Accident Prevention Plan

(Shatha Aldahban)

TECH 462 –Industrial Safety Engineering

March 16, 2015

Table of Contents

Introduction

               Goal & Intentions                                                                 Page 5

          Company Presidents Statement                                                        Page 6

Management Responsibilities                             

Manager Responsibilities                                                                  Page 8

Supervisors Responsibilities                                                   Page 8-9

Employee Orientation

How and When                                                                       Page 11

Emergency Action Plan                                                           Page 12-24

Emergency Shutdown Procedures                                           Page 25

Injury and Illness Procedures

Procedures                                                                               Page 27

Record Keeping                                                                       Page 27

Supervisor Responsibilities                                                     Page 28

Report Form                                                                           Page 29

Incident/Accident Investigation Procedures

Procedure Steps                                                                      Page 31

Worksheet Form                                                                     Page 32

Incident/accident Table                                                            Page 33

Safety Guidelines

General Guidelines                                                                  Page 35-36

Equipment Specific                                                                 Page 37

Individual Specific                                                                   Page 38

Safety Disciplinary Policy

Safety Disciplinary Policy                                                       Page 40

Safety Awareness Program

Safety Committee                                                                             Page 42

Safety Meetings                                                                       Page 43

Safety Training Forms                                                             Page 43-44

Safety Award Program                                                            Page 45

Appendix A: Material Safety Data Sheet

(ACETOPHENONE) MSDS                                                   Page 47

(CALCIUM CARBONATE) MSDS                                        Page 48

Appendix B: State and Federal Posters

(Job and Safety It’s the Law)                                                  Page 50

(In Case of Injury at Work)                                                     Page 51

(Fire Safety)                                                                                      Page 52

(Health and Safety at Work)                                                   Page 53

(Speak Up For Safety)                                                             Page 54

(Please Use Your Safety Gear)                                                          Page 55

Appendix C: OSHA Forms and Instructions

OSHA Form Instructions                                                                  Page 57

OSHA Form 300                                                                     Page 58

OSHA Form 300A                                                                  Page 59

OSHA Form 301                                                                     Page 60

          ADDITIONAL FORMS                                                              Page 61-73

Introduction

            SAFETY AND HEALTH POLICY FOR XYZ COMPANY

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

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

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

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

Letter From The President

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

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

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

Signed,

                        The Company President

Management Responsibilities

Responsibilities for safety and health include the establishment and maintenance of an effective communication system among workers, supervisors and management officials.  To this end, all personnel are responsible to assure that their messages are received and understood by the intended receiver.  Specific safety and health responsibilities for company personnel are as follows:

A.     Management Officials

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

B.     Supervisors

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

Employee Orientation

How and When

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

EMERGENCY ACTION PLAN for: XYZ COMPANY

Facility Name: ____________________

Facility Address: ___________________

DATE PREPARED: ___/_____/______

EMERGENCY PERSONNEL NAMES AND PHONE NUMBERS

DESIGNATED RESPONSIBLE OFFICIAL (Highest Ranking Manager at

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

Name: Phone: (________________)

EMERGENCY COORDINATOR:

Name: Phone: (______________)

AREA/FLOOR MONITORS (If applicable):

Area/Floor: Name: Phone: (_______________)

Area/Floor: Name: Phone: (_______________)

ASSISTANTS TO PHYSICALLY CHALLENGED (If applicable):

Name: Phone: (_______________)

Name: Phone: (________________)

Date ____/____/____

EVACUATION ROUTES

• Evacuation route maps have been posted in each work area. The

following information is marked on evacuation maps:

1. Emergency exits

2. Primary and secondary evacuation routes

3. Locations of fire extinguishers

4. Fire alarm pull stations’ location

a. Assembly points

• Site personnel should know at least two evacuation routes.

EMERGENCY PHONE NUMBERS

FIRE DEPARTMENT: ________________

PARAMEDICS: _______________

AMBULANCE: _______________

POLICE: ________________

FEDERAL PROTECTIVE SERVICE: ________________

SECURITY (If applicable): _________________

BUILDING MANAGER (If applicable): ________________

UTILITY COMPANY EMERGENCY CONTACTS

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

ELECTRIC: _____________________

WATER: _______________________

GAS (if applicable): __________________________

TELEPHONE COMPANY: _______________________

Date: ___/____/_____

EMERGENCY REPORTING AND EVACUATION PROCEDURES

Types of emergencies to be reported by site personnel are:

• MEDICAL

• FIRE

• SEVERE WEATHER

• BOMB THREAT

• CHEMICAL SPILL

• STRUCTURE CLIMBING/DESCENDING

• EXTENDED POWER LOSS

• OTHER (specify)___________________________________

MEDICAL EMERGENCY

• Call medical emergency phone number (check applicable):