Resolution No. 5925
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RESOLUTION NO. 5925
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF VERNON-APPROVING THE CITY OF
VERNON SAFETY PROGRAM, APRIL, 1991
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WHEREAS, SB 198 approved by the Governor October 2,
1989 requires, in part, every employer to establish, implement
and maintain an effective injury prevention program; and
WHEREAS, said program must be in writing and must
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include those certain elements contained in Labor Code Section
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6401.7; and
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WHEREAS, the City must have its written safety program
in place not later than July 1, 1991.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF VERNON AS FOLLOWS:
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SECTION 1: The City Council of the city of Vernon
hereby finds and determines that the recitals contained
hereinabove are true and correct.
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SECTION 2: The City council of the city of Vernon
hereby approves the City of Vernon Safety Program, April, 1991,
a copy of which has been presented to the City Council
concurrently with this resolution and the ci ty Council hereby
orders said Program to be received and filed by the City Clerk.
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SECTION 3: The City Clerk of the City of Vernon shall
certify to the passage of this resolution and thereupon and
thereafter the same shall be in full force and effect.
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APPROVED AND ADOPTED this 21st day of May, 1991.
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---~.ONIS C. MAL q, May r ....
A~/~~ .
BRUCE V. MALKENHORST, c~ty Clerk
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STATE OF CALIFORNIA )
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COUNTY OF LOS ANGELES )
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I, BRUCE V. MALKENHORST, City Clerk of the City of
Vernon, do hereby certify that the foregoing Resolution, being
Resolution No. 5925, was duly adopted by the city Council of the
City of Vernon at a regular meeting of the City Council duly
held on Tuesday, May 21, 1991, and thereafter duly signed by the
Mayor of the City of Vernon.
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(SEAL)
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BRUCE V. MALKENHORST, City Clerk
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CITY OF VERNON
SAFETY PROGRAM
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APRIL, 1991
Chapter I
Chapter II
Chapter III
Chapter IV
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Chapter V
Chapter VI
Chapter VII
Chapter VIII
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SAFETY PROGRAM
TABLE OF CONTENTS
PAGE
INTRODUCTION
Safety Policy, Procedures, organization,
Responsibilities
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ADMINISTRATIVE PROCEDURES
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Generalized Procedures, CAL/OSHA Requirements
SAFETY COMMITTEE
Committee organization, Meeting Procedures,
Activities, Tailgate Meetings
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SAFETY INSPECTION
Procedures for Locating and
possible Hazards, Exhibit A
Problem
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Eliminating
- Report of Safety
WORK-RELATED INJURY/ILLNESS 12
Job Injury Procedures, Modified Work, Lost
Time, Follow-up visits, Physicians, Treatment
Facilities, Reporting Requirements, Exhibit B -
DWC Form 1, Exhibit C - On the Job Injury Log,
Exhibit D - supervisor's Report of Accident,
Exhibit E - Form 5020
ACCIDENT INVESTIGATION AND ANALYSIS 16
Checklist for Identifying Key Factors, Employer
Level Investigation
AUTOMOTIVE ACCIDENTS 21
Accident Procedures, Accident Investigation
Committee, Exhibit F - AIC, Exhibit G - AIC
Findings and Recommendations
SAFETY AND HEALTH ENFORCEMENT 22
Safety Counseling, Work Practice Enforcement
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Chapter IX
Chapter X
Chapter XI
Chapter XII
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Chapter XIII
OPERATIONS IN THE PUBLIC WAY
Traffic controlslBarricades, Pedestrian
Safety
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SAFETY TRAINING 25
Job Safety Analysis (JSA) and Job
Instruction Training (JIT) , Exhibit H - J.S.A.
sample, Exhibit I - J.S.A. Form
SAFETY REGULATIONS 28
Principal Causes of Accidents, General Safety
Rules, Office Safety, Clothing and Equipment,
Material Handling, Electrical, Housekeeping,
Automotive, Ladders and Platforms, Pneumatic
Tools, Burns and Welding , Chemicals, Excavations,
Street, Repairs, Sub-Surface operations, and
Confined Spaces
HAZARDOUS MATERIALS 40
Contingency Plan, Training Plans, supervisor
Guidelines, Training Documentation, Exhibit K -
Hazard Communication Program Forms
EMERGENCY PREPAREDNESS
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CHAPTER I
INTRODUCTION
SAFETY POLICY
The purpose of this outline is to establish general methods and
procedures for developing and maintaining a program of accident
prevention throughout the operations of the City of Vernon.
In carrying out these purposes, ,this program has as its specific
objectives the prevention of physical injury, disability, sickness,
loss of work, fatalities and destruction or damage to property of
the city. As an additional objective, it also includes the
prevention of accidents involving the citizens or property within
the City of Vernon.
A common and sympathetic interest exists between the City's
management and employees. in the maintenance of an adequate and
effective accident. prevention program. The promotion of this common
interest is furthered and extended through close cooperation.
The procedures that follow anticipate that'such cooperation will be
established and maintained at all times between management, its
employees and employee associations.
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PROCEDURES
The general procedures to be followed are divided into three parts
as follows:
1. Eliminate unsafe structures, installations, \; :Jrking conditions,
acts of individuals, and unsafe automotive and other equipment.
2. Organize and supervise a program of safety information and
training among the employees to teach:
a. The correct use of tools and equipment.
b. Safe work methods.
c. safety precautions.
d. Application of safety rules for accident prevention.
e. Proper use of safety devices.
f. Safety.orientation of new employees.
3. Maintain records of accidents and safety performance.
Investigate and <analyze all accidents, prepare reports for
management and submit recommendations for preventive measures.
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ORGANIZATION
The organization of the safety program utilizes all existing
channels of authority within the City of Vernon. In addition to
these established channels,a supplementary organization has been
set up with specific responsibility for the safety program as
follows:
Risk Manaqer. The Risk Manager is the safety officer and
serves under the direction of the City Administrator in all
functions in connection with this program. The Risk Manager
shall serve as an advisor to the Safety Committee.
Safetv Coordinator. Safety Coordinators will be department
safety representatives. They will be responsible for reporting
unsafe conditions to their respective Department Heads and the
Risk Manager.
Safetvcommittee. The safety Committee will consist of the
Risk Manager,.and Safety Coordinators. The Committee will be
responsible for the overall operation ofthe.safety program.
The Safety Committee shall meet once each month at a regularly
scheduled date and time.
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Tailqate Meetinqs. These meetings will provide the Safety
Coordinator with the opportunity to impress upon personnel the
necessity of making accident prevention an essential part of
the job. Tailgate meetings shall be held biweekly at a
regularly scheduled date and time.
RESPONSIBILITIES
Risk Manaqer
The Risk Manager is responsible for the development, organization,
coordination and implementation of safety programs and safety
education. Responsibilities also include work site inspections,
hazard reduction andlor elimination of accident/injury
investigation, reporting and management.
The Risk Manager will advise the city Administrator as well as
Department Heads, supervisors and employees of unsafe conditions,
problems related to accident prevention and recommendations for
loss control. The Risk Manager will not fulfill obligations. of
administrators or supervisors relative to providing safe. work
environments, necessary equipment, training as well as inspections
in the interest of accident prevention. The Risk Manager will
prepare a monthly loss analysis report to the city Administrator,
City C:>uncil and Department Heads.
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Department Head
The Department Head is responsible for fulfillment of departmental
goals and objectives as well as health and welfare of each employee
in the department. In the adopted safety policy, the highest
priority has been placed on employee safety, which, therefore
becomes the responsibility of the respective administrator. It is
normal ,practice for supervisors to be delegated the authority to
carry out safety policy in his or her department; but the
responsibility for meeting objectives and the protection of
employees in performance of their assignments cannot be
transferred.
SUPERVISOR
Supervisors will assume the responsibility of thoroughly
instructing their personnel in the safe practices to be observed in
their work si tuations. They will consistently enforce safety
standards and requirements to the utmost of their ability and
authority. Supervisors will act positively to. eliminate any
potential hazards within the activities under their jurisdiction
and they will set the example of good safety practice in all
spheres of their endeavors. The principal duties .of supervisors in
discharging responsibilities for safety are as follows:
Enforce all safety regulations in effect and make employees
aware that violations of safety rules will not be tolerated.
Make sure all injuries are reported promptly and all accidents
are reported even if injury is not apparent.
Conduct thorough investigations of all accidents and take
necessary steps to prevent recurrence through employee safety
education, operating procedures or modification of equipment.
D. Provide employees with complete safety instructions regarding
their duties prior to the employee actually starting to work.
E. Conduct regular safety checks of the area, including a careful
examination of all new and relocated equipment before it is
placed in operation.
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H. Develop and administer an effective program of good
housekeeping and maintain high standards of personal and
operational cleanliness throughout all operations.
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I. Provide safety equipment and protective devices. for each job
based on knowledge of applicable standards or on recommendation
of the Department Head andlor Risk Manager.
J. Conduct tailgate meetings for safety education at bimonthly
intervals, allow discussion period for employees to express
their concerns, ask questions, etc.
K. Give full support to all safety procedures, activities and
programs.
EMPLOYEE
Each employee, as part of the comprehensive safety and loss
prevention program, is expected to place safe work practices and
identification of unsafe conditions in their highest priority while
performing their daily tasks. Each employee's safety commitment
must include, but is not limited to the following:
A. Using the safety equipment which has been provided in
performing his daily work assignments.
B. wearing the prescribed uniform and safety shoes as required.
wearing any and all safety apparatus as required by the job.
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c. Not operating equipment or using tool for which training or
orientation has not been received.
D. Warning supervisors and co-workers of unsafe conditions or
practices they are engaged in which could lead to or cause an
accident.
E. Reporting defective equipment, including vehicles, immediately
to a supervisor and filing repair orders per departmental
policy.
F. Reporting dangerous or unsafe conditions that exist in the work
place as well as throughout the city. This would include
defective sidewalks, broken curbs, hanging limbs, loose
handrails, open manholes, sunken basins and sewers, missing
signs, etc.
G. Reporting of all injuries and accidents regardless of severity.
H. Taking care not to abuse tools and equipment, so that these
items will be in usable condition for as long as possible as
well as to ensure that they are in the best possible condition
while being used.
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CHAPTER II
ADMINISTRATIVE PROCEDURES
Under the direction of the Risk Manager, administrative procedures
shall be established for the following:
1. The Safety Committee shall meet once each month. Meeting date
and time may be changed by a consensus of the committee but no
less than one meeting each month is required.
2. Department Heads will allocate time for their Safety
Coordinators to conduct Tailgate meetings within their
departments. These meetings will be conducted bimonthly.
3. A written record of the minutes of the Safety Committee and
Tailgate meetings shall be made. A copy of such minutes will
be made and forwarded to Risk Management.
4. Prompt written response of action(s) taken on reports from
Risk Management andlor recommendations submitted by the Safety
Committee.
5. Effective accident investigation.
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6. Action against individual violators of safety rules and
practices.
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Safety training programs for employees and supervisory
personnel.
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Complaints from employees concerning a possible injury or
illness potential.
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Inspections, audits and a periodic review of all premises,
equipment and materials. Recommendations may be categorized
as follows:
a. Immediate Action - those items which post imminent danger
or which require only modest expenditures of time and
material, and can be accomplished by the person having
direct responsibility.
b. As Soon As possible - those items which require the
assistance of another department, routine maintenance
items, hazards which may lead to possible serious injury
and those requiring a modest expenditure of time and money.
c. As Schedule Permits - those items which are temporarily
acceptable but will require correction.
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d. Pre-planninq Necessary - recommendations requiring new -
programs, equipment or process.
DOCUMENTATION
Action on any of the above shall be documented in all instances.
CAL/OSHA POSTING. REPORTING AND RECORD KEEPING REOUIREMENTS
1. Postinq Requirements
CAL/OSHA poster must be posted in a prominent place. This
poster states the intent and coverage of CALI OSHA and the
responsibilities of employers and employees to maintain a safe
and healthful working environment.
2. Reportinq
All fatal accidents, catastrophes involving .five or more
employees and serious injuries requiring hospitalization for
more than 24 hours must be reported to the nearest office of
the Division of Industrial Safety immediately, and in no case
more than 24 hours (El Monte office, (818) 901-5403).
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Records shall be made and maintained in accordance with
CAL/OSHA requirements. The official records will be kept by
the Risk Manager.
4. Inspections
The CAL/OSHA inspector usually will arrive unannouced. Refer
the inspector to the Risk Manager.
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CHAPTER III
SAFETY COMMITTEE
COMMITTEE ORGANIZATION
Representation on the Safety Committee shall be as follows:
1. All City departments will be represented by a Safety
Coordinator.
2. Committee members shall serve for two years or until replaced
by the Department Head.
3. The Risk Manager shall be the Chairperson.
4. One. of the committee persons may be designated as vice-
chairperson who will chair the meetings in the absence of the
chairperson.
5. 'chairperson may appoint a secretary to record the minutes of
the meetings.
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Chairperson may appoint sub-committees and members as
required with approval of the city Administrator.
MEETINGS
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The safety committee shall meet monthly at a regularly scheduled
date and time. Meetings should not extend beyond one and one-half
hours and should normally be of one hour duration or less depending
on the business to be conducted.
COMMITTEE MEETING PROCEDURES
committee meeting procedures areas follows:
Start of meeting - chairperson (date and time).
Roll call - record members present and absent.
Introduction of visitors, if any.
Review minutes of previous meetings and approve or amend.
Unfinished business (reports from committees).
Review of accidents and recommendations to prevent recurrence.
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7. New business (recommendations, suggestions, hazardous
situations) .
8. Other business, ,if any.
9. Announcement of next meeting, date, time and place.
10. Adjourn meeting (time).
SCOPE OF COMMITTEE ACTIVITIES
The Safety Committee recommends matters of policy such as training
needs and methods, safety equipment, rules and practices, etc.
They review accident reports and statistics; and project future
plans for the advancement of the safety program .through the basic
elements: engineering, education and enforcement.
SUB-COMMITTEES
A. Accident Investiqation Committee - the cOmmittee is comprised
of the Risk Manager and a designated management employee from
the department in which the accident occurred.
B. Safety Awards Committee - reviews employee safety suggestions
and determines awards given per Committee policy.
C. Safety Education Committee - responsible for the educational
development and generalized safety programming of all
employees.
D. Safety Inspection Committee - responsible for the coordination
of City-wide annual and specialized inspections. This
committee may function at the department level.
SUPERVISOR1S INJURY REPORTS
The Accident Investigation Committee will review every
injurYlaccident and recommend an action to prevent recurrence,
whenever possible. A copy of the recommendations will be forwarded
to the affected Department Head and city Administrator for further
action.
RECOMMENDATIONS, SUGGESTIONS AND HAZARDOUS SITUATIONS
Committee members are encouraged to bring all safety matters to the
attention of the affected Department Head for correction prior to
being brought up at a committee meeting.
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Every recommendation, suggestion or reported hazardous situation
shall be assigned for action and report to that Committee person
where the situation exists. However, there may be situations when
the Chairperson may ,have to contact management on a particular
problem or where the services of the Risk Manager may be required.
In no case shall new business be brought up and recorded without an
assignment of responsibility.
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The Safety Committee person who has been assigned a project will do
the necessary research andlor contact the Department Head for
appropriate action.
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CHAPTER IV
SAFETY INSPECTION
A. Purpose
The purpose of this part of the program is to eliminate unsafe
structures, installations, working conditions and equipment.
B. Procedures for Locatinq Hazards
1. Periodic inspections will be conducted to recognize and
correct unsafe working conditions, acts and environmental
hazards on or about facilities of the City, as follows:
a. Supervisors must maintain a continuous visual
inspection of locations, equipment, tools, personal
protective devices and working conditions under their
supervision.
b. Safety Coordinators will conduct periodic inspections
of departments they represent.
c. Employees will report all possible hazards andlor
safety problems to the supervisor.
d. The Risk Manager may inspect facilities and working
conditions and submit hislher findings and
recommendations to management.
C. Procedure to Eliminate or Correct Hazards
1. The supervisor responsible makes corrections whenever it is
within his authority to do so.
2. If corrections are beyond the authority of the supervisor
responsible, he prepares a request for correction and
submits it through established channels for. approval.
3. In the event the recommended corrections are of an urgent
nature, verbal approval is obtained from the proper
authority, followed by the written request for approval.
4. If correction cannot immediately be made and danger to
human life and property is imminent, the equipment will be
taken out of service and "tagged" to prohibit its use or
the operation will be stopped until such time as the hazard
is either removed or corrected.
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5. If the possible hazard and/or problem does not pose-an
imminent danger to human life or property, the employee
shall:
a. Notify the supervisor of the problem.
b. Complete the "Report of Safety Problem" form.
(Exhibit A)
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EXHIBIT A
CITY OF VERNON
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Subm~ttedby:
Date:
Department: .
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Tne ~tem(s) addressed in tnis report have been brought to the
attent~on of:
A.
B.
Immediate Supervisor
Safety Coordinator
Department Heatd
Safety Committee
Date:
Date:
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c.
D.
Date:
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Date:
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1. Descript~on of problem (include exact location):
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2. Safety Comm~ttee F~ndings and Recommendations:
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3. Act10ns Taken:
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4. Onsite Review by Risk Manager:
Date: Signature:.. _ . ._____ _._ _ .. . _
D. Follow:-Up
1. Tne Safety Committee will present its findings and
recommendations to tne Risk Manager.
2. Tne. Risk Hanager will review tne Committee's
recommendations and submit a final report of
recommended action to tne C~ty Administrator.
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CHAPTER V
WORK-RELATED INJURY/ILLNESS
PROCEDURES - TIME OF INJURY
1. Report the injury to your supervisor immediately. If the
injury. is serious and no supervisor is present, get medical
attention first.
2. Secure a Medical Service Order form from your supervisor.
3. Medical Service Order form must be completed by physician and
returned to supervisor.
MODIFIED WORK
1. If restrictions are. placed upon the injured employee, the
employee shall notify the supervisor of said restrictions.
2. If the supervisor determines that no modified work assignment
is available, the employee shall remain off work until one
becomes available or released to full duty.
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3.
Employees will notify their supervisors prior to any absence
from home beyond two days.
4. Modified work assignments are the responsibility of the
department head and supervisor.
LOST TIME
1. The treating physician must authorize all time off from work.
The certification of time off may be subject to concurrence by
a City physician.
2. It is the employee's responsibility to return doctors' notes
for all.time off for the purpose of paYroll reporting. Any
time off not supported by documentation will be charged against
the employee's benefit time (i.e., vacation, compo time, etc.).
FOLLOW-UP VISITS
1. Employees are required to attend all scheduled follow-up
visits.
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2. If an appointment cannot be kept, it is the employee's
responsibility to cancel andlor reschedule aminimum.of 24
hours in advance.
3. Failure to comply with the above may result in a monetary
expense to the employee if it is charged to the city by the
treating physician.
PHYSICIANS
1. Employees should be treated at Park Place Medical Center or
Leonis Medical Group unless an Industrial Injury Physician
Designation Form is on file in the employee's personnel file.
2. In the event of serious injury the employee should go to the
nearest medical facility.
TREATMENT FACILITIES
1. Park Place Medical Center
3400 E. Florence Avenue, Huntington Park
24-hour Service, Seven (7) days a week.
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2. Leonis Medical Group
2770 Leonis Blvd., Vernon
Hours: 6:30 AM - 6:00 PM, Monday - Friday
Extreme Emerqencies
White Memorial Hospital
414 N. Boyle Avenue, Los Angeles
REPORTING REOUIREMENTS
1. If an employee is injured on the job give himlher DWC Form 1
(1-1-90) Employee's Claim For Workers' Compensation Benefits
within 24 hours of date you are informed. This may be handed
to the employee or mailed regular mail but must be done within
24 hours of date youlearnhe/she has been injured. (see sample
at ,end of this section, Exhibit B.)
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2. Complete the On The Job Iniurv Loq indicating employee's name,
injury date, date you were informed of the injury, date you
provided the DWC Form 1, .date the DWC Form 1 ,was returned to
you and the employee's signature that helshe did receive the
DWC Form 1. If employee is unavailable to.signfor the form,
the supervisor may sign indicating that employee is
unavailable. (See sample at the end of this section, Exhibit
C. )
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3. complete the supervisor's Report of Accident. (See sample at
the end of this section, Exhibit D.)
4. Employer's Report of Occupational Injury or Illness (Form
5020). Compl~te this form only if the injury is other than
first aid. If in doubt, complete Form 5020 and send to Risk
Management. Risk Management will make the determination.
(See sample at the end of this section, Exhibit E.)
complete Form 5020 as follows:
#1 Thru #5 are always the same.
#6 Full name of injured employee.
#7 Injured employee's date of birth.
#8 Injured employee's home address (NOT EMPLOYER'S
ADDRESS). This is because certain documents (checks,
doctor's appointments, etc.) are sent directly to the
injured employee. If the City's address is used, these
documents may not get to the employee within the
necessary'. time frame .
#8A
( #9
#10
#11
#12
Injured. employee's home phone number. Include area code.
Injured employee's sex.
Injured employee's classification (i.e., utilitYman III,
Diesel Operator, etc.).
Injured employee's social Security number.
City department injured employee is employed by, plus
department number .(i.e., community services
(Engineering/Planning 1040); Fire 1033; etc.)
#13 Hours usually worked.
#14 Gross monthly wages (if unknown, check with Finance -
PaYroll). If hourly employee, give hourly wage rate.
#15 Give address where injury occurred.
#15A Los Angeles County.
#15B If injury actually occurred on city property, answer
"Yes".
"..~,,,.. .' ~"..','i ~ ,~~ i .">, r~_ .~~ 11':-) ,
If injury occurred elsewhere (i.e., public street,
private residence, etc.) answer "No."
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#16 Explain what injured employee was attempting to do when
inyury occurred.
#17 Specifically state the HOW and WHY of how the injury
occurred.
#18 Specifically state what object injured or caused injury
to employee.
#19A What kind of injury did employee complain of.
#20 Name, street address, city and state of first treating
physician.
#21 Name, street address, city and state of hospital, if
employee was hospitalized.
#22 Calendar date of injury.
#23 Time of day.
#24 If employee was under doctor's orders not to return to
work the answer is "Yes" and give the date last worked.
If employee was returned to work immediately, the answer
is "No."
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#25
If employee has returned to work the answer is "Yes" and
give the date returned.
If employee is still under doctor's orders not to return
to work at time this form is completed, the answer is
"No." ..
#26 If employee died due to this .injury I the answer is "Yes"
and give date.
If empl,oyee did not die, answer is "No."
NOTE: In cases of employee death, Risk Management must
be notified immediately as .this must be reported
to the state within 24 hours.
Completed by: signature; Title and Date.
This form MUST be completed by the injured employee's supervisor,
NEVER by the injured employee.
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EXHIBIT B
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Department of Industrial Relations
DMSION OF WORKERS' COMPENSATION
EMPLOYEFS CLAIM FOR WORKERS' COMPENSATION BENEFITS
(J you are injured'or become ill because of your job, you are entitled to workers' compensation benefit~
Complete the "Employee" section and give the form to your employer. Keep the copy marked "Employee's Temporary
Receipt" until you receive the dated copy from your employer. You may contact the State's Office of Benefit Assistance
and Enforcement at 1-800-736-7401 if you need help in filling out this fonn or in obtaining your benefits. An explanation
of workers' compensation benefits is included on the reverse of this form.
You should also have received a pamphlet from your employer describing workers' compensation benefits and the
procedures to obtain them.
EMPLOYEE:
Today's Date
Zip
a.m. _ p.rn.
EMPLOYER: COMPLETE THIS SECTION AND GIVE THE EMPLOYEE A COpy IMMEDIATELY AS A RECEIPT.
8. Name and address of employer
9. Date employer fIrst knew of injury
10. Date claim form was provided to employee
11. Date employer received claim form
12. Name and address of insurance carner or adjusting agency
13. Signature of Employer Representative
14. Title
15. Telephone
EMPLOYER: You are required to date this fonn and provide copies to your insurer and to the employee, dependent or representative
who filed the claim within one working day of receipt of completed form from employee.
SIGNING THIS FORM IS NOT AN ADMISSION OF LIABILITY
Original (Employer's Copy) 90 89SSS DWCForm 1 (1/1/90)
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EXHIBIT D
CITY OF VERNON
SUPERVISOR'S REPORT OF ACCIDENT/EXPOSURE
1. Name of Injured
Sex: M
Job Title
F
2 . Department
Supervisor
3. Address Where Accident/Exposure Occurred
4. Vlhat \'las Employee Doing When Injured?
5. Were There witnesses?
6. How did Accident/Exposure Occur?
7. If Exposure, Product/Chemical Involved?
(
8. Duration of Exposure:
hours
min
sec
unk
9. Object of Substance that Directly Injured Employee?
10. Nature of .Injury or Illness and Part of Body Affected
11. Date of Injury I IllnesslExposure
Time
12. Has Employee Returned to Work? _YES I Date Returned
_NO, still Off Work
13. Was First Aid Adequate Treatment?
14. Did Employee GO to the Doctor?
of Doctor or Clinic
YES
NO
YES
NO
If Yes, Name
15. Did the Employee Commit an Unsafe Act? Explain
16. Explain Factors that could have contributed to the Accident
(Improper Attitude, Physical Impairment i.e., eyesight,
hearing, fatigue, etc., or Lack of Knowledge or Skill)
(
;:'\.
17. What have you personally done. to Prevent Similar Accidents?
Employee
Date
supervisor
Date
Department Head
Date
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(
EXHIBIT E
State of California
Forward to Department of Industrial Relations. P. O. Box 5971, San Francisco. CA 94101
Retain white copy for your files and mail yellow copy to
OSHA Case
or File No.
PLEASE TYPE ALL INFORMATION. IF POSSIBLE
EMPLOYER'S REPORT
COLEN ANO LEE
>: OCCUPATIONAL
INJURY OR ILLNESS
1930 South Brea Canyon Read. Suite 100. Diamond Bar, CA 91765
Risk Managemen. Services (714) 861-0816.
PIC~ X X X ELITE X'X X . TYPEWPITERALlGNMENTGlJlDE ..
California law requires an employer to report within five days every industrial injury or occupational disease which: (a) Results in lost time beyond the day of injury.
or (b) requites medical treatment other than first aid. PLEASE NOTE: In addition, il death results or if the injury or illness: (a) Requires inpatient hospitalization of
more than 24 hours for other than medical observation; or (b) results in loss of any member of the body; or (cl produces any serious degree of permanent
disfigurement, then the nearest district office of the California Division of Occupational Safety and Health also must be notified immediately by telephone or
telegraph. This notification is not required. however, i~ the injury or death results from an accident on a publiC street or highway.
v
2. MAILING AODRESS {Number and Streel. City. ZIp)
I. FIRM NAME
1 A. POLICY NUMBER
PLEASE 00 NOT
USE THIS
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CASE NO.
3. . LOCATION. IFDIFFE.R~NT FROM MAIL ADDRESS' (Number and Street. City. ZIp),
3A.. LOCATION CODE.
:-"QwNERSHIP
4A. NATURE OF.BUSINESS e.o. painUng contractor. wholesale grocer. sawmill, hotel. ete.
. --,--.-
5. STATE UNEMPLOYMENT INSURANCE ACCT. NO:,.
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'7. ~.;>~ THE ACCIDENTjR EXPOSURE~U~? (Plea, . ,se cleScrJbe fuHy th~ events ~l resUlled 1~~inIUry or occuPationa',dis_e..Tell wIlat happened .nd~ " ha~.
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.:-:".~ -cnemiCallhat iniIated hillkIn; In easel 01 atratnI. ~ "ing he was 1Hting. 'pulling. etc..'.',' :~~f' ~:.~.-'_ i"~~.~ :''-::-:-:': ~"~-1"c.:;~ok~>~ .-'-...-;.)i._.~,,'':.....;;...:~'';.:.-.c.~~~.:.:~~-1''".-' '..:1 ."IW::-...~... :;u_j,;-;;.;s;:~~- ~~~~~
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~~~~.~~.~~~
CHAPTER VI
ACCIDENT INVESTIGATION AND ANALYSIS
ACCIDENT INVESTIGATION
Good accident investigation starts long before the accident happens
and ends after the accident occurred. WE MUST KNOW THE CAUSE IF WE
WANT TO CORRECT THE PROBLEM. If we use a step-by-step guideline
process, investigations can be effective. First, look at the steps
to accident investigation:
1. You must clearly understand the need to investigate
2. You must be .prepared to do the investigation
3. Gather all the facts about the accident
4. Analyze the facts you gathered
5. Based on facts, develop you conclusions
6. Then analyze the conclusions
(
i .
Document conclusions in a report
t . !'~al:e specific recommendations to get action
S. Sell your recommendations to get action
10. Follow-up on the recommendations to get compliance
~~. Then critique your whole investigation
12. Follow-up again on the corrective action
Usually accident investigation only involves gathering facts about
the accident and making conclusions. This is not enough. An
investigator must get the big picture and prevent reoccurrences.
THE STEPS ARE:
1. THE NEED: Do you really want to prevent further accidents? Or
are you just going through the process?
2. PREPARATION: If you wait until the accident happens it is too
late for preparation. You need a pre-plan to follow and few
tools. The pre-plan should be short and only cover a few
things.
16
YOUR PROGRAM SHOULD INCLUDE:
1. Prompt accident reporting system to let certain people know
immediately.
2. Get emergency people to the scene as soon as possible.
3. Procedures to preserve evidence at the accident site.
4. Notify the investigator immediately.
The investigator should arrive at the scene prepared with procedure
checklist, pen, paper, camera, tape and proper clothing.
GATHER FACTS:
(
When you,go to the acciden't scene, expect to go to work, follow
your pre-plan. Evaluate what you see as you approach the accident
site. Look. around to locate things and people, glance at scat.tered
debris. If nobody's in charge, take charge until someone can.take
over. Medical attention comes first, then evaluate how large the
area is. It. really helps when you are organized and going. in the
right direction. Pick-up debris evidence that might be swept up
later, get phone numbers of witnesses and call.them later.whenyou
have the time, take photos from all angles, make sketches and take
measurements. After you leave the accident site, examine records,
procedures, etc. Talk to all the witnesses. If you are organized
and follow the pre-plan, you will gather a lot of fact information.
ANALYZING THE FACTS:
You have already mentally weighed the facts as you covered them,
weigh all witness statements for credibility and how they support
the evidence. Include analysis of all facts gathered, including
management and supervision procedures. As you analyze the facts,
search for more facts and contributing factors. DOCUMENT
EVERYTHING. This will help to get the big picture.
CONCLUSIONS:
start to reach conclusions about what happened and what caused the
accident. Write a statement on conclusions then turn back to
analysis.
ANALYSIS:
('
{
This step was ongoing up to now and has not really stopped~ Next,
get any additional information that you might need and analyze it
or discard it. '
17
THE REPORT:
This is where you put it together. You gathered information from
the beginning to the end. You've analyzed it and reached
conclusions. start by just briefly telling what .happened in
narrative style, such as:
"On September 20, 1990, at 8:15 a.m., in the public .works
yard, a hydraulic 10-ton jack was removing the dual rear
wheels. The mechanic was seriously injured".
When you tell the story leave out. information that will not
contribute to your conclusions. Make recommendations that are
supported in the report. You report needs to be clear and concise.
The reader must .understand what happened. Do not include anything
that is not needed. Pictures and diagrams must contribute meaning
to the report, if not, leave them out.
RECOMMENDATIONS:
(
The investigation is not done when the conclusions are made as to
the causes of the accident . Corrective action must be taken.
Specific recommendations are needed for each cause factor or
situation. This way management can easily determine who's
responsibility it is to take corrective action. The best way,' is
to hold one person accountable for correction. On most accidents,
you should have many specific recommendations for corrective action
to straighten out the problems.
CORRECT:
The conditions and causal factors that allowed the accident to
occur is the action step of investigation. Someone should demand
corrective action to keep this accident from happening again.
Accountability of action is in order. Sometimes corrective action
is not easy to carry out. But if each recommendation is clear, you
can take action to check up on each one of them.
FOLLOW. THROUGH:
Do not. stop. Keep checking and following upon the corrective
action to see if the recommendation.was corrected or implemented.
If it,is corrected, your investigation is still not finished.
CRITIOUE:
In investigations, just like accidents, usually a lot of things are
found wrong. Things can be found wrong with the way the
18
investigation went, such as initial planning, gathering facts and
analyzing them. In emergencies, these alwaysshowup....maybe you
had a wrong phone number of a key witness. Now is a good time to
critique the investigation process and take action so the same
things do not happen again.
DOUBLE CHECK:
Nothing seems to get done the way it is supposed to and a double
check is needed to assure every item that specif:.c people were
responsible for and said they were going to do, actually was done.
The same goes fer your critique step. Frequently f a triple cl1ec):
or follow-up is needed to actually get things done.
SUMMARY:
Many accidents do not justify a very extensive investigation. But
you still must investigate if you want maximum accident prevention
benefit. By following these steps you will do the investigation as
thoroughly as possible.
(
(
19
EMPLOYER LEVEL INVESTIGATION
Investigate when an injury appears to be questionable, two or more
employees are involved or there is a possible third party. This
could include:
1.
2,
3.
4.
5.
6.
7.
8.
( ~.
10.
11.
12.
13.
Monday morning injuries
Off-premise injuries
Injuries whicl1 are reported late
Injuries with unauthorized treatment
Injuries where there is a dispute as to the time, place and
manner in which the accident occurred
Automobile accidents, generally
Special errand injuries
Injuries <which occur en route toa second job site
Injuries which occur while an employee is driving his own car
Injuries which occur while an employee is driving to or from
work.
Injuries which occur while an employee is driving a vehicle.
Injuries without witnesses
Injuries which are reported by very new or short term
employees
14. Injuries whIch are reported by employees who have several
prior claims.
15. Injuries which fall under the five statutory defenses of:
1. INTOXICATION
2. SELF-INFLICTED INJURY
3. INITIAL PHYSICAL AGGRESSOR
4. OFF-DUTY RECREATIONAL ACTIVITY
5. SUICIDE
Make inquiries to supervisors. If appropriate talk to witness and
witnesses and fellow employees. Ask around for information.
20
CHAPTER VII
AUTOMOTIVE ACCIDENTS
AUTOMOTIVE ACCIDENT PROCEDURES
Every employee driving, in control of, or responsible for any city-
owned motor vehicle involved in an accident (NO MATTER HOW SLIGHT),
must do the following:
1. Notify the Police Department to respond and make an accident
report. They will be responsible for photographing involved
vehicles.
2. Notify your supervisor.
21
EXHIBIT F
AIC NO#
ACCIDENT INVESTIGATION COMMITTEE
DATE:
DATE OF ACCIDENT:
TIME OF ACCIDENT:
LOCATION:
EMPLOYEE:
ACCOUNT NUMBER:
DAMAGE:
VEHICLE:
SPECIAL REPORTS:
c
COMMITTEE:
PURPOSE OF INVESTIGATION:
Review all aspects of incident.
Report all findings and recommendations to the city Ad-
ministrator.
AGENDA:
1.
2.
3.
4.
Primary cause of accident.
Is accident chargeable?
will disciplinary action be recommended?
Prevention of future accidents.
\RISKMGT\AICMTG\SS
~.
ACCIDENT INVESTIGATION COMMITTEE
FINDINGS AND RECOMMENDATIONS
DATE:
DATE OF ACCIDENT:
TIME:
EMPLOYEE:
COMMITTEE:
EXHIEIT G
AIC #
., Risk Manager
In reviewing the incident with the Accident Investigation
committee, the following is submitted for your review:
PRIMARY CAUSE OF ACCIDENT:
(
ACCIDENT CHARG~&BLE:
DISCIPLINARY ACTION:
PREVENTION OF FUTURE INCIDENTS:
\RISKMGT\AICFNDS\SS
(
Respectfully submitted,
Risk Manager
CHAPTER VIII
SAFETY AND HEALTH ENFORCEMENT
SAFETY AND HEALTH WORK PRACTICES ENFORCEMENT
Safety and health work practices enforcement has as its goal the
elimination of on-the-job injuries due to equipment, materials,
Ir,ethods usec1,safety clev.:..ces, and acts of individual employees. To
accomplish this goal, the department head and supervisor must make
the employee conscious of the importance of safety to the employee,
fellow employees, and City property.
1. The Risk Manager will provide a workers' compensation loss
analysis to each department head on a monthly basis. The
department head will review the report and take whatever steps
appropriate to curtail or eliminate workers' compensation
injuries.
(
2. In the event of a work related injury, the employee will sign
the Supervisor's Report of Accident/Exposure acknowledging 'the
fact that he/she has read the report andagreesjdisagrees with
its content. Supervisor will counsel employee on ways the
injuryjaccident could have been prevented.
3. Inj,uryjaccident repeaters are employees who have had two or
more on-the-job injuries within the preceding six months.
Safety counseling will be conducted by the department head to
discuss corrective action which may include:
a. a verbal reprimand
b. a letter of reprimand to the employee, a copy of which will
be placed in his/her personnel file.
c. suspension
d. termination
All recommended corrective action will be approved by the City
Administrator and City Council.
22
CHAPTER IX
OPERATIONS IN THE PUBLIC WAY
TRAFFIC CONTROLS/BARRICADES
Whenever operations are taking place in streets, parkways,
sidewalks or other places where citizens as well as employees may
be endangered, the supervisor or crew leader on the work site is as
responsible for the safety of the public in this type of operation
as he is for getting the job done. He must spend ample, time
before, during and after the work to protect employees and the
public from the hazards created by this work. The following
procedures are to be.followed:
1. If street work is to be done, preparations will be made for
traffic and pedestrian safety before work actually begins.
2.
If traffic is affected by the operation, proper signage will
be used to warn in advance of work area (construction ahead)
and,traffic control signs in and around the work area will be
properly placed and maintained through the period when work or
traffic obstructions exist.
(
3. Signage will be in accordance with the "state of California
Department of Transportation Traffic Manual" and departmental
policy.
4. Where barricades and signs are used overnight, supervisors
will examine work area for proper placement at the end of the
workday before leaving.
5. Lighted barrica.des or reflectorized cones will be used
for overnight protection.
6. Where traffic must be periodically stopped or obstructed by
workers or equipment in the traveled portion of the roadway,
a flagman with protective vest will be used.
7. All workers in or near the roadway will wear reflective vests
or while at the work site, department issued uniforms.
8. Flagmen will be used to slow or direct traffic where approach
to work area does not provide adequate visibility by drivers.
9. Assistance in setting up signage or barricading is available
at any time from the Community service Department.
23
10. All plates used to cover holes in the street on a temporary
basis will be spiked in place.
11. In any case where streets are significantly obstructed or
closed for any period of time, the Police and Fire Departments
will be notified of the situation and approximately how long
the closure will be in effect.
PEDESTRIAN SAFETY
1. When pedestrian traffic is impeded by city operations,
barricades, restrictive tape or ~ope, or other restraint will
be used to protect the public from the work.
2. If pedestrian traffic must be routed into the street,
protection from traffic will be provided by cones, barricades
and signs, if necessary.
3. Holes in the sidewalk or parkway which must be left open will
be covered, whenever possible, along with perimeter
protection. Every possible means of preventing accidental
entry into the hole should be used.
4: .
Where an unusual situation exists that cannot be easily
resolved, or when personal injury or damage to equipment or
property occurs as a result of operations, contact the
Supervisor immeciiately.
(
24
CHAPTER X
SAFEl'Y 'l'RAINING
Each department has the responsibility of providing on-the-job
training to each employee on the topics that will permit the
employee to do his job safely and efficiently. This training shall
include:
- Orientation to departmental and City-wide safety and
work rules.
- Procedures for reporting on-the-job injuries
- Workers' Compensation process
- City requirements for use of vehicles
(-
- Reporting of Unsafe, Conditions
In addition, specialized training must be offered in the use of
tools and equipment in order to maximize the capabilities of the
equipment as well as to prolong its usable life and to prevent
accidents.
Every employee is expected to request instruction in those tasks or
pieces of equipment with which they are not familiar.
JOB SAFETY ANALYSIS (JSA)
A Job Safety Analysis is a structured outline used to train and
review procedures in a manner that highlights the key points and
hazards in each task. It is recommended that the Job Safety
Analysis be prepared for each special function where many people
are trained regularly to do the job and where serious injury
potential exist.
JOB SAFETY ANALYSIS (JSA)
JOB INSTRUCTION TRAINING (JITl
A. Definitions:
1. Job Safety Analvsis: A procedure that identifies hazards
or potential accidents in each step of a job, and develops
solutions that will even eliminate or guard against
hazards.
25
2. Job Instruction.Training: A technique for on-the-job
instructors when teaching a person how to perfor~ a
particular task.
B. Job Safety Analysis Procedure
1. Select the job to be analyzed
Priority for selection
a. Frequency of injuries
b. Potential for severe injury
c. Newly established jobs
d. Jobs where changes have been made
2. Break down the job
a. List steps in sequence
b. Not too detailed
c. Not too general
(
d. Technique of making a JSA
(1). Select the right man to observe
(2). Brief him on the purpose
(3). Observe him performing the job
(4). Record each step in the breakdown
(5). Check the breakdown with the operator
3. Identify hazards and potential accidents
a. Environmental hazards (mist, fume, dust, etc.)
b. Potential accidents (slip, trip, stain, etc.)
4. Develop solutions to eliminate hazards
a. Change existing conditions
b. Find a new way to do the job
c. Different tools, materials, equipment or location
(
26
5. The JSA should be developed by the operator and the
supervisor
C. Job Instruction Training Procedure
1. Planning the training
a. Inventory present skills
b. Analyze the need for training
2. How to instruct - the four-step method (JIT)
a. Prepare the worker
(1). Put him at ease
(2). Define the job
(3). Place in correct position
b. Present the operation
(1). One step at a time
(
(2). Tell and show each step
(3). stress each key point
c. Tryout performance
(1). Have him perform the task
(2). Have him explain each key point
(3). Make sure he understands
d. Follow-up
(1). Put him on his own
(2). Designate to whom he goes for help
(3). Check frequently
(4). Encourage questions
27
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EXHIBIT I
CHAPTER XI
SAFETY REGULATIONS
PRINCJPAL CAUS$S OF ACCIDENTS
We can eliminate unsafe actions and conditions, and thereby
decrease the possibility of accidents, by gaining a better
understanding of the common causes of accidents. The following
list represents the ten principal causes of accidents:
Improper lifting
Material handling
Slips and falls
Falling or flying objects
Bumping into stationary objects
Improper tools or equipment
Failure to use protective equipment
Failure to observe rules and instructions
Improper work procedure
Poor housekeeping
GENERAL SAFETY RULES
(
1.
4- .
(
Fighting, horseplay and practical joking is prohibited.
No work shall be started in any unit, or any equipment,
without the knowledge and consent of supervisor assigned.
An employee shall immediately report any unsafe conditions or
practices to his supervisor.
5.
All injuries occurring on the job, no matter how slight, must
be reported to the supervisor immediately.
Running except for emergency purposes is prohibited
6.
Obey all warning signs; they are for your protection.
Keep working areas clean and in an orderly condition.
Equipment and material will be neatly arranged.
7.
8.
Be constantly on the alert for unsafe conditions and report
such conditions to your supervisor.
9.
Place air lines, cords, water hose, etc., so as to avoid
tripping hazards.
10.
Keep clear of suspended or swinging loads.
28
11. When carrying or handling material with others, make sure you
understand each other to avoid injury that might be caused by
unexpected shifting or dropping without warning.
OFFICE SAFETY
1.
desk
as
Good
3. Be extra cautious when you come up to a door that can be
pushed toward you. Take 'it easy when pushing one open and
slow down when coming to a blind corner.
4. Haste when walking between desks results in.bruises and falls.
watch out for electrical and telephone cords and keep them out
of aisleways. Electrical and telephone cords should not be
under plastic floor mats.
5. All file, desk and table drawers shall .be kept closed when not
in use. As soon as you leave them, close them. Never open
more than one file drawer at a time.
c
6.
Overloading the top drawer or opening two drawers at the same
time of unsecured file cabinets has caused many an injury and
damage. If unfamiliar with the file cabinet, test the drawers
and be careful not to pull them out too far if there is no
locking device on them.
7. Furniture such as tables, desks and chairs must be maintained
in good condition and free from sharp corners, projecting
edges, wobbly legs, etc.
8. Tilting chairs can be a hazard when improperly used and care
should be taken to assure that they are in good condition.
Learn the limits. Be sure your chair is behind you before you
sit down.
9. Never use chairs, desks or other office furniture as a
makeshift ladder. Use a step ladder. Don't overreach and
lose your balance.
10. Message spindles are a frequent source of puncture wounds to
hands and other parts of the body. When used, thepoint shall
be protected by a suitable blunt cover, or preferably, the
point should be bent a horizontal angle.
11. Keep the blades of paper cutter closed when not in use.
29
12. Pencils are safest when carried point, down in pockets..
13. Scissors, paper cutters, glass and razor blades can cause
painful injuries. Report such injuries at once and take
precautions from infection.
14. Keep your hands clear of electric typewriter carriages while
they are in motion~
15. Paper can cut and it hurts. Use a sponge or other wetting
device for envelopes. Use rubber finger guards when working
with stacks of paper.
16. Keep paper clips, thumb tacks, and pins in a place where they
can't injure you. Keep razor blades or ex acto blades covered.
Even a little scratch can get infected.
17. Be sure equipment is grounded and the cord is in good
condition. If a machine gives you a shock or starts
smoking, unpluq it and report it.
18. The City of,Vernon maintains a non-smoking policy in the work
environment.
:9. Hot plates are not permitted.
(
CLOTHING AIm SAFETY EOUIPMENT
Employees shall dress suitably for the work in which they are
engaged. Wearing apparel that may contribute to injury or
disability shall not be worn.
2. Employees shall not work with bare head, bare arms, or exposed
body parts in areas where they may be exposed to burns from
corrosives, hot substances or hot equipment.
3. Minimum requirements for work shoes are sUbstantially
constructed shoes. The wearing of moccasins, tennis shoes,
house slippers, thongs, etc. will not be permitted. Work
boots are mandatory where foot hazards are apparent.
4. certain working conditions and areas require the use of
protective equipment, such as respirators, gas masks, face
shields, goggles, etc. An employee so engaged shall use such
protective devices and special wearing apparel as may be
required.
5. Employees must be familiar with all protective devices and
wearing apparel that they may be required to use. They shall
make certain that such equipment is in good condition and
adequate before ,it is used.
30
6. The proper type of goggles and face protection shall be used
by employees while performing any of the following duties:
a. operating pneumatic tools.
b. Using a hammer or other tools to .strike metals.
c. using wire brushes or other tools to remove scale, rust,
paint, cinder, dust, etc.
d. Using a grinding, polishing or burnishing wheel.
e. Sandblasting, paint spraying or power sanding.
f. Handling acids, hot liquids, caustics, or other corrosive
substances.
g. Working around machinery or equipment where loose
particles will endanger the eyes.
h. Welding and cutting.
c
Contact lenses present a hazard to employees working where
chemicals, acids, solvents or any foreign particle enters the
eye. An employee who wears contact lenses in areas where
these hazards exist is required to wear goggles.
8 . 1'.11 employees using hazardous chemicals, etc. must be familiar
with location and use of eye wash equipment.
I .
TOOLS 'AND EOUIPMENT
l. Tools shall be kept in good condition and free from grease.
2 . Tools shall not be thrown, dropped, laid on. moving machinery,
or left lying around when not in use.
3. Use the proper tool for the job.
4. When tools'break, wear out or otherwise become dangerous to
use, they will be replaced.
5. Keep impact tools free from mushroomed heads.
6. Power machinery and power tools shall be operated only.by
employees who are properly trained and assigned such duties.
7. All machinery and power tools shall be operated within .their
respective load and speed limits.
8. Power $hall not be turned off or on without proper warning and
31
caution to see that no person is exposed to danger.
-.
9. Noemploy~e will ride a load or the blocks of any hoisting
device.
~O. Machinery suards shall be in place and properly adjusted
before and ,while machinery is in, motion. Missing or defective
guards shall be reported immediately.
11. Machinery shall not be cleaned, adjusted or repaired, .while in
motion.
12. Machinery and power tools shall be prcperlygrounded.
MATERIAL HANDLING
1. Do not try to lift objects that are bulky or too heavy to lift
comfortably; secure help.
2. Use the following technique to lift:
a. Get a firm footing.
(
b. Bend at the knees to grasp the object.
c. Keep the back straight and as nearly upright as possible.
d. Get a firm hold on the object.
e. Lift gradually by straightening the legs, keeping the back
straight and upright.
f. Similar safe procedures will be followed when putting a
load down.
3. Use power assist equipment where possible when material must
be moved.
4. store material in such a manner ,as to prevent collapsing or
tipping.
5. Loads on forklifts, trucks, etc., shall be stable to'prevent
skips, slides, or tip overs.
6. Material will not be stored on top of lockers.
7. Use proper tools when opening boxes, barrels or other
containers.
32
ELECTRICAL
1. Electrical work and repairs will be done by trained employees
only.
2. Electric cords will not be spliced.
3. Circuits shall not be overloaded.
4. Fuses shall not be wired across, plugged, or replaced with
higher amperage fuses.
5. Electrical equipment or lights shall not be altered except by
authorized personnel.
6. All electrical equipment shall be properly grounded.
7. No material or equipment will be stored or- placed within 30
inches of any electric panel or controller.
HOUSEKEEPING
1-
( 2.
'.
3.
4.
5.
6.
7.
Good housekeeping is essential for efficient operation and
prevention of accidents.
All areas will.be marked and kept clean and free fr011l trash
and accuffiulatio~ of waste materials.
Trash receptacles will be used and emptied regularly.
Scrap metal will be placed in separate but appropriate
containers.
Oil-soaked rags will be kept in containers with tight-
fitting lids.
Containers wIll be labeled as to what they contain.
Floors, working areas, and platforms shall be kept free
of dangerous "proj ections or obstructions and shall be
maintained,in<goodrepair and reasonably free from oil.
8. Proper cleaning material and methods shall be used for the
task.
9. Gasoline or other,volatile liquids shall not be used,for
Cleaning purposes.
AUTOMOTIVE
1. Movement of various pieces of mobile equipment and vehicles
33
1.
2 .
( "')
.... .
~
~ .
~ .
7 .
8.
in and around shop areas require adherence to all motor
traffic regulations.
2. All traffic signs, signals, speed limits, and road markings
shall be obeyed.
3. Seat belts, where provided, will be worn at all times when
riding in or operating any vehicle.
4. Operators of motor vehicles will have a current operator's
permit in their possession for the vehicle being driven. This
does not apply to a mechanic who must move a vehicle to and
from parking areas to repair bays. However, supervisors will
insure that the mechanic is qualified to operate the vehicles.
5. courtesy and consideration is expected of all employees while
operating motor vehicles.
PORTABLE LADDERS AND WORK PLATFORMS
Inspect all ladders and work platforms before using them.
Report any defects to your supervisor immediately.
Makeshift ladders or work platforms will not be used.
When necessary to work overhead, use a ladder or work platform
of sufficieu~ leng~h or height to be able to reach your work.
Work platforms of 30 inches or higher will be provided with
hand and guardrails.
Metal ladders will not be used for electrical work.
Metal ladders will be labeled with a warning, "Do Not Use For
Electric Work."
Never use a ladder without safety feet suitable for the floor
or ground it s-::.ands on. Exception: Stepladders.
Ladders shall be placed so that the base is placed from
the wall or object 1/4 of the vertical distance from the
bottom to the top support of the ladder.
9. Never place a ladder on another object such as a barrel or box
to gain added height.
10. Tie or secure the ladder at the top where possible, and
either tie or brace it at the bottom.
11. Be sure your shoes are not greasy, or otherwise slippery
before you climb a ladder or work platform. When climbing or
descending, face the ladder and use both hands. Do not reach
34
out more tr-an an arm's length from a ladder.
{,
(
12. Never work from the top rung of ladder.
PNEUMATIC TOOLS AND LINES
1. Use of compressed air on or about your body or the body of any
person is ,forbidden.
2. Use of compressed air or gases for blowing dust or chips from
your body, clothing or work area is prohibited.
3. Attach air hoses only to compressed air lines.
4. Hoses shall be kept neatly coiled, when not in use, to prevent
tripping hazards.
5. Turn off valves on airlines and tools when not in use.
6. Wear eye protection when using pneumatic tools and when
cracking or opening valves.
(
Frequent inspections will be made of all air lines' and their
connectors to insure that they can withstand the pressure.
Defective air lines and connectors \<!ill be removed from
service'.
~ . Wear ear protection vlhen required.
BURNING AND WELDING
Oxy-Acetylene Equipment
a. only authorized and properly trained personnel will be
permitted to .install or remove special fittings on oxygen
and acetylene cylinders.
b. Oxy-acetylene equipment shall be used only by authorized
employees.
c. Extreme caution shall be observed when handling oxygen and
acetylene cylinders.
d. Safety caps will be securely in place on all compressed
gas cylinders when not in use.
e. Gas cylinders shall not be moved by means of magnets or
slings.
f. Gas cylinders shall be used or stored in a vertical
position and securely fastened to prevent them from
35
(
tipping over or falling.
g. oxygen and acetylene cylinders will be stored at least 20
feet apart. '
oxygen (and (' acetylene cylindersiwilll1ot;.'beYstored>where
they are subjected to unusual heat sources or oil and
grease.
i. Empty cylinders shall be returned to their proper storage
area.
j. Cylinders and personnel shall be protected from sparks and
slag.
k. When burning or welding, make sure that sparks and flames
will not start a fire in nearby material.
l. Excess hose lengths will be coiled or arranged to prevent
tripping hazards.
m. When working overhead, enough hose will.be.usedso,that
cylinders may be kept on the ground or other<secure
location.
c
n. Welders will wear eye, face, hand,respiratory,.' foot and
body protection as required.
o. Welding will not be done in confined spaces without
adequate ventilation or an approved type respirator.
2. Electric Welding
a. Welding will not be done without a shield fitted with
filter glass of the proper shade.
b. Never look at a welding arc with the naked eye.
c. Welding screens or shields shall be set up between. welders
and other employees.
d. Eye protection shall be worn when chipping, scaling,
peening.
e. Material to be welded and all components including the
welding machine will be adequately grounded to a common
grounding system.
f. The safety ground attached to the welding machine or
transformer will be connected to "ground" before
equipment is energized.
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(:
CHEMICALS
1. Extreme care shall be exercised by all personnel handling or
working with acids, caustics, solvents, petroleum products, or
chlorine.
2. In mixing acid and water, always pour the acid into the water
slowly. Never pour the water into ,the acid.
3. Handle tools carefully while working around acid or other
chemicals to avoid dropping them where they may cause a
splash.
4. After tools have been used near corrosive chemicals, clean
them thoroughly by neutralizing with lime baking soda.
5. Wear protecti vegoggles, respiratory equipment ,andprotective
clothing when the inhalation of fumes or hazardous substances
or injurious bodily contact with acids or other corrosive
materials may,occur.
6. Wash out eyes with large quantities of clean water immediately
if chemicals splash intcthem, and report to a, doctor or
emergency room'immediately.
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.,
I .
All spilled acids or caustics shall be cleaned up immediately.
Spilled acid shall not be mopped up with organic materials
such as sawdust, waste, or cloth. Use neutralizing agents
such as lime or baking soda, then wash down with water
following cleanup.
8. Containers of, injurious chemicals or hazardous substances
shall be plainly labeled, indicating hazards and precautionary
measures to be observed.
9. Only authorized personnel shall use pesticides, herbicides,
fungicides, or any agricultural chemicals having critical
toxicity.
10. Rules stating the proper safety equipment required will be
posted at the storage area of chemicals , hazardous substances,
pesticides, and herbicides.
EXCAVATIONS. STREET REPAIRS. SUB-SURFACE OPERATIONS. AND CC~FINED
SPACES
1. The foreman or person in charge of an excavation to a depth of
five (5) feet or more shall see that it is effectively shored
and guarded in accordance with the State Construction Safety
Orders.
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2. Excavated material shall be kept at least one (1) foot-from
excavations of less than five (5) feet in depth and. two (2)
feet from the edge of deeper excavations.
3. The foreman or person in charge of an excavation toa depth of
five (5) feet or more shall provide a sturdy ladder for
access. The ladder shall be placed within twenty-five (25)
feet of the working area.
4. The foreman in charge, of an excavation shall see that there is
no work done which could cause the undermining of foundations.,
retaining walls, or other structures until adequate. safety
measures have been taken.
5. Excavating machinery shall be kept away from electrical, gas,
and waterlines.... Where excavation is necessary, the operator
of 'the equipment shall first determine the location of
electrical, gas and water lines that may be in the area. of
excavation, and a qualified observer must be present to guide
the operation.
6. Only one man should direct the operation of excavating
machinery.
7.
All persons working around excavating machinery shall be in a
safe,position so as not to be in danger of falling into or
otherwise ,contacting the machinery.
8. The foreman or leadmanshall make tests in all closed
compartments, manholes, storm drains, tanks, voids, and other
confined spaces for oxygen deficiency, explosive gases, ~nd
other dangerous gases which may be present. Employeesshall
not enter such areas until the foreman or leadman has issued
an "all clear".' This must be done at each time of entry or
re-entry.
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9. Smoking or open flames are prohibited in or about open
manholes or sewers. "No Smoking", "No Open Flames" signs
shall b,e. posted.
10. Hard hats shall be worn at all times by workers in or around
excavations, trenches, tunnels, sewers, or other sub-surface
operations.
FIRE PREVENTJON
1. Prevention of fire is a responsibility shared by all,
regardless of the type of job.
2.
Whenever you suspect or detect a fire, the Fire Department
shall be notified. Use of telephone, Vernon communication
Center Ext. 351 or 800 and 911 from an outside telephone also
38
(
by Radio. Calmly report location an extent of the fire. In,
addition, priority must be given to the safe evacuation of
personnel from the affected area.
3. If you have followed the preceding procedures and have been
trained in the use of available First Aid Portable Fire
Extinguishers, you are encouraged to attempt to suppress a
small fire in the incipient stage.
4. If you have the ., slightest doubt whether or not to fight the
fire--OON'T--instead, GET OUT, closing the door behind you.
Remember, NEVER, jeopardize your safety o,r ,the safety of those
around you by attempting to put out afire.
5. Flammable liquids shall be stored or handled in approved
hazardous locations, cabinets and safety containers only.
6. Keep all flammable liquids or other hazardous materials away
from open flames and other sources of ignition.
7 . Practice good housekeeping . without fuel, a f ire cannot exist.
8.
Remove, shield or cover combustible equipment or material that
will be within the range of any activity where open flame,
sparks or hot metal is produced, i.e., welding, torches, etc.
A fire extinguisher will be available where such work is
perfonr.ed.
(
,...
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Fire fighting equipment shall not be blocked and will be
easily accessible.
10. Fires are classified according to A,B,C. (Refer to Exhibit )
39
EXHIBIT
Labels o.n extinguishers indicate the class and relative size o.f the fire that they can be expected
to. handle. -
m~
CLASS A EXTINGUISHERS: Ordinary co.mbustibles. Wo.od, clo.th"paper, rubber, many
plastics, and o.therco.mmo.n materials that burn easily.
rn .El
CLASS B EXTINGUISHERS: Rammable liquids. Gaso.line and other flammable liquids, oil,
grease, tar, o.il-based paint, lacquer and flammable gas.
fm@
CLASS C EXTINGUISHERS: Electrical equipment. Energized electrical equipment,
including \\'iring, fuse boxes, circuit breakers, machinery and
appliances.
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Befol"'e E=ightrng a Fil'E
· No.tify Fire Department:
Ext. 351 or 800. Fran outside phone, 911
· Evacuate Cast Members and Guests fro.m the affected area.
· Stay lo.w. Pro.tect yo.urself. Avo.id breathing the heated smoke and fumes o.r the
extinguishing agent.
· Never fight ,a fire if the fire is spreading beyo.nd the immediate area; if the fire co.uld
blo.ck yo.ur escape ro.ute; if you are unsure o.f the pro.per o.peratio.n o.f the
extinguisher; Dr if yo.u are in do.ubt if the extinguisher is designed fo.r the type o.f fire
at hand.
However, if yo.u do. fight the fir,e with a po.rtable fire
extinguisher, remember:
· Pull the pin
· Aim lo.w
· Squeeze the handle
· Sweep fro.m side to. side
lJp '~'.....~.',,'...^/ ,~...... ..,
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,,/41 ~
P-A-S-S
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CHAPTER,XII
HAZARDOUS MATERIALS
CONTINGENCY PLANS
Emergency response plans and procedures are developed for use in
the event of a release or. threatened release of hazardous ma.ter,ial.
The state of California Office of Emergency Services.. (OES)
regulations specify that the contingency plan should be ,.scaled
appropriately for the size and nature of the business, the nature
of damage potential of the hazardous materials handled and the
proximity of the business to residential areas and other
populations. These plans must include the following items:
1. Reportinq and Notification:
a. In the event of a spill, release or threatened release,
regardless of size, involving a hazardous material, the
event will be reported immediately to emergency telephone
#911.
b. Dispatch 911 will notify the Fire Department, police
Department and other relevant departments.
(
Mitiq~tion:
a. Coincident ' with, reporting, emergency response team members
will immediately commence cleanup and necessary action ,to
mitigate the release in accordance with their instructions
and the written procedures. A copy of these procedures is
attached to this contingency plan.
...
oJ .
Evacuation:
a. Should it become necessary to evacuate the facility, the
order will be given via Police and Fire Department
loudspeakers on vehicles.
b. Upon receiving the order to evacuate, employees will shut
down their machines and immediately proceed to the nearest
exit as directed.
c. All employees will report to their supervisors at a
designated location.
4. Emerqencv Response Assistance:
c,
a. The members of the emergency response team will stand by
to assist the emergency response agency and,offer.the
benefit of their special knowledge of the facility and its
40
contents.
b. The following employees will stand by to offer technical
advice to the emergency response agency personnel if
necessary:
1. All Department Heads
2. All Supervisors
5. Medical Assistance:
a. All employees affected by exposure to the hazardous
materials released during the spill or release should be
transported to the White Memorial Hospital, which is the
most appropriate facility for treatment of chemical-
related injuries. A copy of the appropriate Material
Safety Data Sheet should accompany the affected persons to
the hospital.
TRAINING PLANS
(
The training plan will provide safety procedures in handling
hazardous materials and in the event of a release or threatened
release of a hazardous material. The "training will be done
initially for present employees, for all new employees and
refreshed at least annually thereafter. The training will take
into consideration the position of the employee in terms of job
assignment and responsibility during a hazardous materials
incident.
The training program will be reasonable and appropriate for the
size of the operation and the quantity and nature of hazardous
materials handled. At a minimum, the training will include:
-Methods of safe handling of hazardous.materials;
-Procedures for coordination with local emergency response
organization;
-Use of emergency response equipment and supplies under
control of the handler; ,and
-The City'S contingency plan andpracedures.
The contingency plan will document the content of the training
program and ensure that the appropriate personnel receive initial
and refresher training.
SUPERVISOR GUIDELINES:
1. Be sure that the training program is consistent with the
extent of the hazards present in the ,business and the types of
events anticipated.
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2. The required training in, safe handling ,of hazardousmateria,].f; .
will be/incorporated into the OSHA Hazard Communication'
Program.
3. The training will be consistent with each employee's
responsibility. Therefore, considerable training will be
afforded to a number .of the city's emergency response team,
while an 'employee whose ,responsibility is limited to knowing
when and how to evacuate will, receive only minimal training.
4. A procedure for documenting that both initial and refresher
training has been done will be included as part of the
training plan and provisions to preserve these records
established.
5. Duetoithe,overlap in the OSHA hazard communication training
and emergency'response'training, both types of training will
be handled together possibly using MSDS to. illustrate
emergency response procedures for particularly hazardous
materials. This approach is especially appropriate for
required ,.' new employee training in both these areas.
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EXHIBITK
HAZA1U>COMMUNICATIONPROGRAM
CITY NAME:
ADDRESS:
1. PERSON RESPONSIBLE FOR THE HAZARD COMMUNICATION PROGRAM:
2. INVENTORY OF HAZARDOUS SUBSTANCES IS ATTACHED AND ALSO
LOCATED:
3. MATERIAL SAFETY DATA SHEETS (MSDSs) FOR ALL HAZARDOUS
SUBSTANCES ARE LOCATED AT:
AND A COpy OF THE HAZARD COMMUNICATION STANDARD AND CITY
PROGRAM ARE KEPT WITH THE MSDSs.
4. EMPLOYEES MAY REVIEW MSDSs AND THE STANDARD BY FOLLOWING THIS
PROCEDURE:
MSDSsNOT,ON HAND REQUESTED BY EMPLOYEES WILL BE REQUESTED OF
SUPPLIERS WITHIN 7 DAYS BY LETTER.
(
THE MSDS FI~E IS UPDATED WITH NEW INFORMATION AND NEW HAZARDS
IDENTIFIED BY:
ANY NEW HAZARDS WILL BE REPORTED IMMEDIATELY TO
AND AFFECTED ,EMPLOYEES
NOTIFIED WITHIN 30 DAYS.
6. CONTAINERS OF HAZARDOUS MATERIALS ENTERING THE PLANT WILL BE
CHECKED BY
TO ASSURE'THAT THEY ARE PROPERLY LABELED WITH THE CHEMICAL
NAME OF THE 'CONTENTS, THE APPROPRIATE HAZARD WARNING AND THE
NAME AND ADDRESS OF THE SUPPLIER OR MANUFACTURER.
7. IN-PLANT CONTAINERS OF HAZARDOUS MATERIALS WILL BE LABELED
WITH<THECHEMICALNAME AND HAZARD WARNING. EXCEPTIONS MUST
BE APPROVED. BY
THE FOLLOWING EXCEPTIONS HAVE BEEN APPROVED:
8. NON-ROUTINE TASKS INVOLVING HAZARDOUS MATERIALS ARE:
PROCEDURES FOR COMPLYING WITH THE HAZARD COMMUNICATION
STANDARD FOR THESE JOBS ARE THE FOLLOWING:
9. EMPLOYEE TRAINING IS ,.PROVIDED TO ALL EMPLOYEES.. AND .FOR _ALL
EMPLOYEES. THIS TRAINING COVERS THE FOLLOWINGAREA~,:
A. THE BASIC REQUIREMENTS OF THE HAZARD COMMUNICATION
STANDARD AND THEIR RIGHT TO INFORMATION ON CHEMICAL
HAZARDS.
B. OUR CITY' S. PROGRAM TO COMPLY WITH THE < STANDARD, .. AND
PRo.CEDURESTO FOLLOW TO SEETHE STANDARD, COMPANY PROGRAM
AND MSDSs.
C. HOW TO INTERPRET AND USE THE LABELSON,CONTAINERS OF
HAZARDOUS MATERIALS.
D. THE POTENTIAL PHYSICAL HAZARDS AND HEALTH EFFECTS/OF THE
HAZARDOUS SUBSTANCES AND HOW TO USE MSDSs FOR MORE
INFORMATION.
E. HOW TO HANDLE THE HAZARDOUS SUBSTANCES SAFELY AND OTHER
PROTECTIVE MEASURES IN PLACE.
F. WHAT TO DO IN AN EMERGENCY, RELEASE OR OVER-EXPOSURE TO.
THE CHEMICALS.
G. HOW THE PRESENCE OF HAZARDOUS CHEMICALS CAN BE DETECTED IN
THE WORK AREA.
10. THIS TRAINING IS DOCUMENTED IN THE FOLLOWING MANNER:
RECORDS ARE MAINTAINED AT THE.FOLLOWIN~LOCATION:
(-
1i. TRAINING CONCERNING NEW H..~ZARDS (NEW CHEMICALS OR NE""w
INFORMATION ON MSDSs) WILL BE PROVIDED WITHIN 30 DAYS AND
DOCUMENTED.
12. PERIODIC REFRESHER TRAINING WILL BE PROVIDED AND DOCUMENTED AS
FOLLOWS:
13. OUTSIDE EMPLOYEES (SUBCONTRACTORS AND VISITORS) WILL BE
ADVISED OF CHEMICAL HAZARDS IN OUR PLANT IN THE FOLLOWING
MANNER :
CONTRACTORS WILL BE REQUIRED TO. PROVIDE. INFORMATION ON ANY
CHEMICALS USED IN OUR FACILITY AS A CONDITION o.F THEIR
CONTRACT.
OUR CITY RELIES o.NTHE INFORMATION CONTAINED IN MSDSs AS PERMITTED
BY THE OSHA HAZARD COMMUNICATION STANDARD AND DOES NOT PERFORM
INDEPENDENT HAZARD DETERMINATIONS. REVIEWED AND APPROVED:
SUPERVISOR
DATE
(
HAZARDOUS MATERIALS TRAINING PLAN FOR EMPLOYEES
1. All employaeshave been trained in the contents of the
contingency plan and the emergency plans and procedures.
2. All training will be documented by employee signature on a
training session sign up sheet. This record of training will
be maintained by the supervisor.
3. Refresher training will be done on an annual basis and
documented as indicated above.
4. New employees will be trained on both OSHA,Hazard
Communication and Hazardous Material Emergency Response
Procedures prior to working with hazardous substances. This
training will be documented as indicated above and reflected
in the new employee's personnel record.
EIrtergencyteam members will receive special training in
emergency ,response procedures. Incident mitigation and first
aid treatment. This training will be documented as indicated
above.
,5.
6. Employees who handle hazardous materials will be trained in
the safe handling of hazardous materials, procedures to
mitigate releases or threatened releases of hazardous
materials and other appropriate emergency actions. This
training will be documented.
I. Management and other personnel responsible for incident
reporting will receive special training with regard to the
reporting of releases or threatened releases of hazardous
materials. This training will be documented.
Date: Prepared By:
CHAPTER XIII
EMERGENCY PREPAREDNESS
An emergency/disaster plan describes what the employee life safety
hazards are and what actions the employer and employees must take
in a life/injury-threatening emergency.
The City of Vernon's emergency plan will include the following
items:
1. A statement of the City'S emergency/disaster policy, purposes,
authority, responsibility, control measures, and an
organization chart.
2. An evaluation of expected disasters and their risks.
3 . Maps of the City t S facilities showing locations of equipment,
medical supplies, fire equipment, shelters, a command center,
and evacuation routes.
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A list of coope~ating agencies anc how to contact them.
5.
A warning system and the types of signals used.
A communications/command center with the home phone number
and other pertinent information for each employee.
6.
...,
I .
Shutdown procedures and facility security measures.
8.
policies for handling visitors and other non-employees during
the emergency.
9.
Any other item deemed necessary.
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