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POL: 2010 JEFFERSON COUNTY SAFETY MANUAL w JEFFERSON COUNTY CLERK & RECORDER Box H ,..,v BRED IN 5o�tdes. Montana S � �h. AZ"'" ,efi "+' t% �`' .� :;'i-�;;•_ r.`',iii f�i^.L,1,71--,--4.- „.....v:....... . . .- -g I f 1 . itvs,„ _ A, SON COQ i The Jefferson County Safety Manual was revised and adopted t by the Jefferson County Commission on May 25, 2010 e3,<-- -- j-----/ ‘----1-- r • Tomas E. Lythgo hair 166.2_ ( Dave Kirsch 0 //‘1%t Leonard Wortman TABLE OF CONTENTS Page Introduction 2. Statement of Policy 3. Section 1. Jefferson County Employee Safety Responsibilities 4. Safety Orientation, Guidelines, and Employee Responsibilities 5. Section 2. Organization of Safety Committee 6. Safety Committee Membership 7. Section 3. Guidelines for Safety and Incident Prevention 8. Safety Bulletin Board 9. Section 4. Safety Equipment 10 Section 5. Audiometric Testing 11 Section 6. Vehicle Fleet Safety 12. Vehicle Fleet Safety Procedures 14. Minimum Qualification for Operation of Vehicles 15. Employee Actions at Accident Scenes 16. I Section 7. Health Safety and loss Control Inspections 16. Section 8. Record Keeping 18. Occupational Injury and Illness Record Keeping 18. Incident Reporting 20. Reporting Vehicular Collision 20. Reporting Property Damage or Incident/Loss 21. Section 9. Investigations Procedures 22. Incident Investigation Checklist 22. Incidents Involving Defective Equipment 27. Section 10. Lockout/Tagout 28. Appendix "A" 29 Incident Report Form. 30. Appendix "B" 31. Safety Checklist-Building & Grounds 32. Safety Checklist-Office, Special Rooms 33. Safety Checklist-Maintenance Shops 34. Safety Checklist-County Trailers, Cars & Sheds36. Safety Checklist- Solid Waste Building& Grounds 37. Appendix "C" 39. Injury/Illness Reporting Procedure 40. Appendix "D" 42 Emergency Action Evacuation Plan 43. Appendix "E" 45. Labor Workplace Hazard Notification 46. Safety Orientation Form 47. 1. INTRODUCTION An effective safety program, while consisting of many parts, has as its goal the highest level of injury/illness and incident reduction attainable. Our county experiences losses from employee and personal injuries, property damaged by vandalism, theft and fire, damage and injury to the general public and through unsafe operation of our motor vehicle fleets. The Jefferson County Safety Program is designed to establish and maintain a Safety Committee with staff participation to enable the county to provide for the well-being and safety of the employees and residents of Jefferson County. It is fully endorsed and supported by the county Commissioners and the Board of MACo, and it is to be incorporated into the operational procedures of each Jefferson County department and to comply with the current Federal and State Safety and Health Regulations. The county and each of its departments should introduce changes to the program, wherever necessary, to make it compatible with local circumstances. These changes should be coordinated with the county Safety Committee/Safety Coordinator. • 2. SAFETY ORIENTATION, GUIDELINES,AND EMPLOYEE RESPONSIBILITIES Before performing official duties, the employee should be given a safety orientation by the supervisor and/or the Safety Coordinator. The "Safety Orientation Form" (Appendix D) is to be signed by the supervisor and/or Safety Coordinator and employee, and included in the employee's personnel file. Additional safety orientations should be given whenever a particular job involves a new piece of equipment,material or procedure. SAFETY ORIENTATION RECOMMENDATIONS: 1. All county employees should receive a Safety Orientation at the beginning of employment. 2. incident Injury/Illness Reporting Procedure (Appendix "C"): All incidents, no matter how minor, should be reported PROMPTLY to the immediate supervisor(verbal reporting is considered "Notice" given) for evaluation, reporting, and investigation. The evaluation/investigation should determine the possible consequences that could result if the situation is not corrected and the appropriate action based upon those findings should take place. • • MINOR INJURIES (Requiring first aide, doctor visit/outpatient care): After the emergency actions following an incident and proper injury/illness reporting procedures have been followed (Appendix C), an investigation of the incident should be conducted by the immediate supervisor/Safety Coordinator. The findings of the investigation should be documented on the county's Incident Investigation form , filed with the Safety Coordinator, and reported to the Safety Committee for review. • MAJOR INJURIES - (Requiring doctor/hospitalization) - The Board of County Commissioners, and Department Head/Elected Official in charge should be notified immediately. All emergency actions and proper injury/illness and incident reporting procedures should be followed (Appendix "C"). An investigation should be conducted by the proper authority and should be reviewed by the Safety Coordinator/Safety Committee. • FATALITY - or if two or more employees are hospitalized, the Board of County Commissioners, and Dept. Head/Elected Official should be notified and the incident reported immediately to the nearest office of the Department of Labor and Industry,phone 444-6401 and MACo Risk Management, phone 449-4370 (office) within 24 hours after the occurrence of the incident. The report should relate the circumstances, the number of fatalities, and the extent of any injuries. 3. Tour of Facilities and Equipment should be provided by the Safety Coordinator/immediate supervisor. 4. First Aid information should include how to obtain treatment, location of First Aid boxes, and location and names of trained First Aiders. 5. Emergency Action Evacuation Procedure information(Appendix "D") should include `Exit' locations, evacuation routes, and rally points; Fire alarm and use of fire fighting 5. • equipment; specific procedures (medical, chemical, fire, etc) if applicable, emergency notification systems used including Emergency Phone Intercom, reverse 911, or radio or cell phones, and that Incident Command protocol is to be followed during any emergency or evacuation. 4. Potential Hazard information should include a list of potential hazards that may be encountered while working at the facility(sign and date Labor Workplace Hazard Notification Appendix "E", and return to Personnel). 5. The Safety Program should be explained and include the structure and functions of the Employee Safety Committee; duties of the Safety Coordinator;responsibilities of Dept. Heads/Elected Officials; and a discussion of the Safety Policies and Procedures. 6. Personal work habits and responsibilities should include proper lifting techniques; horseplay; good housekeeping; safe work procedure; and no alcohol, drug or smoking policy. a SECTION 2: EMPLOYEES SAFETY COMMITTEE PURPOSE: To provide the mechanism to promote and maintain a safe and healthy working environment for Jefferson County employees, and to protect the public's resources. To evaluate and make recommendations regarding incidents, practices, resources, and issues. To reduce the county's exposure to risk and loss. And to assist the Jefferson County Commission in the administration of the Safety Program. PROCEDURES: The roles and responsibilities of the Safety Committee should be as follows: Action by Action Board of County 1. Coordinate selection of members to the Safety Commissioners Committee. 2. Review and evaluate findings and recommendations. 3. Coordinate with Department Heads as needed to implement committee recommendations. Committee Chair/Safety Coordinator: 1. Prepare Agenda 2. Chairs meetings 3. Report findings and recommendations to appropriate authorities. 4. Appoint subcommittees and task forces as needed Vice-Chairman: 1. Perform duties of Chairman in his/her absence. ` Committee Secretary: 1. Record minutes of the meeting. 2. Receive and file Committee reports. 6. Safety Committee: 1. To meet monthly. 2. Attend meetings, and document all activities including meeting agendas, minutes and recommendations. 3. Review and aid in the coordination of safety activities of all departments within the county. 4. Review all department level safety reports, safety suggestions and comments. 5. Review all incident reports to study causes and determine methods to prevent recurrence. 6. Review and discuss all pertinent safety recommendations submitted by the County Safety Coordinator. Jefferson County Safety Committee Membership: • The Commission will request all Dept. Heads/Elected Officials to encourage and support volunteers from their departments to apply for a position on the Safety Committee. • The Commission will review all applications and select 5-7 members to be appointed to the Safety Committee for the period of one year. Attendance is required. • At the end of one year a Safety Committee member may elect to remain on the committee, or be replaced. Membership will be appointed on a yearly basis. • The Safety Committee rule of order will be informal, with consensus by majority. • The Safety Coordinator will chair the Safety Committee. • An alternate chair (in the event of the chairman's absence) and a secretary will be appointed by the committee members. • The Safety Committee will meet once a month on a scheduled basis. Any member not able to attend should notify the Safety Coordinator in advance for participation via. Telephone conference call. • The Safety Committee should request an alternating Dept. Head/Elected Official and Commissioner to participate in a meeting at least every four months. The county Safety Coordinator should act as the chairperson and advisor to all department level Safety Committee meetings while being an ex-officio member of those meeting. The Safety Coordinator should coordinate the investigation of all personal injury and property loss incidents, annual Safety Committee departmental Safety Inspections, and should make a semi-annual report on the Safety Program status to the Risk Manager of MACo. 7. SAFETY BULLETIN BOARD A safety bulletin board will be provided for the display of Safety Committee activities, safety posters and other safety education material. The safety bulletin board will be maintained at the county Courthouse to provide employees with a centralized location for posting of safety-related information. Employees are encouraged to provide safety material for the safety bulletin board and safety meetings. RECOMMENDATIONS: The following considerations should be made for bulletin boards: 1. Place in a spot where there is greatest employee exposure(entrance hall to the Jefferson County Courthouse). 2. Postings should be arranged in a way to attract attention. 3. Posters, and other information that becomes dated or worn should be changed periodically. 4. A specific safety bulletin board or portion of an existing board should be designated and that spot reserved EXCLUSIVELY for safety material. 5. The Safety Committee/Safety Coordinator is designated to maintain the bulletin board as recommended above. The following items are required to be posted: Citation and Notice(as appropriate) MONTANA 300 Summary(specifically during month of February 8. SECTION 3: GUIDELINES FOR SAFETY AND INCIDENT PREVENTION PURPOSE: To establish guidelines and areas of responsibility for maintaining a safe and healthy work environment. Dept. Head/Elected Official or immediate supervisor should make sure that the employees under his/her supervision are well acquainted with existing safety rules and should see that the rules are uniformly enforced. Safety education and adherence of all safety rules should be promoted by supervisors. Everyone should be constantly on the alert to observe and report unsafe working practices or existing hazardous working conditions with the aim of immediate correction. Employees should: 1. Be informed of and observe established safe practices. 2. Notify supervisors of any unsafe conditions or equipment they discover. In the event any employee believes that his or her safety concerns are not getting reasonably addressed by the supervisor, the employee should report that concern to the Safety Coordinator or any member of the Safety Committee on the Incident Report form (Safety Violation). 3. Use Personal Protective Equipment(PPE) such as hard toed shoes, safety vests, safety glasses, and hard hat where required. 4. Use guards or other protective devices on machinery and equipment. 5. Follow safe behavior practices. 6. Attend any required training or orientation to increase safety awareness. 7. Not report to work under the influence of alcohol or drugs. (Note: the use of any prescription drugs that alter the ability to function safely should be reported to your supervisor). 8. Report all job-related injuries or illnesses to their supervisors promptly. 9. Assist supervisors in their investigation of any incident of which they have knowledge; accident investigation is fact finding, not fault finding. 10. Refrain from smoking in "no smoking" areas. 11. Refrain from operating, modifying, adjusting or using equipment in an unauthorized manner. The county maintains Worker's Compensation Insurance to cover injury/illnesses incurred by county employees when on duty. Liability insurance is carried to cover incidents affecting citizens and visitors if there is negligence by staff or the county. 9. SECTION 4: SAFETY EQUIPMENT PURPOSE: To establish a policy that requires employees to use Personal Protective Equipment (PPE) when performing certain hazardous tasks or when in an unsafe environment. STATEMENT OF POLICY: Protecting our employees by providing a safe work environment is a core safety value of Jefferson County. It is the county's objective that employees use recommended Personal Protective Equipment (PPE) in areas where their use would prevent employee injuries. The use of proper PPE should be determined as conditions warrant and/or ordered to do so by a supervisor. Employees should take necessary precautions, follow proper safety procedures, and use recommended PPE when necessary to avoid exposure to injury or illness to themselves and others. The following are recommended uses for PPE per OSHA General Industry Standards: • Hard Hats - when working in areas where there is a potential for injury to the head from falling objects. (29 CFR 1910.135(a)(1) • Safety Vests or High Visibility Clothing - High visibility is one of the most prominent needs for workers who must perform tasks near moving vehicles or equipment. (23 CFR 634.1) • Protective Footwear - when working in areas where there is a danger of foot injuries due to falling or rolling objects, or objects piercing the sole, and where such employees's feet are exposed to electrical hazards. (1910.136(a) Hand Protection - to use appropriate hand protection when employees' hands are exposed to hazards such as those from skin absorption of harmful substances; severe cuts or lacerations; severe abrasions; punctures; chemical burns; thermal bums; and harmful temperature extremes. (1910.138(a) Eye and Face Protection - use of appropriate eye or face protection when exposed to eye or face hazards from flying particles, molten metal, liquid chemicals, acids or caustic liquids, chemical gases or vapors, or potentially injurious light radiation. (1910.133(a)(2) • Hearing Protection - Protection against the effects of noise exposure shall be provided when employees are exposed to an 8-hour time-weighted average of 85 decibels or greater. (1910.95) • Personal Fall Arrest System - means a system used to arrest an employee in a fall from a working level. (1910.66 App C General Industry) ( 1926.502(d) Construction ) Employees should wear clothing suitable for the job to be performed. Suitable clothing means clothing that will minimize the possibility of damage from moving machinery, hot or injurious substances, weather conditions, or harmful agents. 10. Supervisors should be responsible to ensure compliance with the provisions of this policy and the State Administrative Code by all members of their crews, or departments. Failure to comply with requirements for wearing safety apparel and/or using safety equipment may result in disciplinary action, including termination for repetitive or gross violations. The personal protective equipment selected should meet applicable standards, such as those of Occupational Safety and Health Administration (OSHA), the Mine Safety and Health Administration (MSHA), National Institute for the Occupational Safety and Health (NIOSH), American National Standards Institute(ANSI), or the National Fire Protection Association (NFPA). SECTION 5: AUDIOMETRIC TESTING AND HEARING CONSERVATION PURPOSE: To establish policy and procedures for an on-going Comprehensive Hearing Conservation program. RECOMMENDATION: Annual audiometric testing of employees' hearing should be conducted as needed in cases of noise overexposure, in accordance with OSHA Noise Standard 29 CFR 1910.95. The county should consider the hearing test and results provided by the CDL physical, as required every two years for license renewal, as the accepted baseline audiometric testing for new hires in the Road/Solid Waste Depts., Maintenance Shops, and Solid Waste Dept. truck drivers. All employees exposed to an eight (8) hour time weighted average sound of 85 decibels or greater should submit to an annual audiometric test and should be required to wear hearing protectors while performing such work. Testing may be arranged by the depai tu,ent head through the County Health Nurse or other appropriate testing facilities and coordinated with the employee's immediate supervisor. Detailed records, including test results, should be maintained in the Personnel file. Employees who violate any State law which requires use of hearing protectors in a high noise environment may be subject to disciplinary action. 11. SECTION 6: VEHICLE FLEET SAFETY VEHICLE FLEET SAFETY INTRODUCTION: The operation of vehicles is required in many aspects of county employment. How each vehicle is handled and maintained directly affects the effectiveness and efficiency of government services. Each year injuries,property and liability damage claims continue to increase. Most direct costs of these incidents are paid by insurance. However, the indirect costs are paid by the county, such as increased premiums, loss of vehicle use, vehicle replacement costs, loss of employee productivity, deductible payments, increased paperwork, etc. PURPOSE: The purpose of the Vehicle Fleet Safety policies and procedures is to insure that acceptable standards of proficiency and safety are maintained by each employee who operates a vehicle on county business. RECOMMENDATIONS: 1. The county is dedicated to eliminating conditions that adversely affect the well being of employees and otherwise threaten financial stability through incident losses. 2. Employees should operate all vehicles used for county business in a safe and economical manner. In order to accomplish this, the following practices should be followed: A. All drivers should have a valid Montana Driver's license for the vehicle operated. B. All applicable motor vehicle laws should be adhered to. Any traffic citations should be reported to the Dept. Head/Elected Official or supervisor, and should be the responsibility of the operator. C. No unauthorized passengers or drivers should be allowed to either operate or ride in county vehicles. Transporting family members in county vehicles should be allowed only when the family member is accompanying an employee to a business meeting or official function with a signed waiver for each specific function. D. Seat belts should be worn at all times while either operating or riding as a passenger in the vehicle. E. All vehicle collisions or property damage accidents should be reported and investigated as per policy. F. County vehicles should be used for official use only. 12. G. County vehicles should not be taken home overnight except as follows: (1) Employees may take a county vehicle home for one night when attendance to an out-of-county meeting takes place late at night after normal working hours or early in the morning prior to normal working hours. (2) Those employees designated by their Dept. Head/Elected Official. (3) For more than one night when specifically authorized by the Board of County Commissioners in writing. (4) As specifically designated by the county board overseeing that employee. H. County vehicles should be available for county business on a first come first serve basis. I. County vehicles may be used for travel to lunch when an employee is on business, or when an employee is in a location where driving to obtain his/her personal vehicle would result in an extra and unnecessary expenditure of time and money. J. Vehicles should be operated only when they are in safe operating condition. 3. Each driver's privilege to operate a vehicle on official business extends only as long as the driver operates the vehicle in a safe and efficient manner. A record of"preventable" incidents may be cause for appropriate disciplinary action. 4. Any employee performing work which requires the operation of a county vehicle should notify his/her immediate supervisor in those cases where his/her license is expired, suspended or revoked and/or is unable to obtain an occupational permit from the State Department of Licensing. Failure to report may be cause for disciplinary action. 5. Selection of employees who will be required to drive full or part-time should be done with care. No employee should drive a county vehicle unless certified to operate it by the employee's supervisor. 6. Vehicle Accidents should be reported and investigated in accordance with related policies and procedures. 7. Vehicles should contain appropriate warning and safety devices as needed. 8. Personal vehicles should not be used on official business unless there is no county vehicle available. Any employee using a personal vehicle on county business should maintain auto liability insurance of at least the following limits: l 13. A. Bodily Injury: $50,000 Each Person, $100,000 Each Occurrence. B. Property Damage: $25,000 Each Occurrence C. Uninsured Motorist: $30,000 Each Person, $60,000 Each Occurrence. VEHICLE FLEET SAFETY PROCEDURES: Driver Selection - Even though driving may be incidental to the primary reasons county employees are hired, the considerations given to driver selection are often the most important factor that will affect county vehicle incidents. 1. Evaluation of driver qualifications should be made through the following: A. Previous Employers Reference Check to verify employment and to help determine the driving qualifications and history of the applicant. B. Motor Vehicle Records Check made through the Jefferson County Sheriff's Office. C. Personnel File review to consider driver training received, record of preventable accidents, driving history,driving certifications, Vehicle Operator Record, etc. 2. Drivers of county vehicles may be considered qualified to drive when they meet the following criteria: A. Possess a valid driver's license of the proper class. B. Capable of passing a physical examination when a question of fitness to drive arises because of illness or injury. C. Capable of passing written tests on driving regulations whenever required. D. Capable of passing a driving test. E. Have demonstrated proficiency with the particular type of vehicle or equipment routine to be utilized. Driver Training - The Safety Committee may periodically administer,or arrange for attendance at a Defensive Driving course. Assignments for said course should be made as follows: A. Mandatory attendance for employees who demonstrate questionable driving capabilities or habits as determined by their immediate supervisor. B. Voluntary attendance for employee who have not attended a Defensive Driver Course in the past five (5)years. 14. MINIMUM QUALIFICATION FOR THE OPERATION OF COUNTY-OWNED MOTOR VEHICLES AND PRIVATELY-OWNED VEHICLES WHILE CONDUCTING OFFICIAL BUSINESS PURPOSE: To insure that an acceptable standard of proficiency and safety is met by each employee who operates county-owned motor vehicles. (Also refer to Jefferson County Personnel Policy). RECOMMENDATIONS: 1. Employees are encouraged to use county vehicles instead of their own for official county business whenever possible. 2. Personal vehicles may be used for official county business with the prior approval of the employee's Department Head/Elected Official. Employee's using their personal vehicles will be reimbursed at the prevailing rate established by the Board of County Commissioners after submittal of the appropriate form to their Dept. Head/Elected Official. No County employee should be required to provide their own vehicle for conducting county business unless required in their job description. 3. All employees whose duties require the operation of a county-owned motor vehicle or who operate a privately-owned vehicle while conducting official business as a part of their employment with the county, should possess a valid Montana State Drivers' License and a safe driving record. 4. Prior to acceptance for employment with the county in a position that would necessitate the operation of a motor vehicle in the course of performing the assigned duties of that position, an employee's motor vehicle operators record may be requested from the State Department of Motor Vehicles by the Personnel Office. If a Department of Motor Vehicles review indicates three or more moving violations within three years of the date of review, the employee may be denied authorization to operate a vehicle while representing the county. If the employment is incumbent upon the ability to operate a vehicle, the prospective employee may be denied employment. 5. Employees operating county-owned motor vehicles or privately-owned vehicles while conducting official business should observe all traffic laws, rules and regulations, and the dictates of common sense and good judgment. 6. If during the course of employment an employee exhibits a disregard for acceptable safe driving procedures,the responsible Dept. Head/Elected Official may deny further authorization to operate a vehicle while representing the county. 7. Any employee who operates a privately-owned vehicle while conducting official business for the county should maintain automobile liability insurance of $25,000/$50,000/$10,000 pursuant to §61-6-103. MCA. Employees who do not maintain minimum liability coverage should not operate privately-owned vehicles in an official • capacity. 15. EMPLOYEE ACTIONS AT ACCIDENT SCENES PURPOSE: To establish policy guidelines for employees traveling in county-owned vehicles for rendering assistance at accident scenes. RECOMMENDATION: 1. It should be the responsibility of county employees, while traveling in county vehicles to stop at accident scenes and render whatever assistance that is within their capability if it is safe to do so. It is not the intention of this policy to impose strict procedures in governing the actions of employees at accident scenes. It is realized that each employee should use his/her own judgment in determining if assistance is needed and what assistance they are capable of providing. 2. As a minimum, the employee should ensure that police and fire personnel have been notified (if necessary). If injuries have occurred, and the employee is capable and qualified, first aid may be rendered to the victim. 3. The employee should remain at the accident scene until emergency vehicles arrive and offer assistance to police and fire personnel as needed. • 4. The employee should remain polite and helpful in all circumstances and never speculate on cause, effect or blame involved in the accident. 5. An Incident Report should be completed by the employee, preferably within 24 hours, describing their involvement at the accident and forwarded to the Safety Coordinator/Safety Committee. SECTION 7: HEALTH, SAFETY AND LOSS CONTROL INSPECTIONS PURPOSE: The purpose of periodic Health, Safety and Loss Control Inspections is to identify any risks or occupational health and safety concerns, and correct them so as to protect the county's employees and assets (financial and physical) and to reduce risk of incident, injury and other forms of loss. RECOMMENDATIONS: 1. On an annual basis, the Safety Committee Inspection team should inspect, or cause to be inspected, all county facilities. 2. The county cooperates with the Federal or State government in any Occupational Safety and Health Administration (OSHA)related inspections within the county. The Safety Coordinator or Safety Committee member(s) should accompany the State Bureau of Safety and OSHA personnel on any inspections. 3. Employees should assist and cooperate in all inspections to insure that all areas are reviewed, and that all hazards are identified. 16. PROCEDURES: 1. Safety and Fire Inspections. Inspections should be conducted in a manner designated by the Safety Committee, drawing upon the assistance of staff, and consultants, etc. as needed. Safety Committee inspections may address any area of loss control, and should be documented in writing. A. Emphasis should be placed upon condition of facilities, equipment, and machines as well as implementation of the overall program, such as: (1) Good Housekeeping (2) Use of prescribed Personal Protective Equipment (PPE). (3) Compliance with written policies and procedures. (4) Qualifications of drivers and condition of vehicles. (5) Condition of ladders and other equipment. (6) Proper maintenance of electrical equipment,power tools, and hand tools (7) Proper guarding of open pits, ditches, tanks, etc. (8) Proper storage and handling of flammable and combustibles. (9) Fire extinguishers, first aid kits, and emergency lighting. (10) Noise levels. (11) Dust levels. B. Facilities and equipment noted to be unsafe for use should be tagged by the inspector. C. Responsible Dept. Heads/Elected Officials should advise the Safety Committee as to the action taken or to be taken to remove identified hazards. 2. MONTANA DEPARTMENT OF LABOR AND MONTANA BUREAU OF SAFETY Inspections. Labor and Industry Safety Bureau inspection compliance officers generally concern themselves with safe working practices, use of Personal Protective Equipment (PPE), adequacy of protective equipment, guarding of machines, use of shoring, equipment configurations with respect to operation protection, etc. A. In the event of receipt of a Montana Safety Code Violation, insure that the violation is posted on a bulletin board nearest to the violation until it has been abated. B. The Dept. Head/Elected Official should insure that the correction of a violation is performed within the thirty(30) day abatement period,unless the abatement period has been extended. C. Prepare timely requests for a variance or for a hearing when the citation is questionable and should be aggrieved. 17. D. Notify the Board of County Commissioners when modifications require the expenditure of funds so that appropriate action can be taken. E. The Dept. Head/Elected Official should prepare any requests for extensions needed indicating why it is needed, and how long the delay will be, with a copy to the Safety Coordinator/Safety Committee. F. Upon actual completion of corrective action, the Dept. Head/Elected Official will certify by date and signature at the bottom of the citation form that each violation has been abated. The form will then be mailed to the Labor and Industry Safety Bureau,with a copy delivered to the Safety Coordinator/Safety Committee. SECTION 8: RECORD KEEPING OCCUPATIONAL INJURY AND ILLNESS In accordance with applicable requirements of the Safety Culture Act/OSHA Standards, the Safety Coordinator should ensure the appropriate records are kept as follows: 1. Maintain a log and summary of Occupational Injuries and Illness on Montana OSHA Form 300 (provided by MACo). Recordable cases include every occupational injury or illness that involves: 1. Death 2. Days away from work 3. Restricted work or transfer to another job 4. Medical treatment BEYOND first aid 5. Loss of consciousness 6. A significant injury or illness diagnosed by a physician or other licensed health care professional. 2. Original copies of all First Reports generated when an employee is injured on the job should be kept in the Personnel Dept. files (First Reports are faxed or electronically emailed to the Claims Dept. of MACo's Worker's Comp. Division). 3. During the month of February, posting of the completed summary OSHA 300A form for the previous year. 4. Maintain records for five years following the year to which they relate. 5. Enter each recordable injury and illness on the log as early as practicable,but no later than seven (7) calendar days after receiving the information that a recordable case has occurred. 6. Responsibility: Safety Coordinator is responsible for maintaining records and ensuring proper postings 18. REPORTING POLICIES AND PROCEDURES OCCUPATIONAL INCIDENT INJURY/ILLNESS (Appendix "C"): 1. All occupational injuries! illnesses, no matter how minor, should be reported as soon as physically able, and no later than the end of the working shift to the immediate supervisor (Verbal reporting constitutes "notice given"). 2. The employee should obtain appropriate medical treatment in accordance with the Safety and Health policies. 3. If the incident caused illness/injury(physical harm to the body), a First Report Form must be filed with MACo's Worker's Comp. Division. The form can be obtained from each employee's Dept. Head /Elected Official (Red - Incident Reporting File). That file contains the Incident Reporting Procedure (Appendix "C") and detailed, color coded instructions on how to fill out the First Report and who is responsible for each section. Every question should be answered to ensure that your medical costs and any salary lost because of the injury will be paid. The Safety Coordinator should send (fax/email) the First Report form on to MACo's Worker's Comp. Division. and should deliver the original/copies to the Personnel Dept. 4. The immediate supervisor should record all appropriate information that will facilitate a thorough investigation of the incident by the Safety Coordinator. 5. In the event of a fatality or multiple injuries requiring hospitalization the Board of County Commissioner, Dept. Head/Elected Official, Dept. of Labor& Industries (444-6401), and MACo's Risk Management Dept. (444-4370) should be notified immediately. 6. In the event of a fatality, notification of next of kin, or those persons so designated by the employee in event of an emergency, should be coordinated through and approved by the County Commissioner's office. 7. The Safety Coordinator should be the prime contact between the county and the MACo Worker's Comp. Division for industrial injury claims. 8. All injuries should be considered "alleged injuries" if they are suspicious in nature, not witnessed, reported late or of a non-visible nature. 9. The employee Safety Committee should review all industrial accidents and injuries and recommend appropriate actions to avoid, prevent or reduce future similar incidents. 10. Employees should refer all formal requests for production of evidence relating to industrial incidents to the Jefferson County Attorney prior to releasing any information. 19. INCIDENT REPORTING PURPOSE OF REPORTING: Reporting is a basic and essential part of an effective management and loss control program. Since every incident includes a sequence of contributing causes, it is possible to avoid a repeat performance of the first event by recognizing and reducing or eliminating these causes. The removal of a single cause can prevent a recurrence. Incident Report forms can be found in each department (Red - Accident Reporting file) and may be used for Property Damage With/Without Injury, Near Miss, or Safety Violations reporting. In the case of a "Near Miss" the report should be delivered to the Dept. Head/Elected Official and Safety Coordinator for investigation and mitigation. "Safety Violations" should be reported to the Dept. Head/Elected official and Safety Coordinator for resolution. "Property Damage With/Without Injury" should be reported to the Dept. Head/Elected Official, the Incident Report form filed with the Clerk & Recorder for processing, and a copy provided to the Safety Coordinator. Timely and complete reporting facilitates incident investigation, and may also preserve and protect the health and safety of injured persons, and the resources of the county. DEFINITIONS: • Occupational Injury is defined as a personal injury arising out of, and in the course of employment with the county. Occupational Illness is defined as a disease caused by certain hazardous conditions or materials when there is a direct causal connection between the conditions under which the work is performed and the occupational disease. Incident is defined as an event, intentional or unintentional, that resulted in or contributed to, or could have (near miss) resulted in or contributed to a loss, injury, damage, or harm to persons or property from fire, theft, vandalism, weather, etc. REPORTING POLICIES and PROCEDURES: VEHICULAR COLLISION I. All vehicular collisions involving county vehicles or personal vehicles used on county business, no matter how minor, should be reported promptly to Law Enforcement, the Department Head /Elected Official, and Safety Coordinator as soon as physically able. The employee should also request that all parties and properties concerned remain at the scene of the incident if possible until a law enforcement representative has released them. 2. An employee involved in a collision should obtain appropriate medical treatment if needed, as outlined in the county's Safety policies. 3. Each employee should refrain from making statements regarding the incident with anyone other than the investigating officer, employer's officials, and employer or personal insurance company representatives. Statements should be confined to factual observations. 20. 4. Anytime an incident causes injury, a MACo Worker's Compensation "First Report" should be filed with MACo's Worker's Comp. Claims Dept. Any damage to property requires an"Incident Report"to be completed and filed with the Jefferson County Clerk and Recorder's office(copy to Safety Coordinator). In the case of a fatality or if two or more employees are hospitalized, the Dept. Head/Elected Official should report the incident to the Board of County Commissioners, the nearest office of the Department of Labor and Industry,phone 444 - 6401 and MACo Risk Management, phone 444-4370. The report should relate the circumstances, the number of fatalities, and the extent of any injuries. 5. Employees should cooperate and assist in the reporting and gathering of incident and injury data. The following actions maybe necessary: a. The employee should fill out an Incident Report and submit it to the Department Head/Elected official for comment. The report should then be filed with the Clerk and Recorder's office for processing(copy to Safety Coordinator), and inclusion in the employee's personnel file. b. Damage to the vehicle should be reported to the insurance carrier(or appropriate body) on the Auto Incident Notice form available from and processed through the Clerk and Recorder's office. c. If the incident may result in someone alleging liability against the county, the • Clerk and Recorder's office should also file the report with the county insurance carrier(or risk pool, etc.). d. If the incident is serious,the insurance carrier should be notified immediately. 6. The employee Safety Committee should review all collisions and recommend actions to avoid,prevent, or reduce future similar incidents. 7. County employees should refer all formal requests in production of evidence relating to a vehicular collision to the County Attorney prior to releasing any information. REPORTING POLICIES AND PROCEDURES: PROPERTY DAMAGE OR INCIDENT/LOSS INVESTIGATION The purpose of incident investigation is to prevent repeat incidents by learning causes so that corrective actions can be taken to implement needed physical changes, improve operating procedures, improve safety and supervision, upgrade training, and reduce the probability of a repeat event and the resulting loss of human and economic resources. 1. All incidents, no matter how minor, which result or may result in a liability claim against the county, or give the county a liability claim against others, should be promptly reported to the Dept. Head/Elected Official. 2. All damage to or loss of county property in excess of one hundred dollars ($100) in value should be reported (excluding cracked windshields) to the Dept. Head/Elected Official using an "Incident Report"(Property Damage With/Without Injury form -Appendix "A") to be filed with the Clerk& Recorders Office for processing(copy to Safety Coordinator). This includes damage to buildings, grounds, infrastructure, signs, equipment, tools, supplies, etc. Damage that is 21. not of natural cause should be reported to the Jefferson County Sheriffs Department as soon as possible. The employee and the immediate supervisor should cooperate with the thorough investigation of the incident. 3. Employees should not discuss details of the investigation with unauthorized persons and should not admit liability. 4. APPENDIX "A" - INCIDENT REPORT FORM ;Property Damage With/Without Injury. SECTION 9: INVESTIGATION PROCEDURES INCIDENT INVESTIGATION CHECKLIST 1. Descriptions and Identification of the Premises A. Exact location, giving street numbers and any other designation necessary to pinpoint the location. B. Type of building(Use and construction type) C. Age of building (If necessary, obtain name of architect,contractor and builder). D. General condition of building or area. (1) Is building or area in good general condition? • (2) Is building or area well maintained? (3) Is building kept in good repair? E. Use to which facility, area or equipment is put. (1) Is the use proper? (2) Is the use lawful? (3) Is the use hazardous in any way? (4) Does the use create a nuisance? F. What is the history of previous incidents with this facility, area or equipment? 2. Ownership and Control A. Who owns the facility or equipment? B. How long has local government used facility or equipment? C. If another tenant or facility user is involved, obtain a list of names, addresses and phone numbers,and their insurance company. D. Obtain a copy of building lease when applicable. E. Does a landlord control the area of a facility complained of? If so, obtain name, address and phone number,including his insurance company. F. Who is responsible for the cleaning and general maintenance? If not local government, obtain names, addresses and phone numbers, including their insurance companies. 3. Coverage A. Make sure the incident occurred within the local government's jurisdiction. B. Make sure the incident occurred on local government property. 22. C. Are there any easements within the incident area? D. Did the incident occur under the possible control of someone else, and not the local government? E. Were there any contracts or hold harmless agreements signed that have a bearing on this incident? If yes, obtain. F. Can liability be transferred to another party(contractor,hold harmless signer, private property owner)? G. Does the county's insurance coverage this incident? H. Check for possible completed operations: (1) Obtain exact date when work was done. (2) Was job accepted as completed? (3)Was payment made for completed job? (4) Were any exposures left at site? (5) Were any complaints made about workmanship? (6) Were any repairs made, or conditions corrected? (7)Are inspection records available, complete? (8) Did the operation involve a service or maintenance contract? If so, obtain. 4. Actual or Constructive Notice A. Who was responsible for the general maintenance of the building, area or equipment? B. Was the individual aware of the risk or exposure? C. How did it come to his attention? D. When did it come to his attention? E. How long had the condition been permitted to exist? F. Were any regular inspections made? By whom? Reports made? G. If the local government was unaware of the exposure, could it have been identified through a regular inspection? H. Was the building, area or equipment regularly inspected? I. Are safety precautions regularly used in maintenance? 5. Physical Conditions A. Describe the condition that caused the incident. B. Exact location. Preserve any evidence. Take pictures. C. If pertinent, describe composition, nature, condition of floor(wet, debris, slick, broken, rough, slope, cracked, obstructed). D. Was the incident caused by defective conditions owing to ordinary wear and tear? Faulty construction? E. Describe lighting conditions (time of day,weather, windows, shades,power, lights). F. Describe weather conditions. G. Were any warning or cautionary signs posted? Photograph. H. Are blueprints or plans available if necessary? Where? I. Did facility meet code? J. Had repairs been made? By whom, when,how, guarantee? 23. 6. Reports and Witnesses A. Obtain signed statements from all parties. B. Were any confessions or admissions made? Obtain. C. Document any injuries sustained. D. Obtain names, addresses, and phone numbers of all witnesses and involved. E. Obtain names, addresses, and phone numbers of outside witnesses who can testify regarding conditions, policies, procedures, practices, routines, etc. F. Obtain a police, physician,or other available reports. 7. Information from Claimant A. Claimant's name and all previous names or aliases under which the claimant was even known. B. Age, general appearance, and impression made. Obtain any legally permissible public information as to the claimant's character, intelligence, integrity, driving record, police record, etc. C. Present and previous address and phone number. D. Military status if applicable. E. Dependency status. F. Employment history. G. Possible distractions to claimant: (1)Weather (2)Was claimant carrying any packages, umbrella, or other objects that could have affected vision,balance, etc. Describe. (3) Was claimant watching someone or something? (4) Was claimant talking to anyone at time of incident? (5)Was claimant daydreaming or preoccupied? (6) Was claimant awake? (7) Was claimant worried or under stress? (8) Was claimant tired? H. Did the claimant's clothes have any bearing on the incident? (1) Hat over eyes? (2) Collar or hat over ears? (3) Were clothing or shoes a tripping or other hazard? I. Did claimants physical condition have any bearing on the incident? (I) Medical condition (heart disease, epilepsy, faintness, etc.) (2) Alcohol or drug use. (3) Illness or lack of sleep (work hours?) (4) Any physical disabilities? Describe. (5) Eyesight (need glasses? wearing glasses/contacts?) J. Ascertain circumstances surrounding claimant incident. (1) Was claimant invited guest, trespasser? (2) Why was claimant in area? (3) Who was with claimant just prior and following incident? Interview. (4) If claim involves injury, how was claimant hurt? 24. Street & Sidewalk Incidents 1. Describe composition of street or walk. 2. Determine in publicly or privately owned? Easements? 3. Were attempts made to guard or barricade the exposure? 4. Were any warning signs placed around the defect? 5. Had there been previous complaints about the exposure? 6. Did the abutting property owner have any responsibility? 7. Who originally constructed the street or walk?When? 8. If the exposure was caused by tree roots, who planted, maintains,owns them? 9. Snow and Ice Cases A. Describe slope. B. Was ice caused by leaking water? If so, was leek from public water main or private service line, or defective spout or other part of building? C. If snow was involved, how much? When did it stop snowing?Who is responsible for snow removal? D. Was snow hard, packed, soft, icy? E. Was attempt made to clean the snow? Who? When? F. Was cleaned snow piled up so that it melted and created hazard? G. Was there any defect under the snow? H. What was weather at time of incident? I. Review snow removal resolution,policy,procedures. Were they complied with? Slippery Floors Cases 1. Was the floor wet? Who caused it to be wet? 2. Were any caution or warning signs put out? 3. When was floor last waxed? By whom? 4. Obtain information on wax used (manufacturer, directions for use, manufacturer's insurer). 5. Were manufacturer's directions complied with? 6. What method was used to apply wax? 7. If necessary, obtain chemical analysis of wax and have a friction test made before waxing, after waxing, and after buffing. Stairway Cases 1. What is description and construction of stairs? 2. What are measurements (height, depth, width)? 3. Are all steps of equal height, etc? 4. What is condition of steps? 5. Do stairs have covering? Of what? Condition? 6. Did stairs have any signs? Defective? 7. Were stairs unusual in any way? (curved, winding) 25. 8. Give location and description of any landings. 9. Do construction of stairs conform to building code? If not, what violations are there? 10. Was there any obstruction on stairs? Describe fully. 11. Were stairs lighted? 12. Were stairs in common use? Who else uses them? 13. Any complaints or reports ever made about stairs? 14. Was there a handrail? Exactly where, how fastened, what composition, what condition, how high? 15. What kind of shoes was claimant wearing?Describe soles and condition? 16. Was claimant carrying anything? Describe fully? 17. Was claimant wearing anything that could catch, cause trip, fall or obscure vision? 18. What caused the incident? (trip, slip, failure to use handrail,loss of balance, intoxication, etc.) 19. How did claimant fall (backwards, forwards, side, lurch)? 20. Did claimant attempt to catch rail or self? Which foot was forward? 21. Diagram exact location of fall. Between which steps? Falling Object Cases 1. From where did the object fall? 2. What was the exact spot where it landed? 3. What sort of object fell? 4. Who owned the object? 5. What caused the fall? 6. If the object that fell was in or a piece of a building: A. Who was in control of the building? B. How old was the building? C. When was area last inspected? D. Have pieces ever fallen previously? E. Were shelves secure? F. Were weather factors involved? G. How were materials stacked?Where? 7. If a construction case: A. Were the floors covered? B. Who was working above? Obtain all names, addresses and phone numbers, including contractors, subcontractors and insurers. C. What caused the fall? Who? Construction Cases 1. Obtain names and insurance carriers of all parties. 2. Obtain copies of all contracts. 3. Who controlled the operation? Who supervised the work? 4. Was the work unusually hazardous? 5. Were the workers experienced? 6. Were they licensed, if required? 7. Were they properly supervised? 26. 8. Were they engaged in unusual or unorthodox practices or techniques? 9. What was the nature of their tools and equipment? Who furnished them? 10. Was the construction regularly inspected? Obtain all daily work logs and inspection reports. 11. Were defects noted? Should they have been? By whom? 12. Were any repairs made? When,by whom,how? If not,why not? 13. What safety measures were taken? By whom? (lanterns,barricades, walkways, overhangs, etc.) 14. Was the Manual, Uniform Traffic Control Devices (MUTCD) complied with? 15. Was contractor complying with all general and special conditions? 16. Were all safety(OSHA) conditions complied with? 17. Was special safety equipment available? Was it used? If not, why not? 18. Obtain all pre-construction photographs and films. Take post incident photographs. 19. Were plans properly filed with building division?Approved? 20. Were inspections regularly made? Obtain. 21. Did job conform to code? 22. Were any correction notices ever issued? Were they complied with? 23. Has a certificate of occupancy been issued? Obtain. Animal Incidents 1. Description of the animal (species, domestic or wild, size, condition, nature and reputation) 2. Who owns animal? Control's animal? 3. Why was claimant in vicinity of animal? 4. Was animal provoked? 5. Was animal on leash? 6. Was animal on owner's premises? 7. Had owner been warned about Animal Control Resolution? 8. What is local government policy on animal control enforcement? Was it followed? 9. Had any previous complaints been made about the animal? By whom?When? Of what nature? 10. Had Police or other officials, or Animal Control or other officials been aware of this animal? Any previous citations issued? Complaints made? INCIDENTS INVOLVING DEFECTIVE EQUIPMENT Procedures for accidents involving potentially defective equipment. RECOMMENDATIONS: When an incident happens where defective equipment is a possibility, the following action should be taken: 1. Attend to any injuries of employees or others. 2. Turn equipment in question over to the employee's supervisor, who shall consult with the Safety Coordinator. 3. A detailed report should be written within one day to include circumstances surrounding the incident and manufacturing information available concerning the equipment in question. This report should be submitted to the Safety Committee. 27. SECTION 10: TYPICAL MINIMAL LOCKOUT/TAGOUT SYSTEM PROCEDURES LOCKOUT/TAGOUT PROCEDURES FOR JEFFERSON COUNTY Lockout/Tagout of energy isolating devices should be used to ensure that the machine or equipment is isolated from all potentially hazardous energy,and locked out or tagged out before employees perform any servicing or maintenance activities where the unexpected energization, start-up, or release of stored energy could cause injury. Sequence of Lockout/Tagout System Procedures: I. Notify all affected employees that a Lockout/Tagout system is going to be utilized and the reason therefore. The authorized employee should know the type and magnitude of energy that the machine or equipment utilizes and should understand the hazards. 2. If the machine or equipment is operating, shut it down by the normal stopping procedure. 3. Operate the switch, valve, or other energy isolating device so the equipment is isolated from its energy source. Stored energy(such as springs, elevated machine members, rotating flywheels, hydraulic systems, and air,gas, steam, or water pressure)must be dissipated or restrained by methods such as repositioning,blocking,bleeding down, etc. 4. Lockout/Tagout the energy isolating devices with assigned locks or tags. 5. After ensuring that no personnel are exposed, and checking on the disconnect of energy source, operate the push button or other operating controls to make certain the • equipment will not operate. 6. CAUTION-Return operating controls to neutral or off position after the test. The equipment is now locked out or tagged out. Restoring Machines or Equipment to Normal Production Operations: I. After the servicing/maintenance is complete and equipment is ready for normal operation, check the area around the machine or equipment to ensure that no one is exposed. 2. After all guards have been reinstalled, employees are in the clear, remove the Lockout/Tagout devices. Operate the energy isolating devices to restore energy to the equipment Procedure Involving More Than One Person: In the preceding steps, if more than one individual is required to Lockout/Tagout equipment, each shall place his/her own Lockout/Tagout device on the equipment. When an energy isolating device cannot accept multiple locks or tags, a hasp may be used. If lockout is used, a single lock may be used to lockout the machine or equipment with the key being placed in a box or cabinet. Each employee will use his/her own lock to secure the box or cabinet. As each person no longer needs to maintain his or her lockout protection, that person will remove their lock. Basic Rules for Using Lockout/Tagout System Procedures: All equipment should be locked out or tagged out to protect against accidental or inadvertent operation when such operation could cause injury to personnel. Do not attempt to operate any switch, valve ,or other energy isolating device where it is locked out or tagged out. 28. Appendix "A" INCIDENT REPORT FORM *PROPERTY DAMAGE WITH/WITHOUT INJURY (Report to Supervisor & Clerk & Recorder for processing copy to Safety Coordinator) •NEAR MISS (Report to Supervisor & Safety Coordinator) *SAFETY VIOLATION (Report to Supervisor & Safety Coordinator) 29. JEFFERSON COUNTY INCIDENT REPORT *PROPERTY DAMAGE WITH/WITHOUT INJURY • *NEAR MISS *SAFETY VIOLATION Time and date of occurrence: _ o'clock_ .m. mo/day/year Exact location: Describe the incident violation: Describe the weather conditions at the time of the incident/violation if applicable: Describe the events leading up to the incident/violation: Describe the equipment involved and damage caused if any: Estimated cost of damages: $ • If applicable, draw a diagram or sketch and attach: Full name, address and phone number of all witnesses involved: Name Address Phone# • Attach witness statements: Determine corrective actions: Employees Signature: _ Date: Supervisor's Signature: Date: *Return AccidentAllness and Property Damage Without Injury report to Clerk and Recorder for processing. *Near Miss and Safety Violations reported to Dept. Head/Elected Official and Safety Coordinator for investigation. *Reporting safety violations may remain anonymous. 30. Appendix "B" Safety Inspection Checklists 31. Jefferson County SAFETY INSPECTION FORM HAZARD CHECKLIST BUILDING AND GROUNDS Date: Department or County Facility: Safety Inspection performed by: This checklist is intended only as a guide. Look for other unsafe acts and conditions and report them to your safety committee so that corrective action can be taken. Buildings SAT. UNSAT. N/A 1. Lights free of loose wires,jagged glass, etc. that could cause injuries ( ) ( ) ( ) 2. Fire alarms, switches, wires, etc. in good regular repair-no bare wires hanging loose that could cause injuries ( ) ( ) ( ) 3. Windows and doors free of sharp edges or splinters that could cause injuries - no broken window panes ( ) ( ) ( ) 4. Electrical and extension cords in good repair- no defects that could cause injuries due to tripping, short circuit, fires or other hazards ( ) ( ) ( ) 5. Floors free of tripping hazards including machinery, • supplies, loose or broken tile, or defective finish ( ( ( ) • 6. Locks function properly ( ( 3 ) 7. Plumbing fixtures and outlets in good repair ( ( ) ( ) 8. Ladders safe and equipped with non-skid feet ( ( ))) ( ) 9. Safe and appropriate lighting in work areas, stairwells, and hallways ( ) ( ) ( ) Grounds 10. Grounds, blacktop, and sidewalks free of undermining hole's or cracks large enough to cause tripping accidents. ( ) ( ) ( ) 11. No dirt or water flowing on sidewalk ( ) ( ) ( ) 12. All areas free of debris,broken glass and other hazardous materials ( ) ( ) ( ) 13. Sprinklers and pipe- no jagged edges or pipe protruding out of ground that could cause tripping- no slipping hazards due tp ur 14. Safe procedures posted p in chemical ( ( ( 1 a areas ( (t )S 15. All chemicals and hazardous matenals properly marked. ( 16. Shrubs and trees -no branches hanging over onto walkways ( ) ( ) ( ) 17. Posts or fencing in good repair, free from loose or falling pieces that could cause accidents ( ) ( ) ( 1 18. Crawl holes free of sharp edges ( ) ( ) S 19. Faucets - drinking faucets, down spouts free of sharp edges ( ) ) 20. Fencing free of sharp corners and edges ( )) jj (j Sj 21. Field and court area properly maintained and dept clean. COMMENTS AND RECOMMENDATION: 32. JEFFERSON COUNTY SAFETY INSPECTION FORM HAZARD CHECKLIST OFFICE, SPECIAL ROOMS Date: Department or County Facility: Safety Inspection performed by: This checklist is intended only as a guide. Look for other unsafe acts and conditions and report them to your safety committee so that corrective action can be taken. Fire Safety SAT. UNSAT. N/A 1. Flammable liquids stored in metal cabins or approved safety cans ( ) ( ) ( ) 2. No flammable materials attached to ceilings ( ) ( ) ( ) 3. Portable fire extinguishers mounted and positions clearly marked ( ) ( ) ( ) • 4. Storage rooms and closets free of accumulated flammable waste materials ( ) ( ) ( ) 5. Decorations made made ofnon-flammable materials ( ) ( } ( ) 6. Oily rags disposed of in non-combustible containers ( ) 7. Fire exits clearly marked and accessible ( ) 8. Signs posted outside indicating fire extinguisher in office .. ( ) ( ) ( ) Housekeeping 9. Aisles and passageways unobstructed (3'minimum) ( ) ( ) ( 10. Step ladders or non-skid step stools provided for access to shelves in closets and storerooms ( ) ( ) ( ) 11. Chemicals and toxic materials kept in labeled containers and properly stored ( ) ( ) ( ) 12. Adequate space provided for storage of tools and materials I I 13. lighting and ventilation adequate in all areas ((( ))} 14. Cords and cables secured prevent tripping hazards 15. Access to electrical panel unobstructed Equipment and Materials 16. Ladders equipped with non-skid feed and fee of defects. ( ) ( ) ( ) 17. Paper and paper cutter equipped with bay and guard and spring adjusted to hold b lade up in position ( ) ( ) ( 18. Hand tools maintained in ood condition ( ) (( )) 19. File cabinets anchored to prevent tipping ( ) 20. Personnel protective equipment used when handling corrosive or toxic substances ( ) ( ) ( ) 21. Heavy objects stored on lower shelves ( ) ( ) ( ) COMMENTS and RECOMMENDATIONS: 33. Jefferson County SAFETY INSPECTION FORM HAZARD CHECKLIST MAINTENANCE , ROAD & BRIDGE SHOPS Date: Department or County Facility: Safety Inspection performed by: This checklist is intended only as a guide. Look for other unsafe acts and conditions and report them to your safety committee so that corrective action can be taken. Housekeeping SAT. UNSAT. N/A 1. Permanent aisles and passageways clearly defined and unobstructed ( ) ( ) ( ) 2. All materials piled, racked and stored in safe manner... ( ) ( ) ( ) 3. Tools are returned to proper storage ( ) ( ) ( ) 4. Floors are clean, dry and free from tripping and slipping hazards ( ) ( ) ( ) • 5. Corrosive and toxic materials properly stored in closed containers and Hazmat properly identified and segregated ( ) ( ) ( ) 6. Waste materials and scrap lumber are collected in metal bins ( ) ( ) ( ) 7. Overhead storage areas provided with guardrails, toeboards and adequate aisles ( ) ( ) ( ) 8. Cords and cables secured to prevent tripping ( ) ( ) ( ) Fire Prevention 9. Oily rags collected in closed metal containers ( ) ( ) ( ) 10. Flammable wastes disposed of properly ( ) ( ) ( ) 11. Drums and containers grounded when pouring flammable liquids ( ) ( ) ( ) 12. Access to electrical panels unobstructed materials ( ) ( ) ( ) 13. Fire extinguishers properly mounted near exit doors and marked ( ) ( ) ( ) 14. Oxygen and acetylene tanks stored separately ( ) ( ) ( ) 15. All chemicals and hazardous materials properly marked. ( ) ( ) ( ) 16. Volatile substances stored in metal cabinets or safety can and marked "Flammable" ( ) ( ) ( ) 17. Point of operation guards provided on dangerous machinery ( ) ( ) ( ) 18. moving parts of power driven machinery(revolving shafts, gears,belts and pulleys, etc.) guarded by enclosure ( ) ( ) ( ) 1,1 19. Ladders equipped with safety feet and maintained in good condition ( ) ( ) ( ) 20. No cracked or broken pallets in use ( ) ( ) ( ) 21. Electrical equipment is grounded and wiring in good condition ( ) ( ) ( ) Housekeeping SAT. UNSAT. N/A 22. Grinding wheels equipped with hood guards and shields; tool rests adjusted to one eighth inch of wheel ( ) ( ) ( ) 23. Lifting and hoisting equipment has capacity markings clearly marked and visible ( ) ( ) ( ) 24. Metal ladder marked "CAUTION -DO NOT USE NEAR ELECTRICAL EQUIPMENT" ( ) ( ) ( ) 25. Sign posted around air compressor warning employees the machine is automatically controlled and may start at any time ( ) ( ) ( ) 26. Sufficient space provided for working around electrical equipment ( ) ( ) ( ) 27. Gas cylinders secured when in storage. Welding areas • are ventilated and screened ( ) ( ) ( ) • 28. Ropes, chains, slings used for material handling are in good condition ( ) ( ) ( ) 29. Proper acid battery storage and battery charger pole protected ( ) ( ) ( ) COMMENTS and RECOMMENDATIONS: 35. Jefferson County SAFETY INSPECTION FORM HAZARD CHECKLIST County Trailers, Cars and Sheds Date: Department or County Facility: Safety Inspection performed by: This checklist is intended only as a guide. Look for other unsafe acts and conditions and report them to your safety committee so that corrective action can be taken. Trailers SAT. UNSAT. N/A 1. Portable fire extinguishers mounted and position clearly marked ( ) ( ) ( ) 2. Closets free of accumulated flammable waste materials.. ( ) ( ) ( ) 3. Fire exits clearly marked and accessible ( ) ( ) ( ) 4. No flammable materials attached to ceiling ( ) ( ) ( ) 5. Aisles and passageways unobstructed ( ) ( ) ( ) 6. Lighting and ventilation adequate in all areas ( ) ( ) ( ) 7. Cords and cables secured to prevent tripping hazards.... ( ) ( ) ( ) 8. Access to electrical panel unobstructed ( ) ( ) ( ) 9. Steps to trailer doors secured ( ) ( ) ( ) Cars 10. Portable fire extinguishers in trunk and in chargeable condition ... ( ) ( ) ( ) Sheds 11. Flammable liquids stored in metal cabinets or safety cans ( ) ( ) ( ) 12. No flammable materials attached to ceiling ( ) ( ) ( ) 13. Free of accumulated flammable waste material ( ) ( ) ( ) 14. Oily rags disposed of in non-combustible containers ( ) ( ) ( ) 15. Electrical equipment grounded with 3-prong plug and turned off when not in use ( ) ( ) ( ) 16. ladder equipped with non-skid feet and free of defects.. ( ) ( ) ( ) 17. Hand tools maintained in good condition ( ) ( ) ( ) COMMENTS and RECOMMENDATIONS: 36. Jefferson County SAFETY INSPECTION FORM HAZARD CHECKLIST SOLID WASTE SITES BUILDING AND GROUNDS Date: Department or County Facility: Safety Inspection performed by: This checklist is intended only as a guide. Look for other unsafe acts and conditions and report them to your safety committee so that corrective action can be taken. Buildings SAT. UNSAT. N/A 1. Housekeeping-no unnecessary clutter(stacked newspapers, books, magazines), no empty food & beverage containers, personal items brought in on daily basis only, floors clean, garbage emptied, dust controlled ( ) ( ) ( ) 2. Heating stove in good condition, wood supply neatly stacked&in fire safe location,no flammable starting fluids used ( ) ( ) ( ) 3. Proper protective equipment (PPE) in good condition &readily available i 4. Easy access to Safety/MSDS binder ( ) 5. Ladders and other equipment in safe working order. 6. Proper storage and handling of flammables and combustibles ( ) ( ) ( ) 7. Maintained fire extinguishers properly mounted near exit doors and marked. ( ) ( ) ( ) 8. First aid kits (up to date), and emergency lighting (functional) and easily accessible. ( ) ( ) ( ) 9. Lights free of loose wires,jagged glass, etc. that could cause injuries. ( ) ( ) ( ) 10. Electrical switches, wires, etc. in good repair- no bare wires hanging loose that could cause injuries. ( ) ( ) ( ) 11. Windows and doors free of sharp edges or splinters that could cause injuries -no broken window panes.... ( ) ( ) ( ) 12. Electrical and extension cords in good repair-no defects that could cause injuries due to tripping, short circuit, fires or other hazards ( ) ( ) ( ) 13. Floors free of tripping hazards including machinery, supplies, loose or broken tile, or defective finish 14. Locks function properly ( ( ) ( ) 15. Proper ventilation. Grounds 16. Grounds, blacktop, and sidewalks free of undermining hole's or cracks large enough to cause tripping accidents. ( ) ( ) ( ) 17. All areas free of debris, broken glass and other hazardous materials ( ) ( ) ( ) 18. Safe procedures posted in chemical storage areas ( ) ( ) ( ) 37. 19. All chemicals and hazardous materials properly marked and stored. ( ) ( ) ( ) 20. Posts or fencing in good repair, free of loose or falling pieces, sharp corners and edges that could cause accidents. ( ) ( ) ( ) 21. Fields and disposal areas properly maintained and kept clean. ( ) ( ) ( ) 22. Signage in good condition and legible. ( ) ( ) ( ) COMMENTS and RECOMMENDATIONS: 38. Appendix "C" INJURY / ILLNESS INCIDENT REPORTING PROCEDURE 39. • o b1 JEFFERSON COUNTY F° EMPLOYEE INJURY/ILLNESS*INCIDENT/NEAR MISS REPORTING PROCEDURE Ejj; FR SON cO' An employee has an occupational: * Injury - if there is physical harm to the body usually requiring a doctor's visitas defined in 39- 71-119, MCA, and interpreted by ERD. * Illness/Disease - also causing physical harm to the body and usually requiring a doctor's visit, as defined in 39-71-116(20), MCA, and interpreted by ERD. * Incident - an event, intentional or unintentional, that resulted in or contributed to, or could have resulted in or contributed to a loss, injury, damage, or harm to persons or property. * Near Miss - an incident 1 . All occupational injuries/illness, should be reported by the employee, as soon as possible. and no later than the end of the working shift to the immediate supervisor (Verbal reporting constitutes "notice given"). 2. If medical attention (usually a doctor's visit) other than simple first aid is required, the employee should go to a medical facility for the care needed. The employee should then return with any written medical recommendations pertaining to work restrictions, or time off. 3. The Safety Coordinator should be notified of any occupational incident involving injury/illness, or near miss with in 24 hours. 4. If the incident caused injury/illness (physical harm to the body), a "First Report Form", available from the immediate supervisor, should be filled out (within 30 days of the incident) and filed within 6 days with the MACo Workman's Compensation Division. • The form should be submitted for injuries/illness, in order to protect the employees right to benefits in the event a seemingly minor injury develops into a more serious condition. • The employee , if physically able, should be responsible for the information in the "Worker". "Accident Description" (as detailed as possible), "Medical" (use N/A if no medical attention is needed). and "Signature" fields. (See color coded First Report Sample in Injury/Illness Reporting File /Yellow.) • The employees immediate supervisor should be responsible for the "Employer" field. (See color coded First Report Sample in Injury/Illness Reporting File�. In the case of a Dept. Head or Elected Official being the injuredparty it should be the policy that their First Report will be signed by the Commission Chair. • • Every question should be answered to ensure that your medical costs and any salary lost because of the iniurv/illness will be paid. 40. • The First Report should then be taken to the Safety Coordinator who should obtain the necessary information required for record keeping of the OSHA 300/300A forms and to confirm that the First Report is complete with the exception of the "Wages" information field. • The First Report should then go to the Payroll Dept. of the Clerk & Recorder's Office for the "Wages" field, and "Tax I. D."and "Payroll Classification Code" in the "Employer's" field of the First Report to be completed. (See color coded First Report Sample in Injury/Illness Reporting Folder/P i1.) • Copies of any written medical recommendations pertaining to work restrictions, or time off,, from the doctor should be attached to the First Report. • The First Report and copies of any work related medical paperwork should then he sent (usually Faxed) on to the MACo Workman's Compensation Division. • The original First Report and copies of medical paperwork should be delivered to and kept on file in the Personnel Dept.. • The employee should receive a claim number by mail from the Workman's • Compensation claims adjuster. That information should be provided by the employee to the medical facility where treatment was received, for the payment of medical expenses. • The Safety Coordinator should receive an email with the claim number and should communicate with the MACo claims adjusters to facilitate and assure the best outcome of the claim. 5. An Incident Report should be filled out for any Near Miss situation. The near miss should be reported to immediate supervisor and the Incident Report Form filled out and delivered to the Safety Coordinator within 24 hours. The Incident Report for a near miss will be kept in the Safety Coordinator's Incident file. • The immediate supervisor should record all appropriate information that will facilitate a thorough investigation of the incident. • The Safety Coordinator should provide the Incident Investigation Forms b. In all cases of occupational injury/illness, or near miss incidents an investigation performed by the Safety Coordinator and/or Dept. Head should take place as soon as possible. Time is of the essence for clarity of recall when determining the cause and corrective action to be taken. 7. The Safety Coordinator should report the necessary information regarding First Reports, Incident Reports, and Investigations to the Safety Committee in order to analyze the situation and provide preventative recommendations and solutions to eliminate a possible recurrence. 41. Appendix "D" Emergency Action Evacuation Plan 42. • o,,�weD, Emergency Evacuation Plan Jefferson County, Montana 201 W. Centennial P.O. Box 13 Iir Boulder,MT 59632 kksoN coUN' In the event of emergency: • The means of reporting fires and other emergencies: • Fire in the courthouse should be reported by activating the fire alarm system. • Fire at any other location should be reported by calling 911/Dispatch (225-4075). • All other emergencies in any location should be reported by calling 911/Dispatch (225-4075). • Employees are alerted to fire or other emergencies by: • Fire Alarm system (courthouse) • Emergency Phone Intercom • Reverse 911 via. Sheriff's dispatch • Personnel in the field may be notified by radio or cell phone by their immediate supervisor. • All procedures and direction in an emergency situation will follow Incident Command protocol. • Emergency Intercom, Reverse 911, and radio or cell phone communication will provide a verbal description of the emergency, and status of evacuation proceedings. • In the event of a fire or other emergency requiring evacuation, ALL employees should evacuate immediately. • In the event of emergencies requiring to shelter-in-place, ALL employees should remain to shelter-in-place. • In the event of an emergency, employees should evacuate by means of the nearest available marked exit. • Portable fire extinguishers are provided in the workplace for employee use. In the event of fire, any employee may voluntarily use extinguishers in an attempt to extinguish an incipient stage fire (low level) before evacuating. • Critical operations shutdown procedures are not required, because no employees are authorized to delay evacuation for this purpose. ▪ No employees are assigned to perform medical or rescue duties during emergency evacuation situations. • Visitors/Public should be assisted with exiting the building safely. 43. • After an on site emergency evacuation, employees should rally in the following location (s): • County Courthouse Campus rally at the flagpole on the north side of the courthouse. Boulder Library and Public Health Dept. rally at the landscaped island in the Library parking lot. • County Shop rally at the fire hydrant on the south side of the building. • Solid Waste site attendants should proceed to the farthest safe point along the entrance route to the facility. • Road shop personnel should proceed to the farthest safe point along the entrance route to the facility. • In the event of an emergency affecting personnel working in the field they should receive emergency and evacuation instruction from their immediate supervisor by radio or cell phone. • After an emergency evacuation, the procedure for accounting for all personnel will be an employee count taken by the department supervisor or accountable employees in the event of their absence, for each department involved. • For further assistance with emergency evacuation procedures,the following agencies may be contacted: Sheriffs Dept.; Fire Depts.; Ambulance Services; Local Disaster and Emergency Services; and the Public Health Dept. 44. • Appendix "E" Forms Labor Workplace hazard Notification and Safety Orientation Sign and return both forms to Personnel Officer 45. • S. VEMEO N p3 __, Jefferson County Labor Workplace Hazard Notification SON COUN1 We at Jefferson County want to insure your work experience with us is safe and satisfactory for both employee and employer. The following is a list of potential hazards you may encounter while working at our facility. Please take time to read this list and ASK ANY QUESTION you may have about the list or the facility. Sign the form when you are done. If you have difficulty reading or do not understand anything on this list,please let us know and we will help you through the list. Moving Equipment: Watch for moving equipment including customer traffic and waste transfer equipment. Make eye contact with the driver before going near this type of equipment. Do not walk under or near a raised load (loader bucket or truck tipping) Possible Contaminants in the Waste Stream Do no touch any material which may be hazardous. Contact your supervisor before handling the following: Ammunition Containers with harmful liquids (Clorox,pesticides, Drano, Acids,etc.) Containers with flammable liquids(gasoline,paint thinner,etc.) Potential medical waste, which may contain Blood Borne Pathogen Slips and Falls • Watch where you walk,the area may contain glass wire or other materials. Surfaces and slopes may be sloped,irregular,and mush, snow or ice covered. Do not climb on equipment or jump off steps,docks,etc. Metal or rubber box flaps are slippery,especially when wet. Use caution on these surfaces Lifting Obiects Do not lift an item if it's too heavy or awkward. Get help from a co-worker. Make sure you have proper footing and balance. Lift with your legs,not your backs. Do not twist when lifting. Emergency Action Plan Report accidents, spills, leaks, fires, injuries, etc. inunediately to your Department Head or the Jefferson County Sheriff's Dispatch. Know evacuation route and rally point in the event of an emergency. Hazard Communication Many containers are labeled with contents and health hazards. Follow all warnings. Material Safety Data Sheets are available to affected county employees. ASK if you have any questions before handling any chemicals. Lockout/Tagout-Confined Spaces Do not remove any lockout/tagout device if you did not install it. Do not enter any area labeled Confined Space or Asbestos Hazard Do not reach into any area or place where you may get caught in machinery. Personal Protective Equipment Wear all required personal protective equipment provided for the job that you are given. Printed Name: Signature: Date: • 46.