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									                          UNIVERSITY OF WISCONSIN-STEVENS POINT
                            HAZARD COMMUNICATION STANDARD’S
                             EMPLOYEE RIGHT-TO- KNOW POLICY




                                                 Revised by:
                                  Environmental Health and Safety Office
                                   University of Wisconsin-Stevens Point
                                        101 George Stien Building
                                         Stevens point, WI 54481
                                               (715) 346-2320




University of Wisconsin-Stevens Point                                       Effective 12/1999
EHS Manual                                                        Revised by EHS Officer 5/06
Hazard Communication Std – Written Plan                                                 1of24
         CONTENTS                                                           PAGE


Hazard Communication Program..............................................4
    Purpose
    Background

General University Policy and Administrative Structure.............5
   University Policy
   Applicability
   Employer Responsibilities
   Administrative Structure
   Organization Chart

Administrative Responsibilities....................................................7
   EHS Officer
   Manager/Supervisor

Employee Rights and Responsibilities..........................................8
   Employee Rights
   Employee Responsibilities

Procedures for Program Implementation and Maintenance……..10
    Chemical Inventory
    Manager/Supervisor Training
    Job Specific Training and Education
    Training Documentation

Material Safety Data Sheets.........................................................12

Labels and Other Forms of Warning.............................................13
    Labels
    Acceptable Alternate Warnings

Community Right to Know Emergency Plans.................................14

Contract Employee Notification......................................................14

Appendix A
   Form HCP-1 Management Training Certification
   Form HCP-2 Employee Training Attendance Record
   Form HCP-4 Chemical Exposure Accident Report
   Form HCP-6 Employee Request for MSDS

Appendix B
   Form HCP-3 Work Area Chemical Inventory List

Appendix C
    Form HCP-5 HCP Validation Checklist


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Appendix D
   OSHA 29 CFR 1910.1200 Hazard Communication Standard
   OSHA Health Hazard Definitions
   OSHA Hazard Determination

Appendix E
   Wis. Stat. 101.11 Employer’s Duty to Furnish Safe Employment and Place
   Wis. Stat. 101.58 Employees’ Right to Know

Appendix F
   Expanded List of Definitions

Appendix G
   EPA 40 CFR Part 370 Community Right to Know Standard (SARA)

Appendix H
   Health Hazard Warning Information

Work Location Material Safety Data Sheets (MSDS)

Department Procedures
(optional)




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                                  ENVIRONMENTAL HEALTH & SAFETY
                                     EMPLOYEE RIGHT-TO-KNOW
                                  HAZARD COMMUNICATION PROGRAM

                                               PURPOSE

This document establishes the policies, objectives, and administrative requirements for the Hazard
Communication Program (HCP) at the University of Wisconsin-Stevens Point (UWSP). The policies
set forth in this document are intended to ensure compliance with Federal and State regulatory
requirements. Applicable regulations are the Occupational Safety and Health Administration (OSHA)
29 CFR 1910.1200, Hazard Communication Standard (HCS) or Right-to-Know (RTK) regulation;
Wisconsin Department of Commerce (DCOMM) 32.50; and the Environmental Protection Agency
(EPA) 40 CFR Part 370, Community Right to Know Standard (SARA) and Emergency Plan.

                                              BACKGROUND

The Hazard Communication Standard (OSHA 29 CFR 1910.1200) was promulgated to protect
employees handling hazardous chemicals. It states that employees have the right to know the
hazards involved with the chemicals and products they work with.

The state of Wisconsin, under the authority of DCOMM, has adopted a hazard communication
standard identical to the federal standard.

The standard requires a written hazard communication program (HCP) at each work place. The
written program is intended to ensure that hazard information is provided to exposed employees. This
written program covers the need for:

        1)       A chemical inventory list;

        2)       Container labels and other forms of warning;

        3)       Collection and availability of Material Safety Data Sheets (MSDSs); and

        4)       Employee information and training.




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             GENERAL UNIVERSITY POLICY AND ADMINISTRATIVE STRUCTURE

                                            UNIVERSITY POLICY

It is the policy of UWSP to ensure that:

        1. Hazardous substances present in the work place are properly identified and labeled.

        2. Employees have access to information on the hazards of these substances.

        3. Employees are provided with information on how to prevent injuries or illnesses due to
           exposure to these substances.

        4. Identify, by job title, who has the responsibility for maintaining the program, the MSDS
           sheets, conduct training, etc.

                                              APPLICABILITY

The Employee Right to Know policy applies to all personnel who work with or supervise operations
involving work with chemicals on the UWSP campus. This includes all UWSP employees (FTE, LTE,
and students), outside contractors working on UWSP facilities, and students not covered by the
Chemical Lab Standard who come in contact with chemicals. Chemicals of concern are those
regulated chemicals that pose a physical and/or health hazard during routine or non-routine
operations.

                                        EMPLOYER RESPONSIBILITIES

The Chancellor of UWSP is responsible for assuring that UWSP is in compliance with applicable
Federal and State occupational safety and health regulations. The Vice Chancellor of Business
Affairs has been designated by the Chancellor as the OSHA/DCOMM compliance representative.
Under the direction of the Director of Safety and Loss Control, the Environmental Health and Safety
Officer has been delegated responsibility for development, implementation, and oversight of the
program for compliance with hazard communication regulations. Management personnel are
responsible for implementing and maintaining a Hazard Communication Program (HCP) in areas they
administer, as detailed in this document. Employees are responsible for becoming informed about
the chemical hazards in the work place by attending training courses, reading labels on products they
use, and referring to Material Safety Data Sheets.




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        Administrative Structure for the Program at UWSP


The administrative structure of responsibility for implementing the State of Wisconsin DCOMM
Employee Right to Know regulation at UWSP is given in the flow chart below.

                   ORGANIZATIONAL FLOW CHART FOR IMPLEMENTATION
             OF EMPLOYEE HAZARD COMMUNICATION – RIGHT-TO-KNOW AT UWSP



                                               Chancellor
                                                UWSP


                                            Vice Chancellor
                                            Business Affairs


                                                 Director
                                         Safety and Loss Control


                                 Environmental Health and Safety     ----   Environmental Health
                                            Officer                         and Safety Committee


                                Department Managers/Supervisors
                                              or
                                 Designated Trained Individuals


                                                Employees
                                        Faculty/Staff and Students




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                                   ADMINISTRATIVE RESPONSIBILITIES


Environmental Health and Safety (EHS) Officer:

        Develop and provide overall administrative guidance and supervision for the Hazard
         Communication Program (HCP), including interpretation of the regulations when clarification
         is required;

        Provide training for managers, supervisors or the designated trained individuals (as defined
         under Manager/Supervisor Responsibilities), who will then be responsible for the training of
         all departmental employees. Training will include all applicable rules and regulations in the
         Hazard Communication Standard and should be documented on Form HCP-1 (Appendix A);

        Provide guidance and assistance, where needed, for the preparation of procedures, survey
         reports, chemical inventories, and training programs required by the HCP;

        Ensure that each manager/supervisor has completed the HCP training and has trained their
         respective employees;

        Verify chemical inventory and storage locations through random audits;

        Handle Material Safety Data Sheet requests and workplace surveys;

        Ensure that copies of the UWSP Accident Report for Non-Employees Form HCP-4 (Appendix
         A) are forwarded to Protective Services, Risk Management, and the Personnel Office; and

        Maintain a master file of documentation and records associated with the HCP, including but
         not limited to: Training records; Chemical inventories; Employee exposure information; and
         MSDSs (paper copy and electronic database)

Manager/Supervisor Responsibilities:

        Attend Employee Hazard Communication Program (HCP) training sessions covering the
         requirements of this program and management responsibilities, or send their representative
         who will be the designated trained individual (DTI) for the work area. Administrative approval
         from the appropriate administrative department director, or academic department head is
         required before responsibilities can be delegated;

        Ensure that each employee in the assigned unit has completed the HCP training and is
         familiar with the chemicals used in the work place;

        Ensure that all HCP training is documented using the Employee Hazard Communication
         Employee Training Attendance Record Form HCP-2 (Appendix A). A copy of the attendance
         record will be forwarded to the Environmental Health and Safety (EH&S) Officer;

        Ensure that an employee HCP is incorporated into routine training sessions in their
         respective work areas;

        Ensure that training is provided:
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     1) to new employees at the time of the initial assignment to their area,

     2) whenever a new hazard is introduced into the work area, and

     3) whenever the employee is reassigned to an area using new or different chemicals and/or
        processes;

        Ensure that safe and healthful work conditions are maintained;

        Ensure that the EH&S Office is contacted with questions concerning compliance or
         interpretation of the Right-to-Know (RTK) regulation, or that employee questions are referred
         directly to the EH&S office;

        Maintain an inventory list in Appendix B of the Employee RTK binder of all chemicals used in
         the work area. Chemical Inventory Form HCP-3 found in appendix B should be used. The
         initial inventory list and copies of all updates will be forwarded to the EH&S Officer. A
         periodic inventory is required.

        Review and understand MSDSs on chemicals used by employees under their direct
         supervision and inform employees as new MSDSs become available;
        Ensure that MSDSs are available in the work area and are readily accessible to employees
         as detailed in the; Material Safety Data Sheet section;

        Ensure that employee requests for MSDSs and other safety materials are promptly handled,
         requesting any necessary information from the EH&S Office. (Employees must be notified of
         any delays in filling requests.);

        Ensure that containers are labeled according to the specifications outlined in the Labels and
         Other Warnings section;

        Ensure that information and materials for appropriate labeling are provided to the employee;

        Ensure that contract employees under their administrative control are informed about
         hazardous chemicals in the work place; and

        Document accidents involving chemical exposure on the Accident Report Forms in Appendix
         A (forms are provided for both employee and non-employee accidents), and report all
         chemical accidents within 24 hours to Protective Services (ext. 3456).

                               EMPLOYEE RIGHTS AND RESPONSIBILITIES

Employee Rights:

        To be informed about the known health hazards and toxic properties of the chemical
         substances in their work environment;

        To have Material Safety Data Sheets (MSDSs) readily accessible in the work area during
         each shift;

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        To request an MSDS for any chemical or product used in the workplace using Form HCP-6
         (Appendix A);

        To be properly trained to work safely with hazardous chemicals;

        To file a complaint with DCOMM if they feel they are being exposed to an unsafe work place
         and the situation is not being solved internally; and

        Not to be discharged, suspended, or otherwise discriminated against by their employer for
         exercising their rights by filing a complaint.

Employee Responsibilities:

        To attend the training seminars on the Hazard Communication Standard;

        To label all containers in accordance with university policy as outlined in the section labeled
         “Labels and Other Forms of Warning”;

        To use safe work practices, protective clothing and equipment required for the job or task;

        To inform the EH&S Officer or their supervisor, whichever is applicable, of accidents and
         conditions or work practices believed to be a hazard to their health or the health of other
         individuals; and

        To communicate relevant aspects of this program to students, if applicable, to assure that
         safe practices are used in the workplace and classroom.




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               PROCEDURE FOR PROGRAM IMPLEMENTATION AND MAINTENANCE

Chemical Inventory

Managers or supervisors will ensure that an inventory of all chemicals used in the work area is
performed periodically. A list of chemicals, storage location, and quantities of the chemicals must be
submitted to the Environmental Health and Safety (EH&S) Officer on Form HCP-3 (Appendix A). For
each work area, a current chemical inventory list should be included in appendix B of this document.
The EH&S Office will be responsible for maintaining a master inventory of all chemicals at UWSP.
Master inventories will be updated periodically and retained for a period of thirty (30) years.

Validation of the chemical inventory and hazard communication training will be conducted by the
EH&S Office. Chemical inventory validation procedures will consist of random, periodic inspections to
verify chemical usage, quantities, and storage locations for each work area. Completed validation
checklists (Form HCP-5) should be filed in the Employee Right-to-Know (RTK) binder under Appendix
C.

Manager/Supervisor Training

Managers/supervisors will serve as the Right-to-Know (RTK) coordinator in the immediate work area.
They will be trained on the Hazard Communication Standard, the program developed for
implementation of the regulation at UWSP, and the responsibilities for implementation of the program
in their specific work area(s). Training will be provided by the Environmental Health and Safety
(EH&S) Officer or designee.

Managers/supervisors may wish to designate an employee to serve as the responsible RTK
coordinator for their work area. Administrative approval is required before responsibilities can be
delegated.

Job Specific Training and Education

The hazards associated with chemicals used in the work area must be communicated to employees.
The UWSP written Hazard Communication Program will be made available to all employees. Hazard
information and necessary protective precautions for chemicals that the employee may come in
contact with during their tour of duty can be found on the Material Safety Data Sheet
(MSDS).Working with the Environmental Health and Safety (EH&S) Officer, the department manager,
supervisor, or designated trainer will be responsible for training employees in the Hazard
Communication Program and job specific activities involving hazardous chemicals. Training will:

        Describe operations in the employees’ work area where hazardous chemicals are present
         and explain safe handling procedures for those chemicals;

        Indicate the location and availability of the written hazard communication program, including
         the list(s) of hazardous chemicals;

        Explain what an MSDS is, how to read the MSDS (i.e. what each section contains and where
         to look for specific information), where MSDSs are kept in each work area, and how to obtain
         a copy of an MSDS;



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        Instruct employees on the use of personal protective equipment (PPE), why it is important,
         and the MSDS section detailing the PPE for each chemical;

        Explain the labeling system used at UWSP as outlined in the Labels and Other Forms of
         Warning Section;

        Encourage employees to familiarize themselves with the chemicals they use. Information
         should be updated as needed and before the employees work with new chemicals to ensure
         maximum understanding and employee protection;

        Describe methods and observations that may be used to detect the presence or release of a
         hazardous chemical in the work area or at the work site such as visual appearances or odor
         of hazardous chemicals when being released, etc. (Physical symptoms and other potential
         risks resulting from exposure to the chemicals in the work area should be included in the
         training);

        Explain to employees what to do in case of a chemical emergency such as a mechanical
         accident, spill or leak; and,

        Familiarize employees with caution or other warning signs used in the work area.

                                  TRAINING DOCUMENTATION

Each employee will be asked to sign the employee attendance form HCP-2 (Appendix A) at the end
of each training session. A copy of this form should be forwarded to the Environmental Health and
Safety Officer. The master copy should be retained by the trainer.




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                                MATERIAL SAFETY DATA SHEETS (MSDS)

The Material Safety Data Sheet (MSDS) is a detailed, technical document containing the physical
chemical properties and hazard information about a specific product. In accordance with the Hazard
Communication Standard of OSHA (Appendix D) and DCOMM Employees’ Right to Know regulations
(Appendix E), an MSDS is to be prepared by manufacturers and/or distributors of chemical products.
MSDSs for all chemicals and/or chemical mixtures will be provided by chemical manufacturers and/or
distributors in accordance with State Procurement Procedures. UWSP will rely upon this method of
obtaining accurate, complete, and current MSDSs. Prior to the purchase of a new chemical, it is
recommended that a current MSDS be requested and reviewed in consultation with the
Environmental Health and Safety (EH&S) Officer. Every new product should be reviewed before
being ordered.

        A copy of individual MSDSs for each chemical will be maintained in a master file in the EH&S
         Office. EH&S will review MSDSs for completeness. MSDSs will be considered unacceptable
         if any information required by OSHA 29 CFR 1910.1200 (g) (2) is omitted. Master file copies
         of MSDSs will be retained for thirty (30) years after the last date the chemical was received
         on campus.

        MSDSs will be made available and accessible during all work shifts.

        Employees will be made aware of the MSDS binder location in their work area. A copy of
         each new or updated MSDS will be posted or, in some other manner, be made available for
         review by the employees prior to being placed in the work area binder.

        In the event that an MSDS is not available for a chemical used in a particular work area, an
         MSDS should be requested from the EH&S master file using the Employee Request for
         Material Safety Data Sheet Form HCP-6, (Appendix A). Supervisors must ensure that
         employee’s requests for MSDSs and other pertinent materials are promptly handled. The
         employee must be notified of any delays in responding to an MSDS request by the EH&S
         Officer.

        Upon receipt of the employee “MSDS Request Form”, EH&S will forward a copy of the MSDS
         directly to the employee. An additional copy will be sent to the department supervisor for
         placement in the work area Employee Right-to-Know binder.

        In the event that a requested MSDS is not in the master file, EH&S will request a current
         MSDS from the manufacturer and/or chemical distributor. Requesting employee will be
         notified of this action by the EH&S Officer. Once the MSDS is received, a copy will be sent to
         the employee and the department supervisor.

        A record should be kept by EH&S of all MSDS requests. This will include the date the
         “MSDS Request Form” is received and the date copies of the requested MSDSs are sent to
         the employee and the department supervisor.

        If an MSDS is not received from the manufacturer within 30 days of request, a follow up will
         be made to determine the status of obtaining the MSDS. If the MSDS is not received within
         10 days of the follow up, the EH&S Officer may notify DCOMM in writing.


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                                LABELS AND OTHER FORMS OF WARNING

It is University Policy that all containers of hazardous chemicals be correctly labeled as described
below. The Environmental Health & Safety (EHS) Office will provide information for obtaining labels
for stationary and portable containers upon request.

                                                LABELS

        All chemicals and/or products (identified on the chemical inventory list) are subject to the
         labeling requirements of the Hazard Communication Standard (HCS).

        Each original shipment container, portable container, and stationary process container will
         include the appropriate hazard warning for each chemical, or mixture as a whole, based on
         the method of hazard determination (OSHA 29 CFR 1910.1200 [d] [2]). Specifically, each
         original incoming container will be labeled, tagged, or marked by the manufacturer/distributor
         with the following minimum information:

         1)   Identity of the hazardous chemical(s). “Identity” means the trade name or chemical
         name as given on the MSDS and listed in the chemical inventory list. Definitions of
         commonly used terms are listed in Appendix F.

         2)    The appropriate hazard warning, including health, flammability, reactivity, and
         Personal Protective Equipment (PPE) data. Health Hazard Warning Information (Appendix
         H) summarizes the acceptable coding system.

         3)      Name and address of the chemical manufacturer, importer, or other responsible party.

        Labels and other forms of warning must be legible, in English, and prominently displayed on
         the container.

        Existing labels on incoming containers must not be removed or defaced unless appropriately
         relabeled immediately with the required information.

        Secondary containers (safety cans, plastic bottles, etc.) will be labeled with the trade and/or
         chemical name and hazard warnings (health, reactivity, flammability, PPE).

        The use of unmarked, portable containers of hazardous chemicals is not permitted at UWSP.
         No container, even tap water, is to be unlabeled.

        Chemical containers, both hazardous and non-hazardous, must be inspected by the work
         area supervisor to ensure that they are properly labeled. Incorrectly labeled containers must
         be corrected immediately.


                                  ACCEPTABLE ALTERNATE WARNINGS

Alternatives and allowable exceptions to the above labeling requirements at UWSP are:

        For stationary process containers (i.e. 55 gallon drums, 30 gallon drums, 5 gallon carboy),
         alternate identification methods may used if the hazards of the chemical as specified in
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         OSHA 29 CFR 1910.1200 (f)(4) are effectively conveyed to the employee. Alternate
         methods of labeling are: signs, placards, batch tickets (tags).

        A numbering or lettering system may be an acceptable form of identification on the above
         types of labels. However, all employees must be trained to understand this method of
         identification and know where to find the applicable MSDS in their work area.

                        COMMUNITY RIGHT TO KNOW EMERGENCY PLANNING

UWSP must also comply with the Environmental Protection Agency’s (EPA) Emergency and
Hazardous Chemical Inventory Forms and Community Right-to-Know reporting requirements, EPA 40
CFR part 370 (Appendix G), as administered by the Wisconsin State Emergency Response Board
(SERB).

Any interested person wanting information about the presence of hazardous chemicals at UWSP may
request information through the Portage County Local Emergency Planning Committee (LEPC).
Accessible information includes:

           1)    An inventory list of hazardous chemicals exceeding
                 reportable quantities.

           2)    The storage location(s) and approximate quantities
                 of the chemicals.

For purposes of Emergency Planning, the LEPC and SERB will be notified of the hazardous
chemicals present at UWSP in amounts equal to or greater than the threshold planning quantity for
each chemical. Reporting of these chemicals will be handled by the Environmental Health and Safety
Office. The responding fire department will be notified of the location of the hazardous chemicals on
campus which exceed reporting quantities and supplied with MSDSs as necessary to respond safely
and adequately in emergency situations.

                                 CONTRACT EMPLOYEE’S NOTIFICATION

A designated UWSP representative will be responsible for informing contract employees, through the
contract supervisor, about existing hazardous chemicals in the work area for chemicals purchased
by UWSP. The university representative can be the project leader, contract negotiator or designated
individual directly responsible for the project or function.

Information regarding hazardous chemicals introduced into the work place by the contracted service
will be disseminated to all employees by the contractor. The term “employee” in this section refers to
contracted and university personnel.

The contractor must be notified, by attachment to the contract, of the location of the inventory list,
Material Safety Data Sheets (MSDSs), and the procedure for obtaining an MSDS in case of an
emergency. The contract attachment must be signed to acknowledge the exchange of information.




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Appendix A                                                                                    HCP-1

                    MANAGER/SUPERVISOR/DESIGNATED TRAINED INDIVIDUAL
                                     CERTIFICATION


I acknowledge that I have received Hazard Communication Training. I have been informed about the
labeling, material safety data sheet and training requirements of the Right-to-Know (RTK) law. I have
been provided with written documentation on the RTK policy at UWSP.


Name: ____________________________________ Date: ________________
              (please print)


Title: ____________________________________ Phone: ________________



Work area or department: ______________________________________________________


Manager/Supervisor ______________________


Designated Trained Individual:____________________________



Signature: ___________________________________________________________




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Appendix A                                                                                 HCP-2

                  EMPLOYEE RIGHT-TO-KNOW TRAINING ATTENDANCE RECORD


Trainer: ________________________________        Date:_______________________


Location of Training: ____________________________________________________

Work Area of Department: ______________________________________________

I acknowledge that I have received training specific to my work area about how to read and find
information on a Material Safety Data Sheet (MSDS), where MSDSs are located in my work area, and
what the labeling requirements are at the University of Wisconsin-Stevens Point.


          PRINTED NAME                                 SIGNATURE


_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________


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Appendix A                                                                                  HCP-4

                 CHEMICAL EXPOSURE ACCIDENT REPORT FOR NON-EMPLOYEES

Name      _______________________________________ Report Date ___________________

Address __________________________________________________________________________
        __________________________________________________________________________
Phone __________________________________________________________________________
============================================================================

Date of Injury ____________________ Time _________ Specific Location ___________________

Accident (Describe in Detail)
_________________________________________________________________________________

_________________________________________________________________________________

Emergency Procedures (Describe)
_________________________________________________________________________________

_________________________________________________________________________________

Taken to: Hospital _______ Health Services _______ Other (Specify Location)_______________

Refused Medical Assistance ______Yes ______No; Why?_________________________________

_________________________________________________________________________________

_________________________________________________________________________________
============================================================================
Witnesses

Name ___________________________________Name _____________________________

Address ___________________________________ Address _______________________________

Phone ___________________________________ Phone ________________________________
============================================================================
Manager/Supervisor/Instructor Comments/Observations ___________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Manager/Supervisor/Instructor Signature ___________________________________Date ________

Complete & Forward this report within 24 hours to: ENVIRONMENTAL HEALTH & SAFETY - STIEN
BUILDING. If injured party is an employee, employee's supervisor should complete worker's
compensation form and forward to the Safety and Loss Control Office, within 24 hours of accident.



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Appendix A                                                                                  HCP-6

Send to: Environmental Health and Safety Office

         EMPLOYEE MATERIAL SAFETY DATA SHEET (MSDS) REQUEST PROCEDURES

If the MSDS of interest is not in the employee's work area, a request may be made to the
Environmental Health & Safety (EHS) Office for a copy of the specific MSDS.

Upon receipt of the employee's written request, EHS will supply a copy of the MSDS directly to the
employee. An additional copy will be sent to the supervisor for placement in the work area file.

If the MSDS is not in the master file, EHS will:

1.      Request the MSDS from the manufacturer.
2.      Notify employee that the MSDS is not in the master file and that the MSDS has been
        requested from the manufacturer.
3.      Notify DCOMM of the manufacturer's non-compliance if the MSDS is not received within the
        time specified in the MSDS section of this document.
4.      Notify employee that the manufacturer has been reported to DCOMM.


               ----------------DO NOT MARK BELOW THESE LINES----------------
_______________________________________________________________________
                                    FOR OFFICE USE ONLY
MSDS                                    Request                              Processed
By:_________________________________________________________(date)________________




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Appendix B                                                                                   HCP-3
                                        CHEMICAL INVENTORY FORM

Work Area/Department: ___________________                         Date: ___________
Supervisor: ______________________ Person Completing Report: _____________________
Location: _____________________                     Title: ________________________

Page __ of __                                                    Total Quantity:

           PRODUCT                       MFGR      <1    > 1 or = 5    >5 or = 55      > 55 gal or   MSDS
                                                   gal   gal           gal             > 220 Kg      (Y/N)




University of Wisconsin-Stevens Point                                    Effective 12/1999
EHS Manual                                                     Revised by EHS Officer 5/06
Hazard Communication – Written Plan                                                 20of24
                            Procedure for Completing Chemical Inventory Forms

The Chemical Inventory Form should be completed as thoroughly and accurately as possible with the
most recent information you have available. The following descriptions explain what information is
needed in each of the four columns. A separate form must be submitted for each storage location.
Send a copy to the EHS Officer.

                 1. Product: The name of the product as found on the product label and/or MSDS.
                    This may be a trade name, chemical name or common name.

                 2. Manufacturer: The name of the company who made the product.

                 3. Total: Check the amount of product stored at the location at the time of inventory.

                 4. MSDS: Do you have a copy of the MSDS for the product(s) being reported?




University of Wisconsin-Stevens Point                                        Effective 12/1999
EHS Manual                                                         Revised by EHS Officer 5/06
Hazard Communication – Written Plan                                                     21of24
Appendix C                                                                           HCP-5
                      CHEMICAL INVENTORY AND HCP VALIDATION CHECKLIST

Location:____________________________________________________Date:______

Work Area/Dept.:_______________________ Name: __________________________

Supervisor: ___________________________________________________________


CHEMICAL MANUFACTURER                    QUANTITY   MSDS DATE                  DISTRIBUTOR

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________




University of Wisconsin-Stevens Point                            Effective 12/1999
EHS Manual                                             Revised by EHS Officer 5/06
Hazard Communication – Written Plan                                         22of24
Appendix D

OSHA 29 CFR 1910.1200 Hazard Communication Standard
OSHA Health Hazard Definitions
OSHA Hazard Determination




University of Wisconsin-Stevens Point                           Effective 12/1999
EHS Manual                                            Revised by EHS Officer 5/06
Hazard Communication – Written Plan                                        23of24
                                  HAZARD COMMUNICATION CHECKLIST


Is there a list of hazardous substances used in your workplace?

Is there a written hazard communication program dealing with Material Safety Data Sheets
(MSDS), labeling, and employee training?

Is each container for a hazardous substance (i.e., vats, bottles, storage tanks, etc.) labeled with
product identity and a hazard warning (communication of the specific health hazards and physical
hazards)?

Is there a Material Safety Data Sheet readily available for each hazardous substance used?

Is there an employee training program for hazardous substances?

Does this program include:

           An explanation of what an MSDS is and how to use and obtain one?

           MSDS contents for each hazardous substance or class of substances?

           Explanation of "Right to Know?"

           Identification of where an employee can see the employers written hazard
           communication program and where hazardous substances are present in their work
           areas?

           The physical and health hazards of substances in the work area, and specific protective
           measures to be used?

           Details of the hazard communication program, including how to use the labeling system
           and MSDS's?

Are employees trained in the following:

           How to recognize tasks that might result in occupational exposure?

           How to use work practices, engineering controls, personal protective equipment, and to
           know their limitations?

           How to obtain information on the types selection, proper use, location, removal
           handling, decontamination, and disposal of personal protective equipment?

           Who to contact and what to do in an emergency?




University of Wisconsin-Stevens Point                                        Effective 12/1999
EHS Manual                                                         Revised by EHS Officer 5/06
Hazard Communication – Written Plan                                                     24of24

								
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