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DEPARTMENT OF PUBLIC WORKS BUREAU OF ENGINEERING INJURY AND ILLNESS PREVENTION PROGRAM JUNE 2017

DEPARTMENT OF PUBLIC WORKS BUREAU OF …eng2.lacity.org/techdocs/IIPP/BOE_IIPP.pdfthe nearest Cal/OSHA District Office within eight (8) hours of discovery with the following information

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  • DEPARTMENT OF PUBLIC WORKS BUREAU OF ENGINEERING

    INJURY AND ILLNESS PREVENTION PROGRAM

    JUNE 2017

  • BUREAU OF ENGINEERING INJURY AND ILLNESS PREVENTION PROGRAM

    Document Control Page

    Review Frequency: Annual

    Prepared/Revised/Reviewed Description of Changes Approved

    Date By Date By

    5/31/2017 B. Stoker/G. Morimoto Program revision (all) I II I I II I

    1

  • BUREAU OF ENGINEERING INJURY AND ILLNESS PREVENTION PROGRAM

    Table of Contents

    Document Control Page ................................................................................................................1

    Table of Contents ..........................................................................................................................2

    Policy Statement ............................................................................................................................3

    Introduction ....................................................................................................................................4

    Responsibility ................................................................................................................................4

    Communication ..............................................................................................................................5

    Compliance ....................................................................................................................................6

    Hazard Assessment ......................................................................................................................6

    Accident Investigations ..................................................................................................................7

    Hazard Correction .........................................................................................................................8

    Training and Instruction .................................................................................................................9

    Recordkeeping ............................................................................................................................10

    Appendix A Organization Chart ...................................................................................................12

    Appendix B Code of Safe Practices ............................................................................................14

    Appendix C Safety Inspection Checklist ......................................................................................16

    Appendix D Reporting Safety Concerns or Suggestion ...............................................................17

    Appendix E Cal OSHA Pocket Guide for the Construction Industry ...........................................20

    Appendix F Cal OSHA Tailgate/Toolbox Topics ........................................................................108

    Appendix G City of LA Employers Report of Injury or Illness Form 5020 .................................110

    Appendix H Workers Compensation Claim Form (DWC-1) .......................................................117

    Appendix I Bureau of Engineering Attendance Roster ..............................................................124

    2

  • Introduction

    In California, every employer is required by law (Labor Code Section 6300) to provide a safe and healthful workplace for his/her employees. Title 8 (T8), of the California Code of Regulations (CCR), requires every California employer to have an effective Injury and Illness Prevention Program (IIPP) in writing and must be in accordance with T8 CCR Section 3203 of the General Industry Safety Orders (GISO). The required elements are:

    Management commitment/assignment of responsibility; Safety communications system with employees; System for assuring employee compliance with safe work practices; Scheduled hazard inspections/evaluation system; Accident investigations; Hazard correction procedures for correcting unsafe/unhealthy conditions; Safety and health training and instruction; and Recordkeeping and documentation.

    This IIPP is a framework for all employees to recognize his or her responsibility to protect life, property and the financial resources of the organization. Every employee is responsible in establishing and maintaining a safe workplace.

    Every manager shall maintain a copy of the Bureaus IIPP. An electronic copy is available on the Bureaus Safety and Health homepage. Supervisors will assist employees with the implementation and clarification of the employee roles within the program. Questions regarding the program can be directed to the Safety Engineer at (213) 485-5317.

    Responsibility

    The General Manager (City Engineer) has the authority to establish general polices and responsibilities of the IIPP.

    The Safety Engineer is the IIPP program administrator. The Safety Engineer, under the authority of the City Engineer, will evaluate and implement a comprehensive occupational safety and health program. The Safety Engineer shall have the authority to enforce all applicable safety and health regulations.

    Managers and Supervisors are responsible for the IIPP implementation, maintenance and enforcement. Manager and Supervisor responsibilities include:

    Establish workplace objectives for accident and illness prevention

    Identify/clarify/enforce employee safety responsibility/compliance

    Establish workplace safety accountability with employees

    Encourage employees to report safety and health concerns without fear ofreprisal

    Allocate Bureau resources to identifying/controlling new/existing hazards in theworkplace

    Install engineering controls where applicable

    Promote safety training for employees Implement safety meetings and discussions with employees

    4

  • Conduct safety assessment/inspections of operations and equipment in all workareas

    Provide adequate personal protective equipment, including instructions for properuse and limitations

    Investigate all work-related accidents, injuries and near-miss incidents Address work conditions that poses an imminent hazard to employees Correct hazards and unsafe acts when discovered Provide documented safety training to employees under their supervision Provide job task/job specific training for the task performed Re-train employees whenever a new process, procedure, or equipment item has

    been introduced into the workplace or when training deficiencies are discovered Document employees failure to comply with safe work policies and procedures

    Every employee is responsible for complying with applicable safety and health regulations, policies and procedures. Employees have an obligation to work safely. Employee responsibilities will include, but are not limited to the following:

    Familiarize themselves with the Bureaus written IIPP, safety policies andprocedures and emergency plans

    Adherence to the policies and procedures Participate in safety related training and meetings Report unsafe condition/equipment immediately to their supervisor or manager Report all job-related injuries or accidents immediately to their supervisor or

    manager Utilize required personal protective equipment Only operate equipment or machinery for which they have been trained and

    authorized to operate Continuously maintain a safe worksite

    Communication

    Two-way communication on matters relating to occupational safety and health is an essential element to an effective safety and health program. Managers, supervisors and employees are responsible for ensuring that all safety and health policies and procedures are clearly communicated and understood at all levels of employment in a form readily understandable by all employees. Communications regarding safety shall be encouraged without fear of reprisal. The Bureaus communication system shall provide, but not be limited to the following:

    Conduct new employee orientation that discuss safety and health policies andprocedures

    Review IIPP elements periodically

    Provide workplace safety training programs

    Establish regularly scheduled safety meetings with managers, supervisors andemployees

    Establish an (recognized/anonymous) unsafe or safety suggestion reportingsystem for employees to communication safety issues to management

    Publish and post written safety information reinforcing the Bureaus commitmentto safety and health

    Communicate safety concerns to all levels of the Bureau

    5

  • Document all safety communication efforts

    Compliance

    Managers, supervisors and employees are responsible for complying with safe work practices. The Bureaus system for ensuring worker compliance shall include the following:

    Informing employees on the provisions of the Bureaus IIPP

    New employee orientation

    Safety meetings/tailgates

    Safety and health training

    Evaluating the safety performance of all employees

    Recognizing employees who perform duties in a safe manner

    Providing training to employees who demonstrate deficient safety performance

    Disciplining employees who fail to comply with safe work practices

    General workplace safety practices include, but are not limited to the following:

    IIPP implementation Emergency Action and Fire Prevention Plan Medical emergencies, first aid and emergency procedures Prevention of musculoskeletal disorders Workplace housekeeping (i.e. workstation, storage area, stairways, aisles,

    walkways, emergency exits, electrical panel, fire prevention equipment, andtemporary storage locations)

    Prohibiting horseplay, scuffling, or other acts that adversely influence safety Proper reporting of hazards and accidents to supervisors and managers Hazard communication, including worker awareness of potential chemical hazards,

    proper handling and container labeling Proper storage and handling of toxic and hazardous substances

    Hazard Assessment

    Periodic inspections provide a method of identifying existing or potential hazards in the workplace by eliminating or controlling them. Hazard control is the heart of an effective Injury and Illness Prevention Program.

    If hazards occur or recur, this reflects a breakdown in the hazard control system. The hazard control system is then, the basis for developing safe work procedures and injury illness prevention training.

    An effective hazard control system will identify: hazards that exist or develop in your workplace, how to correct those hazards, and steps you can take to prevent their recurrence. Hazard assessments shall occur under the following conditions:

    Periodic facility/workplace inspections When the IIPP is established When a new substances, processes, procedures or equipment is introduced into

    the workplace and presents a potential hazard

    6

  • When an unidentified hazard is recognized When occupational injuries and illnesses occur When employees are hired and/or reassign to permanent/intermittent work

    operations or tasks which a hazard evaluation has not been conducted Whenever workplace conditions warrant an inspection

    Accident Investigations

    The primary focus of an accident investigation is to identify and understand why the accident or near miss occurred and what actions can be taken to prevent recurrence.

    Procedures for investigating workplace accidents include:

    Visiting the accident scene as soon as possible Interviewing injured workers and witnesses Examining the workplace for factors associated with the accident/near miss Determining the root cause of the accident Taking corrective action to prevent the accident/near miss from reoccurring Recording the findings and corrective actions taken

    Managers and Supervisors are to determine the following:

    What happened (including when)? How/why did the incident happen? What should be done? What action has been taken?

    Supervisors investigating accidents or injuries shall document all information gathered during the investigation. Documentation shall include pictures, interviews, diagrams, schematics and drawings. Supervisors must ensure the following documents have been completed:

    City of Los Angeles, Personnel Department, Employers Report of OccupationalInjury or Illness (Form 5020) including all Accident Investigation Forms. (Form5020 is required for occupational injury or illness which results in lost timebeyond the date of the incident or requires medical treatment beyond first aid).

    State of California Department of Industrial Relations Division of WorkersCompensation, Workers Compensation Claim Form (DWC 1)

    Serious injuries (defined by Cal/OSHA) are investigated by the Safety Engineer and the Division Manager.

    "Serious injury or illness" means any injury or illness occurring in a place of employment or in connection with any employment which requires inpatient hospitalization for a period in excess of 24 hours for other than medical observation or in which an employee suffers a loss of any member of the body or suffers any serious degree of permanent disfigurement, but does not include any injury or illness or death caused by the commission of a Penal Code violation, except the violation of Section 385 of the Penal Code, or an accident on a public street or highway. Section 330(h), Title 8, California Administrative Code.

    7

  • Fatalities/Serious Injury

    For accidents that cause death, dismemberment, permanent disfigurement, or that requires in-patient hospitalization of an employee for a period in excess of twenty-four (24) hours for other than medical observation, the Manager or Supervisor must notifythe nearest Cal/OSHA District Office within eight (8) hours of discovery with thefollowing information.

    As required by Title 8 regulations, section 342, you must include the following information in your phone call, if available:

    1. Time and date of accident/event2. Employer's name, address and telephone number3. Name and job title of the person reporting the accident4. Address of accident/event site5. Name of person to contact at accident/event site6. Name and address of injured employee(s)7. Nature of injuries8. Location where injured employee(s) was/were taken for medical treatment9. List and identity of other law enforcement agencies present at the

    accident/event site10. Description of accident/event and whether the accident scene or instrumentality

    has been altered

    City of Los Angeles Contacts Bureau of Engineering Safety Engineer (213) 485-5317

    Personnel Department Safety Administrator (213) 473-7097

    Cal/OSHA District Offices Long Beach 3939 Atlantic Ave., Suite 212, Long Beach 90807 (562) 506-0810

    Los Angeles 320 W. 4th St., Rm. 670, L.A. 90013 (213) 576-7451 Van Nuys 6150 Van Nuys Blvd., Suite 405, Van Nuys 91401 (818) 901-5403

    Hazard Correction

    Hazards that are discovered as the result of periodic inspections or during normal operations shall be corrected promptly. Reports of unsafe conditions by employees shall be investigated promptly by supervisors. The Bureau recognizes that hazards range from imminent danger to relatively low risks and shall be managed accordingly. The supervisors corrective action must include an evaluation of the potential hazard and a suitable timeline for correction.

    Imminent Hazards

    Serious hazards present an imminent danger to life or limb and immediate action shall be taken to mitigate the hazard. Employees must immediately discontinue work and notify the supervisor or manager. All employees shall be removed from the hazard(s) until the hazard can be abated or controlled to eliminate risk to the employee. Access to the work location(s) specific to the hazard shall be restricted until a competent person can review, abate and/or control the imminent hazard. Proper training, safeguards and

    8

    https://www.dir.ca.gov/title8/342.html

  • personal protective equipment shall be used prior to any corrective action implementation to an imminent hazard situation. All corrective action shall be documented.

    General Hazards

    General or non-imminent hazards shall be reported to the supervisor, manager, Administration Division or building maintenance. Employees shall initiate correction in a timely manner, eliminating risk to employees as best possible (i.e. warning signs, caution tape, cones, barricades).

    Training and Instruction

    Effective dissemination of safety information is essential for the success of the Bureaus IIPP. Training includes general safe work practices as well as specific instruction on control of hazards unique to each employees job assignment. Supervisors will be an integral part of the training process with each employee. Employee training and instruction at minimum must be provided:

    To all employees when your program is first established To all new employees To all employees given new job assignments for which training has not been

    previously received Whenever new substances, processes, procedures or equipment are introduced

    to the workplace and present a new hazard Whenever you or your supervisors are made aware of a new or previously

    unrecognized hazard For all supervisors to assure they are familiar with the safety and health hazards

    to which employees under their immediate direction and control may be exposed

    The Bureau uses many types of training methods to communicate safety-related information to employees. Training may vary widely with respect to instructional method, setting, and subject matter. Types of training applicable to all employees include:

    1. Classroom instruction, which involves the presentation of general or specificsafety information. These classes are taught by Bureau employees or outsidecontractors.

    2. On-the-job training, in which a small number of employees receive instructionfrom the supervisor. On-the-job training can also include instruction on how tooperate and maintain new equipment by manufacturer representatives.

    3. Written instructions or training materials, which include memos, safety bulletins,and policy letters.

    General safety training refers to instruction which is applicable to all Bureau employees and not related to specialized trades or procedures. The Bureau ensures that all new employees shall attend a new hire orientation provided by the Bureau. New hire orientation shall include the following safety and health subjects:

    1. Basic safety training and introduction to the Bureaus IIPP, including an overallreview of employees rights and employers responsibilities under the CaliforniaCode of Regulations, Title 8.

    9

  • 2. Instruction on reporting injuries and unsafe conditions, and employees rightsunder Workers Compensation law.

    Many workplace operations require specialized training or instruction under the California Code of Regulations, Title 8. Before employees can be allowed to perform certain job tasks, supervisors must ensure that employees have completed required training courses. These specialized training courses include, but are not limited to: Respiratory Fit Instruction, Bloodborne Pathogen Exposure, Workplace Violence, Emergency Evacuation and Hazard Communication.

    It is the responsibility of each supervisor to ensure that employees receive general and job specific safety training for each employee under his/her direct control. Supervisors are required to review employees compliance with instruction given regarding safety rules, regulations, and policies established by the Bureaus IIPP. The supervisor must ensure that employees comprehend the training they are provided, ensuring that language barriers and/or literacy difficulties are accommodated. Instruction by supervisors shall include the following subjects:

    1. Safe work procedures, personal protective equipment, evacuation andemergency response, hazard communication and identification, and reporting ofworkplace safety hazards.

    2. Protection of employees from hazards specific to their individual job duties.3. New substances, processes, procedures, or equipment introduced into the

    workplace that may create new hazards, when new or previously unrecognizedhazards are brought to a supervisors attention.

    The person performing safety training must ensure that appropriate records are preserved and maintained. All safety training records must include the subject title, name of employee, Paysr number, the date of training and the person who administered the training. Please use the Bureaus training roster in Appendix I. The supervisors shall retain all documentation of employee safety training and ensure that a copy has been sent to the Bureaus Administration Division Training Section mailstop 311. All documentation regarding safety training shall be kept on file at the location where the employee reports to work.

    Recordkeeping

    Maintaining documentation is a crucial element in being able to demonstrate steps to an effective safety program. Adequate recordkeeping in accidents, work-related injuries, illnesses and property losses enables our organization to learn from the past and make corrections for future operations. Information gathered from audits, investigations and inspections are vital in the steps for improving our IIPPs effectiveness. Record keeping element will include, but is not limited to the following:

    Injury and illness records (i.e. Form 5020, Cal OSHA 300, 301, 300A) Fatalities and serious injuries Exposure Records (if applicable) Access to employee medical records (through the Citys Medical Services

    Division) Inspections and audits Safety meetings

    10

  • Safety training Vehicle accidents (Form 88)

    Managers and Supervisors shall ensure each fatality, injury or illness that is work-related is documented with the appropriate forms.

    11

  • Appendix A Organization Chart

    Refer to the Bureau of Engineering Intranet Homepage for the most current document

    12

  • 13

  • Appendix B Code of Safe Practices

    General 1. Comply with safety policies and procedures necessary to establish and maintain a safe work

    environment.2. Report all unsafe conditions to the immediate Supervisor and/or Manager.3. Report all work-related accidents, injuries or illnesses to the immediate Supervisor and/or

    Manager regardless of severity.4. All employees shall be given frequent accident prevention instructions at least every 10-working

    days.5. Anyone known to be under the influence of drugs or an intoxicating substance, which impairs an

    employees ability to safely perform a task, shall not be allowed on the job in such condition. Thisinformation shall be reported immediately to the Supervisor and Manager.

    6. No one knowingly, shall be permitted or be required to work while the employee's ability and/oralertness is impaired by fatigue, illness or other causes that might unnecessarily expose theemployee(s) to an accident or injury.

    7. Horseplay, pranks or jokes that may adversely influence employee safety or well-being shall beprohibited and discouraged.

    8. Work shall be well planned and supervised to prevent injuries.9. Employees shall not enter manholes, underground vaults, chambers, tanks, silos, or other similar

    places that receive little ventilation, unless it has been determined that is safe to enter and theemployee has adequate training and instructions.

    Electrical 1. Electrical panels shall have 30 inches of unobstructed clearance in front of the access panel.2. Electrical rooms shall be free of combustible or flammable material.3. All electrical outlets shall have approved protective coverings.4. Extension cords shall not be used as a substitute for permanent wiring.5. No person shall use extension cords when cords are: spliced or extended so as to exceed their

    original length; extended from one room to another; stapled, nailed or otherwise fastened to walls,floors, or ceilings; placed under rugs; used to supply more electrical currents that the cordsintended rating; frayed, deteriorated, damaged, or have exposed wire.

    6. Trained and authorized employees shall only be allowed to work on office electrical equipment.

    Physical 1. Ensure that all stairs, hallways, walkways and exits are well illuminated and free of obstructions

    for safe emergency exit.2. Caution shall be used when transitioning from one elevation to another. Handrails shall be used

    when necessary.3. All chair legs or casters shall be in contact with the floor when in use. Do not lean beyond the

    chairs center of gravity.4. Do not reach for supplies or equipment higher than your head. Use a stepladder or ladder to

    prevent muscle strains.5. When lifting heavy objects, employees shall lift load with their legs (back perpendicular to floor) or

    use an approved mechanical lifting device (i.e. hand truck, pallet jack, forklift). Seek employeeassistance with loads that are too heavy or awkward.

    6. Do not use chairs, boxes, buckets or tabletops in substitution for a stepladder or ladder.7. Keep cabinet and desk drawers closed when not in use to prevent bump and trip injuries. Top-

    heavy file cabinets (opened) may cause cabinets to topple over.

    14

  • 8. Office paper cutters (blades) shall be in a secured closed position when not in use. If theprotective equipment (i.e. blade guard, latch, blade spring tensioner) is damaged or missing, thecutter shall be tagged, secured and removed from service until repairs can be completed.

    9. Employees shall ensure that all-protective guards and protective devices are in place andproperly adjusted prior to use. Protective guards and devices shall not be removed or disabled.Defective or deficient equipment shall be reported to the immediate supervisor, tagged, securedand removed from service until safe to operate.

    10. Appropriate and adequate footwear shall be used at all times. Inappropriate footwear (i.e. opentoed, balding sole,) shall not be worn especially in construction and process areas.

    11. File cabinets, bookcases computers and accessories shall be secured to a fixed object to preventaccidental movement during an earthquake.

    12. Good housekeeping shall be maintained at all times.13. Walkways and floors shall be maintained free from slips or tripping hazards (i.e. liquids, electrical

    cords, boxes, paper, and debris). Liquid spills shall be cleaned immediately.14. Work surfaces shall be maintained dry or appropriate means taken to assure surfaces are slip-

    resistant.

    Emergencies/Fire 1. In the event of a fire, immediately notify all building tenants according to the procedures outlined

    in the Emergency Safety Procedures.2. Employees shall not use fire extinguishers unless they have received adequate fire extinguisher

    training.3. STOP Work Immediately upon discovering a fire alarm and proceed to the nearest safe exit.

    Upon exiting the building, close doors and proceed to the nearest Evacuation Zone or safe areafor a personnel count.

    4. Floor Wardens/Assistant Floor Wardens shall be responsible for coordinating floor evacuationprocedures during an actual emergency.

    5. Designated employees shall assist the physically challenged tenants to a safe location during anemergency.

    6. Emergency Exit doors and corridors shall remain unobstructed at all times.7. Exit Doors shall remain unlocked during business hours.8. Remove heat sources or ignition from flammable storage location.9. Maintain all hazardous and flammable materials in the proper storage container and area.10. Maintain hazardous chemicals in a manner that will not react with other unintended materials,

    chemical or temperature.11. Hazardous materials/chemicals shall be used and handled in accordance with the manufacturer

    recommendation as identified in the Safety Data Sheet (SDS).

    15

  • Appendix C Safety Inspection Checklist

    Division/Group: Location/Area:

    Date: Prepared By:

    Safe Work Condition/Safe Work Practice Y/N Corrective Action(s) Required

    1. Doors, hallways, aisles, pathways and walkwaysshall be free and clear of obstruction?

    2. Step stool or an appropriate ladder available forelevated storage areas?

    3. Handcart or dolly available for lifting/moving?

    4. Cabinet doors, drawers and file cabinets closedwhen not in use?

    5. Chairs in good condition?

    6. Paper cutter closed and latched?

    7. Sharp items properly secured to prevent injuries?

    8. Material stored or secured not to create a hazardor restrict exits during an earthquake oremergency?

    9. Shelves, file cabinets, lockers etc. anchored forearthquake?

    10. Emergency procedures and evacuation plan up todate?

    11. Are EXIT signs illuminated and visible?

    12. First Aid kits available and inspected?

    13. Electrical cords used as permanent power source?

    14. Electrical cords free from doors, aisles or hangingfrom walls and ceilings?

    15. Electrical cords damaged or overloaded? (i.e.frayed wires, ground terminal in place)

    16. Electrical outlets cover plates in place?

    17. Fire extinguisher inspection tags up to date andready for emergency use?

    18. Fire extinguishers or fire hose properly identifiedand readily accessible? (every 75ft. with 30 inchesfrontal clearance)

    19. Are portable heaters or heat sources clear offlammable or combustible material?

    20. Work areas free of excess combustibles?

    21. All hazardous materials and chemicals properlylabeled and stored?

    22. Cal/OSHA required posting posted? (i.e. OSHA300, IIPP)

    Corrective action (specify in detail):

    Is hazard imminent? Yes / No (If yes, provide temporary mitigation measures and describe on back side)

    Person responsible for correction: Copy provided to:

    (Date/time) Reviewed by: Date:

    16

  • Appendix D Reporting Safety Concerns or Suggestion

    1. Print legibly when completing this safety concern or suggestion.

    2. Employees complete Part A in its entirety (except Name and Phone No. if reporting

    anonymously).

    3. Include detailed information on site/address/location and describe safety concern or suggestion.

    4. Form submittal (It is recommended that the employee retains a copy of this document)

    a. Non-anonymous safety concern or suggestion should be submitted to their immediate

    supervisor.

    b. Anonymous safety concern or suggestion can be submitted to the immediate supervisor or

    BOE Safety.

    5. Supervisors complete Part B in its entirety upon receiving document.

    6. The completed document shall be submitted to Safety.

    a. Mail Stop 730

    b. Deliver to Safety 7th floor PWB, 1149 South Broadway, LA, CA 90015

    Employees are encouraged to report all safety concerns without fear of reprisal against employee(s).

    Employees have the right to remain anonymous in reporting safety concerns. If the employee chooses

    to remain anonymous, the results of the investigation will be posted at the site nearest to the safety

    concern.

    17

  • Reporting Safety Concerns or Suggestion Flow Chart

    Employee Safety Concern or Suggestion?

    No report necessary

    No

    Employee anonymously completes part A Reporting Safety

    Concern or Suggestion and submits to

    immediate supervisor or Safety.

    Resolved

    Safety may advise method or means to resolution and

    completes part C.

    Supervisor sets interim safety measures and

    completes part B and submits to

    Safety.

    No

    Employee completes part A Reporting Safety Concern or Suggestion and

    submits to immediate supervisor.

    Supervisor is notified. Supervisor and Employee

    resolve promptly?

    No

    No

    Yes

    Yes

    Interim safety measures remain in effect. Advise

    employee and supervisor reasons for delay. Track

    until resolved.

    Employee wants to remain anonymous?

    Can employee resolve?

    Yes

    Yes

    Inform employee, supervisor

    and affected employees.

    18

  • Reporting Safety Concerns or Suggestion

    Part A To be completed by Employee Case No. (Internal Use)

    Name Phone No. (Optional) (Optional)

    Div/Dept/Group Supervisor

    Site/Address/Location Date

    Has this safety concern or suggestion been brought to the attention of your supervisor?

    Yes, Supervisors name and date

    No, Explain why not

    Do you want to be contacted by Safety? Yes No (Provide phone number above) Do you wish to remain anonymous? Yes No Describe safety concern or suggestion; including the location for investigation.

    Part B To be completed by Supervisor Date Received:

    Corrective Action

    Signature: Date Completed:

    Part C To be completed by Safety Date Received:

    Are interim safety measures adequate? Yes No

    Corrective Action

    Hazard been mitigated or removed? Yes No

    Signature: Date Completed:

    If the safety concern creates an immediate employee hazard, notify your immediate supervisor or bureau safety representative at (213) 485-5317. All personal information on this form can remain confidential.

    19

  • Appendix E Cal OSHA Pocket Guide for the Construction Industry

    Refer to the Cal OSHA website for the most current document. http://www.dir.ca.gov/dosh/dosh_publications/ConstGuideOnline.pdf

    20

  • CAL/OSHA POCKET GUIDE FOR THE CONSTRUCTION INDUSTRY

    www.dir.ca.gov

    21

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  • Cal

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    http://www.dir.ca.gov/samples/search/query.htm

  • Cal

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    623,

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    9(a)

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    s, t

    wo

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    rway

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    qui

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    . 162

    9(a)

    (4)

    J.Th

    e fo

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    604.

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    . 171

    8(a)

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    0(c)

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    25

    http://www.dir.ca.gov/title8/1629.htmlhttp://www.dir.ca.gov/title8/3637.htmlhttp://www.dir.ca.gov/title8/3648.htmlhttp://www.dir.ca.gov/title8/3637.htmlhttp://www.dir.ca.gov/title8/3642.htmlhttp://www.dir.ca.gov/title8/3657.htmlhttp://www.dir.ca.gov/title8/1630.htmlhttp://www.dir.ca.gov/title8/1735.htmlhttp://www.dir.ca.gov/title8/1604_29.htmlhttp://www.dir.ca.gov/title8/1604_1.htmlhttp://www.dir.ca.gov/title8/1675.htmlhttp://www.dir.ca.gov/title8/1623.htmlhttp://www.dir.ca.gov/title8/1624.htmlhttp://www.dir.ca.gov/title8/1625.htmlhttp://www.dir.ca.gov/title8/1629.htmlhttp://www.dir.ca.gov/title8/1629.htmlhttp://www.dir.ca.gov/title8/1629.htmlhttp://www.dir.ca.gov/title8/1604_1.htmlhttp://www.dir.ca.gov/title8/1629.htmlhttp://www.dir.ca.gov/title8/1629.htmlhttp://www.dir.ca.gov/title8/1718.htmlhttp://www.dir.ca.gov/title8/1720.html

  • Cal

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    330

    (h)

    26

    http://www.dir.ca.gov/title8/1509.htmlhttp://www.dir.ca.gov/title8/3203.htmlhttp://www.dir.ca.gov/title8/1509.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/5144.htmlhttp://www.dir.ca.gov/title8/3395.htmlhttp://www.dir.ca.gov/title8/1671_1.htmlhttp://www.dir.ca.gov/title8/340.htmlhttp://www.dir.ca.gov/title8/1509.htmlhttp://www.dir.ca.gov/title8/1512.htmlhttp://www.dir.ca.gov/title8/3204.htmlhttp://www.dir.ca.gov/title8/461.htmlhttp://www.dir.ca.gov/title8/3664.htmlhttp://www.dir.ca.gov/title8/3650.htmlhttp://www.dir.ca.gov/title8/1671_1.htmlhttp://www.dir.ca.gov/title8/1671_2.htmlhttp://www.dir.ca.gov/title8/411_3.htmlhttp://www.dir.ca.gov/title8/341_4.htmlhttp://www.dir.ca.gov/title8/341_10.htmlhttp://www.dir.ca.gov/title8/332_4.htmlhttp://www.dir.ca.gov/title8/341_10.htmlhttp://www.dir.ca.gov/title8/1529.htmlhttp://www.dir.ca.gov/title8/1532_1.htmlhttp://www.dir.ca.gov/title8/5156.htmlhttp://www.dir.ca.gov/title8/5157.htmlhttp://www.dir.ca.gov/title8/5158.htmlhttp://www.dir.ca.gov/title8/1671_2.htmlhttp://www.dir.ca.gov/title8/2947.htmlhttp://www.dir.ca.gov/title8/1691.htmlhttp://www.dir.ca.gov/title8/1801.htmlhttp://www.dir.ca.gov/title8/3320.htmlhttp://www.dir.ca.gov/title8/3314.htmlhttp://www.dir.ca.gov/title8/1509.htmlhttp://www.dir.ca.gov/title8/3203.htmlhttp://www.dir.ca.gov/title8/342.htmlhttp://www.dir.ca.gov/title8/330.html

  • Cal

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    cket

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    | Jun

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    C

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    A P

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    Ind

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    une

    2015

    2.B

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    1.1,

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    .70

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    rea.

    341

    .6

    27

    http://www.dir.ca.gov/title8/5248.htmlhttp://www.dir.ca.gov/title8/341_1.htmlhttp://www.dir.ca.gov/title8/341_9.htmlhttp://www.dir.ca.gov/title8/5203.htmlhttp://www.dir.ca.gov/title8/1532_1.htmlhttp://www.dir.ca.gov/title8/1529.htmlhttp://www.dir.ca.gov/title8/1535.htmlhttp://www.dir.ca.gov/title8/1532.htmlhttp://www.dir.ca.gov/title8/1532_2.htmlhttp://www.dir.ca.gov/title8/1532_1.htmlhttp://www.dir.ca.gov/title8/5190.htmlhttp://www.dir.ca.gov/title8/5210.htmlhttp://www.dir.ca.gov/title8/5217.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/461.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/341_1.htmlhttp://www.dir.ca.gov/title8/344_70.htmlhttp://www.dir.ca.gov/title8/341_1.htmlhttp://www.dir.ca.gov/title8/341.htmlhttp://www.dir.ca.gov/title8/1610_9.htmlhttp://www.dir.ca.gov/title8/1618_1.htmlhttp://www.dir.ca.gov/title8/341_15.htmlhttp://www.dir.ca.gov/samples/search/query.htmhttp://www.dir.ca.gov/title8/341_6.html

  • Cal

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    cket

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    uctio

    n In

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    try

    | Jun

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    98

    C

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    A P

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    tion

    Ind

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    2.B

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    Lic

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    Aeri

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