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PARTNERSHIP AGREEMENT
BETWEEN
DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
PHILADELPHIA AREA OFFICE
AND
AKER PHILADELPHIA SHIPYARD, INC.
AND
THE PHILADELPHIA METAL TRADES COUNCIL
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Opening Statement
In a cooperative effort to foster safe and healthful worksites and meet the
Occupational Safety and Health Administration’s (OSHA) strategic goal of
improving the safety, health, and well-being of the nation’s workforce, OSHA
and Aker Philadelphia Shipyard, Inc. (Aker Philadelphia Shipyard) and the
Philadelphia Metal Trades Council have agreed to the joint implementation of
this Safety Partnership.
The primary goal of this partnership is to develop a cooperative
relationship with Aker Philadelphia Shipyard to assist it in creating safety
and health management systems at the worksite that will insure its employees
are protected from injuries and illnesses and will encourage the company’s
application to VPP (Voluntary Protection Program). The partnership is to be
established with Aker Philadelphia Shipyard and the Philadelphia Metal
Trades Council for a two-year period.
I. Identification of Partners
Philadelphia OSHA Area Office
Aker Philadelphia Shipyard, Inc.
The Philadelphia Metal Trades Council
II. Background, Purpose and Scope
By entering into this agreement, OSHA, Aker Philadelphia Shipyard and the
Philadelphia Metal Trades Council agree to work cooperatively to improve the
safety and health program at Aker Philadelphia Shipyard and to eliminate the
hazards at the site that are the cause of injuries and illnesses to its
workers and contractors.
Employee rights which are guaranteed under the OSH Act shall not be
infringed upon as a result of this partnership. This partnership does not
preclude employees and/or employers from exercising any right provided under
the OSH Act, nor does it abrogate any responsibility to comply with rules
and regulations adopted pursuant to the Act.
It is anticipated that routine worker involvement in the day to day
implementation of worksite safety and health programs will be assured,
including worker participation in team meetings, job hazard analyses, safety
and health program reviews, and accident investigations
III. Goals, Strategies, Measures (See Appendix B for full statement).
Aker Philadelphia Shipyard, the Philadelphia Metal Trades Council and OSHA
will work in partnership to achieve the following goals:
Promote, institute and maintain a safety and health management system based
on OSHA’s 1989 Guidelines which incorporates these four basic program
elements: Management Leadership and Employee Involvement; Worksite Analysis;
Hazard Prevention and Control; Training
Reduce or maintain injury and illness rates to/at levels that would meet
eligibility requirements for VPP (3 year average TCIR and DART Rates (or
equivalent rates) are below at least 1 of the most recent 3 years BLS rates
for the established NAICS code).
Encourage Aker Philadelphia Shipyard’s participation in OSHA’s Voluntary
Protection Program (VPP).
IV. Partnership Management
The Partnership Management Team (PMT) will facilitate the direction of the
Partnership. The PMT will consist of the representatives listed in Appendix
A. OSHA’s representative will serve in an advisory capacity to the PMT and
will perform duties as outlined in Section VI.
The PMT will perform a variety of activities to facilitate the success of
the Partnership, including:
Using the OSHA Challenge Program Stages for General Industry (Appendix C) as
a guide, select and assign the steps and duties needed to carry out Aker
Philadelphia Shipyard’s commitments under the partnership agreement.
Encourage Aker Philadelphia Shipyard’s participation in VPP(1).
Meet at least quarterly to track Aker Philadelphia Shipyard’s progress under
the agreement and to make adjustments as needed.
Resolve partnership conflicts and issues.
Communicate partnership activities, including best practices and successes,
throughout Aker Philadelphia Shipyard, Inc.
Prepare an annual evaluation with final approval by OSHA. The evaluation
will be due each year on the effective date of the partnership, and will
follow the written format shown in Appendix D.
V. Aker Philadelphia Shipyard agrees to:
Visibly lead in the design, implementation, and continuous improvement of
the site’s safety and health policies and activities.
Implement safety and health programs with a commitment that routinely
extends beyond what is required by OSHA regulation.
Provide the necessary resources of staff, time and money to ensure that all
persons on the worksite are protected from injury and illness hazards.
Ensure that all employees, from the top-level management down, have clearly
written and defined safety and health responsibilities.
Ensure that written safety and health management systems are implemented
that effectively address worksite hazards by identifying and tracking them
to guarantee their correction and control.
Ensure training programs are implemented that help employees clearly
understand their occupational hazards and how to control them.
Conduct baseline safety, health and employee surveys and share results with
OSHA.
Share ongoing measurement data with OSHA needed to evaluate the
partnership’s effectiveness.
VI. OSHA agrees to:
Work cooperatively with Aker Philadelphia Shipyard to provide safety and
health information, technical assistance, and training (as resources allow),
to facilitate safety and health management systems improvements.
Conduct an initial evaluation of the Aker Philadelphia Shipyard’s safety and
health management system and report the findings to the PMT to help it
determine the best steps to take to carry out the partnership agreement and
work toward VPP application. (Note: OSHA’s onsite non-enforcement policy for
partnerships will apply during any site walkaround by an OSHA Compliance
Assistance Specialist (CAS). See Section VII.)
Meet at least quarterly with the PMT to track Aker Philadelphia Shipyard’s
progress under the agreement, review its injury and illness experience and
to make adjustments as needed.
VII. The Philadelphia Metal Trades Council agrees to:
Provide a representative, if available, to attend the initial
non-enforcement inspection and to encourage safety consciousness and safe
working behaviors.
Encourage all workers on this project to take advantage of communication and
training opportunities presented by this partnership agreement.
Encourage all workers at this facility to follow all safety and health
regulations, policies, and procedures applicable to their work.
Participate in the project Labor-Management Safety and Health Committee
Meetings as needed.
Recognize and promote the voluntary participation of members in the
Partnership Management Team
The Philadelphia Metal Trades Council, through its participation in this
partnership, does not assume any obligation or liability for safety and
health compliance.
VIII. Onsite Non-enforcement Verification:
During an onsite non-enforcement verification, OSHA conducts a review of the
partner’s worksite in a non-enforcement capacity to assess the
implementation of the partnership agreement. During such visits, if OSHA
personnel identify serious hazards, OSHA and site management will agree upon
a date for correction. If OSHA identifies serious hazards that the site
management refuses to correct, the OSHA Compliance Assistance Specialist
will make a referral to the Area Office for an enforcement inspection.
Annually, OSHA will conduct an onsite non-enforcement verification at Aker
Philadelphia Shipyard. The purpose of the visit is to continue to support
the company’s efforts to improve its safety and health management system and
to prepare the required annual evaluation to gauge the effectiveness of the
partnership.
In addition to a walkaround by an OSHA CAS, documentation will be selected
for review that relates to the agreement’s goals, objectives and stated
measures and will include a review of injury and illness data and survey
results.
IX. Benefits:
Aker Philadelphia Shipyard in Philadelphia, Pennsylvania is granted a six
month deferral from programmed inspections upon entry into the partnership.
OSHA will designate an experienced safety and health staff person to serve
as a resource and liaison to Aker Philadelphia Shipyard to provide training
and technical assistance as outlined in the agreement, and to serve as an
advisor to the Partnership Management Team.
OSHA will not issue penalties for other-than-serious violations, provided
the violations are abated during a compliance inspection.
When calculating initial penalty reductions, OSHA may provide an additional
10% penalty reduction for good faith over and above what is allowed by the
Field Inspection Reference Manual (FIRM). This additional reduction will not
apply to high gravity serious, willful, failure to abate or repeat
citations. In cases where Aker Philadelphia Shipyard’s total penalty
reduction is 100 percent or more, the minimum penalty provisions of OSHA’s
FIRM will apply.
X. Formal Complaints and OSHA Investigations:
OSHA personnel will continue to conduct investigations resulting from formal
complaints, referrals, fatalities, catastrophes, other accidents or
significant events at this partnering worksite. These investigations will be
conducted outside of this partnership agreement in accordance with
established OSHA enforcement policy. Violations documented during such
investigations may result in the issuance of citations and penalties.
XI. Evaluation:
An annual evaluation will be prepared by the PMT and OSHA with final
approval by OSHA. The evaluation will be due each year on the effective date
of the partnership, and will follow the written format shown in Appendix D.
XII. Termination:
This agreement will terminate two years from the date of the signing. If
either OSHA or Aker Philadelphia Shipyard wishes to withdraw its
participation prior to the established termination date, the agreement will
terminate upon receiving a written notice of the intent to withdraw from
either signatory.
OSHA will terminate the partnership if Aker Philadelphia Shipyard is issued
a citation related to workplace hazards which resulted in a fatality.
XIII. Paperwork Reduction Act Notice:
Paperwork Reduction Act Notice Form Approved OMB# 1218-0244 Expires
01-31-2009. Public reporting burden for the time needed to develop the
Partnership requirements, craft agreement language, and conduct an internal
review process is estimated to be an average of 11 burden hours per
respondent.
Albert D’Imperio
Area Director
Philadelphia Area Office
Occupational Safety and Health Administration |
Date |
James Miller
President and CEO
Aker Philadelphia Shipyard, Inc. |
Date |
|
|
Gary Gaydosh
President
Philadelphia Metal Trades Council |
Date |
|
(1) VPP is administered separately from
OSHA’s Strategic Partnership Program. Participation in the partnership is not a
guarantee of acceptance into VPP.
Appendix A – Partnership Management Team (Volunteers)
SUBJECT TO CHANGE
Management Employees -
Safety Manager-
Production-
Supervisor-
Supervisor-
Supervisor-
Hourly Employees -
i.e.
Machinist-
Plumber -
Appendix B – Goals, Strategies, Measures
| Goals |
Strategies |
Measures |
Promote, institute and maintain a safety and
health management system based on OSHA’s 1989 Guidelines which
incorporates these four basic program elements: Management Leadership and
Employee Involvement; Worksite Analysis; Hazard Prevention and Control;
Training
Reduce or maintain injury and illness rates to/at levels that would meet
eligibility requirements for VPP (3 year average TCIR and DART Rates (or
equivalent rates) are below at least 1 of the most recent 3 years BLS
rates for the established NAICS code)
Encourage Aker Philadelphia Shipyard’s participation in OSHA’s Voluntary
Protection Program (VPP). |
1st Year of Agreement:
As soon as the agreement is signed, OSHA will conduct an initial
evaluation of Aker Philadelphia Shipyard’s safety and health management
system and report its finding to the PMT. The evaluation will include a
walkaround of the facility and a review of the safety and health
management system as described in the Challenge Tools (Appendix C). OSHA’s
onsite non-enforcement partnership policy will apply during the
evaluation.
Quarterly, or as soon as possible, OSHA will train the PMT and designated
company management and employees in the duties and responsibilities under
each of the four basic safety and health program elements.
As soon as each training module is completed, the PMT will assign
responsibilities and create a written timeline to carry out the
appropriate steps for the Challenge Stages in each of the four program
elements.
Notes: Emphasis for the OSHA training is on the immediate, practical
application of the four basic elements, not on introductory VPP background
information and justification or theory. Training should be tied to the
OSHA Challenge Stages shown in Appendix C.
PMT focus is on conducting the baseline assessments and surveys needed for
early identification of the top causes of injuries and illnesses through a
review of the site’s injury and illness experience and other supporting
documentation.
Additional focus is on adopting protocols to address the top causes of
injuries and illnesses and to abate hazards.
Additional focus is also on developing a system for tracking, reporting
and recording near misses. |
1st Year of Agreement:
Completed Challenge Stages
TCIR and DART rates |
| |
2nd Year of Agreement:
PMT meets at least quarterly with OSHA to track progress in completing
Challenge Stages, review safety and health program system and injury and
illness experience and make adjustments as needed to meet partnership
goals.
OSHA representative and the VPPP Association mentor conduct mock VPP
inspection.
Aker Philadelphia Shipyard completes VPP application if possible under
guidance of VPPP Association mentor. The OSHA representative will review
for completeness. |
2nd Year of Agreement:
Completed Challenge Stages
TCIR and DART rates
Mock VPP inspection with results reported to company by 3rd quarter of the
2nd year of partnership.
Completed VPP application by end of agreement. |
Appendix C – Challenge Stages
Challenge Stages at a Glance
| 1. Management
Leadership |
| Element |
Stage I |
Stage II |
Stage III |
| 1.1 Management Commitment |
| Mission and Policy Statements |
Develop S&H Mission Statement, with input
from
employees, and a S&H Policy Statement. |
Communicate statements; incorporate into new
employee/contractor orientation. |
Take proactive steps to ensure understanding
by all employees and contract workers and that they become a routine part
of regular communication. |
| Leadership by Example |
Begins to participate in S&H activities and
follow S&H rules. |
Continue; increase frequency of manager
participation in S&H activities. |
Continue; ensure total involvement of all
executives, managers, & supervisors
|
| Resources |
Commit initial resources to control
identified hazards. Begin integrating S&H into other aspects of management
planning. |
Provide additional resources for S&H
activities, including access to certified S&H and licensed health care
professionals, and improve integration of S&H into other planning
processes. |
Continue committing and ensuring the
utilization of adequate resources. Ensure integration of S&H into all
planning processes in the site. |
| Goals and Objectives |
Establish & communicate annual S&H goals &
objectives based on findings from baseline hazard and trend analyses; and
assessment of the site’s safety and health practices. |
Review the site’s progress towards
achievement of S&H goals & objectives; establish & communicate new goals,
as appropriate. |
Review, revise, and continue communicating
S&H goals and objectives. Ensure S&H goals and objectives are routinely
considered in site’s activities and programs. |
| Responsibility, Authority, and Accountability
|
Develop a safety and health accountability
plan for managers, supervisors, and non-supervisory employees. |
Enforce accountability plan. |
Fully implement accountability system for all
workers, including incorporation of S&H responsibilities into job
descriptions and performance plans. Assign additional responsibilities to
non-supervisory employees as appropriate. |
| Communication |
Establish clear lines of communication with
employees & provide reasonable access to top management re: S&H issues.
|
Maintain clear lines of communication with
employees re: S&H issues |
Encourage open dialogue between management
staff and employees. |
| Disciplinary Plan |
No action required |
Develop & begin implementing disciplinary
plan for managers and employees. |
Ensure discipline is equitably enforced,
ensure higher levels of compliance. |
| Annual Self-Evaluation |
No action required |
No action required |
Develop system and written procedures to
annually evaluate the total site’s S&H management system. Complete at
least one annual self-evaluation of the site’s safety and health
management system. |
| 1.2 Employee Involvement |
| Employee S&H Perception Survey |
Conduct baseline employee S&H practices
perception survey. |
No action required |
Conduct follow-up employee S& H perception
survey. |
S&H Practices Change
Plan |
Develop an action plan to address findings
from the baseline employee S&H practices perception survey. |
Implement steps defined in the site’s action
plan to improve S&H culture. |
Continue; ensure significant improvement in
S&H culture |
| Employee Notification |
Notify all employees of their S&H rights, the
site’s participation in Challenge, & VPP principles. |
Notify new employees of their S&H rights,
site participation in Challenge, & VPP principles. Incorporate into new
employee/contractor orientation. |
Continue for new employees. At least
annually, reenforce for all employees. Encourage freely reporting
workplace hazards without reprisal. |
| Meaningful Employee Involvement |
Establish a few key S&H teams; begin
involving employees in S&H activities. |
Increase participation on teams, and/or form
additional teams. Involve employees in safety and health activities (e.g.,
accident/near-miss investigations). |
All needed teams are functioning and
meaningfully contributing to S&H. Ensure regular teams are routinely
conducting audits, accident/incident investigations, self-inspections, and
job hazard analyses. Improve and continue the site’s hazard reporting
system. |
| 1.3 Contract Worker Coverage |
| Adherence to Rules |
Require contractors and their employees to
comply with OSHA and site S&H rules. |
Improve and continue to enforce policy for
S&H violations. |
Improve and continue- enforce policy for
safety and health violations. |
| Contractor Selection |
No action required |
Consider contractors’ safety and health
performance in the bidding process, including a review of injury/illness
rates. |
Fully establish and use selection criteria.
Encourage contractors to develop their own S&H management systems &
decrease high rates. |
| Contractor Hazards |
Contractor ensures correction of any hazards
in their work areas. |
Develop & implement a formalized method
including assignment of responsibility to identify, correct, & track
hazards in contractors’ work areas. |
Include responsibility for hazard correction
in writing, in the contracts. |
| Removal Policy |
No action required
|
Develop & implement contractor policy for S&H
violations, including removal and other penalties. |
Penalty policy is understood by all
contractors, described in their contracts, and adhered to. |
|
2. Worksite Analysis |
| Element |
Stage I |
Stage II |
Stage III |
|
Baseline Safety and IH Hazard Analysis
|
Conduct the baseline analysis (may use outside
sources), including a chemical inventory and evaluation of typical safety
and health hazards.
|
No action required
|
Re-do baseline survey, if warranted by significant
changes in tasks, equipment, or processes. |
|
Hazard Analysis of Routine Jobs, Tasks, And Processes
|
No action required
|
Conduct hazard analysis and recommend controls for
routine jobs, tasks, & processes that have had associated
injuries/illnesses or significant incidents or near-misses; are perceived
as high-hazard; or are required by a regulation or standard; observe
guidelines.
|
Conduct hazard analysis and recommend controls for
routine jobs, tasks, and processes that have written procedures, have been
recommended for more indepth analysis, or are determined by the
Challenge participant to warrant hazard analysis |
|
Hazard Analysis of Significant Changes
|
No action required
|
No action required
|
Conduct hazard analysis for significant changes (e.g.,
non-routine tasks or new processes, materials, equipment and facilities)
and recommend controls prior to the activity or use. |
|
Pre-use Analysis
|
No action required
|
No action required
|
Conduct pre-use hazard analysis of new equipment,
chemicals, facilities, or significantly different operations or
procedures. and recommend controls prior to the activity or use. |
|
IH Program
|
No action required (See Baseline Hazard Analysis).
|
Follow up on results of baseline IH study. Conduct more in-depth analysis if warranted to
determine actual employee exposures. Establish, document, & implement future
sampling schedule, strategy, and rationale.
|
Continue to follow the written IH
program; take proactive steps to improve control of health hazards to prevent
occupational disease. |
|
Routine Self-inspections
|
No action required
|
Develop a documented system for routinely scheduled
self-inspections of the workplace; conduct inspections with S&H staff;
covering entire worksite, at least semi-annually.
|
Continue to conduct routine self-inspections. Increase
frequency to at least monthly, with the entire worksite covered at least
quarterly. |
|
Employee Hazard Reporting System
|
No action required
|
Develop & begin implementing hazard-reporting system
for employees (maybe anonymous),
|
Encourage more active reporting; ensure regular
feedback, using different media, to all employees on status of hazards
reported. |
|
Investigation of Accidents and Near-Misses
|
Develop and implement system to report and investigate
accidents. Determine root causes and track correction to completion.
|
Expand system to include reporting and investigation of
near misses. Continue investigating accidents, begin investigating
near-misses, and making corrective actions.
|
Thoroughly report and investigate all accidents and
near-misses. |
|
Trend Analysis
|
Conduct trend analysis of injury & illness history
(previous 3 years of OSHA 200/300 logs) and begin developing a plan for
conducting analysis of other S&H-related information
|
Conduct trend analysis of other S&H information not yet
studied; conduct one of injury & illness history if a year has gone by
since initial analysis. |
Trend analysis takes place regularly (at
least annually) for all types of S&H information, and is utilized in setting
future goals to address identified trends. |
|
3. Hazard Prevention & Control |
| Element |
Stage I |
Stage II |
Stage III |
Certified Professional
Resources |
(see Management Commitment) |
(see Management Commitment) |
(see Management Commitment) |
|
Hazard Elimination & Control Methods |
Develop an action plan to prioritize and implement
controls for hazards identified, through the baseline S&IH study,
trend analysis of OSHA logs and accident investigations.
Implement controls or (interim protection if long-term abatement) for top
priority hazards before moving onto Stage II. |
Complete long term abatement projects from Stage I.
Develop an action plan to prioritize and implement controls for hazards
identified through self-inspections,
employee reports of hazards, and nearmiss investigations.
Implement hazard controls (or interim protection) for top priority hazards
before moving onto Stage III. |
Complete long term abatement projects from Stage II.
Continue to pro-actively identify, prioritize, and implement controls for
hazards identified through all means (hazard analysis, trend analysis,
accident and near miss investigation, self-inspections, employee reports of
hazards, pre-use analysis, etc) so that there is a continuous loop of hazard
id and control. |
|
Hazard Control Programs |
Inventory existing hazard control programs required by OSHA
standards. Develop missing programs or modify existing programs. |
Implement hazard control programs developed or modified
in Stage I and train all workers on these programs. |
Review hazard control programs annually and updated as
new processes, jobs, and tasks are begun. |
Documented System for Hazard Correction
Tracking |
Develop and begin implementing a hazard tracking system
for hazards identified through the baseline hazard analysis, trend
analysis of OSHA logs,
and accident investigations. |
Expand tracking system to include hazards identified
through hazard analysis of routine jobs; self-inspections; employee
reports of hazards; and near miss investigations. |
Tracking system is fully functioning and includes
hazards identified through all methods.
|
|
Preventive Maintenance |
Conduct an inventory of equipment and machinery
requiring preventive maintenance. |
Review equipment inventory. Establish and implement
preventive maintenance schedule. |
Ensure schedule is routinely observed and preventive
maintenance is regularly conducted. |
|
Occupational Health Care Program |
Conduct records review of previous three years OSHA 200/300 logs. Compare with insurance claims forms and ensure
records are in order. Provide physician services for emergencies (see below).
|
Continue to provide access to licensed health care
providers, health services, physician care, and emergency medical care.
Arrange for services based on the outcomes of the baseline safety and
health analysis. |
Continue providing services listed in Stage I and II.
In addition- Health Care providers visit the site, and assist in
identifying causes and symptoms of injury/illness. Care provided in within
the scope of licensure. |
|
Emergency Preparedness and Response |
Establish & communicate written procedures for
responding to all types of emergencies; Make emergency services available
on all shifts including: ambulances, EMT’s, emergency clinics, or hospital
emergency rooms.
Provide at least one employee trained in first aid & CPR for each shift or an
equally effective alternative.
Conduct at least one evacuation drill & assess its effectiveness. |
Continue providing emergency medical services.
Establish an Emergency Response Team including first aid and CPR trained
employees. Conduct at least one drill and assess it’s effectiveness and
follow-up on recommendations to improve emergency evacuation drills. |
Continue providing emergency medical services.
Establish a Haz. Mat. Team if necessary.
Consult with local fire department to ensure adequate coverage for fire,
explosion, or chemical release.
Conduct evacuation drills at least annually and assess their effectiveness.
Provide AED and training on its use for those on the Emergency Response Team. |
|
4. Safety and Health Training |
| Element |
Stage I |
Stage II |
Stage III |
|
General guidelines |
Observe OSHA guidelines in providing training for required
programs.
|
Continue observing OSHA VPP guidelines in providing training.
|
Continue observing OSHA VPP guidelines in providing training. |
|
Training for all workers |
Provide training to all workers on their S&H rights,
Challenge, VPP fundamental principles, hazards in the workplace, PPE,
emergency evacuation procedures, and individual emergency
responsibilities. |
Continue providing training to all workers, including new workers, on their
S&H rights, Challenge, VPP fundamental principles, hazards in the workplace,
PPE, emergency evacuation procedures, and individual emergency
responsibilities.
|
Take proactive steps to improve & continue providing
training to all workers, including new workers, on their S&H rights,
Challenge, VPP fundamental principles, hazards in the workplace, PPE,
emergency evacuation procedures, and individual emergency responsibilities |
|
Training for specific groups of workers |
Provide specific training to managers
and supervisors, to designated S&H staff and others with S&H responsibilities,
and to contract workers to equip them with knowledge & skills needed to
perform their S&H responsibilities in Stage I (i.e., hazard recognition,
accident investigation and root cause analysis, hazard controls, OSHA
standards, and VPP requirements). |
Provide specific training to managers and supervisors,
to designated S&H staff and others with S&H responsibilities, and to
contract workers to equip them with knowledge & skills needed to perform
their S&H responsibilities in Stage II.
|
Take proactive steps to provide
specific training to all employees and contract workers to equip them with the
knowledge & skills they need to perform their S&H responsibilities in Stage
III. |
|
Appendix D
OSHA STRATEGIC PARTNERSHIP PROGRAM
ANNUAL PARTNERSHIP EVALUATION REPORT
| Goals of Partnership |
| Goal |
Strategy |
Measure |
| |
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| |
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| |
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|
| |
|
|
| Strategic Management Plan Target
Areas (check one) |
| Construction |
|
Amputations in Manufacturing |
|
| General Industry |
|
|
|
| Strategic
Management Plan Areas of Emphasis (check all applicable) |
| Amputations in Construction |
|
Oil and Gas Field Services |
|
| Blast Furnaces and Basic Steel Products |
|
Preserve Fruits and Vegetables |
|
| Blood Lead Levels |
|
Public Warehousing and Storage |
|
| Concrete, Gypsum and Plaster Products |
|
Ship/Boat Building and Repair |
|
| Ergo/Musculoskeletal |
|
Silica-Related Disease |
|
| Landscaping/Horticultural Services |
|
|
|
|
Section 1 |
General Partnership Information |
| Date of Evaluation Report |
|
| Evaluation Period |
| Start Date |
|
End Date |
|
| Evaluation Contact Person |
|
| Originating Office |
|
| Partnership Coverage |
| # Active Employers |
|
# Active Employees |
|
| Industry Coverage (note range or
specific SIC and NAICS for each partner) |
| Partner |
SIC |
NAICS |
| |
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Section 2 |
Activities Performed |
|
Note whether an activity was provided for by the OSP and whether it was
performed |
| |
Required |
Performed |
| a. Training |
|
|
| b. Consultation Visits |
|
|
| c. Safety and Health Management Systems
Reviewed/Developed |
|
|
| d. Technical Assistance |
|
|
| e. VPP-Focused Activities |
|
|
| f. OSHA Enforcement
Inspection |
|
|
| g. Offsite Verifications |
|
|
| h. Onsite Non-Enforcement Interactions |
|
|
| i. Participant Self-Inspections |
|
|
| j. Other Activities |
|
|
| 2a. Training (if performed,
provide the following totals) |
| Training sessions conducted by OSHA staff |
|
| Training sessions conducted by non-OSHA staff |
|
| Employees trained |
|
| Training hours provided to employees |
|
| Supervisors/managers trained |
|
| Training hours provided to supervisors/managers |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2b.
Consultation Visits (if performed, provide the following total) |
| Consultation visits to partner sites |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2c. Safety and Health Management
Systems (if performed, provide the following total) |
| Systems implemented or improved using the
1989 Guidelines as a model |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2d. Technical Assistance (if
performed, note type and by whom) |
| |
Provided by OSHA Staff |
Provided by Partners |
Provided by Other Party |
| Conference/Seminar Participation |
|
|
|
| Interpretation/Explanation of Standards or OSHA Policy |
|
|
|
| Abatement Assistance |
|
|
|
| Speeches |
|
|
|
| Other (please specify) |
|
|
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2e. VPP-Focused Activities (if
performed, provide the following totals) |
| Partners/participants actively seeking VPP participation |
|
| Applications submitted |
|
| VPP participants |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2f. OSHA Enforcement Activity (if
performed, provide the following totals for any programmed, unprogrammed, and verification-related
inspections) |
| OSHA enforcement inspections conducted |
|
| OSHA enforcement inspections in compliance |
|
| OSHA enforcement inspections with violations cited |
|
| Average number of citations classified as Serious, Repeat, and
Willful |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2g. Offsite Verification (if
performed provide the following total) |
| Offsite verifications performed |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2h. Onsite Non-Enforcement
Verification (if performed provide the following total) |
| Onsite non-enforcement verifications performed |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2i. Participant Self-Inspections
(if performed provide the following totals) |
| Self-inspections performed |
|
| Hazards and/or violations identified and corrected/abated |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2j. Other Activities (briefly describe other
activities performed) |
|
|
Section 3 |
Illness and Injury Information* |
| Year |
Hours |
Total Cases |
TCIR |
# of Days Away from Work Restricted and
Transferred Activity Cases |
DART |
| 2008 |
|
|
|
|
|
| 2009 |
|
|
|
|
|
| 2010 |
|
|
|
|
|
| Total |
|
|
|
|
|
| Three-Year Rate (2008-2010) |
|
|
|
|
BLS National Average for 2006 |
|
|
|
| Baseline |
|
|
|
|
|
*Sample Chart – not required format
|
|
Section 4 |
Partnership Plans, Benefits, and Recommendations |
| Changes and Challenges
(check all applicable) |
| |
Changes |
Challenges |
| Management Structure |
|
|
| Participants |
|
|
| Data Collection |
|
|
| Employee Involvement |
|
|
| OSHA Enforcement Inspections |
|
|
| Partnership Outreach |
|
|
| Training |
|
|
| Other (specify) |
|
|
| Comments |
|
| Plans to Improve
(check all applicable) |
| |
Improvements |
N/A |
| Meet more often |
|
|
| Improve data collection |
|
|
| Conduct more training |
|
|
| Change goals |
|
|
| Comments |
|
| Partnership Benefits (check all
applicable) |
| Increased safety and health awareness |
|
| Improved relationship with OSHA |
|
| Improved relationship with employers |
|
| Improved relationship with employees or unions |
|
| Increased number of participants |
|
| Other (specify) |
|
| Comments |
|
| Status Recommendation
(Check one) |
| Partnership Completed |
|
| Continue/Renew |
|
| Continue with the following provisions: |
|
|
| Terminate (provide explanation) |
|
|
| |
|
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