RMWEA Safety Committee WASTEWATER TREATMENT PLANT Safety Performance Survey: Jan. 1, Dec. 31, 2014

Transcription

1 RMWEA Safety Committee WASTEWATER TREATMENT PLANT Safety Performance Survey: Jan. 1, Dec. 31, 2014 Details of the Organization Your Name: Plant Manager s Name: Organization Name: Mailing Address: City/St/Zip: Phone: Fax: Wastewater Treatment Plant Avg. Daily MGD: Population Served: Number of Full-Time employees: Number of Part-Time employees: Survey includes: (Please check one) Wastewater treatment plant staff only Wastewater treatment and collection system staff Summary of your accident statistics for The summary table only looks at the following injury classifications. Basic first aid cases are not recordable. Lost Workday Injury: Employee is not able to return to his/her next regularly scheduled shift. Restricted Duty Injury: Employee cannot perform all the duties normally conducted with his/her position. Recordable Injury: Employee receives medical treatment above and beyond basic first aid (i.e. prescription medicine). A Total 2014 employee hours worked. B. Total number of lost workday and restricted duty injuries. C. Total number of lost workdays. D. Total number of restricted duty workdays. E. Total number of medical only recordable injuries. F. Total number of fatalities. G. Total number of recordable injuries (add rows B, E, and F together from this table) H. Total recordable injury rate (Row G) x 200,000 (Row A) I. Lost workday/restricted duty injury rate (Row B) x 200,000 (Row A) For each of the organization s recordable injuries, please fill in the info below. Examples for the column subjects are provided below. As space allows, please be as descriptive as possible. # Years of work experience of employee Cause of injury Type of Injury Part of Body Injured Location of Accident Injury Classification (circle one and give # of days, if applicable) 1. Lost time 2. Lost time 3. Lost time 4. Lost time 5. Lost time 6. Lost time 7. Lost time 8. Lost time 9. Lost time *Additional pages may be added as necessary. Causes of injury: Struck by moving object, Struck against object, Excessive lifting/pushing/pulling, Awkward position, Repetitive motion, Fall to different level, Falls on same level, Contact with electrical current, Contact with temperature extremes, Chemical contact, Caught in/under/or between objects, Animal or insect bite, Occupational illness (hearing loss, respiratory, stress), Motor vehicle, Other? Type of Injury: Chemical burn, Thermal burn (fire, electrical, temp.), Foreign body, Fracture, Irritation/reaction (bites, stings), Respiratory, Strain, Sprain, Contusion, Laceration, Occupational illness (hearing loss, respiratory, stress), Other? Location of Accident: Preliminary treatment (screens, grit removal), Tanks or settling basins/pits/ponds, disinfection process, Sludge handling (digesters, centrifuges, belt press), Manholes (in and around, include traffic sites), Pump stations, Wet or dry wells, Walkways, Laboratory, Offsite, Roadways, Maintenance shop/yard, Other?

2 RMWEA Safety Committee WASTEWATER TREATMENT PLANT Safety Performance Survey: Jan. 1, Dec. 31, 2014 Health and Safety Program The responses below will help the RMWEA Safety Committee recognize organizations with exceptional safety practices and identify key areas to support focused outreach efforts. Please check mark the appropriate response. In Place Being Developed Not Applicable 1. Does your organization have a health and safety manual? If yes, please identify any specific chapters/procedures below: Accident Investigation Bloodborne Pathogens / Exposure Control Crane/Hoists Confined spaces Personal Protective Equipment Electrical Safety (Arc Flash) Emergency Preparedness Fire Prevention (extinguishers, etc.) First Aid/CPR Fall Protection Hot work Hazard Communication Respiratory Protection Laboratory Safety (Chemical Hygiene) Lockout/tagout Vehicle Safety 2. Is safety training conducted for employees? If yes, please identify the classes below: Accident Investigation Bloodborne Pathogens / Exposure Control Confined spaces Crane/Hoists Personal Protective Equipment Electrical Safety (Arc Flash) Emergency Preparedness Fire Extinguishers First Aid/CPR Fall Protection Hot work Hazard Communication Respiratory Protection Lockout/tagout Forklift Other: 3. Does your organization have a written safety policy? Yes No 4. Are accidents reported in a timely manner and investigated? Yes No 5. Do employees attend regularly scheduled safety meetings? Yes No 6. Is there a designated employee in charge of health and safety? If yes, please list name, number, and Yes No 7. Are facility safety inspections conducted? If yes, how often? 8. Would you be willing to fill next year s annual survey on-line instead of a paper copy if this option was available? Yes Yes No No Are there any unique safety initiatives that you would like us to know about? If so, please describe this below and provide a point of contact. This info may be used to recognize outstanding safety efforts by our membership. A member of the RMWEA safety committee will contact you before any information is distributed.

3 Ms. Brenna Durkin Littleton/Englewood Wastewater Treatment Plant 2900 S. Platte River Drive Englewood, Colorado 80110

4 Rocky Mountain Water Environment Association (RMWEA) Occupational Safety Committee Dear RMWEA Member: The RMWEA Safety Committee performs several functions that are of benefit to our industry. These functions include providing safety speakers at various operator seminars and organizing seminars that deal strictly with safety topics. In addition, the Safety Committee mails this Safety Survey on an annual basis, compiles the data, publishes the summary data in Rumbles, and recognizes treatment plants with outstanding safety efforts and records. To better understand the safety performance and efforts at each organization, the survey was expanded this year to a two page format. Please note that it is not our intent to highlight organizations with less than perfect safety records. The objective of this survey is to provide a data summary that we might all use to improve our safety programs. If your safety data is in a format that will not allow you to answer some of the questions, please fill in what you can and attach a copy of your safety data or information with your submission. The committee will attempt to interpret and incorporate your data into the safety survey format. We would much rather get the data in your format rather than none at all. The Safety Committee will present certificates of recognition to those systems with outstanding safety records at the RMWEA Annual Conference and publish the tabulated data. Occupational Safety Committee Safety Survey: Jan. 1, Dec. 31, 2014 Survey Instructions: After you complete the survey, please send it to the committee via postal mail or fax using the contact information below. Mailing Address: Littleton/Englewood WWTP c/o: Brenna Durkin 2900 S. Platte River Drive Englewood, CO Fax: (303) If you have any questions, please contact Brenna Durkin at: Phone: (303) bdurkin@englewoodgov.org Questions/Comments for the RMWEA Occupational Health & Safety Committee? Contact Brian O Malley at (303) or bomalley@mwrd.dst.co.us. Not a member of RMWEA? Join now and enjoy the many benefits of membership such as high quality technical journals and manuals, technical conferences, operator training programs, local and regional legislative and regulatory activities, educational programs, affiliations with other professional organizations, and much, much more! Visit for more details We will tabulate the data beginning 3/1/15 and would greatly appreciate your response by 2/28/15. Thank you for your participation! Sincerely, RMWEA Occupational Safety Committee

5 RMWEA Safety Committee c/o Littleton/Englewood WWTP 2900 South Platte River Dr. Englewood, CO