Documente Academic
Documente Profesional
Documente Cultură
January 1, 2004
Guide No. 17
Guide to Developing a Corporate Safety Program
for Industrial Painting and Coating Contractors
9.
10.
11.
12.
1. SCOPE
This guide has been developed to provide guidance in
developing a company safety program for contractors who
apply industrial coatings. Contractors seeking to be certified
in accordance with the requirements of SSPC Qualification
Procedures (e.g. No.1, No. 2, and No. 3) must present written
verification that their company has a safety program in effect
and that program rules are constantly monitored and enforced. This guide identifies the core elements and requirements for developing a company safety program that incorporates good safety practice as well as regulatory requirements, and complies with the requirements for SSPC certification as well as meeting the current OSHA guidelines for
a company safety program.
SCOPE
DEFINITIONS
JUSTIFICATION FOR A SAFETY PROGRAM
CORE ELEMENTS OF A COMPANY SAFETY PROGRAM
MANAGEMENT LEADERSHIP AND EMPLOYEE PARTICIPATION
HAZARD IDENTIFICATION
HAZARD PREVENTION AND CONTROL
INFORMATION AND TRAINING
Although it is intended for this guide to be a comprehensive document, some facility owners, such as the U.S Army
Corps of Engineers, the U.S. Military, and the Nuclear
Regulatory Commission, may require companies working in
their facilities to include additional program elements. Also,
regulations on a federal, state and local level are constantly
changing and program elements must be periodically reviewed and supplemented or modified to ensure compliance.
--```,``-`-`,,`,,`,`,,`---
1
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
SSPC Guide 17
January 1, 2004
2. DEFINITIONS
2
Not for Resale
--```,``-`-`,,`,,`,`,,`---
SSPC Guide 17
January 1, 2004
Commitment
Owners and top management should make a sincere
commitment to the program and provide the financial and
management resources to support and foster the program
for it to be effective. There must be a signed written policy
statement by the companys top executive officer or manager stating the companys commitment to safety and a
safety program. Failure to make a sincere commitment only
adds to wasted company resources. An example of such a
statement is: Our company is committed to provide facilities, equipment and management to assure a safe working
environment for employees and to achieve the lowest possible personal and financial loss due to accidents and
injuries. Every employee in the company must know and
understand the companys safety goal and commitment.
This includes the disciplinary policy and action for not
following the companys safety program.
Authority
--```,``-`-`,,`,,`,`,,`---
Managers, supervisors and employees must be provided with the authority and resources to carry out their
safety and health responsibilities. Company management
must promptly oversee the correction of unsafe conditions
and/or activities. Equipment that cannot be operated safely
must be repaired to ensure safe operation, or replaced.
Although disciplinary action may be required when employees do not follow safety rules and policies, an employer
should encourage employees to report accidents and nearmisses and to make recommendations to improve workplace health and safety concerns.
Equipment, Facilities and Competent and Responsible
Personnel
3
Not for Resale
SSPC Guide 17
January 1, 2004
6. HAZARD IDENTIFICATION
1926.451
1926.454
1926.500
Scaffolds
Scaffolds, Training requirements
Fall Protection: Scope, application, and
definitions applicable to this subpart
1926.502
Fall protection systems: Criteria and
practices
1926 Subpart M App C, Personal Fall Arrest Systems
Non-Mandatory Guidelines for
Complying with 1926.502(d)
1926 Subpart M App E, Sample Fall Protection Plan
Non-Mandatory Guidelines for
Complying with 1926.502(k)
1926.503
Fall Protection, Training Requirements
1926.550
Cranes and derricks
1926.552
Material hoists, personnel hoists, and
elevators
1926.1053
Ladders
1926.1060
Stairways and Ladders, Training requirements
1926.1127
Cadmium
Employee Participation
Employees should participate in the company safety
program. An employer should provide employees with an
opportunity to assist with the establishment, implementation
and evaluation of the program. This can be accomplished by
requiring employees to assist with safety training, audits,
and incident investigations. The establishment of a communication system between all levels of management and
workers is essential. Safety data must be collected and evaluated on a regular basis. All employees should be informed
about any safety concerns. Employers must regularly communicate with all employees about workplace safety and
health matters. Employees must be provided with access to
information relevant to the program. Mechanisms should be
implemented for employees at all levels to become involved
in the identification and assessment of hazards. They should
assist in prioritizing hazards, training about the hazards and
evaluation of program elements that deal with the hazard.
Provisions for employees to be away from their normal work
activities must be made so that they may receive training,
attend meetings and conduct other activities that may be
required by the program. An effective safety program integrates safety into the employees daily job performance and
behavior, and rewards employees who have good safety
performance.
--```,``-`-`,,`,,`,`,,`---
4
Not for Resale
SSPC Guide 17
January 1, 2004
employee has already been adequately trained. The employer must provide updated information and training as
often as necessary to ensure employees are adequately
informed and trained, particularly when workplace conditions are changed which create new hazards or increase an
existing hazard. All such training must be documented and
be readily available for inspection.
TABLE 1
OSHA TRAINING REQUIREMENTS
Hazard
Blood Borne Pathogens
29CFR
1910.1030
Training Requirements
1. An accessible copy of the regulatory text of this standard and an explanation
of its contents. 2. A general explanation of the epidemiology and symptoms of
bloodborne diseases.3. An explanation of the modes of transmission of
bloodborne pathogens.4. An explanation of the employers exposure control
plan and the means by which the employee can obtain a copy of the written
plan.5. An explanation of the appropriate methods for recognizing tasks and
other activities that may involve exposure to blood and other potentially infectious materials.
Confined Spaces,
Permit Required
1910.146
Fall Protection
1926.503
First Aid
1910.151
The employer shall provide training so that all employees whose work is
regulated by this section acquire the understanding, knowledge, and skills
necessary for the safe performance of the duties assigned under this section.
The employer shall provide a training program for each employee who might be
exposed to fall hazards. The program shall enable each employee to recognize
the hazards of falling and shall train each employee in the procedures to be
followed in order to minimize these hazards.
In the absence of an infirmary, clinic, or hospital in near proximity to the
workplace, which is used for the treatment of all injured employees, a person or
persons shall be adequately trained to render first aid. Adequate first aid
supplies shall be readily available.
Hazard Communication
Standard
1910.1200
1926.59
Hearing Protectors
1910.95
Ladders
1926.1060
1926.62
5
Not for Resale
employer shall assure that each employee is trained in the following:the content
of this standard and its appendices; the specific nature of the operations which
could result in exposure to lead above the action level; the purpose, proper
selection, fitting, use, and limitations of respirators; the purpose and a description of the medical surveillance program, and the medical removal protection
program including information concerning the adverse health effects associated
with excessive exposure to lead (with particular attention to the adverse
reproductive effects on both males and females and hazards to the fetus and
additional precautions for employees who are pregnant); the engineering
controls and work practices associated with the employees job assignment; the
contents of any compliance plan in effect; instructions to employees that
chelating agents should not routinely be used to remove lead from their bodies
and should not be used at all except under the direction of a licensed physician;
and the employees right of access to records under 29 CFR 1910.20, Access
to information and training materials.The employer shall make readily available
to all affected employees a copy of 29 CFR 1926.62 and its appendices.
Lockout and Tagging Circuits 1910.147 The employer shall establish a program consisting of energy control procedures,
employee training and periodic inspections to ensure that before any employee
performs any servicing or maintenance on a machine or equipment where the
unexpected energizing, startup or release of stored energy could occur and
cause injury, the machine or equipment shall be isolated from the energy source
and rendered inoperative.
Portable Fire Extinguishers 1910.157
Where the employer has provided portable fire extinguishers for employee use
in the workplace, the employer shall also provide an educational program to
familiarize employees with the general principles of fire extinguisher use and the
hazards involved with the incipient stage of firefighting. The employer shall
provide the education described above upon initial employment and at least
annually thereafter.
Powered Industrial
Truck Operator Training
1910.178
These provisions mandate a training program that bases the amount and type
of training required on: the operators prior knowledge and skill; the types of
powered industrial trucks the operator will operate in the workplace; the hazards
present in the workplace; and the operators demonstrated ability to operate a
powered industrial truck safely. Refresher training is required if: the operator
is involved in an accident or a near-miss incident; the operator has been
observed operating the vehicle in an unsafe manner; the operator has been
determined during an evaluation to need additional training; there are changes
in the workplace that could affect safe operation of the truck; or the operator
isassigned to operate a different type of truck. Evaluations of each operators
performance are required as part of the initial and refresher training, and at least
once every three years.
Respiratory Protection
1910.134
In any workplace where respirators are necessary to protect the health of the
employee or whenever respirators are required by the employer, the employer
shall establish and implement a written respiratory protection program with
work-site-specific procedures. The program shall be updated as necessary to
reflect those changes in workplace conditions that affect respirator use. The
employer shall include in the program the following provisions of this section, as
applicable: Training of employees in the proper use of respirators, including
putting on and removing them, any limitations on their use, and their maintenance; and procedures for regularly evaluating the effectiveness of the program.
Scaffolding
1926.451
The employer shall have each employee who performs work while on a scaffold
trained by a person qualified in the subject matter to recognize the hazards
6
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
--```,``-`-`,,`,,`,`,,`---
SSPC Guide 17
January 1, 2004
SSPC Guide 17
January 1, 2004
Personal Protective
Equipment
1910.132
The employer shall provide training to each employee who is required by this
section to use PPE. Each such employee shall be trained to know at least the
following: When PPE is necessary; what PPEis necessary; how to properly don,
doff, adjust, and wear PPE; the limitations of the PPE; and the proper care,
maintenance, useful life and disposal of the PPE. Each affected employee shall
demonstrate an understanding of the specified training and the ability to use
PPE properly, before being allowed to perform work requiring the use of PPE.
Training requirements: Upon an employees first entering into employment and
at least annually thereafter, each employer shall inform current employees
covered by this section of the form of:
The existence, location, and availability of any records covered by this
section;
The person responsible for maintaining and providing access to records; and
Each employees right of access to these records
9. EVALUATION OF PROGRAM
EFFECTIVENESS
OSHA regulations, reports and other pertinent documents must be collected and distributed to appropriate
personnel to insure compliance with the regulations. Either
an electronic or a printed copy of the current regulations is
frequently required at the workstation or project site.
Written safety rules and/or Safe Operating Practices
(SOPs) must be developed for each major work activity or
piece of equipment. Hazards must be identified and the correct
personal protective equipment, employee training and job procedures specified to avoid accidents. Examples of SOPs related to
industrial painting are included in Appendix B.
The content of a safety program for a company performing industrial coating activities should, at a minimum, address
the following subjects, as applicable to company operations.
An effective safety program requires assigned personnel to enforce program requirements, conduct safety inspections and audits of work practices, and maintain safety
records and summary data to verify compliance with the
company safety program. Management should periodically
evaluate accident reports to determine if there is any adverse trend and determine if company policy is being followed. Work site audits should be conducted to insure SOPs
and safe practices are being followed. The development and
use of checklists is useful in preventing items from being
overlooked. Accident investigations should be conducted
for all near misses and accidents. It is important to document
exact details and determine the cause of all accidents.
Findings should be reported to appropriate personnel and
corrective measures taken.
Preface
Program Statement and Signature Page Figure 1
Administration
Company Safety Policy and Rules Figure 2
Safety Goals - Figure 3
Safety Responsibilities Figure 4
Schedule of Training and Activities Figure 5
Disciplinary Action Policy
Regulations, Publications and other Safety-Related
Documents
Records, Reports and Forms
Substance Abuse
General
Emergency Response
Inclement Weather
7
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
--```,``-`-`,,`,,`,`,,`---
associated with the type of scaffold being used and to understand the procedures to control or minimize those hazards.
Only employees who have been trained in the operation of the particular tool in
use shall be allowed to operate a power-actuated tool.
SSPC Guide 17
January 1, 2004
--```,``-`-`,,`,,`,`,,`---
Sanitation
Housekeeping
First Aid
Violence in the Workplace
Illumination
Heat and Cold Stress
Vehicle Safety
Personal Protective Equipment
Eye, Ear and Head
Hand, Foot and Body
Reproductive Qrgans
Respiratory Protection
Site Related Protection
Means of Egress, Signs, Alarms, and Barricades,
Security Measures
Confined Space Entry
Ventilation for Vapors, Dusts and Fumes
Working Near Water
Poisonous Plants and Vermin
Ventilation
Fall Protection
Scaffolds
Stairways and Ladders
Guarding Floor and Wall Openings
Fall Protection Equipment (Nets and Harness)
Powered Equipment
Vehicle Mounted Elevating and Rotating Work
Platforms for Aerial Lifts
Cranes, Hoists, and Rigging Equipment
Hand Powered Tools
Powered Washers, Sprayers, and Arc Spray
Equipment
Powered Trucks and Loaders
Abrasive Blast Machines
Compressors and Dust Collectors
Associated Pressurized Air Lines and
Electrical Lines
Chemical and Biological Hazards
Hazard Communication Program
Blood Borne Pathogens
Lead, Cadmium, Arsenic
Fire Protection
Fire Prevention and Protection
Flammable Liquids
Compressed Gasses
Hot Work Hazards Related to Welding and
Thermal Spray Safety
Electrical
Lockout/ Tagout
Electrical Installations and Equipment
Numerous governmental agencies are available to assist in developing and evaluating a company safety program. OSHA maintains an extensive web site (http://
www.osha.gov) where the regulations, the latest news,
libraries and other information may be searched and downloaded to a computer. Links are also provided to the states
and territories that have been approved to administer the
OSHA regulations in their region, as listed below:
Alaska
Arizona
California
Connecticut *
Hawaii
Indiana
Iowa
Kentucky
Maryland
South Carolina
Tennessee
Utah
Vermont
Virgin Islands
Virginia
Washington
Wyoming
8
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
Michigan
Minnesota
Nevada
New Jersey*
New Mexico
New York*
North Carolina
Oregon
Puerto Rico
SSPC Guide 17
January 1, 2004
TABLE 2
ADDITIONAL SAFETY RESOURCES ON THE INTERNET
(AS OF DATE OF PUBLICATION)
American National Standards Institute (ANSI) http://www.ansi.org (ANSIstandards available from Global
Engineering Documents at http://www.global-his.com)
American Subcontractors Association On Line Resource For Safety Compliance - http://www.intecweb.com/FASA/
fasahome.htm
Associated Industries Insurance Company Inc. - http://www.aiic-insurance.com/Loss_Control/
Business Owners Toolkit - http://www.toolkit.cch.com/
Bureau of Business Safety, Security and Manufacturing Center for Disease Control Web page for Contractor Safety - http://www.cdc.gov/od/ohs/manual/cntractr.htm
Global Internet Roadmap for Injury Control - http://www.injurycontrol.com/icrin/
Electronic Library of Construction Occupational Safety and Health (ELCOSH) - http//www.cdc.gov/niosh/elcosh/
index.html
Environmental Health and Safety - http://www.xids.com/xrxcontr/safety/
Insure.com - http://www.insure.com/business/workerscomp/basics.html
MSDS on the Internet - http://www.ilpi.com/msds/index.html
National Ag Safety Data Base - http://www.cdc.gov/nasd/menu/topic/topic.html
National Institute of Occupational Safety and Health - http://www.cdc.gov/niosh/homepage.html
National Fire Protection Association - http://www.nfpa.org/Home/index.asp
National Floor Safety Association - http://www.nfsi.org/
National Hearing Conservation Association - http://www.hearingconservation.org/
National Occupational Health and Safety Commission - http://nohsc.info.au.com/
National Safety Council - http://www.nsc.org/
Occupational Health & Safety magazine - http://www.ohsonline.com/
Occupational Health and Safety Review Commission - http://www.oshrc.gov/
OccupationalHazards.com - http://ww.occupationalhazards.com/
Oregon Occupational Safety and Health - http://www.ilpi.com/msds/index.html
OSH for Everyone, Contractor Safety - http://www.oshforeveryone.org/wsib/osh_pgm/contractor/contractor.html
Paint Safety Net - http://www.paintingsafety.net/
Safety Equipment Institute - http://www.SEInet.org/
SafetyInfo - http://www.safetyinfo.com/
SafetyLog 300 - http://www.safetylog300.com
Tennessee Safety and Environmental, Inc. - http://www.tnsafety.com/con_saf.html
Wallops Contractors Safety Council http://safety1st.gsfc.nasa.gov
--```,``-`-`,,`,,`,`,,`---
9
Not for Resale
SSPC Guide 17
January 1, 2004
10
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
--```,``-`-`,,`,,`,`,,`---
CERTIFIED INDUSTRIAL
PAINTING COMPANY
SSPC Guide 17
January 1, 2004
CERTIFIED INDUSTRIAL
PAINTING COMPANY
COMPANY LOGO HERE
Certified Industrial Painting Company
Your Street, City, State and Zip Code
SAFETY POLICY
1. Accidents and injuries can be prevented.
2. Management supervisors and employees are responsible, and will be held
accountable, for preventing injuries and occupational illnesses.
3. Occupational safety and health is a required part of every employees job
performance
4. Working safely is a condition of employment.
5. All workplace hazards can be safeguarded.
6. Training employees to work safely is essential and is the responsibility of
management/supervision.
7. Prevention of personal injuries and accidents is everyones responsibility
CARDINAL RULES
Offenses that may be grounds for dismissal are:
1.
2.
3.
4.
5.
6.
7.
Failure to immediately report all incidents (accidents, injuries and near misses)
Possession or use of illicit drugs or alcohol
Possession of firearms
Malicious destruction of company property
Fighting or horseplay
Falsification of safety and company documents
Failure to implement required work practices or properly use safety training and
supplied equipment
8. Intentional violation of companys safety policy
9. Repeated violation of companys safety policy.
10 Placing oneself or others in imminent danger (potentially life-threatening
circumstances)
--```,``-`-`,,`,,`,`,,`---
11
Not for Resale
SSPC Guide 17
January 1, 2004
CERTIFIED INDUSTRIAL
PAINTING COMPANY
COMPANY LOGO HERE
SAFETY GOALS
Short Term Goals (Next 12 Months)
Review hazards and prioritize
Provide resources to facilitate safety improvements
Upgrade facilities and equipment
Review OSHA and State regulations
Increase employee safety awareness
Achieve supervisor commitment to the program
Develop continuing safety training
12
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
--```,``-`-`,,`,,`,`,,`---
SSPC Guide 17
January 1, 2004
CERTIFIED INDUSTRIAL
PAINTING COMPANY
COMPANY LOGO HERE
Managers
Authorize, fund and budget the safety program
Supervisors
Conduct regular facility and job site inspections/audits for safety hazards
Ensure employees are provided with the correct tools and PPE as necessary for their job.
Ensure employees are trained for their jobs
Conduct safety meetings to exchange safety information and provide training as scheduled.
Conduct investigations of all accidents, injuries, illnesses, and near misses to accurately determine the
cause and action necessary to prevent future occurrences.
Initiate immediate corrective action to correct unsafe conditions or activities.
Employees
Comply with the applicable safety policy, rules and procedures
Attend and participate in training and meetings
Report unsafe acts or conditions
Assist with safety audits and accident/incident investigations
13
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
--```,``-`-`,,`,,`,`,,`---
SAFETY RESPONSIBILITIES
SSPC Guide 17
January 1, 2004
Responsible Person:
E employee
S Supervisor
Each Use
Equipment/Tool Inspection
PPE Inspection
On Job Safety Meetings
Off Job Safety Meetings
Work Place Audits
Accident/Incident Investigation
Review Safety Reports
Drug Test
C competent person
Weekly
Monthly Quarterly
Annually
E
E
E&S
S
E&S&M
E&S
M
E&S&M
TRAINING
Fire Protection
Ladders
Hazard Communication
Scaffolds
Lock Out/Tag Out
C
C
C
C
C
14
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
M - manager
--```,``-`-`,,`,,`,`,,`---
SSPC Guide 17
January 1, 2004
HAZARD REVIEW:
Exposure to blood or bodily fluids could occur after an accident.
RECOMMENDED PPE:
Rubber gloves, plastic bags, disinfectant
PROCEDURE:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Always treat blood and bodily fluids as if they are infected with transmittable diseases.
Report any accident/incident involving the transfer of blood or bodily fluids to the
supervisor immediately.
Obtain Personal Protective Equipment (PPE) and ensure its use by all employees
considered to be at risk of infection.
Ensure gloves are worn for touching blood and bodily fluids, mucous membranes or
non-intact skin of all persons, for handling items or surfaces soiled with blood or bodily
fluids, and for rendering assistance to injured persons.
Always wash hands and arms after helping a victim. If washing facilities are not available, transport the exposed individual to a facility where soap and water are available.
For employees trained in CPR, separate yourself from direct contact with the victim by
using a face shield or mask, or one-way resuscitating device.
Handle all items that are believed to be human waste products (i.e., blood, soiled
clothing, needles, or items identified with the universal biohazard symbol) with personal protective equipment.
Dispose of all items contaminated with blood or bodily fluids in a plastic bag, along
with gloves and other protective equipment used during the disposal process. The
bag should then be labeled as to its contents and a Safety Officer notified for disposal
procedures.
Decontaminate all equipment and working surfaces with an appropriate disinfectant to
eliminate the potential for infection.
Certified Industrial Painting Company provides a free hepatitis B vaccination for employees considered at the greatest risk of infection. A copy of the exposure control
plan is available by request for all employees to review.
15
--```,``-`-`,,`,,`,`,,`---
(Bloodborne Pathogens)
SSPC Guide 17
January 1, 2004
HAZARD REVIEW:
High velocity particles traveling in excess to 660 feet per second, high-pressure compressed
air lines and receivers, loud noise, flying objects, toxic dust, and sparks,
RECOMMENDED PPE:
Blast hood (respirator), face shield, blast suit, leather gloves, safety shoes, ear plugs
PROCEDURE:
1. Read the manufacturers operating instructions and have a competent person demonstrate and provide instruction in the safe use of the control.
2. Never modify, remove or substitute parts for any components in the system.
3. Never disable the control by taping or any other method.
4. Inspect and clean the control hose line fittings before connecting them.
5. Inspect functionality and shut off response before each use.
Related SOPS:
16
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
--```,``-`-`,,`,,`,`,,`---
(REQUIRED BY OSHA*)
SSPC Guide 17
January 1, 2004
VEHICLE OPERATION
HAZARD REVIEW:
Potential impact from heavy and/or flying objects, exposure to flammable and other hazardous
liquids, exposure to pinch and crush points.
RECOMMENDED PPE:
Seatbelt, sunglasses
PROCEDURE:
1. All drivers shall be properly licensed.
2. Supervisors shall verify that drivers are capable and qualified on each type of
vehicle before allowing the vehicle to be operated unsupervised
3. Drivers shall perform a pre-operational check of their vehicle. Be familiar with
operators manual.
4. No vehicle shall be operated in an unsafe condition
5. Drivers and passengers are required to wear seat belts in vehicles.
6. Drive defensively, observe speed limits and obey all traffic laws when operating
vehicles.
7. Drivers must avoid performing distracting activities such as talking on the telephone, reading, eating, smoking, etc while operating the vehicle.
8. Plan ahead to minimize or eliminate the need for backing. Always check to the rear
before backing.
9. Choose safest location possible to park vehicles. Avoid parking in other vehicles
blind spots.
10. Keep windshield, windshield wipers, side windows and mirrors clean.
11. Clean headlights, taillights and emergency light covers.
12. Remove key from unattended vehicles.
13. Ensure the vehicle is not left running when unattended. If it is necessary to leave
a manual transmission vehicle running while unattended (to power warning lights,
etc.), the vehicle must be properly secured with wheel chocks in front and back on
the same tire.
17
--```,``-`-`,,`,,`,`,,`---
(D)
(E)
Attention: This form contains information relating to employee health and must be
used in a manner that protects the confidentiality of employees to the extent possible
while the information is being used for occupational safety and health programs.
Establishment name
Days away
from work
Remained at work
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
days
2002
Year:
(M)
(4)
(5)
City/State
Using these four categories, check ONLY the most Enter the number of days
the injured or ill worker
serious result for each case:
was:
Death
days
days
Date of injury
(F)
Describe injury or illness, parts of body affected, and object/substance that
directly injured or made person ill. (e.g. Second degree burns on right forearm
from acetylene torch)
You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid. You
must also record significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional. You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in 29
CFR Part 1904.8 through 1904.12. Feel free to use two lines for a single case if you need to. You must complete an Injury and Illness Incident Report (OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If you're not
sure if a case is recordable, call your local OSHA office for help.
(A)
Job Title
(e.g. welder)
10
days
days
Employee's Name
11
days
days
Case #
(3)
(1)
(2)
(L)
(5)
Away from
work
12
days
days
(K)
On the job
transfer or
restriction
13
days
days
(J)
Other
recordable
cases
14
days
(I)
(4)
--```,``-`-`,,`,,`,`,,`---
Job transfer
or restiction
15
days
days
(H)
16
days
(G)
17
days
or onset of
illness
(month/day)
(3)
(2)
days
18
19
(1)
days
All other
illnesses
Poisoning
Poisoning
days
Totals
Be sure to transfer these totals to the Summary page (Form 300A before you post it.
Repiratory
condition
Repiratory
condition
20
Note: If additional entries are required, just copy rows from the bottom of the case area and paste them back.
the instructions, search and gather the data needed, and complete and review the collection of information. Persons are not required
Public reporting burden for this collection of information is estimated to average 14 minutes per response, including time to review
to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments
about these estimates or any other aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistics,
Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.
Skin Disorder
Skin
Disorder
Injury
Injury
19
Year: #REF!
#REF!
(L)
#REF!
(K)
#REF!
#REF!
(4) Poisonings
#REF!
(I)
#REF!
#REF!
#REF!
(J)
Total number of
other recordable
cases
ZIP
Phone
Company executive
Sign here
Employment Information
(If you don't have
these figures, see the Worksheet on the back of OSHA Form 300A to estimate)
Industry description:
--```,``-`-`,,`,,`,`,,`---
Public reporting burden for this collection of information is estimated to average 50 minutes per response, including time to review
the instructions, search and gather the data needed, and complete and review the collection of information. Persons are not required
to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments
about these estimates or any other aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistics,
Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.
Post this Summary page from February 1 to April 30 of the year following the year covered by the form.
#REF!
(1) Injuries
Total number of
(M)
Total number of
days away from
work
#REF!
(H)
Total number of
cases with days
away from work
Number of Days
#REF!
(G)
Number of Cases
City
State
Street
Establishment name:
Facility Information:
All establishments covered by part 1904 must complete this Summary page, even if no work-related injuries or illnesses occurred during the year. Remember
to review the Log to verify that the entries are complete and accurate before completing this summary. Using the Log, count the individual entries you made for
each category. Then write the totals below, making sure you've added the entries from every page of the Log. If you had no cases, write "0". Employees,
former employees, and thier representatives have the right to review the OSHA Form 300 in its entirety. They also have limited access to the OSHA Form 301
or its equivalent. See 29 CFR Part 1904.35 for further details on the access provisions for these forms.
Date
Title
Attention: This form contains information relating to employee health and must
be used in a manner that protects the confidentiality of employees to the extent
possible while the information is being used for occupational safety and health
programs.
This Injury and Illness Incident Report is one of the first forms you must fill out when a recordable work-related injury or illness has occurred. Together with the Log of Work- Related Injuries and Illnesses and the
accompanying Summary, these forms help the employer and OSHA develop a picture of the extent and severity of work-related incidents.
Within 7 calendar days after you receive information that a recordable work- related injury or illness has occurred, you must fill out this form or an equivalent. Some state workers compensation, insurance, or other
reports may be acceptable substitutes. To be considered an equivalent form, any substitute must contain all the information asked for on this form.
According to Public Law 91- 596 and 29 CFR 1904, OSHA s recordkeeping rule, you must keep this form on file for 5 years following the year to which it pertains. If you need additional copies of this form, you may
photocopy and use as many as you need.
Full Name
Title
2002
Date
Year:
Phone
(Transfer the case number from the log after you record the case.)
AM / PM
AM / PM
ZIP
13) Time of event
14) What was the employee doing just before the incident occurred? Describe the activity, as well as the tools, equipment or material the employee
Street
/
/
2)
Date of birth
City
3)
Date hired
16) What was the injury or illness? Tell us the part of the body that was affected; be more specific than "hurt," "pain," or "sore." Examples: "strained back";
when gasket broke during replacement"; "Worker developed soreness in wrist over time."
15) What happened? Tell us how the injury occurred. Examples: "When ladder slipped on wet floor, worker fell 20 feet"; "Worker was sprayed with chlorine
was using. Be specific. Examples: "Climbing a ladder while carrying roofing materials"; spraying chlorine from hand sprayer"; "daily computer key-entry."
4)
____ Female
______
Male
5)
6)
ZIP
If treatment was given away from the worksite, where was it given?
State
17) What object or substance directly harmed the employee? Examples: "concrete floor"; "chlorine"; "radial arm saw." (If this question does not
apply, leave it blank.
Date of death
20
7)
Facility
Street
City
____ No
____ No
Yes
Yes
8)
______
9)
______
Public reporting burden for this collection of information is estimated to average 22 minutes per response, including
time to review the instructions, search and gather the data needed, and complete and review the collection of
information. Persons are not required to respond to the collection of information unless it displays a currently valid
OMB control number. If you have any comments about these estimates or any other aspects of this data collection,
contact: US Department of Labor, OSHA Office of Statistics, Room N-3644, 200 Constitution Avenue, NW,
Washington, DC 20210. Do not send the completed forms to this office.
--```,``-`-`,,`,,`,`,,`---
SSPC-Guide 17
January 1, 2004
Title
Rules of Construction
General Safety
1926.66(a)
[Do.] (b)
[Do.] (c)-(d)
[Do.] (e)-(g)
1926.95
1926.96
1926.100
1926.101
Hearing Protection
1910.36(b)(4)
1910.37(q)(1)
[Do.] (k)(2)
1910.38(a)
1910.151(c)
1910.141(a)(2)(v)
[Do.] (h)
[Do.] (d)(1)-(3)
[Do.] (g)(2)
[Do.] (a)(5)
[Do.] (e)
1910.94
1910.12.00
1910.119
1910.120
1910.107(a)
[Do.] (b)(1)-(10)
[Do.] (c)-(d)
[Do.] (h)-(j)
1910.132
1910.136
1910.95
21
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
1910.5(a)
[Do.] (c)
[Do.] (d)
1910.12(b)
1910.20
--```,``-`-`,,`,,`,`,,`---
SSPC-Guide 17
January 1, 2004
1926.150(c)(1)(xi)
[Do.] (xii)
[Do.] (xiii)
[Do.] (xiv)
1926.152
1926.152(b)(5)
[Do.] (h)
[Do.] (i)
[Do.] (j)
[Do.] (k)(1)-(3)
[Do.] (k)(4)
1926.153(a)(3)
[Do.] (m)(1)
[Do.] (2)
[Do.] (3)
[Do.] (4)
[Do.] (n)
[Do.] (o)
1926.156
1926.157
1926.158
1926.159
1926.200(c)(3)
1926.201
1926.202
1926.250(c)
[Do.] (d)
1926.251(a)(5)
[Do.] (a)(6)
[Do.] (b)(6)(i)-(ii)
[Do.] (c)(6)-(7)
[Do.] (c)(8)
[Do.] (c)(9)
[Do.] (c)(10)-(12)
[Do.] (c)(13)-(15)
[Do.] (d)(3)-(6)
[Do.] (e)(3)-(5)
[Do.] (e)(6)-(7)
[Do.] (e)(8)
Title
Eye And Face Protection
Respiratory Protection
22
Not for Resale
1910.147
1910.157(g)(1)
[Do.] (g)(2)
[Do.] (c)(4)
[Do.] (e)(3)
1910.107(e)(2)
1910.106(j)
[Do.] (b)
[Do.] (c)
[Do.] (g)(4)
[Do.] (a)(22)
1910.110(a)(4)
[Do.] (d)(1)
[Do.] (d)(2)
[Do.] (d)(7)(vii)
[Do.] (d)(7)(viii)
[Do.] (b)(5)(iii)
[Do.] (d)(10)
1910.160
1910.162
1910.164
1910.165
1910.145(d)(4)
1910.176(c)
XXX
1910.184(a)
[Do.] (d)
[Do.] (e)(3)(i)-(ii)
[Do.] (c)(2)-(3)
[Do.] (c)(5)
[Do.] (c)(7)
[Do.] (c)(10)-(12)
[Do.] (f)(2)-(4)
[Do.] (h)(2)-(5)
[Do.] (i)(2)-(4)
[Do.] (i)(6)-(7)
[Do.] (i)(9)
--```,``-`-`,,`,,`,`,,`---
SSPC-Guide 17
January 1, 2004
Title
Tools - Hand And Power -General
Requirements
Deadman Control
Abrasive Wheels And Tools
Woodworking Tools
--```,``-`-`,,`,,`,`,,`---
1910.28(a)(15)
[Do.] (18)
[Do.] (20)
1910.29(a)
[Do.] (c)
1910.184(c)(9)
1910.176(f)
1910.178(m)(3)
[Do.] (12)
1910.21(g)(9)
SSPC-Guide 17
January 1, 2004
Title
Asbestos
Air Contaminants
Coal Tar Pitch Volatiles; Interpretation Of
Term
Carcinogens
Alpha-Naphthylamine
[Reserved]
Methyl Chloromethyl Ether
3.3'-Dichlorobenzidine (And Its Salts)
Bis-Chloromethyl Ether
Beta-Naphthylamine
Benzidine
4-Aminodiphenyl
Ethyleneimine
Beta-Propiolactone
-Acetylaminofluorene
4-Dimethylaminoazobenzene
N-Nitrosodimethylamine
Vinyl Chloride
Inorganic Arsenic
Cadmium
Benzene
Coke Oven Emissions
Bloodborne Pathogens
1,2-Dibromo-3-Chloropropane
Acrylonitrile
Ethylene Oxide
Formaldehyde
--```,``-`-`,,`,,`,`,,`---
24
Copyright The Society for Protective Coatings
Provided by IHS under license with SSPC
No reproduction or networking permitted without license from IHS
1910.1000
1910.1002
1910.1003
1910.1004
1910.1005
1910.1006
1910.1007
1910.1008
1910.1009
1910.1010
1910.1011
1910.1012
1910.1013
1910.1014
1910.1015
1910.1016
1910.1017
1910.1018
1910.1028
1910.1029
1910.1030
1910.1044
1910.1045
1910.1047
1910.1048