
2. An employee training program.
3. Periodic inspections of the procedures.
ENERGY CONTROL PROCEDURES
The written procedures must identify the information that authorized employees must know in
order to control hazardous energy during servicing or maintenance. If this information is the
same for various machines or equipment or if other means of logical grouping exists, then a
single energy control procedure may be sufficient. If there are other conditions, such as multiple
energy sources, different connection means, or a particular sequence that must be followed to
shut down the machine or equipment, then the employer must develop separate energy control
procedures to protect employees.
The energy control procedure must contain the following elements:
57
SECTION 10 LOCKOUT/TAGOUT PROGRAM
1. A statement on how the procedure will be used.
2. The procedural steps needed to shut down, isolate, block, and secure machines or
equipment.
3. The steps designating the safe placement, removal, and transfer of lockout/tagout
devices and who has the responsibility for them.
4. The specific requirements for testing machines or equipment to determine and
verify the effectiveness of locks, tags, and other energy control measures.
The procedure must also include the following six steps for the shutdown of the machine or
equipment:
Step 1 - Prepare for shutdown
Identify energy sources that you must isolate. Whenever possible, refer to written
procedures provided.
Notify affected employees what equipment is going to be locked out.
Step 2 - Shut down the equipment
Use normal stopping procedures for the equipment you're servicing.
Step 3 - Isolate the equipment
Close valves, throw main disconnects, throw circuit breakers.
Disconnect or cap any auxiliary power sources such as secondary electric, steam,
hydraulic, or pneumatic systems.
Step 4 - Apply Lockout/Tagout Devices
Locks are the preferred method of controlling energy.
Locks and tags should be used whenever possible
Special information should be written on tags when needed.
When tags are used by themselves, all affected employees should be notified and warned
not to activate switches, circuits, etc.
Step 5 - Control Stored Energy
Relieve, disconnect or restrain any residual hazardous energy that could be present.
Check that all moving parts have stopped turning.
Relieve trapped pressure.
Blank pipe flanges.
Install ground wires to discharge electrical capacitors.
Block or support elevated equipment.
Step 6 - Verify Isolation of Equipment
Warn employees and make sure everyone is clear of the lockout area.
Test to make sure the right system has been locked out and cannot be operated.
58
SECTION 10 LOCKOUT/TAGOUT PROGRAM
Press all start buttons or other activating controls, then return them to the 'off' position.
This will prevent the equipment from starting by itself when energy is restored.
The following steps must be taken when re energizing the machinery or equipment:
Step 1. Clear machines or equipment of tools and materials.
Step 2. Remove employees from the machines or equipment area.
Step 3. Assure that machines or equipment components are operationally intact.
Step 4. Notify affected employees that lockout or tagout devices have been removed from
the equipment.
Step 5. Assure that lockout or tagout devices are removed from each energy-isolating
device by the employee who applied the device.
Step 6. Re-energize the equipment.
GROUP LOCKOUT
Certain procedures should be followed in the event that multiple employees are involved in
performing maintenance on equipment. The following provisions should be followed in this
circumstance:
Everyone working on a particular piece of equipment must have his/her lock on the
energy isolating device with the use of a multiple hasp or similar lockout device.
Each lock must only have one key. This key must remain in the possession of the
employee who used this lock until it is removed.
When the work is transferred to different shifts, authorized employees on the second shift
will place their locks on the lockout device. Then, and only then can the first shift
employees remove their locks.
Each authorized person working on a piece of equipment that is locked out must 'sign off'
on the tags provided. These tags must also be dated.
ENERGY ISOLATING DEVICES
Energy isolating devices generally come in two forms: the tagging device or the locking device.
When the isolating device cannot be locked out, the employer must use tagout or modify the
equipment so it can be locked out.
Employees must be trained in the following limitations of tags:
Tags are essentially warning devices affixed to energy-isolating devices and do not provide
the physical restraint of a lock.
59
SECTION 10 LOCKOUT/TAGOUT PROGRAM
When a tag is attached to an isolating means, it is not to be removed except by the person
who applied it, and it is never to be bypassed, ignored, or otherwise defeated.
Tags must be legible and understandable by all employees.
Tags and their means of attachment must be made of materials that will withstand the
environmental conditions encountered in the workplace.
Tags may evoke a false sense of security. They are only one part of an overall energy
control program.
Tags must be securely attached to the energy-isolating devices so that they cannot be
detached accidentally during use.
If the energy-isolating device is lockable, the employer shall use locks unless he or she can prove
that the use of tags would provide protection at least as effective as locks and would assure "full
employee protection."
REQUIREMENTS FOR
LOCKOUT/TAGOUT DEVICES
Whichever devices are used, they must be singularly identified, must be the only devices used for
controlling hazardous energy, and must meet the following requirements:
Durable - Lockout and tagout devices must withstand the environment to which they are
exposed for the maximum duration of the expected exposure. Tagout devices must be
constructed and printed so that they do not deteriorate or become illegible, especially
when used in corrosive or wet environments.
Standardized - Both lockout and tagout devices must be standardized according to either
color, shape, or size. Tagout devices must also be standardized according to print and
format.
Substantial - Lockout and tagout devices must be substantial enough to minimize early
removal or accidental removal. Locks must be able to withstand reasonable force, but
also be able to be removed with bolt cutters or other metal cutting tools. Tags must be
non-reusable, attachable by hand, self-locking, and non-releasable, with a minimum
unlocking strength of no less than 50 pounds.
Identifiable - Locks and tags must clearly identify the employee who applies them. Tags
must also warn against hazardous conditions if the machinery or equipment is energized
and must include a legend such as the following:
DO NOT START, DO NOT OPEN, DO NOT CLOSE, DO NOT ENERGIZE, AND DO
NOT OPERATE.
60
SECTION 10 LOCKOUT/TAGOUT PROGRAM
EMPLOYEE TRAINING
The employer must provide effective initial training and retraining as necessary and must certify
that such training has been given to all employees covered by the standard. The certification
must contain each employee‟s name and dates of training.
For the purpose of the standard there are three types of employees: authorized, affected, and
other. The amount of training that an employee receives is based upon:
The relationship of that employee's job to the machine or equipment being locked or tagged
out.
The degree of knowledge relevant to hazardous energy that he or she must possess.
PERIODIC INSPECTION
Periodic inspections must be performed at least annually to assure that the energy control
procedures continue to be implemented properly and that the employees are familiar with their
responsibilities under those procedures. In addition, the employer must certify that the periodic
inspections have been performed.
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SECTION 10 LOCKOUT/TAGOUT PROGRAM
ADDITIONAL SAFETY
REQUIREMENTS
Outside Personnel (contractors, etc.) - The on site employer and the outside employer must
inform each other of their respective lockout or tagout procedures. Each employer must ensure
that his or her personnel must understand and comply with all restrictions and/or prohibitions of
the other employer's energy control program.
Group Lockout or Tagout - During all group lockout/tagout operations where the release of
hazardous energy is possible, each authorized employee performing servicing or maintenance
shall be protected by his/her personal lockout or tagout device or comparable mechanism that
affords equivalent protection.
Shift or Personnel Changes - Specific procedures must ensure the continuity of lockout
protection during shift or personnel changes.
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SECTION 10 LOCKOUT/TAGOUT PROGRAM
Self-Assessment Program
Facility/Area
Date:
Page: of
TOPIC: Lockout/Tagout controls
REFERENCES: Company XYZ Lockout/Tagout Procedure. XXXXX. Rev. B.
PERFORMANCE
OBJECTIVE: Implementation of an effective lockout/tagout program to protect workers from hazardous energy
sources.
CRITERIA: 1) Detailed procedures define the program.
2) Personnel are trained to uses these procedures.
3) Supplies, equipment and hardware are available to implement the program.
LINES OF INQUIRY:
A. DOCUMENT REVIEW
A notebook containing lockout/tagout permits is available.
The notebook separates active from inactive permits.
Inactive permits more than one-year-old have been removed from notebook.
All permits have signatures of the issuing authority and servicing supervisor.
B. WALKDOWN
Walkdown all open lockout/tagout permits to determine whether:
All equipment is tagged properly.
Tags are numbered according to the applicable permit.
Tags are legible.
Equipment components are in positions designated on the applicable permit.
Locks/locking devices are installed in the positions designated on applicable permits.
No unauthorized tags are observed.
C. OBSERVATION
Accompany operators installing protection in accordance with a lockout/tagout permit to determine whether:
Operators have documented training on the lockout/tagout procedure.
The permit is complete and accurate.
Tags are fully and accurately completed.
-63-
SECTION 10 LOCKOUT/TAGOUT PROGRAM
Equipment components are independently verified to be in the positions designated on the applicable permit.
Tags are installed on the correct components.
Tags are attached securely in a location obvious to passersby.
Each employee has a supply of locks.
Locks (if required) are attached to prevent movement of components from the protecting position.
FINDINGS/CONCERNS/ACTIONS
Finding and Action Taken:
1)
2)
3)
4)
Concern and Action Taken:
1)
2)
3)
4)
Comments:
Completed by: Date:
Manager or Supervisor
Reviewed by: Date:
Area Manager
64
SECTION 10 LOCKOUT/TAGOUT PROGRAM
ENERGY SOURCE EVALUATION
DATE: ________ / _____ / ______ CONDUCTED BY: _______________________________
In order to determine all energy sources for each piece or type of machine or equipment, fill in the following table.
LOCATION: ______________________________ WORK CENTER: __________________________________
EQUIPMENT NAME: _________________________________________________________________________
MODEL: __________________________________ SERIAL #: _______________________________________
LOCKOUT PROCEDURE NUMBER: ____________________________________________________________
ENERGY SOURCE\ LOCATION OF ISOLATING MEANS OF
MAGNITUDE DEVICE ISOLATION
ELECTRICAL
ENGINE
SPRING
COUNTER WEIGHT
FLYWHEEL
HYDRAULIC
PNEUMATIC
CHEMICAL
THERMAL
OTHER
__________________________
OTHER
__________________________
65
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SECTION 10 LOCKOUT/TAGOUT PROGRAM
Lockout/Tagout
Specific Energy Control Procedures
Procedure for placing the ___________________________ in zero mechanical state.
Location:_________________ Date:_______________
Supervisor:_______________
Types and Magnitudes of energy sources:
Electric ____ ____Volts Hydraulic ____ ____psi
Pneumatic ____ ____psi Steam ____ ____psi
Gas ____ ____psi Water ____ ____psi
Engine ____ ____ Other ____ ____
Procedure for controlling hazardous energy:
1. Notify affected employees that the machine is about to be shutdown and locked out.
Specific instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
2. Shut down the machine or equipment using normal stopping procedures.
Specific instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
______________________________
3. Isolate all energy sources listed below.
Specific instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
______________________________________________________
66
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SECTION 10 LOCKOUT/TAGOUT PROGRAM
4. A. Apply locks to all devices operated in step three.
Specific Instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
B. If a tag is used instead of a lock when the energy isolating device is incapable of
lockout, the following additional safety precaution(s) shall be taken:
Specific Instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
5. Block or dissipate all stored energy.
Specific Instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
6. Verify that the machine is locked out by testing the machines operating controls. Be sure
to return all of the machines controls back to the "off" or "neutral" position(s) after
testing.
Specific Instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________
Other Comments:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
67
--
SECTION 10 LOCKOUT/TAGOUT PROGRAM
Lockout/Tagout
Training Checklist
Employee Name (Print) Employee Signature Date
68
--
SECTION 10 LOCKOUT/TAGOUT PROGRAM
SECTION 11
EMERGENCY ACTION AND FIRE PREVENTION PLAN
SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Purpose
The purpose of this plan is to protect all employees of The Fidlar Companies in the event of an
emergency and to be prepared to handle these emergencies in an efficient manner. The responsibilities
include providing for the safety of personnel, preserving facilities and equipment, protecting the public
from on-site incidents that affect the health and safety of the community, and contributing to overall
community emergency preparedness.
Organization Functions and Responsibility
Those designated Emergency Coordinator (EC) in the chain of command section of this plan shall
determine if there is a need for evacuation; give the order for the alarm to be sounded; direct the
evacuation activities; and maintain a list of outside emergency services. When the first person on this list
is not available, refer to the chain of command section to determine who is next in command.
Management shall screen and approve all press releases with the media.
The designated EC shall obtain outside aid when necessary. There may be a need for outside services
such as the fire department, hospital ambulance service, or law enforcement.
Management shall direct the care and treatment of the injured until medical assistance arrives.
All telephone receptionists shall maintain the switchboard and refuse incoming calls until directed
otherwise by the EC. Emergency calls are to have priority.
The supervisors shall account for their crews in the event of a facility evacuation.
Employees, upon hearing the evacuation announcement or signal, shall shut down their equipment.
Required personal protective equipment is to remain in use. Employees shall proceed quickly to the
assigned assembly area, as located on the evacuation maps.
Employees shall remain at their assigned assembly area and shall remain there, pending further
instructions from their Supervisor.
Facilities / Information Systems
The following facilities are to be consulted in the event of an emergency situation:
Radio / Television Radio and TV news stations can be consulted to identify the possibility or
occurrence of a weather emergency that warrants emergency action.
Alarms Community alarms may be sounded in the event of a weather emergency.
Facility alarms should be sounded in the event of facility fire or tornado and
an announcement over the intercom system shall be made concerning the
nature of the emergency.
Evacuation Maps Depending on the complexity of the building, evacuation maps should be
developed that identify exits, fire extinguishers, and alarm pull boxes for
easy reference.
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SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Evacuation Procedures
The evacuation procedures are specific for each section of each building. Every employee shall be
trained in evacuation procedures specific to each location.
Evacuation maps shall be located throughout each area for easy reference. These maps shall contain fire
extinguisher locations as well as exit locations.
Emergency shutdown procedures shall also be followed in the event of emergency evacuation. Shutdown
procedures are specific for each The Fidlar Companies operation.
In general, the following procedures will be followed in the event of a facility evacuation:
1. All employees will stop what they are doing.
2. Next, if the employee operates equipment that has the potential to create more harm if it
is not properly shut down, then the employee will take the proper steps to shut down the
equipment (only if the employee is not in any immediate danger).
3. The employee will then follow the specific route established for the area in which he/she
is working to evacuate the facility (included in the training).
4. The employee must then report to their designated supervisor at the assembly area so the
supervisors may take a head count.
5. The employee must then remain in the designated assembly area until further instructions
have been given by the supervisor.
Evacuation Assembly Areas
All employees shall be trained to go the designated assembly area.
After employees have reached their assembly areas, their supervisors shall immediately take a head count
to ensure that no one is left in the building. Employees are to remain in the assembly area, pending
instruction from the supervisor.
Fire Safety Procedures
In the event of a facility fire, the following procedures should be followed:
1. Employees who first notice the fire shall call 9-1-1 and notify a supervisor or member of
management.
2. If the Emergency Coordinator determines that the fire is serious, he/she shall make an
announcement over the intercom notifying employees to evacuate the facility.
3. After notification has been given over the intercom, all employees shall evacuate the
plant; specifically following the instruction given in the training for evacuation.
4. All employees must then congregate to the designated assembly area.
5. After the supervisors have determined where everyone is, they shall then notify the Fire
Fighters of any missing personnel.
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SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Fire Prevention Procedures
In order to prevent fires from occurring, some steps must be taken. These steps include everyday
activities, such as housekeeping and material storage. These steps will help to reduce the accumulation
of flammable material in one particular area, thus reducing the potential for an uncontrollable fire.
Every employee at The Fidlar Companies is responsible for maintaining a clean workspace. Every
employee's workspace shall be free from tripping hazards wherever possible.
All employees shall recognize the existence of designated aisleways. Employees shall not block these
aisleways with materials that may impede travel.
Adequate space must be maintained at every workstation. Aisleways to these workstations must also be
kept clear.
All records and paper storage shall comply with the city Fire Codes as to proper storage and limits to
storage.
All flammables stored in excess of 25 gallons shall be stored in a flammable storage cabinet. All other
forms of flammables stored in quantities less than 25 gallons must be secured in a safe location and away
from stored oxygen cylinders.
When transferring flammable liquids to containers, those containers must be explosion proof with flash
resisters in tact.
All flammable gas cylinders shall not be stored next to oxygen cylinders.
Flammable materials may not be stored near any of the welding operations.
Building heat furnaces shall be serviced by appropriate personnel. Inspections are performed annually by
an outside contractor.
The building‟s sprinkler system should be checked annually to ensure that it is in proper working order.
72
SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Fire Extinguishers
Fire extinguishers are the company's first line of defense against fire. Major fires, resulting in financial,
as well as, human losses, usually begin as small, controllable fires. Fire extinguishers can be used to
prevent these small fires from becoming major ones. To organize your fire prevention program, each
location shall designate a Fire Marshall. The Fire Marshall shall administer this program by coordinating
services, and conducting inspections. The name and title of the designated Fire Marshall shall be
permanently recorded on the Fire Extinguisher Inventory List. The Fire Marshall is responsible for
organizing the following components of the program:
Equipment Selection and Distribution
1. Fire extinguishers shall be selected based on the class of anticipated workplace fires and
on the size and degree of hazard, which would effect their use (in most cases, an ABC
rated fire extinguisher should be used).
2. Fire extinguishers shall be distributed so that the travel distance from the hazard area to
any extinguisher is 50 feet or less.
Fire Extinguisher Identification
1. Every fire extinguisher shall have a non-duplicating identification number clearly
marked on it. The number shall also be marked on the wall or location of the fire
extinguisher to ensure that the extinguishers remain in their specified positions.
2. The number, type, and general description of location shall be listed for all fire
extinguishers on the fire extinguisher inventory list.
3. The location and number of all fire extinguishers shall be clearly marked on the
evacuation maps. These maps will assist the inspector to locate all fire extinguishers.
Inspection
1. Inspection is a "quick check" that an extinguisher is available and will operate. This is
accomplished by physically checking that all fire extinguishers are in their designated
places, have not been tampered with, and that there is no obvious physical damage or
condition to prevent reliable operation.
2. Fire extinguisher inspections shall be conducted when initially placed into service and
monthly thereafter by the designated Fire Marshall. Fire extinguisher inspection data
shall be recorded on the back of the fire extinguisher inspection tag.
3. The designated Fire Marshall's fire extinguisher inspection shall ensure that:
A. The operating instructions, which appear in the name plate, are legible
and facing outward.
B. The seal and tamper indicator are not broken or missing.
C. The pressure gauge reading or indicator is in the operable position.
D. There are no obstructions to access or visibility.
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SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Maintenance
All fire extinguishers shall be inspected each year by a licensed agent or a qualified fire
extinguisher service contractor. Fire extinguishers, which have been discharged, damaged, or
have been identified as needing maintenance will be serviced immediately.
Record Keeping
Each extinguisher shall have a tag or label securely attached that indicates:
1. A record that maintenance and recharging were performed by a qualified
contractor for the current year.
2. Month and year of inspections by the designated Fire Marshall.
3. The designated Fire Marshall's initials for each month's inspection.
Training
All employees shall receive training on the general principles of fire extinguisher use and the
hazards involved with this type of fire fighting. This training shall be provided upon initial
employment and at least annually thereafter. Such training shall be documented on the employee
training certification form.
*NOTE: Employees are not designated to fight fires. Any use of fire extinguishers is to
be considered voluntary and thus explained in the training session.
Tornado Safety Procedures
When a tornado has been sighted in the area, certain procedures should be followed. In the event of a
tornado warning, an announcement should be made over the intercom system to notify employees. After
the announcement, employees should be instructed to do the following:
Move to designated shelter areas (i.e. basements, designated rooms, etc).
Stay away from windows.
Take shelter under sturdy benches, tables or desks.
Stay away from masonry block walls.
Move to the lowest level of the building that you occupy.
Stay away from the corners of the building.
After a tornado strikes, employees shall report to their designated assembly area when it is safe to do so.
An announcement shall be made when conditions are safe. The Supervisor must then take attendance to
verify the status of his/her employees.
74
SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Chain of Command
A chain of command should be established to minimize confusion so that employees will have no doubt
who has authority for making decisions. An Emergency Coordinator (EC) will be designated for each
building. Because of the importance of these functions. adequate backup must be arranged so that
trained personnel are always available. Those EC's designated in the chain of command list shall be
responsible for:
1. Assessing the situation and determining whether an emergency exists that requires
activating the emergency procedures.
2. Ensuring that outside emergency service, such as medical aid and local fire departments
are called in, when necessary.
3. Directing all efforts in the area, including evacuating personnel and minimizing property
loss.
First Shift Chain of Command
(Write in your chain of command with Employee names)
Second Shift Chain of Command
(Write in your chain of command with Employee names)
Communications
A method of communications is needed to alert employees to the evacuation or to take other action as
required in the plan. Alarms should be audible or seen by all people in the location. The alarm should be
distinctive and recognizable as a signal to evacuate the work area or perform actions designated under the
emergency action plan. The employer should explain to each employee the means for reporting
emergencies, such as public address systems, or telephones. Emergency phone numbers (9-1-1) should
be posted in or near telephones, on employee's notice boards, or in other conspicuous locations. All
employees shall be trained to identify the warning signals for emergency situations. In the event of a
power outage, announcements concerning emergency conditions will be personally given to each
supervisor working at The Fidlar Companies by the EC's.
Management shall be notified of the circumstances following an emergency, which threatens a The Fidlar
Companies facility or the lives of employees as soon as possible.
Accounting for Personnel
The person in command will need to know when all personnel have been accounted for. This can be
difficult during shift changes or if contractors or customers are on site. All area supervisors are
appointed to account for personnel and to inform the person in charge of those personnel believed to be
missing.
Each department supervisor is responsible for creating and maintaining list of current employees in
his/her department. This list will be copied and given to the EC. In the event of a facility evacuation,
these lists will be cross referenced to check for attendance. Those not accounted for will be assumed
missing.
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SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Every guest that enters a The Fidlar Companies facility shall sign in and out. In the event of a facility
evacuation, the receptionist shall obtain this list to help account for all visitors and expedite a search for
those who are missing.
Each location has evacuation maps with exits indicated, as well as alternate exits. Specific routes should
be designated as exit routes in emergencies (included in the training session).
Rescue and Medical Duties for Employees
In the event of a medical emergency, employees are directed to contact emergency medical assistance by
dialing 9-1-1 immediately. Employees are not expected to perform any rescue or medical duties.
Therefore, there are no provisions for training employees in these tasks. The municipal emergency
medical facility is located at a distance approximately (? miles) away. The municipal fire and police
departments are located at a distance approximately (? miles) away. Emergency phone numbers are
posted at each production area phone. At no time should an employee be directed to perform emergency
duties, which may endanger his/her life.
Training
Training is important to the effectiveness of an emergency plan. Before implementing an emergency
action plan, a sufficient number of persons must be trained to assist in the safe and orderly evacuation of
employees and/or customers. Training for each type of disaster response is necessary so that employees
know what actions are required.
All employees should be trained in the following:
1. Evacuation plans
2. Alarm systems
3. Reporting procedures for personnel
4. Shutdown procedures
5. Types of potential emergencies: fire, tornado, flood, etc.
These training programs should be provided as follows:
1. Initially when the plan is developed
2. For all new employees
3. When new equipment, materials, or processes are introduced
4. When procedures have been updated or revised
5. When exercises show that employee's performance must be improved
6. At least annually
A drill should be held for all personnel, at random intervals at least annually, and an evaluation of
performance made immediately by management and employees. When possible, drills should include
groups supplying outside services such as fire and police departments. In buildings with several places
of employment, the emergency plans should be reviewed periodically and updated to maintain adequate
personnel response and program efficiency.
76
SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Emergency Action and Fire Prevention Plan
Training Checklist
Employee Name (Print) Employee Signature Date
77
SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
Fire Extinguisher Training Checklist
Employee Name (Print) Employee Signature Date
78
SECTION 11 EMERGENCY ACTION AND FIRE PREVENTION PLAN
SECTION 12
RESPIRATORY PROTECTION PROGRAM
SECTION 12 RESPIRATORY PROTECTION PROGRAM
RESPIRATORY PROTECTION PROGRAM
14.1 OBJECTIVE
14.1.1 The purpose of this program is to ensure that employees of The Fidlar
Companies, Inc. are protected from the hazards associated with
atmospheric contaminants and oxygen deficient environments. This
program allows the The Fidlar Companies, Inc. to be in compliance with
OSHA‘s 29 CFR 1926.103. It is the policy of The Fidlar Companies, Inc. to
have as a primary objective, the prevention of exposure to its employees
from atmospheric contamination. In the event that effective administration
and engineering controls are not feasible, appropriate respirators shall be
provided for and used by all city employees as necessary.
14.1.2 A ―Grandfather Clause‖ is in effect for annual respirator training, fit testing,
respirator problem evaluations and medical evaluations that have been
performed within a 12-month period before the effective date of OSHA
1910.134(n) (4/8/98).
14.2 APPLICABILITY/
SCOPE
14.2.1 This program applies to all The Fidlar Companies, Inc. employees who need
to wear a respirator to perform assigned duties.
14.3 ACCOUNTABILITY
14.3.1 Respirator Administrator
14.3.1.1 Has the overall responsibility for the respiratory program,
including monitoring respiratory hazards, maintaining records
and conducting program evaluations annually.
14.3.1.2 Approves respiratory protection programs for each operation
that involves the use of respirators.
14.3.1.3 Approves training programs for employees.
14.3.1.4 Approves fit test procedures for employees.
14.3.1.5 Approves respiratory make and models for The Fidlar
Companies, Inc. use.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.3.2 Supervisors
14.3.2.1 Initiate the written respiratory protection program for each
operation that involves respiratory use.
14.3.2.2 Ensure that employees are given all the necessary training, fit
testing, and medical clearances before authorizing them to wear
a respirator.
14.3.2.3 Monitor employee compliance with the respirator program
requirements.
14.3.3 Employees
14.3.3.1 Employees are responsible to follow all guidelines set forth in
this program.
14.3.3.2 Report any defects, malfunctions, or other problems with the
respirator immediately.
14.3.3.3 Report any symptoms of illness that may be related to respirator
usage.
14.3.3.4 Report any changes to health status to the physician.
14.3.3.5 Perform positive and negative fit checks each time a respirator is
used.
14.3.3.6 Clean their respirator at the end of each shift according to
training provided.
14.3.3.7 Store the respirator according to training provided.
14.3.4 Selection of Respirators
14.3.4.1 Choosing the right equipment involves several steps:
determining what the hazard is and its extent, choosing
equipment that is certified for the function, and ensuring that
the device is performing the intended function. The proper
selection of respirators must be made according to the flow chart
diagram and respirator decision logic sequence (Form 18.5.3)
provided in this program.
14.3.5 Respirator Decision Logic Sequence
14.3.5.1 After all criteria have been identified and evaluated, and after
the requirements and restrictions of the respiratory protection
program have been met, the following sequence of questions
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
(Form 18.5.4) can be used to identify the class of respirators that
should provide adequate respiratory protection:
1. Is the respiratory intended for use during fire fighting?
a. If Yes, only a self-contained breathing apparatus (SCBA) with a
full facepiece operated in pressure demand or other positive
pressure mode is recommended.
b. If no, proceed to step 2.
2. Is the respirator intended for use in an oxygen-deficient atmosphere
(less than 19.5% oxygen by volume at sea level)?
a. If yes, any type of SCBA or supplied-air respirator (SAR) with an
escape pack is recommended. The auxiliary SCBA (escape pack)
must be of sufficient duration to permit escape to safety if the air
supply is interrupted. If additional contaminants are present,
proceed to step 3.
b. If no, proceed to step 3.
3. Is the respirator intended for use during emergency situations?
a. If yes, two types of respirators are recommended: a SCBA with a
full facepiece operated in pressure demand or other positive
pressure mode or a SAR with a full facepiece operated in
pressure demand or other positive pressure mode. Auxiliary
SCBA must be of sufficient duration to permit escape to safety if
the air supply is interrupted.
b. If no, proceed to step 4.
4. Is the containment regulated by the Department of Labor as a
potential occupational carcinogen or identified by NIOSH as a
potential human carcinogen in the workplace, and is the
contaminant detectable in the atmosphere?
a. If yes, two types of respirators are recommended: a SCBA with a
full facepiece operated in pressure demand or other positive
pressure mode or a SAR with a full facepiece operated in
pressure demand or other positive pressure mode. Auxiliary
SCBA must be of sufficient duration to permit escape to safety if
the air supply is interrupted.
b. If no, proceed to step 5.
5. Is the exposure concentration of the contaminant, as determined by
acceptable industrial hygiene methods, less than the NIOSH PEL or
other applicable exposure limit?
a. If yes, a respirator would not be required except for an escape
situation. Proceed to step 7.
b. If no, proceed to step 6.
6. Are conditions such that a worker who is required to wear a
respirator can escape from the work area and not suffer loss of life or
immediate or delayed irreversible health effects if the respiratory
fails? (Are the conditions not immediately dangerous to life and
health IDLH?)
a. If yes, conditions are not considered to be IDLH. Proceed to step
7.
b. If no, conditions are considered to be ISLH. Two types of
respirators are recommended: a SCBA with a full facepiece
operated in pressure demand or other positive pressure mode or
a SAR with a full facepiece operated in pressure demand or other
positive pressure mode. The auxiliary SCBA must be of sufficient
duration to permit escape to safety if the air supply is
interrupted.
7. Is the contaminant an eye irritant, or can the contaminant cause eye
damage at the exposure concentration?
a. If yes, a respirator equipped with a full facepiece, helmet, or hood
is recommended. Proceed to step 8.
b. If no, an orinasal respirator may still be an option, depending on
the exposure concentration. Proceed to step 8.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
8. Divide the eight-hour time-weighted average (TWA) exposure
concentration for the contaminant (or maximum exposure
concentration for a contaminant with a ceiling limit) determined in
step 5 by the NIOSH PEL or other applicable exposure limit to
determine the maximum protection factor required. For escape
respirators, determine the potential for generation of a hazardous
condition caused by an accident or equipment failure. If a potentially
hazardous condition could occur or a minimum protection factor has
been calculated, proceed to step nine.
9. If the physical state of the contaminant is a particulate (solid or
liquid) during period of respirator use, proceed to step 10; if it is a
combination of gas or vapor and particulate, proceed to step 12.
10. Particulate Respirators
a. Is the particulate respirator intended only for escape purposes?
1. If yes, use an ―escape only‖ respirator.
2. If no, the particulate respirator is intended for use during
normal work activities. Proceed to step 10B.
b. A filter medium that will provide protection against exposure to
the particulate in question is recommended.
11. Gas/Vapor Respirators
a. Is the gas/vapor respirator intended for ―escape only‖ purposes?
1. If yes, use a respirator rated for ―escape only‖ purposes.
2. If no, the gas/vapor respirator is intended for use during
normal work activities. Proceed to step 11B.
b. Are the warning properties for the gas/vapor contaminant
adequate at or below the NIOSH PEL or other applicable
exposure limit?
1. If yes, proceed to step 11C.
2. If no, an air-purifying respirator equipped with an effective
end-of-service-life indicator (ESLI), a supplied air respirator,
or a self-contained breathing apparatus is recommended.
c. An air-purifying chemical cartridge/canister respirator is
recommended that has a sorbent suitable for the chemical
properties of the anticipated gas/vapor contaminant(s) and for
the anticipated exposure levels.
12. Combination Particulate and Gas/Vapor Respirators
a. Is the combination respirator intended for ―escape only‖
purposes?
1. If yes, use respirators rated for ―escape only‖ purposes.
2. If no, the combination respirator is intended for use during
normal work activities.
b. Does the gas/vapor contaminant have adequate warning
properties at or below the NIOSH PEL or other applicable
exposure limit?
1. If yes, proceed to step C.
2. If no, either and air-purifying respirator equipped with an
effective ESLI, a supplied-air respirator, or a self-contained
respirator is recommended.
14.4.1 Training
14.4.1.1 Supervisors and workers must be taught the proper selection,
use, and maintenance of respirators.
14.4.1.2 All employees required to use respiratory equipment must be
instructed in the proper use of the equipment and its limitations.
Those employees who will be required to use respiratory
protective equipment in atmospheres immediately dangerous to
life or health must be trained in rescue procedures.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.4.1.3 The training, conducted by a competent person, must include
instructions on respirator fit and how to check the facepiece-to-
face seal. The employee must be given an opportunity to handle
the respirator, wear it in normal air for a period of time to
become familiar with it and to practice adjusting it, and then
wear it in a test atmosphere.
14.1.1.1Training must include an explanation of the following:
14.1.1.1.1 Nature of the respiratory hazard and what may
happen if the respirator is not used properly.
14.1.1.1.2 Engineering and administrative controls being used
and the need for the respirator as added protection.
14.1.1.1.3 Reason(s) for the selection of a particular type of
respirator.
14.1.1.1.4 Limitations of the selected respirator.
14.1.1.1.5 Methods of donning the respirator and checking its fit
and operation.
14.1.1.1.6 Proper wear of the respirator.
14.1.1.1.7 Respirator maintenance and storage.
14.1.1.1.8 Proper method for handling emergency situations.
14.1.1.2Users should know that improper respirator use or maintenance may
cause overexposure. They should know that continued use of poorly
fitted and maintained respirators can also cause chronic disease or
death from overexposure to air contaminants.
14.4.2 Fit Testing
14.1.2.1Full facepieces, half masks, quarter masks and even the different
brands of the same type of respirator marketed, have different fit
characteristics. No one respirator will fit everyone.
14.1.2.2Corrective glasses worn by employees also present a problem when
fitting respirators. Special mountings are available to hold corrective
lenses inside full facepieces. If corrective lenses are needed, the
facepiece and lenses must be fitted by a qualified individual to
provide good vision, comfort, and proper sealing. The user must
receive fitting instructions including demonstrations and practice in
how to wear the respirator, how to adjust it, and how to determine if
it fits properly.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.1.2.3Although respirators are designed for maximum efficiency, they
cannot provide protection without a tight seal between the facepiece
and the face of the wearer. Consequently, beards and other facial hair
can substantially reduce he effectiveness of a facepiece. The absence
of dentures can seriously affect the fit of a facepiece. To ensure proper
respiratory protection, a facepiece must be checked each time a
respirator is worn. This can be accomplished by performing either a
positive-pressure or negative-pressure check. Detailed instructions
for performing these tests can be found in the ANSI standard.
14.1.2.4The effectiveness of the fit of the facepiece can be tested two ways:
qualitatively and quantitatively.
14.1.2.5Qualitative fit testing involves the introduction of a harmless odorous
or irritating substance into the breathing zone around the respirator
being worn. If no odor or irritation is detected by the wear, a proper
fit is indicated.
14.1.2.6Quantitative fit testing offers more accurate, detailed information on
respirator fit. It involves the introduction of a harmless aerosol to the
wearer while he or she is in the test changer. While the wearer
performs exercises that could induce facepiece leakage, the air inside
and outside the facepiece is then measured for the presence of the
harmless aerosol to determine any leakage into the respirator.
14.4.3 Inspection, Cleaning, Maintaining, and Storing
14.1.3.1All respirators must be inspected for wear and deterioration or their
components before and after each use. Special attention should be
given to rubber or plastic parts that can deteriorate. The facepiece,
especially the face seal surface, headband, valves, connective tube,
fittings, and canister must be in good condition. A respirator
inspection must include a check of the tightness of the connections.
14.1.3.2SCBA‘s must be inspected at least monthly. Air and oxygen cylinders
must be carefully charged according to the manufacturer‘s
instructions. Regular and warning devices must be checked to ensure
their proper function. Records must be kept of inspection dates and
findings.
14.1.3.3Chemical cartridges and gas mask canisters must be replaced as
necessary to provide complete protection. The manufacturer‘s
recommendations must be followed. Mechanical filters must be
replaced as necessary to avoid high resistance to breathing.
14.1.3.4Repairs must be made only by experience persons using parts
specifically designed for the respirator. The manufacturer‘s
instructions should be consulted for any repair, and no attempt
should be made to repair or replace components or make adjustments
or repairs beyond the manufacturer‘s recommendations.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.1.3.5A respirator that has been used must be cleaned and disinfected
before it is reissued. Emergency-use rescue equipment must be
cleaned and disinfected immediately after each use. Respirators must
be stored to protect against dust, sunlight, heat, extreme cold,
excessive moisture, or damaging chemicals. Protection against any
mechanical damage also should be provided. Respirators should be
stored so that facepieces and exhalation valves will rest in a normal
position to prevent the rubber or plastic from reforming into an
abnormal shape.
14.1.3.6Respirators may be washed in a detergent solution and then
disinfected by immersion in a sanitizing solution. Clean-sanitizers
that effectively clean the respirator and contain a bactericidal agent
are commercially available. The bacterial agent frequently used is a
quaternary ammonium compound. Strong cleaning and sanitizing
agents and many solvents can damage rubber or elastomeric
respirator parts. Such materials must be used with caution or after
consultation with the respirator manufacturer.
14.4.4 Medical Questionnaire
14.1.4.1All employees required to wear a respirator must be issued the
medical questionnaire. (Form 18.2.5).
14.1.4.2In order to keep the results of this questionnaire confidential, it
should be administered by:
14.1.4.2.1 The preferred method would be to give the
questionnaire to the employee with an envelope. When the
questionnaire is filled out, the employee will deliver it to the
physician or other licensed health care provider for review.
14.1.4.2.2 A second method would be to identify a person within
the organization who is not related to Human Resources, is
licensed to perform fit tests and is under strict confidentiality.
14.4.5 Medical Examinations
14.1.5.1Persons assigned to tasks that require the use of a respirator must be
physically able to perform the work while using the respirator. A
physician or other licensed health care provider (PLHCP) must
determine if the potential respirator user is capable of using a
respirator without any adverse effects. Some of the individuals may
have a condition that prohibits them from wearing a respirator (i.e.,
asthma, lung disease, etc.). The respirator user‘s medical status must
then be reviewed periodically as long as they wear respirators.
14.1.5.2When respirators are worn in toxic atmospheres, the individual must
be provided with appropriate laboratory tests. These may include
urine, blood, or fecal analysis and other techniques to determine the
intake and excretion of toxic substances. The findings of these tests,
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
when correlated with other exposure data, such as air sampling data
for wearers of such equipment, can serve as an indication of the
effectiveness of the program. Positive evidence of exposure must be
followed up with appropriate surveillance of work area conditions to
determine if there is any relationship to inadequate respiratory
protection or a need for additional engineering controls.
14.4.6 Work Area Surveillance
14.1.6.1Surveillance must be maintained of the conditions in the work area
and of the degree of worker exposures or stress (combination of work
rate, environmental conditions, and physiological burdens of wearing
a respirator). Changes in operating procedures, temperature, air
movement, humidity, and work practices may influence the
concentration of a substance in the work area atmosphere. These
factors necessitate periodic monitoring of the air contaminant
concentration. Testing must continue to ensure that the contaminant
exposure has not risen above the maximum protective capacity of the
respirators being used.
14.1.6.2Employees using SCBA‘s, or SAR‘s with auxiliary SCBA‘s, in confined
spaces where the environment is or may be immediately dangerous to
life and health must wear safety harnesses and lifelines. A second
person equipped with complete protective gear must be standing by
ready to help if the first workers gets into trouble. Communications
(visual, voice, or signal line) must be maintained with all persons
present. Precautions must be taken so that, in the even of an
accident, one person will be unaffected and have the proper rescue
equipment to assist the others in an emergency situation.
14.4.7 Air Quality Standards
14.1.7.1Compressed air, compressed oxygen, liquid air, and liquid oxygen
used for respiration must be of high purity. Oxygen must meet the
requirements of the United States Pharmacopoeia for medical or
breathable oxygen. Breathable air must meet at least the
requirement for Grade D breathable air described in Compressed Gas
Association (CGA). Compressed oxygen must not be used in open
circuit SCBA‘s or SAR‘s that have previously used compressed air.
Oxygen must never be used with air-line respirators. Containers of
breathable gas must be clearly marked.
14.1.7.2The compressor for supplied air must be equipped with the necessary
safety devices and alarms. Compressor must be constructed and
situated to avoid any entry of contaminated air into the system and
must be equipped with suitable in-line, air-purifying sorbent beds and
filters installed to ensure air quality. The system also must have a
receiver of sufficient capacity to enable the wearer to escape from a
contaminated atmosphere in the event of compressor failure and
alarm to indicate compressor failure and overheating. If an oil-
lubricated compressor is used, it must have a high-temperature or
carbon monoxide alarm or both. If only the High-temperature alarm
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
is used, the air from the compressor must be tested frequently for
carbon monoxide.
14.4.8 Approved Respirators
14.1.8.1Only NIOSH approved respirators shall be worn. When selecting a
respirator for a particular situation, consult the supplemental
selection charts (Form 18.2.3) for uses.
14.2 FORMS
14.4.1 Respirator Fit Testing Procedures
14.4.2 Rainbow Passage
14.4.3 Respirator Selection Chart
14.4.4 NIOSH Respirator Decision Logic Sequence &
Respirator Protection Training Checklist
14.4.5 Medical Questionnaire
14.4.6 Appendix ―D‖ For Nonmandatory Respirator Use
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.5.1 Respirator Fit Testing Procedures
Each time a respirator is issued to a The Fidlar Companies, Inc. employee, that employee
must perform a fit test to ensure that the respirator will give the proper fit and protection
to that employee. A respirator fit test consists of various exercises that are listed in this
section.
The fitting of half-mask respirators should be started with those having multiple sizes and
a variety of interchangeable cartridges and canisters such as the MSA Comfo II-M, North
M. Survivair M, A-O M, or Scott-M. Use the tests outlined below to assure that the
facepiece is properly adjusted and a proper fit is obtained.
Positive Pressure Test
With the exhaust port(s) blocked, the positive pressure of slight exhalation should remain
constant for several seconds. The test subject should cover the exhaust port(s) and exhale
slowly to ensure that a proper seal exists.
Negative Pressure Test
With the intake port(s) blocked, the negative pressure of slight inhalation should remain
constant for several seconds. The test subject should cover the inhalation port(s) and inhale
slowly to ensure that a proper seal exists.
Exercise Regime
The next part of the fit test will require the use of banana oil (isoamyl acetate) when
testing organic vapor cartridges or (Bitrex) when using high efficiency filters. Tents or
hoods should only be used with banana oil tests.
If the employee can detect the isoamyl acetate or Bitrex at anytime during the test, the
respirator should be checked for faults, adjusted, or replaced with another unit. Once this
is done the employee shall be re-tested.
Exercise #1
Normal Breathing. In the normal standing position, without talking, the subject shall
breathe normally for at least one minute.
Exercise #2
Deep Breathing. In the normal standing position the subject shall do deep breathing for at
least one minute pausing so as not to hyperventilate.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
Exercise #3
Turning Head Side to Side. Standing in place the subject shall slowly turn his/her head
from side between the extreme positions to each side. The head shall be held at each
extreme position for at least 5 seconds. Perform for at least three complete cycles.
Exercise #4
Moving Head Up and Down. Standing in place, the subject shall slowly move his/her head
up and down between the extreme position straight up and the extreme position straight
down. The head shall be held at each extreme position for at least 5 seconds. Perform for at
lest three complete cycles.
Exercise #5
Reading. The test subject (keeping eyes closed) shall repeat after the test conductor the
―rainbow passage‖ located on the next page. The subject shall talk slowly and aloud so as to
be heard clearly by the test conductor or monitor.
Exercise #6
Grimace. The test subject shall grimace, smile, frown, and generally contort the face using
the facial muscles. Continue for at least 15 seconds.
Exercise #7
Bend Over and Touch Toes. The test subject shall bend at the waist and touch their toes
and return to the upright position. Repeat for at least 30 seconds.
Exercise #8
Jogging In Place. The test subject shall jog in place for at least 30 seconds.
Exercise #9
Normal Breathing. Same as number 1.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.5.2 Rainbow Passage
When the sun strikes raindrops in the air, they act like a prism and
form a rainbow. The rainbow is a division of white light into many
beautiful colors. These take the shape of a long round arch, with its
path high above, and its two ends apparently beyond the horizon. There
is, according to legend, a boiling pot of gold at one end. People look, but
no one ever finds it. When a man looks for something beyond reach, his
friends say he is looking for the pot of gold at the end of the rainbow.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.5.3 Respirator Selection Chart
Table 1.—Assigned protection factor classifications of respirators for protection
against particulate exposures1
Assigned
Protection Factor Type of Respirator
5 Single-use (see definition in Glossary) or quarter mask2
respirator
10 Any air-purifying half-mask respirator including disposable3
(see definition in Glossary) equipped with any type of
particulate filter except single use2,4
Any air-purifying full facepiece respirator equipped with any
type of particulate filter5
Any supplied-air respirator equipped with a half-mask and
operated in a demand (negative pressure) mode4
25 Any powered air-purifying respirator equipped with a hood or
helmet and any type of particulate filter4
Any supplied-air respirator equipped with a hood or helmet
and operated in a continuous flow mode4
50 Any air-purifying full facepiece respirator equipped with a
high efficiency filter2
Any powered air-purifying respirator equipped with a tight-
fitting facepiece and a high efficiency filter4
Any supplied-air respirator equipped with a full facepiece and
operated in a demand (negative pressure) mode2
Any supplied-air respirator equipped with a tight-fitting
facepiece and operated in a continuous flow mode4
1 Only high efficiency filters are permitted for protection against particulates having exposure limits less than
0.05 mg/m3.
2 The assigned protection factors (APF‘s) were determined by Los Alamos National Laboratories (LANL) by
conducting quantitative fit testing on a panel of human volunteers [6].
3 An APF factor of 10 can be assigned to disposable particulate respirators if they have been properly fitted
using a quantitative fit test.
4 APF‘s were based on workplace protection factor (WPF) data or laboratory data more recently reported than
the LANL data [7–11, 14–17].
5 The APF was based on consideration of efficiency of dust, fume, and/or mist filters.
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
Form 14.5.4
The NIOSH Respirator Decision Logic Sequence (Publication No. 87-108) is presented in
Figure 1 in the form of a flow chart. This flow chart can be used to identify suitable classes
of respirators for adequate protection against specific environmental conditions. Refer to
the corresponding narrative section for additional information pertaining to a specific part
of the flow chart.
Form 14.5.4—Flow Chart of Respirator Decision Logic Sequence
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
Form 18.5.4—Flow Chart of Respirator Decision Logic Sequence continued
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.5.4 Respirator Protection Training Checklist
Employee Name (Print) Employee Signature Date
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.5.5 Medical Questionnaire
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SECTION 12 RESPIRATORY PROTECTION PROGRAM
14.5.6 Appendix D for Nonmandatory Respirator Use
Appendix D to Sec. 1910.134 (Nonmandatory) Information for employees using respirators
when not required under the Standard.
Respirators are an effective method of protection against designated hazards when
properly selected and worn. Respirator use is encouraged, even when exposures are below
the exposure limit, to provide an additional level of comfort and protection for workers.
However, if a respirator is used improperly or not kept clean, the respirator itself can
become a hazard to the worker. Sometimes, workers may wear respirators to avoid
exposures to hazards, even if the amount of hazardous substance does not exceed the limits
set by OSHA standards. If your employer provides respirators for your voluntary use, or if
you provide your own respirator, you need to take certain precautions to be sure that the
respirator itself does not present a hazard.
You should do the following:
1. Read and heed all instructions provided by the manufacturer on use, maintenance,
cleaning and care, and warnings regarding the respirators limitations.
2. Choose respirators certified for use to protect against the contaminant of concern.
NIOSH, the National Institute for Occupational Safety and Health of the U.S.
Department of Health and Human services, certifies respirators. A label or statement
of certification should appear on the respirator or respirator packaging. It will tell you
what the respirator is designed for and how much it will protect you.
3. Do not wear your respirator into atmospheres containing contaminants for which your
respirator is not designed to protect against. For example, a respirator designed to filter
dust particles will not protect you against gases, vapors, or very small solid particles of
fumes or smoke.
4. Keep track of your respirator so that you do not mistakenly use someone else‘s
respirator.
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Respirator Medical Evaluation Questionnaire
To the employer: Answers to questions in Section 1, and to question 9 in Section 2 or Part A, do not require a medical examination.
To the employee: Can you read? (check one):……………………………………………………. Yes No
Your employer must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you. To
maintain your confidentiality, your employer or supervisor must not look at or review your answers, and your employer must tell you how to deliver
or send this questionnaire to the health care professional who will review it.
The following information must be provided by every employee who has been selected to use any type of respirator (please print).
Name Job title:
Age (to nearest year): Sex (check one): Male Female Date
Check the type of respirator you will use (you can check more
Height: Feet Inches Weight Lbs. than one category):
a. N, R, or P disposable respirator (filter-mask, non-
Phone number where you can be reached by the health care person who cartridge type only).
reviews this (include area code): b. Other type (for example, half- or full-facepiece type,
powered-air purifying, supplied-air, self-contained
The best time to call you at this number: breathing apparatus).
Has your employer told you how to contact the health care Have you worn a respirator: ……………… Yes No
Person who will review this (check one): Yes No If “yes,” what type(s):
Part A — Section 2 (Mandatory)
Questions 1 through 9 below must be answered by every employee who has been selected to use any type of respirator (please check “yes” or “no”).
1. Do you currently smoke tobacco, or have you smoked tobacco in the last month ..................................................................... Yes No
2. Have you ever had any of the following conditions?
a...................................................................................................................................................................................... Seizures (fits):
Yes ........................................................................................................................................................................................ No
b. .................................................................................................................................................................................... Allergic
reactions that interfere with breathing: .............................................................................................................................. Yes No
c...................................................................................................................................................................................... Claustrophobia
(fear of closed-in places):................................................................................................................................................... Yes No
d. .................................................................................................................................................................................... Trouble
smelling odors: .................................................................................................................................................................. Yes No
e...................................................................................................................................................................................... Trouble
smelling odors: .................................................................................................................................................................. Yes No
3. Have you ever had any of the following pulmonary or lung problems?
a. Asbestosis: ......................................................................................................................................................................... Yes No
b. Asthma: .............................................................................................................................................................................. Yes No
c. Chronic bronchitis: ............................................................................................................................................................ Yes No
d. Emphysema:....................................................................................................................................................................... Yes No
e. Pneumonia: ........................................................................................................................................................................ Yes No
f. Tuberculosis: ..................................................................................................................................................................... Yes No
98
g. Silicosis: ............................................................................................................................................................................ Yes No
h. Pneumothorax (collapsed lung): ........................................................................................................................................ Yes No
i. Lung cancer: ...................................................................................................................................................................... Yes No
j. Broken ribs: ....................................................................................................................................................................... Yes No
k. Any chest injuries or surgeries: .......................................................................................................................................... Yes No
l. Any other lung problem that you‟ve been told about: ....................................................................................................... Yes No
4. Do you currently have any of the following symptoms of pulmonary or lung illness?
a. Shortness of breath: ........................................................................................................................................................... Yes No
b. Shortness of breath when walking fast on level ground or working up a slight hill or incline: ......................................... Yes No
c. Shortness of breath when walking with other people at an ordinary pace on level ground: .............................................. Yes No
d. Have to stop for breath when walking at your own pace on level ground: ....................................................................... Yes No
e. Shortness of breath when washing or dressing yourself: ................................................................................................... Yes No
f. Shortness of breath that interferes with your job: .............................................................................................................. Yes No
g. Coughing that produces phlegm (thick sputum): ............................................................................................................... Yes No
h. Coughing that wakes you early in the morning:................................................................................................................. Yes No
i. Coughing that occurs mostly when you are lying down: ................................................................................................... Yes No
j. Coughing up blood in the last month:................................................................................................................................ Yes No
k. Wheezing: .......................................................................................................................................................................... Yes No
l. Wheezing that interferes with your job: ............................................................................................................................. Yes No
m. Chest pain when you breathe deeply: ................................................................................................................................ Yes No
n. Any other symptoms that you think may be related to lung problems: .............................................................................. Yes No
5. Have you ever had any of the following cardiovascular or heart problems?
a. Heart attack: ....................................................................................................................................................................... Yes No
b. Stroke:................................................................................................................................................................................ Yes No
c. Angina: .............................................................................................................................................................................. Yes No
d. Heart failure: ...................................................................................................................................................................... Yes No
e. Swelling in your legs or feet (not caused by walking): ...................................................................................................... Yes No
f. Heart arrhythmia (heart beating irregularly): ..................................................................................................................... Yes No
g. High blood pressure: .......................................................................................................................................................... Yes No
h. Any other heart problem that you‟ve been told about: ....................................................................................................... Yes No
6. Have you ever had any of the following cardiovascular or heart symptoms?
a. Frequent pain or tightness in your chest: ........................................................................................................................... Yes No
b. Pain or tightness in your chest during physical activity: .................................................................................................... Yes No
c. Pain or tightness in your chest that interferes with your job: ............................................................................................. Yes No
d. In the past two years, have you noticed your heart skipping or missing a beat: ................................................................. Yes No
e. Heartburn or indigestion that is not related to eating: ........................................................................................................ Yes No
f. Any other symptoms that you think may be related to heart or circulation problems: ....................................................... Yes No
7. Do you currently take medication for any of the following problems?
a. Breathing or lung problems: .............................................................................................................................................. Yes No
b. Heart trouble: ..................................................................................................................................................................... Yes No
c. Blood pressure: .................................................................................................................................................................. Yes No
d. Seizures (fits): .................................................................................................................................................................... Yes No
8. If you‟ve used a respirator, have you ever had any of the following problems?
(If you‟ve never used a respirator go to question 9)
99
a. Eye irritation: ..................................................................................................................................................................... Yes No
b. Skin allergies or rashes: ..................................................................................................................................................... Yes No
c. Anxiety: ............................................................................................................................................................................. Yes No
d. General weakness or fatigue: ............................................................................................................................................. Yes No
e. Other problem that interferes with your respirator use: ..................................................................................................... Yes No
9. Would you like to talk to the health care professional who will review this questionnaire about your
answers to this questionnaire: .................................................................................................................................................... Yes No
Questions 10 to 15 below must be answered by every employee who has been selected to use either a full-facepiece respirator or a self-contained breathing apparatus
(SCBA). For employees who have been selected to use other types of respirators, answering these questions is voluntary.
10. Have you ever lost vision in either eye (temporarily or permanently): ...................................................................................... Yes No
11. Do you currently have any of the following vision problems?
a. Wear contact lenses: .......................................................................................................................................................... Yes No
b. Wear glasses: ..................................................................................................................................................................... Yes No
c. Color blind:........................................................................................................................................................................ Yes No
d. Other eye or vision problem: ............................................................................................................................................. Yes No
12. Have you ever had an injury to your ears, including a broken ear drum: .................................................................................. Yes No
13. Do you currently have any of the following hearing problems?
a. Difficulty hearing:.............................................................................................................................................................. Yes No
b. Wear a hearing aid: ............................................................................................................................................................ Yes No
c. Any other hearing or ear problem: ..................................................................................................................................... Yes No
14. Have you ever had a back injury:............................................................................................................................................... Yes No
15. Do you currently have any of the following musculoskeletal problems?
a. Weakness in any of your arms, hands, legs, or feet: .......................................................................................................... Yes No
b. Back pain: .......................................................................................................................................................................... Yes No
c. Difficulty fully moving your arms and legs: ...................................................................................................................... Yes No
d. Pain or stiffness when you lean forward or backward at the waist: ................................................................................... Yes No
e. Difficulty fully moving your head up or down: ................................................................................................................. Yes No
f. Difficulty fully moving your head side to side:.................................................................................................................. Yes No
g. Difficulty bending at your knees: ...................................................................................................................................... Yes No
h. Difficulty squatting to the ground: ..................................................................................................................................... Yes No
i. Climbing a flight of stairs or a ladder carrying more than 25 lbs: ...................................................................................... Yes No
j. Any other muscle or skeletal problem that interferes with using a respirator: ................................................................... Yes No
Part B
Any of the following questions, and other questions not listed, may be added to the questionnaire at the discretion of the health care
professional who will review the questionnaire.
1. In your present job, are you working at high altitudes (over 5,000 feet) or in a place that has lower
than normal amounts of oxygen: ................................................................................................................................................ Yes No
If “yes,” do you have feelings of dizziness, shortness of breath, pounding in your chest, or other
symptoms when you‟re working under these conditions: .......................................................................................................... Yes No
2. At work or at home, have you ever been exposed to hazardous solvents, hazardous airborne
chemicals (e.g. gases, fumes, or dust), or have you come into skin contact with hazardous
chemicals: .................................................................................................................................................................................. Yes No
If “yes,” name the chemicals if you know them:
100
3. Have you ever worked with any of the materials, or under any of the conditions, listed below:
a. Asbestos:............................................................................................................................................................................ Yes No
b. Silica (e.g. in sandblasting): ............................................................................................................................................... Yes No
c. Tungsten/cobalt (e.g. grinding or welding this material): .................................................................................................. Yes No
d. Beryllium: .......................................................................................................................................................................... Yes No
e. Aluminum: ......................................................................................................................................................................... Yes No
f. Coal (for example, mining): ............................................................................................................................................... Yes No
g. Iron: ................................................................................................................................................................................... Yes No
h. Tin: .................................................................................................................................................................................... Yes No
i. Dusty environments: .......................................................................................................................................................... Yes No
j. Other hazardous exposures: ............................................................................................................................................... Yes No
If “yes,” describe these exposures:
4. List any second jobs or side businesses you have:
5. List your previous occupations:
6. List your current and previous hobbies:
7. Have you been in the military services?..................................................................................................................................... Yes No
If “yes,” were you exposed to biological or chemical agents (either in training or combat): ..................................................... Yes No
8. Have you ever worked on a HAZMAT team? ........................................................................................................................... Yes No
9. Other than medications for breathing and lung problems, heart trouble, blood pressure, and
seizures mentioned earlier in this questionnaire, are you taking any other medications for any
reason (including over-the-counter medications): ..................................................................................................................... Yes No
If “yes,” name the medications if you know them:
10. Will you be using any of the following items with your respirator(s)?
a. HEPA Filters: .................................................................................................................................................................... Yes No
b. Canisters (for example, gas masks): ................................................................................................................................... Yes No
c. Cartridges: ......................................................................................................................................................................... Yes No
11. How often are you expected to use the respirator(s)?
a. Escape only (no rescue): .................................................................................................................................................... Yes No
b. Emergency rescue only: ..................................................................................................................................................... Yes No
c. Less than 5 hours per week: ............................................................................................................................................... Yes No
d. Less than 2 hours per day: ................................................................................................................................................. Yes No
e. 2 to 4 hours per day: .......................................................................................................................................................... Yes No
f. Over 4 hours per day: ........................................................................................................................................................ Yes No
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12. During the period you are using the respirator(s), is your work effort:
a. Light (less than 200 kcal per hour): ................................................................................................................................... Yes No
If “yes,” how long does this period last during the average shift: ___________ hrs ____ mins.. ................................... Yes No
Examples of a light work effort are sitting while writing, typing, drafting, or performing light assembly
work; or standing while operating a drill press (1-3 lbs.) or controlling machines.
b. Moderate (200 to 350 kcal per hour): ................................................................................................................................ Yes No
If “yes,” how long does this period last during the average shift: ___________ hrs. ____ mins. .................................... Yes No
Examples of moderate work effort are sitting while nailing or filing; driving a truck or bus in urban
traffic; standing while drilling, nailing, performing assembly work, or transferring a moderate load
(about 35 lbs.) at trunk level; walking on a level surface about 2 mpg or down a 5-degree grade about 3
mph; or pushing a wheelbarrow with a heavy load (about 100 lbs.) on a level surface.
c. Heavy (above 350 kcal per hour): ...................................................................................................................................... Yes No
If “yes,” how long does this period last during the average shift: ___________ hrs. ____ mins.
Examples of heavy work are lifting a heavy load (about 50 lbs.) from the floor to your waist or
shoulder; working on a loading dock; shoveling; standing while bricklaying or chipping castings;
walking up an 8-degree grade about 2 mph; climbing stairs with a heavy load (about 50 lbs.).
13. Will you be wearing protective clothing and/or equipment (other than the respirator) when you‟re using
your respirator: ......................................................................................................................................................................... Yes No
If “yes,” describe this protective clothing and/or equipment
14. Will you be working under hot conditions (temperature exceeding 77ºF): ............................................................................... Yes No
15. Will you be working under humid conditions: .......................................................................................................................... Yes No
16. Describe the work you‟ll be doing while you‟re using your respirator(s):
17. Describe any special or hazardous conditions you might encounter when you‟re using your respirator(s)
(for example, confined spaces, life-threatening gases):
18. Provide the following information, if you know it, for each toxic substance that you‟ll be exposed to when
you‟re using your respirator(s):
Name of the first toxic substance:
Estimated maximum exposure level per shift:
Duration of exposure per shift:
102
Name of the second toxic substance:
Estimated maximum exposure level per shift:
Duration of exposure per shift:
Name of the third toxic substance:
Estimated maximum exposure level per shift:
Duration of exposure per shift:
The name of other toxic substances that you‟ll be exposed to while using your respirator:
19. Describe any special responsibilities you‟ll have while using your respirator(s) that may affect the safety and
well-being of others (for example, rescue, security):
PLHCP Follow-Up Medical Examination
Employee Name: Recommendations about employee use of the respirator:
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Job title: Limitations-
Date of this follow-up:
Reasons for follow-up:
Actions:
Need for follow-up medical evaluations-
Signed: Date signed:
Copy of recommendation given to Date given:
employee? Yes No
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SECTION 13
DRUG AND ALCOHOL PROGRAM
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SECTION 13 DRUG AND ALCOHOL PROGRAM
Policy Statement
The parties recognize the problems created by drug and alcohol abuse and the need to
develop prevention and treatment programs. The Fidlar Companies have a commitment
to protect people and property, and to provide a safe working environment. The purpose
of the following program is to establish and maintain a drug free, alcohol free, safe,
healthy work environment for all of its employees.
Definitions
Company Premises - all property, facilities, land, buildings, structures, automobiles,
trucks and other vehicles owned, leased, or used by the company.
Prohibited Items and Substances - Prohibited substances include illegal drugs
(including controlled substances, look alike drugs and designer drugs), alcoholic
beverages, and drug paraphernalia in the possession of or being used by an employee on
the job.
Employee - Individuals, who perform work for The Fidlar Companies, including
management, supervision, engineering, tradesmen, and clerical personnel.
Accident - Any event resulting in injury to a person or property to which an employee, or
contractor/contractor's employee, contributed as a direct or indirect cause.
Incident - An event which has all the attributes of an accident, except that no harm was
caused to person or property.
Reasonable Cause - Reasonable cause shall be defined as tardiness, excessive
absenteeism, and erratic behavior such as noticeable imbalance, incoherence, and
disorientation.
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SECTION 13 DRUG AND ALCOHOL PROGRAM
Confidentiality
All parties to this policy and program have only the interests of employees in mind,
therefore, we encourage any employee with a substance abuse problem to come forward
and voluntarily accept our assistance in dealing with the illness. An employee assistance
program will provide guidance and direction for you during your recovery period. If you
volunteer for help, the company will make every reasonable effort to return you to work
upon your recovery. The company will also take action to assure that your illness is
handled in a confidential manner.
All actions taken under this policy and program will be confidential and disclosed only to
those with a "need to know."
When a test is required, the specimen will be identified by a code number, not by name, to
insure confidentiality of the donor. Each specimen container will be properly labeled and
made tamper proof. The donor must witness this procedure.
Unless an initial positive result is confirmed as positive, it shall be deemed negative and
reported by the laboratory as such.
The handling and transportation of each specimen will be properly documented through
the strict chain of custody procedures.
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SECTION 13 DRUG AND ALCOHOL PROGRAM
Rules, Disciplinary Actions - Grievance Procedures
A. Rules
All employees must report to work in a physical condition that will enable them to
perform their jobs in a safe and efficient manner. Employees shall not:
1. Use, possess, dispense or receive prohibited substances on or at the job site;
or
2. Report to work with any measurable amount of prohibited substances in their
system.
B. Discipline
When the company has reasonable cause to believe an employee is under the influence
of a prohibited substance, for reasons of safety, the employee may be suspended until
the results are available. If no test results are received after three working days, the
employee, if available, shall be returned to work with back pay. If the test results
prove negative, the employee shall be reinstated with back pay. In all other cases:
1. Applicants testing positive for drug use will not be hired.
2. Employees who have not voluntarily come forward, and who test positive for a
drug use, will be terminated.
3. Employees who refuse to cooperate with testing procedures will be terminated.
4. Employees found in possession of drugs or drug paraphernalia will be terminated.
5. Employees found selling or distributing drugs will be terminated.
6. Employees found under the influence of alcohol while on duty, or while operating
a company vehicle, will be subject to termination.
C. Prescription Drugs
Employees using a prescribed medication, which may impair the performance of job
duties, either mental or motor functions, must immediately inform their supervisor of
such prescription drug use. For the safety of all employees, the company will consult
with you and your physical to determine if a re-assignment of duties is necessary.
The company will attempt to accommodate your needs by making an appropriate re-
assignment. However, if a re-assignment is not possible, you will be placed on temporary
medical leave until released as fit for duty by the prescribing physician.
D. Grievances
All aspects of this policy and program shall be subject to the grievance procedure of the
applicable collective bargaining agreements.
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SECTION 13 DRUG AND ALCOHOL PROGRAM
Drug and Alcohol Testing
The parties to this policy and program agree that under certain circumstances, the
company will find it necessary to conduct drug and alcohol testing. While "random"
testing is not necessary for the proper operation of this policy and program, it may be
necessary to require testing under the following conditions:
1. A pre-employment drug and alcohol test may be administered to all applicants
for employment.
2. A test may be administered in the event a supervisor has a reasonable cause to
believe that the employee has reported to work under the influence, or is or has
been under the influence while on the job; or has violated this drug policy.
During the process of establishing reasonable cause for testing , the employee
has the right to request his on-site representative to be present;
3. Testing may be required if an employee is involved in a workplace
accident/incident or if there is a workplace injury;
4. Testing may be required as a part of a follow-up to counseling or rehabilitation
for substance abuse, for up to a 1-year period;
5. Employees may also be tested on a voluntary basis.
Each employee will be required to sign a consent and chain of custody form, assuring
proper documentation and accuracy. If an employee refuses to sign a consent form
authorizing the test, ongoing employment by the company will be terminated.
Drug testing will be conducted by an independent accredited laboratory (designated by
the labor union) and may consist of either blood or urine tests, or both, as required. Blood
tests will be utilized for post accident investigation only.
The company will bear the costs of all testing procedures.
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SECTION 13 DRUG AND ALCOHOL PROGRAM
Rehabilitation and Employee Assistance Program
Employees are encouraged to seek help for a drug or alcohol problem before it
deteriorates into a disciplinary matter. If an employee voluntarily notifies supervision that
he or she may have a substance abuse problem, the company will assist in locating a
suitable employee assistance program for treatment, and will counsel the employee
regarding medical benefits available under the company or union health and
welfare/insurance program.
If treatment necessitates time away from work, the company shall provide for the
employee an unpaid leave of absence for purposes of participation in an agreed upon
treatment program. An employee who successfully completes a rehabilitation program
shall be reinstated to his/her former employment status, if work for which he/she is
qualified exists.
Employees returning to work after successfully completing the rehabilitation program will
be subject to drug tests without prior notice for a period of one year. A positive test will
then result in disciplinary action as previously outlined in this policy and program.
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SECTION 14
POWERED INDUSTRIAL TRUCK
111
OBJECTIVE
The Fidlar Companies has developed a Powered Industrial Truck (PIT) Program to minimize the
risk of employee injury and property damage loss from the use of Powered Industrial Trucks. It is
The Fidlar Companies’ intent to communicate and monitor appropriate standards of conduct in the
performance of routine forklift operations.
APPLICABILITY / SCOPE
It is the responsibility of the management and the supervisor of The Fidlar Companies to ensure
that all employees that operate PIT‟s are certified.
A Powered Industrial Truck is defined as a fork truck, platform lift truck, motorized hand truck,
and other specialized industrial truck powered by electric motors or internal combustion engines.
This does not apply to compressed air or nonflammable compressed gas-operated industrial
trucks, nor to farm vehicles, nor to vehicles intended primarily for earth moving or over-the-road
hauling.
ACCOUNTABILITY
The Fidlar Companies’ Forklift Program Coordinator’s responsibilities are:
Selection of the appropriate type of industrial truck related to the atmosphere conditions
in which it will be used (refer to Appendix A).
Ensuring that all PIT operators have been trained and are authorized.
The Supervisor’s responsibilities are:
Ensure that all PIT operators have been trained and authorized.
Ensure that operators are following all operating procedures.
Ensure that any PIT operator observed driving in an unsafe manner is removed until
retraining is conducted.
The PIT Operators responsibilities are:
Follow all operating procedures.
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Operating Procedures
General Rules
1. Lift trucks shall not be driven up to anyone standing in front of a bench or other fixed object.
2. All body parts (hands, arms, head, feet, legs, etc.) are prohibited outside the operator
compartment of the truck, between the uprights of the mast or within the reach mechanism or
other attachments of the truck.
3. Passengers are not allowed to ride on powered industrial trucks.
4. Operators shall not block access to fire or emergency exits, stairways, fire equipment or
electrical panels.
5. Under all travel conditions; operate the truck at a speed that will permit it to be brought to a
stop in a safe manner.
6. Stunt driving and horseplay shall be prohibited.
7. The operator must slow down for wet and slippery floors.
8. Running over loose objects on the floor is prohibited.
9. The operator is responsible for cleaning up all fluid leaks (oil, hydraulic fluid, etc.) from the
floor.
10. Operators are required to report all lift truck accidents involving personnel, building
structures and equipment to shift leaders and department mangers.
11. The operator shall handle loads only within the capacity rating of the truck.
12. Lift trucks shall not be used for any purpose other than what they were designed.
13. No person shall be allowed to stand or pass under the elevated portion of any truck whether
empty or loaded.
14. Lift trucks shall not be started or any of its functions or attachments operated from any
position other than from the designated operator‟s position.
15. The operator shall look 360 degrees traveling with a lift truck, especially when backing up.
16. The operator shall observe all traffic regulations and under normal traffic conditions, keep to
the right.
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17. A safe distance of no less than three truck lengths shall be maintained when following
another lift truck and additional truck length per adverse condition and the operator shall
keep his/her truck under control at all times and additional truck lengths per adverse
conditions.
18. The operator shall not pass another truck traveling in the same direction.
19. Operators shall slow down and sound the horn at cross aisles and other locations where
vision is obstructed.
20. The operator must keep a clear view of the path of travel and observe for other traffic,
personnel and safe clearances. If the load being carried obstructs forward view, travel with
the load trailing (except when ascending a ramp or entering a trailer).
21. When the forks are empty, the operator shall travel with the forks at a negative pitch as low to
the floor as practical. The operator is responsible for adjusting the height of the forks to a
safe level when the operating terrain warrants.
22. When traveling with a load on the forks, the operator shall travel with the load as low to the
floor as practical with the load tilted slightly for improved stability.
23. At no time shall a powered industrial lift truck be parked on inclines, ramps or dock plates.
24. A powered industrial truck is considered to be ATTENDED when the operator is less than 25
feet from the truck, which remains in his view. Before leaving the operator‟s position, the
operator shall:
Bring truck to a complete Stop.
Place directional controls in neutral.
Apply the parking brake.
Lower the forks or attachments fully until resting completely flat on the floor. When
lowering unloaded forks, the forks shall be tilted forward first and then lowered to the
ground until the tips of the forks come in contact with the floor.
25. A powered industrial truck is considered to be UNATTENDED when the operator is more
than 25 feet from the truck which remains in his view. Or whenever the operator leaves the
truck and it is not in view regardless of distance from the truck. Before leaving the operator‟s
position in the instance, the operator shall:
Follow the procedures in item above
Stop the engine or turn off the controls
26. If the lift truck is not put on a charge during off shifts or weekends, the operator shall
disconnect the battery plug from the truck plug. NOTE: During normal production
operation, the lift truck may remain plugged into the battery when left unattended.
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To change an LP gas tank, the operator shall:
Put on leather work gloves and goggles.
Disconnect lift truck valve from the employ LP cylinder.
Replace with full cylinder.
NOTE: The pin on the lift truck must fit into the cut hole(s) provided on the gas cylinder.
THIS IS REQUIRED BY LAW.
27. Strap in the cylinder and reconnect the truck valve securely to the cylinder in outlet.
28. Open cylinder valve and listen for leaks.
29. If leaking, close cylinder valve and slowly uncouple the fuel valve. Try to reconnect. If still
leaking, try a different cylinder and notify shift leader or department management of faulty
cylinder.
30. If no leaks are present, lift truck my be utilized.
31. Lift trucks shall not be operated with a leak in the fuel system until the leak has been
corrected.
32. The operator shall use the following back up procedure and sequence:
Pivot at the waist and inspect the area of operation in the rear of the fork truck. Watching for
obstructions and pedestrians.
Blow the horn to alert any pedestrians that may or may not be visible.
Engage the directional lever to the reverse position.
Concentrate on the removal of the forks from the load to avoid any load disturbance, as
you back the fork truck out of the load.
Stop the fork truck 18” to 24” away from the loads resting location and lower the forks to
the proper travel height and angle.
33. During load placement, the operator shall:
Square the fork truck with the load resting location.
Stop the fork truck 18” to 24” away from the load resting location.
Raise the load to proper entry height.
Drive forward with the load and position the load over its resting location.
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Lower the load to a height of 4” if possible.
Tilt the load forward to a level position.
Lower the load to its resting position.
Back up the unit using proper back up procedures and sequence.
34. During load retrieving, the operator shall:
Square the fork truck with the load resting location.
Stop the fork truck 18” to 24” away from the load resting location.
Raise the forks to the proper entry height.
Enter the load and maintain the clearance around the forks to avoid load disturbance.
Raise the load so it is completely suspended form it‟s resting platform.
Tilt the load back.
Visually inspect the rear area of the fork truck to ensure no pedestrians are behind or
around the unit.
Back up the unit using proper back up procedures and sequence.
Back up the fork truck 18” to 24” and stop.
Lower the load to the proper travel height.
TRAINING
Under no circumstances shall an employee operate a powered industrial truck/forklift until he/she
has successfully completed The Fidlar Companies „s forklift operation training program. This
includes all new operators regardless of claimed previous experience.
Training must consist of a combination of formal instruction and practical training. Formal
instruction may include lectures, conferences, classroom discussions, demonstrations, and written
or oral tests.
Initial Training
Powered industrial truck operators shall receive initial training in the following topics:
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Truck-related training topics:
Operating instructions, warnings, and precautions for the types of truck the operator will
authorized to operate.
Differences between the truck and the automobile.
Truck controls and instrumentation: where they are located, what they do, and how they work.
Engine or motor operation.
Steering and maneuvering.
Visibility (including restrictions due to loading).
Fork and attachment adaptation, operation, and use limitations.
Vehicle capacity.
Vehicle stability.
Any vehicle inspection and maintenance that the operator will be required to perform.
Refueling and/or charging and recharging the batteries.
Operating limitations.
Any other operating instructions, warnings, or precautions listed in the operator‟s manual for the
types of vehicle that the employee is being trained to operate.
Workplace –Related Topics:
Surface conditions where the vehicle will be operated.
Composition of loads to be carried and load stability.
Load manipulation, stacking, and unstacking.
Pedestrian traffic in areas where the vehicle will be operated.
Narrow aisles and other restricted places where the vehicle will be operated.
Hazardous (classified) locations where the vehicle will be operated.
Ramps and other sloped surfaces that could affect the vehicle‟s stability.
Closed environments and other areas where insufficient ventilation or poor vehicle maintenance
could cause a buildup of carbon monoxide or diesel exhaust.
117
Other unique or potentially hazardous environmental conditions in the workplace that could
affect safe operation.
Refresher Training
Refresher training, including an evaluation of the effectiveness of that training shall be conducted
when needed to ensure that the operator has the knowledge and skills needed to operate the
powered industrial truck safely. Refresher training in relevant topics shall be provided to the
operator when:
The operator has been observed to operate the vehicle in an unsafe manner.
The operator has been involved in an accident or near- miss incident.
The operator has received an evaluation that reveals that the operator is not operating the truck
safely.
The operator is assigned to drive a different type of truck.
A condition in the workplace changes in a manner that could affect safe operation of the truck.
Evaluation
Once every 3 years an evaluation will be conducted of each powered industrial truck operator‟s
performance.
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Appendix B
SAMPLE PERFORMANCE TEST
FOR FORKLIFT OPERATORS
EMPLOYEE: DATE: TIME: a.m./p.m.
Pass Fail
Shows familiarity with truck controls.
Gave proper signals when turning.
Slowed down at intersections.
Sounded horn at intersections.
Obeyed signs.
Kept a clear view of direction of travel.
Turned corners correctly – was aware of rear end swing.
Yielded to pedestrians.
Drove under control and within proper traffic aisles.
Approached load properly.
Lifted load properly.
Maneuvered properly.
Traveled with load at proper height.
Lowered load smoothly/slowly.
Stops smoothly/completely.
Load balanced properly.
Forks under load all the way.
Carried parts/stock in approved containers.
Checked bridge plates / ramps.
Did place loads within marked area.
Did stack loads evenly and neatly.
Did drive backward when required.
Did check load weights.
Did place forks on the floor when parked, controls neutralized, brake on set,
power off.
Followed proper instruction for maintenance – checked both a beginning and
end.
Pass/Fail Rating Evaluator
(Demo only use form from owners manual)
119
Appendix C
OPERATOR’S DAILY REPORT
Engine-Powered Lift Trucks
Truck No. Make Date Shift
Hour Meter Reading: Start End Hours for Shift
CHECK EACH ITEM SHIFT Explain below if not OK
If OK write OK Start During End or any other action taken
1. Fuel level
2. Oil level and pressure
3. Water level and fan belt
4. Brakes – service and parking
5. Lights – head, tail and warning
6. Horn
7. Hour meter and gauges
8. Steering
9. Tires
10. Hydraulic controls
11. Other conditions
Remarks and additional explanation or suggestions
Operator’s Signature _____________________________
(Demo only use form from owners manual)
120
SECTION 15
CRISIS MANAGEMENT
121
SECTION 15 CRISIS MANAGEMENT PROGRAM
I. INTRODUCTION
A Crisis is defined as "a time of danger or trouble whose outcome decides whether possible bad
consequences will follow." In crisis situations involving (The Fidlar Companies), we must be ready to
respond so that we can effectively manage any number of crises such as, but not limited to, accidents,
explosions, takeovers, natural disasters, and strikes. With this in mind, we have developed this Crisis
Management Plan to be used at each location. The purpose of this manual is to provide you, the
location Management Team, with the information and tools necessary to develop your own Crisis
Management Plan, specifically tailored to your needs and to your location. Additional information
relevant to your operations should be added to your crisis management plan, including:
lease/site plans
maps of electrical rooms/fire systems/sprinkler systems/phone lines, etc.
tenant and employee emergency contact lists
It is imperative that his manual and its guidelines be reviewed thoroughly with all of the members of
the Crisis Management Team. Everyone must have access to the completed plan and know the
procedures.
As an additional step, it is important that you prepare a condensed emergency plan for your tenants
outlining the procedures for their use.
After your plan is completed, a final step should be to meet with your city's safety and law enforcement
officials for review. The development of a strong and ongoing working relationship with these
officials will allow for the greatest amount of preparedness in the event a crisis occurs.
As an introduction to the crisis plan, it is important to first note the stages of a crisis:
Stage One begins with the initial incident, confusion, sometimes panic. The Crisis Management Team
must act quickly.
Stage Two should ideally come within the first hour of the incident, once you have researched the
situation and have information to disseminate. The lapse of time between Stage One and Stage Two
can sometimes have a more damaging effect on a company's image than the actual disaster at hand.
The longer you wait to communicate to your anxious public -- owners, customers, employees, the
media -- the greater the opportunities for speculation, accusations, and doubtfulness of the company‟s
credibility when an announcement is finally made. Stage Two can last several hours or several days,
depending on the duration of the crisis situation, and the number of update announcements necessary.
Stage Three is the aftermath. Investigations begin, insurance and legal departments become involved.
Feedback can come from your public in the form of telephone inquiries, letters, lack of sales, boycotts,
and more. You must attempt to resume business and restore a good public image and credibility.
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SECTION 15 CRISIS MANAGEMENT PROGRAM
II. PREPARATION
A. Anticipate the Crisis
The first step of preparedness is to anticipate the variety and extent of crisis situations that
your particular location could experience. This can be done in just a few moments with
your staff. Following are some potential crisis situations for you to consider:
Accident Fire
Bomb (scare or actual) Gangs
Community protest Gossip
Crime (murder, rape, shooting) Hazards (work conditions)
Criminal allegations Labor (strikes)
Disaster (weather) Lawsuits
Environnemental (pollution) Poor sales
Explosion Suicide
B. Designate A Spokesperson
It is essential that one person be selected to make statements regarding the crisis. This will
eliminate any confusion or conflicting information that may damage the credibility of the
company. The individual you select as a spokesperson should be able to reach the site of
the crisis in a reasonably short time. This spokesperson will become the “voice to the
community” during a crisis. At all locations, we suggest the Manager be designated as the
spokesperson. Though the entire staff assists with preparation of his/her statements to the
press, the Manager is the face and name that should be associated with handling the crisis.
Also, take time to select an alternative spokesperson should the Manager be out of town or
unavailable when the crisis strikes. This alternate should be as well versed and familiar
with the plan as the original spokesperson.
Let all your key employees (management, security, corporate, administrative assistant)
know in advance who these persons will be, so they can direct all inquiries in the right
direction.
C. Organize Teams
Be sure everyone knows their team and its primary responsibility. This concept of “team
work” should never be stronger than during a crisis, when everyone may be needed for a
variety of duties.
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SECTION 15 CRISIS MANAGEMENT PROGRAM
Crisis Management Team
This team is primarily responsible for assessing the situation and communicating
with the Corporate Office and local emergency officials. This is an “operational”
team, overseeing protection of people and property. This team is comprised of the
“decision makers” regarding actions to be taken in a crisis.
Key members of this team will include (specific to location):
Location Manager
Marketing Directory
Maintenance Supervisor
Manager‟s Administrative Assistant
Security Director
Possible additions (specific to location):
Remaining office staff
Corporate personnel
Crisis Communication Team
This team is primarily responsible for communicating to the various public groups
the actions to be taken. This includes preparation and distribution of media
announcements, coaching spokesperson, and maintaining the facility's credibility.
Key members of this team will include (specific to location):
Managers
Marketing Director
Director of Public Relations
Possible additions (specific to location):
Corporate Marketing Director
(NOTE: It is necessary for someone in upper management to participate in both
the Crisis Management Team and Crisis Communications Team, to assure that
communication between the two remain constant.)
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SECTION 15 CRISIS MANAGEMENT PROGRAM
Resource Team
This includes additional outside resource personnel and services that may be
called on in an emergency. It can include, but is not limited to:
Corporate representatives
Corporate legal counsel
Local legal counsel
(NOTE: Once your teams have been organized, it is wise to have a meeting to
review specific responsibilities, necessary tools, and to answer any questions).
D. Reporting Procedures
In all situations, contact:
Risk Managers:
Thilman & Filippini
1 East Wacker Drive, Suite 1800
Chicago, Illinois 60601
Attention: Risk Management Department
(312) 527-9500
E. Selecting an Alternative ―Crisis Management Office‖
This area is designated for use by the Crisis Management Team which is evaluating
the situation and assisting the emergency agencies on site.
The Management Office is the preferred location for a Crisis Management Office.
However, in the event the Management Office has been damaged or is inaccessible,
an alternative location should be predetermined.
This location should be as close as possible to the actual crisis site, keeping safety in
mind. Except for the spokesperson, most of the management and crisis
communication teams will remain in the Crisis Management Office throughout the
duration of the crisis. The area should be protected by security, have electricity and
many of the resources found in the Management Office. These resources should
include, but not be limited to the following: telephones, computers, copy machines,
fax machines, safety manuals, and most importantly, this plan.
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SECTION 15 CRISIS MANAGEMENT PROGRAM
Prepare Information Kits About The Location. These can be simple folders
containing the following:
Fact sheet on the location
An information brochure, if available
Map of the location
Background information on the location
Optional: Good quality publicity photograph of the location (black & white)
F. Designate A ―Visitors Area‖
This location is designated for standby employees, family members, and others in the
event of a crisis. This is an area where they can wait during an emergency situation.
G. Maintain Updated Contact Lists
Be sure you have “after-hours” numbers, too, since most crisis situations take place
on weekends or holidays.
Management Staff
Maintenance and Security Personnel
Corporate Personnel
Government/Emergency Services
Local Media
Tenant Lists
Miscellaneous
(Legal counsel, alarm company, messenger service, etc.)
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SECTION 15 CRISIS MANAGEMENT PROGRAM
III. CRISIS MANAGEMENT & CONTACT INFORMATION
A. Anticipated Crises
Bomb Lawsuits
Criminal Acts Medical Emergencies
Fire Severe Weather
Hazardous Chemical Spills Others
B. Designated Spokesperson: _______________
Home phone:_________________
C. Alternate Spokesperson: ________________
Home phone:__________________
D. Alternate Crisis Center
1. Crisis Management Office location, if Management Office is not available:
a. Location:_________________
b. Contact Person:_____________________
c. Any Restrictions? (Circle any of the following):
Telephones
Copy machine
Computer
Fax machine
Safety Manuals
This Plan
E. Designated Visitor Area
1. Location:____________________________
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*SAMPLE LISTS OF EMERGENCY CONTACT*
INFORMATION
CRISIS MANAGEMENT TEAM
HOME PHONE BEEPER OR
NAME NUMBER MOBILE
CRISIS COMMUNICATION TEAM
HOME PHONE
NAME NUMBER
RESOURCE TEAM
HOME PHONE
NAME NUMBER
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EMERGENCY TELEPHONE NUMBERS
Fire Department 911
Police Department 911
Paramedics 911
***Verify the correct emergency numbers for your location. You may not be in a 911 zone!!!
Nearby Hospital:__________________________
Crisis Intervention: PH:_____________
Emergency Dept: PH:_____________
Administration: PH:_____________
Red Cross Emergency Team: ______ County Red Cross
PH:__________________
Salvation Army: PH:__________________
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EMERGENCY TELEPHONE NUMBERS
REPAIR AND RECOVERY
Local Repair Firms Utility Companies
Roofer: Phone Gas Company Phone
______ Roofing
Glass Repair Electric Company
______ Glass
Plumber: Water Company
______ Plumbing
Sprinkler System: Telephone Company: Business
Repairs
Fire Alarm: Public Telephones: Business
______ Alarm Repairs
Locksmith:
______ Locksmith
Electrician: Traffic Control:
Snow Removal: Airport:
Other:
FBI OSHA
ATF Chemical/Oil Spill
Response
_____ City Post Office National Weather Svc.
_____ DOT National Weather Svc.
_____ Township
County Courthouse
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IV. WHEN A CRISIS STRIKES
A. Implementing The Crisis Plan
Using the Public Relations Society of America‟s theory of R-A-C-E, we can
implement the Crisis Management Plan using Research, Action, Communication and
Evaluation.
1. Research
Since the Crisis Management Plan for this location will be already developed, you
will be well on your way to handling the problems that arise. Research is perhaps the
most critical part of the Crisis Plan. If your subsequent actions, decisions and
communications are based on incomplete or inaccurate information, you may create a
public relations nightmare.
The Crisis Management Team must meet and review the situation. If unable to meet,
a telephone conference will be necessary to discuss the following questions.
Answering these questions will help the Crisis Management Team determine what
actions should be taken.
What is the nature of the crisis?
Where did it take place?
What areas of the location are affected?
Is the Management Office accessible?
Have there been any deaths or injuries?
How many?
Have the injured/dead been identified?
Where have they been taken?
Have authorities been notified?
Who else is involved?
(Ex. A plane crash would include airport officials, FAA, etc. in addition to
fire and police departments)
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Who is at the scene now?
Many times this meeting of the Crisis Management Team will actually take
place at the scene. If not, though, you will need constant radio communication
so your decisions and actions are based on the most current information
available, and they have the support of emergency personnel.
Have entrances to the location been sealed?
Have all security staff been asked to report to duty?
Is there a present or potential danger?
Is there the possibility of an explosion, for example, causing further damage
and injuries?
Has the Corporate Office been consulted?
Are the media on the scene? En route?
Many news rooms have a police radio and dispatch a crew as soon as an
emergency call is announced, sometimes arriving on the scene before
emergency vehicles and personnel.
2. Action
Once the Crisis Management Team has the necessary information, a number of
decisions will be made that will result in one or more of the following actions:
Do we stay open for business?
Restrict area affected by Crisis?
Limit access in and out of this location?
Do we close the location?
Does the situation require an emergency evacuation?
Do we evacuate all non-employees only?
If needed, what is the best method of evacuation?
Request assistance of police?
To which Crisis Management Office do we all report?
If the Management Office is not accessible, remember that you will need a
predetermined alternate site.
Do we need additional assistance of corporate personnel and other managers and
marketing directors?
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3. Communication
There are two primary rules to communicating during a crisis. By following these
rules, you may help to avert any bad publicity surrounding the crisis.
You must recognize that each public has a different concern and is seeking
different information.
The public will question their safety and potential dangers.
Employees will have questions: How can I get help? Will I go without pay as
a result of this crisis? Tomorrow is payday; will I get my check?
Renters will ask about the extent of damage to their apartments and
belongings. When can they gain access to their apartments? What are the
plans alternate housing? They will also have legal and insurance questions.
The public will question who was “at fault”, and more.
Lastly, and most probably the media will ask all of the above and more!
You want to provide information to all the “publics” as soon as possible.
This is necessary to remain in control of the news, maintain credibility and minimize
incoming calls and panic.
Actions taken by the Crisis Communication Team might include:
Preparation of Initial Announcement.
Coaching spokesperson before interview(s).
Continuous updates from the scene as new information becomes available for
release.
Communicating with employees, stores, customers, the Corporate Office and
the media through a variety of means.
Who is at the scene now?
(Many times this meeting of the Crisis Management Team will actually take
place at the scene. If not, though, you will need constant radio communication
so your decisions and actions are based on the most current information
available, and they have the support of emergency personnel.)
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Have entrances to this location been sealed?
Have all security staff been asked to report to duty?
Is there a present or potential danger?
(Is there a possibility of an explosion, for example, causing further damage and
injuries?)
Has the Corporate Office been consulted?
Are the media on the scene? En route?
(Many news rooms dispatch a crew as soon as an emergency call is announced,
sometimes arriving on the scene before emergency vehicles and personnel.)
4. Evaluation
The evaluation process is an ongoing one, both during the crisis and after it is over.
Evaluation during the crisis will take into consideration:
Are additional personnel needed?
Is the property secure?
Are all persons safe?
Did the media interpret the message correctly?
Do we need to employ alternate means of communication?
Are facilities and supplies adequate?
After the crisis has ended, you will want to know:
Were we prepared?
Did all teams respond and assume their responsibilities?
In what areas were we weakest?
How did we fare in the media?
Review press clippings and television new video.
Did our spokesperson appear in control?
How well did we cooperate with the emergency service agencies?
Did we take any unnecessary risks?
What has been the response from our stores, employees, customers, and the public?
What changes can we make now? What can we do differently to assure improved
handling of any future crisis?
Evaluations can be conducted in staff meetings, by anonymous comment cards, or any other
method you desire. It is not important to assess blame for mistakes made, but rather to learn
from those mistakes so that you are better prepared in the future.
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B. Notifying Next of Kin
One hopes they never have to assume this responsibility, but if such notification does
become necessary, the following procedure is suggested.
The manner in which an employee‟s family has been notified to his/her injury or death
reflects on the Company. The speed with which you let an employee‟s family know
he/she has been hurt, and the way in which you do this can help ease the pain, giving the
family strength to face the crisis and afford them comfort when they need it most. Your
treatment of the family of an employee in an emergency will become known to other
employees and their families.
Assign an executive in upper management to notify the family.
As soon as the emergency becomes known, determine as closely as possible
the extent and nature of injuries.
Find out immediately where the victim is being taken.
Dispatch the member(s) of the management staff handling notification to the
victim‟s home as soon as you know where the victim is.
In case of injury rather than death, give the staff member going to the home a
head start. Have someone else from top management call the victim‟s family
and explain that an accident has occurred and he/she has been injured. If
questioned, say you are waiting to hear from the doctor and that someone is
already on the way to their home to help in any way possible.
Keep someone at the Management Office in contact with the hospital to learn
as much as possible about the victim.
Upon reaching the home, the member of management should first call the
Management Office for any new developments. Depending on the situation,
the staff member should offer to take the spouse/family to the hospital, find
someone to watch the children, or make any calls the spouse/family wishes.
In cases of death, the staff member, after telling the family member, must offer
to assist in any possible way; making calls or handling arrangements. It is
helpful to learn the names of the family doctor and minister.
The staff member should remain at the home until other family members
arrive or as long as time allows. It is the staff member‟s duty to protect the
family from calls or visits from the press.
Take the initiative in requesting form the Company‟s payroll department any
salary, and all benefits owed the deceased as soon as possible.
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Be prepared to pull strings when necessary. Make reservations through
Company for immediate family to fly in, order food rather than make the
family cook, etc. Be ready to assist in any situation.
Learn the name of a close friend or relative of the family and stay in constant
contact with them through the time of the funeral. This will provide a good
reading on any possible needs.
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V. MEDIA RELATIONS
How we fare during a crisis may be heavily dependent upon previous media relations, policies
regarding media inquiries, and the public‟s present perception of the company.
In preparing for a crisis, it is important to meet the media in your town on a professional basis
through personal contacts. If the first time you talk to the media is during a crisis, then there is
something wrong. Reporters are not always bad people. Some 95% of the media are reputable
and can, in fact, help you get your job done. Their business is to ask questions, even those you
might not like to answer.
Most importantly, keep in mind that bad news travels fast. The worse the news, the faster it
travels, and the sooner you will hear from a reporter. However, the media can help you reduce
panic, prepare for action, and alert and warn the public, if needed.
Finally, if crisis or disaster situations are handled poorly, they create unfavorable impressions in
the public mind that can undo a positive public relations image that may have been built up
through many years of extensive community service.
In the event you are asked to make an immediate statement after a crisis, the following represents
a good emergency media response:
(Ex. Details are sketchy. We are investigating and as soon as we know the facts, we
will share them with you. We will call you as soon as there is something to report.)
A. Tips for Dealing With The News Media
DO's and DON'T's The following is are lists of DOs and DON'Ts when dealing with
the media. Refer to this list as a reminder of what should be done and what is said to
the media. The Crisis Communication team and designated spokesperson should be
very familiar with these lists.
DO:
Do designate one trained spokesperson.
Make sure everyone knows who that person is and where they can be reached at
all times, as well as the alternate spokesperson.
Do make sure the reporters know who the spokesperson is.
The corporate spokesperson is the only one authorized to make any statements or
give information to the media. However, a technical person may be used to
answer questions pertaining to detailed operations, if needed.
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Do get the news out first.
You want to gain control of the situation.(Refer to Sample Press Release)
Do express sympathy.
When the crisis has resulted in deaths or injuries, first express your sympathy and
concern for the victims and their families.
Do tell the truth.
The truth will eventually be discovered, and if you deliberately mislead the media, your
credibility will be damaged. This doesn't mean you have to give every detail, but be
truthful.
Do emphasize the good record of the Company.
If precautions were taken to avoid the crisis, point them out. Also mention the team
work by your employees, and what the company is doing to minimize the effect on the
community.
Do correct inaccuracies.
If incorrect information has appeared in the news media, be sure to follow-up and
correct the statement. Misstatements, distortions and false charges, unless corrected,
tend to become part of the story. Unless you correct it, it will be repeated again and
again.
Do keep a log of all media inquiries.
It will provide a source of media contacts to send follow-up information to after the
crisis. The follow-up contact may result in some much-needed favorable media
coverage.
Do provide adequate technical information.
You may need to provide illustrations or rely on a credible “third party” expert for such
information. Most importantly, be concise and avoid jargon.
Do provide continuous updates to the media.
A company‟s image during the crisis can be damaged if only the initial “bad news” is
released. It is important to offer frequent updates containing additional information and
positive statements about the company. Also, remember that most broadcast reporters
are trying to fill a particular time frame; usually 30 seconds or less. Practice editing the
information in your remarks to fit your needs and the reporters‟, rather than making the
reporter edit your remarks to fit the time frame.
Do be cooperative.
Always make the reporters feel that you are trying to help. The media is your outlet to
the public. Keep any hostility on your part to yourself. However, look out for the
reporter who makes you so comfortable you are soon chatting away like old friends. Do
not forget that you are being interviewed, and will be quoted.
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DON’T:
Don’t say ―No Comment.‖
Most experts agree this suggests you have something to hide. Instead, say that
you “don‟t have enough information” and that you will get back the reporter later.
Don’t speculate.
If you do not know something, admit it. Telling a reporter “I don‟t know” is not
an admission of stupidity -- but if at all possible, follow it up with “but I‟ll find
out and get back to you.” Make sure you call back. In particular, be careful not to
speculate on the cause of the crisis or extent of casualties or damages. Such
comments could be used against the Company in legal matters following the
crisis.
Don’t blame anyone for anything publicly.
Again, legal difficulties could arise.
Don’t speak "off the record."
There is no such thing! If you do not want a statement used, don't say it. Assume
everything you say will be published.
Don’t make ad-lib comments.
Try to anticipate questions and have background and standby statements written.
Ad-lib comments may not be interpreted the way you intended and they may be
reported out of context.
Don’t say too much.
When you have said enough to answer the question or to explain what needs to be
explained, SHUT UP! Don‟t fall for the reporter‟s tactic of looking at you
expectantly with the microphone in your face. Look expectantly back at the
reporter with your lips firmly closed, and await another question.
Don’t repeat a reporter’s negative questions or misleading words.
If you repeat them in your response, they, too, could be used out of context and
attributed to you.
Don’t release information on personnel casualties until families have been
notified.
Unverified names may end up in print and cause unnecessary grief.
Don’t use comparisons.
Your problem may then be linked with worse disasters.
Don’t show favoritism.
Information given to one media representative should be given to all.
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Don't wear sunglasses when being interviewed.
You will be perceived as being "shifty" and hiding something.
Handling Questions Under Fire While most reporters behave professionally, some may
bring to the interview an intent to have the story come out a certain way. Be aware of the
following common tactics and make sure you are able to make your points understood:
The Loaded Questions. A questions that begins with a series of false or misleading
statements and then asks for your response. Restate the question, correcting the
misinformation, then answer it. Consider how you might answer the following:
“Considering the rise in violent crimes at your location, have you stepped up
security?”
Unacceptable Alternatives. The question gives a choice between two extreme or
false situations. Again, restate the questions, explaining the real situation.
Hypothetical Questions. You are asked to comment on a “what if” situation, one
that is usually a guess on the part of the reporter. Respond only to real situations;
don‟t make guesses, and don‟t answer questions that are beyond your realm of
expertise.
Commentary. You are asked to comment on a statement made by another source.
Unless you have heard the statement firsthand and are qualified to comment, don‟t.
Suggest that the reporter contact the source.
Rapid-fire questions. Also called the “machine gun” technique of firing one
question after another, without waiting for a response. Answer only those questions
you want to answer. If you are repeatedly interrupted by a reporter, simply be silent
until he or she stops, then continue by responding to the questions one at a time.
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B. Preparing The Emergency News Release
1. The contact person should be noted, listing the telephone number of both the
Management Office and Crisis Management Office, if applicable.
2. Be sure to note date and time of initial release and each subsequent update to
maintain accurate chronology of the facts as they become known.
3. Initial release should be a brief statement and should be limited to the following:
What happened?
Where did it happen?
When did it happen?
Extent of personal injuries - do not name any victims until next of kin
have been notified.
How many stores were affected? (No need to name them at this point.)
Facts regarding your actions. (Evacuation, closing, apprehension of
suspects)
Reassurance regarding responsible actions taken. (We wanted to assure
safety. Outside help has been sought and received.)
Status of investigation.
Business resumption.
4. Prior to distribution of news release, have designated person(s) approve release.
Should probably be reviewed by Crisis Management Team, and at least
one person from Corporate Office.
In the event no Corporate employees are available to review news release,
attempt to reach local legal counsel for review of content.
Remember, you want to release only verifiable facts, and do not want to
speculate as to causes, liabilities, cost of damages, or other legal matters.
5. Depending on the circumstances, the initial release may be read aloud and
distributed to all media in the Press Room, if designated, at the site within the first
hour after the incident occurs.
Arrange for a messenger delivery or phone communication to any other
major local media requiring the release.
6. Continue the news preparation and distribution process throughout the duration of
the crisis.
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Update the media with new information such as names of victims, names
of affected stores, any actions taken by police or other emergency
agencies.
7. Send copy of each release and any news clippings or publicity received to the
following by facsimile machine or overnight mail:
Senior Vice President, Operations
Director of Operations
Vice President, Director of Corporate Communications
Corporate Marketing Director
Corporate Legal Counsel
Leasing Manager
Vice President, Leasing
Sample Press Release To eliminate any speculation about the crisis and prevent any
rumors or misinformation that may be damaging to the company, a press release about the
crisis should be formulated and sent to the media. The following page is a sample press
release that gives the basic information about the crisis situation.
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FOR IMMEDIATE RELEASE:_______________________ (Date)
FOR MORE INFORMATION:_______________________ (Contact)
STATEMENT FROM __________________________ (Company Name)
_______________ -- An armed robbery occurred at _______ (Time) on
__________________ (Day), __________________ (Date), 199__ (Year).
No individuals were harmed and the suspects have been apprehended by the
state police. The matter is now being handled by the state police.
All other inquiries should be directed to the state police.
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C. Communication Checklist
When faced with a crisis at your location, one of the first decisions to be made will be:
what actions to be taken, and
how will we communicate to our customers, employees, the public, etc.
Some recommended methods are as follows:
1. News Releases
2. Telephone Calls
3. Press Conferences
4. Radio/TV Public Service Announcements
5. Mailgrams
6. Paid Advertising
Newspaper
Radio
Television
7. Tape Recorded Phone Messages
8. Exterior Property Signage
9. Interior Center Signage
10. Printed Bulletins for Customers
11. Video Tape
12. Tenant Memos
13. Intercom Announcements
14. Tenant Meeting
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*Sample Media Contact List*
And Phone Log
TELEVISION ADDRESS PHONE
RADIO
NEWSPAPER
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CRISIS COMMUNICATION PHONE LOG
DATE TIME COMPANY NAME/PHONE SPECIFIC QUESTIONS CALL HANDLED BY
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VI. SPECIFIC EMERGENCY PROCEDURES
A. BOMB THREAT
Bomb threats are normally transmitted by telephone; the person receiving the call should
obtain precise information. A Bomb Threat Report Form is included in this manual for
recording this information.
It would be advisable to consider each threat seriously. However, it is questionable whether
an evacuation should be taken on the strength of a single call, or only after an object has
been found. The decision to evacuate should be made after consultation with the local
Police Department.
If a threat is received and a search takes place, a senior member from each store will be
needed to allow law enforcement and building management into each store to search the
area. This person will need to familiarize everyone with the layout of the premises.
If a suspicious package is found and an evacuation has not already been issued, it will be
issued. The person who finds the package will immediately notify a supervisor, the policy
or a member of mall management and relay the following information:
1. Where the object is;
2. Why it is suspicious;
3. A description of the object; and
4. Any details of who placed it there, if possible.
While awaiting the arrival of law enforcement authorities, if not already on-site, Security or
Management should:
Make sure no person goes near or attempts to move the object.
Try to establish ownership of the suspicious object. There have been instances
where legitimate property has been left behind in error by innocent people prior
the bomb threat.
Establish the most direct route to the object.
Continue to search, as there may be more than one device. Once law
enforcement arrives at the site, take further orders from them.
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B. FIRE
Prompt and well directed action can be the deciding factor in escaping a major fire loss.
It is important to have an organized plan in place which will help to give direction to personnel,
establish emergency exits, notify fire and police departments, and be very efficient.
The size, style, and makeup of your location's fire plan will depend on many factors such as
location size, the hazards present (stored gas, chemicals, etc.), the type and condition of available
fire equipment, and the nearness and reliability of the local fire department. Local ordinances or
State or Federal regulations may require your location to establish an emergency evacuation plan.
The emergency evacuation plan should give specific instruction information on "what everyone
should do in the event of a fire." The plan should include routes of egress, designated assembly
areas, and a plan to identify all employees and their whereabouts. In addition to establishing this
plan, employees should also be trained on how to use fire extinguishers.
If it is possible, annual fire drills should be performed to test the efficiency of the plan. This will
help to identify weaknesses in the plan. After the weaknesses are identified, then the plan can be
re-written to strengthen them.
The fire plan should include emergency contact information. Phone numbers for the fire
department, police department, and management should be clearly posted on all phones. If your
location has automatic alarms to notify the authorities of a fire, a phone to the fire department
should also be made additionally to give specific information and to verify alarm notification.
If the fire is minor, grab a fire extinguisher and attempt to put it out. Minor occurrences may be
trash cans or trees and shrubs on fire. Fire extinguishers should be clearly identified with
overhead signs and on location maps posted throughout the location.
False Alarms
If the alarm is a “false alarm," you must inform any emergency personnel who arrive on site that
it was a false alarm. A reason must be given as to why the alarm was activated.
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C. HOSTAGE SITUATION
A hostage situation is defined as the holding of another person against their will. The situation
may be an unsuccessful robbery, or may involve a domestic dispute. This crisis situation
involves risk of personal injury. The atmosphere which is most conducive to resolution of the
problem without injury is one of calm emotions and authoritative control over the physical
surroundings and persons involved.
Procedure
1. Once a hostage situation has been identified, the most senior person present at the location
should be notified.
2. The most senior person present will notify the local Police Department with details:
a. What is the situation - how did it occur?
b. How many people are involved?
c. What type of weapon is being used?
d. Where is the situation occurring?
3. All pedestrian traffic is to be blocked on both sides and across from the scene. Adjacent
location managers are to report to the Management Office in case the Police require the use
of their facilities. These stores are to be cleared and locked.
4. NO ACTION is to be taken by company personnel, unless physically threatened. This is
the responsibility of the Police Department.
5. All questions and news media are directed to the location Manager.
6. Once the Police have been notified:
a. Stand by until arrival of an officer.
b. Keep people out of the area.
c. Do not disturb or touch any doors or other articles.
d. Assist the Police if they request any assistance.
e. Notify all management staff not present.
f. Keep a log for future reference.
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NOTE:
The personal safety of the public and all employees must be considered prior to the Police
making an attempt to apprehend the individual. Good communications, complete descriptions
and professional conduct can help the Police, even if the suspect leaves the scene.
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D. MEDICAL EMERGENCIES
When a medical emergency occurs, the prime responsibility of the location supervisor is to make
the individual as comfortable as possible until the arrival of professional help. Only the most
basic first aid should be administered, and then only in extreme emergencies by someone
certified in first aid.
Special precautions should be taken in the event that blood is present. First aid kits should
include plastic gloves, mouth-to-mouth breather inserts, and hazardous waste bags to dispose of
blood soaked materials. This equipment should be used by trained personnel to prevent the
transmission of blood borne pathogens such as AIDS or Hepatitis.
In the event that an ambulance or immediate medical assistance is required, call Paramedics at
the number shown on the Emergency Contact List in this manual. Tell the dispatcher the nature
and the exact location of the Medical Emergency, and remain on the phone until the dispatcher
terminates the call.
The basic first aid procedures listed on the next page are included strictly to enhance your
personal knowledge. These procedures should not be interpreted as instructions to act in a
specific way. Remember your limitations, keep the injured comfortable, and wait for the arrival
of the trained and licensed professionals.
The “Good Samaritan Act” states, in effect, that any person acting in good faith who render
emergency care or treatment at the scene of an emergency, without objection of the injured
person or legal guardian, should not be held liable for any civil damages as the result of such
care, if the person acts as an ordinary, reasonably prudent person would have acted under the
same circumstances.
NOTE:
An unconscious person is assumed to have given no objections to any emergency care or
treatment given.
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E. POWER FAILURES
If the location loses electrical power, the following steps should be completed by management
staff or location supervisors.
. Contact your local power company to advise them of the outage. Their phone number is
located on the Emergency Contact List in this manual.
. If the telephones do not work, attempt to make telephone calls on public telephones.
. Advise the appropriate personnel of the outage.
. Emergency lighting should provide adequate lighting, which should reduce panic.
However, flashlights should be made handy.
. When power is restored, notify the local power company.
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EMPLOYEE DIRECTORY
NAME HOME ADDRESS PHONE
Office Staff
Customer Service:
Maintenance Dept.:
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VII. CONCLUSION
The very nature of our industry forces us to take responsibility for the safety of thousands of
people and millions of dollars of real estate each year.
In the unlikely event of a crisis situation, this plan can help preparedness and organization.
It is important to recognize that Crisis Management efforts do not stop once the immediate
situation is brought under control. Follow-up communications are also an integral part of the
plan, and can include some of the following:
News stories developed and distributed regarding Company efforts, and positive actions taken.
Letters sent to tenants advising them that all is well, providing details regarding resumption of
business, offer of additional assistance, and a thank you for their cooperation.
Personal letters sent to any individual customer affected.
Specially-prepared direct mail pieces sent to community leaders, organizations, suppliers, etc.,
advertising them of recent and future positive aspects and activities of the location.
Also as important is maintaining accurate and detailed records of all incidents for both liability
and law enforcement purposes. Be sure to follow all procedures outlined by our insurance
carrier.
The closing of a major tenant could be perceived as a crisis in one community, while another
location may be faced with the annual threat of natural disasters. The objectives, however,
remain the same:
1. We want to put the situation into perspective and gain control;
2. We want the crisis resolved quickly and fully;
3. We want to maintain our credibility with the media, customers and merchants; and
4. We want to resume business as quickly as possible with minimal personal injuries and
property damage, and a limited effect on sales of the location.
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Written Personal Protective Equipment Program
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SECTION 16 WRITTEN PERSONAL PROTECTIVE EQUIPMENT PROGRAM
The purpose of this program is to protect all employees from the perils associated
with hazardous working conditions after it has been determined that all possible
engineering controls can not be implemented or are not feasible.
ADMINISTRATION OF
RESPONSIBLITIES
Supervisors have the responsibility for the administration of this program.
Effective administration includes the following:
1. A complete hazard assessment for every operation to determine the type of
PPE that is needed.
2. Employee training in the proper use of PPE
3. PPE maintenance and cleaning procedures
4. Enforcement of The Fidlar Companies policy regarding the use of PPE.
HAZARD ASSESSMENT AND
EQUIPMENT SELECTION
All contractors shall assess their workplace to determine if hazards are, or are
likely to be, present which necessitate personal protective equipment.
If a hazard exists, the contractor shall:
Select and require use of appropriate PPE
Communicate selection decisions to employees
Select PPE that fits and does not create a greater hazard to employees
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SECTION 16 WRITTEN PERSONAL PROTECTIVE EQUIPMENT PROGRAM
EYE AND FACE PROTECTION
Affected employees shall use appropriate eye and face protection when exposed to:
Flying particles
Molten metal
Liquid chemicals
Acids or caustics
Chemical gases or vapors
Potentially inurious light radiation
Eye protections with side shields are required where the employee is exposed to
flying objects.
Employees wearing prescription lenses shall wear eye protection that incorporates
the prescription in its design, or can be worn properly over lenses.
All eye and face protection shall be distinctly marked to facilitate identification of
the manufacturer and be approved by ANSI with the marking Z87.
Each employee that is exposed to light radiation during the course of his/her
workday shall use eye protection with filter lenses having a shade number
appropriate for the work being performed. This shade level can be found in the
chart for eye protection on the first page of the hazard assessment sheets.
Employees wearing face protection must also wear eye protection underneath.
Splash goggles are required where the employee is exposed to any liquid chemicals,
acids, or caustics.
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SECTION 16 WRITTEN PERSONAL PROTECTIVE EQUIPMENT PROGRAM
HEAD PROTECTION
All employees shall wear protective helmets where there is a potential for injury to
the head from falling objects.
Protective helmets designed to reduce electric shock shall be worn near exposed
electrical conductors which could contact the head.
If it is determined that head protection is needed for a particular work process or
area, the class of head protection must then be chosen, which would protect against
the particular hazard (Class A, B, or C).
FOOT PROTECTION
Each affected employee shall wear protective footwear where there is a danger of
foot injury due to falling or rolling objects, objects piercing the sole, and where feet
are exposed to electrical hazards.
The different types of foot protection available are:
Impact protection
Penetration protection
Metatarsal protection
Puncture protection
Electrical protection
The type of foot protection chosen shall protect the foot form the type of hazard that
exists at this particular work process.
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SECTION 16 WRITTEN PERSONAL PROTECTIVE EQUIPMENT PROGRAM
HAND PROTECTION
All contractors working on The Fidlar Companies premises shall select and require
employees to use appropriate hand protection when employees‘ hands are exposed
to hazards such as those from:
Skin absorption of harmful substances
Severe cuts or lacerations
Severe abrasions
Punctures
Chemical or thermal burns
Harmful temperature extremes
Selection of PPE should be based on an evaluation of performance characteristics of
the hand protection relative to:
Tasks to be performed
Conditions present
Duration of use
Hazard and potential hazards identified
TRAINING
All contractors shall provide training to employees who are required to use PPE.
The personal protective equipment training must cover the following.
When PPE is necessary
What PPE is necessary
How to correctly wear PPE
Limitations of the PPE
Proper care, maintenance, useful like and disposal
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SECTION 16 WRITTEN PERSONAL PROTECTIVE EQUIPMENT PROGRAM
160
SECTION 17
VEHICLE FLEET SAFETY POLICY
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SECTION 17 VEHICLE FLEET SAFETY POLICY
VEHICLE FLEET SAFETY POLICY
OBJECTIVE
The purpose of this policy is to ensure the safety of those individuals who drive company vehicles.
Vehicle accidents are costly to our company, but more importantly, they may result in injury to you
or others. It is the driver‘s responsibility to operate the vehicle in a safe manner and to drive
defensively to prevent injuries and property damage. As such, the Company endorses all applicable
state motor vehicle regulations relating to driver responsibility. The Company expects each driver to
drive in a safe and courteous manner pursuant to the following safety rules. The attitude you take
when behind the wheel is the single more important factor in driving safely.
______________________________
President
APPLICABILITY/SCOPE
This policy applies to all The Fidlar Companies employees who drive The Fidlar Companies vehicles.
ACCOUNTABILITY
1. _________________ is responsible to ensure that the guidelines set forth in this policy are
followed.
Driver Eligibility
1. Company vehicles are to be driven by authorized employees only, except in emergencies, or in
case of repair testing by a mechanic. Spouses and other family members are not authorized to
drive the Company vehicle.
2. Any employee who has a driver‘s license revoked or suspended shall immediately notify
_______________, and discontinue operation of the company vehicle. Failure to do so may result
in disciplinary action, including dismissal.
3. All accidents, regardless of severity, must be reported to the police and to ________________.
Failing to stop after an accident and/or failure to report an accident may result in disciplinary
action, including dismissal.
4. Drivers must immediately report all summonses received for moving violations during the
operation of a company vehicle to ________________.
5. All CDL drivers must comply with all applicable D.O.T. regulations, including successful
completion on medical, drug, and alcohol evaluations.
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SECTION 17 VEHICLE FLEET SAFETY POLICY
6. Motor Vehicle Reports will be ordered periodically to assess employees‘ driving records. An
unfavorable record will result in a loss of the privilege of driving a Company vehicle. The
following system will be used to determine eligibility to operate a Company vehicle:
ALL TYPE ‘A’ VIOLATIONS (as defined below) WILL RESULT IN TERMINATION OF
DRIVING PRIVILEGES FOR EMPLOYEES AND WILL DISQUALIFY ANY POTENTIAL
DRIVER EMPLOYEES.
ANY DRIVERS (EMPLOYEES OR APPLICANTS) SHOWING ONE OF THE FOLLOWING
WILL BE RESTRICTED FROM DRIVING COMPANY VEHICLES.
1. One (1) or more type ‗A‘ violations in the last three years.
2. Three (3) or more accidents (regardless of fault) in the last three years
3. Four (4) or more type ‗B‘ violations in the last three years.
4. Any combination of accidents and type ‗B‘ violations, which equal four (4) or more in the last
three years.
Type ‘A’ Violations
1. Driving while intoxicated
2. Driving while under the influence of drugs
3. Negligent homicide arising out of the use of a motor vehicle (gross negligence)
4. Operating during a period of suspension or revocation
5. Using a motor vehicle for the commission of a felony
6. Aggravated assault with a motor vehicle
7. Operating a motor vehicle without the owners authority (grand theft)
8. Permitting an unlicensed person to drive
9. Reckless driving
10. Speed contest (racing)
11. Hit and run (bodily injury or property damage)
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SECTION 17 VEHICLE FLEET SAFETY POLICY
Type ‘B’ Violations
1. All moving violations not listed as type ‗A‘ violations
Driver Safety Rules
1. The use of a company vehicle while under the influence of intoxicants and other drugs is
forbidden and is sufficient cause for discipline, including dismissal.
2. No driver shall operate a company vehicle when his/her ability to do so safely has been impaired
by illness, fatigue, injury, or prescription medication.
3. All drivers and passengers operating or riding in company vehicles must wear seat belts, even if
air bags are available.
4. No unauthorized personnel (e.g., hitch-hikers) are allowed to ride in company vehicles.
5. Drives are responsible for the security of Company vehicles assigned to them. The vehicle engine
must be shut off, ignition keys removed, and vehicle doors locked whenever the vehicle is left
unattended. If the vehicle is left with a parking attendant, only the ignition key is to be left.
6. Headlights shall be used 1/2-hour after sunset and 1/2-hour before sunrise, or during inclement
weather or at any time when a distance of 500 feet ahead of the vehicle cannot be seen clearly.
7. All other state laws, local laws, or D.O.T. Motor Carrier Safety Regulations must be obeyed.
Defensive Driving Rules
1. Drivers are required to maintain a safe following distance at all times. To estimate your
following distance, pick a stationary object ahead of you. As the vehicle in front of you passes the
object, begin counting 1001, 1002, 1003, etc. until you reach the same object. This counts the
number of second between you and vehicle ahead of you.
2. Drivers of passenger vehicles should keep a two-second interval between their vehicle and the
vehicle immediately ahead. During slippery road conditions, the following distance should be
increased to at least four seconds.
3. Drivers of heavy trucks should keep a minimum of a three-second interval when not carrying
cargo; and at least four seconds when fully loaded. Following distance should also be increased
when adverse conditions exist.
4. Drivers must yield the right of way at all traffic control signals and signs requiring them to do so.
Drivers should also be prepared to yield for safety‘s sake at any time. Pedestrians and bicycles in
the roadway always have the right of way.
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SECTION 17 VEHICLE FLEET SAFETY POLICY
5. Avoid driving in other driver‘s blind spots; attempt to maintain eye contact with the other driver,
either directly or through mirrors.
6. Drivers must honor posted speed limits. In adverse driving conditions, reduce speed to a safe
operating speed that is consistent with the conditions of the road, weather, lighting, and volume
of traffic. Tires can hydroplane on wet pavement at speeds as low at 40 MPH.
7. Turn signals must be used to show where you are heading; while going into traffic and before
every turn or lane change.
8. When passing or changing lanes, view the entire vehicle in your rear view mirror before pulling
back into that lane.
9. Be alert of other vehicles, pedestrians, and bicyclists when approaching intersections. Never
speed through an intersection on a caution light. Approach a stale green light with your foot
poised over the brake to reduce your reaction time should it be necessary to stop. When the
traffic light turns green, look both ways for oncoming traffic before proceeding.
10. When waiting to make left turns, keep your wheels facing straight ahead. If rear-ended, you will
not be pushed into the lane of oncoming traffic.
11. When stopping behind another vehicle, leave enough space so you can see the rear wheels of the
car in front. This allows room to go around the vehicle if necessary, and may prevent you from
being pushed into the car in front of you if you are rear-ended.
12. Avoiding backing where possible, but when necessary, keep the distance traveled to a minimum
and be particularly careful.
13. Check behind your vehicle. Operators of heavy trucks should walk around their vehicle before
baking and/or have someone guide you.
14. Back to the driver‘s side. Do not back around a corner or into an area of no visibility.
What To Do In Case of An Accident
1. In an attempt to minimize the results of an accident, the driver must prevent further damages or
injuries and obtain all pertinent information and report it accurately.
2. Call for medical aid if necessary.
3. Secure accident scenepull onto shoulder or side of road, redirect traffic, set up road flares/reflectors, etc.
4. Call the police. All accidents, regardless of severity, must be reported to the police. If the driver cannot get to
phone, he should write a note giving location to a reliable appearing motorist and ask him to notify the police.
5. Record names and addresses of driver, witnesses, and occupants of the other vehicles and any medical personnel
who may arrive at the scene.
6. Complete the form locating in the insurance carrier Vehicle Accident Packet. Pertinent information to obtain
includes:
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SECTION 17 VEHICLE FLEET SAFETY POLICY
a) License number of other drivers
b) Insurance company names and policy numbers of other vehicles
c) Make, year, model of other vehicles
d) Date and time of accident
e) Overall road and weather conditions
7. Draw a diagram of the accident scene and note the street names and locations of traffic signs, signals, etc.
8. Do not discuss the accident with anyone at the scene except the police. Do NOT accept any responsibility for the
accident. DON‟T argue with anyone
9. Provide the other party with your name, address, and phone number, drivers license number, and insurance
information.
10. Immediately report the accident to _____________. Provide a copy of the accident record and/or your written
description of the accident to ______________ ASAP.
11. Cooperate fully with any follow-up from insurance carrier claims personnel.
Vehicle Maintenance
1. Proper vehicle maintenance is a basic element of any fleet safety program, not only to ensure a safe, road worthy
vehicle, but also to avoid costly repair expenses and unexpected breakdowns.
2. Registration and inspection is the responsibility of the assigned driver.
3. Drivers of D.O.T. regulated vehicles are required to inspect their vehicle prior to usage, documenting and
notifying the company mechanic of deficiencies found.
4. In addition to inspections required by law for passenger vehicles, routine inspections of critical items, such as
brakes, lights, tires, wipers, etc., must also be completed by drivers of passenger vehicles.
5. The vehicle should be cleaned (interior and exterior) regularly to help maintain its good appears for you and the
Company. A clean vehicle makes a good impression on customers.
6. The vehicle manufacturer‟s maintenance schedule should be referenced and closely following regarding
recommended maintenance intervals.
Discuss responsibilities for maintenance:
Who is responsible for scheduling repairs?
Is prior approval required; if so, from who?
Who is responsible for authorizing repairs and
expenses quoted by repair facility?
Discuss where to obtain serviceboth preventative maintenance and emergency
repairs
Discuss any specific maintenance requirements (i.e., oil changes every 3,000 miles,
engine tune-up every 20,000 miles, winterizing requirements, windshield wipers
replaced at least annually, etc.)
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SECTION 17 VEHICLE FLEET SAFETY POLICY
Discuss type, care, and replacement of tires: specify type required, including snow
tires, rotation and replacement schedule; and where to obtain new tires.
Note any specific type/grade of gasoline required.
Vehicle Expenses & Record
Keeping
1. Discuss any reporting or tracking of mileage required.
2. Discuss reporting requirements and/or records the driver must maintain for maintenance and
repairs performed on the vehicle assigned to them.
3. Discuss expense reporting and reimbursement for gasoline and maintenance.
4. Discuss any personal use charges that may apply.
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SECTION 17 VEHICLE FLEET SAFETY POLICY
Vehicle Fleet Safety Policy Rules
I acknowledge that the information contained in the Company‘s Vehicle Fleet Safety Policy
has been reviewed with me and a copy of the policy and driver rules have been furnished to
me. As a driver of a company vehicle, I understand that it is my responsibility to operate
the vehicle in a safe manner and to drive defensively to prevent injuries and property
damage.
PrintEmployee’s Name
Employee’s Signature Date
Reviewer’s Signature Date
(Sign and retain the original copy in the employee’s file)
168
APPENDIX
PPE HAZARD ASSESSMENT
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APPENDIX PPE HAZARD ASSESSMENT
Hazard Assessment Guide
Location:__________________________ Date:_____________________________
Supervisor:_________________________ Work Process:_____________________
Hazard Assessment
Source of Hazards to Workers:
Impact ___ Heat ___ Compression ___
Penetration ___ Harmful Dust ___ Chemical ___
Light (optical) radiation ___ Other ___
Eye and Face Protection Selection Chart
Source Assessment of Hazard Protection
IMPACT - Chipping, grinding, masonry Flying fragments, objects, large chips, Spectacles with side protection, goggles, face
work, woodworking, sawing, drilling, particles sand dirt etc. shields. See notes (1), (3), (5), (6), (10). For
chiseling, powered fastening, riveting, and severe exposure, use faceshield.
sanding.
HEAT - Furnace operations, pouring, Hot sparks Faceshields, goggles, spectacles with side
casting, hot dipping, and welding. protection. For severe exposure use faceshield.
See notes (1), (2), (3).
Splash from molten metals Faceshields worn over goggles. See notes (1), (2),
(3).
High temperature exposure Screen faceshields, reflective faceshields. See
notes (1), (2), (3).
CHEMICALS - Acid and chemicals Splash Goggles, eyecup and cover types. For severe
handling, degreasing plating. exposure, use faceshield. See notes (3), (11).
Irritating mist Special-purpose goggles.
DUST - Woodworking, buffing, general Nuisance dust Goggles, eyecup and cover types. See notes (8).
dusty conditions.
LIGHT and/or RADIATION - Optical radiation Welding helmets or welding shields. Typical
Welding: Electric Arc shades: 10-14. See notes (9), (12).
Welding: Gas Optical radiation Welding goggles or welding faceshield. Typical
shades: gas welding 4-8, cutting 3-6, brazing 3-4.
See note (9).
Cutting, Torch brazing, Optical radiation Spectacles or welding faceshield. Typical shades,
Torch soldering 1.5-3. See notes (3), (9).
Glare Poor vision Spectacles with shaded or special purpose lenses,
as suitable. See notes (9), (10).
Notes to Eye and Face Protection Selection Chart:
(1) Care should be taken to recognize the possibility of multiple and simultaneous exposure to a variety of hazards. Adequate protection
against the highest level of each of the hazards should be provided. Protective devices do not provide unlimited protection.
(2) Operations involving heat may also involve light radiation. As required by the standard, protection from both hazards must be provided.
(3) Faceshields should only be worn over primary eye protection (spectacles or goggles).
(4) As required by the standard, filter lenses must meet the requirements for shade designations in 1910.133 (a)(5). Tinted and shaded lenses
are not filter lenses unless they are marked or identified as such.
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APPENDIX PPE HAZARD ASSESSMENT
Notes to Eye and Face Protection Selection Chart (continued):
(5) As required by the standard, persons who vision requires the use of prescription (Rx) lenses must wear either protective devices fitted with
prescription (Rx) lenses or protective devices designed to be worn over regular prescription (Rx) eyewear.
(6) Wearers of contact lenses must also wear appropriate eye and face protection devices in a hazardous environment. It should be recognized
that dusty and/or chemical environments may represent an additional hazard to contact lens wearers.
(7) Caution should be exercised in the use of metal frame protective devices in electrical hazard areas.
(8) Atmospheric conditions and the restricted ventilation of the protector can cause lenses to fog. Frequent clean sign may be necessary.
(9) Welding helmets or faceshields should be used only over primary eye protection (spectacles or goggles).
Type of eye/face protection needed for this job:______________________________________________
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APPENDIX PPE HAZARD ASSESSMENT
Hazard Assessment Guide
Selection Guidelines for Head Protection
If any of the following scenarios exist, than some form of head protection is needed.
(mark with an "X" if conditions exist)
Falling object hazards are present.
Working operations are below others who are using tools and materials which could fall.
Working operations are around or under conveyor belts which are carrying parts or materials.
Working operations are below machinery or processes which might cause material or objects to fall.
Are employees working on exposed energized conductors.
If any of the following work is being performed, some form of head protection may be needed.
(mark with an "X" if conditions exist)
Carpentry Sawyer work
Electrician work Welding
Line work Laborer work
Mechanic and Repair work Freight Handling
Plumbing and Pipe Fitting Timber Cutting and Logging
Assembling Stock Handling
Packing Warehouse Laborer work
Wrapping
After determining if head protection is needed, the class of head protection must be selected. The following shows
the three classes of head protection and their ratings. This breakdown of classifications should help determine which
type of head protection is needed.
Classes of Head Protection are A, B, and C
Class A head protection provides protection from impact, penetration, and electrical low voltage conductors rated at
2,200 volts.
Class B head protection provides protection from impact, penetration, and electrical high voltage conductors rated at
20,000 volts.
Class C head protection provides protection from impact and penetration only. These helmets are usually made of
aluminum and should not be used around electrical hazards.
Type of Head protection needed for this job is: A B C None (circle one)
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APPENDIX PPE HAZARD ASSESSMENT
Hazard Assessment Guide
Selection Guidelines for Foot Protection
Safety shoes can provide impact, penetration, puncture, metatarsal, and electrical protection. Make sure that the
shoes chosen will protect against the hazards which are present for each particular job.
If any of the following conditions exist in a particular situation, shoes or boots with impact protection are needed.
(mark with an "X" if conditions exist)
Carrying or handling materials such as packages, objects, parts, or heavy tools, that may be dropped.
Other activities where objects might fall onto the feet.
If any of the following conditions exist in a particular situation, shoes or boots with compression protection are
needed.
(mark with an "X" if conditions exist)
Activities involving skid trucks (manual material handling carts)
Activities around bulk rolls (such as paper rolls)
Activities around heavy pipes.
If any of the following conditions exist, safety shoes or boots with puncture protection would be required.
(mark with an "X")
Employees are exposed to objects such as nails, screws or tacks.
Employees are exposed to objects such as wire, large staples, scrap metal etc.
If any of the following work is being performed, some form of foot protection may be needed.
(mark with an "X")
Shipping and Receiving Clerk duties Wrapping
Stock Clerk duties Crater work
Carpentry Punch and Stamping Press operations
Electrician's work Sawyer work
Machinist's work Welding
Mechanic and Repairer's work Laborer's work
Plumbing and Pipe Fitting Freight Handling
Structural Metal work Gardening and Ground-Keeping
Assembly work Timber Cutting and Logging
Drywall Installation and Lather's work Stock Handling
Packing Warehouse Laborer's work
Type of foot protection needed for this job: Impact Compression Puncture None [circle choice(s)]
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APPENDIX PPE HAZARD ASSESSMENT
Hazard Assessment Guide
Selection Guidelines for Hand Protection
Gloves are often relied upon to prevent cuts, abrasion, burns, and skin contact with chemicals that are capable of
causing local or systematic effects following dermal exposure. Therefore, it is important to select the most
appropriate glove for a particular application and to determine how long it can be worn, and whether it can be
reused.
It is also important to know the performance characteristics of gloves relative to the specific hazard anticipated; e.g.,
chemical hazards, cut hazards, flame hazards, etc.
Other factors to be considered for glove selection in general include:
A) As long as the performance characteristics are acceptable, in certain circumstances, it may be more
cost effective to regularly change cheaper gloves than to reuse more expensive gloves.
B) The work activities of the employee should be studied to determine the degree of dexterity required,
the duration, frequency, and degree of exposure of the hazard, and the physical stresses that will be
applied.
With respect to selection of gloves for protection against chemical hazards:
A) The toxic properties of the chemical(s) must be determined; in particular, the ability of the chemical
to cause local effects on the skin and/or to pass through the skin and cause systemic effects.
B) Generally, any "chemical resistant" glove can be used for dry powders.
C) For mixtures and formulated products (unless specific test data are available), a glove should be
selected on the basis of the chemical component with the shortest breakthrough time, since it is
possible for solvents to carry active ingredients through polymeric materials.
D) Employees must be able to remove the gloves in such a manner as to prevent skin contamination.
Type of hand protection needed for this job:_______________________________________________
Guidelines for Cleaning and Maintenance
It is important that all PPE be kept clean and properly maintained. Cleaning is particularly important for eye and
face protection where dirty or fogged lenses could impair vision. The PPE should be inspected, cleaned and
properly maintained at regular intervals so that the PPE provides the requisite protection.
It is also important to ensure that contaminated PPE which cannot be decontaminated is disposed of in a manner that
protects employees from employees from exposure to hazards.
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