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HomeMy WebLinkAboutRESOLUTION NO. 2024-42 0 0 PERSONNEL POLICY MANUAL ADOPTED BY THE FAIRFAX CITY COUNCIL May 14, 2024 1 CHAPTER 1 - WELCOME CHAPTER 2 - EMPLOYMENT 2.1 Definitions of Employee Status 2.1.1 Full-time Regular Employee 2.1.2 Part-time Regular Employee 2.1.3 Temporary or Seasonal Employee 2.2 Equal Employment opportunity 2.2.1 Job Opening Posting 2.2.2 References 2.2.3 Physical Examination 2.2.4 Proof of Employability 2.2.5 Background Checks 2.2.6 Employment of Relatives 2.2.7 Employment of Minors 2.2.8 Rehires 2.3 ADA Compliance 2.4 Harassment 2.5 Preventing Sexual Harassment in the Workplace 2.5.1 Purpose 2.5.2 Definitions 2.5.3 Procedures 2.6 New Position Orientation Period 2.7 New Hire's Probationary Period 2.8 Residency Requirements 2.9 Personnel Records and Privacy 2.10 Complaint Procedure and Anti-Retaliation Policy CHAPTER 3 - PAYROLL PRACTICES AND HOURS OF WORK 3.1 Certification Schedule 3.2 Rates of Pay 3.3 Rates of Pay Adjustments 3.4 Total Remuneration 3.5 Temporary Pay Increase 3.6 New Appointments 3.7 Performance Evaluation 3.8 Hours of Work 3.9 Pay Periods 3.9.1 Weekly 3.9.2 Monthly 3.9.3 Quarterly 3.9.4 Annually 3.10 Deductions From Pay 3.10.1 Voluntary Deductions 3.10.2 Garnishments from Pay 3.11 Overtime and Compensation 3.11.1 Overtime Work 3.11.2 Flextime Work 3.11.3 Minimum Show-up Time 3.11.4 Compensatory Time Off 3.11.5 Compensatory Time Off Pay Upon Termination 3.11.6 Overtime Computation 3.11.7 Fairfax Fire and Rescue Members 3.12 Attendance CHAPTER 4 - EMPLOYEE BENEFITS AND SERVICES 4.1 Holidays 4.1.1 Holidays Observed 4.1.2 Holiday Pay 4.1.3 Holidays on Saturdays or Sundays 4.1.4 4.2 Vacations 4.2.1 Full-time Eligibility 4.2.2 Part-time Eligibility 4.2.3 Scheduling Vacation 4.2.4 Carryover 4.2.5 Vacation Pay Upon Termination 4.3 Sick Leave 4.3.1 Full-time Eligibility and Accrual 4.3.2 Part-time Eligibility and Accrual 4.3.3 Unpaid Leave of Absence 4.3.4 Notification and Verification 4.3.5 Abuse of Sick Leave 4.3.6 Sick Leave Upon Termination 4.3.7 Work-related Injuries 4.4 Family Medical Leave 4.4.1 Leaves Available 4.4.2 Eligibility Requirements 4.4.3 General Provisions 4.4.4 How and When Leave May be Taken 4.4.5 Notice Requirements 4.4.6 Medical Certification 4.4.7 Rights and Benefits During Leave 4.4.8 Returning to Work 4.5 Military Leave 4.5.1 Leaves Available 4.5.2 Reemployment Rights - Eligibility 4.5.3 Continuation of Benefits During Military Service 4.6 Bereavement Leave 4.6.1 Full-time Eligibility 4.6.2 Part-time Eligibility and Accrual 4.6.3 Use 4.6.4 Payment 4.6.5 Unpaid Bereavement Leave 4.7 Jury and Witness Duty 4.8 Voting Leave 4.9 Maternity/Paternity Leave 4.10 Unpaid Leave of Absence 4.11 Group Health , Life Insurance, Dental, Short-term Disability, AD&D Benefits 4.11.1 Eligibility 4.11.2 Start of Coverage 4.11.3 Continuation of Coverage 4.11.4 Life Insurance 4.11.5 Continuation Coverage under Iowa Code Chapter 509A 4.11.6 Short-term Disability Insurance 4.11.7 AD&D Insurance 4.11.8 Dental Insurance 4.12 Personal Days 4.12.1 Full-time Eligibility and Accrual 4.12.2 Part-time Eligibility and Accrual 4.12.3 Personal Days Upon Termination 4.13 Business Travel 4.13.1 Authorization 4.13.2 Travel Expenses 4.13.3 Safety 4.13.4 Accidents and Violations 4.13.5 Record Keeping 4.13.6 Compensation Time 4.13.7 Conduct 3 4.14 PTO Donation 4.14.1Form 4.14.2 Review 4.14.3 Recipient Criteria 4.14.4 Donor Criteria 4.14.5 Process 4.15 IPERS 4.15.1 Contributions 4.15.2 Participation 4.15.3 Ending Employment CHAPTER 5 - STANDARDS OF CONDUCT & CORRECTIVE ACTION 5.1 Policy 5.2 Work Rules 5.3 Corrective Action/Discipline 5.4 Telephone Use CHAPTER 6 - SAFETY AND HEALTH 6.1 Promoting a Safe Work Environment 6.2 Smoking Policy 6.3 Bloodborne Pathogens Program 6.4 Confined Space Program 6.5 Fall Protection Program 6.6 Hazard Communication Program 6.7 Lockout-Tagout Program 6.8 Personal Protective Equipment Program CHAPTER 7 - EMPLOYEE COMMUNICATIONS 7.1 Privacy Expectations 7.2 Bulletin Boards 7.3 Open Door 7.4 Electronic Communications Policy CHAPTER 8 - SUBSTANCE ABUSE POLICY 8.1 All Employees 8.1.1 Purpose 8.1.2 General Rule 8.1.3 Legal Drugs 8.1.4 Alcohol or Drug Possession, Transfer of Use 8.1.5 Impairment During Work Hours 8.2 Prospective Employees 8.2.1 Drug Testing or Prospective Employees 8.2.2 Scheduling and Cost of pre-Employment Testing 8.3 Employees Covered by the Federal Motor Carrier Safety Administration 8.3.1 Testing Program 8.3.2 Required Hours of Compliance and Prohibited Behavior 8.3.3 Designated Representative (DER) 8.3.4 Collection Facility 8.3.5 Documentation 8.3.6 Circumstances for Testing 8.3.7 Expenses of Administering the Testing Program 8.3.8 Refusal to Submit to a Controlled Substances Test 8.3.9 Testing Procedures 8.3.10 Test Results 8.3.11 Returning to Work 8.3.12 Expenses of Treatment 8.3.13 Time Off 8.3.14 Treatment and Rehabilitation 8.3.15 Second Positive Test Results 8.3.16 Conduct and Performance 8.3.17 Effect of Alcohol and Controlled Substances 8.3.18 Acknowledgement CHAPTER 9 - MISCELLANEOUS 9.1 General Housekeeping 9.2 Use of Equipment and Vehicles 9.3 Dress Code 9.4 Uniforms 9.5 Safety Equipment 9.6 Cell Phone 9.7 Computers 9.8 Professional Memberships/Endorsements/Licenses 9.9 Training Assistance 9.10 Disaster Recovery Plan - Computer Based Policy CHAPTER 10 - SEPARATION 10.1 Employee Separation ELECTRONIC COMMUNICATION POLICY (Appendix A) A.1 Purpose A.2 Privacy A.3 Security A.4 Public Information A.5 Electronic Records Retention Policy A.6 Acceptable Use Guidelines A.7 Personal Use A.8 Violations A.9 Disclaimers DISASTER RECOVERY PLAN (Appendix B) B.1 Passwords B.2 Log Off/Time Out B.3 Running Anti-Virus Programs B.4 Storing of System Backup Tapes B.5 Disaster Recovery Plan B.6 Computer-based Systems Policy Review and Amendment 5 CITY OF FAIRFAX PERSONNEL POLICY MANUAL CHAPTER 1 - WELCOME Welcome to the City of procedures, employment benefits, and other matters concerning your employment with the City of Fairfax. Some of the policies and benefits described in this manual, such as the group health insurance plan, are covered in greater detail in official policy documents from the insurance carrier. You should refer to those documents for more information. All City of Fairfax employees are covered by this manual, except: 1. Elected officials; 2. Employees hired on a contractual basis; 3. Members of boards and commissions; 4. Persons appointed to serve without compensation. This manual is provided for informational purposes only. The policies, procedures, benefits, and plans described in the manual may be revised by the City of Fairfax without prior notice. The City of Fairfax retains the exclusive right to revise the manual at any time. When changes are made, you will receive a supplement or a new manual. Any promises, representations or actions by a City official or employee that are contrary to this manual are not the official policy of the City of Fairfax and are of no force or effect. This employee manual is not intended to create any contractual rights in favor of you or the City. This manual is not to be construed as an employment contract or as a promise that you will be employed for any specified period of time. Employment can be terminated at any time at the will of either you or the City of Fairfax. Nothing in this manual changes the at-will nature of your employment with the City of Fairfax. ________________________________________________________________________________ CHAPTER 2 -EMPLOYMENT 2.1Definitions of Employee Status: 2.1.1 Full-time regular employee: Full- normal full-time thirty (30) hour work week on a regular basis. 2.1.2 Part-time regular employee: Part-time regular employee means an employee hired who may work fewer than thirty (30) hours per week on a regular basis. Part-time regular employees are not eligible for any benefits described in this manual, unless otherwise indicated or required by law. 2.1.3 Temporary or seasonal employee: Temporary or seasonal employee means an employee engaged to work full-time or part- later than upon completion of a specific assignment. Temporary or seasonal employees are not eligible for any benefits described in this manual, unless otherwise indicated or required by law. 2.2 Equal Employment Opportunity: te qualified individuals on the basis of their qualifications, interest and aptitude, and without unlawful regard to race, religion, color, sex, age, national origin, disability, or any other characteristic protected by local, state or federal law and to comply with t not limited to recruiting, hiring, training, transfers, promotions and benefits. 2.2.1 Job Opening Posting: Whenever a position with the City becomes available, a notice of such opening will be posted at City Hall, the Fairfax Public Library and the Fairfax Post Office for at least ten calendar days before the deadline for filling the position. The notice will contain the position title, a brief job description, and minimum hiring specifications. Applications including current employees, shall be considered on the basis of ability, performance, experience, training, aptitude and other job-related qualifications. 2.2.2 References: Upon your written request, the City will release only non-confidential information, including, but not limited to, dates of employment, job description and salary. The City will release any information relating to the results of federally required drug tests in accordance with the applicable law. 2.2.3 Physical Examination: The City may require an employee to submit to a job-related physical examination before the employee starts work if the physical examination is required of entering employees in the classification. The results of the examination will be kept in a confidential file separate from other employee records. 2.2.4 Proof of Employability: To comply with the Immigration Reform and Control Act of 1986, the City requires all employees to present documented proof of identity and eligibility in the United States. You are required to complete Section 1 of the Form 1-9 on the first day of employment, and to submit proof of employability and identity within three days of hire. 2.2.5 Background Check: The City of Fairfax may require a background check prior to employment, this may include confirmation of previous employment, credit, sex offender registry, criminal information and/or social media review. The City of Fairfax may exclude an individual from employment on the basis of these background checks after completing an individualized assessment considering: the nature and gravity of the offense or conduct; the time that has passed since the offense, conduct and/or completion of the sentence; and the nature of the job held or sought. 2.2.6 Employment of Relatives: Relatives of current employees are eligible for employment with the City, subject to limitations of state law governing the employment of relatives of public officials and employees and the terms of this policy. To avoid the appearance of favoritism and difficulties in administering discipline, the City will not hire, appoint, transfer, promote, or otherwise place an individual in a position that involves the supervision of, or by, a family member, unless approved by the City Council or Mayor as well as the Department Head -grandchild, niece, nephew, aunt, or uncle. 7 **This policy applies to all City departments and all categories of employment, including full-time, part-time, and temporary classifications. 2.2.7 Employment of Minors: Employment of all individuals under the age of eighteen (18) years, whether full- time, part-time, or temporary, shall be subject to all provisions of Chapter 92, Iowa Code and its revisions. 2.2.8 Rehires: Former employees applying to be rehired, may be considered for employment as members of the general public. However, special consideration will be given to past job performance, the circumstances surrounding knowledge of City procedures and operations. A person who is separated in good standing may be reinstated with prior approval of the City Council, to his/her previous position within one (1) year following separation, provided the individual has remained qualified for the position and that the position is available and such reinstatement would be in the best interest of the City. 2.3 ADA Compliance: In compliance with the Americans with Disabilities Act (ADA), the City of Fairfax will consider reasonable accommodation to enable qualified applicants or employees with disabilities to perform the essential functions of the position. The City encourages applicants or employees to make suggestions regarding reasonable accommodations to the Mayor and Department Head. 2.4 Harassment: Harassment sex, age, national origin, disability or any other characteristic protected by local, state, or federal law, is strictly forbidden. Harassing conduct in the workplace includes, but is not limited to: epithets, slurs, or negative stereotyping; threatening, intimidating or hostile acts or words; and written or printed material made or posted in the workplace or in the course of employment for the City that denigrates or shows hostility toward an individual or group. If you believe that you are being harassed or subjected to discrimination of any kind, you should use the complaint procedure 2.5 Preventing Sexual Harassment in the Workplace: 2.5.1 Purpose: It is the policy of the City of Fairfax that all employees are responsible for maintaining a workplace free from sexual harassment. Submission to sexual harassment shall not be a condition of employment or advancement with the City of Fairfax. The City strongly disapproves of offensive or inappropriate sexual behavior in the workplace and all employees must avoid any conduct which could be viewed as sexual harassment. Part 1604, and reaffirms that sexual harassment in the workplace is illegal under Title VII of the Civil Rights Act of 1964, as amended. 2.5.2 Definitions: Sexual harassment is illegal discrimination on the basis of sex. It can consist of unwelcome sexual advances, requests for sexual favors, or other physical or verbal conduct of a sexual or harassing nature by supervisors, managers, co-workers, or others in the workplace. Sexual harassment exists when: 1. Submission to such conduct is made either explicitly or implicitly, a term or condition of your employment; 2. Submission to or rejection of the conduct is used as the basis for decisions affecting your employment; or 3. The conduct has the purpose or effect of creating an intimidating, hostile, or offensive working environment. Sexual harassment may consist of a variety of behaviors, including, but not limited to the following examples: 1. Verbal conduct such as sexual innuendo, suggestive comments, jokes of a sexual nature, sexual propositions or threats; 2. Nonverbal or visual materials such as derogatory posters, photography, graffiti, cartoons, drawings or gestures; 3. Physical contact such as unwelcome touching, hugging, kissing, coerced sexual contact, or assault; 4. Threats or demands to submit to sexual requests in order to keep your job or receive some job-related benefit; or 5. Retaliation for reporting or threatening to report harassment. 2.5.3 Procedures: 1. Any employee who has a complaint of sexual harassment at work, by anyone, including supervisors, co- workers or visitors to the workplace, should immediately bring the problem to the attention of the Mayor or, in the case of involvement by the Mayor, to their Department Head. 2. The person receiving a complaint of sexual harassment shall immediately notify the Mayor and Department Head who may name an impartial investigator. Investigations will be conducted in a timely manner. Confidentiality will be maintained to the extent that it is possible. 3. Investigation of a complaint normally will include conferring with the parties involved and any named or apparent witnesses. All employees shall be protected from coercion, intimidation, retaliation, interference or discrimination for filing a complaint under this policy, participating in an investigation or filing a complaint with a state or federal agency. 4. Any employee determined after investigation to have harassed another employee will be subject to appropriate disciplinary procedures depending upon the severity of the behavior, up to and including termination. The City will take appropriate action intended to punish the offender and to prevent further harassment. 5. A non-employee who subjects an employee to sexual harassment in the workplace will be informed of the 2.6 Period: Health insurance coverage shall not accrue to new hire employees for the first thirty (30) days of employment. Certifications, employment, unless circumstances warrant an extension of time agreed by the City. 2.7 The probationary period for a new hire will be ninety (90) days. 2.8 Residency Requirements: In order to ensure a reasonable response time for emergency standby personnel of the City of Fairfax, such personnel may be required, within six (6) months of the date of hire, to establish residency within the Fairfax fire district. Emergency standby personnel are those employees in the Water, Sanitary Sewer and Public Works departments who are normally assigned weeknight and weekend standby status for emergency response to situations requiring immediate attention. For purposes of this policy, residence shall mean the actual domicile of the employee where that employee normally eats, sleeps and maintains ose of meeting the requirement 2.9 Personnel Records and Privacy: The City maintains personnel files on each employee. These files contain job-related information including performance appraisals, disciplinary records, and beneficiary designations. Any information contained in the files will be released only if required by law or if you make a written request for the City to release the information for reference purposes. If you are interested in reviewing the contents of your file, you may do so at a time mutually agreed upon by you and your Department Head, except you will not have access to or be able to review letters of reference received or furnished by the employer or any reference check performed by the employer. A representative of the City may be present during your review. You may, at your own expense, request and receive copies of the contents of your personnel file, except as provided above. ss, telephone number, marital status, emergency contact, beneficiary designations and number of dependents. 2.10 Complaint Procedure and Anti-Retaliation Policy The City will not tolerate any form of discrimination or harassment. The City will not tolerate retaliation for reporting discrimination or harassment. Complaints will be handled quickly, confidentially and with no retaliation. Complaints of discrimination or harassment should be brought to the attention of your Department Head or Mayor. Oral complaints will be requested to be recorded in writing, to initiate the complaint procedure. After notification of an employee's complaint, a confidential investigation by appropriate management or an outside investigator will immediately be initiated to gather all facts about the complaint. After the investigation has been completed, a determination will be made by appropriate management 9 regarding the resolution of the case. If the City determines that an employee has harassed another employee or discriminated against another employee, appropriate disciplinary action will be taken against the offending employee, up to and including termination. CHAPTER 3 - PAYROLL PRACTICES AND HOURS OF WORK 3.1 Certification Schedule: The City Council shall establish a schedule of compensation tied to certain certifications. The City Council must authorize any employee to begin training for a new level of certification. 3.2 Rates of Pay: The City Council shall establish the rate of pay for each employee by considering: the duties, performance, responsibilities and requirements for each position; the prevailing rates of pay including indirect pay for fringe benefits for similar work within the City's recruitment area for that position; cost of living adjustment; and the City's ability to pay such wages. 3.3 Rates of Pay Adjustments: The City Council shall annually review and determine any rate of pay adjustments needed. The rate of pay adjustments needed shall be determined annually through the evaluation of each employee's job performance by the appropriate supervisory personnel review and recommendation by the employee's Department Head and/or the Mayor. Evaluations are to be completed each year by December 31st. All rates of pay adjustments must be approved by the City Council. 3.4 Total Remuneration: Any rate of pay established for an employee shall be the total remuneration for the employee, but not to be construed as including overtime, group medical insurance benefits, life insurance, pension, or reimbursement of uniforms and official travel. Except as otherwise provided, no employee shall receive pay from the city in addition to the rate of pay authorized for services rendered by him/her, either in the discharge of ordinary duties or any additional duties which may be imposed upon the employee, or which he/she may undertake or volunteer to perform. Under no circumstances may city services be extended by employees in exchange for special rewards, gifts or other remuneration from someone else. 3.5 Temporary Pay Increase: If an employee's duties are expanded temporarily, the City Council may grant an increase in the rate of pay to the employee during the time the employee is responsible for the additional duties. 3.6 New Appointments: Upon initial appointment to a position, the employee will receive the minimum salary for the position, unless the individual selected possesses sufficient qualifications and experience relevant to the position, in which case the Mayor and Department Head may recommend a higher salary. 3.7 Performance Evaluation: Performance appraisal is a continual process. The Mayor and/or Department Heads are responsible for conducting a formal performance evaluation of each of their employees once a year, and at the completion of an employee's probationary period. Such evaluations should be written on a form providing convenient and measurable recording of the work quality and progress of the employee. The evaluations should be reviewed by the Mayor, the Department Head, and employee and signed by all parties involved in the process. The following schedule of evaluation of employees is recommended: A. Midway through the probationary period; B. At the end of the probationary period; and C. By the end of the calendar year. 3.8Hours of Work: Regular full-time employees normally work eight (8) hours per day with a total of forty (40) hours per week. Lunch breaks are not included as a paid benefit. Two fifteen-minutepaid rest periods are allowed during each work day. Employees may be called back to work during rest breaks, if conditions require. Non-exempt nursing mothers are allowed reasonable break time to express breast milk for her nursing child for one (1) year Weekly schedules and rest periods for all employees will be established by the Mayor and/or Department Head. Daily and weekly work schedules may be changed at the discretion of the City to meet varying conditions and workload. Changes in work schedules will be announced as far in advance as possible. Employees are responsible to keep accurate time cards showing all time worked. Employees are responsible to sign off their completed, accurate time card no later than the first business day after the end of the work period. For weekly payroll, this shall be the first business day after each Sunday. For monthly payroll, this shall be the first business day after the end of each month. Failure to turn in accurately completed and signed-off time cards immediately following the work period may result in a delay of generating your payroll check. 3.9 Pay Periods: 3.9.1 Weekly: The workweek for weekly payroll purposes shall begin at 00:00 on Monday and end at 24:00 on Sunday. All regular full-time employees and part-time employees as requested by the employee and approved by the Mayor are paid weekly, no later than the end of the working day every Wednesday for the preceding week of work that ended on that Sunday. It is the regular practice of the City to, if possible, process payroll the first work day after the end of the work week. If a regular payday falls on a holiday, you will usually be paid on the next workday. If you are taking vacation and have given at least two weeks prior notice to the payroll department, you may receive your vacation pay the payday before your vacation begins, if requested. 3.9.2 Monthly: The work period for monthly payroll shall begin at 00:00 on the first business day of the month and end at 24:00 on the last business day of each month. The City does not currently have any employees who are paid monthly, normally by the end of the second business day of each month. If you are taking vacation during the regular pay date and have given at least two weeks prior notice to the payroll department, you may receive your vacation check before you leave for vacation. 3.9.3 Quarterly: The Mayor and City Council are paid quarterly. The work period for these quarterly payroll employees shall begin at 00:00 on January 1 and end at 24:00 on March 31; April 1 and end at 24:00 on June 30; July 1 and end at 24:00 on September 30; and October 1 and end at 24:00 on December 31. All quarterly paid employees will be paid by the end of the week following the last city council meeting for that quarter. 3.9.4 Annually: The Fairfax Fire and Rescue members are paid annually. The work period for these annual payroll employees shall begin at 00:00 on January 1 and end at 24:00 on December 31. All annually paid employees will be paid by the end of the second week in January for the previous twelve (12) months ending December 31. 3.10 Deductions from Pay: 3.10.1 Voluntary Deductions: Payroll deductions are voluntary, with the exception of government mandated deductions, and made only if authorized, in writing, by the employee. If the employee authorizes a deduction, the payroll department will process this request as soon as possible, but no later than by the second paycheck after the request is filed. An example of an allowable deduction would be the expense for eligible spouse and/or dependent Life, and/or Liberty National Life Insurance Company policy premiums. 11 3.10.2 Garnishments from Pay: The City will garnish wages from an employee's paycheck only as required by court order and applicable laws. 3.11 Overtime and Compensation: 3.11.1 Overtime Work: You will receive compensation for approved overtime work at the rate of time and one- half your hourly rate for each hour worked over eight (8) hours in a regularly scheduled work day and for each hour worked over forty (40) hours in a work week. Individual departments will distribute overtime and on call work as equitably as possible among employees who do similar work. This may include work before and after regular work hours as well as work on the weekends and holidays. 3.11.2 Flextime Work: If approved by the Mayor or Library Board, the Parks and Recreation Director, the Library Director, part-time Library employees, and part-time, seasonal Parks and Recreation Department employees may work a flextime schedule. This allows employees to break-up their normal work hours into days with more hours than 8 and not receive overtime until the weekly total goes over 40 hours, per federal regulations. 3.11.3 Minimum Show-up Time: If you are required to report to work after you have left work for the day, before your scheduled work start time, or on a day you are not scheduled to work a regular shift, you will receive a credit of a minimum of three (3) work hours. Show-up time does not include -the--the- includes, for example, time spent outside of work and outside of scheduled work hours reviewing or responding to emails, time spent outside of work and outside of scheduled work hours taking work-related phone calls, and time spent outside of work and outside of scheduled work hours finishing work projects. The City will take disciplinary action, up to and including termination, if a non-exempt employee participates in off-the-clock work without the permission of the Mayor or the Department Head. 3.11.4 Compensatory Time Off: Compensatory time off, instead of paying overtime, shall be accrued at the rate of one and one-half hours for each overtime hour worked. The City of Fairfax does not want employees to accrue more than a current total of 100 hours of compensatory time. After this total has been reached, the employee will be notified to use some of the compensatory hours or be paid out compensatory hours in order to get the hours accrued fewer than 100. The decision to pay out compensatory time accrued instead of giving time off shall be made by the Mayor or the Department Head. If paid, this shall be paid at the regular rate earned by the employee at the time the employee receives such payment. 3.11.5 Compensatory Time Off Pay Upon Termination: If your employment is terminated for any reason, you will be paid for unused accrued compensatory time off. 3.11.6 Overtime Computation: Hours taken as holiday, vacation, bereavement, sick, compensatory time, and personal days will be considered as time worked for computation of overtime. 3.11.7 Fairfax Fire and Rescue Members: Members of the Fairfax Fire and Rescue Department do not receive compensation for time spent in training, in meetings, or while on their regular weekend duty. Their compensation for fire department activities is set by resolution of the City Council and includes salaries for officers, a per call response fee, and a per fire call paperwork fee. Members of the Fairfax Fire and Rescue Department who are also City of Fairfax employees in a different department may respond to fire calls or do needed tasks for the fire department. The City of Fairfax recognizes the public benefit to have these members available during the day hours. While responding to call or doing needed tasks for the fire department they will be paid their regular compensation rate for their regular working hours in addition to their fire department compensation. They will allocate time spent to the fire department on their timecard. 3.12 Attendance: The City relies on you to report to work regularly and on time. If you are going to be late or absent, you must contact the Mayor and/or Department Head immediately. If you have to leave early, you must obtain approval from the Mayor and/or Department Head. The City will take disciplinary action, up to and including termination, where attendance is unacceptable. This policy shall not be construed to conflict with the Americans with Disabilities Act, the Family and Medical Leave Act, the Iowa Civil Rights Act, and other applicable federal and state laws. ! 13 CHAPTER 4 - EMPLOYEE BENEFITS AND SERVICES 4.1 Holidays: 4.1.1 Holidays Observed: The City of Fairfax will observe the following holidays: Good Friday Memorial Day Fourth of July Labor Day Thanksgiving Day The day after Thanksgiving Day Christmas Eve Day Christmas Day 4.1.2 Holiday Pay: All regular full-time employees will receive eight (8) hours of regular pay for each of these observed holidays. 4.1.3 Holidays on Saturdays or Sundays and During Authorized Paid Leave: Holidays occurring on Saturday will be granted on the previous Friday, and holidays occurring on Sunday will be granted on the following Monday. If the holiday occurs during authorized paid leave, the day will be considered as a holiday and not as the authorized paid leave. 4.2 Vacations: 4.2.1 Full-time Eligibility: Regular full-time employees who are actively and continuously employed are eligible for paid vacation, which will be awarded as a lump sum on the anniversary hire date, as per the following schedule, unless a different schedule is negotiated at the time of hire. Vacation does not accrue nor is it awarded during unpaid leave. a) Following the completion of one (1) year of employment, 40 hours of vacation will be awarded. b) Following the completion of two (2) years of employment, 80 hours of vacation will be awarded. c) Following the completion of seven (7) years of employment, an additional 40 hours of vacation will be awarded . d) Following the completion of twelve (12) years of employment, an additional 40 hours of vacation will be 160 hours. 4.2.2 Part-time Eligibility: All regular part-time employees will receive vacation time as outlined above but based on the previous year's average work week, which will be accrued on the anniversary hire date, as per the following schedule: 40 Hours will be paid for each week of vacation awarded a) 35 -40 Hours 35 Hours will be paid for each week of vacation awarded b) 30 - 35 Hours 30 Hours will be paid for each week of vacation awarded c) 25 -30 Hours 25 Hours will be paid for each week of vacation awarded d) 20 - 25 Hours Department Heads will be responsible to work with the payroll department to determine if a part-time employee becomes eligible for benefits. 4.2.3 Scheduling Vacation: Scheduled vacation requests should be requested at least one (1) week prior to the proposed start of your vacation. Unscheduled vacation requests will be honored when possible by reason of workload or staffing availability. Vacation preferences are subject to staffing requirements as determined by the City. Conflicts in vacation dates will be resolved by preference to the employee who submitted the request first and based on the required work schedule. If all are equal, preference will be given to the employee with greater seniority in employment. 4.2.4 Carryover: Vacation time must be used within twelve (12) months of entitlement. Entitlement is determined by the anniversary of the hire date. Vacation time may be carried over to the following year of employment with approval from the Mayor and Department Head, up to a maximum of 40 hours. Additional vacation awarded, but not used as of the anniversary hire date will be forfeited. 4.2.5 Vacation Pay Upon Termination: If your employment is terminated for any reason, you will be paid for unused awarded vacation. 4.3 Sick Leave: 4.3.1. Full-time Eligibility and Accrual: Regular full-time employees shall be awarded paid sick leave as a lump sum on July 1 at the rate of four (4) days, which is thirty-two (32) hours, per fiscal year for a maximum accumulation of thirty (30) days, which is two hundred and forty (240) hours. After an employee reaches 240 hours accumulated, they will not be awarded any further sick time until some is used and their total is below 240 hours. At that time, on the next July 1 you will be awarded sick time up to the maximum of the 32 hours or an amount to make the total 240 hours, whichever is less. 4.3.2 Part-time Eligibility and Accrual: Regular part-time employees who work anywhere from 20 hours to 40 hours per week will be awarded sick pay on July 1 based on the previous fiscal year's average work week as follows: A. 35 - 40 Hours Four (4) Sick days, which is thirty-two (32) hours, will be awarded per year. B. 30-35 Hours Three (3) Sick days, which is twenty-four (24) hours, will be awarded per year C. 25 - 30 Hours Two (2) Sick days, which is sixteen (16) hours, will be awarded per year D. 20 - 25 Hours One (1) Sick day, which is eight (8) hours, will be awarded per year Department Heads will be responsible to work with the payroll department to determine if a part-time employee becomes eligible for benefits 4.3.3 Unpaid Leave of Absence: Sick leave does not accrue nor is it awarded during any unpaid leave of absence. 4.3.4 Notification and Verification: To be eligible for sick leave payment, an employee shall notify the City as soon as possible, unless the employee is unable to notify the employer because of an emergency. After five (5) consecutive sick days, at the discretion of the Mayor and Department Head, a doctor's verification may be requested. Department Head. This paperwork will 4.3.5 Abuse of Sick Leave: If sick leave appears to be abused as evidenced by a pattern of use not necessitated by proven illness, injury or after five (5) days of consecutive sick days, at the discretion of the Mayor or Department Head, you may be required to submit competent proof of the necessity for such absence. Abuse of sick leave privileges will constitute grounds for disciplinary action up to and including termination. 4.3.6 Sick Leave Upon Termination: You will not be paid for any unused accrued or awarded sick leave should your employment with the City be terminated for any reason. 4.3.7 Work-related Injuries: To provide for payment of your medical expenses and partial salary continuation in the event of a work--term disability policy. The amount and duration of benefits payable depend upon the nature of your injury or illness. If you are injured on the job, you must notify the Mayor and the Department Head immediately. Within twenty-four (24) hours of the injury, you or your Department Head or Mayor must report the injury, including all details, to the City -related injuries in 4.4 Family and Medical Leave: 4.4.1 Leaves Available: It is the policy of the City to provide unpaid family and medical leave in accordance with the federal Family and Medical Leave Act (FMLA) of 1993 or any subsequent revisions. An eligible employee will be granted up to twelve (12) work weeks of unpaid leav for any of the following qualifying reasons: A. The birth and/or need to care for your newborn child. B. The placement of a child with you for adoption or foster care. C. The need to care for your spouse, son, daughter, or parent with a serious health condition. D. perform his or her job functions. 15 4.4.2 Eligibility Requirements: To be eligible for family and medical leave, you must have worked for the City for at least twelve (12) months (which do not have to be consecutive), and for at least 1,250 hours during the twelve (12) months immediately preceding the start of the leave. 4.4.3 General Provisions: of age or a son or daughter who is older who is incapable of self-care because of a mental or physical disability at the time the FMLA leave is to commence. An employee responsibility for care and includes a biological, adopted, foster, or step--in- irment, or physical or mental condition that involves in-patient care in a hospital, hospice, or residential care facility, or continuing treatment by a health care provider. 4.4.4 How and When Leave May be Taken: Family and medical leave is taken either in consecutive workweeks; intermittently in separate blocks of time; or by reducing the number of days you work per week, or hours per day. Intermittent or reduced schedule leave may be taken when medically necessary to care for your spouse, child, or parent with a serious health condition, or because of your own serious health condition. You must provide the City with medical certification of the need for intermittent or reduced schedule leave, and must attempt to schedule your intermittent or reduced schedule leave so as not to disrupt City operations. You may be transferred temporarily to an alternative position or schedule, with equivalent pay and benefits, which better accommodates the intermittent leave or reduced schedule. Leave for the birth of a child or placement of a child for adoption or foster care must be taken within twelve (12) months of the birth, adoption, or placement. of FMLA protected leave means the 12-month period beginning on the date the employee first takes leave for any of the reasons set forth previously. Employees who have paid leave available (vacation, sick or other PTO) are not required to exhaust their available paid time off before taking FMLA leave. Employees must provide the required notice and certification before the medical leave commences, unless it is an emergency situation and then as soon as practicable. 4.4.5 Notice Requirements: If you know in advance that you will be taking leave because of birth, adoption, or placement of a foster child in your home, or because of planned medical treatment for you or a covered family member, you must notify your Department Head at least thirty (30) days in advance. If circumstances require that the leave begin in less than thirty (30) days, you must notify your Department Head as soon as possible. When the need for leave is foreseeable based on planned medical treatment for you or your covered family member, the City expects you to consult with your Department Head and to make a reasonable effort to schedule the treatment so as to not unduly disrupt City operations. 4.4.6 Medical Certification: When leave is requested to care for a child, or parent with a serious health condition, or because of your own serious health condition, you must provide the City with written medical certification from the appropriate health care provider using a form provided by the City. This certification will include the date of onset, the probable duration, type of treatment, and other appropriate medical facts concerning the condition. If you are seeking leave for your own health condition, the certification must also state that you are unable to perform the functions of your position. For leave to care for a family member, the certification must state that you are needed to care for the family member, and an estimate of the amount of time you will be needed. Other certification requirements apply in the case of intermittent or reduced schedule leave. Costs associated with the completion of eligibility paperwork are the responsibility of the employee. If you fail to certification is provided. The City may require a second medical opinion and periodic re-certification of the medical condition at its own expense. If the medical opinion sought by the City differs from the certification provided by your physician, the City may, at its own expense, require the opinion of a third health care provider chosen by you and the City. The third opinion will be binding. 4.4.7 Rights and Benefits During Leave: Seniority, sick leave and vacation will accrue or be awarded only during periods of paid leave. While you are on FMLA leave, the City will continue your health insurance coverage at the same level and under the same conditions that coverage would have been provided had you continued working. You will be required to continue to pay your contribution to the premium if such circumstance existed prior to your leave. While on FMLA leave, employees are not entitled to be awarded vacation, sick or any other paid time off. Under certain circumstances, if you fail to return to work after an approved FMLA leave, the City may require you to reimburse it for the amount the City paid for your health insurance premium during the leave. 4.4.8 Returning to Work: At the conclusion of your FMLA leave, you will be restored to your position, or one with equivalent pay, benefits, and conditions of employment, provided you have complied with the requirements of this policy. If you were not awarded paid time off due to being on FMLA leave and return to work, the City of Fairfax will review your eligibility to see if paid time off should be awarded to you for service previous to taking FMLA leave. 4.5 Military Leave: 4.5.1. Leaves Available: The City will grant leaves of absence for military service to full-time and part-time regular employees in accordance with applicable state and federal laws. A full-time or part-time regular employee who is a member of the uniformed services, when ordered by proper authority to serve in the uniformed services, shall be granted leave for the period of service. This leave shall be without loss of pay for the first thirty (30) calendar days of the leave. You are entitled to thirty (30) calendar days of paid leave for military service per calendar year. Any amount shall count as one day toward the thirty (30) calendar days without loss of pay. Absences required for military service time, or unpaid leave, and in accordance with applicable state and federal law. 4.5.2 Reemployment Rights - Eligibility: Your eligibility for reemployment with the City after you complete military service will be determined in accordance with applicable state and federal law. Conditions for reemployment are briefly explained as follows: A. You, or an appropriate officer of the uniformed service in which you serve, must give advance written or verbal notice of your service to your Department Head, unless military necessity prevents you from giving notice or it is otherwise impossible or unreasonable; B. The cumulative length of the absence and all previous absences from your employment with City for reason of military service must not exceed five (5) years; C. Your discharge from military service must be honorable; and D. When you return from military service, you must report to work or submit a timely application for reemployment according to the following schedule: For service of less than 30 days you must report to work by the beginning of your first regularly scheduled work day that would fall eight hours after you return home. For service of 31 to 180 days you must apply for reemployment within 14 days after completing service. For service of 181 days or more you must apply for reemployment no later than 90 days after completing service. 17 4.5.3 Continuation of Benefits During Military Service: Employees on leave for military service and any of A. An employee that leaves employment for less than 31 days is entitled to continued health insurance coverage, and will not be required to pay more than what an active employee would pay for coverage. B. An employee that leaves employment for more than 30 days is allowed to elect to receive continued hichever event occurs first. The City may require the employee to pay up to 100% of the premium under this circumstance. 4.6 Bereavement Leave: 4.6.1 Full-time Eligibility: All regular full-time employees will be granted three (3) paid bereavement leave days, which is 24 hours, per death. This includes immediate family members only (spouse, children, grandchildren, parents, grandparents, brothers, sisters and in-laws). 4.6.2 Part-time Eligibility and Accrual: All regular part-time employees shall receive paid bereavement leave based on the previous fiscal year's average work week, which will be as per the following schedule: A. 35 - 40 Hours Three (3) Days, which is twenty-four hours, will be granted B. 30 - 35 Hours Two (2) Days, which is sixteen hours, will be granted C. 20-30 Hours One (1) Day, which is eight hours, will be granted Department Heads will be responsible to work with the payroll department to determine if a part-time employee becomes eligible for benefits 4.6.3 Use: Bereavement leave shall only be used for the scheduled workdays falling within the period commencing upon the death and extending through the day after the funeral. To qualify for bereavement leave, the employee must attend the funeral or memorial service. 4.6.4 Payment: Payment will be made only for those days and hours which you would have worked. If a death in your family occurs, please notify your Department Head and the Mayor regarding the expected length of your absence. 4.6.5 Unpaid Bereavement Leave: Any employee may request an unpaid leave not to exceed one (1) day to attend the funeral of a non-immediate family member, subject to the approval of the Mayor or Department Head. 4.7 Jury and Witness Duty: All employees required to report for jury duty shall receive a paid leave of absence for the time spent on jury duty. Leave for jury duty is paid leave, the City will continue your regular salary, but you must submit certification of the number of hours spent in jury service and assign any compensation you receive in connection with such duty, less any reimbursement for travel or meal expenses, to the City. Employees subpoenaed to appear as a witness in a civil or criminal proceeding in which that employee is not directly involved as a plaintiff or defendant shall be granted a leave without pay. Employees who must appear as a witness in a civil or criminal proceeding in which they are directly involved as a plaintiff or defendant may be eligible for an unpaid leave of absence under Section 4.10 of this manual. Hours spent by an employee appearing as witness in any job-related legal proceeding at the direction of the City shall be considered to be work time. If such proceeding occurs outside of working hours, such employee shall be paid at one and one- half (1.5) times the regular pay for a minimum of two hours or actual time spent, whichever is more. All employees summoned to jury duty shall promptly notify their Department Head. An employee who is summoned for jury duty, but is not selected, shall return to work and an employee who is selected for jury duty shall return to work when released 4.8 Voting Leave: The City encourages all employees to fulfill their civic responsibilities and to vote in all official public elections. Generally, your working hours are such that you will have ample time to cast your vote before or after working hours. However, if you do not have three (3) consecutive non-working hours between the opening and closing of polls in which to vote, you may submit a written request to the Mayor and Department Head as soon as possible before the election for paid time off of up to 1 (one) hour to vote. 4.9 Maternity Leave: conditions related to pregnancy or child birth, in conformity with Iowa law, the City will grant the employee an unpaid leave of absence for the period the employee is not able to perform the duties of employment, or for eight (8) weeks, whichever is less. In the event an employee is disabled as a result of pregnancy or following the birth of a child, FMLA permits up to twelve (12) weeks of unpaid leave. Employees are not required to exhaust their vacation and other available awarded paid time off before taking unpaid Maternity Leave. 4.10 Unpaid Leave of Absence: Unpaid leaves of absence may be granted in certain circumstances. If you have exhausted all sick leave, vacation, compensatory time and FMLA leave, you may request an unpaid leave of absence. Approval of unpaid leave is at the discretion of the City. During an unpaid leave granted under this section, you do not receive compensation, do not accrue seniority, and are not awarded vacation, sick leave, or other paid time off benefits. The City does not make contributions to retirement programs for the duration of the leave. You may continue in the group health insurance plan during the unpaid leave of absence under this th section by paying the full cost of the premium by the 15 of the month for the next premium will result in termination of the coverage. If you plan to return to work following an unpaid leave of absence taken under this section, you must notify the Mayor and Department Head before the end of your leave. The City will attempt to restore you to the position you held at the start of your leave, or in a comparable position, if possible. If no such position is available, you may be offered a position of lesser responsibility or compensation. If no accommodation is reached, your employment could be terminated. 4.11 Group Health, Life Insurance, Short-term Disability, Vision Coverage, Dental Coverage, and AD&D Benefits: The policies, procedures, benefits, and plans described in the manual may be revised by the City of Fairfax without prior notice. 4.11.1 Eligibility: All regular full-time employees and regular part-time employees that work thirty (30) hours a week shall be provided a single plan medical and hospitalization insurance policy. Eligible employees may request coverage for eligible dependents at their own expense. The City of Fairfax will pay the amount of the premium for lesser plans, the City will contribute towards that smaller premium, up to the premium amount of the best group health plan option. The excess premium may be used towards spouse and/or dependent coverages or in the case of the HSA policy, be contributed to a health savings account, but not received in cash compensation. 4.11.2 Start of Coverage: Coverage for eligible employees is effective the next first of the month after thirty (30) days following the new hire or employee reinstatement date. Upon termination, the employee's insurance coverage extends to the last day of the last month in which they were employed. 4.11.3 Continuation of Coverage: If you resign or your employment is otherwise terminated, or if your work hours are reduced and consequently you or your dependents are no longer eligible to participate in the group health insurance plan offered by the City, you and your eligible dependents have the right to continue to participate for up to eighteen eighteen-month continuation coverage period provided in the event of your termination or reduction in working hours may be extended to thirty-six (36) months if, within that eighteen-month period, you die or become divorced or legally separated, or if a child ceases to have dependent status. 19 In addition, if you enroll for Medicaid during the eighteen-month period, your spouse and dependent children may be entitled to extend their continuation period to thirty-six (36) months, starting on the date that you become eligible for Medicaid. If you are determined to be disabled under the Social Security Act at the time of your termination or reduction in hours, you may be entitled to continuation coverage for up to twenty-nine months. Your eligible dependents may extend coverage, at their expense, for up to thirty-six (36) months in our group health insurance plans in the event of your death, divorce, legal separation, or enrollment for Medicare benefits, or when a child ceases to be eligible for coverage as a dependent under the terms of the plan. If you or your eligible dependents elect to continue in the group health insurance plan, you will be charged for the applicable premium plus administrative costs. Failure to make timely payments may result in termination. If this election for continuation coverage is made, you and your dependents have the right to convert this coverage to an individual policy with our insurance carrier at the end of the continuation period. The City Clerk will contact you concerning these options at the time termination occurs or your work hours are reduced. The City Clerk will contact qualified beneficiaries in the event of your death or enrollment for Medicare benefits. However, in the event that you become divorced or legally separated, or one of your dependents ceases to be eligible for coverage under our group health insurance plan, you and/or your dependent is responsible for contacting the City Clerk to discuss continuation/conversion rights. You and your qualified beneficiaries are also responsible for notifying the City Clerk within sixty (60) days of qualifying for social security disability benefits. 4.11.4 Life Insurance: The City shall maintain a group term life insurance policy in the face amount of twenty- five thousand dollars ($25,000) for all regular full-time and regular part-time employees less than 65 years of age whose average work week is 40 hours per week. Employees over the age of 65, may have the face value of the life insurance reduced according to the policy of the life insurance company. Beneficiary for such policy shall be as named by the employee. 4.11.5 Continuation Coverage under Iowa Code Chapter 509A: Employees who retire from City employment meaning the employee must elect the same coverage at retirement and the retired employee must pay the full cost of the premium. For purposes of this section, a retired employee is one who has applied for and is receiving a retirement allowance. 4.11.6 Short-term Disability Insurance: The City currently provides a short-term disability insurance policy for full-time employees. The City currently pays 100% of this premium. 4.11.7 AD&D Insurance: The City currently provides an AD&D insurance policy for full-time employees. The City currently pays 100% of this premium. 4.11.8 Dental Insurance: The City currently provides a dental insurance policy for full-time employees. The City currently pays 100% of this premium. 4.11.9 Vision Insurance: The City currently provides a vision insurance policy for full-time employees. The City currently pays 100% of this premium. 4.12 Personal Days: 4.12.1 Full-time Eligibility and Accrual: Regular full-time employees shall be awarded personal days as a lump sum on July 1 at the rate of two (2) days, which is sixteen (16) hours, per fiscal year. Personal days may not be carried over to the following fiscal year. If, at the end of a fiscal year an employee has not used all of the 16 hours of personal time, the remaining balance will be forfeited. 4.12.2 Part-time Eligibility and Accrual: Regular part-time employees who work anywhere from 30 hours to 40 hours per week will be awarded personal days as a lump sum on July 1 based on the previous fiscal year's average work week as follows: A. 40 Hours Two (2) days, which is sixteen (16) hours will be earned per year B. 30-40 Hours One (1) day, which is eight (8) hours will be earned per year Department Heads will be responsible to work with the payroll department to determine if a part-time employee becomes eligible for benefits. 4.12.3 Personal Days Upon Termination: If your employment is terminated for any reason, you will be paid for any unused awarded personal hours. 4.13 Business Travel: 4.13.1 Authorization: All business travel outside of regular work duties must be pre-approved by management. 4.13.2 Travel Expenses: All employees will be reimbursed for related expenses incurred while traveling on pre- approved City of Fairfax business as outlined below. A. If an employee uses a personal vehicle for business travel, the employee will be reimbursed at the is required of all employees using a personal vehicle for city business. B. the fuel. C. Lodging and commercial transportation expenses will be paid for by the City of Fairfax. Reservations must be made by the city clerk/treasurer, deputy city clerk, or the Department Head. D. Employees will be paid a per diem as set by Governmental Services Administration (GSA) each day for meal and incidental costs while they are on a business trip for the City of Fairfax. The first and last day will be paid at 75% of the per diem rate. In order to make this per diem payment not taxable, the employee must submit an expense report showing the business purpose of the trip, the date and place of the trip, and show receipts for the lodging while on the business trip. E. Personal expenses not related to the business purpose will not be reimbursed. 4.13.3 Safety: All applicable traffic laws are to be followed. Safety belts must be properly worn at all times in both city and privately owned vehicles used for city business. No texting is allowed while driving. Talking on the phone must be hands free. Distracted driving is not safe and to be kept to a minimum. 4.13.4 Accidents or Violations: Accidents or violations occurring while using a city or privately owned vehicle for city business must be reported to the Mayor and Department Head as soon as possible, which shall be no later than upon completion of travel. All citations generated by such an occurrence and issued to the operator of the vehicle in question will be the responsibility of the employee, except those pertaining to the condition of a city owned vehicle. 4.13.5 Record Keeping: All employees expecting reimbursement for business trip related travel expenses must keep accurate, complete documentation of all expenses. This may include: dates of travel, reason for travel, destination information, beginning and ending odometer readings, and receipts for all expenses to be paid by the City of Fairfax. 4.13.6 Compensation Time: Employees will be compensated for business trip time as outlined below: A. Employees traveling for a business purpose and returning the same day will be compensated for all time spent on the business trip, including travel time. B. Employees traveling for a business purpose on a trip that will require an overnight stay will be compensated for all time spent with a business purpose, including travel time. 4.13.7 Conduct: Employees traveling for a business purpose are representatives of the City of Fairfax and are expected to maintain a high level of professionalism and courtesy and to follow all city policies, rules, and procedures. 21 4.14 PTO Donation: A donation of PTO hours from one employee to another may be authorized if the recipient experiences a FMLA-supported hardship or natural catastrophic disaster. The donated PTO hours will be utilized as the recipient needs it to complete their pay periods. 4.14.1 Form: A potential donor must fill out a PTO Donation Request Form to start the review process. 4.14.2 Review: Department HeadDepartment Head will meet to review the donation request. 4.14.3 Recipient Criteria: A. FMLA-supported hardship, which is prolonged/extended causing the recipient to be required to be away from work. B. Recipient experienced extreme damage to personal property due to a natural disaster causing the recipient to be required to be away from work. C. Recipient must use all of their existing PTO prior to utilizing any donated PTO. D. Recipient shall be liable for all applicable employee taxes and employee IPERS contributions resulting from the use of donated PTO. 4.14.4 Donor Criteria: A. Donor must complete a PTO Donation Request Form. B. Donor must maintain a PTO balance of at least 40 hours after their donation. 4.14.5 Process: If, after review by the Mayor and Department Heads, the donation is approved; the following process shall be followed. A. The PTO hours will be calculated based on dollars. Dondollars, then . B. PTO hours from multiple donors will be pro-rated as needed from their donation. (i.e. If 5 employees donate 20 PTO hours each and the recipient needs just 10 hours of PTO for a pay period, 2 PTO hours will be taken from each of the 5 donors for that pay period). C. PTO donations D. . Unused PTO donations will remain in the donors PTO balance. E. will provide a list of employee donors to the recipient. No details will be shared regarding the amount of PTO hours donated per individual. The City of Fairfax is required to follow all current IPERS rules and regulations. 4.15.1 Contributions: The State of Iowa sets the required contribution rate for both the employee (payroll deduction) and the City of Fairfax. 4.15.2 Participation: All full-time employees and permanent part-time employees are required to participate in IPERS from the date of their employment start. Seasonal or temporary part-time employees may not be considered a participant until they qualify according to IPERS rules. Appointed officials are required to participate in IPERS from the date of their appointment. Elected officials may have an option to participate according to IPERS rules. 4.15.3 Ending Employment: When an employee resigns, is discharged, or retires the City of Fairfax will inform IPERS and assist to work through any required steps for the transition. These steps may be to file for a refund or to start retirement benefits. ! 23 CHAPTER 5 -STANDARDS OF CONDUCT AND CORRECTIVE ACTION 5.1 Policy: In order to maintain safe, efficient and harmonious operations and to continue to provide the highest standard of public service, the City adopted the following rules. Each rule reflects a common understanding of what is acceptable in the workplace. These rules can be modified by the City as changing conditions warrant. The City may take whatever disciplinary action it deems appropriate in response to an offense, even if it is not included in the following list. You must understand that any offense, whether or not it is included in these work rules, may result in disciplinary action, up to and including termination, without prior warning. The City expects your complete cooperation in observing these rules which have been designed for our common protection and benefit. 5.2 Work Rules: While it is not possible to list all the offenses for which you would be disciplined, the following are examples of inappropriate, unacceptable conduct: Unsatisfactory work performance. 1. Falsifying employment or other job-related records. 2. 3. Establishing an unacceptable pattern of tardiness or absenteeism. 4. Engaging in excessive, unnecessary or unauthorized use of City property or supplies, particularly for personal use. 5. Reporting to work intoxicated or under the influence of an ability impairing drug. 6. Illegally manufacturing, possessing, using, selling, distributing or transporting drugs. 7. Bringing or using alcoholic beverages on City property or using alcoholic beverages while engaged in City business off of City premises. 8. Fighting or using obscene, abusive or threatening language. 9. Theft or misappropriation of property of coworkers, customers, clients, or the City. 10. Possessing firearms or weapons not authorized by the City of Fairfax on City property or while on City business. 11. Disregarding safety or security regulations. 12. Engaging in insubordination or failing to cooperate with assigned employees, co-workers or Department Heads. 13. Failing to follow City job instructions or to perform work requested by your Department Head or Mayor. 14. Violating a City safety rule or practice or creating or contributing to unsafe, unhealthy or unsanitary conditions. 15. Failing to maintain confidentiality of City, employee, resident or customer information. 16. 17. Discourteous conduct toward citizens or poor customer service. 5.3 Corrective Action/Discipline: If your performance, work habits, attitude or demeanor become unsatisfactory in the judgment of the City, based on violations of either the rules listed above, or other City policies, rules, procedures, or expectations, you will be subject to disciplinary action, up to and including termination. Certain offenses can be corrected using progressive discipline. Typical progress discipline would include a verbal warning followed by two written warnings. Situations that the City believes will respond to corrective discipline will normally be handled as follows: 1. Department Head or the Mayor will normally give the employee a verbal warning. 2. Suspension: If sufficient improvement has not been made, or if the conduct continues, the employee may be suspended without pay. 3. Termination: If the conduct continues, the City may terminate the employment of the employee. The City reserves the right to use whatever discipline it decides is appropriate in any situation, up to and including termination, without regard to the progressive guidelines explained above. 5.4 Telephone Use: should be made with a cell phone to avoid long distance changes. A long-distance phone call with a chargemay be made only by personnel authorized by their respective Department Head and only for official City business. Personal telephone calls by an employee are permitted. However, use to the point of interference with the performance of job duties may result in corrective action. No personal long-distance calls are to be made on City phones. 25 CHAPTER 6 - SAFETY AND HEALTH 6.1 Promoting a Safe Work Environment: The establishment and maintenance of a safe work environment is the shared responsibility of the City and its employees. The City of Fairfax will attempt to do everything within its control to assure a safe environment and to comply with federal, state, and local safety regulations. Employees are expected to obey safety rules and to exercise caution in all work activities. You are asked to immediately report any unsafe conditions to the Mayor and Department Head and/or City Council. Every employee is expected to report and/or correct unsafe conditions as promptly as possible. All accidents that result in injury must be reported immediately to the Mayor and Department Head regardless of how insignificant the injury may appear. These reports are necessary in order to comply with laws and initiate insurance and Threats, threatening behavior, or acts of violence against employees, visitors, guests, or anyone on City property will not be tolerated. Violations of this policy will lead to disciplinary action up to and including termination, arrest and prosecution. 6.2 Smoking Policy: In accordance with state law, all City of Fairfax-owned buildings, facilities and vehicles are smoke free. All tobacco usage, including smoking and smokeless tobacco, is prohibited in all City-owned buildings, facilities, equipment and vehicles and on all public grounds owned by the City except in designated areas in accordance with the Iowa Smokefree Air Act. Each City- owned building may establish a designated smoking/tobacco usage area. This area must be loc away from all building entrances and must not adversely impact other employees or the general public. Please contact your Department Head to identify these designated smoking areas. Employees are also permitted to smoke or use tobacco products within their personal vehicles which are parked in a City-owned parking lot. Employees who choose to smoke or use tobacco products must do so in accordance with this section and during normal meal and break periods. Employees are not provided additional time away from work to smoke or use tobacco products. 6.3 Bloodborne Pathogens Program: Bloodborne Disease Exposure Control Program 1. Purpose and Applicability of the Bloodborne Disease Exposure Control Program The purpose of this exposure control program is to minimize or eliminate potential employee exposure to human blood and certain other body fluids or tissues by defining special precautions. An additional purpose for this program is to define the administrative responsibilities for the program. It is suggested that the final OSHA Regulations (1910.1030) and Instruction CPL 02-02-069 can also be used as a reference. Other sources of regulatory assistance may include individual state OSHA and public health agencies. In most workplaces, contact with the above materials is not a frequent on-the-job occurrence. An exception is the potential exposure that may occur in first-aid situations where there are open wounds or where breathing resuscitation efforts are required. This program primarily addresses those parts of the regulation that would apply to this minimum exposure. This model bloodborne disease exposure control program is in accordance with applicable state and federal regulations. 2. Definitions Potentially infectious material is defined as human blood and blood products, contaminated sharps and syringes, human tissues and organs and certain body fluids. These body fluids include: semen, vaginal secretions, saliva in dental procedures, cerebrospinal fluid, fluids from joints, chest cavity, heart sac, abdomen or birth sac and any fluid that is visibly contaminated with blood or if the conditions are such that it is difficult or impossible to tell if blood or other body fluids are present. Not included are tears, sweat, saliva, vomit, feces, urine, and nose fluids (unless visibly contaminated with blood or other body fluids). Contact with unbroken skin is not considered to be hazardous. A bloodborne pathogen is defined as any organism present in human blood that can cause disease in humans. These pathogens include, but are not limited to, HBV and HIV. A potentially exposed employee is any employee who may reasonably be expected to be exposed to specific eye, mouth or other mucous membrane or non-intact skin contact with the potentially infectious materials mentioned above while performing assigned duties. 3. Exposure Determination Rules require that each job position with potential exposure to bloodborne pathogens will be placed into either a category in which all employees have potential exposure or into a category in which only some employees have potential exposure. Exposure determination will be made without regard to the use of personal protective equipment (PPE). The City of Fairfax Risk Manager will evaluate job tasks for each department and keep a master list of which employees have potential exposure. The exposure control program will be reviewed and updated to reflect significant changes in jobs or procedures. 4. Universal Precautions Universal precautions are methods of exposure control in which potentially infectious materials are always treated as if they were known to be infected with bloodborne pathogens. The following policies will be followed to protect all employees: A. Employee Responsibilities 1) Gloves will be worn whenever there is the potential for the hands to come in skin contact with blood, infectious materials, mucous membranes, non-intact skin, or surfaces and materials soiled with blood or other potentially infectious materials. 2) Disposable gloves will be replaced as soon as possible when they are visibly soiled, torn, punctured, or may no longer provide a barrier to contamination. Utility gloves may be disinfected for re-use if their protective ability is not compromised, but they will be discarded if they are cracked, peeling, discolored, torn, punctured, or deteriorating. 3) Employees will wash their hands immediately after removing protective gloves or other PPE and after hand contact with blood or other potentially infectious materials. If working away from a facility with a water supply, disinfecting towelettes may be used and hands will be washed with soap and water as soon as possible. 4) All PPE will be removed immediately after completion of the task being performed and placed in a designated appropriate area or container for storage, washing, decontamination, or disposal. 5) Masks, eye protection, or chin-length face shields will be worn if there is a potential for splashes, spray, or spatters of blood or other potentially infectious materials into the air where it may contact the eyes, nose, or mouth. 6) Depending upon the task and degree of exposure expected, protective clothing will be worn that provides effective protection. a. Gowns, coats, aprons, etc. will be worn if there is a potential of contaminating work clothing and a protective cap will be worn if there is the potential for the splashing or spraying of potentially infectious material on the head. b. Fluid resistant clothing will be worn if there is a potential for the splashing or spraying of blood or other potentially infectious materials. c. Fluid proof clothing and shoe covers will be worn if there is a potential for clothing or shoes to become soaked with blood or other potentially infectious materials. 7) If hypodermic needles or other sharps are used, they will not be sheared, bent, broken, or recapped by hand. 27 8) It is prohibited to eat, drink, smoke, apply cosmetics or lip balm, handle contact lenses, or store food and beverages in areas of possible contamination or occupational exposure. 9)All procedures involving blood or other potentially infectious materials will be performed in such a way to minimize splashing, spraying, or the production of aerosols. 10) Direct mouth to mouth contact is prohibited and resuscitation procedures will be performed with mouthpieces, resuscitation bags, pocket masks, or other ventilation devices. 11) Potentially infectious broken glassware and other sharp items will not be picked up directly by hand but will be manipulated using mechanical devices such as a brush, dust pan, tongs, forceps, or cotton swabs. 12) Any container used to hold potentially infectious materials will be closable, leak proof, and display the universal biohazard symbol shown. If the outside of the container is likely to be contaminated also, a second leak proof container will be placed over the first, labeled as above, and closed to prevent leakage during handling, storage, and transport. If puncture of the first container is likely, both containers will be puncture resistant. BIOHAZARD If the above container holds infectious waste for disposal, the disposal method will comply with federal, state and local regulations. 13) If sharps are used, they will be placed immediately in closable, puncture resistant, and disposable containers which are leak proof on the bottom and sides and display the universal biohazard symbol. These containers will be easily accessible to personnel in the immediate area of use and will be replaced routinely and not allowed to become overfilled. 14) If reusable items are contaminated, they will be decontaminated before washing and/or reuse or processing. 15) All laundry used in a potentially infectious situation, will be treated as if it were contaminated and will be handled as little as possible with a minimum of agitation. The laundry will be bagged at the location where it was used, the bag will display the universal biohazard symbol, and the laundry will be sorted only in a well ventilated area by trained employees wearing protective gloves and other appropriate PPE to prevent exposure during handling and sorting. B. Employer Responsibilities 1) Any engineering or work practice controls which would help isolate or remove the hazards will be examined and maintained or replaced on a regular schedule to ensure their effectiveness. 2) The employer will provide appropriate PPE and ensure that affected employees use the appropriate protective equipment and follow the above universal precautions. The supplied equipment may include items such as disposable or reusable gloves, fluid-proof aprons, coats, head and foot coverings, face shields, masks, eye protection, mouthpieces, resuscitation bags, pocket masks, or any other device which would protect the worker from work exposure. 3) PPE will be provided in the appropriate sizes for affected employees and will be readily accessible at the worksite or issued to the employee. If an employee is allergic to the gloves normally provided, hypoallergenic gloves will be provided. 4) Provisions will be made for the cleaning, laundering, or disposal of PPE and all such equipment will be repaired or replaced as needed to maintain its effectiveness. 5) Wherever contamination may occur, the worksite will be maintained in a clean and sanitary condition. An appropriate written schedule for cleaning and the method of disinfection (a solution of 1:10 of household bleach and water is acceptable as is any disinfectant that is tuberculocidal) will be provided and will be based on the work location, the type of contamination, the type of surface to be cleaned, and the type of procedures used. a. All equipment and work surfaces will be cleaned and disinfected immediately after contact with blood or other potentially infectious materials. If protective coverings are used, they will be removed and replaced or whenever they become obviously contaminated. b. Equipment (including containers and receptacles) intended for reuse which may become contaminated will be checked routinely and before servicing or shipping and will be decontaminated as needed. 6) Communication of Hazards to Employees a. Warning labels will be fixed (to prevent their loss or accidental removal) to containers or equipment (e.g. refrigerators) containing contaminated material. b. These labels will be orange-red with lettering of a contrasting color and will display the universal biohazard symbol. c. Signs will be posted at the entrance to any work area where potentially infectious material is located. The sign will include: The word "Biohazard" and the universal biohazard symbol with the sign being orange red with letters of a contrasting color. The name of the infectious agent. Any special instructions for entering the area, and the name and telephone number of the supervisor of the area. 5. Training Once all current employees have been trained, new employees will be trained at the time of initial employment. The training will be appropriate in content and vocabulary to the educational level, literacy, and language background of the employees being trained and will be given annually thereafter. See CFR 1910.1030(g)(2). 1) This program will be available for each affected employee during their work shift along with proper guidance of the contents within. 2) A general explanation of the epidemiology and symptoms of bloodborne diseases. 3) An explanation of the modes of transmission of bloodborne pathogens. 4) An explanation of the employer's exposure control program. 5) The appropriate methods for recognizing tasks and activities that may involve exposure to blood and other potentially infectious materials. 6) The use and limitations of the universal precautions that will prevent or reduce exposure (engineering controls, work practices, and PPE). 7) Information on types, proper use, location, removal, handling, decontamination, and/or disposal of PPE. 8) An explanation of the basis for PPE selection. 9) Information on the hepatitis B vaccine, including its efficacy, safety, and the benefits of being vaccinated. 10) Appropriate actions to take and persons to contact in an emergency. 11) Procedures to follow if an exposure incident occur, including: a. The method of reporting the incident and the medical follow-up that will be available. b. Information on provided medical counseling for exposed individuals. 12) An explanation of hazard labels or color coding for contaminated waste materials. 6. Medical Requirements HBV vaccination will be available to all employees with potential occupational exposure and post-exposure medical follow-up for any employee with an occupational exposure incident. A. All evaluations and the above items will be performed by or under the supervision of a licensed physician and all laboratory tests will be conducted by an accredited laboratory. B. All pertinent medical items will be provided at no cost to the employee and at a reasonable time and place according to standard recommendations for medical practice. C. The vaccination will be offered unless the employee has had a previous HBV vaccination or unless antibody testing has revealed that the employee is immune. D. The employee must sign a consent or decline form. If the employee declines the vaccination initially, but elects to take it at a later date (while still covered under this policy), the vaccination will be provided at that time and if booster doses are recommended at a later date, they will be provided upon the advice of a physician. E. Antibody testing will be provided for those employees who desire testing before deciding whether to receive vaccination. If the employee is found to be immune, an offer of vaccine to that employee is not required. 29 F. The post exposure evaluation will include at least: 1) Documentation of the exposure route, HBV and HIV antibody status of the source individual (if known) and the circumstances of the exposure. 2) If the source individual is known and with permission obtained, the source individual's blood will be tested to determine the presence of HIV and/or HBV infection. The source person's test results will be made available to the exposed employee and the employee will be informed of applicable laws and regulations concerning disclosure of the identity and infectious nature of the source individual. When the source individual is known to be infected with HIV or HBV, testing of the source person's blood need not be repeated. 3) Blood collection from the exposed employee will be done as soon as possible after the exposure incident. Actual testing of the sample may be done at that time or at a later date if the employee so requests. 4) Follow-up procedures will include antibody or antigen testing, counseling, illness reporting, and safe and effective post-exposure treatment to meet standard medical practices. G. For each affected employee, the employer will obtain from the physician a copy of the physician's written opinion and provide a copy to the employee within 15 working days of the completion of the evaluation. Each written opinion will be limited to the following information: 1) The physician's recommendations upon the ability of the employee to receive HBV vaccination. 2) A statement that the employee has been informed of the results of the medical evaluation and that the employee has been told about any medical conditions resulting from exposure which might require further evaluation or treatment. 3) Those specific findings which are related to the employee's ability to receive HBV vaccination. Any other findings will remain confidential. 7. Recordkeeping A. Medical Records 1) An accurate record will be kept for each affected employee regarding his/her hepatitis B status and will include the following: a. Name and social security number. b. A copy of the employee's hepatitis B vaccination records relative to the ability to receive vaccination and the circumstances of any exposure incidents. c. A copy of all results regarding the physician's examination, testing, and post exposure follow-up results. d. A copy of the physician's written opinions. e. A copy of the information that is required to be provided to the physician. 2) These records will be kept confidential and the information will not be reported to anyone except: a. Examination and copying by the employee. b. At the written consent of the employee. c. To enforcement authorities authorized by OSHA. 3) These records will be maintained during the duration of employment plus 30 years. B. Training Records 1) Records of training will include the following: a. A copy of the current training list of at-risk personnel with the current training status of each employee. b. The dates of the training sessions and the name of the instructor. c. A written summary of the contents of the sessions d. The names of all persons attending the sessions. e. These records will be maintained for three years. 2) The records will be made available only: a. To the employee for examination and copying. b. To anyone who has the written consent of the employee. c. When requested by enforcement authorities authorized by OSHA. APPENDICES APPENDIX I HEPATITIS B IMMUNIZATION CONSENT OR DECLINE Employee's Name (please print) Social Security Number I have read the information about Hepatitis B and the Hepatitis B vaccine. I have had an opportunity to ask questions of a qualified nurse or physician and understand the benefits and risks of Hepatitis B vaccination. I understand that I must have 3 doses of the vaccine to obtain immunity. However, as with all medical treatment, there is no guarantee that I will become immune or that I will not experience side effects from the vaccine. CONSENT TO HEPATITIS B VACCINATION Signature of Person to Receive Vaccine Date Signed Signature of Administrator Date Signed DECLINE OF HEPATITIS B VACCINATION I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring Hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine, at no charge to myself. However, I decline Hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with Hepatitis B vaccine, I can receive the vaccination series at no charge to me. Signature of Employee Date Signed Signature of Administrator Date Signed 31 APPENDIX II BLOODBORNE PATHOGEN EXPOSURE INCIDENT REPORT Bloodborne Pathogen Program City of Fairfax Employee Name: Department: Work Location At Time Of Exposure: Summary Of Incident (Route Of Exposure & Circumstances): Date & Time Of Exposure: Duties Of Employee: Supervisor Signature: Employee Signature: Enclosure: Company Bloodborne Pathogen Manual for Physician Use Cc: Health Care Provider, Company File, Employee Copy TO BE COMPLETED BY HEALTH CARE PROVIDER POST EXPOSURE MEDICAL EVALUATION SUMMARY: Signature of Health Care Provider Date Signed APPENDIX III INFORMATION ABOUT HEPATITIS B 1 AND HEPATITIS B VACCINE The Disease Hepatitis B is a viral infection caused by the Hepatitis B virus (HBV) which causes death in 1-2% of infected patients. Most people with Hepatitis B recover completely, but approximately 5-10% become chronic carriers of the virus. Most of these people have no symptoms, but can continue to transmit the disease to others. Some may develop chronic active hepatitis and cirrhosis of the liver. HBV may be a causative factor in the development of liver cancer. Immunization against the Hepatitis B virus can prevent acute hepatitis and its complications. The Vaccine Hepatitis B (Recombivax HB) vaccine is produced from yeast cells. It has been extensively tested for safety and effectiveness in large scale clinical trials. Recombivax has been marketed since 1986. Approximately 90 percent of healthy people who receive two doses of vaccine and a booster achieve high levels of surface antibody (anti-HB) and protection against Hepatitis B virus. Hepatitis B vaccine is recommended for workers s with potential for contact with blood or body fluids. Full immunization requires 3 doses of vaccine over a six month period, although some persons may not develop immunity even after 3 doses. There is no evidence that the vaccine has ever caused Hepatitis B. However, persons who have been infected with HBV prior to receiving the vaccine may go on to develop clinical hepatitis in spite of immunization. Dosage and Administration The Recombivax HB vaccine is given in three intramuscular doses in the deltoid muscle. Two initial doses are given one month apart and the third dose is given six months after the first. Possible Vaccine Side Effects The incidence of side effects is very low. No serious side effects have been reported with the vaccine. Ten to twenty percent of persons experience tenderness and redness at the site of injection and low grade fever. Rarely rash, nausea, joint pain, and mild fatigue have been reported. The possibility exists that other side effects may be identified with more extensive use. 1 Memorandum Regarding a New Policy on Hepatitis B, issued jointly by the Iowa Department of Public Health and the Department of Personnel, 1989 33 APPENDIX IV INFORMATION ABOUT AIDS "AIDS" is shorthand for the acquired (rather than inherited) immune deficiency (a breakdown of the body's defense system, producing susceptibility to certain diseases) syndrome (a group of many disorders and symptoms). People 1 with the full-blown form of AIDS suffer from unusual, life-threatening infections and/or rare forms of cancer." "The virus that causes AIDS and AIDS-related conditions is now called Human Immunodeficiency Virus. HIV is a retrovirus that must live and reproduce inside human cells. It is extremely fragile and does not survive long outside the body. It is present in certain body fluids (notably in blood, semen, and vaginal secretions) of people 1 who have been infected, whether or not they have symptoms". "The virus that causes AIDS also produces milder but often serious illnesses called AIDS Related Complex (ARC). These may include persistent enlargement of lymph nodes, chronic fatigue, fever, weight loss, night sweats, and abnormal blood counts. Many people with ARC improve but others progress to having AIDS itself or remain the 1 same." The virus is spread through sexual contact and exposure to human blood, blood components and certain other body fluids. Evidence has shown that only blood, semen, vaginal secretions and possibly breast milk are implicated in 2 transmission from person to person. The rapid increase of HIV cases increases the risk that workers with duties involving potential contact with the above materials may be exposed to the virus if they do not follow the "Universal Precautions". These blood and body fluid precautions are designed to protect the worker and require that all potential contact be treated as if potentially infectious material contained the HIV virus. Routine social or community contact with an HIV-infected person carries no risk of transmission. Neither Hepatitis B Virus nor HIV is transmitted by casual contact in the work place. The "Universal Precautions" used to protect the worker from HBV and HIV are the same except for the fact that there is currently a vaccine to prevent HBV infection but there is no vaccine for HIV. 1 Aids, What Everyone Should Know, Pamphlet, American College Health Association, 1987 2 Recommendations for Prevention of HIV Transmission in Health Care Settings, OSHA Instruction CPL 2-2.44B, 1990 APPENDIX V Bloodborne Pathogens Self-Assessment Checklist Element: Bloodborne Pathogens - Date: Assessment Team: Instructions: Complete the checklist by answering yes or no to the following questions. Use the identified methods to gather a complete response (D - Document review; I - Interview; V - Visual inspection). Look for discrepancies with the written program and non-conformance with the requirements, along with root causes and potential corrective actions. Criteria Yes No 1.The program is reviewed annually? DI 2.There is an exposure control plan in place? D 3.Determined which employees are potentially exposed due to job duties? DI 4.Appropriate PPE is used for contamination cleanup? V 5.Employees are trained on appropriate disposal of contaminated material, PPE and clothing? DI 6.Biohazard containers are available? V 7.Hazardous areas are marked with warning tags/labels? V 8.Training is provided to the employees are have potential exposure? DI 9.Provided each affected employee with medical consultation and the choice of accepting or DI refusing immunization for Hepatitis B? 10. Records are kept on file of all training and medical activities? D 11. Hand washing/Antiseptic cleaning products available for employee during shift? IV 12. Procedures for cleanup of potentially infectious material are in place? DI 13. Regulated waste cleanup kits and containers are on location? IV 14. Regulated waste is properly disposed of in marked containers or bags? IV Overall Findings (Strengths and Weaknesses): New Goals: 35 DISCLAIMER In 1989, a proposed federal Occupational Safety and Health Administration (OSHA) standard 1910.1030 - Bloodborne Pathogens was issued primarily for health care worker protection against occupational exposure to the AIDS virus (HIV), the Hepatitis B virus (HBV), and other bloodborne infectious agents. An OSHA instruction manual (CPL 2-2.44) was issued as a guide for enforcement procedures for occupational exposures. OSHA released the final regulation (see 1910.1030) on March 6, 1992, and these now apply to any potential occupational exposure to bloodborne pathogens. A 2001 version of the OSHA instruction manual (CPL 02-02- 069) has been issued and is available from individual state OSHA enforcement procedures. For specific information on exposure control procedures call the state agencies involved with public health. Copyright© 2007 Iowa Association of Municipal Utilities. Copyright is not claimed as to any part of the original work prepared by a U.S. government officer or employee as part of that person's official duties. This manual may be reproduced by the owner to facilitate adoption and implementation of the owner's compliance program. No other reproduction is authorized without the express written consent of the Iowa Association of Municipal Utilities. All other rights reserved. Iowa Association of Municipal Utilities th 1735 NE 70 Avenue Ankeny, Iowa 50021-9353 515/289-1999 Disclaimer of Warranty and Limitation of Liability This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is furnished with the understanding that the Association is not engaged in rendering legal or other professional service. If legal advice or other professional or expert assistance is required, the services of a competent professional person should be sought. This publication is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the quality, performance, and accuracy of the manual is with the holder. 6.4 Confined Space Program SECTION 1 -PERMIT REQUIRED A. Program Administration and Operating Procedures The following person is responsible for administering the Permit Required Confined Spaces Program (CSP). Plan Administrator for the City departments covered in this plan Lynn Miller / Brian Merta The Plan Administrator will oversee the program, evaluate it regularly, working with entry supervisors to ensure it is being administered effectively. The primary responsibilities of the Plan Administrator are to: Ensure proper completion/authorization of permits prior to entry into the space. Coordinate employee training/information sessions. Oversee the purchase, repair and maintenance of necessary equipment. Evaluate confined spaces and maintain a record of hazards regarding confined space. Communicate the provisions of the program to other employers conducting work in permit required spaces. Review permits to evaluate proper completion and observe any discrepancies with the program. Authorize any changes in regards to downgrading confined spaces to "non-permit required" status and certify them accordingly. Review and audit the Confined Space program annually, or as needed. The Plan Administrator can also act as an entry supervisor. Entry supervisors (or entry employer for construction operations) will assist the Plan Administrator with the task of implementing and maintaining the Permit Required Confined Spaces Program. Supervisors will ensure that basic procedures are followed for permit required confined spaces. These procedures include: Planning the job (e.g. defining the scope of the work, indicating if hot work is necessary, ensuring employee hazard communication training, etc.). Removing the space from service. Isolating the space (e.g. installing blind flanges, disconnecting lines or drive shafts, etc.). Preparing the space (e.g. ventilating, draining, purging, locking, etc.). Testing the space for appropriate potential hazards (e.g. oxygen deficiency, toxic gases, noise, temperature, etc.). Providing for rescue and retrieval. Establishing entry requirements and emergency procedures. Allowing work to begin only after the authorized permit is obtained. Conducting work as specified on the permit. Seeing that the permit is canceled when work is completed. Informing entrants when a space has been downgraded to non-permit required status. Supervisors are also required to contact the Plan Administrator when questions or problems arise that involve the Permit Required Confined Spaces Program. B. Authorization of Permits A Permit Entry System has been established for those employees who are required to enter permit required confined spaces. The Permit Entry System is initiated by the entry supervisor whenever employees must enter a confined space. Written permits are authorized by the entry supervisor only after all the requirements of the Permit Required Confined Spaces Program have been addressed. The authorizing individual will also cancel the permit after the work has been completed. C. Components of the Permit Required Confined Spaces Program 1. Hazard Identification The Plan Administrator shall ensure that permit required confined spaces are identified in all work areas. The Inventory of Permit Required Confined Spaces (Form CS1) is used for this purpose. The types of hazards involved in a specific confined space may be determined by the Plan Administrator in conjunction with the entry supervisor. This record of permit required confined spaces is kept on file and updated as necessary by the Plan Administrator. Supervisors inform the Plan Administrator of any updated information regarding the permit required confined spaces in their work area, including any new confined spaces identified. 2. Hazard Control Safe entry practices and procedures are used by employees while conducting work in confined spaces. Hazard control is accomplished by: Identifying permit required confined spaces and inventorying the hazards of each (Form CS1). Completing and authorizing a written permit prior to entry (Form CS2). Conducting appropriate employee training sessions. Following standard operating procedures to reduce or eliminate the potential hazards (Appendix I). Establishing emergency rescue procedures (see item # 8). Completing a certification form when permit required confined spaces are downgraded to non- permit status (Form CS3). 37 3. The Permit System A written Confined Space Entry Permit is completed and authorized prior to any employee entering a permit required confined space (in the course of their work). This permit will be completed by the entry supervisor in charge of the project. The completed permit identifies necessary procedures and practices that must be satisfied before and during entry. In addition, the employees serving as attendants and entrants, as well as any other requirements of the permit required confined spaces regulation, are specified on the permit. The specific permit used is Form CS2. Authorization of the confined space permit is delegated to entry supervisors. The entry supervisor in charge of the work to be performed is responsible for ensuring that the requirements of the permit are fulfilled before employees enter the identified confined space. During the time that work is being conducted, the confined space will be immediately evacuated whenever the requirements specified in the permit are not met. (A new permit must then be issued and authorized prior to reentry.) Completed permits shall be maintained for one year. The Permit Required Confined Spaces Flowchart in Appendix III shows the basic permit entry procedures. 4. Employee Information Warning signs can be posted to notify employees of potential hazards in the permit required confined space and entry is limited to authorized personnel. Signs will be posted to identify permit required confined spaces, if feasible, otherwise spaces are listed on the Confined Space Inventory (CS1). The locations of the permit required confined spaces are reviewed during employee training sessions for attendants, entrants, supervisors of confined space projects, and those people who authorize permits. Supervisors will inform employees of permit required confined spaces they may encounter in their work areas as well as cases where warning signs are not feasible (e.g. access to tunnels in the middle of a street). 5. Prevention of Unauthorized Entry Special precautions are taken to limit entry into permit required confined spaces. Precautions to prevent unauthorized entry include posting signs, constructing barriers, and employee training. Supervisors are instructed to prohibit anyone from entering a permit required confined space without a properly authorized permit. Attendants prohibit unauthorized entry into a confined space while work is being conducted in that space. Contractors are to be informed of the permit entry system (and other relative information) by the Plan Administrator. 6. Employee Training Employees receive appropriate training before serving as attendants or entrants. Appropriate training is also required for the supervisor in charge of the work and those people authorizing permits. Employee attendance at training sessions is kept on file with the City of Fairfax department. 7. Equipment Special equipment is used to assess confined space hazards and protect employees from these hazards. These devices include air testing instruments, communications equipment, ventilating equipment, and personal protective equipment. All equipment must be checked for proper operation, calibration, and and make requests for new or additional equipment to the Plan Administrator. 8. Emergency Procedures The entrants and attendants receive training in emergency procedures regarding confined spaces. Rescue equipment is available in the event of an accident while permit required confined space work is being conducted. In addition, the City of Fairfax Fire and Rescue Department will provide emergency services and should be in communication with the department if they are unavailable during permit required space entry. Responders will be notified of the hazards their team may encounter when called upon to perform rescue services along with any additional information that may be requested. The intent is to provide information so that the rescue team can equip, train, and conduct emergency services accordingly. The department will ensure that the rescue team is aware of the types of hazards that may be present in the facility during their rescue operation and will also allow access to facilities and permit required confined spaces to develop appropriate rescue plans and practice rescue operations. 9. Protection from External Hazards While permit required confined space work is being conducted, physical barriers are erected to control pedestrian and vehicle traffic, as necessary. The main intent of this action is to protect attendants and entrants from these hazards during the course of their work. Traffic control requirements can be found in the U. S. Department of Transportation's Manual on Uniform Traffic Control Devices. (MUTCD) 10. Duty to Other Employers Other employers who conduct work at or for the employer are expected to comply with the permit required confined spaces regulation. The Plan Administrator will coordinate entry operations with contracted employers when host personnel and the outside employees are working together in a confined space. If it becomes known to the Plan Administrator that the outside employer has not instituted an appropriate permit entry system, that employer will be prohibited from conducting work in the space. The Plan Administrator ensures that other employers who must conduct work in a permit required confined space are given: The information on Form CS1 regarding the hazards of that space. A completed copy of a confined space permit that indicates the actions that would be taken prior to entry. Any information regarding work place hazards, safety rules, or emergency procedures which are used and which the contractor must be aware of in order to comply with the OSHA Permit Required Confined Spaces regulation. The Plan Administrator will contact the contractor at the end of the project to ensure confined space procedures were appropriate and to inquire about hazards involved in the confined space during that project. Construction Setting In addition to the requirements above, under a construction environment OSHA (29 CFR 1926 Subpart AA) outlines additional precautions that are necessary to fulfil confined space operations. All contractors need to be informed of any confined space work being done on-site along with copies of all material discussed above. In addition, they need to be aware of any hazards they could introduce into the confined spaces. Each confined space will need to be evaluated by a competent person prior to entry, both permit and non-permit spaces. All permit confined space work must utilize continuous atmospheric monitoring when available. If such monitoring devices are not accessible periodic monitor must be frequent enough to ensure continuous safe levels. Work being performed in a large continuous space (e.g. storm sewers), where isolation from an engulfment hazard is not possible, continuous monitoring of the hazard needs to be established. A spotter upstream or electronic sensor, for example, during a storm that could cause flash flooding to alert those in the space. Confined space permits can be suspended instead of being cancelled. As long as safe conditions are met prior to re-entering the space. 11. Confined Space Classification Permit Required Spaces Any space with known hazards and/or a toxic atmosphere, or potential hazards shall be considered a permit required confined space. Non-Permit Space After documented evaluation a confined space that does not contain or, with respect to atmospheric hazards, have the potential to contain any hazard capable of causing death or serious physical harm 39 can be signed off by management as a non-permit required confined space. This should be listed in the confined space index for the department (Form CS1) Downgrading Permit-Required Confined Spaces A permit required confined space may be downgraded to a non-permit confined space by the Plan Administrator if documentation or previous permits and/or other appropriate information indicates that the space contains no confined space hazards. Evidence for this determination is listed on Form CS3 and signed by the Plan Administrator. Identification of these re-certified non-permit required confined spaces will be accomplished through annual training of entry supervisors, attendants, and entrants or by specific notice such as the issuance of a new Form CS3. Completed copies of Certification Form CS3 are available to all entrants of such spaces through the Plan Administrator. Use of the alternative method, as indicated in the OSHA regulation, 1910.146(c)(5) is allowed to downgrade the permit-required confined space when there is only atmospheric hazards. This can be achieved with the use of ventilation where the employer is monitoring and demonstrating that forced air is sufficient in maintaining the permit space, safe. This method may only be used with the specific approval of the Plan Administrator. D. Specific Training and Duties 1. The Entrant In order to adequately perform their duties, entrants receive training in the following areas: a. Knowledge and recognition of the hazards they may encounter in permit spaces including: Recognition of the signs and symptoms of exposure. Understanding the consequences of exposure to these hazards. b. The methods and importance of maintaining contact (communication) with the attendant. Entrants will be instructed to immediately notify the attendant when: They feel or see there is an unsafe condition in the space, or They must evacuate the space for any reason. c. The proper use of protective equipment needed for safe entry and exit. d. The use of continuous atmospheric monitoring devices. e. The proper use and knowledge of external barriers necessary (e.g. barricades, cones, etc.). f. The need to immediately exit the permit space if: The attendant orders evacuation. An automatic alarm on a monitoring device is activated. The entrants feel or see that they are in danger. 2. The Attendant a. Training Attendants receive training in the areas identified below: The method used to keep an accurate count of entrants. Recognition of the hazards encountered in confined spaces. Communication techniques used in confined space work. Appropriate rescue procedures such as methods of summoning help and assisting the rescue team. The duties and authority of attendants. Attendants will receive the same basic hazard recognition training as the entrants. Therefore, attendants and entrants may rotate duties. b. Duties Keep an accurate count of the number of workers in the confined space. Limit entrants in the confined space to those people identified on the permit. Monitor the situation both inside and outside the space for hazards, being alert to any conditions which may require evacuation of the space. Keep in continuous and effective contact with those employees inside the space. Order evacuation of the space as necessary. Know how to use emergency equipment and be familiar with practices to assist with rescue without entering the space. Never leave the work station unless properly relieved or unless all entrants are out of the space. Contact the supervisor in charge or the Plan Administrator if problems arise. Initiate and summon emergency services, if necessary. c. Authority As part of their duties, attendants are authorized to: Prohibit unauthorized personnel from entering the confined space. This includes warning them away from the space as well as asking them to exit the space, if they have entered. Order entrants or unauthorized personnel out of the confined space at will. Reasons to order an evacuation include: o A condition arises that is not allowed by permit. o A behavioral change is noticed in a worker. o A potential hazard occurs outside the confined space that will affect workers in that space. o An uncontrolled hazard is detected in the confined space. o The attendant is not able to carry out the duties assigned. o The attendant must leave the assignment. 3. The Personnel Authorizing the Permit (or Entry Supervisor) a. Training and Duties Training is conducted for those personnel authorizing permits (or in charge of work) to facilitate the appropriate administrative, technical, and managerial aspects of confined space entry. These individuals have the authority to terminate entry at any time. They may also serve as an attendant or enter the space if they have received proper training (and have informed the attendant). Personnel who authorize entry permits will be trained to perform the following duties: Evaluate a space and complete the permit to ensure hazards within the confined space are controlled. Ensure that appropriate procedures, practices, and equipment are in place (before allowing entry). This condition will be signified by authorizing the permit. Cancel the permit, order evacuation of the space, and have it secured whenever unacceptable conditions are encountered. Cancel the permit and have the space returned to normal service once the authorized work has been completed. Prohibit unauthorized personnel from entering the space. The person authorizing the permit evaluates the space during entry (by personal observation or reported information) to assure that conditions are consistent with the terms of the permit. If necessary, steps for corrective action are taken as noted above. E. The Permit The permit form is to be written or printed. The content of the permit is based on the employer's hazard identification and evaluation of the confined space. Key information that needs to be documented is: 1) Identity of the space. 2) Purpose of the entry. 3) Date of entry and authorized duration (not to exceed one year). 4) A list of authorized entrants, attendants, and current entry supervisors. 5) Signature and legible name of person initially authorizing the permit (to indicate conditions for safe entry have been performed). 41 6) Details/dangers of the space that indicate: a.Hazards in the space. b. Measures to isolate the space. c. Measures to control the hazards such as lockout/tagout, purging, flushing lines, and ventilating, etc. d. Acceptable entry conditions to be maintained during entry including concentrations of the airborne hazards that are permissible. e. Initial and continuous monitoring including names or initials of the tester and when the tests were conducted. f. Rescue services that can be summoned and a means of communicating with those services. g. On-site rescue equipment, if necessary. h. Communication equipment and procedures to be used to maintain contact between attendants and entrants. i. Personal protective equipment and clothing necessary to ensure employee safety. j. Any other hazard information for that particular permit space to ensure employee safety, e.g. any hot work must be prominently displayed. SECTION 2 -FORMS NEEDED FOR COMPLIANCE INVENTORY OF CONFINED SPACES Department/Division __Wastewater Dept Hazard Key Building/Location __Collection System CO=Carbon Monoxide Collected by __Kevin Stensland E=Engulfment Date/phone __February 2017 / 319-846-2204 F=Fire/explosion HS=Hydrogen Sulfide THIS INVENTORY SHOULD BE COMPLETED IN CONJUNCTION M=Mechanical O=Oxygen deficiency (d) or enrichment (e) WITH THE PLAN ADMINISTRATOR. P=Physical S=Shock (MARK ALL HAZARDS THAT APPLY) SR=Severity Rating (10 high -1 low) TC=Toxic Chems. Data collected by Kevin Stensland TG=Toxic Gases A=Accessibility (good - fair - poor) NAME OF SPACE/LOCATION HAZARD OR HAZARD CODE (Follow guidelines on Hazard Evaluation, Appendix II) Confined Space TC TG Other Class 4 Lift Stations CO E F HS M O P S SR list list list A NP P Burger Lane X X X X X X X X 6 G P Quarry X X X X X X X X 6 G P East Cemetery X X X X X X X X 6 G P Prairie View X X X X X X X X 6 G P Sanitary Manholes (City wide) X X X X X 7 G P Storm sewer intakes ( City wide) X X X X 3 G P 43 Department/Division __Wastewater Plant Hazard Key Building/Location __480 Front St CO=Carbon Monoxide Collected by __Kevin Stensland E=Engulfment Date/phone __February 2017 / 319-846-2204 F=Fire/explosion HS=Hydrogen Sulfide THIS INVENTORY SHOULD BE COMPLETED IN CONJUNCTION M=Mechanical O=Oxygen deficiency (d) or enrichment (e) WITH THE PLAN ADMINISTRATOR. P=Physical S=Shock (MARK ALL HAZARDS THAT APPLY) SR=Severity Rating (10 high -1 low) TC=Toxic Chems. Data collected by _ Kevin Stensland TG=Toxic Gases A=Accessibility (good - fair - poor) NAME OF SPACE/LOCATION HAZARD OR HAZARD CODE (Follow guidelines on Hazard Evaluation, Appendix II) Confined Space TC TG Other Class Wastewater Plant CO E F HS M O P S SR list list list A Inventory NP P Influent Structure X X X X X 7 G P Grit Chamber X X X X 7 G P Aeration Basin #1 X X 1 G NP Aeration Basin #2 X X 1 G NP Digester Tank X X X 7 F P Biosolids Transfer Wet Well X X X X X X 7 G P Return Pump Wet Well X X X X X X 7 G P Clarifier #1 X 1 G NP INVENTORY OF CONFINED SPACES Department/Division __Water Dept Hazard Key Building/Location __Water Plant CO=Carbon Monoxide Collected by __Kevin Stensland E=Engulfment Date/phone __February 2017 / 319-846-2204 F=Fire/explosion HS=Hydrogen Sulfide THIS INVENTORY SHOULD BE COMPLETED IN CONJUNCTION M=Mechanical O=Oxygen deficiency (d) or enrichment (e) WITH THE PLAN ADMINISTRATOR. P=Physical S=Shock (MARK ALL HAZARDS THAT APPLY) SR=Severity Rating (10 high -1 low) TC=Toxic Chems. Data collected by _Kevin Stensland TG=Toxic Gases A=Accessibility (good - fair - poor) NAME OF SPACE/LOCATION HAZARD OR HAZARD CODE (Follow guidelines on Hazard Evaluation, Appendix II) Confined Space TC TG Other Class Water Plant and CO E F HS M O P S SR list list list A Tower Inventory NP P #1 Contact Tank X X X 7 F P #2 Contact Tank X X X 7 F P #1 Filter Tank X X X 7 F P #2 Filter Tank X X X 7 F P #3 Filter Tank X X X 7 F P #4 Filter Tank X X X 7 F P #5 Filter Tank X X X 7 F P #6 Filter tank X X X 7 F P Water Tower Bowl X X X 7 F P 45 FORM CS1 Department/Division __Wastewater Plant Hazard Key Building/Location __480 Front St CO=Carbon Monoxide Collected by __ Kevin Stensland E=Engulfment Date/phone __February 2017 / 319-846-2204 F=Fire/explosion HS=Hydrogen Sulfide THIS INVENTORY SHOULD BE COMPLETED IN CONJUNCTION M=Mechanical O=Oxygen deficiency (d) or enrichment (e) WITH THE PLAN ADMINISTRATOR. P=Physical S=Shock (MARK ALL HAZARDS THAT APPLY) SR=Severity Rating (10 high -1 low) TC=Toxic Chems. Data collected by _Kevin Stensland TG=Toxic Gases A=Accessibility (good - fair - poor) NAME OF SPACE/LOCATION HAZARD OR HAZARD CODE (Follow guidelines on Hazard Evaluation, Appendix II) Confined Space TC TG Other Class Wastewater Plant CO E F HS M O P S SR list list list A Inventory NP P Clarifier #2 X X 1 G NP Clarifier #1 pump well X X X X X X 7 F P Clarifier #2 pump well X X X X X X 7 F P Clarifier Effluent Manhole X X X X 5 G P UV Channel X 1 G NP Permit-Required Confined Space Permit FORM CS2 City of Fairfax, Iowa Confined Space Entry Permit Permit # Date Use Date Format for Permit# (Sample 140101 Yr Mo Day) Location & Description of Confined Space Purpose of Entry Schedulea.mSchedulea.m d . d . StarDay/Date/Timp.mDay/Date/Timp.m t e . Finish e . Entry Supervisor: Entrants: Attendants: Pre-Entry Administrative Authorization: ǤƦĻ ƚŅ IğǩğƩķƭ Oxygen-Deficient Atmosphere Engulfment Energized Electrical Equipment Oxygen-Enriched Atmosphere Toxic Atmosphere Entrapment Welding/CuttinHazardous g Flammable Atmosphere Chemical {ğŅĻƷǤ tƩĻĭğǒƷźƚƓƭ Self-Contained Breathing Apparatus Protective Gloves Barricade Job Area Air-Line Respirator Lifelines Signs Posted Respirato Fire-Retardant Clothing r Clearances Secured Lockout/Tagou Ventilation t Lighting Remarks Fire Extinguisher Ground Fault Interrupter 9ƓǝźƩƚƓƒĻƓƷğƌ /ƚƓķźƷźƚƓƭ Test To Be Taken Date / Time Re-Testing Date / Time a/ Oxygen: % a/p Oxygen: % p Lower Explosive Lower Explosive a/ Limit: % a/p Limit: % p Toxic Atmosphere: H2SToxic Atmosphere: H2S pppppppp CO: : CO: : m m m m Instrument Instrument Used: Used: Employee Conduction Safety Checks SIGNATURE: Remarks on the overall condition of the confined space. 47 ENTRY AUTHORIZATIONENTRY CANCELLATION All actions and / or conditions for safe entry have been preformed Entry has been completed and all entrants have exited the permit space Entry Entry Supervisor Supervisor Please Print Please Print PERMIT REQUIRED CONFINED SPACES PROGRAM Recertification of a Confined Space Space Location: Effective Date: Evidence that no potential or actual confined space hazards exist in this space (now or in the future): (Attach previous permits or other pertinent documentation to this form.) I certify that the above evidence is accurate and all entry supervisors and appropriate entrants have been notified of the non- permit status of this space. Plan Administrator Date Signature 49 City of Fairfax, Iowa PERMIT REQUIRED CONFINED SPACES PROGRAM (/4 7/2+ 0%2-)4 This permit is required in addition to the Entry Permit prior to doing work which may provide sources of ignition in a confined space. Nature of work to be done: __________________________________________________________________________ __________________________________________________________________________ Equipment which is a source of ignition and must be in the confined space: __________________________________________________________________________ Type of ventilation used to remove fumes or vapors from Hot Work: __________________________________________________________________________ YES NO Confined Space Isolated _____ _____ Confined Space Purged or Ventilated _____ _____ Gas Tests Completed _____ _____ Could Hot Work Be Done Outside _____ _____ I certify that I have verified the procedures and have briefed the crew on the proper practices and hazards of performing "Hot Work" in confined spaces. _______________________________________________ _______________ Signature of Entry Supervisor Date __________________________ Cancellation Date City of Fairfax, Iowa PERMIT REQUIRED CONFINED SPACE PROGRAM RECORD OF EMPLOYEE TRAINING The Permit Required Confined Space standard requires training sessions for attendants, entrants, individuals authorizing permits, and those in charge of the entry. The session noted below was held to meet the requirements specified in the OSHA Permit Required Confined Spaces Program. _ Be sure to attach a summary of the information presented at this training. (A workshop brochure, agenda, course outline, or video tape jacket notes may be used as a summary.) A. Session Title or Topic: _______________________________________________________ B. Date/Time of Session:_________________________________________________________ C. Presented By:___________________________ Trainer's Initials _______ D. Location:____________________________________________________________________ Printed Names (left column) Signatures (right column) of those present: Check if additional signature sheets are attached. 51 City of Fairfax, Iowa PERMIT REQUIRED CONFINED SPACES PROGRAM EQUIPMENT LIST A. Air Monitoring Equipment: Name I.D. # Purpose/ Calibration Inspection Location stored Date Date 1. 2. 3. ________________________ _____________ _____________ ____________ ______________ B. Ventilators/Blowers: Name I.D. # Purpose/location stored 1. 2. 3. ______________________________ _____________ _______________________________ C. Communication Devices: Name I.D. # Purpose/location stored 1. Radios Issued to each employee 2. Cell Phone D. Retrieval/Emergency Rescue Equipment: Name I.D. # Purpose/location stored 1. Tripod / Winch OBI/SALA RM-2044 Garage 2. City of Fairfax, Iowa PERMIT REQUIRED CONFINED SPACES PROGRAM RECORD OF AIR MONITORING RESULTS Name: City of Fairfax Monitor number: DATE/ RESULTS OF ENVIRONMENTAL MONITORING LOCATION OF TIME SPACE TESTED OXYGEN COMBUSTIBLE CO HS OTHER 2 Percent VAPORS % LEL PPM* PPM (LIST) *The term "PPM" means parts per million. 53 SECTION 3 APPENDICES Confined Space Assessment Potential Hazard Definitions Oxygen Test for levels. Levels could be consistent or other processes indirect to the entry have potential of affecting the atmosphere. Carbon Monoxide Test for levels. Levels could be consistent or other processes indirect to the entry have potential of affecting the atmosphere. Combustible Gases (Hydrocarbons) Test for levels. Levels could be consistent or other processes indirect to the entry have potential of affecting the atmosphere. Hydrogen Sulfide Test for levels. Levels could be consistent or other processes indirect to the entry have potential of affecting the atmosphere. Engulfment Flowable material (present in the space) that can or potentially cause the individual to be surrounded by the material leading to suffocation, strangulation, constriction or crushing (e.g. trench with flowing water, grain silo, sewer/storm drain). Caught in/Trapped Where there is a potential to be stuck inside the space through tapered walls, tight spaces, etc. Dust Levels at which they inhibit visibility, could potentially be explosive, or are potentially toxic/harmful. 5 feet visibility minimum. Overhead objects Items overhead that could potentially fall on the entrants. Fall Hazard A possible drop from one level to anther that is 6 feet or more without functional climbing means. Extreme Temps Temperatures that can be dangerous for an extended period of time. Electric Energy Source Potential of an individual being electrocuted due to energized equipment and/or working in an area where electrical lines could be exposed. Falls under the OSHA 1910.147 Lockout/Tagout regulation. Mechanical Energy Source Moving machinery with potential pinch points or entanglement; falls under the 1910.147 standard. Hydraulic/Pneumatic Pressured lines that can cause bodily harm which are being worked on or could be damaged where the work will take place; falls under the 1910.147 standard. Stored Energy Source Any object or device that has potential energy while in a resting state, often associated with tension or gravity (e.g. springs, cables and/or jacks). Chemical Energy Source Material that can cause a chemical reaction when introduced with another substance or released and can become toxic and/or hazardous. APPENDIX II How to Fill Out the Confined Space Permit Section Explanation Provide information on the confined space along with duration of 1 entry and personnel contact Air monitor info and readings of the atmosphere for the space prior 2 to entering Minimum conditions for entry. All will need to be checked once they 3 are met, or if they are not applicable The control measures for hazards in the space. If needed, circle the 4 measure and check off once in place Check the type of communication to be utilized for the entry 5 Check the type of emergency equipment that will be available for the entry. On the back of the permit is the Plan of Action which is 6 used for writing out what steps will be taken should there be an emergency for this entry The names of the attendants and entrants and whether they will be 7 changing duties during the entry Sign off for the space evaluator prior to entry. Also the entry 8 supervisor okaying the permit and entry Sign off for the cancelation or completion of the permit 9 55 APPENDIX III Permit Required Confined Spaces Flowchart APPENDIX IV Confined Space Hazard Evaluation 57 APPENDIX V Confined Space Self-Assessment Checklist Element: Confined Space - !!!!! Date: Assessment Team: Instructions: Complete the checklist by answering yes or no to the following questions. Use the identified methods to gather a complete response (D - Document review; I - Interview; V - Visual inspection). Look for discrepancies with the written program and non-conformance with the requirements, along with root causes and potential corrective actions. Criteria Yes No 15. Have all permit required confined spaces that may be entered by employees during the course of V their work been identified? 16. Is there an inventory of all possible confined spaces, whether these are permit required or non- IV permit required? 17. Each hazard identified in the permit required confined space is evaluated. D 18. Has the severity of the hazards involved in each permit required confined space been DI communicated? 19. Has each non-permit required space been reviewed at least annually to ensure conditions have D not changed? 20. Are there practices and procedures that will be used to enter permit required spaces safely? DI 21. Is there a written permit system which includes a written permit that must be completed and D authorized prior to entry into a permit required confined space? 22. Where feasible signs are posted near permit spaces to notify employees of hazards within the V space and that entry must be authorized. 23. Training is provided for those employees who must work in and around permit spaces. DI 24. Necessary equipment to enter permit spaces (e.g. air testing equipment, communications IV devices, ventilators, retrieval equipment, etc.) is provided and maintained. 25. Have the employees been trained to properly care for the air monitoring equipment? I 26. Is all air monitoring equipment calibrated on a regular basis as specified by the manufacturer? DI 27. Are emergency procedures in place and equipment is available to rescue those who must enter DV permit spaces? 28. The use of barriers or other devices to protect entrants from other safety hazards such as V vehicles, pedestrians, etc., outside of the permit space is practiced. 29. Contractors and other employers are given necessary information when their employees must I enter permit spaces. 30. Contractors are debriefed at the conclusion of a project regarding the permit required confined I space procedures and the hazards encountered. 31. Is there documentation and certification provided when a given space is downgraded to a non- D permit confined space? 32. Review the file of permit entry forms on an annual basis to recognize a pattern and evaluate the D program effectiveness. 33. Is the program reviewed annually and updated if necessary? I 34. Utilize a standard permit form to identify conditions that evaluate potentially hazardous D confined spaces. 35. Are completed entry permits posted near the confined space entrance for all involved to D observe? 36. Identify personnel to authorize the permit and indicate that conditions for entry have been DI completed. 37. Permits are canceled when the work is completed. (The same individual must authorize and D cancel the permit.) 38. Are the permits saved for one year for review? D 39. Ensure that the rescue responders are aware of the types of hazards that they may be confronted I in spaces when performing rescues. 40. Allow access to facilities and permit required confined spaces to develop appropriate rescue I plans and practice rescue operations. Overall Findings (Strengths and Weaknesses): New Goals: DISCLAIMER This important information dealing with the Occupational Safety and Health Administration (OSHA) permit required confined spaces regulation has been assembled in an effort to promote employee safety and health issues in the work place. Due to the wide range of activities conducted by employers and complexity of the law, not every detail about confined space entry can be addressed in this manual. However, the Permit Required Confined Spaces Manual presents the major aspects of the law and can be used as a basis to form your confined spaces program. Managers/supervisors are cautioned to refer to the OSHA Permit Required Confined Spaces standard to determine if additional steps need to be added to this model. In addition, those personnel who are responsible for compliance with the state and federal regulations must be alert to any future changes in the law and keep this manual current and updated. Copyright© 1992 Iowa Association of Municipal Utilities. Copyright is not claimed as to any part of the original work prepared by a U.S. government officer or employee as part of that person's official duties. This manual may be reproduced by the owner to facilitate adoption and implementation of the owner's compliance program. No other reproduction is authorized without the express written consent of the Iowa Association of Municipal Utilities. All other rights reserved. Revised in 2015. Iowa Association of Municipal Utilities th 1735 NE 70 Avenue Ankeny, Iowa 50021-9353 515/289-1999 Disclaimer of Warranty and Limitation of Liability This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is furnished with the understanding that neither the Association nor its licensed agent is engaged in rendering legal or other professional service. If legal advice or other professional or expert assistance is required, the services of a competent professional person should be sought. This publication is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the quality, performance, and accuracy of the manual is with the holder. 59 OSHA REGULATION OF PERMIT REQUIRED CONFINED SPACES 29 CFR 1910.146 1910.146(a) Scope and application. This section contains requirements for practices and procedures to protect employees in general industry from the hazards of entry into permit-required confined spaces. This section does not apply to agriculture, to construction, or to shipyard employment (Parts 1928, 1926, and 1915 of this chapter, respectively). 1910.146(b) Definitions. "Acceptable entry conditions" means the conditions that must exist in a permit space to allow entry and to ensure that employees involved with a permit-required confined space entry can safely enter into and work within the space. "Attendant" means an individual stationed outside one or more permit spaces who monitors the authorized entrants and who performs all attendant's duties assigned in the employer's permit space program. "Authorized entrant" means an employee who is authorized by the employer to enter a permit space. "Blanking or blinding" means the absolute closure of a pipe, line, or duct by the fastening of a solid plate (such as a spectacle blind or a skillet blind) that completely covers the bore and that is capable of withstanding the maximum pressure of the pipe, line, or duct with no leakage beyond the plate. "Confined space" means a space that: (1) Is large enough and so configured that an employee can bodily enter and perform assigned work; and (2) Has limited or restricted means for entry or exit (for example, tanks, vessels, silos, storage bins, hoppers, vaults, and pits are spaces that may have limited means of entry.); and (3) Is not designed for continuous employee occupancy. "Double block and bleed" means the closure of a line, duct, or pipe by closing and locking or tagging two in-line valves and by opening and locking or tagging a drain or vent valve in the line between the two closed valves. "Emergency" means any occurrence (including any failure of hazard control or monitoring equipment) or event internal or external to the permit space that could endanger entrants. "Engulfment" means the surrounding and effective capture of a person by a liquid or finely divided (flowable) solid substance that can be aspirated to cause death by filling or plugging the respiratory system or that can exert enough force on the body to cause death by strangulation, constriction, or crushing. "Entry" means the action by which a person passes through an opening into a permit-required confined space. Entry includes ensuing work activities in that space and is considered to have occurred as soon as any part of the entrant's body breaks the plane of an opening into the space. "Entry permit (permit)" means the written or printed document that is provided by the employer to allow and control entry into a permit space and that contains the information specified in paragraph (f) of this section. "Entry supervisor" means the person (such as the employer, foreman, or crew chief) responsible for determining if acceptable entry conditions are present at a permit space where entry is planned, for authorizing entry and overseeing entry operations, and for terminating entry as required by this section. NOTE: An entry supervisor also may serve as an attendant or as an authorized entrant, as long as that person is trained and equipped as required by this section for each role he or she fills. Also, the duties of entry supervisor may be passed from one individual to another during the course of an entry operation. "Hazardous atmosphere" means an atmosphere that may expose employees to the risk of death, incapacitation, impairment of ability to self-rescue (that is, escape unaided from a permit space), injury, or acute illness from one or more of the following causes: (1) Flammable gas, vapor, or mist in excess of 10 percent of its lower flammable limit (LFL); (2) Airborne combustible dust at a concentration that meets or exceeds its LFL; NOTE: This concentration may be approximated as a condition in which the dust obscures vision at a distance of 5 feet (1.52 m) or less. (3) Atmospheric oxygen concentration below 19.5 percent or above 23.5 percent; (4) Atmospheric concentration of any substance for which a dose or a permissible exposure limit is published in Subpart G, Occupational Health and Environmental Control, or in Subpart Z, Toxic and Hazardous Substances, of this Part and which could result in employee exposure in excess of its dose or permissible exposure limit; NOTE: An atmospheric concentration of any substance that is not capable of causing death, incapacitation, impairment of ability to self-rescue, injury, or acute illness due to its health effects is not covered by this provision. (5) Any other atmospheric condition that is immediately dangerous to life or health. NOTE: For air contaminants for which OSHA has not determined a dose or permissible exposure limit, other sources of information, such as Material Safety Data Sheets that comply with the Hazard Communication Standard, section 1910.1200 of this Part, published information, and internal documents can provide guidance in establishing acceptable atmospheric conditions. "Hot work permit" means the employer's written authorization to perform operations (for example, riveting, welding, cutting, burning, and heating) capable of providing a source of ignition. "Immediately dangerous to life or health (IDLH)" means any condition that poses an immediate or delayed threat to life or that would cause irreversible adverse health effects or that would interfere with an individual's ability to escape unaided from a permit space. NOTE: Some materials -- hydrogen fluoride gas and cadmium vapor, for example -- may produce immediate transient effects that, even if severe, may pass without medical attention, but are followed by sudden, possibly fatal collapse 12-72 hours after exposure. The victim "feels normal" from recovery from transient effects until collapse. Such materials in hazardous quantities are considered to be "immediately" dangerous to life or health. "Inerting" means the displacement of the atmosphere in a permit space by a noncombustible gas (such as nitrogen) to such an extent that the resulting atmosphere is noncombustible. NOTE: This procedure produces an IDLH oxygen-deficient atmosphere. "Isolation" means the process by which a permit space is removed from service and completely protected against the release of energy and material into the space by such means as: blanking or blinding; misaligning or removing sections of lines, pipes, or ducts; a double block and bleed system; lockout or tagout of all sources of energy; or blocking or disconnecting all mechanical linkages. "Line breaking" means the intentional opening of a pipe, line, or duct that is or has been carrying flammable, corrosive, or toxic material, an inert gas, or any fluid at a volume, pressure, or temperature capable of causing injury. 61 "Non-permit confined space" means a confined space that does not contain or, with respect to atmospheric hazards, have the potential to contain any hazard capable of causing death or serious physical harm. "Oxygen deficient atmosphere" means an atmosphere containing less than 19.5 percent oxygen by volume. "Oxygen enriched atmosphere" means an atmosphere containing more than 23.5 percent oxygen by volume. "Permit-required confined space (permit space)" means a confined space that has one or more of the following characteristics: (1) Contains or has a potential to contain a hazardous atmosphere; (2) Contains a material that has the potential for engulfing an entrant; (3) Has an internal configuration such that an entrant could be trapped or asphyxiated by inwardly converging walls or by a floor which slopes downward and tapers to a smaller cross-section; or (4) Contains any other recognized serious safety or health hazard. "Permit-required confined space program (permit space program)" means the employer's overall program for controlling, and, where appropriate, for protecting employees from, permit space hazards and for regulating employee entry into permit spaces. "Permit system" means the employer's written procedure for preparing and issuing permits for entry and for returning the permit space to service following termination of entry. "Prohibited condition" means any condition in a permit space that is not allowed by the permit during the period when entry is authorized. "Rescue service" means the personnel designated to rescue employees from permit spaces. "Retrieval system" means the equipment (including a retrieval line, chest or full-body harness, wristlets, if appropriate, and a lifting device or anchor) used for non-entry rescue of persons from permit spaces. "Testing" means the process by which the hazards that may confront entrants of a permit space are identified and evaluated. Testing includes specifying the tests that are to be performed in the permit space. NOTE: Testing enables employers both to devise and implement adequate control measures for the protection of authorized entrants and to determine if acceptable entry conditions are present immediately prior to, and during, entry. 1910.146(c) General requirements. 1910.146(c)(1) The employer shall evaluate the workplace to determine if any spaces are permit-required confined spaces. NOTE: Proper application of the decision flow chart in Appendix A to section 1910.146 would facilitate compliance with this requirement. 1910.146(c)(2) If the workplace contains permit spaces, the employer shall inform exposed employees, by posting danger signs or by any other equally effective means, of the existence and location of and the danger posed by the permit spaces. NOTE: A sign reading DANGER -- PERMIT-REQUIRED CONFINED SPACE, DO NOT ENTER or using other similar language would satisfy the requirement for a sign. 1910.146(c)(3) If the employer decides that its employees will not enter permit spaces, the employer shall take effective measures to prevent its employees from entering the permit spaces and shall comply with paragraphs (c)(1), (c)(2), (c)(6), and (c)(8) of this section. 1910.146(c)(4) If the employer decides that its employees will enter permit spaces, the employer shall develop and implement a written permit space program that complies with this section. The written program shall be available for inspection by employees and their authorized representatives. 1910.146(c)(5) An employer may use the alternate procedures specified in paragraph (c)(5)(ii) of this section for entering a permit space under the conditions set forth in paragraph (c)(5)(i) of this section. 1910.146(c)(5)(i) An employer whose employees enter a permit space need not comply with paragraphs (d) through (f) and (h) through (k) of this section, provided that: 1910.146(c)(5)(i)(A) The employer can demonstrate that the only hazard posed by the permit space is an actual or potential hazardous atmosphere; 1910.146(c)(5)(i)(B) The employer can demonstrate that continuous forced air ventilation alone is sufficient to maintain that permit space safe for entry; 1910.146(c)(5)(i)(C) The employer develops monitoring and inspection data that supports the demonstrations required by paragraphs (c)(5)(i)(A) and (c)(5)(i)(B) of this section; 1910.146(c)(5)(i)(D) If an initial entry of the permit space is necessary to obtain the data required by paragraph (c)(5)(i)(C) of this section, the entry is performed in compliance with paragraphs (d) through (k) of this section; 63 1910.146(c)(5)(i)(E) The determinations and supporting data required by paragraphs (c)(5)(i)(A), (c)(5)(i)(B), and (c)(5)(i)(C) of this section are documented by the employer and are made available to each employee who enters the permit space under the terms of paragraph (c)(5) of this section or to that employee's authorized representative; and 1910.146(c)(5)(i)(F) Entry into the permit space under the terms of paragraph (c)(5)(i) of this section is performed in accordance with the requirements of paragraph (c)(5)(ii) of this section. NOTE: See paragraph (c)(7) of this section for reclassification of a permit space after all hazards within the space have been eliminated. 1910.146(c)(5)(ii) The following requirements apply to entry into permit spaces that meet the conditions set forth in paragraph (c)(5)(i) of this section. 1910.146(c)(5)(ii)(A) Any conditions making it unsafe to remove an entrance cover shall be eliminated before the cover is removed. 1910.146(c)(5)(ii)(B) When entrance covers are removed, the opening shall be promptly guarded by a railing, temporary cover, or other temporary barrier that will prevent an accidental fall through the opening and that will protect each employee working in the space from foreign objects entering the space. 1910.146(c)(5)(ii)(C) Before an employee enters the space, the internal atmosphere shall be tested, with a calibrated direct-reading instrument, for oxygen content, for flammable gases and vapors, and for potential toxic air contaminants, in that order. Any employee who enters the space, or that employee's authorized representative, shall be provided an opportunity to observe the pre-entry testing required by this paragraph. 1910.146(c)(5)(ii)(C)(1) Oxygen content, 1910.146(c)(5)(ii)(C)(2) Flammable gases and vapors, and 1910.146(c)(5)(ii)(C)(3) Potential toxic air contaminants. 1910.146(c)(5)(ii)(D) There may be no hazardous atmosphere within the space whenever any employee is inside the space. 1910.146(c)(5)(ii)(E) Continuous forced air ventilation shall be used, as follows: 1910.146(c)(5)(ii)(E)(1) An employee may not enter the space until the forced air ventilation has eliminated any hazardous atmosphere; 1910.146(c)(5)(ii)(E)(2) The forced air ventilation shall be so directed as to ventilate the immediate areas where an employee is or will be present within the space and shall continue until all employees have left the space; 1910.146(c)(5)(ii)(E)(3) The air supply for the forced air ventilation shall be from a clean source and may not increase the hazards in the space. 1910.146(c)(5)(ii)(F) The atmosphere within the space shall be periodically tested as necessary to ensure that the continuous forced air ventilation is preventing the accumulation of a hazardous atmosphere. Any employee who enters the space, or that employee's authorized representative, shall be provided with an opportunity to observe the periodic testing required by this paragraph. 1910.146(c)(5)(ii)(G) If a hazardous atmosphere is detected during entry: 1910.146(c)(5)(ii)(G)(1) Each employee shall leave the space immediately; 1910.146(c)(5)(ii)(G)(2) The space shall be evaluated to determine how the hazardous atmosphere developed; and 1910.146(c)(5)(ii)(G)(3) Measures shall be implemented to protect employees from the hazardous atmosphere before any subsequent entry takes place. 65 1910.146(c)(5)(ii)(H) The employer shall verify that the space is safe for entry and that the pre-entry measures required by paragraph (c)(5)(ii) of this section have been taken, through a written certification that contains the date, the location of the space, and the signature of the person providing the certification. The certification shall be made before entry and shall be made available to each employee entering the space or to that employee's authorized representative. 1910.146(c)(6) When there are changes in the use or configuration of a non-permit confined space that might increase the hazards to entrants, the employer shall reevaluate that space and, if necessary, reclassify it as a permit-required confined space. 1910.146(c)(7) A space classified by the employer as a permit-required confined space may be reclassified as a non-permit confined space under the following procedures: 1910.146(c)(7)(i) If the permit space poses no actual or potential atmospheric hazards and if all hazards within the space are eliminated without entry into the space, the permit space may be reclassified as a non-permit confined space for as long as the non-atmospheric hazards remain eliminated. 1910.146(c)(7)(ii) If it is necessary to enter the permit space to eliminate hazards, such entry shall be performed under paragraphs (d) through (k) of this section. If testing and inspection during that entry demonstrate that the hazards within the permit space have been eliminated, the permit space may be reclassified as a non-permit confined space for as long as the hazards remain eliminated. NOTE: Control of atmospheric hazards through forced air ventilation does not constitute elimination of the hazards. Paragraph (c)(5) covers permit space entry where the employer can demonstrate that forced air ventilation alone will control all hazards in the space. 1910.146(c)(7)(iii) The employer shall document the basis for determining that all hazards in a permit space have been eliminated, through a certification that contains the date, the location of the space, and the signature of the person making the determination. The certification shall be made available to each employee entering the space or to that employee's authorized representative. 1910.146(c)(7)(iv) If hazards arise within a permit space that has been declassified to a non-permit space under paragraph (c)(7) of this section, each employee in the space shall exit the space. The employer shall then reevaluate the space and determine whether it must be reclassified as a permit space, in accordance with other applicable provisions of this section. 1910.146(c)(8) When an employer (host employer) arranges to have employees of another employer (contractor) perform work that involves permit space entry, the host employer shall: 1910.146(c)(8)(i) Inform the contractor that the workplace contains permit spaces and that permit space entry is allowed only through compliance with a permit space program meeting the requirements of this section; 1910.146(c)(8)(ii) Apprise the contractor of the elements, including the hazards identified and the host employer's experience with the space, that make the space in question a permit space; 1910.146(c)(8)(iii) Apprise the contractor of any precautions or procedures that the host employer has implemented for the protection of employees in or near permit spaces where contractor personnel will be working; 1910.146(c)(8)(iv) Coordinate entry operations with the contractor, when both host employer personnel and contractor personnel will be working in or near permit spaces, as required by paragraph (d)(11) of this section; and 1910.146(c)(8)(v) Debrief the contractor at the conclusion of the entry operations regarding the permit space program followed and regarding any hazards confronted or created in permit spaces during entry operations. 1910.146(c)(9) In addition to complying with the permit space requirements that apply to all employers, each contractor who is retained to perform permit space entry operations shall: 1910.146(c)(9)(i) Obtain any available information regarding permit space hazards and entry operations from the host employer; 1910.146(c)(9)(ii) Coordinate entry operations with the host employer, when both host employer personnel and contractor personnel will be working in or near permit spaces, as required by paragraph (d)(11) of this section; and 67 1910.146(c)(9)(iii) Inform the host employer of the permit space program that the contractor will follow and of any hazards confronted or created in permit spaces, either through a debriefing or during the entry operation. 1910.146(d) Permit-required confined space program (permit space program). Under the permit space program required by paragraph (c)(4) of this section, the employer shall: 1910.146(d)(1) Implement the measures necessary to prevent unauthorized entry; 1910.146(d)(2) Identify and evaluate the hazards of permit spaces before employees enter them; 1910.146(d)(3) Develop and implement the means, procedures, and practices necessary for safe permit space entry operations, including, but not limited to, the following: 1910.146(d)(3)(i) Specifying acceptable entry conditions; 1910.146(d)(3)(ii) Providing each authorized entrant or that employee's authorized representative with the opportunity to observe any monitoring or testing of permit spaces; 1910.146(d)(3)(iii) Isolating the permit space; 1910.146(d)(3)(iv) Purging, inerting, flushing, or ventilating the permit space as necessary to eliminate or control atmospheric hazards; 1910.146(d)(3)(v) Providing pedestrian, vehicle, or other barriers as necessary to protect entrants from external hazards; and 1910.146(d)(3)(vi) Verifying that conditions in the permit space are acceptable for entry throughout the duration of an authorized entry. 1910.146(d)(4) Provide the following equipment (specified in paragraphs (d)(4)(i) through (d)(4)(ix) of this section) at no cost to employees, maintain that equipment properly, and ensure that employees use that equipment properly: 1910.146(d)(4)(i) Testing and monitoring equipment needed to comply with paragraph (d)(5) of this section; 1910.146(d)(4)(ii) Ventilating equipment needed to obtain acceptable entry conditions; 1910.146(d)(4)(iii) Communications equipment necessary for compliance with paragraphs (h)(3) and (i)(5) of this section; 1910.146(d)(4)(iv) Personal protective equipment insofar as feasible engineering and work practice controls do not adequately protect employees; 1910.146(d)(4)(v) Lighting equipment needed to enable employees to see well enough to work safely and to exit the space quickly in an emergency; 1910.146(d)(4)(vi) Barriers and shields as required by paragraph (d)(3)(iv) of this section; 1910.146(d)(4)(vii) Equipment, such as ladders, needed for safe ingress and egress by authorized entrants; 1910.146(d)(4)(viii) Rescue and emergency equipment needed to comply with paragraph (d)(9) of this section, except to the extent that the equipment is provided by rescue services; and 1910.146(d)(4)(ix) Any other equipment necessary for safe entry into and rescue from permit spaces. 1910.146(d)(5) Evaluate permit space conditions as follows when entry operations are conducted: 69 1910.146(d)(5)(i) Test conditions in the permit space to determine if acceptable entry conditions exist before entry is authorized to begin, except that, if isolation of the space is infeasible because the space is large or is part of a continuous system (such as a sewer), pre-entry testing shall be performed to the extent feasible before entry is authorized and, if entry is authorized, entry conditions shall be continuously monitored in the areas where authorized entrants are working; 1910.146(d)(5)(ii) Test or monitor the permit space as necessary to determine if acceptable entry conditions are being maintained during the course of entry operations; and 1910.146(d)(5)(iii) When testing for atmospheric hazards, test first for oxygen, then for combustible gases and vapors, and then for toxic gases and vapors. 1910.146(d)(5)(iv) Provide each authorized entrant or that employee's authorized representative an opportunity to observe the pre-entry and any subsequent testing or monitoring of permit spaces; 1910.146(d)(5)(v) Reevaluate the permit space in the presence of any authorized entrant or that employee's authorized representative who requests that the employer conduct such reevaluation because the entrant or representative has reason to believe that the evaluation of that space may not have been adequate; 1910.146(d)(5)(vi) Immediately provide each authorized entrant or that employee's authorized representative with the results of any testing conducted in accord with paragraph (d) of this section. NOTE: Atmospheric testing conducted in accordance with Appendix B to section 1910.146 would be considered as satisfying the requirements of this paragraph. For permit space operations in sewers, atmospheric testing conducted in accordance with Appendix B, as supplemented by Appendix E to section 1910.146, would be considered as satisfying the requirements of this paragraph. 1910.146(d)(6) Provide at least one attendant outside the permit space into which entry is authorized for the duration of entry operations; NOTE: Attendants may be assigned to monitor more than one permit space provided the duties described in paragraph (i) of this section can be effectively performed for each permit space that is monitored. Likewise, attendants may be stationed at any location outside the permit space to be monitored as long as the duties described in paragraph (i) of this section can be effectively performed for each permit space that is monitored. 1910.146(d)(7) If multiple spaces are to be monitored by a single attendant, include in the permit program the means and procedures to enable the attendant to respond to an emergency affecting one or more of the permit spaces being monitored without distraction from the attendant's responsibilities under paragraph (i) of this section; 1910.146(d)(8) Designate the persons who are to have active roles (as, for example, authorized entrants, attendants, entry supervisors, or persons who test or monitor the atmosphere in a permit space) in entry operations, identify the duties of each such employee, and provide each such employee with the training required by paragraph (g) of this section; 1910.146(d)(9) Develop and implement procedures for summoning rescue and emergency services, for rescuing entrants from permit spaces, for providing necessary emergency services to rescued employees, and for preventing unauthorized personnel from attempting a rescue; 1910.146(d)(10) Develop and implement a system for the preparation, issuance, use, and cancellation of entry permits as required by this section; 1910.146(d)(11) Develop and implement procedures to coordinate entry operations when employees of more than one employer are working simultaneously as authorized entrants in a permit space, so that employees of one employer do not endanger the employees of any other employer; 1910.146(d)(12) Develop and implement procedures (such as closing off a permit space and canceling the permit) necessary for concluding the entry after entry operations have been completed; 1910.146(d)(13) Review entry operations when the employer has reason to believe that the measures taken under the permit space program may not protect employees and revise the program to correct deficiencies found to exist before subsequent entries are authorized; and NOTE: Examples of circumstances requiring the review of the permit space program are: any unauthorized entry of a permit space, the detection of a permit space hazard not covered by the permit, the detection of a condition prohibited by the permit, the occurrence of an injury or near-miss during entry, a change in the use or configuration of a permit space, and employee complaints about the effectiveness of the program. 1910.146(d)(14) Review the permit space program, using the canceled permits retained under paragraph (e)(6) of this section within 1 year after each entry and revise the program as necessary, to ensure that employees participating in entry operations are protected from permit space hazards. 71 NOTE: Employers may perform a single annual review covering all entries performed during a 12-month period. If no entry is performed during a 12-month period, no review is necessary. Appendix C to section 1910.146 presents examples of permit space programs that are considered to comply with the requirements of paragraph (d) of this section. 1910.146(e) Permit system. 1910.146(e)(1) Before entry is authorized, the employer shall document the completion of measures required by paragraph (d)(3) of this section by preparing an entry permit. NOTE: Appendix D to section 1910.146 presents examples of permits whose elements are considered to comply with the requirements of this section. 1910.146(e)(2) Before entry begins, the entry supervisor identified on the permit shall sign the entry permit to authorize entry. 1910.146(e)(3) The completed permit shall be made available at the time of entry to all authorized entrants or their authorized representatives, by posting it at the entry portal or by any other equally effective means, so that the entrants can confirm that pre-entry preparations have been completed. 1910.146(e)(4) The duration of the permit may not exceed the time required to complete the assigned task or job identified on the permit in accordance with paragraph (f)(2) of this section. 1910.146(e)(5) The entry supervisor shall terminate entry and cancel the entry permit when: 1910.146(e)(5)(i) The entry operations covered by the entry permit have been completed; or 1910.146(e)(5)(ii) A condition that is not allowed under the entry permit arises in or near the permit space. 1910.146(e)(6) The employer shall retain each canceled entry permit for at least 1 year to facilitate the review of the permit-required confined space program required by paragraph (d)(14) of this section. Any problems encountered during an entry operation shall be noted on the pertinent permit so that appropriate revisions to the permit space program can be made. 1910.146(f) Entry permit. The entry permit that documents compliance with this section and authorizes entry to a permit space shall identify: 1910.146(f)(1) The permit space to be entered; 1910.146(f)(2) The purpose of the entry; 1910.146(f)(3) The date and the authorized duration of the entry permit; 1910.146(f)(4) The authorized entrants within the permit space, by name or by such other means (for example, through the use of rosters or tracking systems) as will enable the attendant to determine quickly and accurately, for the duration of the permit, which authorized entrants are inside the permit space; NOTE: This requirement may be met by inserting a reference on the entry permit as to the means used, such as a roster or tracking system, to keep track of the authorized entrants within the permit space. 1910.146(f)(5) The personnel, by name, currently serving as attendants; 1910.146(f)(6) The individual, by name, currently serving as entry supervisor, with a space for the signature or initials of the entry supervisor who originally authorized entry; 1910.146(f)(7) The hazards of the permit space to be entered; 1910.146(f)(8) The measures used to isolate the permit space and to eliminate or control permit space hazards before entry; NOTE: Those measures can include the lockout or tagging of equipment and procedures for purging, inerting, ventilating, and flushing permit spaces. 1910.146(f)(9) The acceptable entry conditions; 73 1910.146(f)(10) The results of initial and periodic tests performed under paragraph (d)(5) of this section, accompanied by the names or initials of the testers and by an indication of when the tests were performed; 1910.146(f)(11) The rescue and emergency services that can be summoned and the means (such as the equipment to use and the numbers to call) for summoning those services; 1910.146(f)(12) The communication procedures used by authorized entrants and attendants to maintain contact during the entry; 1910.146(f)(13) Equipment, such as personal protective equipment, testing equipment, communications equipment, alarm systems, and rescue equipment, to be provided for compliance with this section; 1910.146(f)(14) Any other information whose inclusion is necessary, given the circumstances of the particular confined space, in order to ensure employee safety; and (15) Any additional permits, such as for hot work, that have been issued to authorize work in the permit space. 1910.146(g) Training. 1910.146(g)(1) The employer shall provide training so that all employees whose work is regulated by this section acquire the understanding, knowledge, and skills necessary for the safe performance of the duties assigned under this section. 1910.146(g)(2) Training shall be provided to each affected employee: 1910.146(g)(2)(i) Before the employee is first assigned duties under this section; 1910.146(g)(2)(ii) Before there is a change in assigned duties; 1910.146(g)(2)(iii) Whenever there is a change in permit space operations that presents a hazard about which an employee has not previously been trained; 1910.146(g)(2)(iv) Whenever the employer has reason to believe either that there are deviations from the permit space entry procedures required by paragraph (d)(3) of this section or that there are inadequacies in the employee's knowledge or use of these procedures. 1910.146(g)(3) The training shall establish employee proficiency in the duties required by this section and shall introduce new or revised procedures, as necessary, for compliance with this section. 1910.146(g)(4) The employer shall certify that the training required by paragraphs (g)(1) through (g)(3) of this section has been accomplished. The certification shall contain each employee's name, the signatures or initials of the trainers, and the dates of training. The certification shall be available for inspection by employees and their authorized representatives. 1910.146(h) Duties of authorized entrants. The employer shall ensure that all authorized entrants: 1910.146(h)(1) Know the hazards that may be faced during entry, including information on the mode, signs or symptoms, and consequences of the exposure; 1910.146(h)(2) Properly use equipment as required by paragraph (d)(4) of this section; 1910.146(h)(3) Communicate with the attendant as necessary to enable the attendant to monitor entrant status and to enable the attendant to alert entrants of the need to evacuate the space as required by paragraph (i)(6) of this section; 1910.146(h)(4) Alert the attendant whenever: 1910.146(h)(4)(i) The entrant recognizes any warning sign or symptom of exposure to a dangerous situation, or 75 1910.146(h)(4)(ii) The entrant detects a prohibited condition; and 1910.146(h)(5) Exit from the permit space as quickly as possible whenever: 1910.146(h)(5)(i) An order to evacuate is given by the attendant or the entry supervisor, 1910.146(h)(5)(ii) The entrant recognizes any warning sign or symptom of exposure to a dangerous situation, 1910.146(h)(5)(iii) The entrant detects a prohibited condition, or 1910.146(h)(5)(iv) An evacuation alarm is activated. 1910.146(i) Duties of attendants. The employer shall ensure that each attendant: 1910.146(i)(1) Knows the hazards that may be faced during entry, including information on the mode, signs or symptoms, and consequences of the exposure; 1910.146(i)(2) Is aware of possible behavioral effects of hazard exposure in authorized entrants; 1910.146(i)(3) Continuously maintains an accurate count of authorized entrants in the permit space and ensures that the means used to identify authorized entrants under paragraph (f)(4) of this section accurately identifies who is in the permit space; 1910.146(i)(4) Remains outside the permit space during entry operations until relieved by another attendant; NOTE: When the employer's permit entry program allows attendant entry for rescue, attendants may enter a permit space to attempt a rescue if they have been trained and equipped for rescue operations as required by paragraph (k)(1) of this section and if they have been relieved as required by paragraph (i)(4) of this section. 1910.146(i)(5) Communicates with authorized entrants as necessary to monitor entrant status and to alert entrants of the need to evacuate the space under paragraph (i)(6) of this section; 1910.146(i)(6) Monitors activities inside and outside the space to determine if it is safe for entrants to remain in the space and orders the authorized entrants to evacuate the permit space immediately under any of the following conditions; 1910.146(i)(6)(i) If the attendant detects a prohibited condition; 1910.146(i)(6)(ii) If the attendant detects the behavioral effects of hazard exposure in an authorized entrant; 1910.146(i)(6)(iii) If the attendant detects a situation outside the space that could endanger the authorized entrants; or 1910.146(i)(6)(iv) If the attendant cannot effectively and safely perform all the duties required under paragraph (i) of this section; 1910.146(i)(7) Summon rescue and other emergency services as soon as the attendant determines that authorized entrants may need assistance to escape from permit space hazards; 1910.146(i)(8) Takes the following actions when unauthorized persons approach or enter a permit space while entry is underway: 1910.146(i)(8)(i) Warn the unauthorized persons that they must stay away from the permit space; 1910.146(i)(8)(ii) Advise the unauthorized persons that they must exit immediately if they have entered the permit space; and 1910.146(i)(8)(iii) Inform the authorized entrants and the entry supervisor if unauthorized persons have entered the permit space; 77 1910.146(i)(9) Performs non-entry rescues as specified by the employer's rescue procedure; and 1910.146(i)(10) Performs no duties that might interfere with the attendant's primary duty to monitor and protect the authorized entrants. 1910.146(j) Duties of entry supervisors. The employer shall ensure that each entry supervisor: 1910.146(j)(1) Knows the hazards that may be faced during entry, including information on the mode, signs or symptoms, and consequences of the exposure; 1910.146(j)(2) Verifies, by checking that the appropriate entries have been made on the permit, that all tests specified by the permit have been conducted and that all procedures and equipment specified by the permit are in place before endorsing the permit and allowing entry to begin; 1910.146(j)(3) Terminates the entry and cancels the permit as required by paragraph (e)(5) of this section; 1910.146(j)(4) Verifies that rescue services are available and that the means for summoning them are operable; 1910.146(j)(5) Removes unauthorized individuals who enter or who attempt to enter the permit space during entry operations; and 1910.146(j)(6) Determines, whenever responsibility for a permit space entry operation is transferred and at intervals dictated by the hazards and operations performed within the space, that entry operations remain consistent with terms of the entry permit and that acceptable entry conditions are maintained. 1910.146(k) Rescue and emergency services. 1910.146(k)(1) An employer who designates rescue and emergency services, pursuant to paragraph (d)(9) of this section, shall: 1910.146(k)(1)(i) Evaluate a prospective rescuer's ability to respond to a rescue summons in a timely manner, considering the hazard(s) identified; Note to paragraph (k)(l)(i): What will be considered timely will vary according to the specific hazards involved in each entry. For example, §1910.134, Respiratory Protection, requires that employers provide a standby person or persons capable of immediate action to rescue employee(s) wearing respiratory protection while in work areas defined as IDLH atmospheres. 1910.146(k)(1)(ii) Evaluate a prospective rescue service's ability, in terms of proficiency with rescue-related tasks and equipment, to function appropriately while rescuing entrants from the particular permit space or types of permit spaces identified; 1910.146(k)(1)(iii) Select a rescue team or service from those evaluated that: 1910.146(k)(1)(iii)(A) Has the capability to reach the victim(s) within a time frame that is appropriate for the permit space hazard(s) identified; 1910.146(k)(1)(iii)(B) Is equipped for and proficient in performing the needed rescue services; 1910.146(k)(1)(iv) Inform each rescue team or service of the hazards they may confront when called on to perform rescue at the site; and 1910.146(k)(1)(v) Provide the rescue team or service selected with access to all permit spaces from which rescue may be necessary so that the rescue service can develop appropriate rescue plans and practice rescue operations. Note to paragraph (k)(1): Non-mandatory Appendix F contains examples of criteria which employers can use in evaluating prospective rescuers as required by paragraph (k)(l) of this section. 1910.146(k)(2) An employer whose employees have been designated to provide permit space rescue and emergency services shall take the following measures: 79 1910.146(k)(2)(i) Provide affected employees with the personal protective equipment (PPE) needed to conduct permit space rescues safely and train affected employees so they are proficient in the use of that PPE, at no cost to those employees; 1910.146(k)(2)(ii) Train affected employees to perform assigned rescue duties. The employer must ensure that such employees successfully complete the training required to establish proficiency as an authorized entrant, as provided by paragraphs (g) and (h) of this section; 1910.146(k)(2)(iii) Train affected employees in basic first-aid and cardiopulmonary resuscitation (CPR). The employer shall ensure that at least one member of the rescue team or service holding a current certification in first aid and CPR is available; and 1910.146(k)(2)(iv) Ensure that affected employees practice making permit space rescues at least once every 12 months, by means of simulated rescue operations in which they remove dummies, manikins, or actual persons from the actual permit spaces or from representative permit spaces. Representative permit spaces shall, with respect to opening size, configuration, and accessibility, simulate the types of permit spaces from which rescue is to be performed. 1910.146(k)(3) To facilitate non-entry rescue, retrieval systems or methods shall be used whenever an authorized entrant enters a permit space, unless the retrieval equipment would increase the overall risk of entry or would not contribute to the rescue of the entrant. Retrieval systems shall meet the following requirements. 1910.146(k)(3)(i) Each authorized entrant shall use a chest or full body harness, with a retrieval line attached at the center of the entrant's back near shoulder level, above the entrant's head, or at another point which the employer can establish presents a profile small enough for the successful removal of the entrant. Wristlets may be used in lieu of the chest or full body harness if the employer can demonstrate that the use of a chest or full body harness is infeasible or creates a greater hazard and that the use of wristlets is the safest and most effective alternative. 1910.146(k)(3)(ii) The other end of the retrieval line shall be attached to a mechanical device or fixed point outside the permit space in such a manner that rescue can begin as soon as the rescuer becomes aware that rescue is necessary. A mechanical device shall be available to retrieve personnel from vertical type permit spaces more than 5 feet (1.52 m) deep 1910.146(k)(4) If an injured entrant is exposed to a substance for which a Material Safety Data Sheet (MSDS) or other similar written information is required to be kept at the worksite, that MSDS or written information shall be made available to the medical facility treating the exposed entrant. 1910.146(l) Employee participation. 1910.146(l)(1) Employers shall consult with affected employees and their authorized representatives on the development and implementation of all aspects of the permit space program required by paragraph (c) of this section. 1910.146(l)(2) Employers shall make available to affected employees and their authorized representatives all information required to be developed by this section. \[58 FR 4549, Jan. 14, 1993; 58 FR 34845, June 29, 1993; 59 FR 26115, May 19, 1994; 63 FR 66038, Dec. 1, 1998\] Appendix A to §1910.146 -- Permit-Required Confined Space Decision Flow Chart Note: Appendices A through F serve to provide information and non-mandatory guidelines to assist employers and employees in complying with the appropriate requirements of this section. 81 \[58 FR 4549, Jan. 14, 1993; 58 FR 34846, June 29, 1993; 63 FR 66039, Dec. 1, 1998\] Regulations (Standards -29 CFR) Procedures for Atmospheric Testing. - 1910.146 App B Regulations (Standards - 29 CFR) - Table of Contents 1910 Occupational Safety and Health Standards J General Environmental Controls 1910.146 App B Procedures for Atmospheric Testing. Atmospheric testing is required for two distinct purposes: Evaluation of the hazards of the permit space and verification that acceptable entry conditions for entry into that space exist. (1) Evaluation testing. The atmosphere of a confined space should be analyzed using equipment of sufficient sensitivity and specificity to identify and evaluate any hazardous atmospheres that may exist or arise, so that appropriate permit entry procedures can be developed and acceptable entry conditions stipulated for that space. Evaluation and interpretation of these data, and development of the entry procedure, should be done by, or reviewed by, a technically qualified professional (e.g., OSHA consultation service, or certified industrial hygienist, registered safety engineer, certified safety professional, certified marine chemist, etc.) based on evaluation of all serious hazards. (2) Verification testing. The atmosphere of a permit space which may contain a hazardous atmosphere should be tested for residues of all contaminants identified by evaluation testing using permit specified equipment to determine that residual concentrations at the time of testing and entry are within the range of acceptable entry conditions. Results of testing (i.e., actual concentration, etc.) should be recorded on the permit in the space provided adjacent to the stipulated acceptable entry condition. (3) Duration of testing. Measurement of values for each atmospheric parameter should be made for at least the minimum response time of the test instrument specified by the manufacturer. (4) Testing stratified atmospheres. When monitoring for entries involving a descent into atmospheres that may be stratified, the atmospheric envelope should be tested a distance of approximately 4 feet (1.22 m) in the direction of travel and to each side. If a sampling probe is used, the entrant's rate of progress should be slowed to accommodate the sampling speed and detector response. (5) Order of testing. A test for oxygen is performed first because most combustible gas meters are oxygen dependent and will not provide reliable readings in an oxygen deficient atmosphere. Combustible gases are tested for next because the threat of fire or explosion is both more immediate and more life threatening, in most cases, than exposure to toxic gases and vapors. If tests for toxic gases and vapors are necessary, they are performed last. \[58 FR 4549, Jan. 14, 1993; 58 FR 34846, June 29, 1993\] 83 Regulations (Standards -29 CFR) Examples of Permit-required Confined Space Programs - 1910.146 App C Regulations (Standards - 29 CFR) - Table of Contents 1910 Occupational Safety and Health Standards J General Environmental Controls 1910.146 App C Examples of Permit-required Confined Space Programs Example 1. Workplace. Sewer entry. Potential hazards. The employees could be exposed to the following: Engulfment. Presence of toxic gases. Equal to or more than 10 ppm hydrogen sulfide measured as an 8-hour time- weighted average. If the presence of other toxic contaminants is suspected, specific monitoring programs will be developed. Presence of explosive/flammable gases. Equal to or greater than 10% of the lower flammable limit (LFL). Oxygen Deficiency. A concentration of oxygen in the atmosphere equal to or less than 19.5% by volume. A. ENTRY WITHOUT PERMIT/ATTENDANT Certification. Confined spaces may be entered without the need for a written permit or attendant provided that the space can be maintained in a safe condition for entry by mechanical ventilation alone, as provided in 1910.146(c)(5). All spaces shall be considered permit-required confined spaces until the pre-entry procedures demonstrate otherwise. Any employee required or permitted to pre- check or enter an enclosed/confined space shall have successfully completed, as a minimum, the training as required by the following sections of these procedures. A written copy of operating and rescue procedures as required by these procedures shall be at the work site for the duration of the job. The Confined Space Pre-Entry Check List must be completed by the LEAD WORKER before entry into a confined space. This list verifies completion of items listed below. This check list shall be kept at the job site for duration of the job. If circumstances dictate an interruption in the work, the permit space must be re-evaluated and a new check list must be completed. Control of atmospheric and engulfment hazards. Pumps and Lines. All pumps and lines which may reasonably cause contaminants to flow into the space shall be disconnected, blinded and locked out, or effectively isolated by other means to prevent development of dangerous air contamination or engulfment. Not all laterals to sewers or storm drains require blocking. However, where experience or knowledge of industrial use indicates there is a reasonable potential for contamination of air or engulfment into an occupied sewer, then all affected laterals shall be blocked. If blocking and/or isolation requires entry into the space the provisions for entry into a permit-required confined space must be implemented. Surveillance. The surrounding area shall be surveyed to avoid hazards such as drifting vapors from the tanks, piping, or sewers. Testing. The atmosphere within the space will be tested to determine whether dangerous air contamination and/or oxygen deficiency exists. Detector tubes, alarm only gas monitors and explosion meters are examples of monitoring equipment that may be used to test permit space atmospheres. Testing shall be performed by the LEAD WORKER who has successfully completed the Gas Detector training for the monitor he will use. The minimum parameters to be monitored are oxygen deficiency, LFL, and hydrogen sulfide concentration. A written record of the pre-entry test results shall be made and kept at the work site for the duration of the job. The supervisor will certify in writing, based upon the results of the pre-entry testing, that all hazards have been eliminated. Affected employees shall be able to review the testing results. The most hazardous conditions shall govern when work is being performed in two adjoining, connecting spaces. Entry Procedures. If there are no non-atmospheric hazards present and if the pre-entry tests show there is no dangerous air contamination and/or oxygen deficiency within the space and there is no reason to believe that any is likely to develop, entry into and work within may proceed. Continuous testing of the atmosphere in the immediate vicinity of the workers within the space shall be accomplished. The workers will immediately leave the permit space when any of the gas monitor alarm set points are reached as defined. Workers will not return to the area until a SUPERVISOR who has completed the gas detector training has used a direct reading gas detector to evaluate the situation and has determined that it is safe to enter. Rescue. Arrangements for rescue services are not required where there is no attendant. See the rescue portion of section B., below, for instructions regarding rescue planning where an entry permit is required. B. ENTRY PERMIT REQUIRED Permits. Confined Space Entry Permit. All spaces shall be considered permit-required confined spaces until the pre-entry procedures demonstrate otherwise. Any employee required or permitted to pre-check or enter a permit-required confined space shall have successfully completed, as a minimum, the training as required by the following sections of these procedures. A written copy of operating and rescue procedures as required by these procedures shall be at the work site for the duration of the job. The Confined Space Entry Permit must be completed before approval can be given to enter a permit-required confined space. This permit verifies completion of items listed below. This permit shall be kept at the job site for the duration of the job. If circumstances cause an interruption in the work or a change in the alarm conditions for which entry was approved, a new Confined Space Entry Permit must be completed. Control of atmospheric and engulfment hazards. Surveillance. The surrounding area shall be surveyed to avoid hazards such as drifting vapors from tanks, piping or sewers. Testing. The confined space atmosphere shall be tested to determine whether dangerous air contamination and/or oxygen deficiency exists. A direct reading gas monitor shall be used. Testing shall be performed by the SUPERVISOR who has successfully completed the gas detector training for the monitor he will use. The minimum parameters to be monitored are oxygen deficiency, LFL and hydrogen sulfide concentration. A written record of the pre-entry test results shall be made and kept at the work site for the duration of the job. Affected employees shall be able to review the testing 85 results. The most hazardous conditions shall govern when work is being performed in two adjoining, connected spaces. Space Ventilation. Mechanical ventilation systems, where applicable, shall be set at 100% outside air. Where possible, open additional manholes to increase air circulation. Use portable blowers to augment natural circulation if needed. After a suitable ventilating period, repeat the testing. Entry may not begin until testing has demonstrated that the hazardous atmosphere has been eliminated. Entry Procedures. The following procedure shall be observed under any of the following conditions: 1.) Testing demonstrates the existence of dangerous or deficient conditions and additional ventilation cannot reduce concentrations to safe levels; 2.) The atmosphere tests as safe but unsafe conditions can reasonably be expected to develop; 3.) It is not feasible to provide for ready exit from spaces equipped with automatic fire suppression systems and it is not practical or safe to deactivate such systems; or 4.) An emergency exists and it is not feasible to wait for pre-entry procedures to take effect. All personnel must be trained. A self-contained breathing apparatus shall be worn by any person entering the space. At least one worker shall stand by the outside of the space ready to give assistance in case of emergency. The standby worker shall have a self-contained breathing apparatus available for immediate use. There shall be at least one additional worker within sight or call of the standby worker. Continuous powered communications shall be maintained between the worker within the confined space and standby personnel. If at any time there is any questionable action or non-movement by the worker inside, a verbal check will be made. If there is no response, the worker will be moved immediately. Exception: If the worker is disabled due to falling or impact, he/she shall not be removed from the confined space unless there is immediate danger to his/her life. Local fire department rescue personnel shall be notified immediately. The standby worker may only enter the confined space in case of an emergency (wearing the self-contained breathing apparatus) and only after being relieved by another worker. Safety belt or harness with attached lifeline shall be used by all workers entering the space with the free end of the line secured outside the entry opening. The standby worker shall attempt to remove a disabled worker via his lifeline before entering the space. When practical, these spaces shall be entered through side openings -- those within 3 1/2 feet (1.07 m) of the bottom. When entry must be through a top opening, the safety belt shall be of the harness type that suspends a person upright and a hoisting device or similar apparatus shall be available for lifting workers out of the space. In any situation where their use may endanger the worker, use of a hoisting device or safety belt and attached lifeline may be discontinued. When dangerous air contamination is attributable to flammable and/or explosive substances, lighting and electrical equipment shall be Class 1, Division 1 rated per National Electrical Code and no ignition sources shall be introduced into the area. Continuous gas monitoring shall be performed during all confined space operations. If alarm conditions change adversely, entry personnel shall exit the confined space and a new confined space permit issued. Rescue. Call the fire department services for rescue. Where immediate hazards to injured personnel are present, workers at the site shall implement emergency procedures to fit the situation. Example 2. Workplace. Meat and poultry rendering plants. Cookers and dryers are either batch or continuous in their operation. Multiple batch cookers are operated in parallel. When one unit of a multiple set is shut down for repairs, means are available to isolate that unit from the others which remain in operation. Cookers and dryers are horizontal, cylindrical vessels equipped with a center, rotating shaft and agitator paddles or discs. If the inner shell is jacketed, it is usually heated with steam at pressures up to 150 psig (1034.25 kPa). The rotating shaft assembly of the continuous cooker or dryer is also steam heated. Potential Hazards. The recognized hazards associated with cookers and dryers are the risk that employees could be: 1. Struck or caught by rotating agitator; 2. Engulfed in raw material or hot, recycled fat; 3. Burned by steam from leaks into the cooker/dryer steam jacket or the condenser duct system if steam valves are not properly closed and locked out; 4. Burned by contact with hot metal surfaces, such as the agitator shaft assembly, or inner shell of the cooker/dryer; 5. Heat stress caused by warm atmosphere inside cooker/dryer; 6. Slipping and falling on grease in the cooker/dryer; 7. Electrically shocked by faulty equipment taken into the cooker/dryer; 8. Burned or overcome by fire or products of combustion; or 9. Overcome by fumes generated by welding or cutting done on grease covered surfaces. Permits. The supervisor in this case is always present at the cooker/dryer or other permit entry confined space when entry is made. The supervisor must follow the pre-entry isolation procedures described in the entry permit in preparing for entry, and ensure that the protective clothing, ventilating equipment and any other equipment required by the permit are at the entry site. Control of hazards. Mechanical. Lock out main power switch to agitator motor at main power panel. Affix tag to the lock to inform others that a permit entry confined space entry is in progress. Engulfment. Close all valves in the raw material blow line. Secure each valve in its closed position using chain and lock. Attach a tag to the valve and chain warning that a permit entry confined space entry is in progress. The same procedure shall be used for securing the fat recycle valve. Burns and heat stress. Close steam supply valves to jacket and secure with chains and tags. Insert solid blank at flange in cooker vent line to condenser manifold duct system. Vent cooker/dryer by opening access door at discharge end and top center door to allow natural ventilation throughout the entry. If faster cooling is needed, use an portable ventilation fan to increase ventilation. Cooling water may be circulated through the jacket to reduce both outer and inner surface temperatures of cooker/dryers faster. Check air and inner surface temperatures in cooker/dryer to assure they are within acceptable limits before entering, or use proper protective clothing. 87 Fire and fume hazards. Careful site preparation, such as cleaning the area within 4 inches (10.16 cm) of all welding or torch cutting operations, and proper ventilation are the preferred controls. All welding and cutting operations shall be done in accordance with the requirements of 29 CFR Part 1910, Subpart Q, OSHA's welding standard. Proper ventilation may be achieved by local exhaust ventilation, or the use of portable ventilation fans, or a combination of the two practices. Electrical shock. Electrical equipment used in cooker/dryers shall be in serviceable condition. Slips and falls. Remove residual grease before entering cooker/dryer. Attendant. The supervisor shall be the attendant for employees entering cooker/dryers. Permit. The permit shall specify how isolation shall be done and any other preparations needed before making entry. This is especially important in parallel arrangements of cooker/dryers so that the entire operation need not be shut down to allow safe entry into one unit. Rescue. When necessary, the attendant shall call the fire department as previously arranged. Example 3. Workplace. Workplaces where tank cars, trucks, and trailers, dry bulk tanks and trailers, railroad tank cars, and similar portable tanks are fabricated or serviced. A. During fabrication. These tanks and dry-bulk carriers are entered repeatedly throughout the fabrication process. These products are not configured identically, but the manufacturing processes by which they are made are very similar. Sources of hazards. In addition to the mechanical hazards arising from the risks that an entrant would be injured due to contact with components of the tank or the tools being used, there is also the risk that a worker could be injured by breathing fumes from welding materials or mists or vapors from materials used to coat the tank interior. In addition, many of these vapors and mists are flammable, so the failure to properly ventilate a tank could lead to a fire or explosion. Control of hazards. Welding. Local exhaust ventilation shall be used to remove welding fumes once the tank or carrier is completed to the point that workers may enter and exit only through a manhole. (Follow the requirements of 29 CFR 1910, Subpart Q, OSHA's welding standard, at all times.) Welding gas tanks may never be brought into a tank or carrier that is a permit entry confined space. Application of interior coatings/linings. Atmospheric hazards shall be controlled by forced air ventilation sufficient to keep the atmospheric concentration of flammable materials below 10% of the lower flammable limit (LFL) (or lower explosive limit (LEL), whichever term is used locally). The appropriate respirators are provided and shall be used in addition to providing forced ventilation if the forced ventilation does not maintain acceptable respiratory conditions. Permits. Because of the repetitive nature of the entries in these operations, an "Area Entry Permit" will be issued for a 1 month period to cover those production areas where tanks are fabricated to the point that entry and exit are made using manholes. Authorization. Only the area supervisor may authorize an employee to enter a tank within the permit area. The area supervisor must determine that conditions in the tank trailer, dry bulk trailer or truck, etc. meet permit requirements before authorizing entry. Attendant. The area supervisor shall designate an employee to maintain communication by employer specified means with employees working in tanks to ensure their safety. The attendant may not enter any permit entry confined space to rescue an entrant or for any other reason, unless authorized by the rescue procedure and, even then, only after calling the rescue team and being relieved by an attendant or another worker. Communications and observation. Communications between attendant and entrant(s) shall be maintained throughout entry. Methods of communication that may be specified by the permit include voice, voice powered radio, tapping or rapping codes on tank walls, signalling tugs on a rope, and the attendant's observation that work activities such as chipping, grinding, welding, spraying, etc., which require deliberate operator control continue normally. These activities often generate so much noise that the necessary hearing protection makes communication by voice difficult. Rescue procedures. Acceptable rescue procedures include entry by a team of employee-rescuers, use of public emergency services, and procedures for breaching the tank. The area permit specifies which procedures are available, but the area supervisor makes the final decision based on circumstances. (Certain injuries may make it necessary to breach the tank to remove a person rather than risk additional injury by removal through an existing manhole. However, the supervisor must ensure that no breaching procedure used for rescue would violate terms of the entry permit. For instance, if the tank must be breached by cutting with a torch, the tank surfaces to be cut must be free of volatile or combustible coatings within 4 inches (10.16 cm) of the cutting line and the atmosphere within the tank must be below the LFL. Retrieval line and harnesses. The retrieval lines and harnesses generally required under this standard are usually impractical for use in tanks because the internal configuration of the tanks and their interior baffles and other structures would prevent rescuers from hauling out injured entrants. However, unless the rescue procedure calls for breaching the tank for rescue, the rescue team shall be trained in the use of retrieval lines and harnesses for removing injured employees through manholes. B. Repair or service of "used" tanks and bulk trailers. Sources of hazards. In addition to facing the potential hazards encountered in fabrication or manufacturing, tanks or trailers which have been in service may contain residues of dangerous materials, whether left over from the transportation of hazardous cargoes or generated by chemical or bacterial action on residues of non-hazardous cargoes. Control of atmospheric hazards. A "used" tank shall be brought into areas where tank entry is authorized only after the tank has been emptied, cleansed (without employee entry) of any residues, and purged of any potential atmospheric hazards. Welding. In addition to tank cleaning for control of atmospheric hazards, coating and surface materials shall be removed 4 inches (10.16 cm) or more from any surface area where welding or other torch work will be done and care taken that the atmosphere within the tank remains well below the LFL. (Follow the requirements of 29 CFR 1910, Subpart Q, OSHA's welding standard, at all times.) Permits. An entry permit valid for up to 1 year shall be issued prior to authorization of entry into used tank trailers, dry bulk trailers or trucks. In addition to the pre-entry cleaning requirement, this permit shall require the employee safeguards specified for new tank fabrication or construction permit areas. Authorization. Only the area supervisor may authorize an employee to enter a tank trailer, dry bulk trailer or truck within the permit area. The area supervisor must determine that the entry permit requirements have been met before authorizing entry. \[58 FR 4549, Jan. 14, 1993; 58 FR 34846, June 29, 1993\] 89 Regulations (Standards - 29 CFR) Confined Space Pre-Entry Check List - 1910.146 App D Regulations (Standards - 29 CFR) - Table of Contents 1910 Occupational Safety and Health Standards J General Environmental Controls 1910.146 App D Confined Space Pre-Entry Check List Appendix D to §1910.146 -- Sample Permits Appendix D-1 Confined Space Entry Permit Date and Time Issued: _______________ Date and Time Expires: ________ Job site/Space I.D.: ________________ Job Supervisor:________________ Equipment to be worked on: __________ Work to be performed: _________ Stand-by personnel: __________________ ________________ _____________ 1. Atmospheric Checks: Time ________ Oxygen ________% Explosive ________% L.F.L. Toxic ________PPM 2. Tester's signature: _____________________________ 3. Source isolation (No Entry): N/A Yes No Pumps or lines blinded, ( ) ( ) ( ) disconnected, or blocked ( ) ( ) ( ) 4. Ventilation Modification: N/A Yes No Mechanical ( ) ( ) ( ) Natural Ventilation only ( ) ( ) ( ) 5. Atmospheric check after isolation and Ventilation: Oxygen __________% > 19.5 % Explosive _______% L.F.L < 10 % Toxic ___________PPM < 10 PPM H(2)S Time ____________ Testers signature: _____________________________ 6. Communication procedures: ________________________________________ _____________________________________________________________________ 7. Rescue procedures: _______________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 8. Entry, standby, and back up persons: Yes No Successfully completed required training? Is it current? ( ) ( ) 9. Equipment: N/A Yes No Direct reading gas monitor - tested ( ) ( ) ( ) Safety harnesses and lifelines for entry and standby persons ( ) ( ) ( ) Hoisting equipment ( ) ( ) ( ) Powered communications ( ) ( ) ( ) SCBA's for entry and standby persons ( ) ( ) ( ) Protective Clothing ( ) ( ) ( ) All electric equipment listed Class I, Division I, Group D and Non-sparking tools ( ) ( ) ( ) 10. Periodic atmospheric tests: Oxygen ____% Time ____ Oxygen ____% Time ____ Oxygen ____% Time ____ Oxygen ____% Time ____ Explosive ____% Time ____ Explosive ____% Time ____ Explosive ____% Time ____ Explosive ____% Time ____ Toxic ____% Time ____ Toxic ____% Time ____ Toxic ____% Time ____ Toxic ____% Time ____ We have reviewed the work authorized by this permit and the information contained here-in. Written instructions and safety procedures have been received and are understood. Entry cannot be approved if any squares are marked in the "No" column. This permit is not valid unless all appropriate items are completed. Permit Prepared By: (Supervisor)________________________________________ Approved By: (Unit Supervisor)__________________________________________ Reviewed By (Cs Operations Personnel) : _________________________________ ____________________________________ (printed name) (signature) This permit to be kept at job site. Return job site copy to Safety Office following job completion. Copies: White Original (Safety Office) Yellow (Unit Supervisor) Hard(Job site) Appendix D - 2 ENTRY PERMIT PERMIT VALID FOR 8 HOURS ONLY. ALL COPIES OF PERMIT WILL REMAIN AT JOB SITE UNTIL JOB IS COMPLETED DATE: - - SITE LOCATION and DESCRIPTION ______________________________ PURPOSE OF ENTRY ______________________________________________________ SUPERVISOR(S) in charge of crews Type of Crew Phone # _______________________________________________________________________ _______________________________________________________________________ COMMUNICATION PROCEDURES ______________________________________________ RESCUE PROCEDURES (PHONE NUMBERS AT BOTTOM) ___________________________ _______________________________________________________________________ * BOLD DENOTES MINIMUM REQUIREMENTS TO BE COMPLETED AND REVIEWED PRIOR TO ENTRY* REQUIREMENTS COMPLETED DATE TIME Lock Out/De-energize/Try-out ____ ____ Line(s) Broken-Capped-Blanked ____ ____ Purge-Flush and Vent ____ ____ Ventilation ____ ____ 91 Secure Area (Post and Flag) ____ ____ Breathing Apparatus ____ ____ Resuscitator - Inhalator ____ ____ Standby Safety Personnel ____ ____ Full Body Harness w/"D" ring ____ ____ Emergency Escape Retrieval Equip ____ ____ Lifelines ____ ____ Fire Extinguishers ____ ____ Lighting (Explosive Proof) ____ ____ Protective Clothing ____ ____ Respirator(s) (Air Purifying) ____ ____ Burning and Welding Permit ____ ____ Note: Items that do not apply enter N/A in the blank. **RECORD CONTINUOUS MONITORING RESULTS EVERY 2 HOURS CONTINUOUS MONITORING** Permissible _________________________________ TEST(S) TO BE TAKEN Entry Level PERCENT OF OXYGEN 19.5% to 23.5% ___ ___ ___ ___ ___ ___ ___ ___ LOWER FLAMMABLE LIMIT Under 10% ___ ___ ___ ___ ___ ___ ___ ___ CARBON MONOXIDE +35 PPM ___ ___ ___ ___ ___ ___ ___ ___ Aromatic Hydrocarbon + 1 PPM * 5PPM ___ ___ ___ ___ ___ ___ ___ ___ Hydrogen Cyanide (Skin) * 4PPM ___ ___ ___ ___ ___ ___ ___ ___ Hydrogen Sulfide +10 PPM *15PPM ___ ___ ___ ___ ___ ___ ___ ___ Sulfur Dioxide + 2 PPM * 5PPM ___ ___ ___ ___ ___ ___ ___ ___ Ammonia *35PPM ___ ___ ___ ___ ___ ___ ___ ___ * Short-term exposure limit: Employee can work in the area up to 15 minutes. + 8 hr. Time Weighted Avg.: Employee can work in area 8 hrs (longer with appropriate respiratory protection). REMARKS:_____________________________________________________________ GAS TESTER NAME INSTRUMENT(S) MODEL SERIAL &/OR & CHECK # USED &/OR TYPE UNIT # ________________ _______________ ___________ ____________ ________________ _______________ ___________ ____________ SAFETY STANDBY PERSON IS REQUIRED FOR ALL CONFINED SPACE WORK SAFETY STANDBY CHECK # CONFINED CONFINED PERSON(S) SPACE CHECK # SPACE CHECK # ENTRANT(S) ENTRANT(S) ______________ _______ __________ _______ __________ _______ ______________ _______ __________ _______ __________ _______ SUPERVISOR AUTHORIZING - ALL CONDITIONS SATISFIED____________________ DEPARTMENT/PHONE ___________________________ AMBULANCE 2800 FIRE 2900 Safety 4901 Gas Coordinator 4529/5387 \[58 FR 4549, Jan. 14, 1993; 58 FR 34846, June 29, 1993\] Regulations (Standards - 29 CFR) - Table of Contents 1910 Occupational Safety and Health Standards J General Environmental Controls 1910.146 App E Sewer System Entry. Sewer entry differs in three vital respects from other permit entries; first, there rarely exists any way to completely isolate the space (a section of a continuous system) to be entered; second, because isolation is not complete, the atmosphere may suddenly and unpredictably become lethally hazardous (toxic, flammable or explosive) from causes beyond the control of the entrant or employer, and third, experienced sewer workers are especially knowledgeable in entry and work in their permit spaces because of their frequent entries. Unlike other employments where permit space entry is a rare and exceptional event, sewer workers' usual work environment is a permit space. (1) Adherence to procedure. The employer should designate as entrants only employees who are thoroughly trained in the employer's sewer entry procedures and who demonstrate that they follow these entry procedures exactly as prescribed when performing sewer entries. (2) Atmospheric monitoring. Entrants should be trained in the use of, and be equipped with, atmospheric monitoring equipment which sounds an audible alarm, in addition to its visual readout, whenever one of the following conditions are encountered: Oxygen concentration less than 19.5 percent; flammable gas or vapor at 10 percent or more of the lower flammable limit (LFL); or hydrogen sulfide or carbon monoxide at or above 10 ppm or 35 ppm, respectively, measured as an 8- hour time-weighted average. Atmospheric monitoring equipment needs to be calibrated according to the manufacturer's instructions. The oxygen sensor/broad range sensor is best suited for initial use in situations where the actual or potential contaminants have not been identified, because broad range sensors, unlike substance-specific sensors, enable employers to obtain an overall reading of the hydrocarbons (flammables) present in the space. However, such sensors only indicate that a hazardous threshold of a class of chemicals has been exceeded. They do not measure the levels of contamination of specific substances. Therefore, substance-specific devices, which measure the actual levels of specific substances, are best suited for use where actual and potential contaminants have been identified. The measurements obtained with substance-specific devices are of vital importance to the employer when decisions are made concerning the measures necessary to protect entrants (such as ventilation or personal protective equipment) and the setting and attainment of appropriate entry conditions. However, the sewer environment may suddenly and unpredictably change, and the substance-specific devices may not detect the potentially lethal atmospheric hazards which may enter the sewer environment. Although OSHA considers the information and guidance provided above to be appropriate and useful in most sewer entry situations, the Agency emphasizes that each employer must consider the unique circumstances, including the predictability of the atmosphere, of the sewer permit spaces in the employer's workplace in preparing for entry. Only the employer can decide, based upon his or her knowledge of, and experience with permit spaces in sewer systems, what the best type of testing instrument may be for any specific entry operation. The selected testing instrument should be carried and used by the entrant in sewer line work to monitor the atmosphere in the entrant's environment, and in advance of the entrant's direction of movement, to warn the entrant of any deterioration in atmospheric conditions. Where several entrants are working together in the same immediate location, one instrument, used by the lead entrant, is acceptable. (3) Surge flow and flooding. Sewer crews should develop and maintain liaison, to the extent possible, with the local weather bureau and fire and emergency services in their area so that sewer work may be delayed or interrupted and entrants withdrawn whenever sewer lines might be suddenly flooded by rain or fire suppression activities, or whenever flammable or other hazardous materials are released into sewers during emergencies by industrial or transportation accidents. (4) Special Equipment. Entry into large bore sewers may require the use of special equipment. Such equipment might include such items as atmosphere monitoring devices with automatic audible alarms, escape self-contained breathing apparatus (ESCBA) with at least 10 minute air supply (or 93 other NIOSH approved self-rescuer), and waterproof flashlights, and may also include boats and rafts, radios and rope stand-offs for pulling around bends and corners as needed. \[58 FR 4549, Jan. 14, 1993; 58 FR 34845, June 29, 1993; 59 FR 26115, May 19, 1994\] Regulations (Standards - 29 CFR) - Table of Contents 1910 Occupational Safety and Health Standards J General Environmental Controls 1910.146 App F Non-Mandatory Appendix F -- Rescue Team or Rescue Service Evaluation Criteria Non-Mandatory Appendix F -- Rescue Team or Rescue Service Evaluation Criteria (1) This appendix provides guidance to employers in choosing an appropriate rescue service. It contains criteria that may be used to evaluate the capabilities both of prospective and current rescue teams. Before a rescue team can be trained or chosen, however, a satisfactory permit program, including an analysis of all permit- required confined spaces to identify all potential hazards in those spaces, must be completed. OSHA believes that compliance with all the provisions of §1910.146 will enable employers to conduct permit space operations without recourse to rescue services in nearly all cases. However, experience indicates that circumstances will arise where entrants will need to be rescued from permit spaces. It is therefore important for employers to select rescue services or teams, either on-site or off-site, that are equipped and capable of minimizing harm to both entrants and rescuers if the need arises. (2) For all rescue teams or services, the employer's evaluation should consist of two components: an initial evaluation, in which employers decide whether a potential rescue service or team is adequately trained and equipped to perform permit space rescues of the kind needed at the facility and whether such rescuers can respond in a timely manner, and a performance evaluation, in which employers measure the performance of the team or service during an actual or practice rescue. For example, based on the initial evaluation, an employer may determine that maintaining an on-site rescue team will be more expensive than obtaining the services of an off-site team, without being significantly more effective, and decide to hire a rescue service. During a performance evaluation, the employer could decide, after observing the rescue service perform a practice rescue, that the service's training or preparedness was not adequate to effect a timely or effective rescue at his or her facility and decide to select another rescue service, or to form an internal rescue team. A. Initial Evaluation I. The employer should meet with the prospective rescue service to facilitate the evaluations required by §1910.146(k)(1)(i) and §1910.146(k)(1)(ii). At a minimum, if an off-site rescue service is being considered, the employer must contact the service to plan and coordinate the evaluations required by the standard. Merely posting the service's number or planning to rely on the 911 emergency phone number to obtain these services at the time of a permit space emergency would not comply with paragraph (k)(1) of the standard. II. The capabilities required of a rescue service vary with the type of permit spaces from which rescue may be necessary and the hazards likely to be encountered in those spaces. Answering the questions below will assist employers in determining whether the rescue service is capable of performing rescues in the permit spaces present at the employer's workplace. 1. What are the needs of the employer with regard to response time (time for the rescue service to receive notification, arrive at the scene, and set up and be ready for entry)? For example, if entry is to be made into an IDLH atmosphere, or into a space that can quickly develop an IDLH atmosphere (if ventilation fails or for other reasons), the rescue team or service would need to be standing by at the permit space. On the other hand, if the danger to entrants is restricted to mechanical hazards that would cause injuries (e.g., broken bones, abrasions) a response time of 10 or 15 minutes might be adequate. 2. How quickly can the rescue team or service get from its location to the permit spaces from which rescue may be necessary? Relevant factors to consider would include: the location of the rescue team or service relative to the employer's workplace, the quality of roads and highways to be traveled, potential bottlenecks or traffic congestion that might be encountered in transit, the reliability of the rescuer's vehicles, and the training and skill of its drivers. 3. What is the availability of the rescue service? Is it unavailable at certain times of the day or in certain situations? What is the likelihood that key personnel of the rescue service might be unavailable at times? If the rescue service becomes unavailable while an entry is underway, does it have the capability of notifying the employer so that the employer can instruct the attendant to abort the entry immediately? 4. Does the rescue service meet all the requirements of paragraph (k)(2) of the standard? If not, has it developed a plan that will enable it to meet those requirements in the future? If so, how soon can the plan be implemented? 5. For off-site services, is the service willing to perform rescues at the employer's workplace? (An employer may not rely on a rescuer who declines, for whatever reason, to provide rescue services.) 6. Is an adequate method for communications between the attendant, employer and prospective rescuer available so that a rescue request can be transmitted to the rescuer without delay? How soon after notification can a prospective rescuer dispatch a rescue team to the entry site? 7. For rescues into spaces that may pose significant atmospheric hazards and from which rescue entry, patient packaging and retrieval cannot be safely accomplished in a relatively short time (15-20 minutes), employers should consider using airline respirators (with escape bottles) for the rescuers and to supply rescue air to the patient. If the employer decides to use SCBA, does the prospective rescue service have an ample supply of replacement cylinders and procedures for rescuers to enter and exit (or be retrieved) well within the SCBA's air supply limits? 8. If the space has a vertical entry over 5 feet in depth, can the prospective rescue service properly perform entry rescues? Does the service have the technical knowledge and equipment to perform rope work or elevated rescue, if needed? 9. Does the rescue service have the necessary skills in medical evaluation, patient packaging and emergency response? 10. Does the rescue service have the necessary equipment to perform rescues, or must the equipment be provided by the employer or another source? 95 B. Performance Evaluation Rescue services are required by paragraph (k)(2)(iv) of the standard to practice rescues at least once every 12 months, provided that the team or service has not successfully performed a permit space rescue within that time. As part of each practice session, the service should perform a critique of the practice rescue, or have another qualified party perform the critique, so that deficiencies in procedures, equipment, training, or number of personnel can be identified and corrected. The results of the critique, and the corrections made to respond to the deficiencies identified, should be given to the employer to enable it to determine whether the rescue service can quickly be upgraded to meet the employer's rescue needs or whether another service must be selected. The following questions will assist employers and rescue teams and services evaluate their performance. 1. Have all members of the service been trained as permit space entrants, at a minimum, including training in the potential hazards of all permit spaces, or of representative permit spaces, from which rescue may be needed? Can team members recognize the signs, symptoms, and consequences of exposure to any hazardous atmospheres that may be present in those permit spaces? 2. Is every team member provided with, and properly trained in, the use and need for PPE, such as SCBA or fall arrest equipment, which may be required to perform permit space rescues in the facility? Is every team member properly trained to perform his or her functions and make rescues, and to use any rescue equipment, such as ropes and backboards, that may be needed in a rescue attempt? 3. Are team members trained in the first aid and medical skills needed to treat victims overcome or injured by the types of hazards that may be encountered in the permit spaces at the facility? 4. Do all team members perform their functions safely and efficiently? Do rescue service personnel focus on their own safety before considering the safety of the victim? 5. If necessary, can the rescue service properly test the atmosphere to determine if it is IDLH? 6. Can the rescue personnel identify information pertinent to the rescue from entry permits, hot work permits, and MSDSs? 7. Has the rescue service been informed of any hazards to personnel that may arise from outside the space, such as those that may be caused by future work near the space? 8. If necessary, can the rescue service properly package and retrieve victims from a permit space that has a limited size opening (less than 24 inches (60.9 cm) in diameter), limited internal space, or internal obstacles or hazards? 9. If necessary, can the rescue service safely perform an elevated (high angle) rescue? 10. Does the rescue service have a plan for each of the kinds of permit space rescue operations at the facility? Is the plan adequate for all types of rescue operations that may be needed at the facility? Teams may practice in representative spaces, or in spaces that are "worst-case" or most restrictive with respect to internal configuration, elevation, and portal size. The following characteristics of a practice space should be considered when deciding whether a space is truly representative of an actual permit space: (1) Internal configuration. (a) Open -- there are no obstacles, barriers, or obstructions within the space. One example is a water tank. (b) Obstructed -- the permit space contains some type of obstruction that a rescuer would need to maneuver around. An example would be a baffle or mixing blade. Large equipment, such as a ladder or scaffold, brought into a space for work purposes would be considered an obstruction if the positioning or size of the equipment would make rescue more difficult. (2) Elevation. (a) Elevated -- a permit space where the entrance portal or opening is above grade by 4 feet or more. This type of space usually requires knowledge of high angle rescue procedures because of the difficulty in packaging and transporting a patient to the ground from the portal. (b) Non-elevated -- a permit space with the entrance portal located less than 4 feet above grade. This type of space will allow the rescue team to transport an injured employee normally. (3) Portal size. (a) Restricted -- A portal of 24 inches or less in the least dimension. Portals of this size are too small to allow a rescuer to simply enter the space while using SCBA. The portal size is also too small to allow normal spinal immobilization of an injured employee. (b) Unrestricted -- A portal of greater than 24 inches in the least dimension. These portals allow relatively free movement into and out of the permit space. (4) Space access. (a) Horizontal -- The portal is located on the side of the permit space. Use of retrieval lines could be difficult. (b) Vertical -- The portal is located on the top of the permit space, so that rescuers must climb down, or the bottom of the permit space, so that rescuers must climb up to enter the space. Vertical portals may require knowledge of rope techniques, or special patient packaging to safely retrieve a downed entrant. \[63 FR 66039, Dec. 1, 1998\] 6.5 Fall Protection Program: 1. Purpose and Scope This program contains written policies and procedures intended to comply with the Occupational Safety and Health Administration (OSHA) 29 CFR 1910.23, 1910.66 and ANSI Z359. The purpose of this Fall Protection Program is to identify, evaluate, and eliminate (or control) fall hazards through planning; ensure proper training of personnel exposed to fall hazards; ensure proper installation and use of fall protection and rescue systems; and implement safe fall protection and rescue procedures. This program will establish minimum fall control practices for employees who perform work in areas where they are exposed to heights of four feet or more and at lower heights where potentially hazardous conditions exist. 97 2.Policy Statement The City of Fairfax safety policy is to take every reasonable precaution to protect the health and safety of employees. Implicit in the safety policy is the requirement that employees shall use effective fall protection systems when working in any system that presents a foreseeable exposure to a fall hazard. 3. Program Administration Program Administrator for the City departments covered in this plan Lynn Miller / Brian Merta Adequate and timely resources shall be provided to support this fall protection program. Fall hazards will be identified and documented; and elimination or control of existing fall hazards will be required in the two years, and work with supervisors to ensure it is being administered effectively. The Competent Person will be versed on the fall protection system. The primary responsibilities of the Program Administrator are: Ensure that this Fall Protection Program is developed, implemented, and evaluated. Provide guidance to managers, employees, and other departments. Assign a Competent Person to oversee the Fall Protection Program. Provide training for all authorized and Competent Persons. Develop fall protection and rescue procedures for every fall hazard where an active fall protection system is used and a procedure to identify and eliminate or control new and existing fall hazards. The primary responsibilities of the Competent Person are: Compliance with the Fall Protection Program. Immediate supervision, implementation, and monitoring of the program. Specifying in writing fall protection procedures and the fall protection systems. Conducting a fall hazard survey (Appendix I). Verify training of employees. Evaluating the need for fall arrest equipment and fall prevention systems such as ledges, elevated walkways, platforms roof, etc. Supplying and maintaining the proper equipment for the job. Conducting necessary follow-ups to insure that the application and use is correctly applied to the situation. The primary responsibilities of Authorized Employees are: Evaluating the need for fall arrest equipment and fall prevention systems such as ledges, unprotected scaffolding, rooftops, elevated walkways, etc. Considering the hazards that may be present. Considering the use of temporary scaffolding, handrails, aerial lifts, etc. Discussing possible hazards with the Competent Person. Inspect equipment prior to each use. Properly maintaining and store fall arrest equipment and systems. The responsibilities of a Qualified Person are: Compliance with the Fall Protection Program. Supervision of the design, selection, installation, and inspection of certified anchorages and horizontal lifelines. Calculation of the forces generated by an arrested fall, the total loading, and the deflection of the fall arrest anchorage; the impact on the structural members to which the fall arrest system is attached; and shall determine a safe location for the anchorage. rd The use of a 3 party specialist as the role of Qualified Person may be necessary for building specific fall protection systems. The City of Fairfax Fire and Rescue Department shall be used for any duties associated with the competent rescuer. 4. Training Training for all fall protection and rescue at elevated locations shall conform to ANSI/ASSE and OSHA standards. Competent Persons shall be trained by a Competent Person trainer or a Qualified Person trainer. Training for Competent Persons shall include physical demonstrations by trainees on how to properly select, inspect, anchor, assemble and use fall protection equipment used in locations where they work. Training shall include use of all types of equipment and systems used in locations where the Authorized Persons work, including inspecting systems prior to use, installation, component compatibility, estimating free fall distances, total required clearance, dismantling, storage, and the common hazards associated with each system and component. Competent Person training shall include at least the following information: fall hazard elimination and controls methods applicable fall protection regulations fall hazard surveys and fall protection procedures the responsibilities of designated persons under this program detailed inspection of equipment components and systems fall protection system assessments and determining when a system is unsafe fall protection rescue procedures the selection and use of noncertified anchorages Competent Person update training shall be conducted at least every two years to stay current with the fall protection and rescue educational industry requirements or when new fall protection systems are used or installed or new fall hazards are encountered. Every Authorized Person shall receive training from a Competent Person trainer or Qualified Person trainer before they are exposed to a fall hazard. When the nature of the work, the workplace, or the methods of control change to an extent that prior training is not adequate, the Authorized Person shall be retrained. Retraining is also required when it becomes apparent to their Competent Person that the Authorized Person does not have the required level of skill and knowledge or is not following the required means and methods. Training shall include physical demonstrations by trainees on how to inspect, anchor, assemble, and use the fall protection equipment used in locations where they work. Authorized Person training shall include at least the following information: fall hazard recognition fall hazard elimination and controls methods applicable fall protection regulations the responsibilities of designated persons under this program how to use written fall protection procedures inspection of equipment components and systems before use fall protection rescue procedures Authorized Person update training shall be conducted at least every two years to stay current with the fall protection and rescue educational requirements. If the program administrator determines that training every two years is not beneficial, Authorized Persons shall be evaluated at least annually to ensure that those individuals remain capable of performing the duties assigned. This evaluation shall include a written examination and skill-based performance that cover all of the types of fall protection equipment that the person is authorized to operate. The evaluation of an Authorized Person shall be performed by a Competent Person, Qualified Person, Qualified Person trainer, or Competent Person trainer. 99 5. Inspection, Maintenance, Markings, and Storage Inspecting Fall arrest equipment must be inspected and marked as required before placing into service. A method of tracking equipment inspections, markings and documentation will be maintained. Equipment must be visually inspected before each use and receive a documented inspection at least once a year. Equipment rejected for use shall be destroyed and the action recorded in the equipment records. Equipment records are located in Appendix II. Written or electronic records of inspections completed shall be kept on file for the service life of the equipment. Maintenance Any fall arrest system or component that has been used to arrest a fall shall be immediately All fall protection and fall rescue equipment that has been inspected and determined no longer adequate for service shall be tagged so that the equipment will not be returned to service without the authorization of the Competent Person. The Competent Person shall destroy this equipment, return it to the manufacturer, or, if it is used in training, keep it in a controlled area to prevent reuse. The Competent Person shall verify that the equipment is maintained according to the manufacturer's instructions. Other issues not addressed by the manufacturer's instructions shall be addressed with the manufacturer prior to any attempt to perform maintenance. Storage Proper storage of fall protection and fall rescue equipment shall be incorporated into fall Equipment shall be stored in a manner that protects it from exposure to any conditions that could result in damage. Storage of equipment shall include provisions for limiting access to only those personnel trained in the proper use of the equipment. Markings The legibility and attachment of required markings for rope adjustors, lanyards, connectors, personal energy absorbers, energy absorbing lanyards, and positioning harnesses shall endure for the life of the component or subsystem. 6. Eliminating and Controlling Fall Hazards When choosing methods to eliminate or control fall hazards the following fall protection hierarchy will be used: 1. Elimination or Substitution. Removing the hazard or hazardous work practices. 2. Passive Fall Protection. Isolating or separating the hazard or hazardous work practices from employees and/or others. 3. Fall Restraint. Securing the Authorized Person to an anchorage using a lanyard short enough to 4. Fall Arrest. Attach a person to a system designed to stop a fall after it has begun. 5. Administrative Controls: Establish work practices or procedures to warn an Authorized Person to avoid approaching a fall hazard. Control measures are not mutually exclusive; there may be occasions or situations when more than one control measure should be used to reduce the risk of a fall. 7. Fall Protection System Requirements All components used in a fall protection or rescue system for which requirements have been established shall be incorporated in a way that is consistent with its manufacturer's instructions. The design of fall protection systems shall be based on the results of tests or predictive calculations made by a Qualified Person. The design and installation of certified anchorages and horizontal lifeline fall protection systems or components shall be performed under the direct supervision of a Qualified Person. All fall arrest systems shall limit the maximum arrest force to 1,800 pounds or less and shall be designed such that Authorized Persons subject to a fall shall not strike an obstruction or lower level. A fall restraint system shall be limited to a working surface that is at or less than a slope of 4:12 from horizontal. Guard Railing System The use of a guardrail and toe board system, which is passive fall protection, must adhere to OSHA standard 1910.23(e). Use of this type of system shall be determined by a Competent Person for guarding unprotected edges, ramps, runways platforms, or floor 8. Anchorage Requirements The compatibility between anchorage connectors and anchorages shall be considered when designing or selecting an anchorage and anchorage connector. The exposure of anchorage connectors to sharp edges, excessive bending of wire rope, abrasive surfaces, and physical hazards such as thermal, electrical, and chemical sources shall be considered when designing or selecting an anchorage. Anchorage connectors shall be protected from damage from these exposures. Anchorage requirements are: Anchorages selected for personal fall arrest systems shall have a strength capable of sustaining static loads of at least two times the maximum arrest force permitted on the system when certification exists, or 5,000 lbs. in the absence of certification. When more than one personal fall arrest system is attached to an anchorage, the above anchorage strengths must be multiplied by the number of personal fall arrest systems (PFAS) attached to the anchorage. For work positioning systems, anchorages must withstand a static load of 3,000 lbs. for non- certified anchorages or two times the foreseeable force for certified anchorages. For travel restraint systems, anchorages must withstand a static load of 1,000 lbs. for non- certified anchorages or two times the foreseeable force for certified anchorages. Anchorages selected for rescue systems shall have a strength capable of sustaining static loads of at least 3,100 lbs. for non-certified anchorages, for connection of rescue system only, or meet a safety factor of 5:1 based on the static load placed on the system for certified anchorages. Anchorage connectors shall not be attached to anchorages where such attachment would reduce the anchorage strength below the applicable levels set forth above. Anchorage connections shall be stabilized to prevent unwanted movement or disengagement of the system from the anchorage. Anchorage connectors shall be attached to no more than one PFAS or rescue system unless certified for such purpose. 9. Fall Protection Procedures General Requirements Written fall protection procedures shall be developed and maintained for every location where an active fall protection system is used to control a fall hazard. Authorized Employees shall be informed about any foreseeable fall hazard before the Authorized Person is exposed to the fall hazard. Written fall protection procedures shall specify the fall protection equipment and systems used to protect Authorized Persons from each fall hazard and shall document the proper way to operate the specified fall protection equipment and systems, including installation, inspection, use, and dismantling. Prior to preparing fall protection procedures, a fall hazard survey shall be performed for every workplace activity where Authorized Persons are exposed to a fall hazard. (See Appendix I). Fall distances will need to be calculated for both the fall hazard survey and fall protection procedures (See Appendix VI). 101 A. Fall Hazard Survey Report A fall hazard survey report shall be prepared for each fall hazard to which an Authorized Person may be exposed. The report shall identify at least one method to eliminate or control each identified fall hazard. The fall hazard survey shall be conducted by a Competent Person or Qualified Person who is familiar with, and has access to, information about local work processes, environment, policy and best industry practices, and who collects input from the actual work team familiar with their workplace activities. The fall hazard survey report shall identify all current and predictable workplace paths of Authorized Persons, all fall hazards along such paths, the locations and distances to all obstructions in potential fall paths, and environment factors that may affect the installation, use, inspection, maintenance, and dismantling of any fall protection system. See Appendix I. B. Requirements for Fall Protection Procedures Fall protection procedures shall be prepared specifically for the workplace and tasks where they will be applied except where the same procedure can be effectively applied to multiple workplaces. Fall protection procedures shall provide for 100% continuous fall protection. The procedures are to be created and modified by a qualified or Competent Person. Fall protection procedures shall include training requirements and qualifications of Authorized Persons permitted to use the system. The follow are points to consider when completing a Job Safety Analysis (JSA) for fall protection. Written fall protection procedures for fall arrest systems shall include: Identification of acceptable fall arrest anchorages Clearance requirements Complete setup procedure for access Use and egress from the system Limitations on use of the system, including the maximum free fall, maximum arrest force, and the maximum number and permitted locations of Authorized Persons who may attach to or use the system. Written fall protection procedures for work positioning and travel restraint systems shall include: Identification of acceptable anchorages Complete setup procedure for access; use and egress of the system Limitations on use of the system including the maximum number and permitted locations of Authorized Persons who may attach to or use the system. Fall protection procedures for installing and dismantling fall protection equipment shall include at least the following information: A description of all components used in the fall protection system, specifying the applicable manufacturers, standard, and/or drawings. Required anchorage strengths or other criteria for choosing acceptable anchorages. Any limitations on where or how the system shall be installed Detailed instructions for assembling the components into the fall protection system. If applicable, detailed instructions for disassembling the fall protection system. Fall protection procedures for inspection shall include: Required or recommended inspection intervals. Detailed instructions for inspecting each component of the system. Description of acceptance and rejection criteria, including retirement criteria, of each component of the system. Fall protection procedures shall include a requirement that any incidents, including accidents or close- calls, be investigated to determine if procedures can be improved. 10. Rescue Procedures At the beginning of any work activity where fall protection is an issue, rescue plans must be identified and discussed with all employees involved, in case of a fall. The supervisor or Competent Person will develop the rescue plan. In the event of a fall arrest, all employees will be rescued by on-site personnel with the use of an articulating man lift or ladders where feasible. Alternate rescue would be through City of Fairfax emergency services. In the event of a fall, the following people will be notified as soon as possible: 1. Rescue personnel (911). 2. Fire Department or emergency medical services if necessary. 3. Supervisor All employees involved in a fall arrest or fall will be sent for a medical evaluation to determine extent of injuries. 11. Incident Investigations All fall-related incidents shall be reported to the program administrator and Competent Person. When the activation of a fall protection system occurs, an incident investigation shall transpire. Any activity affecting the equipment or site involved in the incident shall cease, and the site and equipment secured until the investigator permits activity to resume. Incident investigations shall be retained on file for the length of time mandated by the applicable legislative authority, but not less than five years. 12. Program Evaluation The program shall be evaluated by the program administrator at periodic intervals not to exceed two years (ANSI Z359.2-2007 Sec. 8.3). Additionally, the program shall be evaluated when Authorized Persons or Competent Persons identify deficiencies or when there are incidents involving injuries, property damage, or close-calls. A Self-Assessment checklist is located in Appendix VII. 13. Equipment Evaluation All equipment will be subject to inspection prior to each use and documented at least once a year by a Competent Person (ANSI Z359.2-2007 Sec. 5.5.2.2). Each type of equipment will have a certain criteria of what will be inspected (see Appendixes II, III, IV, V). Equipment reject for use shall be destroyed and the action recorded on the inspection checklist. F ALL P ROTECTION A PPENDICES 103 Job Safety Analysis Fall Protection Hazards Job/ Task: Work Area: Date: Title of Worker Who Performs Job: Analysis By: Supervisor/Team Leader: Department: Reviewed By: Required and/or Recommended Personal Protective and Fall Arrest Equipment: Sequence of Basic Job Steps Potential Accidents or Fall Hazards Recommended Safe Job Procedures Fall Protection Safety/Tie-off Points 1. 1. 1. 2. 2. 2. 3. 3. 3. 4. 4. 4. 5. 5. 5. 6. 6. 6. 7. 7. 7. 8. 8. 8. 9. 9. 9. 10. 10. 10. APPENDIX II F ALL HAZARD S URVEY Date: ____________________ Completed By: _____________________________________________________ Location: ____________________________________________________________________________________ Job/Work Description: __________________________________________________________________________ ____________________________________________________________________________________________ Fall Path Description: ___________________________________________________________________________ Current/Future Fall Hazards: _____________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Location & Distance of Hazards: __________________________________________________________________ ____________________________________________________________________________________________ Factors Affecting Fall Equipment (if any): ____________________________________________________________ ____________________________________________________________________________________________ Methods for Controlling/Eliminating Hazards: _______________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ (Attach photos or sketches if necessary) 105 To assist in completing the aforementioned fall hazard survey Consider the following risk factors while completing the survey: Reason for the exposure Severity of the fall (level of injury or death) Obstructions in the fall path Existing fall protection systems or equipment Access to the task/structure Environmental conditions Other workers/contractors in the immediate area Proximity to the fall hazard Other safety hazards (i.e. moving equipment, work process, electrical, etc.) History of accidents or incidents related to the task or structure Hot objects, sparks, flames and heat-producing operations Chemicals hazardous to the Authorized Person or to the fall protection system Environmental contaminants of any form Sharp objects and abrasive surfaces Moving equipment and materials Unstable, uneven and slippery walking/working surfaces Unguarded openings Climatic and weather factors Electrical hazards Foreseeable changes in any of these conditions APPENDIX III F ALL P ROTECTION P ROCEDURE Date: Written By: Location: Job/Work Description: Fall Protection Equipment Acceptable Tie-Off/ Anchorage Points Fall System Setup & Appropriate Clearances Rescue Procedures Approved By: Title: (sign) (date) 107 APPENDIX IV H ARNESS A NNUAL I NSPECTION C HECKLIST In addition to inspection prior to each use, a documented inspection at least once a year shall be conducted. Equipment rejected for use shall be destroyed and the action recorded in the comments below. Harness Model/Name:___________________________________________________________ Serial Number:________________________________ Equip Number:____________________ Date of Manufacture:_____________________________ Date of Purchase: ________________ Inspection Criteria Pass Fail Comments: Hardware: D rings, buckles, keepers, and back pads. Inspect for damage, distortion, sharp edges, burrs, cracks and corrosion Webbing: Inspect for cuts, burns, tears, abrasions, frays, excessive soiling, and discoloration. Stitching: Inspect for pulled or cut stitches Labels: Inspect, making certain all labels are securely held in place and are legible. Other: Other: Overall disposition: Steps taken if removed from service: Date Removed: Inspected By: Date Inspected: PART C. Emergency Response APPENDIX V L ANYARDS A NNUAL I NSPECTION C HECKLIST In addition to inspection prior to each use, a documented inspection at least once a year shall be conducted. Equipment rejected for use shall be destroyed and the action recorded in the comments below. Lanyard Model/Name:___________________________________________________________ Serial Number:__________________________________ Lot Number:____________________ Date of Manufacture:_____________________________ Date of Purchase: ________________ Inspection Criteria Pass Fail Comments: Hardware: Snap hooks, connectors, adjusters, keepers, thimbles, and D rings. Inspect for damage, distortion, sharp edges, burrs, cracks, corrosion and proper operation. Webbing: Inspect for cuts, burns, tears, abrasions, frays, excessive soiling, and discoloration. Stitching: Inspect for pulled or cut stitches. Synthetic Rope: Inspect for pulled or cut yarns, burns, abrasions, knots, excessive soiling, and discoloration. Energy Absorbing Component: Inspect for elongation, tears and excessive soiling. Labels: Inspect, making certain all labels are securely held in place and are legible. Overall disposition: Steps taken if removed from service: Date Removed: Inspected By: Date Inspected: 109 APPENDIX VI C ONNECTORS A NNUAL I NSPECTION C HECKLIST In addition to inspection prior to each use, a documented inspection at least once a year shall be conducted. Equipment rejected for use shall be destroyed and the action recorded in the comments below. Hook/Connector Model/Name:____________________________________________________ Serial Number:__________________________________ Lot Number:____________________ Date of Manufacture:_____________________________ Date of Purchase:________________ Inspection Criteria Pass Fail Comments: Physical Damage: Cracks, sharp edges, burrs, deformities and locking operations Excessive Corrosion: Corrosion which affects the operation and/or strength. Markings: Are marking(s) legible. Gate Mechanism functional. Other: Other: Overall disposition: Steps taken if removed from service: Date Removed: Inspected By: Date Inspected: PART C. Emergency Response APPENDIX VII S ELF-R ETRACTING L ANYARD/L IFELINE A NNUAL I NSPECTION C HECKLIST In addition to inspection prior to each use, a documented inspection at least once a year shall be conducted. Equipment rejected for use shall be destroyed and the action recorded in the comments below. Self-retracting Lanyard/Lifeline Model/Name:________________________________________ Serial Number: ______________________________Lot Number:________________________ Date of Manufacture: ____________________Date of Purchase:_________________________ Inspection Items Pass Fail Comments: Impact Indicator: Inspect indicator for activation rupture of red stitch or elongated indicator Screws/Fasteners: Inspect for damage and make sure all screws and fasteners are tight. Housing: Inspect for distortion, cracks and other damage. Is anchoring loop distorted or damaged. Lanyard/Lifeline: Inspect for cuts, burns, tears, abrasion, frays, excessive soiling and discoloration. Locking Action: Inspect for proper breaking action. Retraction/Extension: Inspect spring tension by pulling lanyard out fully and allowing to retract fully (lifeline must be taut/no slack) Hooks/Connectors: Inspect for physical damage, corrosion, proper orientation and markings. Labels: Inspect, making certain all labels are securely held in place and legible. Overall disposition: Steps taken if removed from service: Date Removed: Inspected By: Date Inspected: 111 APPENDIX VIII F ALL P ROTECTION C ALCULATIONS Typically the maximum free-fall distances are as follows: 6 feet for a system with shock absorbers. 4 feet for a system without shock absorbers. 2 feet for a work positioning system. A basic formula to calculate free fall is as follows: (HD-LL)-DAE=Free-Fall Distance HD = height from the working surface (platform) to the D ring. LL = length of the lanyard. DAE = distance from the anchor point to the edge of the platform. Total Fall Distance Total fall distance is the distance from the anchorage point to the D ring when extended once the fall is arrested. Total Fall Distance = Free Fall Distance + Deceleration Distance By OSHA standards, the maximum free-fall distance is 6 feet, and the maximum deceleration distance is 3-1/2 feet. Clearance A basic formula to calculate the clearance is as follows: Length of Lanyard + Length of Deployed Shock Absorber + Height of the D Ring + Safety Factor (2 - 3 feet). The vertical distance from the anchor point to the next lower level must exceed the clearance height or the worker will hit the surface. PART C. Emergency Response APPENDIX IX SELF ASSEMENT CHECKLIST Element: Fall Protection - Date: Assessment Team: Instructions: Complete the checklist by answering yes or no to the following questions. Use the identified methods to gather a complete response (D - Document review; I - Interview; V - Visual inspection). Look for discrepancies with the written program and non-conformance with the requirements, along with root causes and potential corrective actions. Retain for 5 years. Criteria Yes No 1. Is there an established fall protection program at the facility? D 2. Is the program reviewed every two years? DI 3. Is there a written emergency response plan? D 4. Are fall injuries tracked for program improvement? DI 5. Have individual control procedures been developed for each known hazard? D 6. Has a fall hazard protection inventory of the facility been conducted? DI 7. Is the fall protection equipment stored by manufacture recommendations and only accessed by IV Authorized Employees 8. Are the individual fall hazard procedures reviewed on an annual basis? DI 9. Do Authorized Employees inspect fall protection equipment? V 10. Do the procedures outline techniques to be used for fall protection? D 11. Is training sufficient and routinely conducted before job and include recognition of fall hazards? DIV 12. Employees instructed in the purpose & use of the fall protection procedure? IV 13. Is retraining required whenever there is a change in job assignments, fall protection requirements, DI fall protection procedures, when employee proficiency is in doubt, or close-calls? 14. Are fall procedures shared between host and contractor? I 15. Are contractor safety considerations discussed during training? IV 16. Do contractors notify affected employees of the hazards involved in work? I 17. Is the fall protection plan kept readily at the workplace? D 18. Policy Statement existent and periodically reviewed and amended as necessary? DI 19. Roles and responsibilities defined and assigned appropriately? D 20. Hazard identification and risk assessments conducted by Competent Person(s) in a team? DI 21. Do control methods follow hierarchy of control; and are safe and monitored regularly? DI 22. Do procedures include training requirements, are prepared for every fall hazard, are communicated DIV to everyone involved, provide supervision, and 100% continuous fall protection? 23. V 24. Are anchorages compatible with connectors and capable of sustaining loads? V 25. Are pre-shift inspections and yearly documented inspections executed? DIV 26. Is a maintenance program established, with inventory, procedures, and accompanying records? D Overall Findings (Strengths and Weaknesses): New Goals: 113 DISCLAIMER This important information dealing with the Occupational Safety and Health Administration (OSHA) 29 CFR 1910 Subpart F, dealing with fall protection has been assembled in an effort to promote employee safety and health issues in the work place. Due to the wide range of activities conducted by employers, not every detail about fall protection can be addressed in this program. Managers/supervisors are cautioned to refer to the OSHA guidelines to determine if additional steps need to be added to this model. In addition, those personnel who are responsible for compliance with the state and federal regulations must be alert to any future changes in the law and keep this manual current and updated. Copyright© 2012 Iowa Association of Municipal Utilities. Copyright is not claimed as to any part of the original work prepared by a U.S. government officer or employee as part of that person's official duties. This manual may be reproduced by the owner to facilitate adoption and implementation of the owner's compliance program. No other reproduction is authorized without the express written consent of the Iowa Association of Municipal Utilities. All other rights reserved. Iowa Association of Municipal Utilities th 1735 NE 70 Avenue Ankeny, Iowa 50021-9353 515/289-1999 Disclaimer of Warranty and Limitation of Liability This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is furnished with the understanding that neither the Association nor its licensed agent is engaged in rendering legal or other professional service. If legal advice or other professional or expert assistance is required, the services of a competent professional person should be sought. This publication is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the quality, performance, and accuracy of the manual is with the holder. 6.6 Hazard Communication Program: INTRODUCTION The Hazard Communication Standard The federal Hazard Communication Standard is a law that was passed by Congress in 1985 that deals with hazardous chemicals that are used in the work place. In 1986, the Iowa legislature passed the Iowa Hazardous Right t to match the United Nations (UN) adaptions of the Globally Harmonized System (GHS) and now gives workers collect fines from employers that are not in compliance. Employers in the State of Iowa are required to develop hazardous communication programs as part of the Worker Right to Know section. An inventory of hazardous chemicals Accessible (material) safety data sheets PART C. Emergency Response Appropriate container labels An employee information and training program A written hazard communication program To assist employers, IAMU has developed this manual. It contains the checklists, outlines and other forms that will assist you in creating a hazard communication program for your employees. Obligations for the Community Right to Know and Public Safety/Emergency Response sections are also identified. Superfund Amendment and Reauthorization Act (Title III) In addition to the Community Right to Know sections for the Iowa Right to Know law, this manual includes sections of the Superfund Amendment and Reauthorization Act (SARA) of 1986. The important steps employers must follow under that law will be itemized under SARA followed by the Section number. SECTION 1 WRITTEN HAZARD COMMUNICATION PROGRAM MANUAL Part A - Iowa Hazardous Chemical Risks Worker Right to Know Law 1. Administrative Responsibilities The following person is responsible for administering the Hazard Communication Program (HCP). This person has the primary responsibility to oversee the HCP and ensure that it is organized, implemented, maintained and updated as required by the Iowa Hazardous Chemical risks Worker Right to Know Law. Plan Administrator for the city department covered in this plan To ensure an effective HCP, the following supervisors are responsible for carrying out the details of this program in their work areas. Supervisor Division/Department Work area Lynn Miller Public Works City wide Brian Merta Water and Wastewater City wide 2. Hazard Determination The Employer does not manufacture, import or distribute hazardous chemicals. Therefore, the hazardous chemical evaluation conducted by the specific manufacturer of the chemical(s) used is accepted as the hazard determination required by the Iowa Hazardous Chemical Risks Worker Right to Know Law. 3. Inventory of Hazardous Chemicals and (Material) Safety Data Sheets The Employer has developed a list of all hazardous chemicals and the operations where they are used. The intent is to inform employees about the hazardous chemicals they may encounter in the work place. Work area supervisors (identified in the Administrative Responsibilities section) will update the inventory whenever a new hazardous chemical (or mixture) is introduced into that work area. 115 The Employer will obtain and collect the (material) safety data sheets ((M)SDS) for all hazardous chemicals purchased from chemical manufacturers, importers and distributors. It should be noted that with the GHS update to the HCP, (Material) Safety Data Sheets are now referred to as Safety Data Sheets. However there still may be inventory containing MSDS documents as the company is no longer in business or making that specific chemical, thus not being required to update that products SDS. When hazardous chemicals are generated as a by-product from an in-house process, a (M)SDS of the hazardous chemical(s) will be obtained and placed in the (M)SDS file. The intent is to provide a (material) safety data sheet for all hazardous chemicals encountered by employees in the work place. (M)SDSs will be accessible to employees at any point during their work-shift. The (M)SDS book can be found in these locations: Building Location Updated By Public Works Lab West wall Brian Merta Well House #1 Control room Brian Merta Well House #2 Water Plant Control room Brian Merta Maintenance Shop Office Lynn Miller 4. Hazardous Chemical Container Labels The employer understands that the chemical manufacturer, importer or distributor is obligated to provide adequate hazardous chemical labels for their products. Supervisors will evaluate hazardous chemical containers arriving in their work are to ensure that the label, tag, or markings are appropriate. Supervisors will immediately label, tag, or mark any hazardous chemical container so that it: a. Identifies the hazardous chemical and the chemical identity corresponds with the name used on the (M)SDS and chemical inventory. b. Indicates the appropriate hazard warning and pictogram c. Does not conflict with labels from the Department of Transportation. Supervisors will also ensure: a. The label, tag, or marking is legible, in English, and is prominently displayed. b. address. c. Chemical labels for OSHA specific standards comply with those regulations. d. The labels on incoming containers of hazardous chemicals are not removed or defaced unless the container is immediately marked, tagged, or labeled with the required information. e. Stationary processes that contain hazardous chemicals have the appropriate label or alternative warning attached that conveys the required information. f. Contracted employers working at the facility are notified of the labeling procedure and understand the label (warning) system. PART C. Emergency Response a) Globally Harmonized System Labeling Introduction In order to line up with the adaption made by the UN, OSHA revised the Hazard Communication Program to match proper warnings, visuals and classifications of the Globally Harmonized System \[1910.1200 App. C\]. Along with clarification of vocabulary used that has been standardized to provide consistency throughout the world on all chemical products. The GHS provides such a standardized approach, including detailed criteria for determining what hazardous effects a chemical poses, as well as standardized label elements assigned by hazard class and category. This will enhance both employer and worker comprehension of the hazards, which will help to ensure appropriate handling and safe use of workplace chemicals. In addition, the safety data sheet requirements establish an order of information that is standardized. The harmonized format of the safety data sheets will enable employers, workers, health professionals, and emergency responders to access the information more efficiently and effectively, thus increasing their utility. Pictograms There are nine pictograms under the GHS to convey the health, physical and environmental hazards. The final Hazard Communication Standard (HCS) requires eight of these pictograms, the exception being the environmental pictogram, as environmental hazards are not within OSHA's jurisdiction. The hazard pictograms and their corresponding hazards are shown below. HCS Pictograms and Hazards Health Hazard Flame Exclamation Mark -Heating -Reactives (Non Mandatory) Gas Cylinder Corrosion Exploding Bomb -Reactives Flame over Circle Environment Skull and Crossbones (Non Mandatory) 117 Classifications DangerMore severe indication of a chemical Warning Less severe indication of a chemical Categories: Category 1. Highest level of risk/danger Category 2. Second highest level of risk/danger Category 3. Moderate level of risk/danger Category 4. Low level of risk/danger Some category classification will not go down to a level 4, and instead will have various tiers among one category (i.e. 1A, 1B, 1C) when used to categorize the severity of that product hazard. Example Hazard and Precautionary Statements Hazard and precautionary statements outline exactly what can happen with a chemical product and what an individual needs to do to prevent those hazardous occurrences. The hazard statement is identified as the can take to counteract those events in a safe manner. Container Labeling The container label for the chemical must meet requirements outlined in the new adaptation of the GHS and Hazard Communication standard. There are variations in how the container is labeled, based on what the use and function of that container Shipping Container Product identifier Signal word Hazard statement(s) Pictogram(s) Precautionary statement(s) Name, address, and phone number of the responsible party Workplace (Secondary) Container As outlined in the standard \[1910.1200(f)(6)(ii)\] the secondary container for the workplace must contain a product identifier and words, pictures, symbols, or combination thereof, which provide at least general information regarding the hazards of the chemicals. This is meant to give employees appropriate knowledge to access additional specific information under the Hazard Communication program immediately. Refer to the beginning of this section (4). Temporary/Portable Container Material that is transferred into smaller/portable containers designed to use right away are not required to be labeled as the employee will use up the product that is under their control at all times until empty. PART C. Emergency Response b) NFPA Overview The NFPA 704 standard protects the health and safety of individuals who respond to fire and chemical emergencies in facilities or storage locations where the hazards of materials are not readily apparent or known. The standard addresses the health, flammability, instability and related hazards that are presented by short-term, acute exposure to a material during a fire, spill or other emergency-related condition. NFPA 704 is a simple, recognizable and easily understood marking system that provides a general idea of the severity of the hazards of a material. The standard applies to industrial, commercial and institutional facilities that manufacture, process, use or store hazardous materials. Hazard Symbols A system of categories, colors and numbers was created to provide basic hazard information. It enables firefighters and other emergency personnel to easily decide whether or not to evacuate an area or continue with emergency control operations. The three principal categories of identification are Health, The information is presented in a color and spatial arrangement of the numerical ratings: Health Hazard, blue, lternately, the square-on-point field is permitted to be any contrast of color. If this is the case, then the numbers themselves must be colored coded. eactivity with water, only then can the space be used to indicate other unusual hazards. c) HMIS Overview The Hazardous Materials Identification System (HMIS) labeling system was originally designed for the paint manufacturing industry and developed by the American Coatings Association. The program uses a numerical hazard rating system, labels with colored bars, and training materials similar to the NFPA labeling system. Personal protective equipment information is supplied to give employees information needed to protect themselves from hazardous materials they might encounter on the job. HMIS is not required by OSHA, it is merely a solution companies can adopt for labeling and training that meet OSHA regulations. HMIS and NFPA are controlled by other organizations and will not always sync up with what the federal standard outlines. Both NFPA and HMIS have their numbering system reversed compared to the new GHS adaption. GHS the severity goes from 1 to 4, 1 being the highest. With NFPA and HMIS, severity goes from 4 to 1, with 4 being the highest. 5. Employee Information and Training The Employer provides each employee with information and training about the hazardous chemicals used in their work areas. Additional employee training will be conducted whenever a new hazardous chemical is introduced information prior to working at their assignment in the new work area. 119 The Employer will inform employees of: a.The requirements of the Iowa Hazardous Chemical Risks Worker Right to Know Law. b. The operations where hazardous chemicals are used, including hazardous chemicals that are contained in unlabeled pipes. c. The location of the Written Hazard Communication Program, the list of hazardous chemicals, and the corresponding (material) safety data sheets for those chemicals. d. Product information, signal words along with all OSHA regulated (M)SDS sections and content within. The Employer will train employees about: a. The details of the Hazard Communication Program or Iowa Hazardous Chemical Risks Worker Right to Know Law, including an explanation of the labeling system and SDS formatting including sections, statements, pictograms, identifiers and chemical classifications. b. The ways and methods to detect the presence and/or release of the hazardous chemicals they use, such as monitoring devices, visual appearance and odor as described by the SDS. c. The physical and health hazards of the chemicals being used in their work area. d. The ways employees can protect themselves against hazardous chemicals, including good work practices, emergency procedures, appropriate personal protective equipment and safe handling of the product. The Employer generally schedules employee hazardous chemical training and information sessions in conjunction with monthly safety meetings. Other sessions will be arranged as needed. 6. Special Considerations Non-Routine and Special Tasks Work area supervisors will review known physical and health hazards with employees who must do non-routine and special tasks. This instruction will generally occur at the time the work is scheduled. However, in an emergency, the review may occur immediately before the work begins. If appropriate, the review will include: a. Identification of the hazardous chemicals involved. b. Methods of detecting the presence or release of the chemicals. c. Specific physical and health hazards of the chemicals involved. d. Measures the employee(s) can take to protect themselves from these hazards, such as appropriate work practices, emergency procedures and proper protective equipment. e. An opportunity for employees to review the (material) safety data sheets for any of the hazardous chemicals involved. Notifying Contractors of the Hazardous Chemicals Encountered in the Work Place Contractors will be notified of hazardous chemicals that they may encounter and the protective measures that can be taken to avoid these chemicals. to the contractor prior to the time work begins in that area. The (material) safety data sheets for the chemicals noted will be made available to the contractor. Contractors are required to notify the Employer of any hazardous chemical(s) brought into the work site, and shall provide the Employer with a (material) safety data sheet for each chemical. Lab Safety Standard on May 1, 1990. This standard, known as Occupational Exposures to Hazardous Chemicals in Laboratories, is PART C. Emergency Response - from this law indicate who must comply: The law applies 1. Multiple chemical procedures are used. 2. Protective laboratory practices and equipment are available and in common use to minimize the potential for employee exposure to hazardous chemicals. 3. Relatively small quantities of chemicals are used on a non-production basis. The amount of chemicals used can be easily handled by one person. The law does NOT apply if: 1. The function of the laboratory is to produce commercial quantities of materials. 2. The procedures involved are part of a production process or in any way simulate a production process. (A quality assurance \[QA\] laboratory is an example of a work place that is exempt from this law.) Based on this information, it appears that most laboratories in Iowa do not meet the definition of "laboratory each operation be evaluated by management to ensure it does not meet the definition of laboratory scale with any activities conducted. Part B - Community Right to Know 1. The Iowa Hazardous Chemical Risks Community Right to Know Law The Employer will provide access to information regarding the presence or release of hazardous chemicals at this work place to any interested person. a. A review of the available (material) safety data sheet(s). b. A review of hazardous chemicals used at the work place. c. The approximate quantity of the hazardous chemicals stored, used, or released at the location of concern. If the Employer does not consider the request for information to be relevant to public health and safety, or if the request for information is unreasonable, it may be denied. 2. Superfund Amendment and Reauthorization Act (SARA) Section 311. (Community Right to Know Reporting Requirements) The Employer identifies those Extremely Hazardous Substances (EHS) that are on-hand in amounts greater than the reportable quantity (RQ). Work area supervisors identify, within their location/work area, the EHS material and the amounts of hazardous chemic 121 Applicability: This section applies to employers who have (on hand) an extremely hazardous chemical (EHS) in a Examples: Ammonia (500 pounds), Chlorine (100 pounds), etc. All other hazardous chemicals in quantities of 10,000 pounds or more also apply. EPA can issue RQs under which no facility is required to report. (See the EPA List of Lists, Extremely Hazardous Substances.) http://www.epa.gov/ceppo/pubs/title3.pdf Section 312. (Community Right to Know Reporting Requirements) Based on information gathered for Section 311, the Employer sends the required Tier Two form(s) to the SERC, LEPC, and the local fire department on an annual basis. NOTE: Iowa does not accept the Tier One form. Tier Two must be submitted if the 500 lb./TPQ limit for Section 311 is met. The Iowa Division of Labor Services has developed computer software for submission of the Tier Two form. Submit Tier II Inventory Form(s) for the extremely hazardous substances (or other hazardous chemical) identified. That form includes: a. Chemical or common name on the (M)SDS. b. Maximum range of the chemical available at any time during the preceding calendar year. c. Brief description of the manner of storage of the chemical. d. Location of the chemical at the facility. e. Indication of whether the owner wishes to withhold the information from disclosure to the public. (If not stated, this information will be available to the public.) If applicable, the Tier II forms must be sent to SERC, LEPC, and to local fire department yearly. They are due between January 1 and March 1 of every year. Part C - Emergency Response The individuals and organizations named below are responsible for Emergency Response under Part C: Emergency Response Coordinator Fire Chief Mike Sankot Fire Department (name of organization) City of Fairfax Fire and Rescue Department The Emergency Response Coordinator is responsible for making sure the requirements of the Emergency Response section are completed and updated as required. 1. The Iowa Hazardous Chemical Risks Emergency Response/Public Safety Right to Know Law The Employer has made an agreement with the Fire chief of the Fire Department named above in accordance with the regulations governing the Emergency Response/Public Safety section of the Iowa Hazardous Chemical Risks Worker Right to Know Law. The variance is on file at the Fire Department. As stated in this agreement, the Employer has: PART C. Emergency Response a. Sent the list of hazardous chemicals used or stored in significant amounts to the Fire Department. All information was sent by certified mail. b.Sent other information in sufficient specificity as requested by the Fire Chief. c. Posted the appropriate NFPA sign(s) wherever significant amounts of hazardous chemicals are stored. d. agreement. 2. Superfund Amendment and Reauthorization Act (SARA) Section 302. (Emergency Planning) Work area supervisors identify and report (on the List of Hazardous Chemicals) those Extremely Hazardous Substances (EHS) that are present in the workplace. The Employer will notify the Department of Disaster Services if an amount greater than the Threshold Planning Quantity (TPQ) of any EHS is identified. Section 303. (Emergency Planning) The Emergency Response Coordinator shall participate in the local emergency planning effort. Section 304. (Emergency Release Notification) If it is determined that an emergency release of an Extremely Hazardous Substance (EHS) or a CERCLA hazardous substance is above the reportable quantity (RQ) published by the Environmental Protection Agency (EPA), the Employer will immediately report the release to the Iowa Department of Natural Resources (DNR), the Local Emergency Planning Committee (LEPC), and the local fire department. If the release is a CERCLA hazardous substance, the National Response Center will also be notified. A written follow-up report (including updated information) will be sent to the DNR, LEPC and the local fire department after specific details of the response actions and associated health risks are gathered. Section 313. (Toxic Chemical Release Reporting) If applicable, the Employer will complete the Toxic Release Inventory (Form R) report for each chemical meeting the reporting criteria and send it to the EPA and DNR on an annual basis. SECTION 2 - FORMS NEEDED FOR COMPLIANCE 123 Hazard Communication Self Assessment Checklist Element: Hazard Communication - Date: Assessment Team: Instructions: Complete the checklist by answering yes or no to the following questions. Use the identified methods to gather a complete response (D - Document review; I - Interview; V - Visual inspection). Look for discrepancies with the written program and non-conformance with the requirements, along with root causes and potential corrective actions. Criteria Yes No 41. Has a program for hazard communication training been established? DI 42. Identified the plan administrator for handling the Hazard Communication Program? D 43. Has a chemical inventory of the facility been conducted? DI 44. Are chemical injuries tracked for program improvement? DI 45. Are the Hazard Communication procedures reviewed on an annual basis? DI 46. Are periodic inspections conducted and designed to correct deviations or inadequacies? I 47. D stored at, or released from the work place been obtained? 48. All hazardous chemical containers have been labeled with the chemical identity and the V appropriate hazard warning? 49. (Material) safety data sheets are accessible to all employees during their work shifts? V 50. Update the (M)SDS file whenever a new product is brought into the work place or whenever the DIV hazardous ingredients of a chemical mixture are changed? 51. Conduct employee training about the hazardous chemicals and SDSs used in the work place? DI 52. Keep a written record of the training conducted, a summary of the topics covered, and the DI employees who attended the training? 53. Tell contractors about the hazardous chemicals they may encounter and the protective measures I they can take to avoid them? 54. Comply with Community and Emergency Response Right to Know regulations for Iowa, as DI well as the Superfund Amendment and Reauthorization Act (SARA)? Overall Findings (Strengths and Weaknesses): New Goals: 124 THE LIST OF HAZARDOUS CHEMICALS Building: Dept/Division: Product Other Name Name (on container) Code/Color** Manufacturer (referred to)** Location # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 125 VARIANCE AGREEMENT WITH FIRE DEPARTMENT IOWA PUBLIC SAFETY/EMERGENCY RESPONSE I.Purpose of Variance Agreement The Fire Department and the above-named Employer have entered into an agreement in order to meet the intent of the Public Safety/Emergency Response section of the Iowa Hazardous Chemical Risks Right to Know law. II. General Provisions for Signing The details of the Public Safety/Emergency Response section are followed with the exception of those items identified on the reverse side. Sample Entry for Variance 1. more hazardous chemicals meet the posting requirements. That sign is written in letters that are at least 1½-inches high. 2. In those areas where more than three hazardous chemicals meet the posting requirements, only three NFPA signs will be posted. The signs posted will reflect the chemical with the highest health hazard rating, the chemical with the highest flammability hazard rating, and the chemical with the highest reactivity hazard rating. If hazard ratings in any quadrant are 3. Every special hazard for any chemical stored in a significant amount will be posted, but not duplicated. Special hazard symbols will be placed in the appropriate place of the NFPA sign or immediately below the posted signs. III. Signatures This variance of the Emergency Response/Public Safety section of the Iowa Hazardous Chemical Risks Right to Know law is between the Fire Department and the above-named Employer and is duly noted by the signatures below: _________________________________ ______________________________ Fire Department Chief Date ___________________________________ ________________________________ Employer Representative Date 126 Hazardous Chemicals Identification Form for Contractors Purpose: The Iowa Hazardous Risks Right to Know law requires that the above-named employer notify on-site contractors of the hazardous chemicals they may encounter at this work place and the appropriate protective equipment necessary to avoid those hazards. This form is completed by the Employer Representative named below and given to the contractor prior to starting the contracted work in an effort to meet the intent of the law. Identification: A. Contractor Name: ________________________________________________________ Phone: _______________________ B. Contractor Address: ______________________________________________________ C. Project Name/Location: ___________________________________________________ D. Employer Representative/Title: _____________________________________________ E. below: F. The appropriate personal protective equipment and measures necessary to avoid the effects of these chemicals are as follows: G. The (material) safety data sheets for these chemicals can be found at the following location(s): H. Acknowledged receipt of this form: ___________________________________ _________________________________ Contractor Representative Date 127 DISCLAIMER In an effort to promote employee safety and health issues in the work place, the Iowa Association of Municipal Utilities has assembled important information dealing with the Hazard Communication Standard. Due to the wide range of activities conducted by Iowa municipal utilities and the complexity of the law, every specific issue cannot be addressed in this manual. However, the Written Hazard Communication Program presents the major aspects of the law and can be used as a basis to form the Hazard Communication Program for your utility. regulations to determine if additional steps need to be added to this manual. In addition, employers responsible for compliance with the state and federal regulations must be alert to any future changes in the law and keep this manual current and updated. Copyright© 1992 Iowa Association of Municipal Utilities. Copyright is not claimed as to any part of the compliance program. No other reproduction is authorized without the express written consent of the Iowa Association of Municipal Utilities. All other rights reserved. Revised in 2013. Iowa Association of Municipal Utilities th 1735 NE 70 Avenue Ankeny, IA 50021-9353 515/289-1999 Disclaimer of Warranty and Limitation of Liability This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is furnished with the understanding that neither the Association nor its Licensed Agent is engaged in rendering legal or other professional service. If legal advice or other professional or expert assistance is required, warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the quality, performance, and accuracy of the manual is with the holder. 6.7 Lockout-Tagout Program: INTRODUCTION The Control of Hazardous Energy (Lockout/Tagout) Regulation The purpose of this program is to provide written procedures that are used by personnel to effectively control hazardous energy sources while conducting maintenance and service operations on equipment. The intent of this program is to comply with the Occupational Safety and Health Administration (OSHA) lockout/tagout standard (29 CFR 1910.147). The Lockout/Tagout program is developed so that all potential hazardous energy sources are identified, isolated, and locked, or tagged out before starting service and maintenance of equipment where unexpected start up, release of stored energy, or energization could result in injury or death to employees. The basic provisions of the program include: Establishing an energy control procedure for machines or equipment that requires lockout/tagout. The procedure will be reviewed on at least an annual basis. Providing necessary hardware to isolate, block, or otherwise eliminate applicable energy sources. 128 Providing standardized lockout/tagout devices that are made of durable material and are capable of withstanding environmental conditions. These devices will identify the authorized employee who attached them. Locking or tagging energy "cutoff" (isolating) devices before service or maintenance operations begin to protect employees from hazardous energy sources. Using lockout devices on equipment or a machine whenever it is able to accept a lock. Otherwise, tagout devices and additional steps for employee protection are used. Identifying authorized employees to lockout or tagout equipment. Unauthorized persons shall not remove, operate, or tamper with any lockout and tagout devices. Conducting appropriate employee training regarding the lockout/tagout program. SECTION 1 THE CONTROL OF HAZARDOUS ENERGY PROGRAM A. Scope of the Lockout/Tagout Program This lockout/tagout program has been developed in accordance with instructions provided by the Iowa Association of Municipal Utilities and applicable state and federal regulations. Use of the word "utility/city" shall be construed to mean the municipal utility(ies) of the city and such other departments of city government for which this program has been adopted. B. Exceptions to the Lockout/Tagout Program The lockout/tagout procedures are not required in operations where the employee has complete control of "cord and plug" electrical equipment and the unexpected start-up or energization is totally controlled by unplugging the equipment. When continuity of service is absolutely essential, hot tap operations involving pressurized lines (e.g. gas, steam, water, and petroleum products) may be completed without the specified lockout/tagout procedures. However, this exception may only occur when shutdown is impractical, employees are provided adequate protection, and alternative procedures are documented. C. Administrative and Employee Responsibilities 1. Plan Administrator as Lockout/Tagout Authority The following person is responsible for administering the Lockout/Tagout program at the Utility/City. Plan Administrator for the City departments covered in this plan Lynn Miller / Brian Merta The Plan Administrator is responsible for the overall operation and maintenance of the written Lockout/Tagout program. Basic responsibilities include reviewing, coordinating, and implementing the requirements of the Lockout/Tagout program, as appropriate for each work environment. The Plan Administrator has direct responsibility for: Coordinating the necessary employee lockout/tagout training. Developing energy control procedures for specific equipment or machines that require lockout/tagout. Conducting periodic inspections of the energy control procedures used for specific equipment or machines. Implementing appropriate lockout/tagout procedures, and updating the lockout/tagout program as necessary. Maintaining proper records required by the program. Establishing lockout/tagout procedures for "Special Conditions." Informing outside employees of the Lockout/Tagout program and the energy control procedures that must be followed. 129 2.Supervisor Responsibilities of the work area supervisor include: Ensuring that lockout/tagout equipment is available as needed. Enforcing the proper use of lockout/tagout devices and compliance with energy control procedures. Assisting the Plan Administrator with the employee lockout/tagout training program and the periodic inspection of the energy control procedures for equipment or machines in their work area. Reporting changes in operating procedures (or other changes) that affect the Lockout/Tagout program to the Plan Administrator. Making suggestions to update lockout/tagout procedures, as identified. Contacting the Plan Administrator when questions or problems arise concerning the Lockout/Tagout Program. Submitting specific information as required by the Lockout/Tagout program or as requested by the Plan Administrator. Notifying the Plan Administrator when outside contractors are scheduled to work on machines (or equipment) that requires lockout/tagout procedures. 3. Employees Employees are responsible for following the specific guidelines of the Lockout/Tagout Program. Employees that lockout/tagout equipment or machines in the workplace are called authorized employees. Other employees who must work in the area where equipment or machinery is locked or tagged out are called affected employees. A more detailed description of authorized and affected employee responsibilities follows: a. Duties of Authorized Employees Authorized employees play a key role in the Lockout/Tagout program by: Conducting, implementing, and coordinating hazardous energy isolation and lockout/tagout procedures. They alone apply (and remove) locks and tags as required by the program. Notifying affected employees of the application and removal of lockout/tagout devices in their work area. Assisting the Plan Administrator with periodic inspection of machines or equipment and ensuring that energy control procedures are adequate. A list of authorized employees for the Utility is shown on Form LO/TO1. b. Affected Employees Affected employees are uniquely involved in the program since they operate the equipment or must work in the area where the equipment is locked or tagged out. The responsibilities of affected employees are to: Abide by the rules of the lockout/tagout program, Heed the instructions of the authorized employee(s), and Contact their supervisor (or the Plan Administrator) if questions arise regarding the energy control procedures. D. Basic Program Components 1. Lockout/Tagout Procedures The Utility/City abides by the following lockout/tagout procedures when conducting maintenance/service work on equipment or machines involving hazardous energy sources. Form LO/TO2 or LO/TO3 is completed by the Plan Administrator (in conjunction with authorized employees) to identify and outline proper energy control procedures. Form LO/TO2 or LO/TO3 is completed for the specific equipment or machine that requires lockout/tagout. The authorized employee attaches the form to the equipment or 130 machine that is being maintained/serviced and uses it as a guide while conducting lockout/tagout procedures. (Lockout/tagout procedures are outlined on the back side of Form LO/TO2 and LO/TO3.) The Lockout/Tagout procedures are completed in the following sequence: (a) Identifying Hazardous Energy Sources: The first step in the lockout/tagout procedure is to identify hazardous energy sources. For each type of equipment/machine, authorized employees use Form LO/TO2 or LO/TO3 to identify the: Sources of hazardous energy. Magnitude and type of the energy involved. Method or means to control the hazardous energies. (b) Notifying Affected Employees: Prior to applying energy control procedures, the authorized employee who shuts off the power (or isolates equipment from energy sources) and locks or tags out the equipment notifies the affected employees of those intentions. The authorized employee should: Warn affected employees of the energy shut off. Indicate that the equipment is locked (or tagged) out. Specify the reason for the shutdown. (c) Shutting down Equipment: The equipment or machine to be maintained/serviced is shut affixed to the operating switch or control, if "tagout" is used.) (d) Isolating Equipment: The equipment or machine is de-energized, secured, and isolated from its energy sources before maintenance or servicing begins. Energy isolating/cutoff devices are applied, as appropriate (e.g. hasps, covers, chains, etc). (e) Attaching Lockout/Tagout Devices: When equipped to accept them, locks with identification tags are placed on energy cutoff devices to hold them in the "off" position. Tagout is used only when the equipment/machine will not accept locks. Each authorized employee places a personal lock/tag on the energy isolating device before beginning work. (f) Releasing Stored Energy: After lockout/tagout devices are in place, the stored (potential) energy sources involved with the equipment (e.g. electrical, gravitational, mechanical, and/or thermal energy) are disconnected/drained or otherwise made safe by blocking or repositioning components. This may include: Releasing pressurized hydraulic, air, steam, gas, or water lines. Discharging electrical capacitors. Releasing of spring loaded systems. Blocking any rotating, swinging, or elevated parts. (g) Verifying Isolation: The authorized employee verifies that hazardous energy sources are isolated before maintenance/service begins. This is usually accomplished by turning the normal operating controls for the equipment to the "on" position (and then turning it off again). (h) Performing Work: After verifying that the equipment or machine has been isolated, authorized employees do the service or maintenance work as scheduled. 2. Returning Equipment Back to Service (a) After maintenance/service is completed, but before the system is energized, the authorized employee inspects the equipment or machine and sees that: Operating controls are set to the "off" position. 131 Tools and nonessential items are removed, and equipment components (e.g. guards) are in place. Affected employees and other employees in the work area are warned that power is about to be restored. Employees are safely positioned away from the equipment/system. Locks or tags are removed from the energy isolating device(s) by the employees who applied them. The Plan Administrator is contacted for special conditions or if problems arise. (b) After locks or tags are removed, the authorized employee notifies the supervisor that maintenance/service is completed and returns the machine/equipment to the normal operating mode (as directed). 3. Employee Training (a) Employees who may work in an area where this program applies are informed of the general procedures and function of the lockout tagout program, including the restrictions related to starting or re-energizing machines or equipment that are locked or tagged out. In addition, Appendix I is prominently posted to remind employees of the dangers involved. Affected employees are further instructed on the purpose and use of the energy control procedures. Finally, authorized employees receive in-depth training regarding the Lockout/Tagout program. (b) Employee training is conducted by the Plan Administrator or another qualified designee. Employee attendance and the date of these training sessions are to be recorded. (c) Training of authorized employees includes the topics below: A review of the Lockout/Tagout program. The recognition and identification of hazardous energy sources (e.g. electrical, steam, pressure, etc.). An explanation of lockout/tagout procedures and forms. The steps involved when returning equipment back to service. The correct use of lockout/tagout devices. (d) Training is conducted for the affected and authorized employees at least annually and whenever: There is a new or revised energy control procedure. Their job assignment changes. The Lockout/Tagout program is modified. New hazards arise regarding lockout/tagout, such as a new or modified machine, equipment, or process. Employee Re-training Re-train applicable authorized and affected employees when there is: (a) A change in a job assignment. (b) A new energy control hazard presented by a machine, the equipment, or a process. (c) A change in energy control procedures. Conduct additional retraining if: (a) Inaccuracies regarding employee knowledge or deviations from the use of energy control procedures are revealed by the periodic inspection. (b) The Utility/City has reason to believe it is necessary. Introduce new energy control methods (procedures) and re-establish employee proficiency, as necessary. 132 4. Lockout/Tagout Hardware (a) Appropriate lockout/tagout hardware is provided by the Utility/City and may consist of tags, locks, hasps (group lockout devices), chains and other materials for securing, isolating, or blocking equipment from energy sources. (b) The lockout or tagout device indicates the identity of the authorized employee who attaches it. Tagout devices must also be marked with such appropriate warning as "Do Not Start", "Do Not Operate" or "Do Not Energize". (c) Standardized lockout or tagout devices are affixed to energy isolating devices by authorized employees only. (d) Durable: withstand the environmental conditions where they are used (so as not to deteriorate during use). Tags are not to deteriorate in corrosive or wet environments to the point where printing becomes hard to read (illegible). (e) Standardized: within the facility according to shape, color, or size. Tags must have a standardized print and layout (format). (f) Substantial; Locks: hard to remove without the use of bolt cutters or extreme force. Tags: hard to remove. Self-locking (non-releasing), non-reusable, attachable by hand, with at least 50 lbs. breaking strength (e.g. nylon cable tie). 5. Limited Use of Tagout Tagout devices are not used when locks can be applied. Tagout devices are used only when equipment or a machine cannot accept a lockout device. In that case, all other energy control procedures consistent with the program are followed. When possible, additional control measures are taken to backup the tagout device (e.g. opening an extra disconnecting device or removal of a valve handle). Additional control measures will be applied at the discretion of the Plan Administrator. 6. Periodic Inspection of Energy Control Procedures A periodic inspection of the energy control procedures is conducted at least annually by the Plan Administrator and/or authorized employee(s) designated. If the program review shows inadequacies (e.g. additional program training, modifications in procedures, etc.) corrections are made by the Plan Administrator before any further maintenance/service is conducted on the equipment or machine. Form is used as a guide in evaluating overall departmental compliance to the lockout/tagout standard. The specific Certified Energy Control Procedure (Form LO/TO2 or LO/TO3) is modified by the Plan Administrator, as appropriate. 7. Recordkeeping Lockout/Tagout program records are maintained and updated by the Plan Administrator. These records include: (a) Dates and summaries or outlines of employee training sessions. (b) Attendance records at employee training sessions. (c) A current list of authorized employees. (d) The most recent periodic inspection form(s) used to evaluate the energy control procedures for specific equipment/machines involved in the lockout/tagout program. (e) The current certified energy control procedures for equipment or machines involved in the lockout/tagout program. 133 Training records can also be kept and maintained by outside consultants. 8. Enforcement Anyone found removing a lock or tag without authorization is subject to disciplinary action. Failure of any employee to comply with all aspects of this policy subjects the employee to disciplinary action, which will be determined by the severity of the offense. E. Exchange of Information with Outside Employers When the work of an outside employer involves machines or equipment with specified hazardous energy control procedures, the Plan Administrator ensures that there is an appropriate exchange of information regarding the Lockout/Tagout procedures between the Utility/City and the outside employer. Form LO/TO5 (Exchange of Energy Control Procedures) is used for this purpose. Personnel will be informed of any differences (i.e. restrictions and prohibitions) in the two programs, as appropriate, by the supervisor. To better communicate this information, Form LO/TO5 is attached to a copy of the energy control procedure (Form LO/TO2 or LO/TO3), if applicable. The Plan Administrator sees that the proper information is exchanged prior to the time the specified maintenance or servicing begins. F. Special Conditions The intent of this part is to provide continuity of lockout/tagout protection when unusual circumstances exist. 1. Shutdown of equipment for extended periods If equipment that is being maintained/serviced must be shut down for extended periods of time (i.e. awaiting parts, lack of funding, etc.), the personal lockout/tagout device(s) may be removed by the authorized employee and the isolating device(s) will be secured by a lock/tag attached by the Plan Administrator. When maintenance/servicing can be completed or continued under more ordinary circumstances, authorized employee(s) will reattach the personal lockout/tagout device(s) and the one attached by the Plan Administrator may be removed. 2. Group Lockout/Tagout The Plan Administrator designates an authorized employee to be in-charge of those special cases where group lockout/tagout procedures are necessary (e.g. a work crew). The same policy will be followed for each group in the case where more than one group is involved. This designated authorized employee and the other authorized employees on the crew/group will be identified on Form LO/TO2 (Certified Energy Control Procedures). The designated authorized employee is responsible for: (a) Ensuring the continuity of energy control measures for the group (e.g. obtaining an appropriate group lockout/tagout device). (b) Continually monitoring the work to ensure the crew/group employees are not exposed to hazards associated with lockout/tagout. (c) Verifying that all procedures for "returning the equipment back into service" are completed before taking off the crew/group lockout/tagout device. (d) Contacting the Plan Administrator if problems occur (or additional group coordination is necessary) regarding lockout/tagout. 3. Shift Changes It is the responsibility of the off-going shift supervisor involved with the locked or tagged out equipment or machine to ensure that the continuity of that energy control procedure is maintained until the on-coming shift supervisor arrives. The continuity of the program is maintained through a lockout/tagout device 134 attached by the designated authorized employee(s) or one that is attached by the Plan Administrator or the Supervisor. 4. Removal of Locks/Tags by Other Than the Authorized Employee If a lockout/tagout device has not been removed and all work is completed, the authorized employee who attached it will be contacted to remove it. Lockout/tagout devices are removed only by the person who attached it unless the Plan Administrator determines that special conditions exist (e.g. the employee has gone home and has forgotten to remove his/her lock or tag). The Plan Administrator ensures safety of personnel regarding the removal of a lock/tag under special conditions. The Supervisor assists the Plan Administrator with the following steps and safeguards when this special condition is suspected. (a) Notifying the Plan Administrator that a lock/tag has not been removed and his/her assistance is needed to determine if a special condition exists. (b) Verifying that the authorized employee is not at the facility. (c) Making all reasonable efforts to contact the authorized employee and inform him/her that the device has been removed. (d) Removing the lock/tag. This is done by the Plan Administrator after ensuring that appropriate steps for "Returning Equipment Back to Service" have been taken. (e) Ensuring that the authorized employee has knowledge that the device has been removed before resuming work. See Form LO/TO6 (Employee Notification of Lock/Tag Removal). 5. Testing and Repositioning Machines or Equipment When lockout/tagout (and isolating) devices must be removed during maintenance/servicing and the machine/equipment must be re-energized (e.g. repositioning), the authorized employee takes the following sequence of actions: (a) Clears the machine or equipment of tools and materials. (b) Checks the work area to ensure employees have been safely positioned or removed. (c) Notifies affected employees that lockout/tagout devices have been removed. (d) Removes his/her lockout/tagout device, as necessary. (If the authorized employee who attached the lock/tag is not available, the device may be removed according to the procedure described in item 4, above.) (e) Energizes the machine or equipment and proceeds with testing or repositioning. (f) When testing/repositioning is completed, de-energizes the equipment or machine, applies locks and tags, etc. (i.e. follows the Certified Energy Control Procedure, Form LO/TO2 or LO/TO3). 6.8 - Personal Protective Equipment Program: SECTION 1 - PERSONAL PROTECTIVE EQUIPMENT PROGRAM A. Policy Statement It is the policy of this organization to provide employees with a safe and healthy work place. When practical and feasible this will be accomplished through effective engineering and administrative controls (e.g., equipment guarding, isolation of hazardous operations, general and local ventilation, employee training and safe work practices). When effective engineering and administrative controls are not feasible, or when such controls do not provide full employee protection, employees will be furnished and required to use suitable personal protective equipment. 135 The procedures and practices established in this program apply to all situations where personal protective equipment is worn by employees. All personnel are required to comply with procedures and practices established in this program. Failure to comply with the provisions of this program will result in discipline up to and including termination. B. Responsibilities Employer The employer has a duty to: Adopt and implement policies and procedures to protect employee health and safety through compliance with applicable OSHA safety and health standards. Assess work area hazards. Select suitable personal protective equipment. Furnish employees personal protective equipment in accordance with established policies and procedures. Require employees to use PPE where hazards exist. Inspect work place for the proper use, maintenance, storage and disposal of PPE. Maintain records to document regulatory compliance. Employees Employees have a duty to: Inspect, use, maintain and store personal protective equipment in accordance with established practices, training received and applicable safety and health standards. Use PPE where required. Inspect personal protective equipment before each use. Clean and properly store personal protective equipment. Not to use damaged, defective or soiled personal protective equipment. Dispose of damaged, defective, soiled or single use personal protective equipment in an appropriate waste container. C. Assessment of Hazards and PPE Selection General Procedures and Practices Hazard Assessment Personal protective equipment will be selected on the basis of an assessment of work place hazards. Work place hazards that may necessitate the wearing of personal protective equipment include, but may not be limited to: Environmental conditions, such as temperature extremes, noise and harmful dusts, vapors, mists and gasses. Employee exposure to irritating, sensitizing, toxic and corrosive substances. Employee exposure to physical hazards, such as falling, flying, rolling or moving objects, puncturing or penetrating objects and exposed energized electrical conductors. Employee exposure to etiologic agents; including bloodborne pathogens. PPE Selection Criteria The following factors will be evaluated and considered when selecting suitable personal protective equipment: Nature and severity of the hazard. Portion of the body exposed to the hazard and needing protection. Nature of the work to be performed while wearing personal protective equipment. 136 Duration of time that PPE must be worn. Comfort, proper fitting and worker acceptance. References used to select suitable personal protective equipment will include but may not be limited to: OSHA safety and health standards. Instructions provided by tool and equipment manufactures. Selection charts and guidelines provided by PPE manufacture. ANSI Approved PPE Personal protected equipment selected and used by employees will meet or exceed the following ANSI standards: PPE Type Applicable ANSI Standard Eye and Face Protectors Z87.1 current edition Hard-hats Z89 current edition Protective Footwear Z41 current edition Proper Fit To ensure proper fit, comfort and employee acceptance, each employee will be provided with a selection of different styles and sizes of suitable personal protective equipment from which to choose. Employee Involvement Employees will be encouraged to participate in the hazard assessment, and will have input into PPE selection decisions. Hazard Assessment and PPE Selection for Routine Jobs A walk through survey was conducted in accordance with guidelines suggested by OSHA in Appendix B of 29 CFR 1910, Subpart I to assess actual and potential head, face/eye, hearing, respiratory, hand, body and foot hazards that necessitate the wearing of personal protective equipment. Refer to Standard Operating Procedures and/or Job Safety Analysis and/or PPE Assessments for results of the hazard assessment and specified personal protective equipment. Examples of a PPE Assessments and a Job Safety Analysis seen in Attachment 1. Permit Required Confined Spaces Personal protective equipment required for tasks performed in permit required confined spaces will be determined by a hazard assessment of the specific entry and specified on the confined space entry permit. Refer to confined space entry program. Non-Routine Jobs Personal protective equipment required for non-routine jobs will be determined during pre-job planning. Employees will be informed of hazards that necessitate the use of personal protective equipment during pre-job briefings. Refer to standard operating procedures and/or PPE Assessments and/or Job Safety Analysis. Special Requirements Respirators Respirators will be selected, inspected, used, sanitized and stored in accordance with the respiratory protection program. 137 Hearing Protectors Hearing protectors will be selected, inspected, used, sanitized and stored in accordance with the hearing conservation program. D. Care of Personal Protective Equipment General Requirements Personal protective equipment shall be inspected, sanitized and stored in accordance with applicable OSHA regulations and manufactures instructions. Inspection of PPE Employees shall inspect personal protective equipment before each use. Damaged, defective or soiled personal protective equipment shall not be used. Disposal of Personal Protective Equipment Damaged, defective, soiled or single use personal protective equipment shall be disposed in an appropriate trash receptacle. Cleaning and Sanitation of PPE Personal protective equipment shall be cleaned and sanitized as necessary to ensure comfort, effectiveness and safe use. Items contaminated with hazardous chemicals shall be cleaned or disposed of after each use. Storage of PPE To ensure continued effectiveness, personal protective equipment shall be stored in accordance with applicable safety and health standards, and the manufactures recommendations. In all situations personal protective equipment shall be stored in such a manner so as to prevent physical, chemical and environmental damage. E. Employee Training and Information Initial Employee Training All new, existing and transferred employees will receive training before being allowed to perform work that requires the use of personal protective equipment. Initial employee training and information will include: Information on applicable OSHA safety and health standards. Information on employee responsibilities for the use and care of personal protective equipment. Information on the nature and severity of work place hazards that necessitate the wearing of personal protective equipment. Information on the types of personal protective equipment required for specific areas and jobs, and the criteria used to select the equipment. Instruction on the limitations of personal protective equipment. Instruction on the proper care, maintenance, useful life and disposal of personal protective equipment. Refresher Training Additional or refresher training will be provided when: Workplace observations (e.g., the improper use, care and maintenance of personal protective equipment) indicate a training deficiency. 138 Changes in the work place introduce new hazards. Changes in the types of personal protective equipment render previous training obsolete. F. Work Place Inspections Frequent inspections will be conducted to ensure that the policies, procedures and practices established in this program are observed on a day-to-day basis. Specific observations will include: Use of required personal protective equipment by employees. Proper care, maintenance and storage of personal protective equipment. Proper disposal of damaged, defective, soiled or single use personal protective equipment. Employees will be encouraged to participate in the inspections, and all employees will be informed of inspection results. Refer to Section 2, Record Keeping & Audits, for PPE Workplace Inspections Checklist. G. Annual Audit of PPE Program The effectiveness of the personal protective equipment program will be evaluated each year by a select group of supervisors and employees. Subjects of the audit will include: Employee injuries as related to the use and effectiveness of PPE. Problems resulting from the use of PPE, such as worker acceptance, comfort and proper fit. Accuracy of the work place hazard assessment. Employee training. The select group will make specific recommendations for the correction of any program deficiencies. Refer to Section 2, Record Keeping & Audits, for PPE Annual Audit Checklist. SECTION 2 -RECORD KEEPING & AUDIT FORMS Record Keeping All records pertaining to personal protective equipment will be maintained on file, data base or as an attachment to this document. 139 ATTACHMENT 1 Hazard Assessment and Personal Protective Equipment Required Facility: City Water Plant Location: Water Treatment Plant and Wells Job Task / Operation Evaluator / Certified by: SEAL REPLACEMENT Area: Various Date: 4/6/07 Instructions: Complete a Hazard Assessment for each job operation or task at the facility that requires the use of personal protective equipment (PPE). Fill in the location, area, job task / operation, certified by / evaluator and date of the hazard assessment. On the table, first complete the hazard code (code) section to describe the nature of the hazard. Then complete the hazard description for each hazard of the job operation or task. Follow the hazard description with the required PPE for each hazard. Use the part # codes from the PPE Inventory to identify the PPE. Code HAZARD DESCRIPTION Eye/Face Hand Head Foot Body Resp. Hearing D Chemical Noise Electrical Sparks, Heat W V X Thermal Objects(falling/flying) Flying objects or small particles A/B P Ergonomic Radiation Laser or IR Biological Bright light W Other - Welding A=Safety Glasses & Side Shields B=Goggles C= Mono-Shield(face) D=Ear Plugs/Muffs E=Arc-Flash Hood F=Anti-fatigue Mat G=Dust Mask H=Hardhat I=Leather Gloves J=Sol-Vex® Gloves K=Green/Black Rubber Gloves L=Arc-Flash Coveralls M=Nitrile or Latex Gloves N=Heat Resist Kevlar Gloves O=Vinyl Apron P=Steel Toed Shoes Q=Safety Shoe for Electric R=1/2 Face Respirator w/appropriate filter S=SCBA T=Tyvek Suit U=Ventilation V=Welding Gloves W=Welding Mask X=Welding Apron Y=Insulated Rubber and Protective Gloves for Electric Z=FR-Rated Clothing AA=Harness AB=Sand-Blasting Hood AC=Tinted Face-Shield AD=Welding Goggles (Use the appropriate letter for PPE's required) 140 City Water Plant Job: Task: Date: Seal replacement 03-003 5-8-07 Title Of Worker Who Performs Job: Supervisor/Team Leader: Analysis By: Maintenance Department: Section: Reviewed By: Water Plant Treatment Required and/or Recommended Personal Protective Equipment: Safety glasses, Steel toe boots, Welding mask, Welding gloves, Welding jacket, Ear muffs Sequence of Basic Job Steps Potential Accidents or Hazards Recommended Safe Job Procedures Job/Machine specific training ΐȁ Inform operator and Lockout/Tagout - See Lock-out/Tag-out procedures Αȁ Remove mix chamber drain plug and drain into barrel. Chemical exposure Take caution and be familiar with Hazard Communication Βȁ Rinse out chamber. - - Γȁ Disconnect sealing water lines. - - Δȁ Remove bearing, seal body, spring assembly, split type Ergonomic stress Take caution, use appropriate tool if needed. Watch body retaining ring, rubber boot, filler plate, gasket and o-ring mechanics and hand positioning Εȁ If shaft sleeve shows wear, removed using mapp gas torches Heat and spark exposure See PPE Assessment Ζȁ When shaft is cool, remove any burrs on shaft. - - Ηȁ Heat new shaft sleeve and install on shaft. Heat and spark exposure See PPE Assessment Θȁ Once cooled, coat sleeve with grease and install o-ring - - ΐΏȁ Reinstall gasket, filler plate, new o-ring, rubber boot, brass Ergonomic stress Watch hand positioning sleeves, split retaining ring ΐΐȁ Drive outer mechanical seal from bearing and seal body Ergonomic stress Watch hand positioning ΐΑȁ Clean bearing and seal body, it can be media blasted if needed Dust and noise exposure See PPE Assessment ΐΒȁ Install new outer seal and other half of seal and attach housing Ergonomic stress Watch hand positioning ΐΓȁ Inspect bearing and grease, then install on shaft and secure with Chemical exposure Take caution and be familiar with Hazard Communication 4 bolts and nuts. ΐΔȁ Reconnect sealing water lines. - - 141 ATTACHMENT 1 Hazard Assessment and Personal Protective Equipment Required Facility: Location: Job Task / Operation Evaluator / Certified by: Area: Date: Instructions: Complete a Hazard Assessment for each job operation or task at the facility that requires the use of personal protective equipment (PPE). Fill in the location, area, job task / operation, certified by / evaluator and date of the hazard assessment. On the table, first complete the hazard code (code) section to describe the nature of the hazard. Then complete the hazard description for each hazard of the job operation or task. Follow the hazard description with the required PPE for each hazard. Use the part # codes from the PPE Inventory to identify the PPE. Eye/Face Hand Head Foot Body Resp. Hearing Code HAZARD DESCRIPTION Chemical Noise Electrical Thermal Objects(falling/flying) Ergonomic Radiation Laser or IR Biological Other A=Safety Glasses & Side Shields B=Goggles C= Mono-Shield(face) D=Ear Plugs/Muffs E=Arc-Flash Hood F=Anti-fatigue Mat G=Dust Mask H=Hardhat I=Leather Gloves J=Sol-Vex® Gloves K=Green/Black Rubber Gloves L=Arc-Flash Coveralls M=Nitrile or Latex Gloves N=Heat Resist Kevlar Gloves O=Vinyl Apron P=Steel Toed Shoes Q=Safety Shoe for Electric R=1/2 Face Respirator w/appropriate filter S=SCBA T=Tyvek Suit U=Ventilation V=Welding Gloves W=Welding Mask X=Welding Apron Y=Insulated Rubber and Protective Gloves for Electric Z=FR-Rated Clothing AA=Harness AB=Sand-Blasting Hood AC=Tinted Face-Shield AD=Welding Goggles 142 (Use the appropriate letter for PPE's required) 143 <City Department> Job: Task: Date: Title of Worker Who Performs Job: Supervisor/Team Leader: Analysis By: Department: Section: Reviewed By: Required and/or Recommended Personal Protective Equipment: Sequence of Basic Job Steps Potential Accidents or Hazards Recommended Safe Job Procedures Job/Machine specific training 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 144 Attachment 2 City, Conducted «Ç¼¿¼ÇÌ š¸Ã´ÅÇÀ¸ÁÇ ˜¼¿¿ ˜ÂÆÆ Department: By: Area £´¼ÁǸÁ´Á¶¸ ©»Âà Date: 9/1/94 Inspected: Item To Be Inspected Satisfactory IF No Describe Corrective Actions Taken Yes No Hard-Hats Hard-hats worn by employees where head hazards exist Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of damaged or defective hard-hats Hearing Protectors Worn by employees where noise hazards exist Hearing protectors used by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of single use or damaged hearing protectors Face/Eye Protectors Worn by employees where ­¼¿¿¼´À ­¸¿·¸Å ÁÂÇ Ê¸´Å¼Áº Æ´¹¸ÇÌ eye/face hazards exist Eye/face protectors used by º¿´ÆƸÆ. ŸÁ¹ÂÅÀ¸· ¹ »´Í´Å·Æ & ÿ¼¶Ì employees suitable for hazard Free of damage or defects, and œ´¶¸ ©»¼¸¿· ´Ç ºÅ¼Á·¸Å ·¼ÅÇÌ-´Æ¾¸· £´ÇÇ in clean/sanitary condition Properly fitted and worn £¸Ç¸Å ¨¸´·¸Å Ç ¶¿¸´Á Stored in clean location when not in use Proper disposal of single use or damaged eye/face protectors Respirators ¤¥ª «©›š Worn by employees where ----- respiratory hazards exists Respirators used by employees ----- suitable for hazard Free of damage or defects, and ----- in clean/sanitary condition Properly fitted and worn ----- Stored in clean location when ----- not in use Proper disposal of single use or ----- damaged respirators 145 Item To Be Inspected Satisfactory IF No Describe Corrective Actions Taken YesNo Gloves Used by employees where hand hazards exist Gloves worn by employees suitable for hazard Free of damage or defects, and ¿ÂÉ¸Æ µÌ ôÅÇÆ ¶¿¸´Á¸Å ÊÂÅÁ ÂÈÇ-¨¸Ã¿´¶¸· in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of damaged or defective gloves Protective Clothing Used by employees where hand hazards exist Protective clothing worn by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of single use or damaged protective clothing Protective Footwear Used by employees where hand hazards exist Protective footwear worn by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of damaged or defective or single use footwear Comments and Specific Recommendations ¤¸¸· Ç ¶»¸¶¾ ¸Ë»´ÈÆÇ ¼Á ʸ¿·¼Áº µÂÂÇ» 146 Attachment 2 PPE WORKPLACE INSPECTION CHECKLIST City of Fairfax, Conducted Department: By: Area Date: Inspected: Item To Be Inspected Satisfactory IF No Describe Corrective Actions Taken Yes No Hard-Hats Hard-hats worn by employees where head hazards exist Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of damaged or defective hard-hats Hearing Protectors Worn by employees where noise hazards exist Hearing protectors used by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of single use or damaged hearing protectors Face/Eye Protectors Worn by employees where eye/face hazards exist Eye/face protectors used by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of single use or damaged eye/face protectors Respirators Worn by employees where respiratory hazards exists Respirators used by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of single use or damaged respirators 147 Item To Be Inspected Satisfactory IF No Describe Corrective Actions Taken YesNo Gloves Used by employees where hand hazards exist Gloves worn by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of damaged or defective gloves Protective Clothing Used by employees where hand hazards exist Protective clothing worn by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of single use or damaged protective clothing Protective Footwear Used by employees where hand hazards exist Protective footwear worn by employees suitable for hazard Free of damage or defects, and in clean/sanitary condition Properly fitted and worn Stored in clean location when not in use Proper disposal of damaged or defective or single use footwear Comments and Specific Recommendations 148 Attachment 3 Personal Protective Equipment Self-Assessment Checklist Element: Personal Protective Equipment (PPE) Date: Assessment Team: Instructions: Complete the checklist by answering yes or no to the following questions. Use the identified methods to gather a complete response (D - Document review; I - Interview; V - Visual inspection). Look for discrepancies with the written program and non-conformance with the requirements, along with root causes and potential corrective actions. Retain for 5 years. Criteria Yes No 27. Is the written PPE Program available to employees? IV 28. Has a documented hazard assessment been performed for each job task? D (If no, those remaining - ___________________________________________________________ ) 29. Is a plan (schedule) defined for the completion of any additional hazard assessments? D 30. Are the hazard assessments current? DIV 31. Are hazard assessments conducted by a qualified person(s)? DI 32. Are the hazard assessments available to employees? DIV 33. Is appropriate PPE selected and documented for each identified hazard? DIV 34. Is employee input solicited for PPE selection? IV 35. Are PPE requirements included in job operating procedures? D 36. Does the PPE selection address the medical evaluation requirements? DIV 37. Is information on the type of selected PPE available to employees? D 38. Is PPE distributed from controlled locations? DIV 39. Does PPE requiring employee medical surveillance have effective distribution control? DIV 40. Is selected PPE available to employees? IV 41. Are various sizes and types of PPE made available to match employee needs? DIV 42. Do employees use the selected PPE? V 43. Do visitors and contractors use an equivalent level of PPE? V 44. Are employee activities periodically observed to ensure proper PPE use? IV 45. Is PPE in good condition? V 46. Is PPE cleaned and inspected on a daily basis? IV 47. Are those employees using PPE trained on their proper use requirements? DI 48. Is this training reflected in their use of the equipment? V 49. Are PPE use requirements enforced by designated persons? I 50. Are employees aware of the disciplinary policy regarding PPE use? I 51. Are records maintained on hazard analysis, PPE inventory, training and medical surveillance? D Overall Findings (Strengths and Weaknesses): New Goals: 149 DISCLAIMER In an effort to promote safety and health issues in the work place, the Iowa Association of Municipal Utilities has assembled important information regarding the selection, use and care of personal protective equipment. General industrial standards dealing with this topic are contained in Subpart I - Personal Protective Equipment. Due to the wide range of activities conducted by Iowa Municipal Utilities and the complexity of applicable Occupational Safety and Health Administration (OSHA) regulations, not every detail about personal protective equipment can be addressed in this manual. However, this Personal Protective Equipment Manual presents major aspects of the law and can be used as a basis to form specific procedures and practices for the selection, use and care of personal protective equipment at your utility. Managers/supervisors are cautioned to refer to the OSHA Personal Protective Equipment Sources (Title 29, Code of Federal Regulations, Subpart I of Part 1910) to determine if additional procedures/practices need to be added to this model. In addition, those personnel who are responsible for compliance with the state and federal regulations must be alert for any future changes in the law and keep this manual current and updated. Copyright © 1994 Iowa Association of Municipal Utilities. Copyright is not claimed as to any part of compliance program. No other reproduction is authorized without the express written consent of the Iowa Association of Municipal Utilities. All other rights reserved. Revised in 2014. Iowa Association of Municipal Utilities th 1735 NE 70 Avenue Ankeny, Iowa 50021-9353 515/289-1999 Disclaimer of Warranty and Limitations of Liability This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is furnished with the understanding that neither the Association nor its Licensed Agent is engaged in rendering legal or other professional service. If legal advice or other professional or expert assistance is required, the services of a competent professional person should be sought. This publication is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the quality, performance, and accuracy of the manual is with the holder. 150 CHAPTER 7 - EMPLOYEE COMMUNICATIONS 7.1 Privacy Expectations: All employees are responsible for a level of confidentiality that will preserve an environment that supports sincerity, honesty and ethical behavior. However, as public sector employees supported by public funds, employees should not expect privacy in their work, work stations, and/or anything that belongs to the City used to produce that work. As official government records, most types of communication unless there is a reasonable application of exception, may be made available to the public upon written request in accordance with the requirements of Iowa Code and the Federal Public Information Act. 7.2 Bulletin Boards: Bulletin boards will be maintained at a reasonable gathering area for employees which will be used to communicate information as follows: 1. Legally required posters and notices. 2. Safety rules and related information. 3. Management memos and announcements, including job openings. 4. City sponsored social and recreational events. 7.3 Open Door: The City attempts to ensure employment that is enjoyable and rewarding. All employees are encouraged to participate in a free and continuous exchange of questions, suggestions, and information which will improve municipal service, safety, cost savings, or communications and public relations. Employees are urged to first discuss any ideas or suggestions with their Department Head, but employees should also feel free to contact anyone in the City, including the Mayor. 7.4 Electronic Communications Policy: (Attached as Appendix A) 151 CHAPTER 8 - SUBSTANCE ABUSE POLICY 8.1 All Employees: 8.1.1 Purpose: The City recognizes the problems of substance abuse in society and in the workplace. Substance abuse poses a serious threat to our staff and customers. As a direct result of the City's concern for the health and safety of all employees, the City has adopted this Substance Abuse policy pursuant to Iowa law. 8.1.2 General Rule: All of the City's employees, including persons in the service of the City, must report to work and remain free of drugs, intoxicants, alcohol, narcotics, or any other controlled substance. Our substance abuse policy seeks to balance the privacy of employees with the City's need to maintain a safe, productive work environment free from drugs and alcohol. Our intention is to prevent substance abuse and promote its treatment. We encourage those who use drugs and/or abuse alcohol to seek help in overcoming such a problem. 8.1.3 Legal Drugs: An employee may bring to work and take a prescription drug during work hours only if the drug has been prescribed for the employee by a physician or other authorized prescriber and only if the drug is taken in accordance with the prescriber's directions. All prescription drugs must be kept in the container in which they were received from the pharmacy or other dispenser. An employee may bring to work and take an over-the-counter drug during work hours only if the drug is used for its intended purposes and in accordance with package directions and any other directions of the employee's physician. An employee must notify the Mayor and Department Head whenever the employee is using a prescription or over-the-counter drug which potentially may affect safety or work performance. In deciding whether such a drug may affect safety or work performance, the employee should rely on the warnings or cautions that accompany the particular legal drug. The City does not seek information on all drugs that an individual may be taking, but only those where there is an indication that the drug may affect performance, or there is a caution that one should not engage in certain activities which are part of the employee's job duties while taking the drug. The City reserves the right to take appropriate action, including requiring that the employee no longer work, if the use of the drug is impairing or is deemed likely to impair the employee's faculties or work performance. Abuse of legal drugs will not be tolerated. The City will treat abuse of legal drugs in the same manner as the use of controlled substances. 8.1.4 Alcohol or Drug Possession, Transfer of Use: Except as provided in the above rules concerning legal drugs, an employee who brings or attempts to bring onto City premises, has possession of, uses, consumes, transfers, sells, or attempts to transfer or sell, any alcoholic beverage, prescription drug, or any form of controlled substance, or any "look alike" substance, while on City business or at any time during the employee's work day, whether or not on duty, and whether or not on City business or property, is guilty of misconduct and is subject to discipline, up to and including termination, even for the first offense. 8.1.5 Impairment During Work Hours: An employee whose faculties are impaired during work hours due to the effects of alcohol, the illegal use of a controlled substance, or the abuse of a legal drug, is subject to discipline, up to and including termination, even for the first offense. However, if the City chooses to conduct a drug test, discipline will be imposed in accordance with the rules set forth below. 152 8.2 Prospective Employees: 8.2.1 Drug Testing of Prospective Employees Covered by the Federal Motor Carrier Safety Administration: The City will conduct pre-employment drug testing designed to prevent hiring individuals who use illegal drugs or who abuse legal drugs. The prospective employee may provide any information which may be relevant to the drug test. Such information may include identification of prescription or nonprescription drugs currently or recently used, or any other relevant medical information. All precautions will be taken to ensure that the testing will only measure, and the records concerning the testing only make of all these drugs will apply: * marijuana; * cocaine; * opiates (including morphine and codeine); * phencyclidine (PCP); * amphetamines (includingmethamphetamines) To be considered qualified for employment, the City must receive a "negative" report on the drug screen in order for a prospective employee covered by the Federal Motor Carrier Safety Administration to be considered qualified for employment. If such a "negative" report is not received, the prospective employee will not be considered qualified for employment and the application process will be terminated. If a conditional offer of employment has been extended, the offer will be withdrawn. 8.2.2 Scheduling and Cost of Pre-Employment Testing: The actual costs of pre-employment testing will be paid by the City. 8.3 Employees Covered by the Federal Motor Carrier Safety Administration: 8.3.1 Testing Program: The City of Fairfax requires any employee covered by the Federal Motor Carrier Safety Administration (FMCSA) and Department of Transportation (DOT) to participate in our drug and alcohol testing program. The City of Fairfax is a member of the Drug and Alcohol Testing Alliance (DATA). This is a consortium of local government employers that will administer the testing program along with UnityPoint Health Systems and the City of Fairfax. 8.3.2 Required Hours of Compliance and Prohibited Behavior A driver must not consume alcohol while on duty, four hours prior to on duty time, and up to eight hours following an accident or until the employee undergoes a post-accident test, whichever occurs first. A driver shall not report for duty or remain on duty that requires performing safety-sensitive functions when the driver uses any controlled substance, except when the use is at the instruction of a physician who has advised the driver that the substance does not adversely affect the ability to safely operate a commercial motor vehicle. 8.3.3 Designated Representative (DER): The Mayor of Fairfax or his/her designee will serve as the 8.3.4 Collection Facility: 153 8.3.5 Documentation: employee manual. All of these listed DATA documents shall be cons Substance Abuse Policy. 8.3.6 Circumstance for Testing: The FMCSA and DOT require that controlled substances and alcohol test be given to drivers in the following specific circumstances: 1. Pre-employment - see Section 8.2.1 and 8.2.2 of this document for more information 2. Reasonable Suspicion - employee exhibiting behavior to reasonably suspect that such employee is under the influence of alcohol or drugs can include the following list of behaviors. This is not intended to be a complete list nor must the employee be exhibiting more than one of these behaviors: trouble walking or keeping balance; abnormal speech; flushed, pale, or sweaty face; alcoholic or drug odor on the breath; eyes that are bloodshot, watery, droopy, closed, dilated, glassy, or hidden; actions that are resisting, insubordinate, hyperactive, crying, hostile, threatening, drowsy, or erratic; abnormal eating or chewing of gum, candy, mints, or tobacco. 3. Post-accident - when there is a fatality, the driver is ticketed and someone involved in the accident is treated away from the scene, or the driver is ticketed and a vehicle is towed from the scene 4. Random - FMCSA and DOT regulations require each employee driver of a CMV to participate in a random controlled substance and alcohol testing program. The City of Fairfax is a participant in a large pool of employees as part of a consortium. The required percentages of testing must be met by the entire pool. The City is notified of which employees, if any, have been selected for which type of testing each quarter. Employees are required to submit to testing immediately upon notification by management. 5. Return-to-duty - see section 8.3.11 of this document for more information 6. Follow-up - see section 8.3.11 of this document for more information 8.3.7 Expenses of Administering the Testing Program: All expenses of participation in DATA and any required testing expenses shall be paid by the City of Fairfax. 8.3.8 Refusal to Submit to a Controlled Substances Test: An employee who refuses to submit to a controlled substance test will be immediately removed from safety-sensitive functions and shall be subject to disciplinary action up to and including termination. An employee who refuses to submit to a test also must be evaluated by a substance abuse professional (SAP) even if our policy requires the driver to be terminated. Behavior that constitutes a refusal to submit to a test includes: refusal to take the test, inability to provide sufficient quantities of breath, saliva, or urine to be tested without a valid medical explanation; tampering with or attempting to adulterate the specimen; interfering with the collection procedure; not immediately reporting to the collection site; failing to remain at the collection site until the collection process is complete; having a test result reported by an MRO as adulterated or substituted; or leaving the scene of an accident without a valid reason before the tests have been conducted. 8.3.9 Testing Procedures: 1. Alcohol - The collection sites used to conduct the alcohol screening will have the technicians conduct alcohol screenings and confirmation tests which are DOT certified and the collection site will follow all testing protocols as set forth in the DOT regulation CFR 49 Part 40. The collection sites will verify this upon request. 2. Drug - The collection sites used to conduct the DOT drug testing collections will have the collectors conduct drug testing collections which meet the training and certification requirements as set forth by the DOT regulation CFR 49 Part 40 and follow all testing protocol as set forth in the DOT Urine Specimen Collection Guidelines. The collection sites will verify this upon request. 154 8.3.10 Test Results: No action shall be taken under FMCSA or DOT authority against the driver based solely on test results showing an alcohol concentration of less than 0.02. Test results of less than 0.02 are considered negative for the purposes of this employer testing program. Any employee driver who has an alcohol concentration of 0.02 or greater but less than 0.04 shall not perform or continue to perform safety-sensitive functions until 24 hours following the administration of the test. No other action can be taken under FMCSA or DOT authority against the driver based solely on test results showing an alcohol concentration of less than 0.04. If the test of an employee, who is subject to the requirements of FMCSA or DOT drug and alcohol testing, results in an MRO verified positive test for the use of drugs or an alcohol concentration of 0.04 or greater, the employee will be immediately removed from the performance of safety- sensitive functions and referred to an appropriate substance abuse professional for assessment and enrollment in a treatment and rehabilitation program, if recommended. Results of the positive drug or alcohol test and terms of the rehabilitation will remain confidential, except as provided by the federal regulations. Employees who have a MRO verified positive test for the use of drugs or an alcohol concentration of 0.04 or greater shall be subject to disciplinary action up to and including termination. 8.3.11 Returning to Work: To be able to return to work, employees referred to an appropriate substance abuse professional as a result of an MRO verified positive test or breath testing showing an alcohol concentration above 0.04, must immediately cease any substance abuse, must be subject to testing before returning to safety-sensitive duty, must subject themselves to periodic announced testing for a period of not to exceed sixty months, and must comply with all other conditions of the treatment and counseling program recommended by the substance abuse professional. 8.3.12 Expenses of Treatment: All of the expenses of the substance abuse assessment, treatment, and rehabilitation program shall be paid for by employee. The employee health insurance provider may fund a portion as provided in the benefit plan. 8.3.13 Time Off: An employee required to take time off in order to participate in a rehabilitation program will be permitted to use sick leave, vacation time, accumulated compensatory time, and/or unpaid leave. 8.3.14 Treatment and Rehabilitation: Participation in substance abuse treatment and rehabilitation will not result in disciplinary action; however, non-covered duties may be assigned until the MRO or substance abuse professional determines that the employee may return to duty. Successful completion of the prescribed program will be required for the employee to continue employment with the City. 8.3.15 Second Positive Test Results: If an employee is undergoing substance abuse treatment and counseling or has returned to duty upon successfully completing such treatment and rehabilitation and a subsequent test is verified by the MRO as positive, or results in an alcohol concentration of 0.04 or greater, the employee may be terminated. 8.3.16 Conduct and Performance: Employees who undergo substance abuse treatment and counseling under this policy and who continue to work must meet all established standards of conduct and job performance. 8.3.17 Effects of Alcohol and Controlled Substances: Information can be obtained on the effects of symptoms of an alcohol problem; and available methods of intervening when an alcohol and/or controlled substance problem is suspected from pages 8 - 32 of the Employee Education Guide from the CDL Manual from UnityPoint Clinic as revised January 1, 2020. 155 8.3.18 Acknowledgement: read and familiarize myself with the policy and that I must abide by the terms of the policy as a condition of employment with the City of Fairfax. ______________________________________ ___________________ Name Date 156 CHAPTER 9 - MISCELLANEOUS 9.1 General Housekeeping: It is important that you take pride in your work area and that you keep it neat and orderly at all times. Having your work area well organized contributes to efficiency and it creates a good impression for our citizens. 9.2 Use of City Property, Equipment, and Vehicles: City property, equipment, and vehicles essential in accomplishing job duties are expensive and may be difficult to replace. When using City property, you are expected to exercise care, perform required maintenance, and follow all operating instructions, safety standards, and guidelines. Before using City of Fairfax equipment and vehicles, all employees must demonstrate that they have received any Department Head will authorize competent employees to operate equipment and vehicles. When driving on City business, you are expected to observe area traffic laws. This includes wearing of seat belts and no texting while driving and only hands-free operation of a phone while driving. Tickets that result from an infraction of traffic laws or parking violations are your own responsibility. Notify the Mayor and Department Head if any equipment, machines tools, or vehicles appear to be damaged, defective, or in need of repair. Prompt reporting of these situations could prevent deterioration of equipment and possible injury to employees or others. Your Department Head can answer questions about your responsibility for maintenance and care of equipment or vehicles used on your job. The improper, careless, negligent, destructive, or unsafe use or operation of equipment or vehicles can result in disciplinary action, including termination. If the City of Fairfax management determines there is a benefit to the City for an employee to take home a city-owned vehicle and use this for commuting, this is considered a taxable benefit for the employee. The City will use the IRS Commuting Valuation Rule to determine the value. The 2024 value is $1.50 per one-way commute ($3.00 per round trip). The city-owned vehicle must only be driven by the employee and not for any personal purposes other than commuting or de minimis personal use (such as a stop home). Several City of Fairfax facilities are equipped with a security system. All employees using these facilities shall arm and disarm the security systems as trained and instructed by their Department Head. Employees shall report immediately if any parts of the security systems are not properly functioning. 157 9.3 Dress Code: We expect our employees to be neatly groomed and to dress appropriately for the work they are doing. We do not allow our employees to work in torn or soiled clothing, or attire that may be offensive to our citizens or other employees. Inappropriate attire will be addressed on a case-by-case basis. 9.4 Uniforms: The City of Fairfax wants the maintenance, parks, and building departments full-time employees to give a similar presentation to the community. Employees, while at work for the City of Fairfax, shall at all times wear any needed safety and/or protective gear as required by OSHA regulations. Employees, while at work for the City of Fairfax, shall at all times wear clean, non-damaged clothing. In addition to the typical clothing that covers the torso and legs, the following employees shall wear: Building Administrator, City of Fairfax shirt with city name and steel-toed or composite-toed work boots Parks and Recreation Director, City of Fairfax shirt with city name while out in the parks and steel- toed or composite-toed work boots while doing activities for which these boots are required by OSHA Full-time Maintenance Department employees, City of Fairfax shirt with city name and employee name and steel-toed or composite-toed work boots while doing activities for which these boots are required by OSHA Part-time Maintenance Department employees, steel-toed or composite-toed work boots while doing activities for which these boots are required by OSHA Part-time Parks Department employees, steel-toed or composite-toed work boots while doing activities for which these boots are required by OSHA Each full-time maintenance department, parks department, and building department employee shall be allocated up to $800.00 to use for the purchase, repair, or replacement of clothes or boots required while working for the City of Fairfax. The $800.00 shall be for the fiscal year, which runs from July 1 June 30. Employees requesting to draw funds from this available money, shall fill out a reimbursement form, signed by the Department Head, with itemized receipts. The City will keep track of the usage of the $800.00. Reimbursement will be made after it is verified the employee has this amount available and the City Council approves the claims. If an employee incurs expenses greater than this amount in a fiscal year, there will be no reimbursement over the $800.00 amount. If an employee incurs expenses less than this amount in the fiscal year, there will be no cash given for the difference, another employee cannot use the spending authority, nor can the amount be carried over to the next fiscal year. Any non-safety clothing purchased and reimbursed shall be taxable through payroll. Employees own these clothes and are responsible to launder them. These clothes will not be required to be returned if the work has made the clothes un-washable in the home environment. 9.5 Safety Equipment: Each Department Head shall be trained concerning OSHA standards for Personal Protective Equipment (PPE) requirements. The Department Head is responsible for assigning work tasks and will determine if PPE is required. If so, they are also responsible to see the PPE is used. The City of Fairfax provides hearing protection as needed for safety while performing work tasks. 158 The City of Fairfax provides any head protection as needed for safety while performing work tasks. The City of Fairfax provides any gloves as needed for safety while performing work tasks. The City of Fairfax provides high visibility vests and jackets as needed for safety while performing work tasks. As part of the uniform annual reimbursable amount, all maintenance department employees, full-time parks department employees, and building inspectors are required to wear steel-toed or composite-toed work boots when required by OSHA. The City of Fairfax provides non-prescription safety glasses (both clear and tinted) as needed for safety while performing work tasks. The City of Fairfax will participate in the cost of purchasing prescription safety glasses as needed for safety while performing work tasks. Each employee requiring prescription glasses and performing work tasks which need safety glasses according to OSHA standards will be given a $400.00 annual credit to purchase non-tinted prescription safety glasses. If the glasses cost more than the $400.00, the employee will be required to pay the difference. If the glasses cost less, the difference will not be paid to the employee. If the employee wishes to purchase tinted prescription safety glasses the City of Fairfax will not cover any of the cost. 9.6 Cell Phone: The City of Fairfax provides a cell phone to each of the full-time employees, mayor, and fire chief. These are provided to make the employees more accessible. The employees shall reimburse the City of Fairfax for any personal uses that messages, ring tones, and internet access. If any of the employees listed above who wish to use their personal cell phone for work purposes to avoid dual phones, the City of Fairfax will reimburse the employee $25.00 per month for a non-smart phone and $55.00 per month for a smart phone with a personal data and texting plan. This reimbursement will be ran through payroll and if required by the IRS, will be subject to payroll taxes. The phones must be used during work and for after business hours work emergencies. The use of a personal cell phone for work purposes brings this device under the requirements of public records per Chapter 22 of the Code of Iowa. The public has the right to examine and copy a public record and to publish or otherwise disseminate a public record or the information contained in a public record. By choosing to use a personal cell phone the employee agrees to make available all phone records if required by law. This may require that the phone be turned over to the City of Fairfax to access the records or signing any needed releases to access information through your phone service provider. 9.7 Computers: The City of Fairfax provides computers to staff and elected officials as needed for business purposes. These computers are the property of the City of Fairfax. 9.8 Professional Memberships/Endorsements/Licenses/Certifications: The City of Fairfax wants their employees to be active in professional advancement activities and will consider all requests to assist our employees in this effort. Which, if any, costs associated with these activities that will be paid by the City of Fairfax will be determined by management. The City of Fairfax has adopted certification schedules which outline payroll increases tied to some certifications. The City Council must pre-approve any training working towards a certification listed on these schedules. Once 159 approved by City Council the employee may take the training with the City paying all associated costs as outlined in Section 9.9. The payroll change listed in the schedule will take effect on the date the certification is issued. Membership fees or dues for professional organizations, endorsement fees, and required license expenses related to and the employee, will be paid by the City of Fairfax If such memberships, endorsements, or licenses are of marginal or no benefit to the City of Fairfax, management may determine that only a portion or none of the fees may be reimbursed. Employment with the city is required two (2) years following certification or the employee will reimburse the City for all certification/education related expenses incurred. 9.9 Training Assistance: The City of Fairfax believes in investing in the professional development of its employees. There are many different professional training seminars or conferences available to employees. Some of these training sessions are required to maintain professional endorsements or licenses. Information about training opportunities will be given to management so they may authorize the appropriate employees to attend. The City of Fairfax will pay for registration costs, study time, travel costs as outlined in Section 4-13 Business Travel, testing costs, and license or certification costs as outlined in Section 9.8 Professional Memberships/Endorsement/Licenses/Certifications, for all approved job-related training, except for fire department members. Fire department members are paid on a salary basis for officers plus a per call or fire report amount. The City of Fairfax will not pay a fire department member for training time, study time, or testing time. The City will pay fire department members for travel costs as outlined in Section 4-13 Business Travel, testing costs, and license or certification costs as outlined in Section 9.8 Professional Memberships/Endorsement/Licenses/Certifications. In the event an advanced educational seminar or course becomes available that is directly related to the job assignment and responsibilities of an employee for the City of Fairfax, the employee may request financial assistance to attend. This request must be made in writing prior to beginning the seminar or course in question. The actual amount of assistance granted is at the discretion of management. This could range from nothing up to the full amount of tuition for the course. Assistance will be granted on a reimbursement basis and only if the course is completed satisfactorily Employment with the city is required two (2) years following completion or the employee will reimburse the City for all education related expenses incurred. 9.10 Disaster Recovery Plan - Computer Based Policy (Attached as Appendix B) 160 CHAPTER 10 - SEPARATION 10.1 Employee Separation: The City expects you to provide written notice to the Mayor and Department Head at least two weeks before the effective date of your resignation. Employment records will reflect the last day worked as the date of termination. You will receive pay through the last day worked. If you resign or are otherwise terminated, you will be paid for unused awarded paid vacation, personal, or compensation time. All City of Fairfax property must be returned immediately when employment with the City ends. This includes, but is not limited to: keys, city credit card, vehicles, city ID, tools, computers, city telephone, manuals, and any other City of Fairfax items. 161 CITY OF FAIRFAX ELECTRONIC COMMUNICATION POLICY (Appendix A) E-MAIL AND INTERNET ACCESS SYSTEMS A.l Purpose: The purpose of this policy is to provide guidelines regarding the use of the internet and e-mail services by employees of the City of Fairfax. The City encourages the use of e-mail and internet services by authorized and trained employees to support the access and exchange of information. As such, employees shall use these services responsibly and in full compliance with this policy. A.2 Privacy: Under routine circumstances, the City will not monitor employee e-mail messages or internet usage logs. However, the City reserves the right to do so without prior notification to employees. Employees who use the e-mail and internet systems cannot assume the systems afford them any level of confidentiality or privacy. As City-owned resources, the e-mail and internet systems are subject to assessment and inspection by the Mayor and Department Head or other personnel authorized by same. Employees should therefore not assume electronic communications are totally private and should transmit highly sensitive or confidential information in other ways. Such assessments and inspections may be undertaken when there is a legitimate purpose to do so, such as: 1. For the transfer of messages and files from one employee account to another employee account. 2. When there is evidence of, or suspicion of, use of the e-mail or internet access systems in violation of this policy or any City policy. 3. When there is evidence of, or suspicion of, a breach of the security of the e-mail or internet access systems. 4. To assist in the investigation of a crime. 5. When required by law to do so. A.3 Security: Generally e-mail and internet access systems are not secure. Employees using these systems should assume their messages can be intercepted and monitored by unauthorized persons. Each employee is directly responsible for any and all activity occurring under his or her e-mail name or internet account. If an employee suspects the security of his or her e-mail or internet account has been breached, he or she shall notify a Department Head as soon as reasonably possible. A.4 Public Information: E-mail (both internal and external via the internet) is considered to be a public record and may be subject to public disclosure in accordance with applicable law. A.5 Electronic Records Retention Policy: The City of Fairfax is committed to convert records to electronic format. This improves retrieval, lessens the need for physical storage, and is more secure. 162 Employees have the obligation to review their e- to be retained beyond 90 days shall be kept, preferably electronically. On a weekly basis, each employee shall review their e-mail and delete all messages no longer needed or required to be retained. A.6 Acceptable Use Guidelines: Employees shall use the e-mail and internet access systems only for the purpose of conducting the business of the City, except as noted in the following section. While using the e-mail and internet access systems, employees shall follow established e-mail and internet customs, rules and guidelines. For example: 1. Employees shall use the e-mail and internet access systems for lawful purposes only. 2. Transmission of or access to material (text or images) that could be construed as harassing, threatening, obscene, sexist, racist, slanderous, fraudulent, or unethical is prohibited. 3. Transmission of documents in violation of copyright laws is prohibited. 4. Use of the e-mail or internet access systems for commercial purposes or for personal profit is prohibited. 5. -mail or internet systems, or the systems of any other entity, by the distribution of a computer virus, worm, or other malicious file, or by overloading a system, is prohibited. 6. Unauthorized access to another i 7. Downloading e-mail attachments or other files at a PC not having an active virus detection program running is prohibited. 8. Opening a message from an unknown source is strongly discouraged (such messages often contain computer viruses and should be deleted immediately) 9. Downloading software in violation of a software license agreement is prohibited. 10. Use of the e-mail or internet access systems for gaming, political activity, and fund raising or religious promotion is prohibited. 11. Use of the e-mail or iweb; engage in on-line forums, chat rooms, or newsgroups; and visit popular sites of personal interest is prohibited. 12. Employees shall properly identify themselves when sending e-mail or when using any internet service, and shall clearly distinguish between personal opinion and City policy. 13. Employees shall not engage in unauthorized transactions which may incur a cost. 14. Employees shall respect the privacy of others. 15. Employees shall not send or contrive to send or retransmit anonymous messages or publicize proprietary or confidential information. 16. Employees shall not subscribe to mail lists or list servers that are not related to official business or to professional enhancement in support of a mission. A.7 Personal Use: Employees may use the e-mail and Internet access systems for personal use provided that such use: 1. Is incidental and infrequent. 2. workers 3. Does not generate a direct cost to the city. 4. Does not interfere with or burden the e-mail or internet access systems. 5. Does not consume large system resources or storage capacity or otherwise deplete system resources available for business activity. 6. Is in compliance with all other sections of this policy. 163 reflect ethical behavior and appropriate use of city resources. Examples of acceptable personal use include 1. Personal conversation incident to a business-oriented e-mail message. 2. Infrequent transmission of brief, personal e-mail messages. 3. Infrequent access to a web-based e-mail service to transmit personal e-mail messages. A.8 Violations: -mail and internet access systems is a privilege afforded to authorized users. This privilege may be revoked at any time for violations of this policy. The Mayor and Department Head or a designee will evaluate said violations on a case-by-case basis. Department Heads are responsible for enforcement and reporting violations of this policy or misuse of City equipment to the Mayor. Employees found to have violated this policy, or to have engaged in illegal or unethical practices, will be subject to disciplinary action, up to and including termination and criminal prosecution. The City expressly reserves the right, without prior notice, to alter and update this policy from time to time. Any A.9 Disclaimers: A wide variety of information exists on the internet. Some persons may find part of that information to be offensive or otherwise objectionable. Employees should be aware the City has no control over and can, therefore, not be responsible for the information on the Internet other than what we as an organization place there. 164 CITY OF FAIRFAX DISASTER RECOVERY PLAN COMPUTER BASED POLICY (Appendix B) B.l Passwords: Department Head should have record of all passwords in order to ensure continued business operation. When additional users will be using a computer or software, they will be assigned a password of their own. Confidentiality is a requirement. All passwords will be changed when employment is terminated. B.2 Log Off/Time Out: Each computer must be logged off if the user will be away for more than an hour. B.3 Running Anti-Virus Programs: The city shall scan for viruses and check for updates every day the city office is open. B.4 System Backup: A full system backup shall be kept on the server and in a cloud-based program. B.5 Disaster Recovery Plan: In the event of fire, windstorm, or other type of disaster, the City of Fairfax must have a disaster recovery plan in place to ensure continued service to citizens of Fairfax, and to maintain the ability to record, process and report financial data. In the event that City Hall should be damaged or destroyed, temporary office facilities will need to be established at a different location in Fairfax. Replacement computers and printers will be purchased immediately. In order to protect data already existing on the computers, a full system backup shall be completed each day with the backup stored on the server and in a cloud-based transactions will have to be recreated. While any type of disaster will impose a hardship on the City, taking these steps should minimize the damaging effects of such an event. B.6 Computer-based Systems Policy Review and Amendment: This Computer-Based Systems Policy shall be reviewed every four years or more frequently as appropriate. ! 165 CITY OF FAIRFAX STATEMENT OF UNDERSTANDING AND RECEIPT OF PERSONNEL POLICY THE UNDERSIGNED acknowledges that he/she has been provided with a copy of the Personnel Policy for the City The contents of this manual are presented for information only. The plans, policies, and procedures described are not conditions of employment. The City of Fairfax reserves the right to modify, revoke, suspend, terminate or change any or all plans, policies, or procedures, in whole or in part, at any time with or without notice. The language, which appears in this manual, is not intended to create nor is it to be construed to constitute a contract between the City of Fairfax and any one or all of its employees. Dated this ____________ day of_____________________ , ______________ . ______________________________________________________ ______________________________________________________ 166