HomeMy WebLinkAbout19 053 Airport Service Provider's Contract 2019 (Phoenix AMG Inc.) By-law THE CORPORATION OF THE MUNICIPALITY OF KINCARDINE
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N�g/kliY OF 1(11/G1W
BY-LAW
NO. 2019 - 053
BEING A BY-LAW TO AUTHORIZE THE SIGNING OF AN AGREEMENT
WITH PHOENIX AMG INC.
TO PROVIDE SERVICES AT THE MUNICIPAL AIRPORT
WHEREAS Section 8 (1) and 9 of the Municipal Act, 2001, S.O. 2001, c. 25, as
amended, provide that the powers of a municipality under this or any other Act
shall be interpreted broadly so as to confer broad authority on the municipality to
• enable the municipality to govern its affairs as it considers appropriate and to
enhance the municipality's ability to respond to municipal issues and has the
capacity, rights, powers and privileges of a natural person for the purpose of
exercising its authority under this or any other Act;
WHEREAS the Municipality owns the Municipal Airport, Transport Canada
identifier CNS7, a registered public aerodrome, located on the west side of
Highway #21 in the Municipality of Kincardine;
AND WHEREAS The Corporation of the Municipality of Kincardine deems it
advisable to enter into a contract to provide management services at the
Kincardine Airport;
NOW THEREFORE the Council of The Corporation of the Municipality of
Kincardine ENACTS as follows:
1. That The Corporation of the Municipality of Kincardine enter into an Airport
Service Provider's Contract with Phoenix AMG Inc. for the provision of
management services at the Municipal Airport, in accordance with the
• terms and conditions outlined in the agreement attached hereto as
Schedule `A' and forming part of this by-law.
2. That the Mayor and Chief Administrative Officer be authorized and
directed to execute, on behalf of the Council of The Corporation of the
Municipality of Kincardine any documents required for the execution of this
contract.
3. That this by-law shall come into full force and effect upon its final passage.
4. That this by-law may be cited as the "Airport Service Provider's Contract
2019 (Phoenix AMG Inc.) By-law".
READ a FIRST and SECOND TIME this 1st day of April, 2019.
READ a THIRD TIME and FINALLY PASSED this 1st day of April, 2019.
• Mayor Clerk
This is Schedule
n., ,n to By--Law
No0019-0assed the;day
of \ 2019
SCHEDULE A
Airport Service Provider's Contract
ct
This AGREEMENT made this day ofd,2019.
BETWEEN:
THE CORPORATION OF THE MUNICIPALITY OF KINCARDINE
Hereinafter called the "Municipality" Of the First Part,
- And -
Phoenix AMG Inc.
Hereinafter called "Contractor" Of the Second Part
WHEREAS the Municipality owns the Municipal Airport (hereinafter called the
Airport), Transport Canada identifier CNS7, is a registered public aerodrome, located
on the west side of Highway#21 in the Municipality of Kincardine, and which
consists of generally the following: runways, taxiway, apron, grassed area, hangars,
terminal, navaid equipment and fuel facilities;
AND WHEREAS the Municipality agrees to hire a Contractor to provide
management services at the Kincardine Airport and has directed that a Contract
Agreement be enacted;
NOW THEREFORE THIS AGREEMENT WITNESSETH THAT in consideration
of the premises and of the covenants and agreements hereinafter contained and
other goods and valuable consideration, the receipt and sufficiency of which is
hereby acknowledged,the parties hereto agree as follows:
1.0 MUNICIPAL OVERSIGHT
The Contractor reports to the Director of Public Works or designate, on all airport
operational matters, including but not limited to, grounds and airside
maintenance, airport operations and systems, aviation standards and capital
projects.
The Office of the Chief Administrative Officer(CAO) oversees hangar leasehold
relations and airport marketing and promotions.
2.0 TERM OF CONTRACT
a. The Agreement will be for three(3)years,to cover the period April 1St,2019
to March 31st,2022,with the option of an extension for another three(3)year
term to expire March 31St, 2025. The Municipality is under no obligation to
extend the Agreement beyond its initial term. The decision to extend the
contract will be mutually agreed upon between the Municipality and the
Contractor.
b. In the event the contract is extended for the optional three-year period, the
compensation rates for the period of the three (3) year extension will be
negotiated prior to the granting of the extension.
c. Further renewal for a shorter term shall be agreed to in writing in the event
that the second full three (3) year Agreement is not negotiated or finalized.
Such extensions shall be in accordance with the same terms and conditions
of the initial agreement. Notice of extensions shall be given ninety(90)days
in advance of the termination of the initial contract.
d. The continuation of the services beyond the initial term of the Agreement
shall be for the purposes of ensuring a smooth continuity and/or transition of
the Airport Management and Operation functions. During this transition
period,the Contractor shall be paid for services rendered in accordance with
the terms of this agreement, or the negotiated extension, as applicable.
3.0 MANAGEMENT FEE
a. The Contractor shall be paid the annual fee of$90,000.00 plus H.S.T for
the year April 1, 2019 to March 31, 2020,for the services set out in this
contract.
b. All fees must be in Canadian Funds and include all applicable taxes,
identified separately.
c. The annual fee shall include all labour costs and associated Canada
Revenue Agency Statutory obligations as noted in attached contract. All
risk for profit/loss shall be the sole responsibility of the Contractor.
d. The Contractor agrees to provide the services outlined in this Agreement
for the annual fee.
e. The annual fee will be adjusted each April 1st during the term of the
Agreement by the change in the Ontario Consumer Price Index(CPI)over
the previous twelve (12) months (January 1St— December 31St). The first
adjustment will be effective April 1St,2020.
f. Payment will be made to the Contractor monthly during the term of the
Agreement. Additional payments for approved services will be paid by
invoice submitted by the Contractor.
4.0 SCOPE OF WORK
4.1 Responsibilities of the Municipality
a. The Municipality of Kincardine is the owner of the Kincardine Municipal
Airport,and as such, shall be responsible for the overall policy direction for
the maintenance, operations and management of the Airport.
b. The Airport's annual operating and capital budgets will be subject to the
approval of Municipal Council.
c. The Municipality will determine capital, and operational improvements
needed at the Airport.
d. The Municipality will determine the types and levels of fees to be charged
at the Airport,with all receipts payable to the Municipality, unless otherwise
stated or agreed to.
e. The Municipality shall remove snow (as required) from the runway,
taxiways, the refuelling areas, the hangar-line, the driveway, the parking
lot, the entrance to the apron and general aviation area to the extent
required for the winter activities.The Municipality will supply the necessary
equipment,to be operated by the Contractor,to remove snow from around
the Terminal Building and hangar entrances.
f. The Municipality will cut grass adjacent to the runways and aprons; and
will provide the necessary equipment,to be operated by the Contractor,to
cut grass around the terminal, hangars.
g. The Municipality reserves the right to subcontract equipment operations
work and the Contractor will oversee the necessary work performed on the
Municipality's behalf. The Municipality will provide fuel for Municipality
provided equipment.
h. Damage to Municipality-owned equipment due to Contractor operator
negligence shall result in the Contractor paying 50%of the cost of repair.
This shall be subject to the Municipality reasonably demonstrating that the
damage is not due to normal wear and tear from industry-standard
equipment operation.
i. The Municipality will provide appropriate office space and furnishings
(including computer and fax machine) in the Terminal Building for the
purpose of carrying out airport management duties. The cost of operating
the Terminal Building will include hydro, telephone (excluding personal
calls), heat, janitorial supplies, light bulbs for buildings, repairs to
furnishings and buildings, and will be provided by the Municipality.
j. The Municipality will supply the necessary lights for the runway and repairs
to Municipality provided equipment.
4.2 Responsibilities of the Contractor
a. The Contractor will ensure that aircraft operating areas and other facilities
are inspected on a daily basis in accordance with Transport Canada
regulations and generally accepted airport operating practices. Additional
inspections will be made in poor weather conditions and during the winter
months. The Contractor will keep a written or electronic record of all
inspections and will provide copies of all inspection reports to the Director
of Public Works. Any hazards or deficiencies identified during these
inspections will either be rectified immediately or reported to London Flight
Service by NOTAM. The Contractor is responsible for issuing aircraft and
airport advisories which may be required for Airport users.
b. The Contractor will keep a record of Airport movements/aircraft activity
during attended hours.
c. The Contractor will ensure that they are personally in attendance at the
Airport for a minimum of forty (40) hours per week, with the exception of
scheduled personal holidays and approved absences from the Airport on
airport business. The Municipality reserves the right to monitor the amount
of time the Contractor is absent from the Airport.
d. Additional hours required to work outside the normal hours of operation
will be subject to the approval of the Municipality.
e. The Contractor will sell aircraft fuel provided by the Municipality during the
attended hours and will make arrangements for after-hours sales. The
Contractor will deposit all fuel receipts directly with the Municipality and
supply all information on fuel sales to the Director of Finance. The
Contractor will maintain records of all fuel sales and inventory and take
tank depth recordings and other inspections as required under the
Gasoline Handling Act or other applicable Acts. The Contractor will carry
out fuel quality testing on a schedule to be provided by the Municipality.
f. The Contractor is to remove snow (daily) from around the Terminal
Building and hangar entrances to the extent required for the winter
activities. The Contractor will provide the Municipality with a winter
maintenance and snow-clearing program for approval prior to October 15th
of each year during the term of the Agreement except in the first year of
the Agreement the winter maintenance and snow-clearing plan will be
provided by November 15th.A map detailing areas of responsibility will be
provided by the Municipality.
g. The Contractor will cut grass in the vicinity of the Terminal Building and
around the hangars. The Contractor will provide the Municipality with a
grass-cutting schedule for approval prior to April 15th of each year during
the term of the Agreement except in the first year of the Agreement the
grass-cutting plan will be provided by May 15th. A map detailing areas of
responsibility will be provided by the Municipality.
h. The Contractor will ensure that the Terminal Building is cleaned and
maintained to the satisfaction of the Municipality and will submit invoices
to the Municipality on a monthly basis for the purchase of cleaning and
toilet supplies.
i. The Contractor will ensure that the runway and other aircraft movement
areas are maintained to Transport Canada and the Ministry of
Transportation of Ontario Standards, and to the satisfaction of the
Municipality, and without limiting the generality of the foregoing, replacing
burned out light bulbs, keeping the wind indicator in good repair, sign
maintenance and runway markers. The Contractor will maintain,with the
approval of the Municipality, a supply of replacement items as required for
the above maintenance at the expense of the Municipality.
j. The Contractor will be responsible for directing aircraft to a suitable tie-
down area and collecting fees as established by the Municipality.
k. The Contractor will supply a vehicle in good operating condition for
carrying out duties on airport property.
I. The Contractor will answer telephone and aircraft radio calls and provide
information relating to runway conditions, including updating the municipal
website, as required. The Municipality will supply the Contractor with a
hand-held radio while the Contractor is conducting runway inspections
and/or maintenance.
m. The Contractor will supervise and control access of persons or vehicles to
the Airport property and will provide at all times for the safety and welfare
of the flying and non-flying public.
n. The Contractor will submit the following reports to the Municipality on a
monthly basis regarding the operation of the Airport:
i. Monthly operating and maintenance report(invoices);
ii. Summary of fuel purchases and sales;
iii. Summary of aircraft movements during staffed hours and an
estimate of movements when the airport is not staffed; and,
iv. Marketing report detailing the status of activities during the
month in the following areas:
1. Special events;
2. New hangar development;
3. New airport users, air cargo/courier operations;
4. Community awareness program.
v. The Contractor in conjunction with the Municipality will be
required to prepare and submit an annual report inclusive of
presenting such details at an annual meeting of relevant
stakeholders.
o. The Municipality will provide the Contractor with the format for various
Municipal reports. The Contractor may submit report formats for approval
by the Municipality.
p. The Contractor will maintain an Airport Operations Manual, Emergency
Response Plan, Wildlife Control Plan, and a Snow Removal and Ice
Control Plan in cooperation with the Municipality,the Fire Department,the
local detachment of the Ontario Provincial Police and other organizations
as may be required.
q. The Contractor must enforce and meet all requirements of the Aeronautics
Act and the Canadian Air Regulations (CAR's) and all other statutes that
may apply or are deemed to apply.
r. The Contractor must ensure professional service and attitude at all times
in dealing with all users of the Airport. The Contractor will be provided with
business cards paid for by the Municipality,which will be used exclusively
for Airport business.
s. The Contractor is responsible for marketing and developing the
commercial, industrial and business use of the Airport by local industry,
new industry to the area, courier operators, air freight operators,
passenger air carriers, military operators and government air operators,
with the intention of increasing the revenues from user fees,fuel sales and
hangar leases.
t. The Contractor will assist in the preparation of the Airport annual operating
and capital budgets.
u. The Contractor will be required to operate the Airport within the annual
operating and capital budget as approved by Municipality Council. Any
expenditure that would cause an over expenditure in an approved budget
line account must be authorized by the Director of Public Works or their
designate prior to the Contractor authorizing or initiating the expenditure.
v. The Contractor will be required to obtain prior approval from the Director
of Public Works or their designate for any single or cumulative purchase
with a value in excess of$1,000 including HST.
w. The Contractor shall provide a cell phone number, which airport users
will call for off-hours service. The monthly charge for the cell phone will
be paid by the Contractor.
x. The Contractor shall comply with relevant Canada Revenue Agency
obligations.
y. The Contractor shall be required to comply with the Municipality's Policies
GG 3.8 "Accessibility Standards for Customer Service" (Appendix A),
Policy GG 3.9 "Integrated Accessibility Standards" (Appendix B) and the
Municipality of Kincardine' s Occupational Health & Safety Manual
(attached).
5.0 INSURANCE REQUIREMENTS
The Contractor must supply to the Municipality proof of the following Insurance
provisions:
a. Aviation General Liability Policy — in an amount not less than Five Million
Dollars($5,000,000). The policy shall include but not limited to the following:
bodily injury including death; damage to property including use thereof;
premises and operations liability; blanket contractual liability; contingent
employers liability; personal injury liability; owner's and contractor's
protective coverage; refueling liability; tenants legal liability; non-owned
licensed motor vehicles;sudden and accidental pollution; 120 hour reporting;
vehicle airside liability. The policy must include a cross liability clause and a
severability of insured's clause.
b. Coverage for above policy shall be inclusive of the terminal field, airfield,
ramp and taxiway.
c. Property damage deductible shall not exceed Five thousand dollars
($5,000.00)or as agreed to by the Municipality.
d. Endorsement providing the Municipality with not less than thirty (30) days
written notice of cancellation to coverage.
e. The Municipality shall be named as additional insured to the policy with
respect to liability arising out of the operations of the Named Insured.
f. Automobile Policy—Standard owner's form automobile policy providing third
party liability and accident benefits insurance and covering licensed vehicles
owned or operated by the Contractor.
g. Employee Dishonesty with Third Party Extension - Employee Dishonesty
coverage written by an insurer licensed to conduct business in the
Province of Ontario in an amount of$1,000,000. Coverage shall include
the Third Party Extension.
6.0 INDEMNITY
The Contractor covenants and agrees to keep the Municipality indemnified
against any and all claims and demands whatsoever by any person or entity,
whether in respect of damage to person or property, arising out of or occasioned
by the Contractor's actions or inactions with respect to performance of its duties
and obligations under this Agreement.
7.0 HOURS OF OPERATION&AIRPORT STAFF
a. The Airport will be attended continually by the Contractor or the Contractor's
qualified employees at all times on a daily basis,including statutory holidays.
Staff will be required on site for a 40-hour flex week. Flex hours will provide
the contractor the ability to attend meetings, special events or tend to air
traffic as required. The contractor will be responsible to provide their
schedule to the Municipality for approval. The Contractors proposed
schedule is as follows:
Phoenix AMG Inc.will operate the Airport three hundred and sixty two (362)
days per year utilizing flex hours of Mondays to Friday six(6) hours per day
and Saturday and Sunday five(5)hours per day, making up a forty(40)hour
flex week.
b. The airport may be closed Christmas Day, New Years Day and Good
Friday,with the other statutory holiday hours assessed based on air
traffic and airport activities.
c. Additional hours may be required, from time to time, to accommodate
meetings(i.e. COPA), and Airport events.
d. The Contractor will be permitted reasonable absences from the Airport
during attended hours for the purpose of carrying out the duties of the Airport
Operating Agreement. In the event of such absence the Contractor will
ensure a qualified employee of the Contractor is in attendance at the Airport.
Extended absences may be permitted with the prior approval of the
Municipality.
e. The Contractor will provide all staff required to fulfil the requirements of the
Agreement and will ensure all staff are suitably trained, certified as required
and familiar with Transport Canada regulations and other laws as they may
apply to airports. The Municipality shall be provided with a copy of all
certifications of staff and operations by the Contractor.The Contractor shall
provide a list of all staff working under this contractor to the Municipality.
f. The Contractor and the Contractor's employees are expected to take full
advantage of training courses related to airport operations that may be
available. The Municipality may reimburse the Contractor for major training
expenses,provided the Municipality approves the training course in advance
and it is included in the approved Airport annual operating budget.
g. The Contractor will provide customer service recommendations to the
Municipality.
8.0 DURATION OF AGREEMENT
a. This Agreement shall be effective from April 1,2019 to March 31,2022.
This will be deemed to be a three-year contract subject to the
Contractor meeting his/her obligations as specified herein.
b. Either party may terminate this Contract Agreement upon ninety (90)
days' notice by mailing a notice of termination by registered or certified
mail to the other party.
c. This contract may be terminated with no notice in the event of failure
to comply with the terms of this Agreement, or other serious grounds
as determined by the Council of the Municipality.
9.0 ASSIGNMENTS
This Agreement is not assignable by either party without the written permission
of the other party.
SIGNED, SEALED AND DELIVERED
In the presence of ) THE CORPORATION OF THE
MUNICIPALITY OF KINCARDINE
C
)per:
Ane Ea ie, Mayor
)p= sea1
"'_ on Chambers, CAO
)DATE: (2/ _3j .20/
We have the authority to bind the corporation.
In the presence of ) Phoenix AMG Inc
)per:j��
Ste`phe Rouse, resident
)
)per:
Witness
)DATE: C /2_0 z C- `cA
I have the authority to bind the corporation.
APPENDIX A
POLICY
POLICY NO: GG.3.8
SECTION: GENERAL GOVERNMENT
TITLE/SUBJECT: ACCESSIBILITY STANDARDS FOR CUSTOMER
SERVICE
(Pursuant to Accessibility for Ontarians with Disabilities Act,
2005; Ontario Regulation 191/11 Integrated Accessibility
Standards)
ADOPTED DATE: August 5, 2009 (By-law No. 2009-115)
REVISION DATE: November 4,2009(By-law No. 2009-161)
July 6,2016(By-law No. 2016-081)
PURPOSE
The Municipality of Kincardine is committed to being responsive to the needs of the
community. To do this,we must recognize the diverse needs of individuals and respond
by striving to provide services and facilities that are accessible to all. As a provider of
goods and services, and as an employer,the Municipality of Kincardine is committed to
ensuring its goods or services are provided in an accessible manner.
The Municipality of Kincardine will promote accessibility through the development of
policies, procedures and practices and by ensuring they consider persons with
disabilities. To do so, the Municipality must ensure the policies, procedures and
practices address integration, independence, dignity and equal opportunity.
PRINCIPLES
Reasonable efforts will be made to ensure the following:
(i) That goods or services be provided in a manner that respects the dignity
and independence of persons with disabilities.
(ii) The provision of goods or services to persons with disabilities and others
will be integrated unless an alternate measure is necessary, whether
temporarily or on a permanent basis, to enable a person with a disability
to obtain, use or benefit from the goods or services.
(iii) Persons with disabilities will be given an opportunity equal to that given to
others to obtain, use and benefit from the goods or services.
PROCEDURES AND PRACTICES:
Procedures and practices will strive to reflect or achieve the following:
(i) When communicating with a person with a disability, the Municipality will
do so in a manner that takes into account the person's disability.
(ii) Persons with disabilities requiring a support person or a service animal
should not be restricted in obtaining, using or benefiting from the
Municipality's goods or services.
(iii) Notice is required when facilities or services that people with disabilities
rely on to access Municipality of Kincardine goods or services are
temporarily disrupted.
(iv) Training of staff about provision of goods or services to persons with
disabilities will facilitate the delivery of those goods or services.
(v) The public should have an opportunity to provide feedback on the
provision of goods or services to persons with disabilities.
(vi) The public should have the opportunity to be aware of the availability of
documents related to this policy.
(vii) Municipal documents should be available in formats that take in to
account a person's disability.
(viii) Persons with disabilities should be allowed to use their own personal
assistive devices to obtain, use or benefit from the goods and services
offered by the Municipality.
PROCEDURES
Support Persons
Support person means, in relation to a person with a disability, another person who
accompanies him or her in order to help with communication, mobility, personal care or
medical needs or with access to goods or services.
The Municipality of Kincardine will ensure that a person with a disability, who is
accompanied by a support person, to enter municipal owned and operated public
facilities with their support person and will not prevent the person with the disability
having access to the support person while on the premises.
The Municipality may require a person with a disability to be accompanied by a support
person when on the premises,but only if,after consulting with the person with a disability
and considering the available evidence,the Municipality determines that,
(a) a support person is necessary to protect the health or safety of the
person with a disability or the health or safety of others on the
premises; and
(b) there is no other reasonable way to protect the health or safety of
the person with a disability and the health or safety of others on the
premises.
The Municipality of Kincardine will waive admission fees for support persons who
accompany a person with a disability, into facilities where admission is charged.
(a) The Municipality may require advance notice to facilitate availability,
etc.
(b) Member of public should notify a staff member the presence of the
support person.
(c) If there is confidential information to be disclosed,consent must be
received from the person with the disability.
Service Animals
For the purpose of this policy, a'service animal' is defined as either:
(i) A"guide dog," as defined in section 1 of the Blind Persons Rights'
Act; or
(ii) A"service animal"for a person with a disability. For the purpose of
this policy, an animal is a service animal for a person with a
disability,
(a) if it is readily apparent that the animal is used by the person for
the reasons relating to his or her disability; or
(b) if the person provides documentation from a regulated health
professional confirming that the person requires the animal for
reasons relating to the disability.
The Municipality of Kincardine will ensure that a person with a disability is permitted to
enter all Municipality of Kincardine owned and operated public facilities with the service
' animal and allowed to keep the service animal with him or her unless the service animal
is otherwise excluded by law from the area.
If a service animal is excluded by law from the premises,the Municipality will ensure that
other measures are available to enable the person with a disability to obtain, use or
benefit from the Municipality's goods or services.
Temporary Service Disruptions
If, in order to obtain, use or benefit from a provider's goods or services, persons with
disabilities usually use particular facilities or services of the Municipality (i.e. elevator)
and if there is a temporary disruption in those facilities or services in whole or in part,
the Municipality of Kincardine shall give notice of the disruption to the public.
Notice of the disruption must include information about the reason for the disruption, its
anticipated duration and a description of alternative facilities or services, if any, that are
available.
Notice will be given by posting the information at a conspicuous place on premises
owned or operated by the Municipality, as well as by posting it on the municipal
website.
If the Municipality of Kincardine website should expect a temporary service disruption,
advance notice shall be provided on the website where possible, keeping with the
conditions of the service disruption section of this policy.
Training
The Municipality of Kincardine shall ensure that the following persons receive training
about the provision of its goods or services to persons with disabilities:
(a) Every person who deals with members of the public or other third
parties on behalf of the Municipality, whether the person does so as
an employee, agent, volunteer or otherwise.
(b) Every person who participates in developing the Municipality's
policies, practices and procedures governing the provision of goods
or services to members of the public or other third parties.
The training will include a review of the purposes of the Accessibility for Ontarians with
Disabilities Act and the requirements of applicable regulations and instruction about
the following matters:
(a) How to interact and communicate with persons with various types of
disability, as outlined in this policy.
(b) How to interact with persons with disabilities who use an assistive
device or require the assistance of a guide dog or other service
animal or the assistance of a support person, as outlined in this
policy.
(c) How to use equipment or devices available on the Municipality's
premises or otherwise provided by the Municipality that may help with
the provision of goods or services to a person with a disability.
(d)What to do if a person with a particular type of disability is having
difficulty accessing the Municipality's goods or services.
The training will be provided to each person as soon as practicable after he or she is
assigned the applicable duties.
The Municipality of Kincardine will retain records of the training, including details of the
training provided, as well as the name of the persons trained, the location of training,
and the date of the training.
The Municipality of Kincardine will customize the training going forward, based on the
actual experiences of the persons with disabilities in Municipality of Kincardine owned
or operated facilities and will provide training on changes to the policies, practices and
procedures governing the provision of goods or services to persons with disabilities.
Feedback Process
The Municipality of Kincardine will receive and respond to feedback about the manner
in which it provides goods or services to persons with disabilities. The Municipality shall
ensure that the feedback process is accessible to persons with disabilities by providing,
or arranging for the provision of, accessible formats and communication supports, on
request. While the Municipality will provide a form for submitting feedback, it may be
provided in person, by telephone, in writing, or by delivering an electronic text by email
or on diskette or otherwise
Should a member of the public wish to provide a suggestion on how to improve provision
of goods or services to persons with disabilities:
(a) Member of the public will inform Clerk of the suggestion, who will
discuss with the Manager responsible for the department.
(b) Staff member will assist member of the public in filling out the form,
should they require assistance.
(c) Member of the public will be notified in a timely manner of how the
Municipality of Kincardine will proceed with their suggestion.
(d) Staff response should include: an explanation of how we will
implement the suggestion, a response indicating further
investigation or an explanation why we are unable to implement the
suggestion.
Should a member of the public wish to make positive feedback regarding provision of
goods or services to persons with disabilities:
(a) The feedback will be handled pursuant to the Municipality's Mail
Procedure policy.
Should a member of the public wish to make a complaint regarding the provision of
goods or services to persons with disabilities:
(a) The member of the public with the complaint or concern should
have a discussion with the Manager of the staff person who was
involved in the situation.
(b) Should the discussion not resolve the complaint or the member of
the public is uncomfortable discussing the issue,the member of the
public should fill out a complaint form.A staff person can assist the
member of the public with the complaint form in a manner that takes
into consideration their disability.
(c) The information to be documented on the complaint form by the
member of the public shall include their personal contact
information, the date, a description of the complaint, and what the
member of the public requests to resolve the complaint.
(d) The complaint shall be forwarded to the Clerk's Department to be
dealt with as set out in the Municipality's Citizen Complaint policy,
keeping in mind the principles of this policy when communicating
with a person with a disability.
Notice of Availability of Documents
The Municipality of Kincardine will notify persons to whom it provides goods or
services that documents associated with this policy are available upon request. This
notice will be given by posting the information at a conspicuous place at the Municipal
Administration Centre, by posting it on the municipal website, or by such other method
as is reasonable in the circumstances.
Format of Documents
Should the Municipality of Kincardine be required to give a copy of a document to a
person with a disability, the Municipality shall give the person the document, or the
information contained in the document, in a format that takes into account the person's
disability.
Material printed in-house and publications produced on behalf of The Corporation of the
Municipality of Kincardine should contain a note indicating, "alternate formats are
available upon request"and include relevant contact information.
The Municipality of Kincardine and the person with a disability will try to agree upon the
format to be used for the document or information, subject to feasibility requirements of
this policy.
Alternative formats that should be considered by the Municipality of Kincardine and the
person with the disability will include, but are not limited to:
(i) Print Requests:
Requests for alternative formats should be honoured in the most practical
manner depending on the media chosen, the size and complexity of the
document, the quality and source of the documents, the feasibility of the
request(including the cost)and the number of documents to be converted.
It should be noted that when request for one of these formats is received
and deemed feasible, staff should make every attempt to respond to the
request in the most practical manner and to the satisfaction of the
requestor. If it is determined that the format requested is not feasible,then
other alternative methods of providing the information should be explored
that will still meet the needs of the requestor(e.g.Audio CD or explaining
the information verbally etc.).
(a) Staff members receives request from member of the public for
alternative format.
(b) Employee fills out alternative format request form.
(c) Forwards request to the responsible Manager.
(d) The responsible Manager and the Clerk will determine feasibility,
and
i) if feasible, proceed with alternative format request;
ii) if not feasible; contact individual with feasible solution.
(ii) ASL Interpreter Request:
(a) Employee receives request from public for ASL Interpreter.
(b) Employee fills out alternative format request form.
(c) Forwards request to the responsible Manager.
(d) The responsible department contacts Canadian Hearing Society to
make request.
(e) Once Canadian Hearing Society confirms attendance of ASL
Interpreter, the responsible department contacts individual.
(f) If ASL Interpreter is not available, individual will be contacted with
an alternative solution.
Feasibility will be determined based upon cost in relation to size of document and time
associated with processing document requests.
The time frame attached to the conversion process varies depending on the media
chosen,the size, complexity, quality of source documents and number of documents to
be converted. Documents shall be returned in a timely manner depending on the factors
previously noted.
Conversion shall be processed in-house wherever possible. When a member of the
public requests a record of the Municipality in a multiple format,the department of origin
shall be responsible for the cost of the conversion, materials and distribution, not the
public requestor.
In-house printing, where possible, should adhere to the CNIB's Clear Print Standards.
Assistive Devices
The Municipality of Kincardine will allow persons with disabilities to use their own
personal assistive devices to obtain, use or benefit from the goods or services offered
by the Municipality of Kincardine.
Should a person with a disability be unable to access the Municipality's goods or
services through the use of their own personal assistive device,the Municipality of
Kincardine will ensure the following steps are taken:
(a) Determine if service is inaccessible, based upon individual
requirements.
(b)Assess service delivery and potential service options to meet the
needs of the individual.
(c) Notify person with disability of alternative service and how they can
access the service,temporarily or on a permanent basis.
Contact Information
For more information about this policy, or questions related to accessibility at the
Municipality of Kincardine, please contact us:
Clerk
Municipality of Kincardine
1475 Concession 5
RR#5
Kincardine, ON N2Z 2X6
Phone: 519.396.3468
Fax: 519.396.8288
Email: clerkkincardine.ca
Links
Customer Service Standard, Ontario Regulation 191/11:
https://www.ontario.ca/laws/requlation/110191#BK152
Accessibility for Ontarians with Disabilities Act, 2005:
http://www.e-laws.gov.on.ca/html/statutes/english/elaws statutes 05a11 e.htm
Ministry of Community and Social Services:
http://www.mcss.gov.on.ca/mcss/enqlish/pillars/accessibilityOntario
AccessON: www.accesson.ca
APPENDIX B
POLICY
POLICY NO.: GG.3.9
SECTION: GENERAL GOVERNMENT—CLERK
TITLE/SUBJECT: INTEGRATED ACCESSIBILITY STANDARDS
ADOPTED DATE: April 17,2013
REVISION DATE:
Purpose:
Under the Accessibility for Ontarians with Disabilities Act, 2005 all public and
private sector organizations must meet the requirements of accessibility standards
established by Regulation. This Policy establishes the Integrated Accessibility
Standards in the areas of Employment, Information and Communication and
Transportation for the Municipality of Kincardine in accordance with Ontario Regulation
191/11 and with the Ministry of Community and Social Services intent to "streamline,
align and phase-in accessibility requirements and allow for progress on accessibility and
reduce the regulatory burden for obligated organizations". This Regulation came into
force July 1, 2011.
Scope:
This Policy has been drafted in accordance with the Regulation and addresses
how the Municipality of Kincardine achieves accessibility through meeting the
Regulation's requirements. It provides the overall strategic direction that we will follow
to provide accessibility supports to Ontarians with disabilities.
The requirements of the Regulation include:
(a) Establishment, implementation, maintenance and documentation of a Multi-
Year Accessibility Plan, which outlines the organization's strategy to prevent
and remove barriers and meet its requirements under the Regulation;
(b) Incorporation of accessibility criteria and features when procuring or
acquiring goods, services or facilities;
(c) Training; and
(d) Other specific requirements under the Information and Communication,
Employment and Transportation Standards.
Policy Statement and Organizational Commitment
The Municipality of Kincardine is committed and guided by the four core principles
of Dignity, Independence, Integration and Equal Opportunity and supports the full
inclusion of persons as set out in the Canadian Charter of Rights and Freedoms and the
Accessibility for Ontarians with Disabilities Act, 2005.
The Municipality of Kincardine shall use every effort to ensure that we meet the
needs of people with disabilities, in a timely manner,through the implementation of this
Policy.
Definitions
Accessible Formats may include, but are not limited to, large print, recorded
audio and electronic formats, Braille and other formats usable by persons with
disabilities.
Accommodation means the special arrangement made or assistance provided
so that persons with disabilities can participate in the experiences available to
persons without disabilities. Accommodation will vary depending on the persons'
unique needs.
Communication Supports may include, but are not limited to, captioning,
alternative and augmentative communication supports, plain language, sign
language and other supports that facilitate effective communications.
Communications means the interaction between two or more persons or
entities, or any combination of them, where information is provided, sent or
received.
Conversion Ready means an electronic or digital format that facilitates
conversion into an accessible format.
Information includes data, facts and knowledge that exists in any format,
including text, audio, digital or images, and that conveys meaning.
Internet Website means a collection of related web pages, images, videos or
other digital assets that are addressed relative to a common Uniform Resource
Identifier and is accessible to the public.
Mobility Assistive Device means a cane,walker,wheelchair, scooter of similar
aid.
New Internet Website means either a website with a new domain name or a
website with an existing domain name undergoing a significant refresh.
Redeployment means the reassignment of employees to other departments or
jobs within the organization as an alternative to layoff, when a particular job or
department has been eliminated.
Unconvertible means:
If it is not technically feasible to convert the information or communications;
The technology to convert the information or communications is not readily
available.
Web Content Accessibility Guidelines means the World Wide Web Consortium
recommendation,dated December 2008,and entitled"Web Content Accessibility
Guidelines 2.0".
General Provisions
Multi-Year Accessibility Plan
The Municipality of Kincardine Multi-Year Accessibility Plan outlines a phased-in
strategy to prevent and remove barriers and addresses the current and future
requirements of the Accessibility for Ontarians with Disabilities Act, 2005. The
Municipality of Kincardine will report annually on the progress and implementation
of the Plan, post the information on the Municipality's website and will provide it in
alternative formats upon request. The Plan will be reviewed and updated at least
once every five years.
Procuring or Acquiring Goods,Services or Facilities
The Municipality of Kincardine will use accessibility criteria and features when
P Y
procuring or acquiring goods, services or facilities, except where it is not practical
to do so(in which case, if requested we will provide an explanation).
Training
The Municipality of Kincardine will ensure that training is provided to all employees
and regular fee-for-service staff on the requirements of the accessibility standards
referred to in the Regulation and on the Human Rights Code as it pertains to
persons with disabilities. Training will be provided as soon as practicable. If any
changes are made to this Policy or the requirements training will be provided. The
Municipality of Kincardine shall maintain a record of the dates when training is
provided and the number of individuals to whom it was provided.
Information and Communication Standard
The Municipality of Kincardine will create, provide and receive information and
communications in ways that are accessible to people with disabilities.
If the Municipality of Kincardine determines that it is not technically feasible to
convert the information or communications or the technology to convert the
information or communication is not readily available, we will be obligated to
provide the person that requires the information with:
(a) An explanation as to why the information and communications are
unconvertible; and
(b) A summary of the unconvertible information or communications.
Emergency Information
If the Municipality of Kincardine prepares emergency procedures, plans or public
safety information and makes the information available to the public, we shall
provide the information in an accessible format or with appropriate communication
supports, as soon as practicable, upon request.
Feedback
The Municipality of Kincardine has a process in place for receiving and responding
to feedback and will ensure that those processes are provided in accessible
formats and with communication supports upon request. The Municipality of
Kincardine will notify the public about the availability of accessible formats and
communication supports.
Accessible Formats and Communication Supports
The Municipality of Kincardine shall be obligated to provide or arrange for
accessible formats and communication supports for persons with disabilities:
(a) Upon request in a timely manner that takes into account the persons
accessibility needs due to a disability;
(b) At a cost that is no more than the regular cost charged to other persons;
(c) Consult with the person making the request and determine suitability of an
accessible format or communication support;
(d) Notify the public about the availability of accessible formats and
communication supports.
Website Accessibility
The Municipality of Kincardine has made their internet website and web content
conform to the World Wide Web Consortium Web Content Accessibility Guidelines
2.0 Level A. By January 1, 2014 any new web content will conform to WCAG 2.0
Level A. By January 1, 2021 all internet website and web content will conform to
WCAG 2.0 Level AA.
Employment Standard
The Employment Standard builds upon the existing requirements under the Ontario
Human Rights Code in relation to how to accommodate individuals with disabilities
throughout the job application process and the employment relationship. It applies
in respect to employees and does not apply to volunteers and other non-paid
individuals.
The requirements of the Employment Standard shall be met by the Municipality of
Kincardine by January 1, 2014 unless otherwise specified.
Recruitment
The Municipality of Kincardine shall notify employees and the public about the
availability of accommodations for applicants with disabilities:
(a) During the recruitment process when job applicants are individually selected
to participate in an assessment or selection process;
(b) If a selected applicant requests an accommodation, the Municipality of
Kincardine shall consult with the applicant and provide or arrange for the
provision of a suitable accommodation that takes into account the applicant's
disability;
(c) Notify successful applicants of the policies for accommodating employees
with disabilities.
Employee Notification
In addition and where an employee with a disability requests it,the Municipality of
Kincardine will consult with the employee to provide or arrange for the provision of
accessible formats and communication supports for:
(a) Information that is needed in order to perform the employee's job;
(b) Information that is generally available to employees in the workplace; and
(c) Consult with the employee making the request in determining the suitability of
an accessible format or communication support.
Accessible Formats
In addition and where an employee with a disability requests it,the Municipality of
Kincardine will consult with the employee to provide or arrange for the provision of
accessible formats and communication supports for:
(a) Information that is needed in order to perform the employee's job;
(b) Information that is generally available to employees in the workplace; and
(c) Consult with the employee making the request in determining the suitability of
an accessible format or communication support.
Individual Accommodation Plan
The Municipality of Kincardine shall have in place a written process for the
development of a documented Individual Accommodation Plan for employees with
a disability. Process to include:
(a) The employee's participation in the development of the Individual
Accommodation Plan.
(b) Assessment on an individual basis;
(c) Identification of accommodations to be provided;
(d) Timelines for the provision of accommodations;
(e) The Municipality of Kincardine may request an evaluation by outside medical
or other expert, at our expense,to assist with determining accommodation and
how to achieve accommodation;
(f) Employee may request the participation of a representative from their
bargaining agent, where represented, or otherwise a representative from the
workplace not from a bargaining agent;
(g) Steps taken to protect the privacy of the employee's personal information;
(h) Frequency with which the Individual Accommodation Plan will be reviewed and
updated and the manner in which it will be done;
(i) If denied, the reasons for denial are to be provide to the employee;
(j) A format that takes into account the employee's disability needs;
(k) If requested,any information regarding accessible formats and communication
supports provided;
(I) Identification of any other accommodation that is to be provided.
Return to Work
The Municipality of Kincardine will have in place a return to work process for
employees who have been absent from work due to a disability and require
disability-related accommodation in order to return to work. Such processes must
be documented and must outline the steps that the Municipality of Kincardine will
take to facilitate the return to work and include an Individual Accommodation Plan.
Performance Management, Career Development and Advancement and
Redeployment
The Municipality of-Kincardine will take into account the accommodation needs and
individual accommodation plans of employees when:
(a) Using performance management processes;
(b) Providing career development and advancement information;
(c) Using redeployment procedures.
Workplace Emergency Response Information
The Municipality of Kincardine shall provide individualized workplace emergency
response information to employees who have a disability:
(a) If the disability is such that the individualized information is necessary and the
employer is aware of the need for accommodation due to the employee's
disability;
(b) If the employee who receives an individual workplace emergency response
information requires assistance, and with the employee's consent, the
Municipality of Kincardine shall provide the workplace emergency information
to the person designated by the Municipality of Kincardine to provide
assistance to the employee;
(c) As soon as practicable after becoming aware of the need for accommodation
due to the employee's disability;
(d) Review the individualized workplace emergency response information when
the employee moves to a different location in the organization, when overall
accommodations needs or plans are reviewed and when the employer reviews
its general emergency response policies.
Transportation Standards
The Transportation Standard will make it easier for people to travel in Ontario,
including persons with disabilities, older Ontarians and families travelling with
children in strollers. The Municipality of Kincardine will:
(a) Ensure taxicabs do not charge a higher fare or additional fee to persons with
disabilities;
(b) Ensure taxicabs do not charge a fee for mobility assistive devices;
(c) Ensure taxicabs have appropriate information displayed on the rear bumper
and business cards available in an accessible format;
Ensure contracted Specialized Transportation Service Providers are aware of their
obligations to comply with the Accessibility for Ontarians with Disabilities Act, 2005 and
its Regulations.
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OCCUPATIONAL
II HEALTH and
lki SAFETY
1
Approved by the Municipality of Kincardine
Health and Safety Committee
Prepared by the Municipality of Kincardine
Health and Safety Coordinator
Adopted by the Council of the
Municipality of Kincardine
April 11, 2018
40 (Repeals and supersedes all other Health and
Safety Policies and By-laws)
TABLE OF CONTENTS
Policies Page Number
Definitions 3
MKHS 1 Health and Safety Policy 5
MKHS 2 Individual Responsibilities 7
MKHS 3 Committees 13
MKHS 4 Workplace Inspections 17
MKHS 5 Worker Accident/Incident Reporting Guidelines 19
MKHS 6 WSIB Reporting 23
MKHS 7 Modified Work 25
MKHS 8 Refusal to Work 30
MKHS 9 Health and Safety Training 33
MKHS 10 Hazardous Conditions Reporting 36
MKHS 11 Standard Operating Guidelines 38
MKHS 12 Discipline Policy 43
Guidelines
MKHS 2.1 General Safety Rules 44
MKHS 2.2 Personal Protective Equipment 46
MKHS 2.3 Lockout/Tag out 49
MKHS 2.4 Confined Space 50
MKHS 2.5 Trenching 64
MKHS 2.6 Emergency Guidelines 67
MKHS 2.7 Hearing Protection 70
MKHS 2.8 Fall Protection 72
MKHS 2.9 Traffic Protection 78
Forms
MKHS 001 Health and Safety Information Request Form 81
MKHS 002 Health and Safety Recommendation Form 82
MKHS 003 Workplace Inspection Checklist 83
MKHS 004 Workplace Inspection Reporting Form 88
MKHS 005 Accident/Incident Reporting Guidelines Chart 89
MKHS 006 IAPA First Aid Report Log 90
MKHS 007 Accident/Incident Investigation Report Form 91
MKHS 008 Worker Accident Corrective Action Memo 95
MKHS 009 Modified Work Progress Chart 96
MKHS 010 Unsafe Work Refusal Form 98
MKHS 011 Confined Space and Atmospheric Assessment Permit 99
MKHS 012 Physical Demands Analysis Form 101
MKHS 013 New Worker Site/Safety Orientation Checklist 102
MKHS 014 Site Safety Meeting Form 103
Municipality of Kincardine Occupational Health&Safety Manual Page 2 of 103
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 burns to a major portion of the body; or
g) causes the loss of sight in an eye.
"Employer" (Municipality of Kincardine) 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.
Municipality of Kincardine Occupational Health&Safety Manual Page 3 of 103
"Management" for the purposes of this document shall refer to those persons who exercise
managerial functions for the employer and, to the extent possible, who do so at the
workplace.
"Occupational Health and Safety Act" means the most current published version (green
book) of the Ontario Occupational Health and Safety Act R.S.O. 1990, c. 0.1., including all
associated regulations. This shall include regulations for "Industrial Establishments" and
"Construction Projects".
"Owner" includes a trustee, receiver, mortgagee in possession, tenant, lessee, 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 Occupational Health
and Safety Act.
"Regulation" means the regulations made under the Ontario Occupational Health and Safety
Act.
"Supervisor" means a person who has charge of a workplace or authority over a worker.
"Worker" means a person who performs work or supplies services for monetary
compensation.
"Workplace" means any land, premises, location or thing at, upon, in or near which a worker
works.
Municipality of Kincardine Occupational Health& Safety Manual Page 4 of 103
MUNICIPALITY of KINCARDINE Policy No.: MKHS 1
Description: HEALTH AND SAFETY POLICY
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
The employer and senior management of The Municipality of Kincardine are vitally
interested in the health and safety of its workers. Protection of workers from injury or
occupational disease is a major continuing objective.
The Municipality of Kincardine will make every effort to provide a safe, healthy work
environment. All employers, 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. As Chief Administrative Officer, of The Municipality of Kincardine I
give you my personal commitment that I will comply with my duties under the Act, such
as taking every reasonable precaution for the protection of workers in the workplace.
Supervisors will be held accountable for the health and safety of workers under their
supervision. Supervisors are subject to various duties in the workplace, including the
duty to ensure that machinery and equipment are safe and that workers work in
compliance with established safe work practices and procedures.
Every worker must protect his or her own health and safety by working in compliance
with the law and with safe work practices and procedures established by the employer.
Workers will receive information, training and competent supervision in their specific
work tasks to protect their health and safety.
It is in the best interest of all parties to consider health and safety in every activity.
Commitment to health and safety must form an integral part of this organization, from
the president to the workers.
Chief Administrative Officer Dated
Municipality of Kincardine Occupational Health& Safety Manual Page 5 of 103
Municipality of Kincardine Occupational Health&Safety Manual Page 6 of 103
MUNICIPALITY OF KINCARDINE Policy No.: MKHS 2
Description: INDIVIDUAL RESPONSIBILITIES
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To provide a guideline which outlines the health and safety responsibilities of various
individuals.
2. RESPONSIBILITY:
A. The Municipality of Kincardine, in its capacity as the employer, is responsible for
carrying out the responsibilities and duties outlined through the delegation of these
functions to individuals 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 to carry out assigned
duties.
2. Responsibility and authority can be delegated to subordinates, giving them
the right to act for their supervisors.
3. The supervisor remains accountable for seeing that these responsibilities are
carried out.
4. "Prescribed" refers to a section of the Occupational Health and Safety Act
and Regulations for Industrial Establishments, Construction Projects, etc.
5. "Municipality" refers to the Municipality of Kincardine.
B. Municipality:
1. The Municipality is to ensure that:
a) Equipment, materials and protective devices as prescribed are provided.
b) Equipment, materials and protective devices are maintained in good
condition.
c) Prescribed measures and Guidelines are carried out.
d) Equipment, materials and protective devices are used as prescribed.
e) All areas of the workplace are capable of supporting all loads to which
they may be subjected without causing the materials therein to be
stressed beyond the allowable unit stresses established under The
Building Code Act.
Municipality of Kincardine Occupational Health&Safety Manual Page 7 of 103
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-operation 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.
o) 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.
Municipality of Kincardine Occupational Health&Safety Manual Page 8 of 103
C. Management:
1. This level of the organization includes the Chief Administrative Officer and
Senior Managers.
2. The health and safety responsibilities attached to this level include the
following:
a) Oversee the working environment is maintained in a healthy and safe
condition.
b) Establish and maintain a written health and safety program, with
objectives and standards consistent with applicable legislation as a
minimum.
c) Provide ongoing safety education, including but not restricted to
W.H.M.I.S. and First Aid.
d) Provide standard operating Guidelines that include safe work practices.
e) Evaluate the health and safety performance of subordinates and
divisions.
f) Provide first aid facilities as required.
g) Ensure that personal protective equipment, where required, is provided
and used.
h) Investigate and report accidents/cases of occupational disease to
appropriate authority.
D. Supervisors:
1. This level of the organization includes all those individuals who supervise the
work of other workers, from the Supervisor, up to and could include the CAO
and Senior Managers.
2. The health and safety responsibilities of persons at this level are to:
a) Ensure the occupational health and safety of the workers within their
respective area
b) Be familiar with the applicable requirements of the Occupational Health
and Safety Act and the Regulations, and ensure compliance
c) Understand and enforce the Health and Safety Policies and Guidelines
of the Municipality of Kincardine
d) Ensure that workers wear the appropriate personal protective equipment
e) Advise each worker of the existence of any potential or actual danger to
the health and safety of the worker, of which the supervisor is aware
f) Investigate and determine the causes of all accidents and injuries and
initiate or recommend corrective action
g) Take every precaution reasonable in the circumstance for the protection
of a worker
Municipality of Kincardine Occupational Health&Safety Manual Page 9 of 103
h) Ensure that workers receive proper training and instructions 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 workers 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 responsibilities 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. Workers 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 Personnel Tripartite Agreement).
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 workers 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.
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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 minimize the Municipality's
liability in the event of an injury to a contractor.
Before Awarding a Contract:
a) The contractor is to show proof of current registration and proof of good
standing with the Workplace Safety Insurance Board by providing a
W.S.I.B. Independent Operator Status to the Senior Manager
contracting the service. Contractors are to provide proof of good
standing with the W.S.I.B.
b) A list of all designated substances present at a project site must be
included as part of any tendering information. The Municipality must
ensure that any prospective contractors or sub-contractors have a copy
of the designated substance list before any binding 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 Manager contracting the
service.
e) A copy of the Municipality of Kincardine Occupational Health and Safety
Manual is to be made available by the Senior Manager contracting the
service to the successful contract 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 stop the contractor's
work without penalty to the Municipality if the contractor does not comply
with the Occupational Health and Safety Act, the Health and Safety
Policies and Guidelines of the Municipality, or creates an unacceptable
health and safety hazard.
g) In the event paragraph 4(f) is to be exercised, it shall be exercised by
any of the Municipality's supervisors or designate(s).
Before Work Begins:
a) The Senior Manager contracting the service is to advise the contractor
and its workers of any special hazards, and advise of emergency
guidelines (MKHS 2.6)
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b) The contractor's workers are to have all necessary personal protective
equipment for the work location. Workers not in compliance are to be
ordered off the site until they comply.
c) The contractor is to provide the Municipality's work site supervisory staff,
or designate, with material safety data sheets (SDS) for each chemical
substance to be used on the site.
d) Contractors are to meet with the Municipality's work site supervisory
staff, or designate, prior to commencement of work, to be informed
g
about the location's specific safety rules and safety 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
p
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 workers.
4. In the event that a visitor is required to enter a work area that is normally
restricted to workers:
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 worker.
b) The visitor will use any and all required personal protective equipment.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 3
Description: COMMITTEES
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To develop terms of reference for the Health and Safety Representatives/Committees to
ensure compliance under the Occupational Health and Safety Act.
2. RESPONSIBILITY:
A. The Senior Managers and workplace supervisors are responsible for ensuring that
a Health & Safety Representative/Committee is established and maintained.
B. The Health & Safety Representative/Committee is responsible for ensuring the
proper application of this policy.
3. POLICY:
A. Composition:
1. Below lists the minimum legal requirements (as per Occupational Health and
Safety Act) for determining the correct health and safety representation for
the total number of workers (full-time and part-time at a workplace)
1 Representative more than 5 workers, but less than 20
2 Committee Members 20 or more workers, but less than 50
4 Committee Members 50 or more workers
2. At least 50% of the members must be non-management workers.
3. The worker members must be selected by the workers they 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 (managers).
5. The members will fill this role for a minimum 1-year term of office.
6. Where there are more than 2 members and the term of office is longer than 1
year, an attempt will be made to have overlapping terms of office, so that
continuity can be maintained.
7. The names and work location of all HEALTH AND SAFETY members must
be posted.
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8. At least 6 members of the HEALTH AND SAFETY Committee must be
certified, 4 representing the workers and 2 representing management. If
possible, all committee members will be certified within the first 6 months of
being on the committee. (Terms of Reference for multi-site JHSC)
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. Meetings and Minutes:
1. Committee members may meet as required and as a minimum shall meet
once every 2 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 and co-ordinator 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, for attendance
records only, not to be posted with the minutes
c) an item-by-item record of all items discussed, and the outcome, i.e.:
(1) reports presented and by whom
(2) problems identified
(3) agreed upon recommendations
(4) any action to be taken by individual members
(5) any business the committee has agreed to discuss at the next
meeting
(6) date, time and location of the next meeting
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6. Minutes are to be signed by the co-chairpersons and circulated within 2
weeks, with one copy:
a) posted at each workplace, for a minimum of 2 months
b) forwarded to each Joint HEALTH AND SAFETY Member
c) forwarded to the area supervisor
d) distributed to senior management who normally review committee
recommendations
e) maintenance, personnel, medical or safety department (where
appropriate)
C. General Duties for Committees:
1. Follow the guidelines outlined in the Occupational Health & Safety Act and A
Guide for Joint Health and Safety Committees and Representatives in the
Workplace by the Ministry of Labour.
2. Develop publish and post, at the beginning of each calendar year, a schedule
for the monthly HEALTH AND SAFETY workplace inspections for the year.
3. Workplace inspections will be conducted monthly, by trained, appointed
members, and all substandard acts and working conditions will be
documented on "WORKPLACE HAZARDS REPORT" (MKHS 004), with one
copy:
a) forwarded to the Joint HEALTH AND SAFETY Committee
b) forwarded to the area supervisor and/or Senior Manager for review
4. Review all completed worker "ACCIDENT/INCIDENT INVESTIGATION
REPORT" Form (MKHS 007), analyse information and make
recommendations to management to reduce recurrences.
5. Designate a certified worker member(s) to investigate any accident in which a
person is killed or critically injured (as per Occupational Health and Safety Act
definition)
6. Obtain information regarding:
a) hazardous materials, processes or equipment;
b) designated substances and the respective control-program reports;
c) workplace testing that is being carried out for health and safety
purposes.
7. Receive and respond to any "HEALTH & SAFETY INFORMATION
REQUEST" (MKHS 001)
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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 workers to work safely and to report hazardous or unsafe
conditions immediately to their supervisors.
10. Identify areas of health and safety training for all workers.
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.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 4
Description: WORKPLACE INSPECTIONS
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To assess the quality of workplace conditions, equipment and methods, the success of
or need for safety program initiatives, and the quality and adequacy of controls for
hazards in the workplace.
2. RESPONSIBILITY:
The Health & Safety Committee is responsible for ensuring the proper application of this
policy. Management shall be responsible for ensuring monthly workplace inspections
are completed.
3. POLICY:
A. General:
1. Workplace inspections will be conducted on a monthly basis.
2. If it is not practical to inspect the entire workplace once per month, then a
monthly inspection of part of the workplace shall be conducted, with the entire
workplace being reviewed throughout the course of the year.
3. Inspections should be conducted prior to the Health & Safety meeting,
preferably one week in advance, so that the entire committee can discuss the
observations and recommendations.
4. A schedule of workplace annual inspections for the year is to be developed,
published and posted on the Health & Safety Boards.
5. Annual inspections of Municipal workplaces will be conducted by the two
worker representative or committee members.
B. Inspection:
1. The "Workplace Inspection Checklist" (MKHS 003) will be used as a guide,
and all observed unsatisfactory conditions will be recorded on it. The
information on MKHS 003 is transferred 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.
2. The Health and Safety Committee member will record any suggestions in the
'Recommended Actions' section (MKHS 002) and assign responsibility for
correction to the Manager.
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3. Copies of the "WORKPLACE INSPECTION CHECKLIST"(MKHS 003) will be:
a) reviewed by the JHSC Committee.
b) posted on the Health and Safety section of the bulletin board
c) forwarded to the supervisor and Senior Manager
d) forwarded to the Health and Safety Coordinator for central recording and
filing.
C. Analysis and Follow-up:
1. The manager or supervisor is responsible for reviewing the Workplace
Inspections and initiating the appropriate corrective action for each
discrepancy in his/her area, in order of its priority.
2. The "WORKPLACE INSPECTION REPORTING FORM" (MKHS 004) shall be
reviewed and responded to by the manager or 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.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 5
Description: WORKER ACCIDENT/INCIDENT REPORTING
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To provide a Policy where all accidents and incidents, resulting in injury, occupational
illness and/or property damage, can be investigated to prevent recurrence.
Any accident, incident or "near miss," no matter how slight the injury or damage, should
be reported to the supervisor as soon as possible. The supervisor is responsible for
taking appropriate follow-up action, including directing medical attention, completing an
investigation report and recommending or implementing appropriate corrective actions.
The supervisor must complete accident investigation forms and return them promptly to
the Human Resources Manager and Health and Safety Coordinator.
2. RESPONSIBILITY:
A. Workers are required to report all accidents/incidents/near miss to their immediate
supervisor.
B. The supervisor is responsible for investigating, reporting and corrective action
follow-up of all accidents/incidents/near miss.
3. POLICY:
A. General:
1. All injuries, occupational illnesses, property damage, and incidents must be
reported to the supervisor.
2. Immediately after an accident/incident, the supervisor shall ensure the safety
of workers, public, equipment, and facilities from further injury or damage and
follow the steps outlined in this Guideline.
2. There are four categories of injuries:
a) No Treatment
b) First Aid
c) Medical Aid
d) Critical
B. No Treatment Injury:
1. 'No Treatment Injury' occurs when there is an injury that does not require any
treatment (e.g. bruises)
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2. The worker will report the injury to the supervisor.
3. The supervisor will record the injury in the First 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 First Aid
Report Log.
3. The worker is to report the injury to the supervisor.
D. Medical Aid Injury:
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 worker and record the treatment in the
First Aid Report Log.
b) Transportation (e.g. private vehicle, taxi, ambulance, etc.) of the worker
to a location where professional health care can be delivered (e.g.
doctor's office, hospital).
3. The Health and Safety Coordinator and the Human Resources Department
shall be notified.
4. The supervisor will conduct an investigation as soon as possible.
See Policy MKHS 4 "Accident/Incident Reporting," Section F
E. Critical Injury:
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 burns to a major portion of the body; or
g) causes the loss of sight in an eye
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2. The health and welfare of the worker is paramount. The first priority is to
contact emergency services or arrange transportation for medical care.
3. The supervisor will:
a) ensure transportation (e.g. private vehicle, taxi, ambulance, etc.) of the
worker to a location where professional health care can be delivered
(e.g. doctor's office, hospital).
b) secure the scene for investigation.
c) immediately notify the Senior Manager, the Health and Safety
Coordinator, and the Human Resources Department
d) the Senior Manager and the Health and Safety Coordinator will assist,
when necessary, with notification of the Ministry of Labour.
4. First aid treatment for the injured worker and record the treatment in the First
Aid Report Log.
5. Human Resources will assist with completion of WSIB and health-related
documentation for the worker.
6. The supervisor will conduct an investigation as soon as possible, following
the notification of the accident/incident. See Policy MKHS 4, Section F
F. Accident/Incident Reporting:
1. Investigations will be conducted by the Supervisor and the Health & Safety
Coordinator, with the optional assistance of a member of the Joint Health &
Safety Committee (NOTE: for items with an *, assistance from a member of
the Joint Health & Safety Committee is compulsory), and the findings
documented in the Accident Investigation Report whenever any of the
followings occur:
a) medical aid
b) critical injury*
c) fatality*
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 the accident scene where practical and possible
b) identify witnesses or others having knowledge of the accident/incident
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c) interview the injured worker where practical and possible
d) identify any primary/secondary causes
e) identify any primary/secondary unsafe actions
f) identify any primary/secondary hazardous conditions
g) document the accident scene with photographs if possible
3. Investigations are required to be completed within 24 hours of the incident or
request.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 6
Description: WSIB REPORTING
Effective Date: May 2006 Revised/reviewed: December 2015
1. PURPOSE:
To provide a Policy which outlines the reporting requirements for all compensable
injuries.
2. RESPONSIBILITY:
A. If you are injured or ill because of work, your first priority is to seek proper medical
attention.
B. Workers are required to report all accidents/incidents to a designated individual,
normally the supervisor on duty, and to keep him/her advised of their work status.
C. Your employer or supervisor needs to know about your injury or illness to provide
help, fulfill their employer responsibilities under the Workplace Safety and
Insurance Act, and take measures to prevent further incidents. Report the incident
to your supervisor immediately.
D. For any compensable accidents, the worker and the designated individual are
responsible for completing the required portions of the Accident Investigation
Report and forwarding them to the Human Resources Manager and Health &
Safety Coordinator. The worker's Supervisor is also responsible for co-ordinating
the worker's return to work in conjunction with the HR Dept. and the worker, in
accordance with the physician's recommendations.
E. The Human Resources Manager, or an authorized designate, is responsible for
completing and forwarding the claim to the Workplace Safety Insurance Board
(WSIB).
F. 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 incident, the Supervisor will forward a copy
of the completed Accident Investigation Report to the Human Resources
Manager and Health & Safety Coordinator or designates.
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2. The Human Resources Manager (or authorized designate) must report the
injury to WSIB within 3 days if it involves:
a) Health care treatment, or
b) Time away from work, or
c) Lost wages
The Human Resources Manager will complete WSIB Form 7, and forward to
WSIB within the 72-hour deadline.
As required the Human Resources Manager will forward other documentation
to WSIB as required (e.g. modified hours and earnings).
3. The Worker will:
a) Complete a WSIB Form 6, which is a requirement by WSIB.
b) If required, the worker may be requested to have a "Functional Abilities
Form for a Timely Return to Work" completed by a Physician and sent to
the Human Resources Manager.
B. Subsequent to Filing the Initial Claim:
1. When a worker is authorized by the treating health care professional, they
may return to work on either:
a) Full Duties, or
b) Modified Duties (if modified duties can be accommodated).
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 7
Description: MODIFIED WORK
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To provide a fair and consistent policy for the rehabilitation of workers who have been
injured on the job, the Municipality recognizes the benefits of a formal rehabilitation
program and will undertake to provide meaningful employment for both permanently and
temporarily disabled workers.
2. OBJECTIVES:
A. The objectives of the Early and Safe Return to Work (ESRTVV) program are:
1. To achieve ESRTW with the provision of suitable work which meets the
following guidelines:
a) the worker has the skills for, or can be trained to do this work.
b) the work is within the worker's physical abilities.
2. To shorten periods of disability, and lost time.
3. To provide modified work for the worker which is both safe and productive.
4. To assist workers 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 worker'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 worker
who is unable to perform his normal 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.
4. POLICY:
A. General:
1. Modified work is any job, task, function or combination thereof that a worker,
who suffers from a diminished capacity, may perform safely without risk of re-
injury.
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2. The work must be productive and the result of the work must have value.
3. The program must be seen as temporary, generally not to exceed 8-12 weeks
in duration, and is intended to assist the worker in gradually returning to
his/her regular pre-injury duties.
4. Every Senior Manager will try to accommodate any worker unable to perform
their regular duties.
5. Where the worker's "Senior Manager" is unable to provide a suitable work
assignment, an attempt will be made to place the worker in another
department within the Municipality. This process will be co-ordinated by the
Human Resources Department.
B. Responsibilities:
1. The duties of the workplace supervisor are to:
a) Meet with the worker to set program goals and objectives.
b) Determine if outside professionals are needed (e.g. Ergonomics
Specialist).
c) Establish individual programs for workers, with the help of other
professionals, if required.
d) Ensure there is no conflict with the Tripartite Personnel Agreement.
e) Organize the placement of injured workers in modified jobs.
f) Meet with the worker on the first day back and facilitate the return to
work.
g) Arrange meetings with the worker, as required, to monitor the status of
worker and discuss strategies for future development of the program.
h) Educate workers about the modified work program, safety practices and
the WSIB.
2. With the assistance of the Human Resources Department, the supervisor will:
a) Develop an individual program for the worker and keep him actively
involved in the rehabilitation plan by setting goals, 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.
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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. Following an Injury:
1. For an injury requiring treatment by a health care professional, depending on
the nature/severity of the injury, the worker will be given a "Functional Abilities
Form 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 form to
tailor a program specifically to the worker's abilities.
3. Whenever requested by the Municipality throughout the duration of the claim,
the worker will have an Appendix 2 completed by the attending regulated
health care professional.
4. Regular contact between the worker and the supervisor is to be maintained
throughout the worker's recovery period, with progress meetings held at a
minimum suggested frequency of once every two weeks, and preferably
following the worker'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 worker's progress shall be jointly
reviewed.
D. Modified Work Implementation:
1. When the health care professional indicates that the worker is available for
modified duties, the supervisor and the worker will meet to discuss what work
options are available, those being, in order of priority:
a) A modified pre-injury job
b) An alternate job
c) Another suitable job
2. A "Physical Demands Analysis" (MKHS 012) should be completed by the
supervisor to identify what activities need to be performed in carrying out the
job assignment and to match these with any identified restrictions.
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3. It may be necessary to modify the pre-injury job on a temporary or permanent
basis, to accommodate the worker's physical restrictions. This may include,
but not be limited to:
a) Regular job/tasks may be changed, redesigned or physically 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 difficult tasks.
4. If the pre-injury job cannot be modified to accommodate the injured worker's
needs, alternate jobs may be considered.
5. An alternate job is one that involves work that is approximately the same pay
grid within the organization, looking first at the "home" department, and then
all outside departments.
6. When looking at alternate jobs, consideration should be given to:
a) The worker's previous work history
b) Transferable skills
7. When neither the pre-injury job nor an alternate job is appropriate, other
suitable jobs should be considered.
8. Other suitable jobs are defined as those jobs within the capacity of the worker
and which pose no health or safety risks to him/her, but may be quite different
from the pre-accident job.
E. Program Monitoring:
1. The injured worker should be monitored closely while on a modified work
program, with any difficulties he/she has being reported and evaluated by
his/her workplace supervisors.
2. The information provided on the Appendix 1 (Form 7) will be used to place
the worker in a modified work program within the capabilities 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
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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 performed by the supervisor and the worker. Applicable
recommendations for improvements made as a result of the review should be
documented.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 8
Description: REFUSAL TO WORK
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To create a Policy outlining the steps to be followed when any worker refuses to work
due to unsafe work conditions as defined in the Occupational Health and Safety Act.
2. RESPONSIBILITY:
A. The worker is responsible for immediately informing the supervisor of any unsafe
work conditions.
B. The supervisor is responsible for investigating any reports of unsafe work
conditions and resolving the concern, as defined by this Guideline.
3. POLICY:
A. Right to Refuse Work:
1. A worker 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 worker.
b) The physical condition of the workplace is likely to endanger
himself/herself.
c) Workplace violence is likely to endanger himself or herself.
d) Any equipment he/she is to use, or the physical condition of the
workplace, is in contravention of the Occupational Health and Safety
Act, and such contravention is likely to endanger himself/herself or
another worker.
2. The following workers of the Municipality of Kincardine are limited in their right
to refuse work:
a) A person employed in the operation of:
(1) A first aid clinic or station, Emergency Services Personnel; and
(2) A laundry, food service, power plant or technical service, or facility
used in conjunction with an institution, facility or service referred to
in sub clauses (1) or (2) above.
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B. Upon Refusing to Work:
1. The worker 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 the action can be taken to resolve the complaint without the 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
worker 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) Worker
c) Health and Safety Coordinator
d) A Joint Health and Safety Committee Certified Member
7. The Inspector shall decide whether the equipment or the workplace is likely to
endanger the worker or another person and give his decision, in writing, as
soon as practicable.
8. Pending the investigation and decision of the Inspector, the worker shall
remain in a safe place near his work station during his/her normal working
hours, unless the employer assigns the worker reasonable alternative work
during such hours.
9. Pending the investigation and decision of the Inspector, no worker shall be
assigned to use the equipment/machine/device, or to work in the workplace
that is being investigated, unless the worker to be assigned has been advised
of the work refusal and the reasons for it.
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C. Refusal to Work Flow Chart
WORKER SUPERVISOR AGREEMENT
Promptly reports Investigates forthwith in the
circumstances to presence of the HEALTH AND
supervisor and remains SAFETY Coordinator, or
in a safe place another worker
1 RETURN TO
WORK
DISAGREEMENT
Worker continues to refuse
1
WORKER Another worker may be
Remains in a safe EMPLOYER OR WORKER assigned to operate the
location pending t— Notifies the Ministry of Labour 4-- equipment/machine/device
investigation pending the Investigation,
1 only if they have been
informed of the refusal in
1the presence of the
INSPECTOR HEALTH AND SAFETY
WORKER Investigates report in the Coordinator or Worker
May be assigned presence of worker, employer, Representative
reasonable alternate HEALTH AND SAFETY
work Coordinator.
1
INSPECTOR EQUIPMENT/AREA IS
Gives decision in writing DEEMED SAFE
1 Ir
EQUIPMENT/AREA IS RETURN TO
DEEMED UNSAFE WORK
1
CORRECTIVE ACTION RETURN TO
TAKEN WORK
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 9
Description: HEALTH AND SAFETY TRAINING
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To develop a policy to ensure all workers receive the proper orientation and ongoing
training, necessary for maintaining a safe work environment.
2. RESPONSIBILITY:
A. The supervisor is responsible for ensuring the worker 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
workers.
2. All new workers 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) MKHS 1 RESPONSIBILITIES
b) MKHS 5 WORKER ACCIDENT/INCIDENT REPORTING
GUIDELINES
c) MKHS 8 REFUSAL TO WORK
d) MKHS 9 HEALTH and SAFETY TRAINING
e) MKHS 10 HAZARDOUS CONDITIONS REPORTING
f) MKHS 2.1 GENERAL SAFETY RULES
g) MKHS 2.2 PERSONAL PROTECTIVE EQUIPMENT
h) MKHS 2.6 EMERGENCY GUIDELINES
4. All workers will be shown proper safety guidelines specific to their job by their
supervisor.
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B. WHMIS:
1. Workers, who work with or in proximity to any hazardous materials, shall
receive WHMIS training, including information on the hazardous materials
used in the workplace, their labelling, storage and use, and any health
hazards they may present.
2. The instructions and training shall be developed and implemented by the
Municipality, in consultation with the Health & Safety Committee, and such
training and the workers' familiarity with the information will be reviewed
annually.
3. An MSDS (Material Safety Data Sheet) book will be kept at a location
accessible to all workers (e.g. First Aid Station) for reference.
C. First Aid:
1. A minimum of two people per shift per workplace will be trained in an
approved First Aid course, when the number of workers on shift is greater
than five.
2. The Municipality will sponsor retraining, as required, in order to
maintain compliance with the Workplace Safety & Insurance Board Act.
D. Personal Protective Equipment:
1. All new workers will be provided with personal protective equipment, as
required for the different work applications.
2. Workers will be instructed by their supervisor in the use and care of their
personal protective equipment on an annual basis.
E. Fire Alarms And Extinguishers:
1. All new workers will be shown the location of the fire alarms and
extinguishers.
2. Designated workers for each workplace will be instructed in the proper use of
the fire extinguishers on an annual basis.
F. Emergency Guidelines:
1. All workers will be instructed in MKHS Guideline 2.6
2. A copy of the "Emergency Exits Floor Plan" will be posted on the Health and
Safety Bulletin Board of all municipal buildings where workers work.
3. An evacuation drill shall be performed annually in all municipal buildings
where permanent staff regularly report to work.
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G. Training Program:
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. Workers 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 workers to
develop skills and knowledge. There shall be a planned schedule of training
posted in the workplace and supervisors 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 Space and Lock-Out:
1. A competent worker shall be instructed on MKHS Guideline 2.4 CONFINED
SPACE and MKHS Guideline 2.3 LOCK-OUT when applicable to their
specific workplace duties.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 10
Description: HAZARDOUS CONDITION REPORTING
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To identify the steps to be taken for reporting hazardous conditions that may arise in the
workplace.
2. RESPONSIBILITY:
A. All workers are responsible for reporting to their supervisor any hazardous
conditions that may exist in the workplace.
B. The workplace supervisor is responsible for responding to the worker's concern
and ensuring that the hazardous condition is resolved and the workers are
protected.
3. POLICY:
A. General:
1. A worker shall report to his or her supervisor:
a) the absence of or defect in any equipment or protective device of which
he or she is aware and which may endanger himself or herself or
another worker;
b) any contravention of the Occupational Health & Safety Act or the
regulations, or the Municipality of Kincardine Health & Safety Policies
and Guidelines; and
c) the existence of any hazard of which he or she knows.
2. The supervisor will attempt to resolve the concern, as soon as possible, and
keep the involved worker apprised of the status of the concern.
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 worker's concern is not satisfactorily resolved after a reasonable period
of time (not to exceed five [5] working days), the worker is encouraged to
bring the concern to the attention of a member of the Joint Health & Safety
Committee or the Health and Safety Coordinator.
5. The worker will be asked to document the concern on a "HEALTH & SAFETY
INFORMATION REQUEST" (Form MKHS001), outlining the facts and the
information requested.
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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 worker's supervisor are
responsible for ensuring the worker 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 worker 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.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 11
Description: STANDARD OPERATING GUIDELINES
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To provide a system for developing Standard Operating Guidelines for the operation of
equipment and performance of specific tasks.
2. RESPONSIBILITY:
The workplace supervisor is responsible for ensuring that Standard Operating
Guidelines are written for each critical piece of equipment in the workplace and the
workers who operate the equipment are trained in these Guidelines.
3. POLICY:
A. General:
1. Each workplace will review the various equipment used at the facility and
from this, will develop a list of critical equipment (e.g. Tractor, chipper, dump
truck, fire truck etc.)
2. A Standard Operating Guideline will be developed for each of these critical
pieces of equipment.
3. All workers that operate a piece of critical equipment will be trained in its
Standard Operating Guideline.
B. Standard Operating Guidelines 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) Specific machine requirements (e.g. Temperature/humidity
requirements).
b) Materials:
(1) List of materials that are consumed in the operation of the
equipment (e.g. Compressed air, gasoline).
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c) Pre-Start Up Inspection Checklist:
(1) 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.
(2) The checklist will identify:
i. the frequency of inspection (e.g. daily, weekly, seasonally, etc)
ii. what items are to be checked
iii. what remedial action is taken when a problem is identified
iv. the operator who performs the checklist and the date it is
performed.
(3) The checklist items may include such items as:
i. all guards are in place
ii. all manufacturer's safety features are intact and operational
iii. there is no excessive wear
iv. everything is fastened together properly—nothing is broken
v. all mounts are secured
vi. gauges for such things as pressure and temperature are
functioning and within safe ranges
vii. start-up of equipment will not endanger any worker.
d) Safety Precautions:
(1) List the precautions that the worker should take while running the
equipment, or working in the area, in order to prevent injury to
himself or to others.
(2) Include information concerning potential dangers of which the
worker should be aware.
(3) Some of the areas of concern which may be identified are:
i. electrical grounding
ii. high voltage
iii. radiation
iv. danger of burns from hot or very cold items
v. extreme heat
vi. flying sparks
vii. explosive materials
viii. hot liquids
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ix. toxic fumes
x. flammable fumes or liquids
xi. dangerous moving parts of machinery
xii. equipment shields
xiii. oil on floor
xiv. pits or holes to avoid
xv. pinch points
(4) Information about what to do in emergency situations (e.g. location
of first aid station, emergency stopping, etc.) may also be included
in this section.
e) Personal Protective Equipment (PPE):
(1) This section should list all the personal protective equipment that
must be worn while operating the specific equipment and may
include items such as:
i. head protection (hard hat, sun exposure)
ii. eye protection (safety glasses, face shield)
iii. hearing protection (at no time shall any headphones,
earphones or other music producing earpiece be used by any
worker unless permission has been obtained from the workers
immediate supervisor)
iv. respiratory equipment (filters, scba)
v. protective clothing and gloves (long pants/shirt if so directed by
workers immediate supervisor)
vi. foot protection (as per occupational health and safety act)
f) Preventive Maintenance and Critical Spare Parts:
(1) This section will document preventive maintenance that is to be
performed on equipment.
(2) A checklist of items, specific to each piece of equipment, will be
used to ensure completeness and may parallel the type of list
typically found in an owner's manual.
(3) The required qualifications of the inspector/tester (e.g. Automotive
Mechanic, Electrician, etc.) are to be identified in this section of the
Guideline.
(4) A maintenance checklist will identify:
i. the frequency of the preventative maintenance (daily, weekly,
seasonally, annually etc)
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ii. what items are to be checked
iii. what standards are to be met
iv. the results observed
v. the remedial action to be taken when a problem/deviation is
identified
vi. the operator who completes the checklist and the date it is
performed.
(5) 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:
i. the condition/signal which triggers the maintenance
ii. what activity is to be performed
iii. the action taken
(6) 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:
(1) 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.
(2) Illustrations should be provided, where appropriate, to compliment
the written instructions.
h) Shutdown:
(1) This section should explain the steps to follow for three (3) types of
shutdown situations:
i. emergency shutdown
ii. regular shutdown
iii. long-term (storage) shutdown
(2) Guidelines for each type of shutdown are to be listed in the
order that they are to be carried out.
(3) Shutdown includes both shutdown of equipment and clearing the
work area.
(4) Emptying containers or tanks of liquid, purging lines, etc. are to be
included in the shutdown processes.
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i) Illustrations:
(1) This section should include any prints, drawings, schematics or
illustrations that can further clarify the written Guidelines.
C. Audits:
1. The Standard Operating Guideline should be reviewed on a periodic basis,
and minimally once per year, to
a) ensure the guideline is being applied consistently
b) determine if the operator understands the guideline
c) allow for feedback and suggestions for improvements
2. If an accident occurs while using the equipment, the Standard Operating
Guideline should be reviewed by the Joint Health and Safety Committee, as
part of their accident investigation and analysis
3. If the accident is attributed to failure to follow the Standard Operating
Guideline:
a) the Supervisor should document this infraction and take necessary
action to enforce the guideline.
b) the Joint Health and Safety Committee should include an audit of the
specific Standard Operating Guideline on their subsequent Workplace
Inspections, to observe compliance.
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MUNICIPALITY OF KINCARDINE Policy No.: MKHS 12
Description: DISCIPLINE POLICY
Effective Date: May 2006 Revised/reviewed: September 2017
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 Manager 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 worker prior to instituting any
disciplinary measures.
Accordingly, if a worker is found to be working in a manner that is contrary to the
Occupational Health and Safety Act or 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 or 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 the Municipality of Kincardine Policy Manual, Policy No. GG.6.8 Progressive
Discipline for complete details.
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.1
Description: GENERAL SAFETY RULES
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To provide general guidelines for creating and maintaining a safe work environment.
2. RESPONSIBILITY:
A. The worker is responsible for following the safety rules.
B. The supervisor is responsible for ensuring the guideline is adhered to.
3. GUIDELINE:
A. General Rules:
1. Personal Protection Equipment must be worn when and where required.
2. Report ALL injuries to your supervisor immediately.
3. Report any unsafe conditions, including someone apparently under the
influence or in possession of drugs or alcohol, or any other hazard that may
result in an injury to yourself or a fellow worker.
4. Report any property damage, regardless of how minor.
5. Follow all operator instructions when using or handling hazardous materials
and ensure that all containers of hazardous materials are properly labeled
and stored in designated areas.
6. Obey all posted signs and notices.
7. Always use the correct posture when lifting, and get assistance if the weight is
excessive.
8. Be aware of the location of the Health and Safety bulletin board, the MSDS
Sheets and the posted Occupational Health and Safety Act.
B. Housekeeping:
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. Liquid spills are to be cleaned up immediately to prevent slips and falls.
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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. Equipment Operation:
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, jewellery, 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 turned off and the appropriate lock-out Guideline
(MKHS 2.3 LOCK-OUT) followed, prior to repairs, cleaning, adjustment or
lubrication.
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.2
Description: PERSONAL PROTECTIVE EQUIPMENT
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To provide a guideline that outlines what personal protection equipment is required to be
worn in the workplace.
2. RESPONSIBILITY:
A. The supervisor is responsible to ensure the necessary equipment is worn or used,
training the worker in its use and ensuring the guideline is adhered to.
B. The worker is responsible for the care and maintenance 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 line 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 associations (e.g. CSA, NIOSH,
NFPA etc.) will be used.
3. 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 the critical pieces of
equipment.
4. Training in the use and maintenance of PPE will be provided by the
Supervisor.
5. Records will be kept for the issue of non-disposable PPE.
6. The Joint Health & Safety Committee may audit compliance to this guideline
during their monthly inspections.
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B. Personal Protective Equipment:
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 worn in a reversed manner.
c) Other protective headgear may be assigned to protect individuals from
long- term exposure to the sun or elements.
2. Eye Protection:
a) 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:
(1) chipping;
(2) cutting;
(3) drilling;
(4) exposure to acids, alkali, or other corrosive chemicals;
(5) exposure to very dirty or dusty conditions;
(6) sandblasting;
(7) sawing;
(8) spray painting; and
(9) welding
(10) performing extrication or rescue
3. Hearing Protection:
a) Warning signs are to be posted at the approaches to an area, or on
equipment, where the sound level is more than eighty five (85) 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. Respiratory Equipment:
a) Suitable breathing apparatus shall be worn when workers are likely to
be exposed to injury from:
(1) dangerous gases, vapour, fumes or dust; and
(2) deficiency of oxygen.
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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 Clothing and Gloves:
a) A worker shall be outfitted with the appropriate apparel, where he or she
is exposed to the hazard of injury from contact of his/her skin:
(1) a noxious gas, liquid, fume or dust;
(2) a sharp or jagged object which may puncture, cut 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 care area).
b) Garment, usually a vest, covering the upper body and meeting the
Construction Projects Traffic Control Regulations 69.1, is required to be
worn by all workers involved in construction, maintenance and/or traffic
control while on the roadway.
6. Foot Protection:
a) Where a worker is exposed to the hazard of foot injury he or she shall
wear foot protection appropriate in the circumstances.
b) All workers shall wear green-patch, steel-toed boots or shoes with
puncture resistant soles at all workplaces.
c) Lace-type footwear must be fully laced to provide full support and
prevent accidents.
d) Firefighting boots shall be rated di-electric
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.3
Description: LOCK OUT /TAGOUT
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To create a guideline that ensures equipment is locked out/tagged out when under
repair or if determined to be unsafe, so as not to endanger any personnel.
2. RESPONSIBILITY:
A. The worker 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 single key, will be assigned to those workers who
perform repairs to equipment and/or are responsible for worker safety.
B. The padlock key is to remain in the possession of the assigned worker 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 worker 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 worker 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 worker going off shift is responsible
for ensuring that his/her lock is removed and that a lock from a worker on the
incoming shift replaces it
G. If a worker 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 worker 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 when the equipment is
operating, a "spotter" positioned at the "Emergency Stop Button" replaces the need
for a lock-out.
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.4
Description: CONFINED SPACE
Effective Date: May 2006 Revised/reviewed: May 2015
1. PURPOSE
A. To create a guideline whereby workers can work safely in a confined space.
B. To assure that the Occupational Health and Safety Act R.S.O. 1990, and
specifically Regulation 632/05 "Confined Spaces" is complied with.
C. To train workers 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 perform assigned duties in conformance to
established confined space entry guidelines.
D. To protect workers 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
A. This guideline applies to any person engaged by the Municipality having to enter a
confined space. This shall include management, supervisors, workers and
contractors.
B. 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 performing emergency 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.
3. DEFINITION
A. The Occupational Health and Safety Act R.S.O. 1990, 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 construction, location or
contents or because of work that is done in it;"
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The Occupational Health and Safety Act R.S.O. 1990, Regulation 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 18 per cent or more
than 23 per cent by volume, or
3. the accumulation of atmospheric contaminants, including gases, vapours,
fumes, dusts or mists, that could,
a) result in acute health effects that pose an immediate threat to life, or
b) interfere with a person's ability to escape unaided from a confined
space".
The Occupational Health and Safety Act R.S.O. 1990, Regulation 632/05 defines
"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 and water systems in the
Municipality of Kincardine (All manholes, wet and dry wells, valve chambers, tanks,
vats, sewers, pipes, ducts, flues, digesters, etc.) as well as any and all chlorine gas
storage areas and all other spaces as defined in 3 A.
C. The Municipality of Kincardine guidelines for entry into confined spaces are based
on the degree to which the possibility of a hazard exists considering the nature and
duration of the work to be performed, the adequacy of the ventilation system, and
the nature of the hazard present or likely to be present.
D. The entry into a confined space is represented by one of the four categories as
follows:
CATEGORY 1: a) A hazard does NOT exist in the confined space; and
b) There is NOT a likelihood of a hazard developing while any
person is in the confined space having regard to the
construction, location, nature and duration of the work to be
performed.
CATEGORY 2: In the confined space a hazardous atmosphere IS PRESENT or
IS LIKELY to be present having regard to the construction,
location, nature and duration of the work to be performed.
BUT the confined space can be ADEQUATELY VENTILATED to
eliminate the hazardous atmosphere or its likelihood.
CATEGORY 3: In the confined space a hazardous atmosphere IS PRESENT or
IS LIKELY to be present having regard to the construction,
location, nature and duration of the work to be performed.
AND the confined space CANNOT BE ADEQUATELY
VENTILATED.
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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.
A. 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 the worker shall consult
his/her supervisor before entering to perform work.
4. GUIDELINE:
A. Competent 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, a worker 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 R.S.O. 1990; 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
5. The Municipality of Kincardine shall ensure all staff working in a confined
space have training which shall include:
a) the Occupational Health and Safety Act (Industrial Establishments
Section 67 to 71 or Construction Projects, Section 60 to 63, and
Regulation 632/05 "Confined Spaces")
b) confined space characteristics and hazards
c) atmospheric sensing and detection equipment
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d) personal protective equipment
e) entry guideline
f) emergency and rescue guidelines
g) inspection and operation of personal protective, monitoring, ventilation,
and rescue equipment
h) First aid and CPR
i) Municipality of Kincardine Health and Safety Policies and Guidelines.
6. A competent person and entry worker shall not be permitted to have hair that
interferes with the seal or the operation of the exhalation valve of the
breathing apparatus. Such hair but not limited to includes beards,
moustaches, long bangs and sideburns.
7. It shall be the responsibility of the Senior Manager and the Supervisor to
ensure:
a) that a worker receives the training regarding Confined Space Entry and
Rescue and the Municipal Health and Safety Policies and Guidelines
are adhered to.
b) that an updated list of those workers certified as competent is kept.
c) that competent workers receive `refresher' instruction courses in all
aspects of the work on a yearly basis.
d) that all new and updated information concerning confined spaces work
is brought to the attention of the competent persons.
B. Assessment of Hazard:
1. A worker shall not enter a confined space unless a competent person
evaluates the test results and the degree to which a hazard exists or is likely
to exist considering the construction, location, contents, nature and duration
of the work to be performed. A description of the above mentioned hazards
and the corresponding control measures must be recorded on MKHS 011.
2. Access and Egress. Sufficient personnel and equipment shall be maintained
at the access opening to remove person(s) from the confined space should
the need arise.
3. Industrial Areas. The entry into a sewer in an industrial area requires extra
precautions. There are many other gases and vapours not detectable by
portable testing equipment that may be present within the confined space at
any given time, especially in these areas. The competent 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
Municipality of Kincardine Occupational Health&Safety Manual Page 53 of 103
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 workers 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 Entry:
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 entry permit by the
competent person conducting the tests.
5. If entry must be made and safe conditions cannot be met, self-contained
breathing apparatus (S.C.B.A.) must be worn by all personnel entering the
confined space.
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6. The presence of Hydrogen Sulphide (H2S) in any quantity prohibits entry
unless S.C.B.A. is worn.
7. Ventilation, when required is to be available and activated for at least 10
minutes prior to entry.
8. Review applicable Occupational Health and Safety Act regulations before
commencing work.
9. Determine if lockout guidelines are required. If so, ensure you have tags to
identify the locked out area and your own padlock. (See MKHS Guideline 2.3)
10. Every worker who enters a confined space shall protect themselves against:
a) the release of hazardous substances into the confined space by
blanking or disconnecting piping, or if this is not practical under the
circumstances for practical reasons, by other adequate means;
b) contact with electrical energy inside the confined space that could
endanger the worker by disconnecting, de-energizing, locking out and
tagging the source of electrical energy, or if it is not practical under the
circumstances for technical reasons, by other adequate means;
c) contact with moving parts of equipment inside the confined space by
disconnecting the equipment from its power source, de-energizing the
equipment, locking it out and tagging it, or if this is not practical under
the circumstances for technical reasons, by other adequate 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 and home base (two
way radio, cellular). If such equipment is used inside a confined space, it
must be intrinsically safe.
12. Determine if any specialized tools or equipment are required before starting
the job.
D. Atmospheric Testing Requirements:
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 gases must be carried out
prior to removing the cover if possible (i.e. 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 gases
c) toxics
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3. Continual monitoring of the atmosphere must be carried out while the worker
is in a confined space. Monitoring equipment shall have an audible alarm.
When the device sounds an alarm, 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. Recording 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 Permit MKHS 011. This permit 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 his/her 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 hazard is not possible and
6. A. 1 or 2 apply; the entry worker shall use a Self-Contained Breathing
Apparatus.
3. If mechanical ventilation is used to maintain acceptable atmospheric levels,
an adequate warning system and exit guideline shall also be provided to
ensure that workers have adequate warning of ventilation failure and are able
to exit the confined space in a safe and timely fashion.
4. Ministry of Environment standards require that ventilation equipment must be
able to provide for a minimum of 10 air changes per hour in the confined
space. The Municipality of Kincardine minimum standard shall be 20 air
changes per hour.
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5. Continuous purging with fresh air is recommended whenever a worker is
inside a manhole, even if test results have been satisfactory.
Dangerous atmospheres can be controlled or eliminated either:
• Mechanically—this type of ventilation is basically a portable fan that provides
a sufficient amount of"good air" in exchange for the "bad air". Generally a fan
that provides 750-1000 cubic feet of air per minute is used for vault or
chamber operations. In larger areas such as large tanks and vessels, larger
fans capable of moving up to 5000 cubic feet of air may be required. In the
case of a combustible/explosive atmosphere, an explosive proof fan and/or
ducting is required.
• Alternatively, provision is to be made for "natural ventilation" by means of
opening other covers to create a natural airflow.
NOTE: A minimum safe requirement is 20 air changes per hour with
ventilation in place for a minimum of ten minutes before entry.
• Respiratory Protective Equipment — should be used whenever ventilation is
inadequate or impractical. For certain conditions such as oxygen deficient
atmospheres, or if the level of toxic gas or vapour is unknown or exceeds the
level considered to be immediately dangerous to life 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 toxic gas or vapour is below the
I.D.L.H. level (Immediately Dangerous to Life and Health), air-purifying
respirators may be used provided that the exposure levels never exceed the
limitations of the unit. This can only be determined by a person who is
knowledgeable about the respirator and of the hazards.
NOTE: In the case of explosive atmospheres, special precautions 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 entered 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:
a) Once again a record is required similar to the pre-opening test record.
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G. Entry 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 oxygen content in the atmosphere
of less than 19.5% or more than 23%.
But the space can be ventilated adequately, (20 air changes
per hour minimum), a worker shall not enter unless the
worker is:
a) wearing an approved safety harness to which is
securely attached a rope, the free end of which is held
by a person outside the confined space who is equipped
with a suitable lifting device or a sufficient number of
persons capable of physically removing the worker.
b) the use of an S.C.B.A. is not required under this section
of the Occupational Health and Safety Act, but its use is
recommended, and shall be at the work site at all times.
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NOTE: ENTRY TO SOME CONFINED SPACES IS NOT VERTICAL and may
include stairways and cat walks. Once having entered such a space a worker shall
attach himself/herself to the retrieval equipment before doing work. If this
immediate attachment is not practical because of the distance of the work area
from the retrieval equipment, or because of the type of work being done, then the
entry worker may work without being attached. However, continuous verbal and/or
visual contact with the competent person outside the confined space must be
maintained.
CATEGORY 3: In addition to Category 1 and 2 above and where the confined
space CANNOT be ventilated adequately, a worker shall not
enter the space unless he/she:
1. is equipped with a self-contained breathing apparatus of
sufficient quantity considering the nature and duration of the
work to be performed.
CATEGORY 4: A worker shall not enter a confined space where the gas or
vapour is, or is likely to be, explosive or flammable. The
competent person shall:
1. contact his/her supervisor immediately
2. secure the area from other persons and vehicles
3. eliminate all potential sources of ignition
Some types of 'cold work' (as defined in Definition 3. A.) are permitted in a
confined space likely to have a flammable or explosive atmosphere. However, a
worker shall not enter the space in any event until the proper authorities permit
him/her to do so.
If 'hot work' must be performed, then Section 19 "explosive and flammable
substances" of Ontario Regulation 632/05 shall be adhered to.
H. Emergency 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 a worker is in the confined space and the monitor alarm sounds they must
leave the area immediately.
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4. If a worker is not in the confined space area and the monitor alarm 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 immediately call 911:
a) If the entry worker is attached to retrieval equipment, the competent
person outside the confined space shall attempt to raise them to the
surface and provide the appropriate assistance until help arrives.
b) Under no circumstances shall any worker enter a confined space
to attempt a rescue until help arrives.
I. Communications:
1 . Portable radios may be used to communicate between the worker and the
competent topside worker; however, radios must be intrinsically safe. Cell
phones may be used by the competent topside person outside the confined
space only. Hard hat communications systems, rated intrinsically safe, may
be used if available.
J. Signals:
1 . Verbal: In most situations, it is possible for the person below to shout up to
the topside safety person, or make use of portable radios or hard hat
communications. However, there are occasions when the person below
cannot hear. This requires hand signals.
2. Emergency Hand Signals:
a) Help: moving of arm overhead.
b) Danger or Trouble: 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 other fingers, same
for OK.
e) Direct Attention: point to desired area, such as ear, direction or
mouthpiece.
f) I intend to go up: Thumbs up.
g) I intend to go down: Thumbs down.
h) Question or repetition: Palm of hand up and down.
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APPENDIX 'A'
CONFINED SPACE ENTRY— SUMMARY CHART
TEST RECORD EVALUATE VENTILATE ENTER RESCUE
CATEGORY - sufficient test for - record test - no hazard present - not required - continual monitor - 911 emergency call
1 combustibles, results and - unlikely to occur but - competent person - do not enter confined
oxygen fill out considering recommended outside space until help arrives
deficiency, permit nature and -wear approved - supply air to entrant if
carbon monoxide, duration of the body harness required
hydrogen work - remove entry worker as
sulphide much as possible
CATEGORY - sufficient test for - record test - hazard is present - ventilate until - continual monitor - 911 emergency call
2 combustibles, results and or is likely to be hazard is - competent person - remove entry worker
oxygen fill out present purged outside - supply air to entrant if
deficiency, permit considering the - ventilate to -wear approved required
carbon monoxide, nature and maintain safe body harness - do not enter confined
hydrogen duration of the atmosphere - suitable lifting space until help arrives
sulphide work - minimum 10 air device or sufficient
changes per manpower in place
hour - S.C.B.A.
(recommended)
CATEGORY - sufficient test for - record test - hazard is present - non available - continual monitor - 911 emergency call
3 combustibles, results and or is likely to be or inadequate - competent person - remove entry worker
oxygen fill out present outside - supply air to entrant if
deficiency, permit considering the - wear approved required
carbon monoxide, nature and body harness - do not enter confined
hydrogen duration of the - suitable lifting space until help arrives
sulphide work device or sufficient
manpower in place
- S.C.B.A. (required)
CATEGORY - sufficient test for - record test -flammable or DO NOT ENTER DO NOT ENTER DO NOT ENTER
4 combustibles, results and explosive hazard - notify supervisor and secure area from all potential sources of
oxygen fill out is present or likely ignition
deficiency, permit to be present
carbon monoxide,
hydrogen
sulphide
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APPENDIX `B'
EVALUATION CHART
CONFINED SPACE ENTRY TO BE UNDERTAKEN
TEST THE ATMOSPHERE & RECORD RESULTS
EVALUATE
• Availability of rescue personnel
• Results of tests
• Nature &duration of work
• Ventilation
• Access &egress
• Sludge, other deposits
• Location—i.e. industrial
• Flow
• Isolation of energy and control of materials
movement
SAFE POTENTIAL HAZARD HAZARD
.--
t
• No hazardpresent • Hazard present or ` • Hazard present or /• Explosion or
• Unlikely to develop is likely to be is likely to be flammable
considering nature present present atmosphere is
&duration of work • Ventilation not • Ventilation present or likely to
required adequate to purge be present
• Min. 20 air changes
/ per hour
' • Continual ' • Continual • Ventilate DO
monitoring monitoring • Continual NOT
• Competent person • Competent person monitoring ENTER
outside outside • Competent person
• Safety harness • Rescue system outside
• USE of SCBA is • Rescue system
recommended • USE of SCBA is
_} required
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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
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.5
Description: TRENCHING
Effective Date: May 2006 Revised/reviewed: May 2016
1. PURPOSE:
To provide a guideline whereby workers may work safely in a trench.
2. RESPONSIBILITY:
A. The workers working in the area are responsible for proper application of this
guideline.
B. The Supervisor and Senior Manager are responsible for ensuring that workers
(including contractors) are properly trained and that this guideline is adhered to.
C. The Supervisor shall be in possession of a current copy of the Occupational Health
and Safety Regulations for Construction Projects.
3. GUIDELINE:
A. General:
1. A "trench" means an excavation where the excavation depth exceeds the
excavation width.
2. A "competent worker" in relation to specific work means a worker who.
a) Is qualified because of knowledge, training and experience to perform
the work.
b) Is familiar with the Occupational Health and safety Act and with the
provisions of the regulations that apply to the work, and
c) Has knowledge of all potential and actual danger to health or safety in
the work.
3. Pre-plan:
a) Determine the type of soil that the trench will be located in.
b) Ensure all gas, electrical and other services in and near the area to be
excavated are located and marked.
c) Once all locates are received, they will be reviewed by a competent
worker before the project proceeds.
d) If the service may pose a hazard, the service shall be shut off and
disconnected. If this is not possible, then the owner of the service shall
be requested to supervise the uncovering of the service.
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e) If the trench may affect the stability of an adjacent existing foundation,
building or structure, a supervisor must be notified.
f) If the trench has a water problem, water removal may be required, e.g.
pumps etc.
4. Check Out Equipment:
a) Ensure that trench protection materials are in working condition, e.g.
trench box, hydraulic shoring, pneumatic shoring, wood shoring,
shovels, picks, pumps, traffic control devices etc.
b) A system of communications will be in place between the trench location
and home base.
c) Check all personal protective equipment to ensure that it is in good
repair and in working order.
5. Traffic Control:
a) If the trench is to be made where vehicular traffic is a hazard, the
following are required:
(1) all workers 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, Temporary Conditions
6. Excavate:
a) No person shall be within a 2 metre (six-foot) radius of any mechanized
excavating equipment that is in the process of excavation.
b) No worker 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 worker is in full view of another worker on the surface at all
times.
c) If buried hydro or gas is known to exist near the excavation area, the
work plan will be reviewed with the supervisor before proceeding.
d) When working within 1 metre of underground hydro or gas lines, use
hand-digging or hydro-excavation only.
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B. Emergency Guidelines:
1. Should any abnormalities occur in the trench wall, bottom or surface area
above the trench, it shall be evacuated immediately and the supervisor
notified.
2. Should a trench collapse occur whereby a worker is engulfed or buried:
a) the competent person on top will immediately call 911.
b) under no circumstances shall any worker enter an unsafe trench to
affect rescue operations.
3. A Notice of Trench Work is to be completed by the Supervisor
• Notice of Trench Work [Form 016-0070E]
This form is used by constructors to notify the Ministry of Labour, before work
is begun at a construction project, if the project includes work on a trench
more than 1.2 metres deep into which a worker may enter. This form is
available on Service Ontario.
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.6
Description: EMERGENCY GUIDELINES
Effective Date: May 2006 Revised/reviewed: September 2017
1. PURPOSE:
To create a comprehensive action plan to be taken under various emergency situations.
This shall include business continuity plans for municipal departments and other
accessory plans to manage various emergencies specific to individual departments.
2. RESPONSIBILITY:
A. The on-site supervisor is responsible for the implementation of the "EMERGENCY
GUIDELINES" in the event of an emergency.
B. The worker is responsible for knowing the nearest emergency 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 the CAO, 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 or critical injuries;
g) power outage;
h) loss of or damage 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 department, or small area,
verbal communication may be employed.
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2. In the event of a facility wide evacuation, the fire alarm or paging system will
be employed.
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 workers 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 workers will exit the building immediately, upon notification of the
evacuation directive.
3. Workers 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 workers shall not at any time endeavour to
perform 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. Workers and public will exit in an orderly fashion.
6. Under no condition should a worker turn back.
7. Once outside the building, all workers and public will report to the "Safe
Area", assigned for each facility.
8. The supervisor will perform a head count to ensure to the best of their
knowledge that all workers and public have been evacuated and notify the
appropriate Emergency Service Personnel.
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D. Return to Facility:
1. Once the facility is deemed safe for re-entry, the supervisor will re-walk the
facility with the Emergency Service Personnel.
2. Following this, the supervisor may instruct the workers to return to their
workstations.
E. Long Term Actions:
1. Should the emergency situation begin to deplete or overwhelm the normal
day to day resources of the affected department, the internal business
continuity plan for that department shall be implemented. This business
continuity plan shall be coordinated with and compliment the existing
Community Emergency Response Plan and shall be the responsibility of each
Senior Manager to create and maintain.
2. The Senior Manager shall notify the CAO, who in turn will notify members of
the Municipal Control Group including the Mayor as per the Community
Emergency Response Plan
3. Assistance will be given to the requesting department and staff members as
deemed appropriate by the Municipal Control Group to effectively manage the
emergency and restore normal operations.
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.7
Description: HEARING PROTECTION
Effective Date: May 2006 Revised/reviewed: January 2017
1. PURPOSE:
To prevent hearing loss for all workers and meet the requirements under the
Occupational Health and Safety Act Regulations for Industrial Establishments (Section
139).
2. RESPONSIBILITY:
A. To undertake a program to help prevent the loss of hearing that might occur in
workers who are exposed to excessive noise.
B. To meet the requirements set out in the Occupational Health and Safety Act and
Regulations for Industrial Establishments.
C. 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. GUIDELINE:
A. Administration:
Management, in conjunction with the Joint Health and Safety Committee, will
administer the program.
B. Measurement of Exposure:
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 using a sound level meter, and
if necessary, by an audio-dosimeter. Before testing, management will advise
the Joint Health and Safety Committee of the time and date of the testing.
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.
4. Equipment will be calibrated before each use.
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C. Engineering Controls:
1. Whenever it is economically or technically possible, engineering controls will
be used to lower the noise level exposure of workers.
2. Preventative maintenance controls will be a part of engineering controls.
3. The Manager or Designated Supervisor will be responsible for instituting and
monitoring these controls in conjunction with the Joint Health and Safety
Committee.
D. Hearing Protection:
1. Where engineering controls are not possible, appropriate hearing protection
will be provided by the employer and will be worn by all workers and visitors
in all areas or on all equipment where it has been ascertained that the
possibility of exposure to high levels of noise exists.
2. Each worker required to wear hearing protection will be trained in the proper
use and care of such protective devices. Workers will be responsible for the
wearing of the devices provided to them, where required, and for reporting
any loss of, or defects arising in, those devices to his/her immediate
supervisor.
2. Supervisors/Managers will be responsible for ensuring that these protective
devices are worn where and when necessary, and for taking the disciplinary
action for non-compliance.
3. Designated high noise areas will be posted with warnings of the noise levels
exceeding 85 decibels and the requirement for the wearing of appropriate
hearing protection.
E. Education and Training:
1. Workers will be educated on the potentially harmful effects of noise, and how
to protect their hearing.
2. Workers will be trained in the proper use and care of hearing protection, and
instances where hearing protection is required.
3. Supervisors will give periodic refresher training.
F. Assessment of the Program:
1. The Hearing Conservation Program will be reviewed annually by the Joint
Health and Safety Committee and modified as needed to make the program
more effective.
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.8
Description: FALL PROTECTION
Effective Date: March 2017 Revised/reviewed: September 2017
1. PURPOSE
To create a guideline whereby workers can work safely at heights.
To protect workers by reducing the risk of injury or fatality when working at heights of 3
meters or more above ground level.
To assure that the Occupational Health and Safety Act, and Section 26 of the
Regulations for Construction Projects and Industrial Establishments, Section 85, which
outlines the circumstances where fall protection is required.
To train workers to be able to recognize hazards associated with working at heights, to
respond to anticipated hazards and emergencies, and to perform assigned duties.
To protect workers from hazards that could be present while working at heights.
2. RESPONSIBILITY
A. The Municipality of Kincardine is committed to the health and safety of its workers.
The protection of workers and contractors from any fall hazard is a major
continuing objective.
3. GUIDELINE
A. If the task requires fall protection, Municipality of Kincardine will provide workers
with a CSA approved and up-to-date fall arrest equipment. This is to include safety
harness, lifeline, and lanyard and rope grab.
B. The fall arrest system must be inspected and maintained prior to and after every
use. The maintenance instructions are included with your equipment. If a fall
occurs, all components of the fall arrest system should be removed from service.
C. A competent instructor will provide training in the proper use of a fall protection
system. The training in its use and given adequate oral and written instructions of
each piece of their fall arrest equipment.
D. A worker who may use a fall protection system must meet the working at heights
training requirements of Ontario Regulation 297/13 (Occupational Health and
Safety Awareness and Training). O. Reg. 252/14, s. 1.
E. Signed written training and instruction records for each worker shall be maintained.
F. The training and instruction record shall include the worker's name and the dates
on which training and instruction took place.
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G. All supervisors and workers must make themselves familiar with Section 26 of the
Regulations for Construction Projects and Industrial Establishments, Section 85
which outlines the circumstances where fall protection is required.
H. Fall protection applies where a worker, x; *Welts,` , is exposed to any of the
following hazards:
1. Falling more than 3 metres.
2. Falling more than 1.2 metres, if the work area is used as a path for a
wheelbarrow or similar equipment.
3. Falling into operating machinery.
4. Falling into water or another liquid.
5. Falling into or onto a hazardous substance or object.
6. Falling through an opening on a work surface
I. Before a worker is allowed into an area where a risk of falling exists, the employer
must ensure that the worker is instructed in the fall protection system for the area
and the procedures to be followed.
J. A worker must use the fall protection system provided by the employer.
K. The employer shall provide travel restraint system or a fall protection system:
1. A worker shall be adequately protected by a guardrail system that meets the
requirements of subsections 26.3 (2) to (8).
2. Despite subsection (1) if it is not reasonably possible to install a guardrail
system as that subsection requires, a worker shall be adequately protected
by at least one of the following methods of fall protection:
a) A travel restraint system that meets the requirements of section
b) A fall restricting system that meets the requirements of section
c) A fall arrest system, other than a fall restricting system designed for use
in wood pole climbing that meets the requirements of section
d) A safety net that meets the requirements of section
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Rescue Plan
Written rescue procedures shall be in place before any use of a fall arrest system or safety
net is used. A rescue plan should be in place whenever workers are working at height. This
plan should be posted in a conspicuous place and communicated to all workers before
work begins.
A rescue plan includes; (Appendix A)
1. The designated trained person(s) in charge of rescue.
2. Qualified on-site first aid personnel (with contact numbers) and equipment).
3. Emergency Medical Services (EMS) or fire services .(911)
4. Emergency access to worksite.
5. A back-up system of communications.
6. All rescue or emergency control procedures for any mechanical hoisting systems or
elevating devices being used in the workplace.
7. Annual review and rehearsal of rescue procedures.
8. Procedures to lock-out and secure activated safety devices and unsafe work areas.
Always remember that if you are not certain of what type of fall protection is required for a
particular situation, ask your supervisor for direction.
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Appendix A
Procedures for Rescue of a Worker Suspended in a Safety Harness
Call 911
The rescue of a worker who has fallen and is being suspended in his/her safety harness
needs to be undertaken as quickly as possible for several reasons:
A. The worker may have suffered injuries during the fall and may need medical attention.
B. Workers suspended in their safety harness for long periods may suffer from blood
pooling in the lower body and this can result in "suspension trauma." (See attached
information on treating suspension trauma — have this available on site to provide to
First Aid team and to external emergency crews.)
C. The suspended worker may panic if they are not rescued quickly.
D. The event that led to the fall may create additional risks that need to be addressed.
General Rescue Procedures:
A. If Elevating Work Platform is available on site:
1. Bring it to the site and use it to reach the suspended worker.
2. Ensure that rescue workers are protected against falling.
3. Ensure that the EWP has the load capacity for both the rescuer(s) and the victim.
4. If the victim is not conscious, 2 rescuers will be probably be needed to safely
handle the weight of the victim.
5. Position the EWP platform below the worker and disconnect his lanyard when it is
safe to do so.
6. Treat the victim for Suspension Trauma and any other injuries.
7. Arrange for transport to nearest hospital.
B. If no Elevating Work Platform is available:
1. Where possible, use ladder(s) to reach the victim.
2. Rig separate lifelines for rescuers to use while carrying out the rescue from the
ladder(s).
3. If worker is not conscious or cannot reliably help with his/her own rescue, at least 2
rescuers may be needed.
4. If worker is suspended from a lifeline, where possible, move the suspended victim
to an area that can be safely reached by the ladder(s).
5. If victim is suspended directly from his/her lanyard or from a lifeline, securely attach
a separate lowering line to the victim's harness.
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6. Other rescuers should lower the victim while he/she is being guided by the rescuer
on the ladder.
7. Once the victim has been brought to a safe location, administer First Aid and treat
the person for Suspension Trauma and any other injuries.
8. Arrange for transport to nearest hospital.
C. If the injured person is suspended near the work area and can be safely reached from
the floor below or the area they fell from:
1. Ensure that rescuers are protected against falling.
2. If possible, securely attach a second line to the workers' harnesses to assist in
pulling them to a safe area. (Note: at least 2 strong workers will be needed to pull
someone up.)
3. Ensure that any slack in the retrieving lines is taken up to avoid slippage.
4. Once the victim has been brought to a safe location, administer First Aid and treat
the person for Suspension Trauma and any other injuries and arrange for transport
to the nearest hospital.
D. If a person has fallen and is suspended in an inaccessible area (e.g. a tower, against a
building or structure that has no openings):
1. Specialized rescue techniques are needed for this type of situation. It may involve
a rescuer rappelling or being lowered down to the victim, it may involve using the
lifeline to retrieve the fallen worker, or the use of high-reach emergency equipment.
2. Due to the inherent risk to the rescuers and/or the victim, this type of rescue should
not be undertaken by people without specialized training and experience.
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Fall Protection Checklist
Project Project Location Fall Protection Locations
Supervisor Date Time
Q Step Action Description
Choose appropriate Consider the work to be performed; the training needed for each
fall protection system system, the project conditions, and the availability.
❑ Powered Elevating Perform system checks, ensure level ground, operate according to
Work Platform manufacturers' recommendations, tie off to PEWP or to adequate
anchor point above at all times.
Install and use according to engineer's design drawings, use min. 1/2"
❑ Horizontal Lifeline steel wire, <30 ft. between vertical posts, <15" sag in a 30 ft. span, 3
clips tying wire at beam end, engineer's design drawings available,
workers using a double lanyard, and workers tied off at all times.
❑ 1 . Column adequately secured with %" steel wire or 5/8",
❑ Vertical Lifeline polypropylene rope, vertical lifeline attached, a vertical lifeline with
rope grab extends from the top of the column to base, 1 worker using
lifeline at a time.
❑ Self Retracting Anchor to approved roof anchor, 1 worker using SRL at a time, must
Lifeline (SRL) be moved periodically, lifeline locks up in a quick movement,
automatically retracts when tension removed, minimizing fall distance.
❑ Guardrail, Removes fall potential by providing a physical barrier, must meet
Scaffolding, etc. minimum horizontal and vertical forces, must have toprail, midrail and
toe board, scaffolding must be built accordingly.
Frequent inspections All components of fall protection systems are to be inspected prior to
of fall protection each use by each worker. If a deficiency is found, remove equipment
components from service.
❑ Harness Burns, cuts, loose stitching, frayed webbing, D-rings, grommets and
buckles not worn or damaged, CSA stamp.
❑ Lifelines Burns, cuts, frayed material, no discolouration or other damage.
❑ 2. Burns, cuts, loose stitching, frayed webbing, CSA stamp, shock
❑ Lanyards absorber in good condition, locking snap hook.
❑ Anchor Points Able to support 3600 lbs., verified by a competent worker.
❑ PEWP Maintenance log, manufacturer's recommended inspections.
❑ Rope Grab Damage, cracking, dents, bends, connecting rings centred, rust,
moving parts working smoothly, other wear.
❑ 3 Rescue procedure Refer to Construction Regulations, Sec. 26 for employer's Fall
chosen Rescue requirements.
Engineer's design Engineer's design drawings for:
drawings and ❑Horizontal lifeline ❑Scaffold system UAnchor systems
U 4. manufacturer's Manufacturer's specifications for:
specifications
available UAnchor systems UPEWP USRLs LI Harnesses ❑Rope grab
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MUNICIPALITY OF KINCARDINE Guideline No.: MKHS 2.9
Description: TRAFFIC PROTECTION
Effective Date: January 2017 Revised/reviewed: September 2017
1. PURPOSE
To prevent hearing loss for all workers and meet the requirements under the
Occupational Health and Safety Act Regulations for Industrial Establishments (Section
139).
2. RESPONSIBILTY
This policy applies to all Municipal workers, contractors and sub-contractors. It
applies with modifications to Emergency Services.
This procedure applies to all workers who may be involved in the planning, set up,
and maintenance of proper traffic control to ensure the health and safety
compliance.
3. GUIDELINE
A. Administration:
1. Management
a) Traffic control work is performed in compliance with the provisions of:
b) This Municipal of Kincardine policy and its' guidelines
c) The Ontario Traffic Manual for Temporary Conditions (Book 7 and Field
Edition) The Handbook for Construction Traffic Control Persons Senior
Management shall ensure resources and funds are made available to
ensure work can be carried out in accordance with legislative
requirements, corporate policy and divisional safe work procedures
d) A process is developed for evaluating work operations to determine
where traffic control procedures are needed
e) Appropriate machinery, equipment and protective devices (including
clothing) needed to carry out work in accordance with legislative
requirements and written safe working procedures are provided and
maintained
f) General and specific training are provided to all workers involved in work
that requires traffic control procedures to be used
g) A regular review of traffic control procedures is performance.
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2. Supervisors
a) Be familiar with the Occupational Health and Safety Act, applicable
regulations and standards including:
(1) The Regulations for Construction Projects
(2) The Ontario Traffic Manual for Temporary Conditions (Book 7 and
Field Edition)
(3) The Handbook for Construction Traffic Control Persons
b) Be familiar with all aspects of the County Traffic Control policy and
divisional traffic control procedures and equipment.
c) Identify hazards related to the specific road work conditions, and
implement effective traffic control measures for the protection of
workers.
d) Evaluate and document work operations to determine where traffic
control procedures, devices and training is required in consultation with
joint health and safety committees and business unit health and safety
staff as necessary
e) Ensure an approved Municipality of Kincardine Traffic Control Protection
Plan is completed for all
3. Workers
a) Work in accordance with safe work procedures and specific traffic
control plans
b) Use or wear all equipment required to safely perform workplace specific
activities
c) Report any violations, hazards or deficiencies in equipment to
immediate supervisor without delay
d) Assist supervisory staff in developing a traffic control plan for the
specific work assignment
e) Follow established procedures in the event of an injury, accident or
emergency necessary work; that a copy of the plan remains on the
project and that all workers are familiar with the requirements of the
plan.
4. Joint Occupational Health and Safety Committee
a) Assist supervisory staff in developing safe traffic control plans or
procedures for specific tasks, where applicable
b) Assist management in the annual review of traffic control equipment
and/or devices.
c) Conduct investigations of serious accidents involving traffic control
procedures or training, and which involve Municipality of Kincardine
workers; for the purpose of making recommendations for the
improvement of traffic control plans, procedures and/or training.
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All supervisors and workers who are required to set-up and/or remove traffic
control measures, direct traffic, act as a signaler or work in a work area where
there is a danger from vehicular traffic shall take part in traffic control training.
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MUNICIPALITY OF KINCARDINE
HEALTH AND SAFETY INFORMATION REQUEST
WORKER CONCERN:
Information Requested:
Dated: Name:
HEALTH & SAFETY COMMITTEE RESPONSE:
Sources:
Information:
Dated: Signed:
MKHS 001
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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 S.9 (20), an employer who 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: Signed:
Name:
MKHS 002
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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. Aisleways and Passageways: 1. Ergonomics:
a) Aisles marked a) Design allows normal body positions when
b) Clear and unobstructed seated or standing
a) At least 28 inches wide or as prescribed b) Controls sized to permit operation with
b) Sufficient width for all normal movements clothing/equipment worn
c) Controls follow normal response patterns
2. Exits/Egress: (down for off,etc.)
d) Standard color coding used for warnings and
a) Sufficient exits for prompt escape informational displays
a) No locks or fastenings restricting escape e) Hand tools used permit normal body positions
b) Routes and exits clearly marked f) Limited weight and size of materials lifted or
c) Exits and exit signs adequately illuminated carried by people
d) More than one exit from work area g) Lifting and twisting in combination not
e) Approaches to exits unobstructed required
f) Flammables kept out of exits
g) Doorways at least 28 inches wide or as 2. Lighting(including Facility Grounds/Parking):
prescribed
h) Cleared of ice or snow a) Walking and working areas adequately
i) Open outward onto level floor illuminated during periods of occupancy
b) Lighting fixtures clean
3. Floors: c) Illumination level sufficient for detail or work
performed
a) Clean,orderly,sanitary condition d) Emergency lighting provided
b) Drainage maintained
c) Free of slip,trip or fall hazards 3. Noise Exposure:
d) Free of protrusions, nails,etc.
e) Openings covered or barricaded a) Economically feasible engineering controls
b) Protection provided when sound levels
4. Stairs: exceed standards
c) Hazardous noise areas identified and marked
a) At least 22 inches wide or as prescribed
b) Steps uniform in height and tread depth 4. Ventilation:
c) Open risers if less than 9 inch tread depth
d) Outdoor stairs have grating type treads a) Adequate means provided
e) Treads and nosing slip resistant b) Air inlets and openings arranged to minimize
f) Handrails provided on open sides escape of contaminants
g) Handrails on at least one side if closed c) Enclosures provide continuous inward air flow
h) Vertical clearance at least 7 feet or as d) Separators provided if air is re-circulated
prescribed e) Hoods draw air away from people
i) Stairways adequately lighted f) Hoods connected to exhaust system
j) Cleared and unobstructed 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
MKHS 003-1 other facilities.
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C. HAZARD CONTROLS D. EMERGENCY SYSTEMS
1. Color Control: 1. Emergency Instructions:
a) Red color coding used to indicate immediate a) Operational placards/decals on emergency
danger, flammable/explosive materials and controls(e.g. On-off,open-close)
fire protection b) Emergency instructions at primary phone in
b) Yellow color coding used to indicate areas of each work area
changing condition c) Fire Hazard Symbols on facilities containing
c) Orange color coding used to indicate areas hazardous substances
under modification, e.g. hazardous parts d) Backup communication systems are available
when guards removed e) Evacuation plan is posted
d) Green color coding used to indicate safety
instructions and first aid equipment 2. Emergency Rescue Equipment:
e) Blue color coding used for general information
signs and tags a) Adequate equipment available and properly
f) Color coding systems used to indicate fluid located
and gas system contents and flow b) In serviceable condition
c) Emergency stand-by lighting provided and
2. Materials Labeling: adequate
a) Standard labels affixed to all containers of 3. Eye Baths and Showers:
substances in storage and use
b) Labels legible and visible a) Readily available and accessible in areas
where caustic/corrosive chemicals are used
3. Permit Usage (e,q. Confined Space Entry, b) Water supply provides a minimum of a 15
Excavation/Trenching, Lock-out Systems): minute flush at a comfortable temperature
c) Proper signs and instructions posted
a) Permit has appropriate signatures applied d) Flushed frequently to eliminate contaminants
b) All controls in existence
c) Permit posted or present with workers 4. Fire Protection:
d) Permit within authorized time limits
e) Reviewed as appropriate a) Portable extinguishers readily available and
appropriate for type of materials
4. Signs and Tags: b) Extinguishers inspected monthly
c) Fire hoses properly mounted, accessible and
a) Hazard warning, directional and informational maintained
signs and tags used where there are d) Fire equipment visibly marked
immediate dangers, potential hazards, or e) Fire doors, lids and shutters in good repair
there is need for general instructions f) Sprinkler heads have proper clearance from
b) Signs and tags consistent in use throughout materials and furnishings
the workplace g) Sprinkler master control valves accessible
c) Tags affixed to all defective equipment not and locked open
secured against use h) Adequate and operable fire alarm system
5. Warning Systems: 5. First Aid Kits:
a) Fire/emergency systems operational a) Adequate materials and equipment available
b) Hazard warning systems on appropriate and properly located, as prescribed
vehicles and equipment b) Names of qualified attendants posted
c) Over-pressure warning systems on pressure c) Instructions for accident reporting posted
vessels
d) Over-temperature warning systems on fired
pressure vessels, hazardous material
storage, powered equipment
MKHS 003-2
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E. MATERIALS
4. Stacking and Storage:
1. Chemicals and Fuels:
a) Aisle ways and access paths clear and
a) Tanks/drums of steel or appropriate material. unobstructed
b) Limited to 2,500 gallons b) Small or irregular shaped items properly
c) Tanks adequately vented blocked, interlinked with proper limitations in
d) Pressure relief valves provided on tanks height of storage
e) Tanks/drums grounded when dispensing c) All stacks stable and secure against
f) Adequate spill containment sliding/collapsing
g) Proper spill-absorbent materials and/or d) Proper drainage in storage area
drainage provided e) Storage area clean and cleared of foreign
h) Tanks/drums adequately supported objects/materials
i) Temperature controlled to prevent boiling f) Load limits for racks and platforms posted
j) Adequate storage cabinets provided; fire and observed
resistant and vented g) Combustibles/flammables labeled and stored
k) Storage heated by means not constituting a properly
source of ignition
I) Approved portable safety containers used as 5, Waste Disposal:
required
m) No smoking signs posted where required a) Adequate number of appropriate metal refuse
n) Non-arcing type fans in hazardous substance containers
storage areas b) Separate containers provided for oily rags,
o) Materials separated to avoid incompatibility smoking materials, dusts, flammable scrap,
reactions chemical wastes,etc.
p) Means of exit/egress prescribed c) Safe disposal facilities for wastes
d) Anti-static devices fitted as necessary
2. Compressed Gases(e.g. Propane,gas,oxygen): e) Chemical spill absorbents available in work
areas
a) Stored upright and secured against falling f) Garbage shredder adequately guarded
over
b) Segregated by contents and legibly marked F. PERSONAL PROTECTIVE EQUIPMENT
c) Caps in place and hand tight
d) Protected against rust/corrosion 1. General:
e) Stored away from heat sources
f) Stored away from stairs,elevators and egress a) Instructions on use of equipment are
routes available
g) Inspected for dents, corrosion,test records b) Equipment is readily available and appropriate
h) Adequate ventilation in storage areas for the application
i) Properly installed and connectedc) Equipment is inspected regularly and repaired
j) Oxygen lines properly certified or replaced as needed
k) All compressed gas, air and oxygen lines d) Storage facilities for the equipment are
labeled and identified properly available
e) Review equipment: body protection; ear
3. Herbicides/Pesticides: protection; eye protection; fall protection; foot
protection; hand protection; head protection;
a) Containers properly labeled and stored respiratory protection; reflective apparel
b) Personnel properly trained and certified in the
use of pesticides G. EQUIPMENT
c) Adequate personal protective safety
equipment 1. Electrical Power Systems:
d) Emergency eye wash bath/shower available
e) Pesticides separated from other materials in a a) High voltage and control panels closed and
cool,well-ventilated storage area secured
MKHS 003-3 b) Control panels identified and accessible
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c) General condition of wiring, insulation and 5. Machine Tools and Guarding:
fixtures to standards
d) Grounding tested a) General condition: damage, cleaning and
e) Explosion-proof fixtures in flammable dust or lubrication
vapour areas b) Mechanical power transmission guarded
f) Flexible cords free of splices c) Pinch points and points of operation guarded
g) Lock-out provisions as prescribed d) Fixed guards secured in place
h) Provision for individual disconnects of locked- e) Interlock guards operative
out equipment f) Automatic and operator guards properly
i) Electrical equipment protected from fluids adjusted
j) Adequate provision for manual restart after g) Operating controls guarded against
power failure inadvertent actuation
h) Operating controls locked and key removed
2. Hand and Portable Tools (e.g. Saws, Grinders, when not in use
Fitness Equipment, Lawn Mowers, Chippers, i) Emergency stop buttons operational,correctly
etc.): positioned, labeled and colour coded
j) Isolation and lock-out provided for servicing,
a) Proper general condition of tools: electrical setup, lubrication,etc.
cords,air hoses k) Guards provided for rotating parts, chips or
b) Proper storage when in use particles,sparks, kickbacks, etc.
c) Proper storage when not in use I) Operator and service manuals available
d) Guards and safety devices serviceable
e) Electrical grounding or double insulation 6. Pneumatic Power Systems(e,q. Compressors):
protected
f) Tool retainers installed on pneumatic tools a) Pressures regulated within limits
g) Adjustments correct b) Restraining clips on hose lines
h) Load rating sufficient for work performed c) Compressor drainage and testing
d) General condition of hoses and connections
3. Hydraulic Power Systems: e) Air lines identified
f) Water in pneumatic tools
a) Pressure regulated within power limits
b) General condition: leaks, dents, nicks and 7. Pressure Vessels(e.g. Boilers):
severe scratches of pressure lines and fittings
c) Fluid pressure lines identified a) Meters and controls located on operating floor
d) Remote shut-off available b) Safety valves operational
e) Inspections recorded c) Drains clear and freeze protected
d) Inspection certificate/label appropriate to type
4. Lifting Gear/Equipment (e.g. Elevators, Hoists, e) Pipes, connections, vessels free of dents,
Cranes): notches and severe scratches
f) Shields, platforms and landings as
a) General condition: damage, cleanliness, appropriate
lubrication,servicing g) Remote shutoff to pumps
b) Clearly labelled as to capacity and load h) Respiratory/rescue and confined space
testing equipment available
c) Fitted with overhead guards
d) Controls operational 8. Valves and Mechanical Controls:
e) Limit stops operational
f) Hoist motor brakes operational a) Labelled and colour coded
g) Cable/rope in good repair b) Operational
h) Hoist chain/rope free of kinks and twists c) Readily accessible
i) Hooks not deformed or damaged and safety
latches intact 9. Welding/Weldinq Equipment:
j) Pinch points properly guarded
a) Properly grounded
MKHS 003-4 b) Located in a dry area
c) Properly insulated terminals
Municipality of Kincardine Occupational Health& Safety Manual Page 86 of 103
d) Proper ventilation provided • Shock absorbers
e) Bottles stored upright, capped and chained • Safety belts
• Radiator
H. FACILITIES: • Mirrors Fluid levels
• Hoses(for hydraulic leaks)
1. Office Environment: • First-aid kit
a) Aisleways clear and unobstructed • Roll bars
b) File drawers closed when not in use •
Grab handles
c) Phone cords and electrical wires not located • Drive belts
in places where they might trip anyone • Backup alarms
d) Electrical wiring and circuits are not • Other
overloaded (2) equipment
e) Proper fire extinguishers are available, Mobile e q pment
(construction
conveniently located and in good working equipment, front end loader, grader,
order snow plough, back hoe, lawn mower,
f) No smoking areas identified tractor,street sweeper:
g) Transparent doors marked so they can be • Overhead guards where required
seen • Designated areas for recharging
h) Proper storage of material • Qualified operators only
i) Ground-fault interrupters provided as needed • Physical hazards
j) Supervision has clear visibility of all activity • Fire extinguishers
areas • Operating control functioning properly
k) Adequate supply of refuse containers • Blade condition
I) First-aid/emergency medical equipment • Suitable steps and handholds
readily accessible • Proper air pressure in tires
m) Appropriate fire extinguishers charged and • Protective guards in place
available • Proper fuel storage
2, Grounds, Parking Lots: (3) Tree Trimming/Climbing:
a) Ball fields, parking lots and play areas • Only qualified trimmers work in trees
checked for protruding wire, broken areas, where electrical hazard is present
etc. • Only non-conductive tools are used to
b) Adequate and pertinent direction, information remove branches touching energized
and warning signs posted lines
c) Adequate and strategically located trash • Only Class B hard hats and insulated
receptacles aerial lifts are used
d) Picnic shelters, tables, benches, barbecue • Only one worker occupies an aerial
pits, drinking fountains, etc. of good, safe bucket at one time and a safety belt is
construction and properly maintained required
3. Roads and Waste Management:
a) General Equipment — Vehicles (e.g. Dump LOCATION:
Trucks, Pick-up Trucks, etc.) DATE:
(1) Check condition of:
• Steering INSPECTED BY:
• Emergency brake
• Brakes
• Tires
• Wipers DEFICIENCIES FOUND: n YES n NO
• Lights
• Mufflers
MKHS 003-5
Municipality of Kincardine Occupational Health&Safety Manual Page 87 of 103
Municipality of Kincardine
Joint Health and Safety Committee
Workplace Inspection Reporting Form
Inspection Location(s): H&S Coordinator Initials:
Department/Areas Covered: Date of Inspection:
FOR FOLLOW UP
Hazard Repeat
Item Hazards Class Item Recommended Action By Action Taken Date Authorized
(and location) Observed (see Yes No Whom When Completed Signature
below)
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
Supervisor: Inspected By:
Copies To (For Information): JHSC Supervisor:
Class"A" Hazard: A condition or practice with the potential for permanent disability, loss of life or body part, and/or extensive loss of structure,equipment or material.
Class"B" Hazard: A condition or practice with the potential for serious injury or illness(resulting in serious or temporary disability)or property damage that is disruptive but less so than
Class"C"Hazard: A condition or practice with the potential for injury or illness, or disruptive(non-disabling)property damage.
MKHS 004
Municipality of Kincardine Occupational Health&Safety Manual Page 88 of 103
MUNICIPALITY OF KINCARDINE
ACCIDENT REPORTING GUIDELINES CHART
Worker and Employer Responsibilities
See the Corporate Health and Safety Manual, MKHS-4, "WORKER ACCIDENT/INCIDENT REPORTING GUIDELINES"for more detail.
INJURY WORKER RESPONSIBILITY: EMPLOYER RESPONSIBILITY:
CLASSIFICATION TREATMENT INFORMATION AND FORMS INFORMATION AND FORMS
NO TREATMENT 1. None 1. Report accident/incident to 1. Record accident/incident in IAPA FIRST AID REPORT LOG. (MKHS
(very minor) supervisor. 006)
FIRST AID 1. First Aid given by a 1. Seek first aid treatment. 1. Ensure first aid is administered.
(minor) person qualified to 2. Report accident/incident to 2. Record accident/incident in IAPA FIRST AID REPORT LOG.
give first aid. Supervisor.
MEDICAL AID 1. Treatment given by 1. Seek first aid treatment. 1. Ensure the safety of all workers.
(serious) Health Care 2. Report accident/incident to 2. Ensure administration of first aid, if necessary.
Professional (e.g. Supervisor.
Doctor). 3. Arrange for transportation of worker(s)to Health Care Professional.
3. Take a "FUNCTIONAL 4. Provide worker with "FUNCTIONAL ABILITIES FORM FOR TIMELY
2. May receive First ABILITIES FORM FOR
Aid at workplace TIMELY RETURN TO WORK" RETURN TO WORK" Complete"IAPA ACCIDENT INVESTIGATION
prior to Treatment in and WSIB FORM 7 to attending REPORT" (MKHS 007)within 24 hours.
#1 above Health Care Professional. 5. Forward copies of"IAPA ACCIDENT INVESTIGATION REPORT"to the
Health and Safety Coordinator and WSIB FORM 7 to Treasury for WSIB
reporting
6. Complete CORRECTIVE ACTION MEMO (MKHS 008)within 48 hours of
accident.
CRITICAL 1. Treatment given by 1. Seek first aid treatment. 1. Ensure the safety of all workers.
Health Care 2. Report accident/incident to 2. Ensure administration of first aid, if necessary.
Professional (e.g. Supervisor.
Doctor). 3. Arrange for transportation of worker(s)to Health Care Professional.
3. Take a "FUNCTIONAL 4. Provide worker with "FUNCTIONAL ABILITIES FORM FOR TIMELY
2. May receive First ABILITIES FORM FOR"
RETURN TO WORK" and WSIB FORM 7 to be taken to attending
Aid at workplace TIMELY RETURN TO WORK"
prior to Treatment in Health Care Professional.
and WSIB FORM 7 to attending
#1 above Health Care Professional. 5. Complete"IAPA ACCIDENT INVESTIGATION REPORT" (MKHS 007)
within 24 hours.
6. Forward copies of"IAPA ACCIDENT INVESTIGATION REPORT"to the
Health and Safety Coordinator and WSIB FORM 7 to Treasury for WSIB
reporting
7. Notify immediately Ministry of Labour, CAO, and Department head.
8. Complete CORRECTIVE ACTION MEMO (MKHS 008)within 48 hours of
accident.
Municipality of Kincardine Occupational Health&Safety Manual Page 89 of 103 MKHS 005
ti Industrial Accident
Prevention Association FIRST AID REPORT
WORKER IDENTIFICATION
Last name First name Worker payroll no.
Occupation Department
DETAILS OF INJURY/ILLNESS
Describe the injury,part of body involved and specify right or left side.
Describe the worker's activities at the time of the incident.
Describe what happened. Code L j
------- ---------------------- ---------
What machine,object,substance or agent caused the injury?
Where was the worker when the injury occurred?
List the names of any witnesses.
Date and time of incident 0 a.m. Date and time incident reported ❑a.m.
❑p.m. 0 p.m.
FIRST AID PROVIDED
Describe the first aid treatment or advice given.
FOLLOW UP CARE
What follow up care was advised or arranged?
❑Return to regular work/duties ❑Obtain health care 0 Send home
❑Other(Specify.)---- __--- -- —.
Prepared by Date and time 0 a.m.
0 p.m.
LPFA 1210302 WHITE-Personnel file PINK-Department superiisodmanager BLUE-Pad/logbook
NOTE: IAPA First Aid Report Forms are available from the Health & Safety Co-
ordinator
MKHS 006
Municipality of Kincardine Occupational Health&Safety Manual Page 90 of 103
MUNICIPALITY OF KINCARDINE
ACCIDENT/INCIDENT INVESTIGATION REPORT
ACCIDENT/INCIDENT DESCRIPTION FORWARD COPIES TO:
Name and Employee Health &Safety Coordinator ❑
#of Injured:
Department/Site: Human Resources Manager ❑
❑ a.m.
Date of Injury(DD-MMM-YY) Time of Injury:
❑ p.m.
Date of Report of Medical Time of Report: El a.m.
Aid or Lost Time: ❑ P.m.
Type of accident/incident: Property Damage/Loss to Process: Describe Loss:
A ❑ First Aid ❑ Equipment/property damage
M ❑ Medical Aid Only ❑ Fire
L [' Lost Time ❑ Loss to process
F ❑ Fatal ❑ Environment
Describe Injury(including part of the body affected, left or right side, etc):
Describe How the accident/incident occurred. State the location, what the person(s)was doing or trying to do, and
all details, including anything unusual.:
Is there a written job procedure for the job performed? Yes ❑ No ❑ Not Applicable ❑
Identify equipment/materials involved. Include make, model, size, weight, shape etc.:
List people who witnessed the accident: Department/Phone Number:
Witness 1:
Witness 2:
MKHS 007-1
Municipality of Kincardine Occupational Health&Safety Manual Page 91 of 103
MUNICIPALITY OF KINCARDINE
ACCIDENT/INCIDENT INVESTIGATION REPORT
IMMEDIATE CAUSES
Identify the substandard action(s) and condition(s)that caused or may have caused the accident/incident.
For each item mark Yes or No
Yes No Code SUBSTANDARD ACTIONS Yes No Code SUBSTANDARD ACTIONS
❑ ❑ 01 Operating equipment without authority ❑ ❑ 21 Inadequate guards or barriers
❑ 0 02 Failure to warn ❑ ❑ 22 Inadequate ground support
❑ 0 03 Failure to secure/make safe ❑ ❑ 23 Inadequate/improper protective
equipment
❑ 0 04 Operating at improper speed ❑ ❑ 24 Defective tools, equipment or
materials
❑ ❑ 05 Making safety devices inoperable ❑ ❑ 25 Congestion or restricted action
❑ 0 06 Removing safety devices ❑ ❑ 26 Inadequate Warning System
❑ ❑ 07 Using defective/improper equipment ❑ ❑ 27 Fire and explosion hazards
❑ ❑ 08 Using equipment improperly ❑ ❑ 28 Substandard housekeeping
❑ 0 09 Failure to use personal protective ❑ ❑ 29 Hazardous environmental conditions:
equipment properly gases, dusts, smoke,fumes, vapors
❑ 0 10 Improper loading ❑ ❑ 30 Noise exposure
❑ ❑ 11 Improper placement 0 ❑ 31 Radiation exposure
❑ ❑ 12 Improper lifting ❑ ❑ 32 High or low temperature exposures
❑ ❑ 13 Improper position for task ❑ ❑ 33 Inadequate or excessive illumination
❑ ❑ 14 Servicing equipment in operation ❑ ❑ 34 Inadequate ventilation
❑ ❑ 15 Horseplay ❑ ❑ 35 Ground(rock)conditions
❑ ❑ 16 Influence of alcohol/drugs suspected
For each Yes answer above, complete the following: (Use additional pages if needed)
Code How did the immediate/direct cause(s) above contribute to the accident/incident?
BASIC/UNDERLYING CAUSES
Identify the reasons for the existence of the substandard actions and conditions listed above by marking each
factor Yes or No.
Yes No Code PERSONAL FACTORS Yes No Code JOB FACTORS
❑ ❑ 61 Inadequate physical/mental capability ❑ ❑ 71 Inadequate leadership/supervision
❑ ❑ 62 Lack of knowledge ❑ ❑ 72 Inadequate engineering
❑ ❑ 63 Lack of skill ❑ ❑ 73 Inadequate purchasing
❑ 0 64 Stress—physical or mental ❑ ❑ 74 Inadequate maintenance
❑ 0 65 Improper motivation ❑ ❑ 75 Inadequate tools/equipment
❑ ❑ 06 Removing safety devices ❑ ❑ 76 Inadequate work standards
❑ ❑ 07 Using defective/improper equipment ❑ ❑ 77 Wear and tear
❑ ❑ 08 Using equipment improperly 0 ❑ 78 Abuse/misuse
Give the basic/underlying cause for each of the selected immediate direct causes above by completing the
following:
Immediate/ Basic/Underlying How does the immediate/direct cause stem from the basic/underlying code?
Direct Code Code (Use additional pages if needed)
Basic/underlying causes of accidents/incidents are the result of lack of control. Lack of control in this case was
the result of: (check all that apply)
Inadequate Program ❑ Yes 0 No
Inadequate Standards ❑ Yes 0 No
Inadequate Compliance to Standards ❑ Yes ❑ No
Municipality of Kincardine Occupational Health&Safety Manual Page 92 of 103
MKHS 007-2
MUNICIPALITY OF KINCARDINE
ACCIDENT/INCIDENT INVESTIGATION REPORT
Cause What action has alreadybeentaken toprevent similar occurrences?
Code(s)
Responsibility
Cause What action is recommended to be taken to prevent Responsibility Date to be Date
Code(s) and/or control similar occurrences? Completed Completed
FIRST AID
First Aid Given by:
Was the employee sent to a health care professional? El Yes El No
If Yes, Date employee received health care:
Where was the worker treated for the injury?
(Please check all that apply) ❑ Emergency Dept. El Health Professional Office El Other
Name, address and phone number of health professional:
When did the employer learn that the worker received health care?
To your knowledge, has the employee has a similar injury/disability? ❑ Yes ❑ No
Number of persons requiring outside medical attention as a result of this incident/accident"
MKHS 007-3
Municipality of Kincardine Occupational Health&Safety Manual Page 93 of 103
MUNICIPALITY OF KINCARDINE
ACCIDENT/INCIDENT INVESTIGATION REPORT
Investigation Team Members: Date of Investigation:
(DD-MMM-YY)
Investigator's Comments:
Signature:
Date:
Manager's Comments: Signature:
Date:
Health &Safety Coordinator's Comments:
Signature:
Date:
Space for sketch/diagram and/or additional notes:
Personal information collected on this form is collected under the authority of the Occupational Health & Safety Act, R.S.O. 1990,
Chapter 0.1 and will be used for the purpose of creating a record to be used for health and safety purposes and may be provided to
the Ministry of Labour. Questions about the collection should be addressed to the Clerk of the Municipality of Kincardine at 1475
Concession 5, RR#5, Kincardine, ON N2Z2X6, 519-368-3468.
MKHS 007-4
Municipality of Kincardine Occupational Health&Safety Manual Page 94 of 103
MUNICIPALITY OF KINCARDINE
WORKER ACCIDENT CORRECTIVE ACTION MEMO
How soon after the incident occurred was it investigated?
Was there anything unusual about the worker'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
Day Month Year
Expected Completion Date:
Supervisor's signature:
Senior Manager signature:
Reviewed and approved by CAO:
MKHS 008
Municipality of Kincardine Occupational Health&Safety Manual Page 95 of 103
MUNICIPALITY OF KINCARDINE
MODIFIED WORK PROGRESS CHART
Name of Injured: Senior Manager:
Date of Injury (DD-MMM-YY): Program Start Date:
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 Occupational Health&Safety Manual Page 96 of 103
MUNICIPALITY OF KINCARDINE
MODIFIED WORK PROGRESS CHART
Week 7 Goal
Week 8 Goal:
Week 9 Goal:
Week 10 Goal:
Week 11 Goal:
Week 12 Goal:
Conclusions and Recommendations:
Worker's Signature: Senior Manager Signature:
MKHS 009-2
Municipality of Kincardine Occupational Health&Safety Manual Page 97 of 103
MUNICIPALITY OF KINCARDINE
UNSAFE WORK REFUSAL
PART 1
Job/Task:
Worker Name: Date(DD-MMM-YY):
Reason for Refusal:
Refusal made Under Regulation/Section:
Supervisor's Action:
Supervisor's Name: Date(DD-MMM-YY):
Signature:
PART 2
Joint Health & Safety Committee Member Involved:
Suggested Action:
Action Confirmation:
Supervisor:
Joint Health & Safety Committee Member:
Worker:
Ministry of Labour Contacted:
Date(DD-MMM-YY): Time:
MKHS 010
Municipality of Kincardine Occupational Health&Safety Manual Page 98 of 103
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: Time: ❑ a'm' Expiry Date:
❑ P.m.
GENERAL INFORMATION
Location:
Entry Type: tank >❑ manhole>❑ storm sewer>El sanitary sewer>El valve chamber>EI
wet well >❑ dry well>❑ Other:
Category: 1 >❑ 2 >❑ 3 >❑ 4 >❑
Description and Purpose of Work to be performed:
Hazards Present
or Likely to Occur and
Corresponding Control
Measures:
EQUIPMENT REQUIREMENTS (entry and rescue)
Yes No Yes No
❑ ❑ Lock-out/de-energize ❑ ❑ Tripod escape unit and cable
El El Lines broken—capped or blanked ❑ ❑ Lifelines
❑ El Purge—flush and vent El El Fire extinguishers
El El Ventilation (blower) El El Lighting
El ❑ Secure area (area secured?) El El Protective clothes
❑ ❑ Self Contained Breathing Apparatus ❑ ❑ Communications (radio, cell, hard hat)
El ❑ Respirator
El ❑ 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 Monitoring:
MKHS 011-1
Municipality of Kincardine Occupational Health&Safety Manual Page 99 of 103
Alarm During Entry? YES ❑ NO ❑
If"yes", explain why:
Remedial Action:
ATMOSPHERIC READINGS (beginning at entry, 15 minute intervals thereafter)
ENTRY TIME:
1. Time 02 ppm %LEL CO ppm H2S ppm
2. Time 02 ppm %LEL CO ppm H2S ppm
3. Time 02 ppm %LEL CO ppm H2S ppm
4. Time 02 ppm %LEL CO ppm H2S ppm
5. Time 02 ppm %LEL CO ppm H2S ppm
6. Time 02 ppm %LEL CO ppm H2S ppm
7. Time 02 ppm %LEL CO ppm H2S ppm
8. Time 02 ppm %LEL CO ppm H2S ppm
9. Time 02 ppm %LEL CO ppm H2S ppm
10. Time 02 ppm %LEL CO ppm H2S ppm
11. Time 02 ppm %LEL CO ppm H2S ppm
12. Time 02 ppm %LEL CO ppm H2S ppm
EXIT TIME:
If an emergency occurs,summon help first. Do not enter a confined space or hazardous area until qualified help arrives and entry can be
made safely. If a person is down for no apparent reason,assume that toxic gases or oxygen deficiency could exist. Do not enter without
full protective and self-contained breathing devices.
PERSON(S)AUTHORIZED TO ENTER(PLEASE PRINT):
Signature: Date:
COMPETENT PERSON IN CHARGE OF ENTRY(PLEASE PRINT):
Signature: Date:
ENTRY APPROVED BY(PLEASE PRINT):
Signature: Date:
Telephone: Cell Phone/Pager:
This Permit must be submitted to Supervisor for retention upon completion of Confined Space Entry.
MKHS 011-2
Municipality of Kincardine Occupational Health&Safety Manual Page 100 of 103
MUNICIPALITY OF KINCARDINE
PHYSICAL DEMANDS ANALYSIS
Job Title: Senior Manager:
Hours/Week: 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
Forward/Backw 0 1 2 3 4
and
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
Pulling 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
Handling 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: 0 -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)
MKHS 012
Municipality of Kincardine Occupational Health&Safety Manual Page 101 of 103
MUNICIPALITY OF KINCARDINE
NEW WORKER SITE/SAFETY ORIENTATION CHECKLIST
WORKER DATA:
Name:
Address:
Telephone#:
SITE ORIENTATION — EXPLAIN THE FOLLOWING:
1. Project& duties, sample tasks: El
2. Site specific and general hazards & chemical hazards: El
3. Location of first aid stations/kits & Material Safety Data Sheets locations ❑
*have worker review Material Safety Data Sheets for workplace *
4. Fire safety equipment location & use ❑
5. Accident reporting procedure El
6. Name of work location Health and Safety representative El
& 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 El
• Foot protection El
• Head protection El
• Hearing protection
• Other:
3. Identify & discuss (if applicable):
• Confined Space Entry Equipment and Guideline El
• Fall restraint equipment El
• Other:
4. List training certifications new worker holds:
Confined Space El Fall Protection El First Aid/CPR ❑
Traffic protection ❑ WHMIS El
Other:
5. Other work specific items:
Worker Signature:
Explained by: Supervisor/Competent Person Signature:
Date of Orientation:
MKHS 013
Municipality of Kincardine Occupational Health&Safety Manual Page 102 of 103
MUNICIPALITY OF KINCARDINE
SITE SAFETY MEETING
DATE: DEPARTMENT:
TOPIC: SUPERVISOR:
(PRINT)
DISCUSSED BY:
(PRINT)
ATTENDEE NAME(PLEASE PRINT) ATTENDEE 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
Municipality of Kincardine Occupational Health& Safety Manual Page 103 of 103