HomeMy WebLinkAbout06 108 Occupational Health & Safety
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THE CORPORATION OF THE MUNICIPALITY OF KINCARDINE
BY-LAW
NO. 2006 - 108
BEING A BY-LAW TO ADOPT AN OCCUPATIONAL HEALTH
AND SAFETY MANUAL FOR THE EMPLOYEES OF THE
MUNICIPALITY OF KINCARDINE
WHEREAS the Occupational Health and Safety Act, R.S.O. 1990, c. 0.1 has
been enacted to protect employees from injury or occupational disease while in
the workplace;
AND WHEREAS Sections 8 and 9 (1) of the Municipal Act, 2001, S.D. 2001, c.
25, provide municipalities with the powers of a natural person to enable them to
govern their affairs as they consider appropriate and to enhance their ability to
respond to municipal issues;
AND WHEREAS The Council for The Corporation of the Municipality of
Kincardine and its management team are vitally interested in the health and
safety of all its employees;
AND WHEREAS the Council for The Corporation of the Municipality of
Kincardine deems it expedient to adopt an Occupational Health and Safety
Manual for the employees of the Municipality of Kincardine;
NOW THEREFORE the Council of the Corporation of the Municipality of
Kincardine ENACTS as follows:
1. That the Municipality of Kincardine Occupational Health and Safety
Manual, attached hereto as Schedule "A", be adopted to provide a
standard to promote a safe and healthy work environment for the
employees of the Municipality of Kincardine.
2.
That Policy Numbers GG.4.1, GG.4.2, GG.4.3, GG.4.4, GG.4.5, GG.4.6,
ES.1.1, are hereby repealed
3.
That the provisions contained in this by-law shall supersede any previous
by-laws or policies inconsistent with the provisions contained herein.
4.
This by-law shall come into full force and effect upon its final passing.
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Occupational Health & Safety By-law
By.law No. 2006 - 108
4. This by-law may be cited as the "Occupational Health & Safety By-Law".
READ a FIRST, SECOND, and THIRD time and FINALLY PASSED this 21st
day of June, 2006.
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.INCA~IN[
~ OCCUPATIONAL ~
~ HEALTH and SAFETY --
MANUAL
~. By-Law No. 2006-108 ~
Approved by the Municipality of Kincardine Health
and Safety Conunittee
Prepared by the Municipality of Kincardine Health
and Safety Coordinator
Adopted by the Council of the
Municipality of Kincardine
June 21, 2006
a.... (repeals and supenedaa all other Health and ......
~ Safety Policies 1DI ay___1 "IIIIIIIIIIIII
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Policies
MKHS 1
MKHS 2
MKHS 3
MKHS 4
MKHS 5
MKHS 6
MKHS 7
MKHS 8
MKHS 9
MKHS10
MKHS 11
MKHS 12
Guidelines
MKHS 2.1
MKHS 2.2
MKHS 2.3
MKHS 2.4
MKHS 2.5
MKHS 2.6
MKHS 2.7
Forms
TABLE OF CONTENTS
Paae Number
Definitions................................................................................. .3
Health and Safety Policy.......................................................................... 5
Individual Responsibilities........................................................... ............. 6
Committees.............................. ....... ........................................................ 12
Workplace Inspections............................................................................ 16
Employee AccidenUlncident Reporting Guidelines.................................. 18
WSIB Reporting...................................................................................... 21
Modified Work .................................... ..................................................... 23
Refusal to Work....................................... ................................................ 28
Health and Safety Training.... ......................................... ......................... 31
Hazardous Conditions Reporting ........................ ......... ........................... 34
Standard Operating Guidelines. ........... ....... ............................................ 36
Discipline Policy...................................................................................... 41
General Safety Rules.............................................................................. 42
Personal Protective Equipment..... .......................................................... 44
lockoutfT ag out............. ........... ...... ... ............................... ........... ...... ..... 47
Confined Space................................. .................................. .................... 49
Trenching ...................................... .......................................................... 64
Emergency Guidelines........... ........................................ ......................... 66
Hearing Protection......... ........ .......... .............................. ......................... 69
MKHS 001 Health and Safety Information Request Form ......................................... 73
MKHS 002 Health and Safety Recommendations Form............................................ 74
MKHS 003 Workplace Inspection Hazard Report...................................................... 75
MKHS 004 Workplace Inspection Reporting Form .................................................... 80
MKHS 005 AccidenUlncident Reporting Guidelines Chart......................................... 81
MKHS 006 IAPA First Aid Report log ....................................................................... 82
MKHS 007 IAPA Accident Investigation Report Form ............................................... 83
MKHS 008 Employee Accident Corrective Action Memo .......................................... 85
MKHS 009 Modified Work Progress Chart ................................................................ 86
MKHS 010 Unsafe Work Refusal Form...... ........ ....................................................... 88
MKHS 011 Confined Space and Atmospheric Assessment Permit ...........................89
MKHS 012 Physical Demands Analysis Form........................................................... 91
MKHS 013 New Employee Site/Safety Orientation Checklist.................................... 92
MKHS 014 Site Safety Meeting Form........................................................................ 93
ADDend ices
Appendix 1 WSIB Form 7 ................................... ....................................................... 94
Appendix 2 WSIB Functional Abilities Form Timely Return to Work Form ................. 98
1.
DEFINITIONS
"Act" refers to the Ontario Occupational Health and Safety Act.
"Committee" means a joint health and safety committee established under the Ontario
Occupational Health and Safety Act.
"Competent Person" means a person who,
a) is qualified because of knowledge, training and experience to organize the work and its
performance
b) is familiar with the Ontario Occupational Health and Safety Act and the regulations that
apply to the work, and
c) has knowledge of any potential or actual danger to health or safety in the workplace.
"Construction" includes erection, alteration, repair, dismantling, demolition, structural
maintenance, painting, land clearing, earth moving, grading, excavating, trenching, digging,
boring, drilling, blasting, or concreting, the installation of machinery or plant, and any work or
undertaking in connection with a project but does not include any work or undertaking
underground in a mine.
"Critical Injury" means an injury of a serious nature that,
a) places life in jeopardy;
b) produces unconsciousness;
c) results in substantial loss of blood;
d) involves the fracture of a leg or arm but not a finger or toe;
e) involves the amputation of a leg, arm, hand or foot but not a finger or toe;
f) consists of bums to a major portion of the body; or
g) causes the loss of sight in an eye.
"Employer" means a person who employs one or more workers or contracts for the services
of one or more workers and includes a contractor or subcontractor who performs work or
supplies services and a contractor or subcontractor who undertakes with an owner,
constructor, contractor or subcontractor to perform work or supply services.
"Health and Safety Bulletin Board" means a conspicuous place or places in the workplace
where Health and Safety documents are most likely to come to the attention of the workers.
"Health and Safety Coordinator" means that person so designated by the employer
(Municipality of Kincardine) as stated in said person's job task list to be responsible for, and act
as health and safety coordinator and municipal management representative including;
coordinate, manage, follow up, document, maintain files; research, record and otherwise
oversee all health and safety related functions with respect to work place requirements under
the Act.
"Health and Safety Representative" means a health and safety representative selected
under the Ontario Occupational Health and Safety Act.
"Industrial Establishment" means an office building, factory, arena, shop or office, and any
land, buildings and structures appertaining thereto.
"Management" for the purposes of this document shall refer to those pe ons who exercise
managerial functions for the...employer and, to the extent possible, ho do so at the
workplace.
"Occupational Health and Safety Act" means the most current publis ed version (green
book) of the Ontario Occupational Health and Safety Act R.S.O. 1990, . 0.1. including all
associated regulations. This shall include regulations for "Industrial E tablishments" and
"Construction Projects".
"Owner" includes a trustee, receiver, mortgagee in possession, tenant, Ie see, or occupier of
any lands or premises used or to be used as a workplace, and a person who acts for or on
behalf of an owner as an agent or delegate.
"Prescribed" means prescribed by a regulation made under the Ontario ccupational Health
and Safety Act.
"Regulation" means the regulations. made under the Ontario Occupation Health and Safety
Act.
"Supervisor" means a person who has charge of a workplace or authority ver a worker.
"Worker" means a person who perfonns work or supplies servi es for monetary
compensation. .. "
"Workplace" means any land, premises, location or thing at, upon, in or ear which a worker
works.
Policy No.:
MKHS 1
Description:
HEALTH and SAFETY POLICY
Effective Date:
May 2006
1. PURPOSE:
The elected officials and management of the Municipality of Kincardine are vitally
interested in the health and safety of all its employees. Protection of employees from
injury or occupational disease is a continuing objective. The Municipality of Kincardine
will make every effort to provide a safe, healthy work environment. All supervisors and
workers must be dedicated to the continuing objective of reducing the risk of injury.
The Municipality of Kincardine as an employer is ultimately responsible for worker
health and safety. The Council and Management will take every precaution reasonable
for the protection of a worker.
Supervisors are accountable for the health and safety of workers under their
supervision. Supervisors are responsible to ensure that equipment and machinery is
safe and that the workers comply with established safe work practices and Guidelines.
Workers must receive adequate training in their speCified work tasks to protect their
health and safety.
Every worker must protect his or her own safety by working in compliance with the law
and safe work practices and Guidelines established by the Municipality.
It is in the best interest of all parties to consider health and safety in every activity. The
Municipality of Kincardine is committed in that a policy of health and safety form an
integral part of its vision and everyone from the Mayor to the Worker endorses this
policy.
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Clef Administrative 0 Icer
Policy No.:
MKHS 2
INDIVIDUAL RESPONSIBILITIES
Description:
Effective Date:
May 2006
1. PURPOSE:
To provide a guideline which outlines the health and safety respo sibilltles of various
Individuals.
2. RESPONSIBILITY:
A. The Municipality of Kincardine, in its capacity as the employ r, is responsible for
carrying out the responsibilities and duties outlined throug the delegation of
these functions to indiv1duals in the Municipality.
B. All individuals in the workforce, at all levels and functions, are responsible for
understanding and carrying out the responsibilities and duties as outlined.
3. POLICY:
A. General:
1. "Responsibility" is defined as an Individual's obligation t carry out assigned
duties.
2. Responsibility and authority can be delegated to subor inates, giving them
the right to act for their supervisors.
3. The supervisor remains accountable for seeing that t ese responsibilities
are carried out.
4. "Prescribed" refers to a section of the Occupational Haith and Safety Act
and Regulations fOr Industrial Establishments, Construe on Projects, etc.
5. "Municipality" refers to the Municipality of Kincardine
B. Municipalitv:
1. The Municipality is to ensure that:
a) Equipment, materials and protective devices s prescribed are
provided.
b) Equipment, materials and protective devices are maintained in good
condition.
c) Prescribed measures and Guidelines are carried 0 t.
d) Equipment, materials and protective devices are u d as prescribed.
e) All areas of the workplace are capable of supporti g all loads to which
they may be subjected without causing the mat rials therein to be
stressed beyond the allowable unit stresses est blished under The
Building Code Act.
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f) Workers are provided with information, instruction and supervision so
as to protect the health and safety of the worker.
g) When appointing a supervisor, appoint a competent person.
h) Workers, or person in authority over a worker, are acquainted with any
hazard in the workplace and in the handling, storage, use, disposal
and transport of any article, device, equipment or biological, chemical
or physical agent.
i) It offers assistance and co~peration to a committee member or a
health and safety representative in the carrying out of any of their
functions.
j) It only employs in or about the workplace persons over such age as
may be prescribed.
k) No person who is under such age as may be prescribed is knowingly
permitted in or about the workplace.
I) It takes every precaution reasonable in the circumstances for worker
protection.
m) A copy of the Occupational Health and Safety Act, and any explanatory
material prepared by the Ministry of Labour outlining the rights,
responsibilities and duties of the worker, is posted in the workplace in
both English and the majority language of the workplace.
n) An occupational health service for workers is established as
prescribed, and maintained according to the standards prescribed.
0) Accurate records are kept and maintained of the handling, storage, use
and disposal of biological, chemical or physical agents as prescribed.
p) Records of the exposure of a worker to biological, chemical or physical
agents as may be prescribed, are accurately kept, maintained, and
made available to the worker affected.
q) Appropriate notification is made prior to the use or introduction into a
workplace of such biological, chemical or physical agents as may be
prescribed.
r) The levels of biological, chemical or physical agents are monitored at
such time or times or at such an interval or intervals as prescribed, and
that accurate records of such monitoring be kept and posted.
s) A worker's exposure to biological, chemical or physical agents is
permitted in compliance with standards as prescribed. .
t) Where so prescribed, a worker is only permitted to work or be in a
workplace who has undergone such medical examinations, tests or x-
rays as prescribed, and who is found to be physically fit to do the work
in the workplace.
u) Where so prescribed, a worker is provided with written instructions as
to the methods and guidelines to be USED for the protection of the
worker.
C. Manaoement:
1. This level of the organization includes the Chief Administrative Officer and
Senior Managers.
2. The health and
followino:
a) Oversee the working environment is maintained in healthy and safe
condition.
b) Establish and maintain a written health and sa ety program, with
objectives and standards consistent with applica e legislation as a
minimum.
c) Provide ongoing safety education, including bu not restricted to
W.H.M.I.S. and First Aid.
d) Provide standard operating Guidelines that include s fe work practices.
e) Evaluate the health and safety performance of subordinates and
divisions.
f) Provide first!aidfacilities as required.
g) Ensure that personal protective equipment, where quired, is provided
and used.
h) Investigate and report accidents/cases of occup tional disease to
appropriate authority.
D. Supervisors:
1. This level of the organization includes all those individ als who supervise
the work of other employees, from the Supervisor, up t and could include
the CAO and Senior Managers.
2. The health andsafet res onsibilities of ersons at this I vel are to:
a) Ensure the occupational health and safety of th employees within
their respective area
b) Be familiar with the applicable requirements of the ccupational Health
and Safety Act and the Regulations, and ensure co pliance
c) Understand and enforce the Health and Safety Poli ies and Guidelines
of the Municipality of Kincardine
d) Ensure that employees wear the appropriate ersonal protective
equipment
e) Advise eac:h worker of the existence of any poten al or actual danger
to the health and safety of the worker, of which the upervisor is aware
f) Investigate and determine the causes of all accide ts and injuries and
initiate'or recommend corrective action
g) Take every precaution reasonable in the cir umstance for the
protection ofa worker
h) Ensure that workers receive proper training and ins ructions prior to the
commencement of work
i) Identify and inform superiors of occupational health and safety
concerns
E. Workers and Contract Workers:
1. This level of the organization includes all employees in the workplace, up to
and including the Chief Administrative Officer, as well as those individuals
on the Municipality's payroll on a contract basis.
2. The health and safety resDonsibilities of workers at this level are to:
a) Learn, understand and practice standard operating guidelines
b) Be familiar with and comply with the Occupational Health and Safety
Act, and Regulations and the Municipality of Kincardine Health and
Safety Policies and Guidelines
c) Take every possible precaution to protect themselves and fellow
workers from health and safety hazards and unsafe situations
d) Report unsafe acts or conditions to their supervisor and/or health and
safety committee and/or health and safety coordinator.
e) Report any occupational injury or illness immediately to their
supervisor
f) Use personal protective equipment where required
g) Report any contravention of the Occupational Health and Safety Act or
Regulations to their supervisor or employer.
3. Employees who do not abide by the Occupational Health and Safety Act, or
the Municipality of Kincardine Occupational Health and Safety Manual will
be subject to disciplinary action (see Tripartite Personnel Agreement dated
February 15th, 2006 Section 49.0).
F. Contractors and Sub Contractors:
1. The Occupational Health and Safety Act imposes a duty on the Municipality
to take reasonable precautions to protect all workers including contractors
and their employees and self-employed contractors.
2. Contractors employed by the Municipality will be responsible for taking all
necessary steps to protect persons (workers, visitors, general public, etc.)
and property, from any harm during the course of the contract. Contractors
shall be required to adhere to the Occupational Health and Safety Act and
Health and Safety Policies and Guidelines of the Municipality at all times
while employed by the Municipality of Kincardine.
3. Contractors are classified into two groups as follows:
a) Service contractors, such as snow removal services, plumbers, heating
and air conditioning specialists, etc. are usually employed periodically
(short-term)
b) Contractors, such as construction companies, are employed to carry
out a project, which is of a fairly lengthy duration. (intermediate to
long term)
4. The following outlines the steps necessary to minimiz the Municipality's
liability in the event of an injury to a contractor.
Before Awardina a Contract:
a) The contractor is to show proof of current regist ation and proof of
good standing with the Workplace Safety Insurance Board by providing
a W.S.I.B. Independent Operator Status to th Senior Manager
contracting the service. Contractors are to pro ide proof of good
standing with the W.S.I.B.
b) A list of aU designated substances present at a oject site must be
included as part of any tendering information. Th Municipality must
ensure that any prospective contractors or sub- ontractors have a
copy of t~ designated substance list before any inding contract for
work is executed.
c) The contractor ,is to be advised of the work location s health and safety
rules by the Senior Manager contracting the service
d) The contractor will be required to provide a copy of their health and
safety policy and training program to the Senior anager contracting
the service.
e) A copy of the Municipality of Kincardine Occup tional Health and
Safety Manual is to be made available by th Senior Manager
contracting the service to the successful contr ct bidder and the
contractor shall be required to comply with the health and safety
standards of the Municipality.
f) The Municipality of Kincardine retains the right to op the contractor's
work without penalty to the Municipality if the ntractor does not
comply with the Occupational Health and Safety ct, the Health and
Safety Policies and Guidelines of the Municipa ity, or creates an
unacceptable health and safety hazard.
g) In the event paragraph 4(f) is to be exercised, it s all be exercised by
any of the Municipality's supervisors or designate(s .
Before Work Beaips:
a) The Senior Manager contracting the service is to a vise the contractor
and its workers of any special hazards, and a ise of emergency
guidelines .(MKHS 2.6)
b) The contractor's workers are to have all necessary personal protective
equipment for the work location. Workers not in mpliance are to be
ordered off the site until they comply.
c) The contractor is to provide the Municipality's w rk site supervisory
staff, or designate, with material safety data shee s (MSDS) for each
chemical substance to be used on the site.
d) Contractors are to meet with the Municipality's w rk site supervisory
staff, or designate, prior to commencement of w rk, to be informed
about the-location's specific safety rules and sa ty contacts at the
location.
e) The Municipality's supervisors, or designate(s), are to conduct a safety
inspection of the project site at least once per month, and document
same for future audit purposes (MKHS 003).
f) Where appropriate, the contractor shall post signs at entrances into
construction work areas informing visitors and the general public that
access is restricted, and directing them to report to the Contractor's
Field Office for permission to enter the area.
g) Visitors and the general public are not permitted to travel unescorted in
construction work areas. Where a visitor is required by a contractor or
sub-contractor to enter a restricted construction area, the contractor or
subcontractors will be responsible for ensuring that the visitor is aware
of relevant workplace safety rules, is wearing all required personal
protective equipment and is escorted at all times by the contractor's
appointed representative.
At the Conclusion of the Contract:
a) The contractor is to remove all chemical and hazardous products from
the work site at the end of the project or contract.
G. Visitors and General Public:
1. This classification includes all individuals or organizations not identified in
the above classification, and is external to the Municipality's organization.
2. Where appropriate, signs will be posted at entrances to inform visitors and
the general public about restricted access or the requirement to report to a
receptionist before proceeding further.
3. Visitors and the general public will not be allowed to wander unescorted
through areas that are normally restricted to employees.
4. In the event that a visitor is required to enter a work area that is normally
restricted to employees:
a) The supervisor will be responsible for ensuring that the visitor is aware
of the relevant workplace safety rules and is under the supervision of a
regular employee.
b) The visitor will use any and all required personal protective equipment.
Policy No.:
MKHS 3
COMMITTEES
Description:
Effective Date:
May 2006
1. PURPOSE:
To develop terms of reference for the Health and Safety Representa ves/Committees to
ensure compliance under the Occupational Health and Safety Act.
2. RESPONSIBILITY:
A. The Senior Managers and workplace supervisors are resp sible for ensuring
that a Health & Safety Representative/Committee is establish d and maintained.
B. The Health & Safety Representative/Committee is responsi Ie for ensuring the
proper application of this policy.
3. POLICY:
A. Comoosition:
1. Below lists the minimum legal requirements (as per ccupational Health
and Safety Act)fordetermining the correct health and s fety representation
for the total number of employees (full~time and part-tim at a workplace)
1 Representative more than 5 employees, but Ie s than 20
2 Committee Members 20 or more employees, but les than 50
4 Committee Members 50 or more employees
2. At least 50% of the members must be non-management
3. The worker members must be selected by the workers hey represent; in a
unionized workplace they may be chosen by the union or nominated and
voted in by the membership.
4. The employer shall select the remaining members.
5. The members wiUftll this role fora minimum 1 ~year term
6. Where there are more than 2 members and the term of ffice is longer than
1 year, an attempt will be made to have overlapping ter s of office, so that
continuity can be maintained.
7. The names and work location of all HEALTH AND SAF TV members must
be posted.
8. At least two members of each (if more than one committee required)
HEALTH AND SAFETY Committee must be certified, one representing the
workers and one representing management. If possible, all committee
members will be certified within the first 6 months of being on the
committee.
9. The worker committee members will select one co-chairperson, who
represents the worker members, and one co-chairperson will be appointed
by management, for a minimum one-year term.
B. Meetinas and Minutes:
1. Committee members may meet as required and as a minimum shall meet
once every 3 months. Meetings may be more often as agreed to the by the
committee.
2. Members are responsible for making arrangements with their supervisor for
attendance at the HEALTH AND SAFETY meetings and for preparation time
prior to the meetings. Supervisors shall be as accommodating as their work
schedules will allow.
3. A schedule of Health and Safety meetings for the year is to be developed,
published and posted at the beginning of each calendar year, listing the
date, time and location.
4. An agenda is to be developed by the co-chairpersons for each meeting and
circulated by the secretary at least one week in advance of the meeting.
5. Written minutes of the meeting are to be taken by a committee member or
secretary, outlining the following:
a) the date, time, and location of the meeting held
b) the names of all members and other persons present
c) an item-by-item record of all items discussed, and the outcome, Le.:
- reports presented and by whom
- problems identified
- agreed upon recommendations
- any action to be taken by individual members
~ any business the committee has agreed to discuss at the next
meeting
- any response by management to the committee
- any discussion with respect to the above
- date, time and location of the next meeting
6. Minutes are to be signed by the co-chairpersons and irculated within 2
weeks, with one copy:
a) posted at each workplace
b) forwarded to each Joint HEALTH AND SAFETY Me ber
c) forwarded to the area supervisor
d) distributed to senior management who normally revi w committee
recommendations
e) maintenance, personnel, medical or safety departm nt (where
appropriate)
C. General Duties for Committees:
1. Follow the gUidelines outlined in the Occupational Healt & Safety Act and
A Guide for Joint ealth and Safet Committees and Re resentatives in the
Workplace booklet by the Ministry of Labour.
2. Develop publish and post, at the beginning of eac calendar year, a
schedule for the monthly HEALTH AND SAFETY workp ce inspections for
the year.
3. Workplace inspections will be conducted monthly, by trained, appointed
members, and aU substandard acts and working onditions will be
documented on 'WORKPLACE HAZARDS REPORT" (MKHS 004), with
one copy:
a) forwarded to each Joint HEALTH AND SAFETY Me ber
b) forwarded to the area supervisor and/or Senior Ma ger for review
4. Review all completed "EMPLOYEE ACCIDENT INVESTIGATION
REPORTS" (IAPA Investigation Report Form), analy e information and
make recommendations to management to reduce recur ences.
5. Designate a committee member(s) to investigate any ccident in which a
person is killed or critically injured (as per Occupationa Health and Safety
Act definition)
6. Obtain information regarding:
a) hazardous materials, processes or equipment;
b) designated substances and the respective control- rogram reports;
c) workplace testing that is being carried out for health and safety
purposes.
7. Receive andraspond to any "HEALTH & SAFE Y INFORMATION
REQUEST" (MKHS 001)
8. Provide advice and recommendations to management on health & safety
programs in general, as outlined below:
a) Recommendations to management from the Health and Safety
Committee, for any items not already identified on the "WORKPLACE
HAZARDS REPORT", are to be submitted in writing on the "HEALTH &
SAFETY RECOMMENDATION" (MKHS 002), with the following
information:
(1) Nature of concern with background information and justification
(2) recommended remedial action, listing suggested solutions and
methods of implementation
(3) date
b) The co-chairpersons are responsible for ensuring the written
recommendations, (MKHS 002 & MKHS 004) are received by the
Senior Manager responsible for the reply to Joint Health and Safety
Committee recommendations.
c) Management will respond to the recommendations, in writing, within 21
days with:
(1) timetable for implementation, if employer agrees with the
recommendation
(2) reasons for disagreement, if the recommendation is not acceptable
9. Encourage fellow employees to work safely and to report hazardous or
unsafe conditions immediately to their supervisors.
10. Identify areas of health and safety training for all employees.
11. Be present for, or assist in, work refusal investigations.
12. Be available to accompany a Ministry of labour Officer on his/her inspection
tour of the workplace.
Policy No.:
MKHS 4
WORKPLACE INSPECTIONS
Description:
Effective Date:
MAY 2006
1. PURPOSE:
To assess the quality of workplace conditions, equipment and meth ds, the success of
or need for safety program Initiatives, and the quality and adeq cy of controls for
hazards in the workplace.
2. RESPONSIBILITY:
The Health & Safety Committee is responsible for ensuring the prop r application of this
policy. Management shall be responsible for ensuring monthly wo kplace inspections
are completed.
3. POLICY:
A. General:
1. Workplace inspections will be conducted on a monthly b sis.
2. If it is not practical to inspect the whole workplace onc per month, then a
monthly inspection of part of the workplace shall be nducted, with the
whole workplace being reviewed throughout the course f the year.
3. Inspections should be conducted prior to the Health & Safety meeting,
preferably one week in advance, so that the entire co mittee can discuss
the observation$and recommendations.
4. A schedule of workplace inspections for the year i to be developed,
published and posted by the Health & Safety Committe at the beginning of
each year, listing the date and time.
5. Annual inspections of Municipal workplaces will be conducted by the
committee as a group. These dates and times will not b published.
B. Inspection:
1. Workplace 30 day inspections will be completed by least 2 municipal
staff. (One management and one worker member) The orker member will
be assigned this duty at the preceding Health and Safet meeting.
2. The "WORKPLACE INSPECTION CHECKLIST" (MKH 003) will be used
as a guide and 'all observed unsatisfactory conditions wi I be recorded on it.
MKHS 003 wiU- then be given to the Health and Safe y Coordinator who
transfers this information onto form MKHS 004. MKHS 004 and Health and
Safety Committee recommendations (MKHS 002) will then be sent to the
Senior Manager responsible for a reply for that department.
3. The Health and Safety Committee member will record any suggestions in
the 'Recommended Actions' section (MKHS 002) and assign responsibility
for correction to the area supervisor.
4. Copies of the "WORKPLACE INSPECTION CHECKLlST'(MKHS 003) will
be:
a) posted on the Health and Safety section of the bulletin board
b) forwarded to the area supervisor and Senior Manager
c) circulated to each Health and Safety Committee Member in the
workplace
d) forwarded to the Health and Safety Coordinator for central recording
and filing.
C. Analvsis and Follow-up:
1. The area supervisor is responsible for reviewing the 'WORKPLACE
HAZARDS REPORT"(MKHS 004) and initiating the appropriate corrective
action for each discrepancy in his/her area, in order of its priority.
2. The "WORKPLACE HAZARDS REPORT"(MKHS 004) shall be reviewed
and responded to by the area supervisor within one week, with the following
information:
a) the action taken or planned to be taken
b) the completion date
3. Subsequent workplace inspections will review the items from previous
inspections to ensure the remedial action has. resolved the concern.
Policy No.:
MKHS 5
EMPLOYEE ACCIDENT/INCIDENT REPORTING
MAY 2006
Description:
Effective Date:
1. PURPOSE:
To provide a POlicy where all accidents and incidents, resulting in i jury, occupational
illness and/or property damage, can be investigated to prevent recu nce.
2. RESPONSIBILITY:
A. Employees are required to report all accidents/incidents 0 their immediate
supervisor.
B. The supervisor is responsible for investigating, reporting a corrective action
follow-up of all accidents/incidents
3. POLICY:
A. General:
. 1. All injuries, occupational illnesses, property damage an incidents must be
reported to the supervisor.
2. Immediately attar an accident/incident, the superviso shall ensure the
safety of employees, public, equipment and facilities fr m further injury or
damage and follow the steps outlined in this Guideline.
3. There are four categories of injuries:
a) No Treatment
b) First Aid
c) Medical Aid
d) Critical
B. No Treatment Iniury:
1. 'No Treatment Injury' occurs when there is an injury t at does not require
any treatment (e.g. bruised finger)
2. The employee Will report the injury to the supervisor.
3. The supervisor will record the injury in the "IAPA FI ST AID REPORT
LOG", which is to be kept at the First Aid Station.
C. First Aid Iniury:
1. 'First Aid Injury' is an injury that can be treated at the work site and does not
require treatment from a health care professional. (e.g. a cut finger that
requires a band aid only).
2. First aid treatment will be provided and the treatment recorded in the nlAPA
FIRST AID REPORT LOG".
3. The employee is to report the injury to the supervisor.
D. Medical Aid Iniurv:
1. 'Medical Aid Injury' is an injury that requires treatment (e.g. a cut finger that
requires stitches) from a health care professional (e.g. physician,
chiropractor, etc.), but is not of a critical nature. .
2. The supervisor is to arrange for:
a} first aid treatment for the injured employee and record the treatment in
the "IAPA FIRST AID REPORT LOG".
b) Transportation (e.g. private vehicle, taxi, ambulance, etc.) of the
employee to a location where professional health care can be
delivered (e.g. doctor's office, hospital).
3. A "Functional Abilities Fonn For Timely Return to Work" (Appendix 2) is to
be taken to the attending physician. Also see MKHS 009 "MODIFIED
WORK" regarding employee return to work.
4. The supervisor is to conduct an investigation immediately, or as soon as
possible, following the notification of the accident/incident. See Policy
MKHS 4 "Accident/Incident Reporting", Section F
E. Criticallniurv:
1. A 'Critical Injury' means an injury of a serious nature that:
a) places life in jeopardy
b) produces unconsciousness
c) results in substantial loss of blood
d) involves the fracture of a leg or arm but not a finger or toe
e) involves the amputation of a leg, arm, hand, foot, but not a finger or toe
f) consists of bums to a major portion of the body; or
g) causes the loss of sight in an eye
2. The supervisor is to arrange for:
a) first aid treatment for the injured employee and record the treatment in
the "IAPA FIRST AID REPORT LOG"
b) transportation (e.g. private vehicle, taxi, ambul nee, etc.) of the
employee to a location where professional h Ith care can be
delivered (e.g. doctor's office, hospital).
c) immediate notification of the Ministry of Labour, CA ,Senior Manager,
and Health and Safety Coordinator.
3. A "Functional Abilities Form for Timely Return to Work" ( ppendix 2) is to be
taken to the attending physician. Also see MKHS 009" ODIFIED WORK"
regarding employee return to work.
4. The supervisor is to conduct an investigation immedia ely, or as soon as
possible, following the notification of the accident/inc dent. See Policy
MKHS 4, Section F
F. Accident/Incident Reoortina:
1. Investigations will be conducted by the Supervisor and e Health & Safety
Coordinator, with the optional assistance of a member f m the Joint Health
& Safety Committee (NOTE: for items with an *, assista ce from a member
of the Joint Health & Safety Committee is compulso ), and the findings
documented omthe "IAPA ACCIDENT INVESTIGATIO FORM" whenever
any of the following occur: I
a) medical aid
b) critical injury*
c) fatallty*
d) hazardous substance discharges*
e) Joint Health & Safety request*
f) fire or explosion
g) property damage above $500.00
h) accidents involving possible public liability
i) other accidents
j) acute/chronic occupational illness
2. When conducting the investigation it is important to:
a) preserve the8ccident scene where practical and po sible
b) identify witnesses or others having knowledge of th accident/incident
c) interview the injured employee where practical and ossible
d) identify any primary/secondary causes
e) identify any primary/secondary unsafe actions
f) identify any primary/secondary hazardous conditio s
g) documenUhe accident scene with photographs if p ssible
3. Investigations are required to be completed within 24 h urs of the incident
or request.
Policy No.:
MKHS 6
WSIB REPORTING
MAY 2006
Description:
Effective Date:
1. PURPOSE:
To provide a Policy which outlines the reporting requirements for all compensable
injuries.
2. RESPONSIBILITY:
A. Employees are required to report all accidents/incidents to a designated
individual, normally the supervisor on duty, and to keep himlher advised of their
work status.
B. For any compensable accidents, the employee and the designated individual are
responsible for completing the required portions of the IAPA Accident
Investigation Report and forwarding them to the Human Resources (HR)
Department. The worker's Supervisor is also responsible for co-ordinating the
worker's return to work in conjunction with the HR Dept. and the employee, in
accordance with the physician's recommendations.
C. The Treasury Department, or an authorized designate, is responsible for
completing and forwarding the claim to the Workplace Safety Insurance Board
(WSIB).
D. All persons dealing with any of the documentation related to a claim must
recognize the confidential nature of this material and treat it in accordance with
the Municipal Freedom of Information and Protection of Privacy Act.
3. POLICY:
A. Initial Claim:
1. Within 24 hours of a compensable accident/incident, the Supervisor will
forward a copy of the completed IAPA Accident Investigation Report to the
Treasury Department or designate who will complete and forward the Form
7 to the WSIB within the legislated timeframe. If possible, the worker will
sign the Form 7 prior to forwarding it; however submission will not be
delayed for this.
The pink copy of the Form 7 will be returned to the employee after
submission. A "Functional Abilities Form for a Timely Return to Work"
(Appendix 2) will be provided to the employee to take to the health care
professional. A copy of the form must be returned to the supervisor when
completed.
If the Form 7 is completed by an authorized design a e of the Treasury
Department (ie. workplace supervisor), a copy mus be faxed to the
Treasury Dept. immediately alon with A ndix 2 whe available.
a) complete the Form 7, sign the form and fax it to SIB within the 72-
hour deadline.
b) forward other documentation to WSIB as required ( .g. Modified Hours
and earnings).
2. The Treasury Department (or authorized designate) will:
3. The Employee will:
a) Take "Functional Abilities Form for a Timely Return 0 Work" (Appendix
2) to the medical practitioner, and return the comp ted canary yellow
copy of the Appendix 2 to the employer as soon as ossible.
b) In the event that the employee completes a WS B Form 6 (at the
request of the WSIB), they are required to pro de a copy to the
employer, and the Treasury Department must also copied.
B. SubseQuent to FiUnathe Initial Claim:
1. At the request of the employer, the employee will have an updated
Appendix 2 completed and returned to the supervisor or esignate, who will
then forward a copy of the form to the Human Resources Department.
2. When an employee is authorized by the treating health care professional,
they will return to work on either:
a) Full Duties or
b) Modified Duties
3. The employee's. time sheet may be used to identify he changes in an
employee'S work status but it will not eliminate the requirement for a
completed Appendix 2, or for direct communication with the Human
Resources Department on the employee's status.
Policy No.:
MKHS 7
MODIFIED WORK
Description:
Effective Date:
MAY 2006
1. PURPOSE:
To provide a fair and consistent policy for the rehabilitation of employees who have
been injured on the job, the Municipality recognizes the benefits of a fonnal
rehabilitation program and will undertake to provide meaningful employment for both
pennanently and temporarily disabled employees.
2. OBJECTIVES:
A. The objectives of the Early and Safe Return to Work (ESRlW) program are:
1. To achieve ESRlW with the provision of suitable work which meets the
following guidelines:
a) the employee has the skills for, or can be trained to do this work.
b) the work is within the employee's physical abilities.
2. To shorten periods of disability, and lost time.
3. To provide modified work for the employee which is both safe and
productive.
4. To assist employees in maintaining a sense of confidence and self-esteem
for themselves and their families during the period of disability.
B. The modified work program will be tailored to each employee's specific
requirements, and this goal is more readily achieved when a team effort is used
for modified work/rehabilitation planning.
3. RESPONSIBILITY:
A. The Senior Manager and workplace supervisor are responsible for ensuring that
every reasonable effort is made to provide suitable modified work to any
employee who is unable to perform his nonnal duties as a consequence of an
occupational injury or illness.
B. The injured worker is responsible for active participation in the modified work
program, as defined in this Policy.
3. POLICY:
A. General:
1. Modified work is any job, task, function or combination th reof that a worker,
who suffers from a diminished capacity, may perform s fely without risk of
re-injury.
2. The work must be productive and the result of the wqrk ust have value.
3. The program must be seen as temporary, generally ot to exceed 8-12
weeks in duration, and is intended to assist the em loyee in gradually
returning to his/her regular pre-injury duties.
4. Every Senior Manager will try to accommodate any e ployee unable to
perform their regular duties.
5. Where the employee's "Senior Manager" is unable to provide a suitable
work assignment, an attempt will be made to place the e ployee in another
department within the Municipality. This process will be -ordinated by the
Human Resources. Department.
B. Responsibilities:
1. The duties of the workplace superVisor are to:
a)
b)
c)
d)
e)
f)
g)
h)
Meet with the worker to set program goals and obje ives.
Determine if outside professionals are needed (e.g. Ergonomics
Specialist).
Establish individual programs for workers, with the help of other
professionals,if required.
Ensure there Is no conflict with the Tripartite Pe onnel Agreement
dated February 15th, 2006.
Organize the'placement of Injured workers in modifi d jobs.
Meet with the employee on the first day back and f i1itate the return to
work.
Arrange meetings with the worker, as required, to onitor the status of
worker and disc;uss strategies for future developme t of the program.
Educate workers about the modified work progra ,safety practices
and the WSIB.,
2. With the assistance of the Human Resources Depart ent, the supervisor
will:
a) Develop an individual program for the worker an keep him actively
involved in the rehabilitation plan by setting oals, maintaining
continuous contact and monitoring progress.
b) Ensure that the Modified Work Program does not conflict with the
Tripartite Personnel Agreement dated February 15th, 2006.
c) Keep minutes of all meetings
3. The duties of the worker are to:
a) Maintain regular contact with the workplace supervisor.
b) Obtain clearance from the treating health care professional for the
return to modified work.
c) Notify the relevant WSIB personnel (e.g. Claims Adjudicator and/or
Nurse Case Manager), and the supervisor, of availability for modified
work.
d) Take an active role in developing his/her individual modified work
program.
e) Communicate any concerns to the workplace supervisor so that
potential problems can be resolved immediately.
f) Ensure that other scheduled activities, such as physiotherapy or
doctor's appointments do not interfere with the return to work.
C. Followina an Iniurv:
1. For an injury requiring treatment by a health care professional, depending
on the nature/severity of the injury, the employee will be given a "Functional
Abilities Fonn for a Timely Return to Work" (Appendix 2), to be taken to
his/her health care professional.
2. The Appendix 2 will be accompanied by notification that the Municipality of
Kincardine has a modified work program and awaits the completed fonn to
tailor a program specifically to the employee's abilities.
3. Whenever requested by the Municipality throughout the duration of the
claim, the employee will have an Appendix 2 completed by the attending
regulated health care professional.
4. Regular contact between the employee and the supervisor is to be
maintained throughout the employee's recovery period, with progress
meetings held at a minimum suggested frequency of once every two weeks,
and preferably following the employee's medical appointments.
5. A copy of the completed Appendix 2 will be given to the workplace
supervisor at these progress meetings and the injured employee's progress
shall be jointly reviewed.
D. Modified Work ImDlementation:
1. When the health care professional indicates that the employee is available
for modified duties, the supervisor and the employee will meet to discuss
what work options are available, those being, in order of priority:
a) A modified pre..Jnjuryjob
b) An alternate job
c) Another suitable job
2. A "Physical Demands Analysis" (MKHS 012) should b completed by the
supervisor to identify what activities need to be performe in carrying out the
job assignment and to match these with any identified re trictions.
3. It may be necessary to modify the pre~injury job n a temporary or
permanent basis,to accommodate the employee's p ysical restrictions.
This may include, but not be limited to:
a) Regular job/tasks may be changed, redesigned or ysically modified.
b) Hours may be reduced (e.g. fewer days per week or fewer hours per
day than normal).
c) The volume of work performed may be reduced.
d) Co~workers may provide assistance for more difficu tasks.
4. If the pre-injury job cannot be modified to accom odate the injured
employee's needs, alternate jobs may be considered.
I
5. An alternate job is one that involves work that is apprcj)ximately the same
pay grid within the organization, looking first at the "ho e" department, and
then all outside departments.
6. When looking at alternate jobs, consideration should be iven to:
a) The emplQyee~sprevious work history
b) Transferabfeskills'
7. When neither the pre~injury job nor an alternate job i appropriate, other
suitable jobs should be considered.
8. Other suitable jobs are defined as those jobs within he capacity of the
worker and which pose no health or safety risks to him/h r, but may be quite
different from the (.)fe-accident job.
E. Proaram Monitorino:
1. The injured employee should be monitored closely whil on a modified work
program, with any difficulties he/she has being reporte and evaluated by
his/her workplace supervisors.
2. The information provided on the Appendix 1 (Form 7) ill be used to place
the worker in a modified work program within the capab Iities and limitations
identified.
3. When monitoring an injured worker's participation, the following factors
should be considered:
a) Attendance
b) Productivity
c) Accuracy
d) Problems with particular tasks
e) Ability to increase speed
f) Ability to improve efficiency
4. Once the worker completes his modified work program and returns to full
duties, a complete review of the individual's "Modified Work Progress Chart"
should be perfonned by the supervisor and the worker. Applicable
recommendations for improvements made as a result of the review should
be documented.
Policy No.:
MKHS 8
REFUSAL TO WORK
MAY 2006
Description:
Effective Date:
1. PURPOSE:
To create a Policy outlining the steps to be followed when any e ployee refuses to
work due to unsafe work conditions as defined in the Occupational Health and Safety
Act.
2. RESPONSIBILITY:
A. The employee is responSible for immediately informing the supervisor of any
unsafe work. conditions.
B. The supervisor is responsible for investigating any report of unsafe work
conditions and resolving the concern, as defined by this Guidell e.
3. POLICY:
A. Right to Refuse Work:
1. An employee may refuse to work or do particular work where he/she has
reason to believe.that:
a) Any equipment he/she Is to use or operate is likely to endanger
himself/herself or another employee.
b) The physical condition of the workplace is I kely to endanger
himself/herself.
c) Any equipment he/she is to use, or the physic I condition of the
workplace, is in contravention of the Occupational Health and Safety
Act, and such contravention is likely to endange himself/herself or
another employee.
2. The following eMployees of the Municipality of Kincardin are limited In their
right to refuse work:
a) A person employed in the operation of:
(1) A first aid clinic or station, Emergency Service Personnel; and
(2) A laundry, food service, power plant or technic I service, or facility
used in conjunction with an institution, facilit or service referred
to in sub clauses (1) or (2) above.
B. Uoon Refusina to Work:
1. The employee shall promptly report the circumstances of his/her refusal to
his/her supervisor, who shall promptly investigate the report in the presence
of the worker and one of the following:
a) Health and Safety Coordinator
b) A Joint Health and Safety Committee Worker Member
c} A worker who because of knowledge, experience and training is
selected by a trade union that represents the worker, or if there is no
trade union, is selected by the workers to represent them
2. If action can be taken to resolve the complaint without need for further
investigation, the supervisor will carry out the action and complete Part I of a
"Refusal to Work" (MKHS 010).
3. If further investigation is required to resolve the complaint, Part II of the
"Refusal to Work" form will be completed in the presence of and with input
from a worker member of the Joint Health and Safety Committee.
4. Until the investigation is completed, the worker shall remain in a safe place
near his workstation, unless assigned to alternative work. Another worker
may be assigned to operate the equipment/machine/device pending the
investigation, only if they have been informed of the refusal in the presence
of the health and safety worker representative.
5. If, after the investigation and/or any steps taken to resolve the concern, the
employee feels that there is still an unsafe work condition; the employer
shall notify the Ministry of Labour.
6. A Ministry of Labour Inspector shall investigate the refusal to work in the
presence of the following:
a) Employer
b) Employee
c} Health and Safety Coordinator
d) A Joint Health and Safety Committee Member
7. The Inspector shall decide whether the equipment or the workplace is likely
to endanger the employee or another person and give his decision, in
writing, as soon as practicable.
8. Pending the investigation and decision of the Inspector, the employee shall
remain at a safe place near his work station during his/her normal working
hours, unless the employer assigns the employee reasonable alternative
work during such hours.
9. Pending the investigation and decision of the Inspector, no employee shall
be assigned to use the equipment/machine/device, r to work in the
workplace that Is being investigated, unless the emplo ee to be assigned
has been advised of the work refusal and the reasons fo it.
Policy No.:
Description:
Effective Date:
MKHS 9
HEALTH AND SAFETY TRAINING
MAY 2006
1. PURPOSE:
To develop a policy to ensure all employees receive the proper orientation and ongoing
training, necessary for maintaining a safe work environment.
2. RESPONSIBILITY:
A. The supervisor is responsible for ensuring the employee receives all the
necessary training, as defined in this policy.
B. The Joint Health & Safety Committee is responsible for auditing the records for
compliance. The Health and Safety Coordinator shall maintain all records of the
above auditing process.
3. POLICY:
A. Orientation:
1. Each workplace and all Senior Managers will be given a copy of the current
Occupational Health & Safety Manual, which must be made accessible to all
employees.
2. All new employees will be given an overview of the Occupational Health &
Safety Manual as part of their orientation.
3. The following areas will be reviewed in detail, during the orientation:
a)
b)
c)
d)
e)
f)
g)
h)
MKHS 1
MKHS 4
MKHS 7
MKHS 9
MKHS10
MKHS 2.1
MKHS 2.2
MKHS 2.6
RESPONSIBILITIES
EMPLOYEE ACCIDENTIINCIDENT REPORTING
GUIDELINES
REFUSAL TO WORK
HEALTH and SAFETY TRAINING
HAZARDOUS CONDITIONS REPORTING
GENERAL SAFETY RULES
PERSONAL PROTECTIVE EQUIPMENT
EMERGENCY GUIDELINES
4. All employees will be shown proper safety guidelines specific to their job by
their supervisor.
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n"",..u""'~"';n",,~1 U..~lt'h Jl'r ~~.fAhr ",{r.ann-:.l
P",,,,.. ~ 1 ....f' Oll
B. WHMIS:
1. Any worker, who works with or in proximity to any hazar ous materials, shall
receive WHMIS training, including information on the zardous materials
used in the workplace, their labelling, storage and u e, and any health
hazards they may present.
2. The instructions and training shall be developed and i plemented by the
Municipality, in consultation with the Health & Safety C mmittee, and such
training and the workers' familiarity with the informati n will be reviewed
annually.
3. An MSDS (Material Safety Data Sheet) book will be kept at a location
accessible to all employees (e.g. First Aid Station) for re~ rence.
C. First Aid:
1. A minimum of two people per shift per workplace wi I be trained in an
approved First Aid'icourse, when the number of worke on shift is greater
than five.
2. The MunicipalltywlU sponsor retraining, as req ired, in order to
maintain compliance with the Workplace Safety & Insurance Board
Act.
D. Personal Protective Ea UiDme nt:
1. All new employees will be provided with personal prote tive equipment, as
required for the different work applications.
2. Employees will be instructed by their supervisor in the u e and care of their
personal protecUveequipment on an annual basis.
E. Fire Alarms And Extinauishers:
1. All new employees will be shown the location of t fire alarms and
extinguishers.
2. Designated employees for each workplace will be instr cted in the proper
use of the fire extinguishers on an annual basis.
F. EmeraencvGuidelines:
1. All employees will be instructed in MKHS Guideline 2.6
2. A copy of the "Emergency Exits Floor Plan" will be paste on the Health and
Safety Bulletin Board of all municipal buildings where wa kers work.
3. An evacuation drill shall be perfonned annually in all municipal buildings
where permanent staff regularly report to work.
G. Trainina Proaram:
1. Members of the Health & Safety Committee shall be encouraged to attend
health and safety seminars and workshops to keep their knowledge current.
2. Workers and supervisors shall attend relevant health and safety seminars
and workshops to provide them with basic knowledge and skills necessary
to ensure compliance with the legislation.
3. Employees shall be required to take additional job skills training when job
requirements change.
4. Monthly on-the-job training shall be provided by the employer to all
employees to develop skills and knowledge. There shall be a planned
schedule of training posted in the workplace and suoervisors shall ensure
that critical topics are covered, e.g. WHMIS, EMERGENCY PLAN, FIRST
AID, LIFTING, CONFINED SPACE, TRAFFIC CONTROL etc.
5. To keep personnel current in all aspects of health and safety, literature shall
be provided on all upcoming educational opportunities through the use of
bulletin boards and/or newsletter.
H. Confined Soace and Lock-Out:
1. Designated employees shall be instructed on MKHS Guideline 2.4
CONFINED SPACE and MKHS Guideline 2.3 LOCK-OUT when applicable
to their specific workplace duties.
Policy No.:
Description:
MKHS 10
Effective Date:
HAZARDOUS CONDITION REPORTING
MAY 2006
1. PURPOSE:
To identify the steps to be takenJor reporting hazardous conditions t at may arise in the
workplace.
2. RESPONSIBILITY:
A. All employees are responsible for reporting to their supervi or any hazardous
conditions that may existin the workplace.
B. The workplace supervisor is responsible for responding 0 the employee's
concern and ensuring that the hazardous condition is resolv d and the workers
are protected.
3. POLICY:
A. General:
1. An employee shalll'eport to his or her supervisor:
a) the absence of or defect in any equipment or p tective device of
which he or she is aware and which may endang himself or herself
or another worker;
b) any contravention of the Occupational Health & Safety Act or the
regulations, or the Municipality of Kincardine Healt & Safety Policies
and Guidelines; and
c) the existence of any hazard of which he or she kno s.
2. The supervisor will attempt to resolve the concern, as so n as possible. and
keep the involved employee apprised of the status of the ncern.
3. If the supervisor is unable to resolve the concern, he or she should bring it
to the attention of his or her Senior Manager.
4. If the employee's concern is not satisfactorily resolved after a reasonable
period of time (not to exceed five [5] working days) the employee is
encouraged to bring the concern to the attention of a ember of the Joint
Health & Safety Committee or the Health and Safety Co dinator.
5. The employee will be asked to document the concern on a "HEALTH &
SAFETY INFORMATION REQUEST" (Form MKHS001) outlining the facts
and the information requested.
6. All concerns are to be thoroughly investigated with factual information
pertaining to the concern freely exchanged between the parties involved in
the investigation.
7. The Joint Health & Safety member and the employee's supervisor are
responsible for ensuring the employee is informed of the progress or
resolution of the concern.
8. Concerns not addressed to the satisfaction of the parties involved are to be
placed on the agenda for the next regularly scheduled meeting, or, if
necessary, a special meeting convened by the Joint Health & Safety
Committee Co-chairpersons.
9. This policy does not preclude the employee from exercising his or her right
to refuse to work, as defined under both the Occupational Health & Safety
Act and policy MKHS 8 REFUSAL TO WORK.
Policy No.:
MKHS 11
STANDARD OPERATING GUIDELINES
Description:
Effective Date:
MAY 2006
1. PURPOSE:
To provide a system for developing Standard Operating Guidelines or the operation of
equipment and performance of specific tasks.
2. RESPONSIBILITY:
The workplace supervisor is responsible for ensuring that S andard Operating
Guidelines are written for each critical piece of equipment in the orkplace and the
employees who operate the:equipment are trained in these Guidelin s.
3. POLICY:
A. General:
1. Each workplace will review the various equipment use at the facility and
from this, will develop a list of critical equipment (e.g. Tra tor, chipper, dump
truck, fire truck etc.)
2. A Standard Operating Guideline will be developed for e ch of these critical
pieces of equipment.
3. All employees that operate a piece of critical equipment ill be trained in its
Standard Operating Guideline.
B. Standard Operatino ~uiqelines Format:
1. Each Standard Operating Guideline should consist of the following sections:
a) Equipment:
(1) Brand name, Type, Model Number
(2) Supplier's Name and Address
(3) Specifio machine requirements (e.g. Temperatu~ Ihumidity
requirements)
b) Materials:
List of materials that are consumed in the operatio of the equipment
(e.g. Compressed air, gasoline)
c) Pre-Start Up Inspection Checklist:
A walk around is to be performed prior to starting up the equipment. A
checklist of items, specific to each piece of equipment, will be used to
ensure completeness.
The checklist will identify:
(1) the frequency of inspection (e.g. daily, weekly, seasonally, etc)
(2) what items are to be checked
(3) what remedial action is taken when a problem is identified
(4) the operator who performs the checklist and the date it is
performed
The checklist items may include such items as:
(5) all guards are in place
(6) all manufacturer's safety features are intact and operational
(7) there is no excessive wear
(8) everything is fastened together properly-nothing is broken
(9) all mounts are secured
(10) gauges for such things as pressure and temperature are
functioning and within safe ranges
(11) start-up of equipment will not endanger any worker.
d) Safety Precautions:
List the precautions that the employee should take while running the
equipment, or working in the area, in order to prevent injury to himself
or to others.
Include information concerning potential dangers of which the
employee should be aware.
Some of the areas of concern which may be identified are:
(1) electrical grounding
(2) high voltage
(3) radiation
(4) danger of bums from hot or very cold items
(5) extreme heat
(6) flying sparks
(7) explosive materials
(8) hot liquids
(9) acidic or caustic substances
(10) skin irritants or drying agents
(11) toxic fumes
(12) flammable fumes or liquids
(13) dangerous movingpalts of machinery
(14) equipment shields
(15) oil on floor
(16) pits or holes to avoid
(17) pinch points
Information about what to do in emergency situati s (e.g. location of
first aid station, emergency stopping, etc.) may als be included in this
section.
e) Personal Protective Equipment (PPE):
This section should list all the personal protective e uipment that must
be worn while operating the specific equipment an may include items
such as:
(1 ) head protection (hard hat, sun exposure)
(2) eye protection (safety glasses, face shield)
(3) hearing protection (at no time shall any head hones, earphones
or other music producing earpiece be used by any worker unless
permission has been obtained from the orkers immediate
supervisor)
(4) respiratory equipment (filters, scba)
(5) protective clothing and gloves (long pants/shi if so directed by
employees immediate supervisor)
(6) foot protection (as per occupational health and safety act)
f} Preventive Maintenance and Critical Spare Parts:
This section will document preventive maintena ce that is to be
performed on equipment.
A checklist of items, specific to each piece of equi ment, will be used
to ensure completeness and may parallel the type list typically found
in an owner's manual.
The required qualifications of the inspector/teste (e.g. Automotive
Mechanic,Eleotrician, etc.) are to be identified in this section of the
Guideline.
A maintenance checklist wlllidentify:
(1) the frequency of the preventative maintena ce (daily, weekly,
seasonally, annually etc)
(2) what items are to be checked
(3) what standards are to be met
(4) the results observed
(5) the remedial action to be taken when a problem/deviation is
identified
(6) the operator who completes the checklist and the date it is
performed.
Some maintenance activities may not be performed on a fixed time
schedule, but rather when certain conditions are observed. For these
cases, the Guideline should identify:
(1) the condition/signal which triggers the maintenance
(2) what activity is to be performed
(3) the action taken
For critical equipment where minimum downtime has a serious effect
on the operation, a list of essential spare parts will be developed and
maintained (e.g. standby generator)
g) Operation:
This section explains in detail how to operate the equipment. It should
be as complete and as easily understood as possible. Starting with the
first step, all steps of the operation are listed sequentially and
explanations given for how, as well as what, things are to be done.
The instructions should be stated as simply and concisely as possible,
assuming that the operator has no prior knowledge of the equipment.
Illustrations should be provided, where appropriate, to compliment the
written instructions.
h) Shutdown:
This section should explain the steps to follow for three (3) types of
shutdown situations:
(1) emergency shutdown
(2) regular shutdown
(3) long-term (storage) shutdown
Guidelines for each type of shutdown are to be listed In the order
that they are to be carried out.
Shutdown includes both shutdown of equipment and clearing the work
area.
Emptying containers or tanks of liquid, purging lines, etc. are to be
included in the shutdown processes.
i) Illustrations:
This section should include any prints, drawin s, schematics or
illustrations that can further clarify the written Guide nes.
C. Audits:
1. The Standard Operating Guideline Should be reviewed n a periodic basis,
and minimally once per year, to
a) ensure the gtride Ii ne is being applied consistently
b) determine if the. operator understands the guideline
c) allow for feedback and suggestions for improvemen s
2. If an accident occurs while using the equipment, the tandard Operating
Guideline should be reviewed by the Joint Health and S fety Committee, as
part of their accident investigation and analysis
3. If the accident is attributed to failure to follow the tandard Operating
Guideline:
a) the Supervisor should document this infraction a d take necessary
action to enforce the guideline.
b) the Joint Health and Safety Committee should incl de an audit of the
specific Standard Operating Guideline on their sub equent Workplace
Inspections, to. observe compliance.
Description:
MKHS12
DISCIPLINE POLICY
MAY 2006
Policy No.:
Effective Date:
1. PURPOSE:
It is the policy of the Municipality of Kincardine that all workers shall work in a manner
that promotes health and safety. This includes working in a manner that conforms to
the Occupational Health and Safety Act and to the Municipal Occupational Health and
Safety Manual.
2. RESPONSIBILITY:
All Senior Managers, Supervisors and the CAO shall be responsible for ensuring that
this policy is administered and followed.
3. POLICY:
When a health and safety situation arises where a Senior Managef feels that
disciplinary action may be required, he/she shall gather all the facts including a review
of that workers safety training records and discuss them with the employee prior to
instituting any disciplinary measures.
Accordingly, if a workef is found to be working in a manner that is contrary to the
Occupational Health and Safety Act Of the Municipal Occupational Health and Safety
Manual, that workers safety training records shall be reviewed by that worker's Senior
Manager. If after this review, it is determined that the worker has adequate and current
safety training and was still working in a manner that is contrary to the Occupational
Health and Safety Act Of to the Municipal Occupational Health and Safety Manual, the
worker shall be disciplined in order to reinforce the importance of safe working
practices. Disciplinary action shall be corrective, not punitive.
Refer to Tripartite Personnel Agreement dated February 15th, 2006 Section 49.0 for
complete discipline details.
Guideline No.:
MKHS 2.1
Description:
GENERAL SAFETY RULES
Effective Date:
MAY 2006
1. PURPOSE:
To provide general guidelines for creating and maintaining a safe wo environment.
2. RESPONSIBILITY:
A. The employee is responsible for following the safety rules.
B. The supervisor is responsible for ensuring the guideline is adhe d to.
3. GUIDELINE:
A. General Rules:
1. Personal Protection'Equipment must be worn when and here required.
2. Report ALL injuries to your supervisor immediately.
3. Report any unsafe conditions, including someone ap arently under the
influence or in possession of drugs or alcohol, or any oth r hazard that may
result in an injury to yourself or a fellow employee.
4. Report any property damage, regardless of how minor.
5. Follow all operator instructions when using or handling h zardous materials
and ensure that all containers of hazardous materials a e properly labeled
and stored in designated areas.
6. Obey all posted signs and notices.
7. Always use the correct posture when lifting, and get assi tance if the weight
is excessive.
8. Be aware of the location of the Health and Safety bulleti board, the MSDS
Sheets and the posted Occupational Health and Safety t.
B. Housekeepino:
1 . Aisles are to be kept clear at all times.
2. Individual work areas are to be kept clean and tidy.
3. All materials, tools, products and equipment are to be kept in their
designated areas.
4. All materials, tools, products and equipment are to be kept in their
designated areas.
5. Liquid spills are to be cleaned up immediately to prevent slips and falls.
C. Fire Prevention:
1. Become familiar with the location of fire alarm pull stations, fire
extinguishers and exits.
2. Ensure aisles and exits are not blocked at any time.
3. Anytime a fire extinguisher is used, report it immediately to your supervisor,
so that it can be recharged. Contact the Fire Department for assistance.
4. Senior Managers shall ensure all their workers have been properly trained
in emergency Guidelines specific to their individual work locations. This
shall include annual fire extinguisher training.
D. Eauioment Ooeration:
1. Equipment must not be repaired, adjusted or operated unless you
understand the Standard Operating Guideline.
2. Be aware of the use and location of the "EMERGENCY STOP" button
before using any equipment.
3. Loose clothing, jewelry, and long hair should be secured, so as not to
become entangled with equipment.
4. The operator must check all safety devices before operating the equipment.
5. All equipment must be tumed off and the appropriate lock-out Guideline
(MKHS 2.3 LOCK-OUT) followed, prior to repairs, cleaning, adjustment or
lubrication.
Guideline No.:
Description:
MKHS 2.2
PERSONAL PROTECTIVE EQUIPMENT
MAY 2006
Effective Date:
1. PURPOSE:
To provide a guideline that outlines what personal protection equip ent is required to
be worn in the workplace.
2. RESPONSIBILITY:
A. The supervisor is responsible to ensure the necessary equipm nt is worn or used,
training the employee in its use and ensuring the guideline is ad ered to.
B. The employee is responsible for the care and maintenanc of any personal
protective equipment assigned to them and for the proper application of this
guideline as it applies to them.
3. GUIDELINE:
A. General:
1. Personal Protective Equipment (PPE) is the last Ii e of defence for
controlling occupational hazards, after thorough evaluation and
implementation of:
a) engineering controls;
b) administrative controls; and
c) work practices.
2. Only PPE approved by the appropriate safety asso iations (e.g. CSA,
NIOSH, NFPA etc.) will be used.
5. Specific PPE needs will be identified at each workplace, in accordance with
accepted industry practices and standards, and will be documented in the
specific workplace Standard Operating Guidelines, for t e critical pieces of
equipment.
6. Training in the, use and maintenance of PPE will b provided by the
Supervisor.
7. Records will be:kept for the issue of non~disposable PP
8. The Joint Health & Safety Committee may audit complia ce to this guideline
during their monthly inspections.
B. Personal Protective Eauipment:
1. Head Protection:
a) Hard hats are required by all workers involved in construction or
emergency operations where there is any danger of injury from falling
objects, or from striking the head on overhead objects.
b) Hard hats shall not be drilled, painted or wom in a reversed manner.
c} Other protective headgear may be assigned to protect individuals from
long- term exposure to the sun or elements.
2. Eve Protection:
Where a worker is exposed to the hazard of eye injury, he or she shall wear
eye protection appropriate for the circumstances, which includes, but is not
limited to:
a) chipping;
b) cutting;
c) drilling;
d} exposure to acids, alkali, or other corrosive chemicals;
e) exposure to very dirty or dusty conditions;
f} sandblasting;
g) sawing;
h) spray painting; and
i) welding
j) performing extrication or rescue
3. Hearino Protection:
a) Waming signs are to be posted at the approaches to an area, or on
equipment, where the sound level is more than ninety (90) decibels.
b) Workers are to wear hearing protection when the daily exposure is
more than that permitted for the particular sound level, as defined in
Regulations 834, S 139, of the Occupational Health and Safety Act.
c) Workers shall wear hearing protection, when exposed to a sound level
of one hundred and fifteen (115) decibels or greater.
4. Respiratorv Eauipment:
a) Suitable breathing apparatus shall be wom when workers are likely to
be exposed to injury from:
(1) dangerous gases, vapour, fumes or dust; and
(2) deficiency of oxygen.
b) Equipment can be paper filters, masks with charcoal cartridges,
S.C.B.A. (Self-Contained Breathing Apparatus) or SAR (Supplied Air
Respirator).
5. Protective Clothlna and Gloves:
a) A worker shall be outfitted with the appropriate a arel, where he or
she is exposed to the hazard of injury from contact f his/her skin:
(1) a noxious gas, Iiquid,fume or dust;
(2) a sharp or jagged object which may puncture, ut or abrade his or
her skin;
(3) a hot object, liquid or molten metal;
(4) radiant heat; and
(5) body fluids or pathogenic material (e.g. health re area).
b) Garment, usually a vest, covering the upper bod and meeting the
Construction Projects Traffic Control Regulations 9.1, is required to
be worn by all workers involved in construction, aintenance and/or
traffic control while on the roadway.
6. Foot Protection:
a) Where a worker Is exposed to the hazard of foot in ry he or she shall
wear foot protection appropriate in the circumstance .
b) All workers shall wear green-patch, steel-toed b ots or shoes with
puncture resistant soles when working on constructi n sites.
c) Lace-type footwear must be fully laced to provid full support and
prevent accidents.
d) Fire fighting boots shall be rated di-electrlc
Description:
MKHS 2.3
LOCK OUT / TAGOUT
Guideline No.:
Effective Date:
MAY 2006
1. PURPOSE:
To create a guideline that ensures equipment is locked out/tagged out when under
repair or if detennined to be unsafe, so as not to endanger any personnel.
2. RESPONSIBILITY:
A. The employee working on the equipment is responsible for the proper application
of this guideline.
B. The supervisor is responsible for ensuring that the guideline is adhered to.
3. GUIDELINE:
A. A numbered padlock. with a sinale key. will be assianed to those emplovees who
perronn repairs to eauipment and/or are resoonsible for emplovee safety.
B. The padlock key is to remain in the possession of the assigned employee and is
not to be loaned out.
C. If a piece of equipment is unsafe, or repairs are to be made, a "safety lock-out" is
to be applied and the employee is to fasten his padlock to it, before commencing
any repairs or maintenance.
D. If a piece of equipment cannot be locked out, fuses should be removed and the
switch tagged, identifying the equipment's status.
E. Prior to the removal of the padlock, the employee should check out the
equipment and immediate area to ensure that the equipment can be started
safely.
F. If repairs overlap from one shift to the next, the employee going off shift is
responsible for ensuring that his/her lock is removed and that a lock from an
employee on the incoming shift replaces it
G. If an employee neglects to remove his/her padlock before leaving the facility, the
supervisor shall call him/her at home to return to the facility and remove the
padlock. If this is not possible, the supervisor may remove the padlock, using a
master key, only after he/she has identified that:
1. the employee is not still working on the equipment, and
2. it is safe to start up the equipment
H. In those cases where adjustments can only be made whe the equipment is
operating, a "spotter" positioned at the "Emergency Stop B tton" replaces the
need for a lock-out
Guideline No.:
MKHS 2.4
Description:
CONFINED SPACE
Effective Date:
MAY 2006
1. PURPOSE:
A. To create a guideline whereby employees can work safely in a designated
confined space.
B. To assure that the Occupational Health and Safety Act, and specifically
Regulation 632/05 "Confined Spaces" is complied with.
C. To train employees as per Regulation 632/05 "Confined Spaces" so that they are
able to recognize hazards associated with confined spaces, to respond to
anticipated hazards and emergencies, and to perfonn assigned duties in
confonnance to established confined space entry guidelines.
D. To protect employees from hazards that could be present in confined spaces.
E. To institute a rescue program in the event that such may be required.
2. RESPONSIBILITY:
This guideline applies to any person engaged by the Municipality having to enter a
confined space. This shall include management, supervisors, workers and contractors.
As per Ontario Regulation 632/05, Firefighters (as defined in the Fire Protection and
Prevention Act, 1997) are exempt from Sections 4 to 7 and 9 to 21 of Ontario
Regulation 632/05 "Confined Spaces" while oerfonnina emeraencv work. Firefighters
performing emergency work shall adhere to the remaining sections of the Regulation
and to Municipality of Kincardine Fire Department Standard Operating Guidelines with
regards to confined spaces.
At all other times includina trainina and oractice, firefighters shall follow Municipality of
Kincardine Guideline MKHS 2.4 regarding Confined Spaces in conjunction with
Municipality of Kincardine Fire Department Standard Operating Guidelines for Confined
Spaces, whichever of the two is stricter.
3. DEFINITION:
A. The Occupational Health and Safety Act, Regulation 632/05 defines "confined
space" as:
.. . .. a fully or partially confined space,
1. that is not both designed and constructed for continuous human occupancy,
and
2. in which atmospheric hazards may occur because of co truction, location
or contents or because of work that is done in it;"
The Occupational Health and Safety Act, Regulatio 632/05 defines
"atmospheric hazard" as:
1. the accumulation of flammable, combustible or explosive agents,
2. an oxygen content In the atmosphere that is less than 8 per cent or more
than 23 per cent by volume, or
3. the accumulatiOn of atmospheric contaminants, includi g gases, vapours,
fumes, dusts or mists, that could,
(i) result in acute health effects that pose an immediate hreat to life, or
(ii) interfere with ,a person's ability to escape unaide from a confined
space;"
The Occupational Health and Safety Act, Regulation 632/05 d fines "cold work"
as:
.....work that is not capable of producing a source of ignition;"
B. This shall apply to all sanitary and storm sewer systems an water systems in
the Municipality of Kincardine (All manholes, wet and dry wel s, valve chambers,
tanks, vats, sewers,plpes, ducts, flues, digesters, etc.) as ell as any and all
chlorine gas storage areas and all other spaces as defined in A. above.
C. The Municipality of Kincardine guidelines for entry into c nfined spaces are
based on the degree to which the possibility of a hazard ex ts considering the
nature and duration of the work to be performed, the adequa y of the ventilation
system, and the nature of the hazard present or likely to be pr sent.
D. The entry Into a confined space is represented by one of th four categories as
follows:
CATEGORY 1: a)
b)
A hazard' does NOT exist in the confine space; and
There is NOT a likelihood of a hazard d veloping while any
person is in the confined space ha ing regard to the
construction,location, nature and du ion of the work to
be performed.
CATEGORY 2: In the confined space a hazardous atmosph re IS PRESENT or
IS LIKELY to be present having regard t the construction,
location. nature and duration of the work to b performed.
BUT the confined space can be ADEQUA EL Y VENTILATED
to eliminate the hazardous atmosphere or its likelihood.
CATEGORY 3: In the confined space a hazardous atmosph re IS PRESENT or
IS LIKELY to be present having regard t the construction,
location, nature and duration of the work to b performed.
AND the confined space CANNOT BE ADEQUATELY
VENTILATED.
CATEGORY 4: In the confined space an EXPLOSIVE or FLAMMABLE
atmosphere IS or IS LIKELY to be present having regard to the
construction, location, nature and duration of the work to be
performed.
E. In regard to Section 3 D. above, the levels of Oxygen, Hydrogen Sulphide,
Carbon Monoxide, and Explosive Gases necessary to cause an alarm mode in
the gas detector shall be construed as the definition of "hazard" and "hazardous"
as defined in Section 3 A.
If any doubt exists at the time of entry to a confined space th~ worker shall consult
his/her supervisor before entering to perform work.
4. GUIDELINE:
A. Comoetent Person:
1. Only a competent person shall be permitted to administer and supervise
confined space work.
2. Under no circumstances shall the competent person enter the confined
space at any time.
3. It is imperative that a competent person thoroughly understand the
characteristics differentiating the categories of confined spaces in Section 2
D. This is the key to entry guidelines that follow.
4. In order to be a competent person, an employee must have the following
qualifications:
a) be familiar with the Occupational Health and Safety Act and
Regulations, and their provisions in regard to the health and safety of
the workers
b) be qualified by knowledge of the work, training in the work and
experience to be able to organize the work and ensure that it is done is
a safe manner, in accordance with the Occupational Health and Safety
Act; specifically Regulation 632/05 "Confined Spaces"
c) have knowledge of any potential or actual hazard to the health or
safety of the workers in the work place
d) successfully complete a Confined Space Entry Course including a
written examination every five years
e) effectively demonstrate an actual confined Space Entry and Rescue
every two years
f) be able to successfully complete a medical examination.
5. The Municipality's course of instruction shall include:
a)
the Occupational Health and Safety Act (Indust ial Establishments
Section 67 to 71 or Construction Projects, Sect on 60 to 63, and
Regulation 632/05 "Confined Spaces")
confined space characteristics and hazards
atmospheric sensing and detection equipment
personal Protective equipment
entry guideline
emergen~and rescue guideline
inspection and operation of personal protective, mo itoring, ventilation,
and rescue equipment
cardiopulmonary Resuscitation (CPR) and first aid
Municipality of Kincardine Health and Safety Policie and Guidelines.
b)
c)
d)
e)
f)
g)
h)
i)
6. A competent person and entry worker shall not be pe itted to have hair
that interferes with the seal or the operation of the exh lation valve of the
breathing apparatus. Such hair includes beards, mous aches, long bangs
and sidebums.
7. It shall be the responsibility of the Senior Manager an the Supervisor to
ensure:
a) that an employee receives the training regarding C fined Space Entry
and Rescue and the Municipal Health and S fety Policies and
Guidelines are adhered to.
b) that an updated list of those employees certified as mpetent is kept.
c) that competent employees receive 'refresher' instr tion courses in all
aspects of the work on a yearly basis.
d) that all new and updated information concerning co fined spaces work
is brought to the attention of the competent persons
B. Evaluation of Hazard~
1. A worker shalt' not enter a confined space unless a competent person
evaluates the test results and the degree to which a ha rd exists or is likely
to exist considering the construction, location, contents, ature and duration
of the work to be performed. A description of the above entioned hazards
and the corresponding control measures must be record d on MKHS 011.
2. Access and Egress. Sufficient personnel and equipment hall be maintained
at the access opening to remove person(s) from the co ined space should
the need arise.
3.
Industrial Areas. Ttle entry into a sewer in an industrial
precautions. There are many other gases and vapou
portable testing equipment that may be present within th
any given time;: especially in these areas. The com
rea requires extra
not detectable by
confined space at
tent person must
evaluate the degree to which a hazard exists or is likely to exist with this in
mind.
4. Personal Protective Equipment. Given the work environment both inside
and outside the confined space, specific precautions must be exercised
when performing confined space work. Determine if the work area will fall
under the Construction or Industrial Regulations of the Occupational Health
and Safety Act. Senior Managers and Supervisors, and ultimately, the
competent person shall ensure that each worker who enters a confined
space is provided with adequate personal protective equipment, clothing
and devices, in accordance with this guideline. Such equipment may
include S.C.B.A., hand and eye protection, safety head wear, fall protection,
safety footwear, and other protective clothing as required.
Explosion proof rated lighting and equipment, including communication
equipment shall be used and shall be rated intrinsically safe, whether 120
volt or 12 volt. Provisions will be made before entry to obtain any other
equipment as the situation dictates. All personal protective equipment will
be checked by a competent person prior to use to ensure it is in good repair
and working order.
5. Traffic Protection. If entry is to be made where vehicular traffic is a hazard,
the following are required:
a) all employees will have a fluorescent blaze vest, shirt, or coat with
fluorescent stripes front and back that meets current Occupational
Health and Safety Act standards.
b) cones or delineators meeting all current applicable standards and
regulations will be set up as required by proVincial legislation or per
standard operating guideline for traffic control.
If traffic control is required, then the person shall have a STOP/SLOW sign
and be given both written and verbal instruction. Refer to the publication
entitled "Ontario Traffic Control Manual Book 7".
C. Prior To Entrv:
1. The sensing device( s) shall be calibrated by a competent person per
manufacturer's instructions.
2. Using a calibrated sensing device, obtain an atmospheric reading in
confined space or prior to removal of manhole cover if possible. If readings
are lower than 19.5% or greater than 23% oxygen, or greater than 20% of
the Lower Explosive Limits (L.E.L.), entry is not to be made.
3. Determine if there is a need for a confined space entry permit for either hot
or cold work (MKHS 011).
4. All readings to be recorded on a confined space e try permit by the
competent person conducting the tests.
5. If entry must be made and safe conditions cannot be et, self-contained
breathing apparatus (S.C.B.A.) must be worn by all pe onnel entering the
confined space.
6. The presence of Hydrogen Sulphide (H2S) in any qua tity prohibits entry
unless S.C.B.A~iswom.
7. Ventilation, when : required is to be available and activ ted for at least 10
minutes prior toemry.
8. Review applicable Occupational Health and Safety Act regulations before
commencing work.
9. Determine if lockout guidelines are required. If so, ensu e you have tags to
identify the locked out area and your own padlock. (S MKHS Guideline
2.3)
10. Every employee who enters a confined space shall rotect themselves
against:
a) the release of hazardous substances into the onfined space by
blanking or disconnecting piping, or if this is not ractical under the
circumstances for practical reasons, by other adequ te means;
b) contact with electrical energy inside the confine space that could
endanger the worker by disconnecting, de-energizi g, locking out and
tagging the source of electrical energy, or if it is no practical under the
circumstances for technical reasons, by other adeq ate means;
c) contact with moving parts of equipment inside the confined space by
disconnecting ,the equipment from its power sourc , de-energizing the
equlpmentJIOQking it out and tagging it, or if this is not practical under
the circum$tallCes for technical reasons, by other a equate means;
d) drowning, engulfment, entrapment, suffocation and other hazards from
free-flowing material, by adequate means.
11. Ensure a system. of communications is in place between the worker and the
lock out/safety person and the lock out/safety person a d home base (two
way radio, cellular). If such equipment is used inside confined space, it
must be intrinsically safe.
12. Determine if any specialized tools or equipment are req ired before starting
the job.
D. Atmosoheric Testino Reouirements:
1. A worker shall not enter a confined space unless sufficient tests are made
for oxygen deficiency, combustibles, hydrogen sulphide and carbon
monoxide in appropriate locations by a competent person.
2. In a closed confined space a test for combustibles must be carried out prior
to removing the cover if possible (Le. through the pick holes of a manhole).
This testing would be for the following hazards, listed in order:
a) oxygen deficiency or enrichment
b) combustibles/flammables
c) toxics
3. Continual monitoring of the atmosphere must be carried out while the
worker is in a confined space. Monitoring equipment shall have an audible
alann. When the device sounds an alann, the worker(s) shall leave the
area immediately.
4. Sample location - location is important in sampling because the hazard may
be restricted to a small portion of the entire volume. Primarily it is important
to remember the rule TEST THE WHOLE VOLUME.
E. Recordinc Test Results:
1. A worker shall not enter a confined space unless a competent person
records the results of each test as a permanent record on Confined Space
Atmospheric Assessment and Entry Pennit MKHS 011. This pennit must be
fully completed. (This is a Ministry of labour requirement). This record will
be filed for future reference and documentation.
2. Test results must be recorded at 15 minutes intervals during the entire
duration of the entry.
3. The competent person must place hislher signature on the record.
4. The Senior Manager (representing the employer) shall be responsible for
keeping all records on file for at least five years.
F. Ventilation ReQuirements
1. As per Reg 632/05, a worker shall not enter a confined space which:
a) contains or is likely to contain a gas vapour, dust, mist or smoke that is
toxic or hazardous; or
b) has or is likely to have oxygen content in the atmosphere of less than
19.5% or more than 23%; unless
c) the space can be purged and ventilated to provide and maintain a safe
atmosphere.
2. If adequate ventilation to remove the atmospheric ha rei is not possible
and 6. A. 1 or 2 apply; the entry worker shall use a Self ontained Breathing
Apparatus.
3. If mechanical ventilation is used to maintain acceptable tmospheric levels,
an adequate waming system and exit guideline shall Iso be provided to
ensure that workers have adequate warning of ventila ion failure and are
able to exit the confined space in a safe and timely fashi n.
4. Ministry of Environment standards require that ventilati n equipment must
be able to provide for a minimum of 10 air changes per our in the confined
space. The Municipality of Kincardine minimum stan rei shall be 20 air
changes per hour.
Dangerous atmospheres can be controlled or eliminated eith
5. Continuous purging with fresh air is recommended wh never a worker is
inside a manhole, even if test results have been satista ry.
. Mechanically - this type of ventilation is basically portable fan that
provides a sufficient amount of "good air" in exchang for the "bad air".
Generally a fan that provides 750-1000 cubic feet of ai per minute is used
tor vault or chamber operations. In larger areas such slarge tanks and
vessels, larger fans capable of moving up to 5000 cubi feet of air may be
required. In the case of a combustible/explosive atmos here, an explosive
proof fan and/or ducting is required.
. Alternatively, provision is to be made for "natural venti ation" by means of
opening other covers to create a natural airflow.
NOTE: A minimum safe requirement is 20 air cha ges per hour with
ventilation in place for a minimum of ten minutes before ntry.
. Respiratory Protective Equipment - should be used wh never ventilation is
inadequate or impractical. For certain conditions such s oxygen deficient
atmospheres, or if the level of toxic gas or vapour is u known or exceeds
the level considered to be immediately dangerous to Ii or health, the use
of a self-contained breathing apparatus (S.C.B.A.) or a supplied air
respirator (S.A.R.) with an escape pack is required. If t ic gas or vapour is
below the 1.0.L.H. level (Immediately Dangerous to L e and Health), air-
purifying respirators may be used provided that the e osure levels never
exceed the limitations of the unit. This can only be det rmined by a person
who is knowledgeable about the respirator and of the h ards.
NOTE: In thetaseof explosive atmospheres, special recautions must be
implemented. Entry into an area with a concentration of greater than 50% of
the Lower Explosive Limit (L.E.L.) must not be entell for any reason as
per Ontario Provincial Legislation.
6. Re-test:
a) This test is done with the same equipment as the initial test. The test
should be conducted to ensure that the entire, work area and full depth
of the space is tested and that sensors are given sufficient time to
respond properly.
b) Should the test or the re-test show a problem the supervisor will be
notified before entry is made.
7. Record:
Once again a record is required similar to the pre-opening test record.
G. Entrv Guidelines:
CATEGORY 1: A worker shall not enter a confined space unless:
1. The removal of any cover of a confined space is done
with correct tools to prevent back injuries or the
occurrence of a spark;
2. the atmosphere is continually monitored for oxygen
deficiency, hydrogen sulphide, explosive gases and
carbon monoxide; and
3. he/she is wearing an approved body harness attached to
a rope (ensures maximum ability for a quick retrieval
without injury); and
4. a competent person is stationed outside the nearest
entrance to the confined space at all times, whose duty it
is to remain in constant communications with the entry
worker as described in this guideline. This person shall
be trained in artificial respiration and cardio pulmonary
resuscitation. In case of emergency the competent
person outside the space shall have readily available:
a) suitable communications to summon emergency help
as described 12. C.
b) an approved body harness
c) a rope of sufficient length or a suitable lifting device
d) a self-contained breathing apparatus (SCBA) of at
least 30 minutes duration.
CATEGORY 2: In addition to Category 1 and where a confined space:
1. contains or is likely to contain a gas, vapour, dust, mist or
smoke that is toxic or hazardous; or
2. has or is likely to have an oxyg n content in the
atmosphere of less than 19.5% or mo than 23%.
But the s ace can be ventilated de uatel (20 air
changes per hour minimum), a wor er shall not enter
unless he/she is:
a) wearing an approved safety ha ess to which is
securely attached a rope, the free nd of which is held
by a person outside the conti d space who is
equipped with a suitable lifting dice Qr a sufficient
number of persons capable of phy ically removing the
worker.
b) the use of an S.C.B.A. is not Ii quired under this
section of the Occupational Health nd Safety Act, but
its use is recommended, and shall be at the work site
at all times.
NOTE: ENTRY TO SOME CONFINED SPACES IS NOT V RTICAL and may
include stairways and cat walks. Once having entered suc a space a worker
shall attach hlmselflherself to the retrieval equipment before oing work. If this
immediate attachment is not practical because of the distan e of the work area
from the retrieval equipment, or because of the type of work bing done, then the
entry worker may work without being attached. However, continuous verbal
and/or visual contact with the competent person outside the nfined space must
be maintained.
CATEGORY 3: In addition to Category 1 and 2 above and here the confined
space CANNOT be ventilated adequately, a worker shall not
~rthe space unless he/she:
1.18 equipped with a self-contained bre thing apparatus of
sufficient quantity considering the nat re and duration of
the work to be performed.
CATEGORY 4: A worker shall not enter a confined spac where the gas or
vapour is, or is likely to be, explosive 0 flammable. The
competent person shall:
1. contact his/her supervisor immediatel
2. .secure the area from other persons a vehicles
3., ,eliminate all potential sources of igniti n
Some types of 'cold work' (as defined in Definition 3. A.) are permitted in a
confined space likely to have a flammable or explosive atmo here. However, a
worker shall not enter the space in any event until the prop r authorities permit
him/her to do so.
If 'hot work' must be perfonned, then Section 19 "explosive and flammable
substances" of Ontario Regulation 632/05 shall be adhered to.
H. Emeraencv Rescue Guidelines:
1. During an emergency, an unusual event has happened that renders the
confined space dangerous to human activity within it. Human nature
instinctively insists that we help our co-worker. Rushing into a confined
space unprotected and unprepared is suicidal and will only complicate the
eventual recovery. Time is the critical element in dealing with a worker who
has been overcome by a toxic or oxygen deficient atmosphere. Death may
occur after four minutes.
2. It is essential that emergency services (fire and ambulance) be alerted to
the emergency as early as possible.
3. If an employee is in the confined space and the monitor alann sounds
he/she must leave the area immediately.
4. If an employee is not in the confined space area and the monitor alann
sounds, he/she must not enter the area and should notify the supervisor
immediately.
5. In the event of an emergency situation the competent person stationed
outside the confined space shall:
a) RADIO 911 EMERGENCY to the dispatcher clearly stating the
following:
(1) "My name is and I work for
(2) "I have a confined space emergency."
(3) "My location is facilitv on street
(4) "My civic address is number on street
(5) "I need the Fire Department and Ambulance to respond"
"
..
"
NOTE: Other radio transmissions shall cease until clearance is
given by the base station when the emergency situation has been
alleviated.
The dispatcher shall:
(1) acknowledge call and confinn location
(2) immediately call 911 advising of a confined space emergency and
request that the fire department and ambulance be dispatched.
b) TELEPHONE 911 - from the nearest land line or cellular phone (if no
answer from #1 above), clearly stating the following:
and I work for
"
(1) "My name is
(2) "I have a confined space emergency."
(3) "My location is facilitv on
(4) "My civic address is number on
(5) "I need the Fire Department and Ambulance t
reet
reet
respond"
"
"
c) (1 ) If the entry worker is attached to retriev I equipment, the
competent person outside the confined spa e shall attempt to
raise him/her to the surface and provid the appropriate
assistance until help arrives.
(2) Under no circumstances shall any worke enter a confined
space to attempt a rescue until help arrives
No other rescue guideline shall be used.
I. Communications:
Portable radios may be used to communicate between t e worker and the
competent topside worker, however, radios must be intri sically safe. Cell
phones may be used by the competent topside person 0 tside the confined
space only. Hard hat communications systems, rated intrin cally safe, may be
used if available.
J. Sionals:
1.
Verbal: In most situations, it is possible for the person
the topside safety person, or make use of portable
communications. However, there are occasions whe
cannot hear. This requires hand signals.
low to shout up to
adios or hard hat
the person below
2. Emergency Hand>Signals:
a) Help: moving of arm overhead.
b) Danoer or Tro!)ble: pull the finger across the throat in a cutting motion.
c) No: forefinger or head is waved from side to side for universal
negative response.
d) Yes: form circle with thumb and first finger, extend ther fingers, same
for OK.
e) Direct Attention: point to desired area, such a ear, direction or
mouthpiece.
f) I intend to 00 UP: Thumbs up.
g) I intend to ao down: Thumbs down.
h) Question orreoetltion: Palm of hand up and down.
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I
I SAFE I
I
- No hazard present
- Unlikely to
develop
considering nature
and duration of the
work
I
- Continual monitor
- Competent person
outside
- Safety harness
.
Municipality of Kincardine
APPENDIX ~B'
EVALUATION CHART
CONFINED SPACE ENTRY TO BE
UNDERTAKEN
- TEST THE ATMOSPHERE
- RECORD THE RESULTS
EVALUATE
- Availability of rescue personnel
- Results of tests
- Nature and duration of work
- Ventilation
- Access and egress
- Sludget other deposits
- Location - i.e. industrial
- Flow
- Isolation of energy and control of
materials movement
,
I 'POTENTIAL HAZARD I
- Hazard is present or
is likely to be
present
- Ventilation 'adequate
to purge
- Minimum 20 air
changes per hour
- Hazard is present or
is likely to be
present
- Ventilation not
adequate
- Ventilate
- Contil1Ualmonitor
- Competent person
outside
- Rescue system
- Use of S.C. B.A.
recommeI\ded
- Continual monitor
- Rescue system
- Competent person
outside
- Use ofS.C.B.A.
required
Occupational Health & Safety Manual
I
I HAZARD I
I
- Explosive or
Flammable
atmosphere is
present or is likely
to be present
I
DO
NOT
ENTER
Page 62 of98
GENERAL:
The MU,nicipality of Kincardine Fire Department shall be utilized as a resource for confined
space entry practice and drills as a minimum once annuallv.
REVISING:
This guideline shall be reviewed by all affected departments and the Health and Safety
Committee as a minimum annually and updated by the Health and Safety Coordinator as
required.
Municipality ofK.incardine
Occupational Health & Safety Manual
Page 63 of98
Guideline No.:
MKHS 2.5
TRENCHING
MAY 2006
D..cription:
Effective Date:
1. PURPOSE:
To provide a gUideline whereby employees may work safely in a tren h.
2. RESPONSIBILITY:
A. The employee working In the area is responsible for prope application of this
guideline.
B. The supervisor and Senior Manager are responsible for ensu ng that employees,
includino contractors are properly trained and that this guideli e is adhered to.
C. The supervisor shall be in possession of a current copy f the Occupational
Health and Safety Reaulatlonsfor Construction Proiects.
3. GUIDELINE:
A. General:
1. A "trench" is defined as an excavation whose depth is g ater than its width.
2. Pre-plan:
a) Determine the type of soil that the trench will be 10 ated in. Generally,
municipal operations are carried out in type 3 soil best.
b) Locate and mark all services (gas, electrical, water etc.)
c) If the service may pose a hazard, the service s all be shut off and
disconnected. If this is not possible, then the own r of the service shall
be requested to supervise the uncovering of the se ice.
d) If the trench.may affect the stability of an adjacen existing foundation,
building or structure, a supervisor must be notified.
e) If the trench has a water problem, water removal ay be required. e.g.
pumps etc.
3. Check Out Equipment:
a) Ensure that trench protection materials are in w rkin9 condition. e.g.
trench box, hydraulic shoring, pneumatic sho 'ng, wood shoring,
shovels, picks, pumps, traffic control devices etc.
b) A system of communications will be in place etween the trench
location and home base.
Municipality of Kincardine
Occupational Health 8;;, Safety Manual
Page 64 of98
c) Check all personal protective equipment to ensure that it is in good
repair and in working order.
4. Traffic Control:
a) If the trench is to be made where vehicular traffic is a hazard, the
following are required:
(1) all employees will have a bright orange vest/shirt/coat with
fluorescent stripes front and back.
(2) cones or delineators will be set up as required by legislation for
traffic control.
Where a traffic controller is required, that person shall follow the
Ontario Traffic Control Manual. Book 7. Temoorarv Conditions
5. Excavate:
a) No person shall be within a six-foot radius of any mechanized
excavating equipment that is in the process of excavation.
b) No employee shall enter a trench unless:
(1) proper protection for the worker is in place as outlined in the
current Regulations For Construction Projects in Sections 222
through 242.
(2) the emolovee is in full view of another emolovee on the surface at
all times.
B. Emeraencv Guidelines:
1. Should any abnonnalities occur in the trench wall, bottom or surface area
above the trench, it shall be evacuated immediately and supervision
notified .
2. Should a trench collapse occur whereby an employee is engulfed or buried:
a) the competent person on top will immediately notify home base via
mobile radio or call 911 by cellular phone.
b) home base will call emergency personnel
UNDER NO CIRCUMSTANCES SHALL ANY EMPLOYEE ENTER AN
UNSAFE TRENCH TO AFFECT RESCUE OPERATIONS. NO OTHER
RESCUE GUIDELINE WILL BE USED.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 65 of 98
Guideline No.:
MKHS 2.6
Description:
EMERGENCY GUIDELINES
Effective Date:
MAY 2006
1. PURPOSE:
To create a comprehensive action plan to be taken under various e
This shall include business coAtinulty plans for municipal department and other
accessory plans to manage various emergencies specific to individu I departments.
2. RESPONSIBILITY:
A. The on-site supervisor Is responsible for the Implementation of he "EMERGENCY
GUIDELINES" in the event of an emergency.
B. The employee is responsible for knowing the nearest emergen y exit location and
safety area.
C. The Senior Manager Is responsible for implementation of this guideline, ensuring
this guideline Is adhered to and for reporting any incident to t CAD, as outlined
in the Municipality's "Occupational Health and Safety Manual".
3. GUIDELINE:
A. Definition:
1. An emergency condition may be created as a result of a:
a) fire;
b) explosion;,
c) bomb threat;
d) flood, earthquake or tornado;
e) chemical spill;
f) severe orcritlcal injuries;
g) power outage;
h) loss of or clamage to critical infrastructure; and
I) any other situation that depletes or overwhelms the normal day to day
resources of the affected department
B. Communications:
1. When the emergency situation is restricted to a depart ent, or small area,
verbal communication may be employed.
2. In the event of a facility wide evacuation, the fire ala or paging system
will be employed.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 66 of98
3. If a localized emergency, the supervisor will contact the appropriate
emergency service:
a) ambulance
b) fire
c) hospital
d) police
e) hydro
f) fuel company
4. The supervisor will notify the Senior Manager and/or the CAO if a facility
wide emergency takes place.
5. The supervisor will also contact the Senior Manager and/or the CAO if the
emergency has or may have the potential to affect the public at large
outside the facility.
C. Evacuation:
1. Upon notification of the evacuation directive, designated employees at the
locations below will shut down their assigned equipment or place them in a
hold safe state and exit the building through the nearest safe emergency
exit.
2. All other employees will exit the building immediately, upon notification of
the evacuation directive.
3. Employees of publicly occupied buildings will assist to the best of their
ability with the safe evacuation of members of the public, short of
endangering their own personal safety. Municipal employees shall not at
any time endeavour to perfonn any rescue acts above their trained and
documented ability.
4. The posted "Emergency Exits Floor Plan" shows which exits are to be used
during emergency evacuation.
5. Employees and public will exit in an orderly fashion.
6. Under no condition should an employee turn back.
7. Once outside the building, all employees and public will report to the "Safe
Area", assigned for each facility.
8. The supervisor will perfonn a head count to ensure to the best of their
knowledge that all employees and public have been evacuated and notify
the appropriate Emergency Service Personnel.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 67 of98
D. Return to Facilitv:
1. Once the facility is deemed safe for re-entry, the superv or will re-walk the
facility with the Emergency Service Personnel.
2. Following this, the supervisor may instruct the employe s to return to their
workstations.
E. LonQ Term Actions:
1. Should the emergency situation begin to deplete or ov helm the normal
day to day resources of the affected department, th internal business
continuit Ian or at de artment shall be im lement d. This business
continuity plan shaUbe coordinated with and campi ment the existing
Community Emergency Response Plan and shall be t e responsibility of
each Senior Manager to create and maintain.
2. The Senior Manager shall notify the CAD, who in turn wi! notify members of
the Municipal Control Group including the Mayor as er the Community
Emergency Response Plan
3. Assistance will be given to the requesting department an staff members as
deemed appropriate by the Municipal Control Group to ffectively manage
the emergency and restore normal operations.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 68 of98
Guideline No.:
MKHS 2.7
Description:
HEARING PROTECTION
MAY 2006
Effective Date:
1. PURPOSE:
To prevent hearing loss for all employees and meet the requirements under the
Occuoational Health and Safety Act Reaulations for Industrial EstaQlishments (Section
139).
2. OBJECTIVES:
A. To undertake a program to help prevent the loss of hearing that might occur in
employees who are exposed to excessive noise both on and off the worksite.
B. To meet or surpass the requirements set out in the Occuoational Health and
Safety Act and Reaulations for Industrial Establ1s,tlments (Section 139)
C. Scope: In order to accomplish these objectives, the scope of the program will
include the following:
1. Measurement of Exposure
2. Engineering Controls (where possible)
3. Hearing Protection
4. Education and Training
5. Assessment of the Program
3. GUIDELINES:
A. Administration:
Management, in conjunction with the Joint Health and Safety Committee, will
administer the program.
B. Measurement of EXDOsure:
1. Areas of the workplace will be assessed for the risk of high noise exposure
of 85 decibels (dB) or more. Areas will be tested by means of a sound level
meter, and if necessary, by an audio-dosimeter. Prior to testing,
management will advise the Joint Health and Safety Committee of the time
and date of the testing so the Committee may have representation present.
2. All data will be recorded and made available to management and the Joint
Health and Safety Committee.
3. Noise levels will be checked as often as necessary and at least annually.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 69 of 98
4. A qualified individual skilled in the use of the equi ment required will
conduct testing.
5. Equipment will be calibrated before each use.
C. Enoineerino Controls:
1. Wherever and whenever it is economically or te hnicaUy possible,
engineering controls will be used to lower the noise level exposure of
employees to the required levels or lower.
2. Preventative maintenance controls will be a part of engin ering controls.
3. The Senior Manager or supervisor will be responsible for instituting and
monitoring these controls in conjunction with the Joint Health and Safety
Committee.
D. Hearina Protection:
1. Where engineering controls are not possible, appropriat hearing protection
will be provided' by the Municipality and will be worn by all employees and
visitors in all areas or on all equipment where it has be n ascertained that
the possibility of exposure to high levels of noise exists.
2. Hearing protection will be the type sufficient to reduce he noise levels to
below those stated In the..table of the Occuational He Ith and Safe Act
and Reaulatlons for Industrial Establishments (Section 1 9).
3. Each employee required to wear hearing protection wi I be trained In the
proper use and care of such protective devices. mployees will be
responsible for the wearing of the devices provided to th m, where required,
and for reporting any loss of, or defects arising In, thos devices to his/her
Immediate supervisor.
4. Supervisors will' be. responsible for ensuring that these protective devices
are worn where and when necessary, and for taking th disciplinary action
for non-compliance.
5. Designated high noise areas will be posted with warning of the noise levels
and the requiremEtAtfor the wearing of appropriate heari protection.
E. Education and Trainima:,
1. Employees will be educated on the potential harmful eff ts of noise both at
work and at home, and how to protect their hearing.
2. Employees will be trained in the proper use and care 0 hearing protection
and instances vthere hearing protection is required.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 70 of98
3. Supervisors will give periodic refresher training.
4. Employees will be given an explanation of the results of all hearing tests.
F. Assessment of the Proaram:
1. The Hearing Conservation Program will be reviewed annually and modified
as needed to make the program more effective.
2. Senior Managers and supervisors will do reviews in conjunction with the
Joint Health and Safety Committee.
G. OccuDational Health and Safety Act and Reculations for Industrial
Establishments (Section 139) - Hearing Protection:
1. In this section "decibel" means decibel measured on a type 2 sound level
meter conforming to the Standard Z1 07.1 of the Canadian Standards
Association of operating on the A-weighing network with slow meter
response.
2. Where a worker is exposed to a sound level of ninety decibels or greater:
a) measures shall be taken to reduce the sound level below ninety
decibels; and
b) where such measures are not practicable,
(1) the duration of exposure set out in Column 2 of the Table in
subsection (5) shall not exceed the duration shown for the
particular sound level set opposite thereto in Column 1 of the
table in subsection (5), or
(2) the person shall wear hearing protection.
3. A worker exposed to a sound level of 115 decibels or greater shall wear
hearing protection.
4. Clearly visible warning signs shall be posted at the approaches to an area
where the sound level is more than ninety decibels.
5. The warning signs referred to in subsection 4 shall state:
a) the daily exposure for the particular sound level permitted by the
following table; and
b) that hearing protection must be worn when the daily exposure is more
than that permitted for the particular sound level.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 71 of98
Column 1
Sound Level
in Decibels dB
90
92
95
97
100
102
105
110
115
Over'115
Column 2
Duration
Hours r 24 hour da
8
6
4
3
2
1.5
1
30 min.
15 min. or less
No ex osure
6. Where hearing protection is required, by this section, th protection shall be
sufficient to reduce the sound level below the sound leve in Column 1 of the
Table in SubsectionS for the exposure corresponding to that sound level in
Column 2 ofthe'Table in subsection 5 R.R.O. 1990 Reg. 51, S. 139.
Municipality of Kincardine
Occupational Health & Safety Manual
Page 72 of98
MUNICIPALITY OF KINCARDINE
HEALTH AND SAFETY INFORMATION REQUEST
EMPLOYEE CONCERN:
Infonnation Requested:
Dated:
I Name:
HEALTH & SAFETY COMMITTEE RESPONSE:
Sources:
Infonnation:
Dated:
I Signed:
MKHS 001
_ n._
.
MUNICIPALITY OF KINCARDINE
HEALTH AND SAFETY RECOMENDATION
HEALTH & SAFETY COMMITTEE CONCERN:
Nature of Concern:
Recommended Remedial Action:
Date: Signed:
Name:
MANAGEMENT'S RESPONSE:
Per The Occupational Health and Safety Act 8.9 (20), an employer w o receives written
recommendations from a Committee shall respond in writing within twenty one days.
Acceptance of Recommendation and Implementation Timetable:
Rejection of Recommended Remedial Action and/or Changes:
..
Date: Sioned:
Name:
MKHS 002
',.
MUNICIPALITY OF KINCARDINE
WORKPLACE INSPECTION CHECKLIST
INSTRUCTIONS: Please circle the Item that IS NOT suitable or requires attention.
A. GENERAL CONDITIONS
B. WORK ENVIRONMENT
1. Aislewavs and Passaaewavs:
1. Eraonomics:
a) Aisles marked
b) Clear and unobsbucted
c) At least 28 inches wide or as prescribed
d) Sufficient width for all nonnal movements
2. ExitslEaress:
a) Sufficient exits for prompt escape
b) No locks or fastenings restricting escape
c) Routes and exits clearly marked
d) Exits and exit signs adequately illuminated
e) More than one exit from work area
1) Approaches to exits unobstructed
g) Flammables kept out of exits
h) Doorways at least 28 inches wide or as
prescribed
i) Cleared of ice or snow
j) Open outward onto level floor
a) Design allows nonnal body positions when
seated or standing
b) Controls sized to pennit operation with
clothing/equipment worn
c) Controls follow nonnal response pattems
(down for off, etc.)
d) Standard color coding used for warnings and
infonnational displays
e) Hand tools used pennit nonnal body positions
1) Limited weight and size of materials lifted or
carried by people
g) Lifting and twisting in combination not required
2. Liahtina (includina Facilitv GroundslParkina):
a) Walking and working areas adequately
illuminated during periods of occupancy
b) Lighting fixtures clean
c) Illumination level sufficient for detail or work
perfonned
d) Emergency lighting provided
3. EI22!i:
a) Clean, order1y, sanitary condition
b) Drainage maintained
c) Free of slip, trip or fall hazards
d) Free of protrusions, nails, etc.
e) Openings covered or barricaded
4. ~:
a) At least 22 inches wide or as prescribed
b) Steps unifonn in height and tread depth
c) Open risers if less than 9 inch tread depth
d) Outdoor stairs have grating type treads
e) Treads and nosing slip resistant
1) Handrails provided on open sides
g) Handrails on at least one side if closed
h) Vertical clearance at least 7 feet or as
prescribed
i) Stairways adequately lighted
j) Cleared and unobstructed
3. Noise Exoosure:
a) Economically feasible engineering controls
b) Protection provided when sound levels exceed
standards
c) Hazardous noise areas identified and marked
4. Ventilation:
MKHS 003-1
a) Adequate means provided
b) Air inlets and openings arranged to minimize
escape of contaminants
c) Enclosures provide continuous inward air flow
d) Separators provided if air is re-circulated
e) Hoods draw air away from people
1) Hoods connected to exhaust system
g) Ductwork made of non-combustible material
h) Ductwork sealed and adequately supported
i) Clean-out doors provided every 9-12 feet or as
prescribed
j) Dust collection equipment separated from
other facilities.
C. HAZARD CONTROLS
1. Color Control:
a) Red color coding used to indicate immediate
danger, flammable/explosive materials and fire
protection
b) Yellow color coding used to indicate areas of
changing condition
c) Orange color coding used to indicate areas
under modification, e.g. hazardous parts when
guards removed
d) Green color coding used to indicate safety
instructions and first aid equipment
e) Blue color coding used for general information
signs and tags
ij Color coding systems used to indicate fluid
and gas system contents and flow
2. Materials labelina:
a) Standard labels affixed to all' containers of
substances in storage and use
b) Labels legible and visible
3. Permit Usaae (e.a. Confined Soace Entry.
Excavation/Trenchina, lock-out SYStems):
a) Permit has appropriate signatures applied
b) All controls in existence
c) Permit posted or present with worf<ers
d) Permit within authorized time limits
e) Reviewed as appropriate
4. Sians and Taas:
a) Hazard warning, directional andinfonnational
signs and tags used where there are
immediate dangers, potential hazards, or there
is need for general instructions
b) Signs and tags consistent in use throughout
the workplace
c) Tags affixed to all defective equipment not
secured against use
5. Warnina Svstems:
a) Fire/emergency systems operational
b) Hazard warning systems on appropriate
vehicles and equipment
c) Over-pressure warning systems on pressure
vessels
d) Over-temperature warning systems on tired
pressure vessels, hazardous material storage,
powered equipment
D. EMERGENCY SYSTEM
1.
a) Operational plac rds/decals on emergency
controls (e.g. On~ ff,open-close)
b) Emergency inst ctions at primary phone in
e8ch work area
c) Fire Hazard S bels on facilities containing
hazardous substa cas
d) Backup commun' tion systems are available
e) Evacuation plan i posted
2.
a) Adequate equip ent available and properly
located
b) In serviceable co ition
c) Emergency sta -by lighting provided and
adequate
3.
a) Readily availabl accessible in areas
where caustic/co ive chemicals are used
b) Water supply p vides a minimum of a 15
minute flush at a mfortable temperature
c) Proper signs and i structions posted
d) Flushed frequent! to eliminate contaminants
4. Fire Protection:
a) Portable extingui hers readily available and
appropriate for ty of materials
b) Extinguishers ins ed monthly
c) Fire hoses prope y mounted, accessible and
maintained
d) Fire equipment vi bly marked
e) Fire doors, lids an shutters in good repair
ij Sprinkler heads ave proper clearance from
materials and furn hings
g) Sprinkler master ntrol valves accessible and
locked open
h) Adequate and op ble fire alarm system
5. FirstAid Kits:
a) Adequate materi s and equipment available
and properly locat d, as prescribed
b) Names of qualiti attendants posted
c) Instructions for ident reporting posted
MKHS 003-2
E. MATERIALS
1. Chemicals and Fuels:
a) Tanks/drums of steel or appropriate material.
b) Limited to 2,500 gallons
c) Tanks adequately vented
d) Pressure relief valves provided on tanks
e) Tanks/drums grounded when dispensing
f) Adequate spill containment
g) Proper spill-absorbent materials and/or
drainage provided
h) TanksJdrums adequately supported
i) Temperature controlled to prevent boiling
j) Adequate storage cabinets provided; fire
resistant and vented
k) Storage heated by means not constituting a
source of ignition
I) Approved portable safety containers used as
required
m) No smoking signs posted where required
n) Non-arcing type fans in hazardous substance
storage areas
0) Materials separated to avoid incompatibility
reactions
p) Means of exit/egress prescribed
2. ComDressed Gases (e.g. Prooane. gas. oxvaen):
a) Stored upright and secured against falling over
b) Segregated by contents and legibly marked
c) Caps in place and hand tight
d) Protected against rustlcorrosion
e) Stored away from heat sources
1) Stored away from stairs, elevators and egress
routes
g) Inspected for dents, corrosion, test records
h) Adequate ventilation in storage areas
i) Properly installed and connected
j) Oxygen lines property certified
k) All compressed gas, air and oxygen lines
labeled and identified property
3. HerbicideslPe~:
a) Containers property labeled and stored
b) Personnel property trained and certified in the
use of pesticides
c) Adequate personal protective safety
equipment
d) Emergency eye wash bath/shower available
e) Pesticides separated from other materials in a
cool, well-ventilated storage area
MKHS 003-3
4. Stackino and Storage:
a) Aisle ways and access paths clear and
unobstructed
b) Small or irregular shaped items properly
blocked, interlinked with proper limitations in
height of storage
c) All stacks stable and secure against
sliding/collapsing
d) Proper drainage in storage area
e) Storage area clean and cleared of foreign
objects/materials
f) Load limits for racks and platfonns posted and
observed
g) Combustibleslflammables labeled and stored
properly
5. Waste DisDOsal:
a) Adequate number of appropriate metal refuse
containers
b) Separate containers provided for oily rags,
smoking materials, dusts, flammable scrap,
chemical wastes, etc.
c) Safe disposal facilities for wastes
d) Anti-static devices fitted as necessary
e) Chemical spill absorbents available in work
areas
f) Garbage shredder adequately guarded
F. PERSONAL PROTECTIVE EQUIPMENT
1. General:
a) Instructions on use of equipment are available
b) Equipment is readily available and appropriate
for the application
c) Equipment is inspected regularly and repaired
or replaced as needed
d) Storage facilities for the equipment are
available
e) Review equipment: body protection; ear
protection; eye protection; fall protection; foot
protection; hand protection; head protection;
respiratory protection; reflective apparel
G. EQUIPMENT
1. Electrical Power SYStems:
a) High voltage and control panels closed and
secured
b) Control panels identified and accessible
5. Machine Tools an Guardi
c) General condition of wiring, insulation and
fixtures to standards
d) Grounding tested
e) Explosion-proof fixtures in flammable dust or
vapour areas
Q Flexible cords free of splices
g) Lock-out provisions as prescribed
h) Provision for individual disconnects of locked-
out equipment
i) Electrical equipment protected from fluids
j) Adequate provision for manual restart after
power failure
a) General condl ion: damage, cleaning and
lubrication
b) Mechanical po r transmission guarded
c) Pinch points an points of operation guarded
d) Fixed guards se ured in place
e) Interlock guards perative
Q Automatic and operator guards properly
adjusted
g) Operating co rols guarded against
inadvertent actu 'on
h) Operating contro s locked and key removed
when not in use
i) Emergency stop uttons operational, correctly
positioned, label and colour coded
j) Isolation and lac ut provided for servicing,
. setup, lubrication, tc.
k) Guards provided or rotating parts, chips or
particles, sparks, k kbacks, etc.
I) Operator and servo manuals available
6. Pneumatic Power S
2. Hand and Portable Tools (e.a. Sa~.. Grinders,
Fitness Eaulpment. Lawn Mowers. Chippers,
etc.):
a) Proper general condition of tools: electrical
cords, air hoses
b) Proper storage when in use
c) Proper storage when not in use
d) Guards and safety devices serviceable
e) Electrical grounding or double insulation
protected
Q Tool retainers installed on pneumatic tools
g) Adjustments correct
h) Load rating sufficient for work performed
3. Hvdraulic Power SYStems:
a) Pressures regulat within limits
b) Restraining clips on ase lines
c) Compressor draina and testing
d) General condition of oses and connections
e) Air lines identified
Q Water in pneumatic t
a) Pressure regulated within power limits
b) General condition: leaks, dents, nicks and
severe scratches of pressure nnes. and fittings
c) Fluid pressure lines identified
d) Remote shut-off available
e) Inspections recorded
4. Liffinp Gear/Eauipment (e.g, Elevators,' Hoists.
Cranes}:
a) General condition: damage, cleanliness.
lubrication, servicing
b) Clearly labelled as to capacity and load testing
c) Fitted with overhead guards
d) Controls operational
e) Limit stops operational
Q Hoist motor brakes operational
g) Cable/rope in good repair
h) Hoist chain/rope free of kinks and twists
i) Hooks not defonned or damaged and safety
latches intact
j) Pinch points properly guarded
7. Pressure Vessels e. .
a) Meters and controls I ated on operating floor
b) Safety valves operat' al
c) Drains clear and freez protected
d) Inspection certificatell bel appropriate to type
e) Pipes, connections, essets free of dents,
notches and severe sc tches
n Shields, platfonns and andings as appropriate
g) Remote shutoff to pum s
h) Respiratory/rescue a confined space
eqUipment available
8. Valves and Mechanical Co troIs:
a) Labelled and colour cod d
b) Operational
c) Readily accessible
9. WeldinglWelding Eauipment
MKHS 003-4
a) Properly grounded
b) Located in a dry area
c) Properly insulated termin Is
'i
d) Proper ventilation provided
e) Bottles stored upright, capped and chained
. Shock absorbers
. Safety belts
. Radiator
. Mirrors Fluid levels
. Hoses (for hydraulic leaks)
. First-aid kit
· Roll bars
. Grab handles
· Drive belts
. Backup alarms
. Other
H. FACILITIES:
1. Office Environment:
a) Aisleways clear and unobstructed
b) File drawers closed when not in use
c) Phone cords and electrical wires not located in
places where they might trip anyone
d) Electrical wiring and circuits are not
overloaded
e) Proper fire extinguishers are available,
convenienUy located and in good working
order
1) No smoking areas identified
g) Transparent doors marked so they can be
seen
h) Proper storage of material
i) Ground-fault interrupters provided as needed
j) Supervision has clear visibility of all activity
areas
k) Adequate supply of refuse containers
I) First-aid/emergency medical equipment
readily accessible
m) Appropriate fire extinguishers charged and
available
(2) Mobile equipment (construction
equipment, front end loader, grader, snow
plough, back hoe, lawn mower, tractor,
street sweeper:
· Overhead guards where required
. Designated areas for recharging
. Qualified operators only
. Physical hazards
· Fire extinguishers
· Operating control functioning property
. Blade condition
· Suitable steps and handholds
. Proper air pressure in tires
. Protective guards in place
· Proper fuel storage
(3) Tree Trimming/Climbing:
. Only qualified trimmers work in trees
where electrical hazard is present
. Only non-conductive tools are used to
remove branches touching energized
lines
. Only Class B hard hats and insulated
aerial lifts are used
. Only one worker occupies an aerial
bucket at one time and a safety belt is
required
2. Grounds. Partdna Lots:
a) Ball fields, parking lots and play areas
checked for protruding wire, broken areas, etc.
b) Adequate and pertinent direction, information
and warning signs posted
c) Adequate and strategically located trash
receptacles
d) Picnic shelters, tables, benches, barbecue
pits, drinking fountains, etc. of good, safe
construction and properly maintained
3. Roads and Waste Manaaement:
a) General Equipment - Vehicles (e.g. Dump
Trucks, Pick-up Trucks, etc.)
(1) Check condition at
. Steering
. Emergency brake
. Brakes
. Tires
. Wipers
. lights
. Mufflers
LOCATION:
DATE:
INSPECTED BY:
DEFICIENCIES FOUND: 0 YES D NO
MKHS 003-5
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CDO'- .8 C.CD
EJ::=15e~.5
1iia;~o >-~ 9l
eCD~Oal ~
I-xQ.C:::Eml-
.....
C\i
Ci!
u
i=
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u
00
0'1
...
o
-
00
:
CL.
!
i
tn
a'd
~
~
1
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@
o
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o
o
(I)
:I:
~
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~
~
...
o
~
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c.
'13
.~
::s
~ Industrial Accident .
~ Prevention Association
or agent
..
trealmentor acMes given.
0$
o ObtaIn heafth ONe
Cl other (Sp$Clfy.)
Prepeted by
Date aftd 11IM
LPFA1210802
W1iITE.. ......1110
PlNK.Depadment~
1lIPOJtec1
BLUE'"
F RST AID REPORT
payt<IIIM,
Cl a.m.
o p.m.
-0 Send home
o a.m.
Op.m.
NOTE: IAPA First Aid Report Forms are available from the Haith & Safety Co-
ordinator
MKHS 006
@
1. ~OFIDMllION
2. DEPAFmIlI!Hf
INVESTIGATION REPORT
8. L.OCATlON PI' INClIENT
4. OIITE Of INCIDENT
Ytl
S. liME OF INCID8Hf
a.m./pA
6. DATE OF REPOFn'
I -00"-
I 1.lN,llNJ) WORICER'S NAME
I
~
~
0tI!I
PlIGPI!Im'DMtAGe
14. PFlOPERJY DMIAGl!
Mol
DtrJ/ Mol
Vrl
a. PARrOF F!ICI1V
.. OIIYS lOST
16. NAlU'EOFOtWAOE
llll. INCIDENT COST. . AI'PI.lCABLE
10. NAlUIi OF ItUlI'IV 0fl1UMiSS
18. CClST
EiIImIlId
21. PERSON REI'CfI1'1NG INCIDENT
--
11. OIU!CT/~SUIlSTANCE"
lNFlll::I'INII tWlM
11. QllJECI'I EDIPI8ffl SUBSTANCE
lNI"UCI1NG lWMGE
22. O8JE01'/EQUlPMeNT/SUllSTANC& INVOLVED
12. OCCUPATION
18. l.ENGT11 OF liME ClH TIE .IlI8 18. PSlSClN WITH MOST CONTFIOl. OF 1TB1111
28. PBlSClN WITH MOST 00NTft0l. OF l1EM 1I2
00 -~-
" I ~NOf
lM.. LOSS SlMIITY P01SfTW..
o 0
I&Ijar -
o
-
26. PAOBABlIJ1YOP RECUlFIENCE
o 0 0
ttgh ModDlaI8 ~
28. DescrIJe how the event occcned.
i
a
~
'D. ........4Ilde Causes. What slbStandard ldIons and cordUc:Ins caused or COUld cause theevent'? (See 'Z!A on baCk. ExplaIn .)
I
I 28. Buk: c::..... What $pecIIc. personJEiJor job factors call18d or ccUd cause thIS evert? (See 2M on back.. Explain here.)
2$. ........ ~ w'- has been. dot1eor should bfJ done to control the <<*ISeS'1i8ted? (See 40 on ,*k. Explain here.)
~,
...
I
\100 IlIClIHATufE OF lNVE$1'lGA1CR
81. DATE
0tI!I MoJ YrJ
.. FClU.OWU':CiR*' ..-........,,1(___ ~
3.
&.
aa. ~1URE OF AEVEWER
lM. OIITE
0tI!I MoJ YrJ
l!
4.
6.
NOTE:
IAPA Accident Report Forms are available from the Health &
Safety Co-ordinator
MKHS 007-1
.....--.
.
!TAl 81thahipply.) CODING FOR IN ~DENT ANAt.Y$1S QUAUT\'
~AClIo!Jll ~Condltlone 2- Departme~ c
c 1. Operating equ/pInInt w/lhQUtaulhorlly D 1; Inadequate gU8Itl8 or battle.. S. Tlnle oHnc ~t 'c
0 2- Fdu,.1O Wiilm ' t1 2. lnaclequate'OI' fmpraper proleoIive 8. Part,of bocI CI
0, 3- FalIwe IOsecu,. 8qI.IIpmlInt 9. "'lool 0
0 4~ =tIh9at ~llf'8lld 0 a. DefeclllVe lOols, equipMerit or maleilals 10. Nlilure of h !ury or IllneIa 0
0 5; , king aafety lnopei'abI8 0 4- Congo$lIOn '01' reslrlOled action 11. == CI
1:1 6. ~ 88fetydeVtes 0 I. ~'~ 12- 0
0 1. UelngdeldVe~ o$. Aie. and expIoeIort Itl8 18. Time Cll\th job c
0 a., llliIi111llcllllplll8llr~ 0 7. POor houselceepIngkI 14. PtOperty dl ::e 0
(8 0 9. I"fllI1!1gtouse peceonaI proIective 0 9. ~ envlromnental 16. Cost estImi 0
~propeny coAditioM: gdiS" dusts, &IIIOklI 27& SlIbStllI1da acIloM 0
I 0 10; li'hPfOI:ler'lOlldlnIl fi./Irle$. \I8pOUta 1:1a. Subslllndtli condIlIDn$ 0
0 11. Improper'~ 0 9. NoIse upoeure 284. PeIsonal III :tors ' 0
0 1;1. Improper lIIIIl'lg 0 100 FlaIIatlon exptiBI.IRI 28a. Job fllClOr$ 0
I 0 13, Improper 9O$IlIon fOtlllllk 0 11. HWlor IoWte/nill!lI'l1tU GllpOS1iI'8 as. TypeoflXll laOl 0
a 14. S~equlpmerlIln operauon ,0 'fa ____ or exc:eta llIurnlitaIlon
0 1,$ ~. ' a 1$, IIUldequate venillallon '
0 16. lhIder~oflllcohonincIlQr~ drliIp, as. TYPE OPCC 'lTACT CONTACTWlTH
28A. BASIOCAU8eS (ClheIlk alIlhat 1lPPIY.) 01. struck ~glllI sf; 0'10. EIeclIIIclly
02. Struck by 011. Heat
PertIorlaI' ....,. Job Fecloni 03. Caught In 012. COld
,01.. Inat:Iequate oepabIIIty tl1. iNldtctuate'lelldll/lfI1(lf$Ul)eNl8IOtf 08. itlacIeqoat&work 04. Caught.on o1a, ~
02. LackoflcntlWIedgff o 2. lndqWlteenglnlilfllrg 8liIll\dlttde 1;15- Caughl~ - 014. CMlIce
ca. l.l,clulf'BlcIll 03, InadeqI,Iete ~ o '1.. Wear ancU..' 06. SIlp' tf16. No1I8
C4. -- m4. InadElquate~ as. AbtAst ,orflllsUse 07. Fallonsamt 1awiI' 01&, T_ orl\QXlou$
os. linpfOplk' i1'IcItIVilf/on lJ 5, II'llldeqUate~lfaJlI oa. Fallta lower eve( substsnces
09.
a6. RevleWr'8ruc11on$ to the lnvestigatoI'sanal)'sl$ otill& batlcoausasand remadallMllIon&
I
:11, SlGNAtuRti. I as. 1Tl1J! .. DIn1i
I Dl$' MbJ YrJ
40. MANAGCIVII:I\II ,(Check aU lhetapply.l
".... EIem8nts ,. S 0 P S 0
1. L.ead8i'llhlf1arld ~ 0 0 0 11.. PerIcinal,~Elqulpment 0 0 0
2. ~lplra/nlng a a tJ 12. Heallh ancthyglene GOIItrQI 0 0, d
!i 3., PIaIIIIl!.d ~1U.~ a a 0 18. SyIltsJn ~ 0 D, 0
I' 4. CI1Illlaltaklintif;slaltndpiocetAll8B 0 D 0 14- ~;.nd ClhlIIlge 0' D 0
8. AtlcIdllIItIIncInVesttgallon D 0 0 16. Peison8I:coml1ll.lllkllltlO 0 0 0
8. TlIlllc~ a 0 0 16. Gl.'llUp~ 0 0 D
1. EIllllfIlHiCV pt8jl8l8dnIII!I 0, a 0 1'1. QeneftIt~ 0 1:1 0
a. Rlll8sllnd\Vcllk j)em'lllt D 0 D 18. HirII1I8nd' pIaciemenf' 0 1:1 D
9- AccldenlI1i1c1cl1W~ 0 0 0 1.9. MideriaIlI. and. MI'\IIces'I11an8g8flI8I ,0 I!l 0
1<1. ~'and$kllllraliq, 0 0 0 20. OIf-theiob aaf8ty 0 Q D
L4tifMd: p. PtogJam elemen1.lmpIeI.lUlla1.lOn~' ,8 -lMIdatd(s) II't8d8qu8te: O. 00mp/lanCll wIlhllt8tldald($) ~
t '.:l: ::l A
lMit:r=:m COST FlATlO' INDlFlECT COSttl. TOTAL COSTS
MONTH 00MPI!Iil'SA: ' Of: 1) C)Ilultip1yOOQnii 1 by"X" II1llD1 illnll) (Add ciilunP"1l111Cli3)
J$lUaiy,
Febn/aIy
MlIrCll
I Apri\
May
I June
July
.
August,
$epI8mber
October
NOwmb8r
DIIcIImbIr
T_.!
ollie tI'upp'ql'foiiiollOlll railo'(e;g. 310 f, 410 1, 8IC.~ To...... _COPItS of /hit foJm, oatH (IlOOl4QBolAPAI<f272). LPPAD17111117
MKHS 007-2
MUNICIPALITY OF KINCARDINE
EMPLOYEE ACCIDENT CORRECTIVE ACTION MEMO
How soon after the incident occurred was it investigated?
Was there anything unusual about the employee's assigned task that could have contributed to the
accident?
Were established rules, regulations and Guidelines being followed? Was Personal Protective
Equipment worn?
What could be done to prevent a similar accident from occurring?
What corrective action has already been completed?
What corrective action is planned?
Individual responsible for corrective action:
Date
Dav Month Year
Expected Completion Date
Supervisor's signature:
Senior Manager signature:
Reviewed and approved by CAD:
MKHS 008
MUNICI'PALITY OF KINCARDINE
MODIFIED WORK PROGRESS CHART
Name of Injured: Senior Manager
Date of Injury (DD~MMM~ YV): Program Start D ite:
Injury Description: Completion DatE:
Program Goal: Program Length weeks
Week 1 Goal:
Week 2 Goal:
Week 3 Goal:
Week 4 Goal:
Week 5 Goal:
,
,,'
Week 6 Goal:
MKHS 009-1
,
-
MUNICIPALITY OF KINCARDINE
MODIFIED WORK PROGRESS CHART
Week 7 Goal
Week 8 Goal:
Week 9 Goal:
Week 10 Goal:
I
I
Week 11 Goal:
Week 12 Goal:
Conclusions and Recommendations:
Employee's Signature: I Senior Manager Signature:
MKHS 009-2
p
____on
MUNICIPALITY OF KINCARDINE
UNSAFE 'WORK REFUSAL
ART 1
oblTask:
Employee Name: Date(DD-MMM- YV):
Reason for Refusal:
Refusal made Under Regulation/Section:
Supervisor's Action: "
Supervisor's Name: Date(DD-MMM- VY):
Signature:
ART 2
oint Health & Safety Committee Member Involved:
Suggested Action:
ction Confirmation:
Supervisor:
Joint Health & Safety Committee Member:
Worker:
Ministry of Labour Contacted:
Date(DD-MMM-VY): Time:
"
J
P
J
A
MKHS 010
C'.~:! CC,'",:....".1 ~.. -., .,~ ...0....
\
MUNICIPALITY OF KINCARDINE
CONFINED SPACE ATMOSPHERIC ASSESSMENT AND ENTRY PERMIT
. ALL COPIES OF THIS PERMIT TO REMAIN AT JOB SITE UNTIL JOB IS COMPLETED
. THE MUNICIPALITY of KINCARDINE MKHS 2.4 CONFINED SPACE GUIDELINE SHALL BE ADHERED TO AT ALL TIMES
BEFORE AND DURING ENTRY
. REFER TO APPENDIX "A' . CONFINED SPACE SUMMARY CHART BEFORE ENTRY
. THIS PERMIT IS FOR "COLD WORK" ONLY
Issue Date: I Time: 8 ~:~: I Expiry Date:
GENERAL INFORMATION
Location:
Entry Type: tank >0 manhole >0 storm sewer >0 sanitary sewer >0 valve chamber >0
wet well >0 dry well >0 Other:
Category: 1 >0 2 >0 3 >0 4>0
Description and Purpose of Work to be performed:
Hazards Present
or Likely to Occur and
Corresponding Control
Measures:
EQUIPMENT REQUIREMENTS (entry and rescue)
Y!I. No rrr No
0 0 lock-outlde--energize [j Tripod escape unit and cable
0 0 lines broken - capped or blanked 0 0 lifelines
0 0 Purge - flush and vent 0 0 Fire extinguishers
0 0 Ventilation (blower) 0 0 lighting
0 0 5ecure area (area secured?) 0 0 Protective clothes
0 0 5elf Contained Breathing Apparatus 0 0 Communications (radio, cell, hard hat)
0 0 Respirator
0 0 Body Harness (entry and competent Other:
person)
MONITOR DATA
1. Manufacturer:
Model:
Date of Last Calibration:
Person Monitoring:
2. Manufacturer:
Model:
Date of Last Calibration:
Person Monltorina:
MKHS 011-1
~
This
Alarm During Entry? YES 0 NO 0
If "yes", explain why:
Remedial Action:
ATMOSPHERIC READINGS (beginning at entry, 15 minute intervals thereafter)
ENTRY TIME:
1. Time 02 ppm %LEL CO ppm H2 S ppm
2. Time 02 ppm %LEL CO ppm H2S ppm
3. Time 02 ppm %LEL CO ppm H2 S ppm
4. Time 02 ppm %LEL CO ppm H2:; ppm
5. Time 02 ppm' %LEL CO ppm H2:; ppm
6. Time 02 ppm %LEL CO ppm H2:; ppm
7. Time 02 ppm %LEL CO ppm H2 S ppm
8. Time 02 ppm %LEL CO ppm H2 ~ ppm
9. Time 02 ppm %LEL CO ppm H2 ~ ppm
10. Time 02 ppm %LEL CO ppm H2 ~ ppm
11. Time 02 ppm %LEL CO ppm H2 =' ppm
12. Time 02 ppm %LEL CO ppm H2 S ppm
EXIT TIME:
".'
If an emergency occurs, summon helD first Donat enter a confined space or hazardous area until qualified elp arrives and entry can be
made safely. If a person is down for no apparent reason, assume that toxic gases or oxygen deficiency caul exist Do not enter without
full orotective and self-contained breathina devices.
PERSON(S) AUTHORIZED TO ENTER (PLEASE PRINT):
Sianature: Date:
COMPETENT PERSON IN CHARGE OF ENTRY (PLEASE PRINT):
Slanature: Date:
~~NTRY APPROVED BY (PLEASE PRINT):
Signature: Date:
Telephone: Cell Phone/Pager:
. Permit must be submitted to Supervisor for retention upon completion of Confined Space Ent y.
MKHS 011-2
MUNICIPALITY OF KINCARDINE
PHYSICAL DEMANDS ANALYSIS
Job Title: Senior Manager:
HourslWeek: Completed by:
Date: Phone:
CATEGORY FREQUENCY WEIGHT COMMENTS
Maximum Usual
BENDING
Stooping 0 1 2 3 4
Twisting 0 1 2 3 4
Kneeling 0 1 2 3 4
Crouching 0 1 2 3 4
Crawling 0 1 2 3 4
WALKING
Level Surface 0 1 2 3 4
Rough Surface 0 1 2 3 4
Stairs 0 1 2 3 4
Ladders 0 1 2 3 4
SITTING
Chair 0 1 2 3 4
Stool 0 1 2 3 4
Vehicle Seat 0 1 2 3 4
REACHING
Above Shoulder 0 1 2 3 4
Below Shoulder 0 1 2 3 4
Forwarel/Backw 0 1 2 3 4
arel
LIFTING
Ground Level 0 1 2 3 4
Bench Level 0 1 2 3 4
Shoulder Level 0 1 2 3 4
Overhead 0 1 2 3 4
Carrying 0 1 2 3 4
Pushing 0 1 2 3 4
Pulline 0 1 2 3 4
STANDING
Inside 0 1 2 3 4
Outside 0 1 2 3 4
HANDS
Fine Finger 0 1 2 3 4
Movement
Gripping 0 1 2 3 4
Handline 0 1 2 3 4
FEET
Action - 1 foot 0 1 2 3 4
Action - 2 feet 0 1 2 3 4
Note: ActIvIty Is based on an 8-hour shift
Key: o - NOT REQUIRED
1 - SELDOM REQUIRED
2 - MINOR ACTIVITY (Less than 1 hour per shift)
3 "FREQUENT ACTIVITY (1 - 3 hours per shift)
4 - CONSTANT ACTIVITY (Major demand/requirement of job)
MI(I-I~ 01?
MUNICIPALITY OF KINCARDINE
NEW EMPLOYEE.SITE/SAFETYORIENTATION CHEC <LIST
EMPLOYEE DATA:
Name
, Address:
Telephone #:
i
StTE ORIENTATION - EXPLAIN THE FOllOWING:
1. Project & duties, sample tasks: 0
2. Site speCific and general hazards & chemical hazards: 0
3. Location of first aid stations/kits & Material Safety Data Sheets locations 0
· have employee review Material Safety Data Sheets for workplace ·
4. Fire safety equipment location & use 0
5. Accident reporting procedure 0
6. Name of work location Health and Safety representative 0
& Health and Safety committee members names/contact numbers
SAFETY:
1. Provide a copy.of:
.. Municipality of Kincardine Health and Safety Policies
. Worker duties & responsibilities as outlined in the Occupational
Health and Safety Act (direct to onsite copy)
. Emergency telephone numbers and guidelines
2. Supply personal protective equipment (if required):
. General eye protection
. Foot protection
. Head protection
. Hearing protection
. Other:
3. Identify & discuss (if applicable):
. Confined Space Entry Equipment and Guideline
. Fall restraint equipment
. Other:
4. List training certifications new employee holds:
Confined Space 0 Fall Protection D
Traffic protection 0 WHMIS 0
First Aid/CPR 0
Other:
5. Other work. specific items:
"
Employee Signature:
Explained by: Supervisor/Competent Person Signature:
Date of Orientation:
o
o
D
D
D
D
o
o
MKHS 013
~
...
MUNICIPALITY OF KINCARDINE
SITE SAFETY MEETING
DATE: DEPARTMENT:
TOPIC: SUPERVISOR:
(PRINT)
DISCUSSED BY:
(PRINT)
ATrENDEE NAME (PLEASE PRINTl ATrENDEE SIGNATURE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
MINUTES OF SITE SAFETY MEETING
SUGGESTIONS/COMMENTS
PRESENTER'S SIGNATURE SUPERVISOR'S SIGNATURE
MKHS 014
-
., MaRTo! ORFaXTo:
- 200frotlt,streetWest 41&i344-4684;
; , TorantoOH M5V3il ORl..a884ta-'I3T3
PIeMe'....... Wa.oklnk
.. "'.................n
:-'llblldlf/Oc:cupat/On(atthe'tfmeof8CCldent/1Itiless'-do ...~
APPENDIX 1
WSIBFORM 7
7
Enll,lltYfWS Re~Drt
of 'jJurj/DIH86e(Fonn 7)
laakn~' I
SocIal '.ranceNlimbet
PleaseclJeck Iftblsworkerl$<<
..eft1ciaI
LengQjofti, me I" tIlll; position
whIliWOlklJlffiH'you
spouseQr relati\'eQfthe OlIlployer
li'.WVlf(9rcovered hi.
UIIIOnI~_
o yes 0 ,
Woll(er'sprefened Ia
B ...., DFI'ench
0tIiet
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whete
PoslaI COde
'DesorIp6cin,ofSUSlnessA<<IVifF
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otlllll8S$ I I ' I
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00071 (11105)
A ......to ,tlllll'_ this,...... Is available at -J
P.1of4
APPENDIX 1
.
IhkBrNMre
PI.... PRINT III ItIaclk ...
7
Em....."..... Re~rt
of ..;,1...... (Form 1)
l~mNner I
I SooIlII.....Number I
I I
c:. ....... .Dates .... DebIIIe
7. DId IIIe ICCIiIeIt/IIlnBhappeIl QIl file IlIlpIoJw's SpecIfy..... (tlhoptoor, ........ cIent/- *. I*\dng IClt, 8b:.J.
pftlIlIses(Gllllllil.leased Dr~,. DRO
.. DId,..lIIlCIW/IHIIeSS... DUIllIlI&1he,.... If yes, wII8IIi(dtr. pftlftIce/sblI8, ClId1Ib7t.
cifOlllrlDf 0,. 0 lID
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D~~.can 0--- D~~ DAdaIIUedfDllQIpItaI
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~adlllJlI&S.'" ...ciflieefltl pl'llfestiDniI.
orfacilftJvmobeeted.......... (lfknown)
dd
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ftIllllhed....... tiIJrd1
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....1ol;t1lme 8nd/lIl'llII'lIIItIs- (CQ....... ALL....... aactl_).
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'''1IiIslDst1ime.ND LDstll_ - MOIIIed WIIdc ................. br. T.......
DMyseIf D OIlIer
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.....
a............be811
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If,.., W8S It AceepI8d 0 DeclIned
O IfDedlaed please 8II8oh 8 copycif
Ibe wdtI8n...,..to tlIeWlidlBr.
DIJ07A(11l05).
Telephoae
&t.
Page2of4
APPENDIX 1
. ., EmlJloyel"slteport
~ of .IQllry/DIHase(F... 7)
I C18111l Number I
PIea$e PRINT'" blaCk Ink
\WdtWNaIlle ScloIaI JhliUnlRce NUlIlber
I I
4. .....W.../E~ IntonnatIft.(Do.llOUnclu4eoverdmell8le): I
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APPENDIX 1
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1'HEWOR~C8,8AFEIY AND IN$URANCEACI' ......1aU 8M! A COPY OF THIS FOR. '10 YOUR WORICE1I
0007A(11105) Page 4 of 4
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APPENDIX 2
WSIB FUNCTIONAL ABILITIES FORM FOR TIMELY RETU
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