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SAFETY & LOSS CONTROL PROGRAM

11/16/04 AMI Safety, Inc.

YOUR COMPANY NAME HERE *


ACKNOWLEDGMENT

Your Company Name Here * Safety and Loss Control Manual contains the policies and procedures necessary to promote a safe working environment for all employees. It is important that all employees be fully aware of the contents of this manual. You are required to read the manual and sign and date indicating that you fully understand it. Clarify any questions you may have with Your Company Name Here * supervisors.

I understand that I will be responsible for the return of this Handbook upon termination of my employment with Your Company Name Here. If, for any reason, I fail to return this Handbook to Your Company Name Here, I understand that a $25.00 fee will be deducted from any monies due me at the time of termination and/or resignation.

Your signature below constitutes that you will read the Your Company Name Here * Safety and Loss Control Manual. Your signature also constitutes that you agree to abide by these policies and procedures.

____________________________________________ ____________Employee Signature

Date

____________________________________________ Employee Name (Printed)

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TABLE OF CONTENTS

PART I SAFETY AND HEALTH POLICY

PART II MEDICAL TREATMENT POLICY

PART III ACCIDENT REPORTING PROCEDURES

PART IV SUBSTANCE ABUSE POLICY

PART V SAFETY RULES

PART VI PERSONAL PROTECTION

PART VII EMPLOYEE DISCIPLINARY POLICY

PART VIII VEHICLE OPERATION POLICY

PART IX SAFETY & TRAINING MEETINGS

PART X DAMAGE REIMBURSEMENT POLICY

PART XI HAZARDOUS COMMUNICATION TRAINING

PART XII SCAFFOLDING

11/16/04 AMI Safety, Inc.


SAFETY & LOSS CONTROL PROGRAMPART I SAFETY AND HEALTH POLICY PAGE 1

It is the policy of Your Company Name Here * to provide and maintain safe and healthy working conditions and to follow operating practices that will safeguard all employees. Accident prevention and efficient production go hand-in-hand. All levels of Management have a primary responsibility for the safety and well being of all employees. This responsibility can be met only by working continuously to promote safe work practices and to maintain property, tools and equipment in a safe operating condition.

Supervisors of Your Company Name Here * are responsible and accountable to see that this policy and its procedures are followed and that all OSHA safety standards are met in their areas of control and responsibility.

Supervisors are responsible and accountable for the safety of their employees. This includes the correction of unsafe conditions, unsafe work practices, enforcement of established safety rules and procedures and housekeeping standards. The supervisors are also responsible and accountable to see that their employees are provided with and wear or use the prescribed personal protective equipment that is deemed necessary for a particular job or operation.

The final responsibility for safety rests with the employees. Safe practices on the part of the employees must be part of all operations. Employees must follow safety precautions and rules to protect themselves and their fellow employees. Employees will be held accountable for their safety and for obeying those rules that have been designed for their protection. This also includes those safety regulations outlined in the OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970.

Employee disciplinary action, which may result in immediate dismissal, will be considered for employees found to be in violation of this Company's safety policies, rules and procedures in accordance with Your Company Name Here *'s Disciplinary Policy.

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YOUR COMPANY NAME HERE *AUTHORIZED MEDICAL TREATMENT

POLICY

It is the policy of Your Company Name Here * to provide its employees with the necessary and proper medical treatment for any personal injuries that may occur while in the course of employment with this company.

REPORTING OF INJURIES

An injured employee shall immediately on the occurrence of an accident or as soon as thereafter practicable notify his or her supervisor of the accident and/or injury.

MEDICAL INSTRUCTIONS

The supervisor or an authorized company representative will provide the injured employee with the instructions for obtaining necessary medical treatment.

UNABLE TO CONTACT SUPERVISORS

If the injured employee is unable to contact his or her supervisor immediately for reporting an accident or receiving medical treatment then he or she is to call AMI Safety at (800) 300-6742 to report the accident and/or injury. The representative will provide the necessary instructions.

AUTHORIZED COMPANY PHYSICIANS

The following physicians/facilities have been authorized for treatment of employees who are injured while in the course of employment. If the following facilities are inconvenient, please call AMI Safety at (800) 300-6742 and obtain additional listings.

Joes Medical Center123 Medical ParkwayNowhere, MD

EMERGENCY ROOM TREATMENT

The severity of an injury may necessitate that an employee visit the nearest hospital emergency room for treatment. If this occurs and follow-up treatment is necessary, arrangements must be made to have the employee visit an authorized company physician.

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PART III ACCIDENT REPORTING AND INVESTIGATION PROCEDURES PAGE 1

All injuries, accidents and vehicular accidents occurring or caused by Your Company Name Here * employees must be reported to supervisors immediately upon occurrence. Supervisors are responsible for questioning the employee and recording all information relating to the injury or accident. Supervisors are also responsible for completing the necessary report forms so the insurance company can be notified. It is important that the initial reports be completed and forwarded immediately.

Workers' Compensation Claims:

An “Employee Injury Report” form must be completed for all workers' compensation claims. A response to all items must be completed before the report can be processed. The completed report will be faxed or mailed directly to AMI Safety and also Human Resources for follow-up action.

AMI Safety along with Human Resources may request that the supervisor assist in setting up a “Formal Investigation.” A formal investigation will be considered for the following situations:

1. Accidents that result in employee injuries and the severity of the injuries prevent the employees from returning to their jobs or regular duties.

2. Employees who allege that they were injured on the job, but failed to report the alleged accident at the time of occurrence.

3. A serious incident that occurred and did not result in an employee injury or serious injury, but the incident had the potential to cause a severe injury or fatality.

Vehicular Accidents:

The supervisor must complete the necessary form immediately so that the insurance company can be notified of the claim. Following the initial reporting, AMI Safety and also Human Resources must be contacted so a complete investigation can be scheduled.

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YOUR COMPANY NAME HERE *EMPLOYEE INJURY REPORT

EMPLOYEEINFORMATION Company: Your Company Name Here * Date of Hire:

Name of Injured: Soc. Sec. #Address of Injured:

City:City:

State: Zip: Phone #: ( )

Birth Date: Male [ ] or Female [ ] Married [ ], Single[ ], Widowed [ ], Divorced [ ]

Occupation: Wages Per Hour:

Hours Worked Per Day: Days Worked Per Week:ACCIDENT

INFORMATION Date of Accident: Time of Accident: AM/PM

*Place of Accident (Site, City/County, and State):

How Did Accident Occur?

If Accident is a Slip or Fall, Was Employee Wearing work boots? Yes [ ] or No [ ]

Failure to Observe Safety Rule or Procedure? Yes[ ] or No[ ]Safety Equipment Provided? Yes[ ] or No[ ]

Being Used ? Yes[ ] or No[ ]

Equipment Being Used ? Yes[ ] or No[ ]

INJURYInformation Part of Body Injured:

Type of Injury:

Disabling Injury? Yes[ ] or No[ ] Date Disability Began:Employee Returned to Work? Yes[ ] or No[ ]

Date Returned to Work:

When Did Project Manager Know of Injury?

Name of Project Manager:

TREATMENTINFORMATION Name of Treating Physician: Phone #: ( )

Address of Treating Physician:

Name of Treating Hospital: Phone #: ( )

Address of Treating Hospital:

.

QUESTIONS? CALL (000) 000 - 0000MAIL THIS FORM IMMEDIATELY TO:

INSERT YOUR WORKMAN’S COMP OFFICE WITH ADDRESSOR FAX IMMEDIATELY TO: (111) 111-1111

EMPLOYEE DESCRIPTION OF ACCIDENT/INJURYCompany:

Employee’s Name (Printed):

Date of Accident/Injury:

Location:

Supervision:

Employees Description of Accident:

Employee’s Description of Injury:

Employee Signature: Date:

Witness Signature: Date:

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YOUR COMPANY NAME HERE *VEHICULAR ACCIDENT REPORT

EMPLOYEEINFORMATION

Company: Citation Issued to You? Yes [ ] or No [ ]

Name of Driver: Drivers License #

Address of Driver: City: State & Zip: Home Phone # ( ) Work Phone # ( )

Type of Injury:

ACCIDENT INFORMATION

Date of Accident: Time of Accident: AM/PM

*Place of Accident (Site, City/County, State)

How Did Accident Occur?

COMPANYVEHICLE

INFORMATION

*Vehicle #: *Model *Year: TAG #

Is Vehicle Operable? Yes [ ] or No [ ] *Last 4 digits of VIN #:

Describe Damage:

OTHER DRIVER # 1

INFORMATION

Name of Driver: Drivers License #:

Address: City: State & Zip:

Home Phone # ( ) Work Phone # ( )

Type of Injury

Make: Year: License Plate #:

Is Vehicle Operable? Yes [ ] or No [ ] Citation Issued to Driver? Yes [ ] or No [ ]

Describe Damage:

FOR ADDITIONAL SPACE, USE THE BACK OF FORM. IF USED, BE SURE TO FAX BACK OF FORM.

.

MAIL THIS FORM TO: INSERT YOUR WORKMAN’S COMP OFFICE WITH ADDRESS

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YOUR COMPANY NAME HERE *VEHICULAR ACCIDENT REPORT

OTHER DRIVER # 2

INFORMATION

Name of Driver: Drivers License #:



Type of Injury

Make: Year: License Plate #:

Is Vehicle Operable? Yes [ ] or No [ ] Citation Issued to Driver? Yes [ ] or No [ ]

Describe Damage:

WITNESS # 1INFORMATION

Name:



WITNESS # 2INFORMATION

Name:



FOR ADDITIONAL SPACE, USE THE BACK OF FORM. IF USED, BE SURE TO FAX BACK OF FORM.INSERT YOUR WORKMAN’S COMP OFFICE WITH ADDRESS

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YOUR COMPANY NAME HERE * GENERAL LIABILITY / PROPERTY DAMAGE CLAIM

COMPANY INFONAME DATE REPORTED

EMPLOYEE CITY

SUPERVISOR STATE

ACCIDENT TIME & PLACE

*DATE TIME AM/PM

*STREET

*CITY *STATE *ZIP

PROPERTY DAMAGE

OWNER HOME PHONE

ADDRESS BUS. PHONE

CITY STATE ZIP

DESCRIBE DAMAGE

WITNESSES

NAME- FIRST/LAST ADDRESS PHONE - HOME/WORK

ACCIDENT FACTS

MAIL THIS REPORT IMMEDIATELY TO:INSERT YOUR WORKMAN’S COMP OFFICE WITH ADDRESS

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PART IV SUBSTANCE ABUSE POLICY PAGE 1

NOTICE TO ALL EMPLOYEES

Your Company Name Here *'s “drug-free” requirement is based on the fact that measurable amounts of a controlled substance in a person's body may affect the person to a certain degree. Your Company Name Here * will not tolerate even a small risk that the use of a controlled substance by an employee may endanger the safety of such employee, his co-workers, clients or the general public. For this reason, any controlled substance use that produces a measurable amount of such controlled substance in an employee's body will render the employee UNFIT FOR DUTY and will be grounds for disciplinary action.

Premises as referred to within this policy, is defined as Your Company Name Here * jobsites, delivery sites, property, facilities, land, buildings, automobiles and trucks, whether owned, leased, or used.

The use, possession, ingestion, concealment, transportation, promotion, or sale of the following items or substances is strictly prohibited from all Your Company Name Here * premises:

1. ALCOHOL, ILLEGAL DRUGS, CONTROLLED SUBSTANCES, AND ANY OTHER DRUGS, WHICH MAY AFFECT EMPLOYEE'S SENSES OR MOTOR FUNCTIONS.

2. UNAUTHORIZED ITEMSĭ Stolen Propertyĭ Drug Paraphernalia

3. PRESCRIPTION DRUGS (i.e. controlled substances) - except under the following conditions:A. Employees shall inform their supervisor prior to using prescribed drugs on the job and provide a

physician's release for work assignment.B. Each vial shall be in the employee's name.C. Each prescription shall be not older than one (1) year of the date issued.D. Employee shall only possess amount of medication authorized by his prescription.

NOTE: The Company at all times reserves the right to determine if a prescription drug or medication produces hazardous effects and restrict the use of any such drug or medication accordingly. This may also include restricting the employee’s work activity or presence at the premise.

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URINE SPECIMEN SCREENING:

Your Company Name Here * employees will be required to undergo urine specimen screening under the following conditions:

1. Pre-employment: In an effort to prevent controlled substance users from entering the workplace, Your Company Name Here * requires all new applicants to undergo a pre-employment urine analysis. Applicants are not considered for employment if they do not satisfy the requirements of the tests.

2. Re-employment: Employees seeking re-employment will be required to undergo the testing outlined under Pre-employment.

3. Reasonable suspicion: The Company may require that an employee submit a urine specimen when the supervisor and/or an appropriate Company Official finds there is reason to suspect that employee may be using a controlled substance. This suspicion might include, but not limited to an unsteady gait, loud or slurred speech, or a pattern of absenteeism or tardiness.

4. Periodic: All employees or groups of employees will be subject to unannounced urine specimen screening.

5. Post-accident: Employees who sustain an occupational on-the-job injury, are involved in a company vehicular accident or charged with property damage may be required to provide a urine specimen immediately following the incident. If circumstances prevent the employee from providing a urine specimen for drug analysis immediately, then the employee must provide a urine specimen within 32 hours following the incident or be terminated from employment. The only exception to this policy is for unusual circumstances (i.e., employee hospitalized, etc.) and must be approved by the officer.

6. Random: Employees will be required to provide a urine specimen for analysis on a random basis. When asked to complete a random drug screen, the employee is required to have the test taken within 24 hours of being asked. The monthly system for selecting employees will be completely unbiased and random. The number of employees selected each month will be at a rate to ensure at least 25% of the total number of employees are tested on an annual basis. Employees selected to provide a urine specimen any one-month will not be exempted from the selection process for the remainder of the year.

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NOTICE OF DISCIPLINARY ACTION:

No employee urine specimen screen will be conducted without the employee's written consent. However, any Your Company Name Here * employee who refuses to submit to a urine specimen screen or there is evidence of tampering with the urine specimen or is found in the possession, use, or transportation of any controlled substance, contraband, unauthorized possession of Your Company Name Here * property, or any of the previously mentioned controlled substances or unauthorized items, will be subject to disciplinary action or termination.

Applicants who test positive on the urine specimen will not be considered for employment. Employees who test positive on Periodic, Reasonable Suspicion, Post-Accident or Random drug screens will be suspended for a minimum of five (5) working days without pay.

Upon returning to work, the employee must show negative on a urine drug screen and sign a Return-To-Work Agreement that is satisfactory to the Company. The employee will be responsible for payment of all drug screens required in the Return-To-Work Agreement. Any employee showing positive on any urine specimen screen a second time will be discharged immediately.

Employees who dispute results of the tests may request further testing of the same urine specimen at their own expense. These further tests must be performed by the original laboratory or another one federally certified and is mutually acceptable by Your Company Name Here * and the employee. If there is no such request from the employees for retest of the same specimen within 7 days of the original screen, or if the retest results are positive, the employees will be disciplined in accordance with this policy.

This policy is made for the maximum safety and well being of all Your Company Name Here * employees, the general public and our clients. Your assistance and cooperation for the achievement of this goal is vitally important.

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YOUR COMPANY NAME HERE *SAFETY & LOSS CONTROL PROGRAM

PART V SAFETY RULES PAGE 1

VIOLATION of any safety rule established by Your Company Name Here * including, but not limited to, the rules set out below, may result in the employee being suspended or terminated from employment.

General Rules

1. REPORT all accidents and injuries to a Your Company Name Here * supervisor immediately.

2. REPORT all unsafe conditions to a Your Company Name Here * supervisor immediately.

3. THE POSSESSION, ingestion, concealment, transportation, promotion or sale of the following items or substances are strictly prohibited from all job sites:

ĭ Illegal drugs, controlled substances (including trace amounts), look-alikes and designer drugs

ĭ Unauthorized alcoholic beveragesĭ Unauthorized firearms and weaponsĭ Stolen propertyĭ Drug paraphernaliaĭ Unauthorized prescription drugs

4. HORSEPLAY, fighting or provoking a fight is prohibited on the job site.

5. GOOD HOUSEKEEPING must be maintained at all times.

6. LOOSE CLOTHING must not be worn around moving machinery.

7. TRIPPING HAZARDS must be avoided by placing cords, ropes, etc. out of walkways and stairways.

8. COMPRESSED AIR hoses must never be pointed at anyone or used to clean clothing.

9. TAG LINES must be used when guiding crane loads and do not place your body under a suspended load.

10. NEVER enter a trench that is over 5 feet in depth unless it is shored or sloped. Report any such condition to your supervisor. This includes areas outside of basement walls.

11. UNAUTHORIZED operation, repair or adjustment of machinery or equipment is prohibited.

12. RUNNING on the jobsite is not allowed unless in a Your Company Name Here of emergency.




General Rules (cont’)

13. STEREOS with headphones are not allowed to be worn in the workplace or while operating company vehicles.

14. POWER-ACTUATED TOOLS must be used only by trained personnel.

15. GUARDS must be in place on all equipment (stationary and mobile) before the equipment is used.

16. SAFETY HARNESSES AND LANYARDS must be worn when working from un-barricaded elevated areas 6' or more above the ground or floor level.

Personal Protection

1. SAFETY GLASSES with side shields will be provided by Your Company Name Here and are mandatory at all times while on the job site.

2. WORK SHOES must be worn that support the ankle and guard against puncture wounds. Western type boots, tennis and sneaker type shoes are not allowed to be worn on any job sites.

3. GLOVES must be worn when handling materials with sharp edges.

Ladders

1. LADDERS must:ĭNot be used with broken or missing rungsĭNot be paintedĭBe equipped with non-skid safety feetĭBe used by only one person at a time

2. STRAIGHT LADDERS must:ĭExtend above the landing 3 feet if used for accessĭBe tied off at the top or secured at the foot of ladderĭBe placed so that the ladder foot is placed 25% of ladder length away from structure base

3. STEP-LADDERS must:ĭNot be used as straight laddersĭNot use the top 2 steps, which includes the top, for standingĭDo not work or climb from the backside of the ladder




Electrical

1. ELECTRICAL EQUIPMENT must be grounded, using a 3-wire grounded extension cord (minimum 12 gauge wire) and receptacle. Tools with 2-wire cords must be double insulated.

2. GROUND FAULT INTERRUPTERS must be used on electrical tools and cords.

3. ELECTRICAL EXTENSION and portable equipment cords must be visually inspected each day for insulation damage and/or exposed conductors.

4. POWER SOURCES such as electricity, steam, compressed air and/or hydraulics must be locked out by the employee before working on the equipment as follows:

- A lock must be placed on the switch or valve that completely de-energizes the equipment.

- Electrical equipment must be locked out at the main switch and not the control panel start and stop button.

- A lock out red tag must be attached to the lock that identifies the person working on the equipment.

- The one key for the lock must be in the possession of the mechanic or employee working on the equipment.

Fire Prevention

1. OILY RAGS and other types of combustibles must be cleaned up immediately.

2. WELDING or cutting, if possible, must not be performed around combustible materials.

3. FIRE EXTINGUISHERS (ABC type) must be on every jobsite, either on site or in company van. An extinguisher must be in the immediate area when welding or using an open flame.

4. HEATERS and open flames must be kept away from combustible materials.

5. SMOKING is not allowed in the workplace or a client’s home.


SAFETY & LOSS CONTROL PROGRAMPART V SAFETY RULES PAGE 4

Pneumatic Nailers

1. Safety glasses with side shields must be worn when operating the pneumatic nailer.

2. Never free-fire nailers. Nailers should be operated only in firm contact with the workpiece.

3. Disconnect the air supply before:ĭ Leaving the work areaĭ Performing maintenance

4. Do not use the air supply for removing dust from your clothing.

5. Do not remove or tamper with automatic safety devices.

6. Never load or carry tools with the trigger or safety depressed.

7. Never tie the trigger in the fire position.

8. Only use clean, compressed air. Never connect the tool to any other pressure source.

9. Make sure the compressed air is regulated not to exceed the maximum pressure stamped on the tool.

10. Examine the tool each day for missing or defective parts. Make sure there are no obstructions and the safety moves freely on all safety mechanisms.

11. Clean the magazine by removing all dust and dirt particles.

12. Point the nailer away from you and others when connecting the air hose.

13. All safety mechanisms must operate correctly before using the nailer.

14. Do not drive the nail:

ĭ Towards any part of your bodyĭ Near the edge of a boardĭ At a steep angleĭ On top of another nail



PART VI PERSONAL PROTECTION PAGE 1

It is the policy of Your Company Name Here * to require that its employees wear personal protection to prevent or minimize the severity of personal injuries. All safety equipment must conform to applicable ANSI standards.

EYE & FACE PROTECTION:

Safety glasses with side shields will be provided by Your Company Name Here and are mandatory at all times while on the job site.

Additional eye and face protection must be worn when:

ĭ Welding, burning or use cutting torchesĭ Using abrasive wheels, grinders or filesĭ Chipping concrete, stone or metalĭ Working with materials subject to scaling, flaking or chippingĭ Drilling or working under dusty conditionsĭ Sanding or water blastingĭ Waterproofingĭ Using explosive actuated fastening or nailing toolsĭ Working with compressed air or other gasesĭ Working with chemicals or other hazardous materialsĭ Using chop, chain or masonry sawsĭ Working near any of the above named operations

FOOTWEAR:

Your Company Name Here * requires that all of its field employees wear substantial work shoes that provide ankle support and resistance to puncture wounds. Western type boots, sneakers and sandals are not allowed to be worn on any job sites.


SAFETY & LOSS CONTROL PROGRAMPART VI PERSONAL PROTECTION PAGE 2

RESPIRATORY PROTECTION

Your Company Name Here * will furnish its employees with respiratory protection when required. Whenever it is determined through analytical methods that employee(s) may be potentially overexposed, in accordance with OSHA standards, to dusts, mists, fumes or chemicals, proper respiratory protection will be defined and employee(s) will be required to wear the equipment.

HEARING PROTECTION

Your Company Name Here * requires its employees to wear hearing protection when operating high noise level machinery, equipment or job tasks where high impact noise levels occur (i.e., concrete saws, blowers, etc.). Your Company Name Here * will furnish hearing protection. Employees performing such tasks must request the hearing protection from their supervision.

GLOVE & HAND PROTECTION

Gloves provided by the Company must be worn when handling objects or substances that could cut, tear, burn or otherwise injure the hands. Gloves must not be used when operating drill presses, power saws or similar rotating machinery.



PART VII EMPLOYEE DISCIPLINARY POLICY PAGE 1

Safety rules and procedures have been established by this Company for the protection of all employees engaged in job site activity. All employees are required to adhere to these rules and procedures while on Your Company Name Here * job sites.

An employee's disregard for adhering to the policies, rules and procedures can result in serious injury to himself and his fellow employees. This type of work behavior cannot be tolerated by the management of Your Company Name Here *

Your Company Name Here * has implemented a 3-step disciplinary procedure, which, under most circumstances, will provide a written warning to the employee that describes the violation that has occurred. It is the intent of Your Company Name Here * to discuss the violation with the employee and provide necessary instructions for the proper safe procedure.

However, if Your Company Name Here * determines that an employee knew the proper rule, procedure or policy and willfully disregarded it, that employee may be terminated immediately.

Employee disciplinary action will be considered for any employee who is found to be in violation of the Company's safety policies, rules and procedures in accordance with the following schedule.

ĭ First violation will result in a written warning to the employee.

ĭ Second violation within a 1-year period may result in the employee being suspended for 3 days.

ĭ Third violation within a 1-year period may result in the employee being terminated from employment.

A copy of all records of employee disciplinary action must be sent to the company office to be included in the employee's personnel file.

Employees who violate the SUBSTANCE ABUSE POLICY will be subject to disciplinary action outlined in that policy.

ATTACHMENT I - DISCIPLINARY ACTION NOTICE



DISCIPLINARY ACTION NOTICE

EMPLOYEE'S NAME

DATE OF WARNING The above employee was given a warning on this date for the following violation:

INSTRUCTIONS

1. Remind the employee of the Company's Disciplinary Policy.

2. Contact Human Resources immediately to identify any previous warnings in the employee's personnel file.

3. The employee is subject to suspension or termination if this warning represents the second or third warning for a violation within the previous one-year period.

4. Forward this warning to the Human Resources Department so it can be placed in the employee's personnel file.

5. Make sure the employee and the supervisor sign this warning.

EMPLOYEE ACKNOWLEDGMENT

I have read and understood the Your Company Name Here * policy for Employee Discipline. I also understand the policy, rule or procedure violation that has led to this action.

_____________________________ ____________________________ Employee Signature Date

_____________________________ ____________________________ Supervisor Signature

Date


SAFETY & LOSS CONTROL PROGRAMPART VIII VEHICLE OPERATION POLICY PAGE 1

Your safety and the safety of those around you are of the utmost importance to us and to your families. Exceeding the speed limit on the roadways, rushing in and out of lanes while on the highway or on the neighborhood roads, running a red light or performing any kind of reckless act in a vehicle can endanger yourself and everyone around you. Please include in the management of your daily schedule enough time to get where you need to go timely and safely.

GENERAL REQUIREMENTS FOR DRIVERS

1. All applicants or transfer employees for vehicular operation positions must satisfy the requirements of a drug screen as outlined under Your Company Name Here *’s Substance Abuse Policy.

2. Applicants for driving positions may not be hired if their current driving records show a DWI or DUI within the previous 5-year period.

3. Applicants for driving positions may not be hired if their current driving records show 3 or more serious violations within the previous 3-year period.

4. MVR's may be obtained and evaluated for all drivers on a periodic basis.

5. Seatbelts must be worn at all times when operating vehicles.

6. Report all defects, accidents and/or vehicle damage immediately. Vehicle damage not previously reported will be charged to the current driver when the damage is discovered.

7. Report traffic citations, license revocation or suspension immediately to your supervisor.

8. Do not make any statements concerning an accident other than to police officers or company representatives. Under no circumstances, admit accident liability.

9. Do not allow any unauthorized riders or passengers in company trucks.

10. Do not wear earphones of any type while operating company vehicles.

11. Mobile cell phones must not be used when the vehicle is in motion.

12. All vehicles must be kept clean and orderly at all times. Vehicles must be locked when not in use.

13. Any fines resulting from speeding or any other traffic violation while operating a

company vehicle will be the sole responsibility of the employee. Parking citations will be reviewed on a Your Company Name Here-by-Your Company Name Here basis.

In the event we receive a phone call from the police or another driver, reporting that you are driving recklessly, a ticket from a camera indicating you were speeding or running a red light, or upon receipt of your driving record from the Motor Vehicle Administration any of which total 3 infractions in a 12 month period, we will be forced to respond with the regulations dictated by our insurance company. They are outlined in the following pages.

YOUR COMPANY NAME HERE *SAFETY & LOSS CONTROL PROGRAM

PART VIII VEHICLE OPERATION POLICY PAGE 2

DWI and/or DUI CITATIONS

An employee convicted of a DWI or DUI will be placed on probation for one year after the conviction date and may be disqualified from operating a company vehicle. The employee will be required to complete any court required Alcohol or Substance Abuse Awareness programs.

SERIOUS VIOLATION CITATION(S)

One Serious Violation within a 3-year period - A warning letter will be issued to the employee

Two Serious Violations within a 3-year period - A warning letter will be issued to the employee and a recommendation to complete a defensive driving course

Three or more Serious Violations within a 3 year period - The employee will be required to complete a defensive driving course and present a certificate of completion to management within a specified time period and a warning that any further serious violations will result in losing the privilege of driving a Your Company Name Here owned vehicle.

Four or more Serious Violations within a 3 year period – loss of driving a Your Company Name Here owned vehicle.

Serious Violations Include:ĭ Driving while intoxicated (DWI)ĭ Driving while under the influence of alcohol or drugs (DUI)ĭ Failure to stop when involved in an accidentĭ Reckless Drivingĭ Speeding 10 MPH or more over the speed limitĭ Driving while license is suspended or revokedĭ Attempting to elude a police officerĭ Failure to obey traffic control device or traffic signĭ Following too closelyĭ Failure to yield right of wayĭ Failure to stop for a school busĭ Failure to stop or yield before entering a highwayĭ Involved in an accident

APPLICANTS FOR DRIVING POSITIONS:· Must not have 3 or more serious violations in previous 3 year period· Must not have an alcohol or drug related citation in previous 5-year period



PART IX SAFETY & TRAINING MEETINGS PAGE 1

A safety meeting will be conducted for all employees. The meetings will be conducted by Your Company Name Here * supervisors. Because injury frequency tends to increase during the middle of the week, it is recommended the meetings be conducted during this time.

The safety meetings are available on AMI Safety’s website: www.amisafety.com. Select “SAFETY MEETING” and type in “Your Company Name Here” as the password. Supervisors have the option to change or replace any meeting topic that he determines to be timely and appropriate. For example, supervisors may elect to discuss a recent serious accident.

Safety meetings are considered training sessions under OSHA. It is important to document training sessions. The employees attending the safety meeting must sign the reverse side of the meeting topic sheet.


SAFETY & LOSS CONTROL PROGRAMPART X DAMAGE REIMBURSEMENT POLICY PAGE 1

It is the policy of Your Company Name Here * to require reimbursement payment from employees whose negligence results in a financial loss to Your Company Name Here *. These losses can be related to the vehicles, property, tools and/or equipment damage.

Reimbursement may be required for all chargeable vehicle, property, tools and/or equipment losses.

The management of Your Company Name Here * will investigate all losses relating to vehicular, property, tools and equipment damage. As a result of the investigation, a determination will be made by management if the incident or accident is “CHARGEABLE” to the employee involved.



PART XI HAZARD COMMUNICATION TRAINING PAGE 1

The purpose of this training session is to inform you of the nature of the materials, which are an integral part of our construction operation.

Since this training is being provided entirely for your benefit, it is essential that you understand the information, which is being presented at this time.

If at any time during your reading of this program, there is something that is not entirely clear or which you do not understand, please do not hesitate to make your questions known. We would like this training program to be a free and informal exchange of information.

The Hazard Communication Standard was developed by OSHA with the goal of reducing the possibility of chemically caused illnesses and injuries by providing employees with as much information as is necessary to understand the hazards of any chemicals that may be used in your work. The standard requires that we have a written Hazard Communication Program, which includes information on container labeling, material safety data sheets, and an employee-training program. Our program also includes information on the chemicals used by our company, chemical hazards you might be exposed to if assigned to a non-routine task, hazards associated with chemicals in unlabeled pipes, and the way we will inform outside contractors of hazards their employees might be exposed to or which you might be exposed when they perform work in our operation.

Before continuing, let’s outline a few things about this program, which are important. First, although the word “hazardous” will be used, keep in mind that we are talking about things like portland cement, aggregated, admixtures, even pigments, which most of you have worked for a good part of your life, rarely with any bad effects. Second, and the real point to this training, is that knowing even a little more about some of these commonly used materials will make you aware of the potential for problems, and help you reduce or totally eliminate safety and health problems when you use these materials. You are the ones using these materials; it's up to you to take this information and make your job as safe as possible.



PART XI HAZARD COMMUNICATION TRAINING PAGE 2

As mentioned, there are three key parts to our Hazard Communication Program: Container Labeling, Material Safety Data Sheets and Training. Let's discuss labeling first.

The standard states that chemical manufacturers and distributors cannot ship containers of chemical unless they are properly labeled with the identity of the hazardous chemical or material. It is our policy not to accept, even on a trial basis, any shipments without a proper label. Labels on containers will tell you what chemical is in the container, what hazard may be present, and the name and address of the manufacturer.

That brings us to the second component of our program, Material Safety Data Sheets. MSDS's are technical bulletins prepared by companies who make chemicals or distribute materials. They should contain the following information: The identity of the material - including chemical and common names; physical and chemical characteristics of the chemical; known acute and chronic health effects and related health information on the chemical; exposure limits; whether the chemical is considered to be a carcinogen - this is, whether it can cause cancer; precautionary measures to take when using the chemical; emergency and first aid procedures; and the name and address of the person who prepared the information.

In general, most MSDS's will have eight separate sections, each presenting different information on the particular chemical. Here is a brief explanation of the types of information found on a MSDS.

Section one will contain the name of the material, who made or supplied it, their address and phone number, and the chemical name or other common names used.

Section two lists any hazardous ingredients found in the material.

Section three will show various physical characteristics of the chemical, including its appearance and odor, boiling point, solubility in water, evaporation rate, vapor density, etc.

Section four offers fire and explosion hazard information such as flash point, how best to extinguish a fire involving the chemical, and other special fire fighting procedures.

Section five talks about reactivity, which is basically how the chemical reacts with other ingredients and which combinations to avoid.


SAFETY & LOSS CONTROL PROGRAMPART XI HAZARD COMMUNICATION TRAINING PAGE 3

Section six will offer health hazard information such as the acute and chronic hazards, signs and symptoms of exposure, effects of overexposure, and emergency and first aid procedures.

Section seven concerns precautions for safe handling use and gives procedures to follow in the event of a spill or leak.

Section eight discusses control measures such as any special protection recommended or required. This could include protective clothing, goggles, gloves, etc.

All Material Safety Data Sheets will not follow exactly the same format, but will contain essentially the same type of information.

Copies of all MSDS's received by us will be kept in the safety books in the site office. The MSDS's, along with our entire Hazard Communication Program, are available to any employee for review in the Company’s main office. Please contact your supervisor if you need any information or call the office.

Let us know if you have any questions on MSDS.

The last item in our Hazard Communication Program is identification of hazards associated with non-routine tasks which some of you might be asked to perform on occasion.

We have identified several of the basic non-routine tasks which employees might be asked to perform. Specific procedures to be followed when performing these tasks will be explained in detail by your supervisor. These procedures, based on manufacturer's recommended practices, must be followed to minimize the chance of illness or injury resulting from the performance of that work.

This concludes the training aspect of our Hazard Communication Program. We hope this information helps you to continue to work safely with the various materials we use everyday. Don't forget, our written Hazard Communication Program is available to all employees to review. Contact your supervisor for instructions.


SAFETY & LOSS CONTROL PROGRAMPART XII SCAFFOLDING PAGE 1

Competent Person - means one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which unsanitary, hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them.

1. Scaffolds must be erected, moved, dismantled or altered under the supervision of a competent person.

2. Employees working on scaffolding must be selected and trained by the competent person.

3. Ropes must be inspected by competent person prior to work shift and after any potentially damaging occurrence.

4. A competent person must determine when it is safe to work on scaffolding during storms and high winds and require employees to use personal fall protection.

5. A competent person must inspect the scaffold and components before each work shift and after any occurrence, which could affect a scaffold’s structural integrity.

6. The competent person must determine the feasibility and safety of providing fall protection for employees erecting or dismantling supported scaffolding.

General Requirements for Scaffolds

1. Each scaffold and component must support its own weight and 4 times the intended load.

2. Platforms on all working levels must be fully planked between the front uprights and guardrail supports.

3. A scaffold platform and walkway must be at least 18 inches wide. In Your Company Name Here's where it is impossible to have the walkways 18 inches wide, guardrails and/or personal fall arrest systems (PFAS) must be used.

4. The platform front edge must be within 14 inches of work face. Guardrails along the front edge and/or PFAS must be used if the gap exceeds 14 inches.

5. The maximum distance from the face for outrigger scaffolds is 3 inches.

6. Platforms 10 feet or less in length, unless cleated or restrained, must extend over the end support at least 6 inches, but not greater than 12 inches if not blocked by guardrails.

7. Platforms greater than 10 feet must not extend over the end support more than 18 inches if not blocked by guardrails.



PART XII SCAFFOLDING PAGE 2

8. Abutted platforms must rest on separate supports.

9. Overlapping platforms using the same support must overlap at least 12 inches or restrained.

10. Scaffolding with a height to base ratio of more than 4:1, including outriggers if used, must be restrained by guying, tying, bracing or equivalent means.

11. Guys, ties and braces (GTB) must be installed where horizontal members support both inner and outer legs.

12. GTBs must be installed at the closest horizontal member to the 4:1 height and repeated vertically at locations of horizontal members every:

ĭ 20 feet for scaffolds 3 feet wide or less - 26 feet for scaffolds greater than 3 feet wide

13. The top GTBs must be placed not further than the 4:1 height from the top.

14. GTBs, when required, must be installed at each at each end of the scaffold.

15. Scaffold uprights must be plumb and bear on base plates, mudsills or other adequate foundations that are level and will not settle.

Access to Scaffolds

1. Portable ladders or other approved means must be used when the platforms are more than 2 feet above or below the access point.

2. Specifically designed hook-on and attachable ladders more than 35 feet must have rest platforms at 35-foot maximum vertical intervals.

3. Direct access to or from another surface is allowed when a 14-inch horizontal and 24 inch vertical distance to another surface is not exceeded.

4. Cross braces must not be used as a means of access or egress.

5. Ladders must not be used on scaffolds to increase the working height.




Fall Protection on Scaffolds

1. Employees on a scaffold more than 10 feet above a lower level must be protected from falling to the lower level.

2. Employees on a walkway located within a scaffold must be protected by a guardrail system installed within 9 1/2 inches of and along at least one side of the walkway.

3. Employees working from scaffolding must be protected by guardrails on all open sides or a Personal Fall Arrest System.

4. PFAS must be attached by a lanyard to a vertical lifeline, horizontal lifeline, or scaffold structural member.

5. Vertical lifelines must be fastened to a fixed safe anchorage point independent of the scaffold.

6. Horizontal lifelines must be secured to two or more structural members of the scaffold.

Guardrails

1. Guardrails must be installed along all open sides and ends of platforms before releasing scaffold to employees other than erection/dismantling crews.

2. Guardrails must meet the following criteria:ĭ Toprail installed 38" to 45" from working platformĭ Midrail installed halfway between platform and toprailĭ Toprail must withstand a 200 pound horizontal or vertical force

3. The following applies when tools, materials or equipment could fall from the scaffold and strike employees:

ĭ the area below the scaffold must be barricaded to prevent employees from entering, or;

ĭ a toeboard, 3 1/2 high and no greater than 1/4" gap between it and platform, must be erected along the edge of platforms more than 10 high.

4. Paneling or screening must be installed between toeboard and toprail if material, etc. are stacked higher than toeboards.




Mobile Scaffolds

1. Cross, horizontal or diagonal braces must be installed to prevent racking or collapse of the scaffold and secure the vertical members together laterally so the scaffold is plumb and level.

2. When working from the scaffold, casters and wheels must be locked to prevent movement.

3. Manual force for moving must not be applied higher than 5 feet above the floor.

4. Power systems used to move scaffolds must be designed for such use. Forklifts, trucks, etc. must not be used unless designed for such use.

5. Employees must not be allowed to ride on scaffolds unless the following conditions exist:ĭ the floor must be 3 degrees of levelĭ the height to base width ratio during movement is 2 to 1 or less.ĭ outriggers, if used, must be installed on both sides of scaffoldĭ power systems must be applied directly to the wheelsĭ no employee is on scaffold which extends beyond wheels, casters or other

supports

6. Platforms must not extend beyond the base supports.

7. Screw jacks or equivalent means must be used to level scaffold

8. Caster stems and wheel stems must be pinned or otherwise secured.

9. Employees on the scaffold must be warned before it is moved.

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