HomeMy WebLinkAbout06-97 - Res. Designating Applicant's Agent RESOLUTION NO.
DESIGNATION DF APPLICANT'S AGENT
WHEREAS, the Mason County Board of Commissioners by Resolution No. 144'SGdeclared
e state nfemergency.
WHEREAS` Mason County is included in the Presidential Declaration of a major disaster for
the state ofWashington.
WHEREAS, the Director of the Department of Emergency Services is charged with the
responsibility for coordinating the overall response and recovery operations pertaining to a disaster.
NOW, THEREFORE, BE IT RESOLVED that Joseph W. Murray, Director, Department of
Emergency Services is hereby authorized to execute for and in behalf of Mason County, a public
agency established under the laws of the state ofWashington. The purpose of this designation isto
be the authorized representative for obtaining federal and/or emergency or disaster assistance funds.
DATED this 11th day of February, 1SS7.
BOARD DF COUNTY COMMISSIONERS
MASON COUNTY, VVASH|NGTON
A02 V
, V 'A�")AVJ,
ATTEST: JOM
CLEIRK OF THE BOARD &YN1`H D. OLSEN, Member
cc: Public Works
DCO
General Services
Central Services
Emergency Services
PUO#1
PUD#3
City ofShelton:
Emergency Management
Development Services
FPC}'a#2. 5.& 17
School Districts:
Shelton
K8a[yM. Knight
Pioneer
Port ofShelton
6 . Accident Procedures and Reporting
a. Purpose® To report and investigate all accidents and near
misses, no matter how minor, to prevent similar accidents, and to
make the county a safer workplace .
b. Background® The purpose of accident investigations is to
determine and correct as many causes of the accident as possible -
not to fix blame or direct discipline . All witnesses to an
accident should be interviewed to help determine what happened and
identify causes .
c . Accident Procedures
I . In the event of an occupational accident, injury,
exposure, or illness; the first and primary consideration is to
seek appropriate first aid and/or medical attention based on the
extent of the injury, illness, or exposure . Reporting all
occupational accidents, illnesses or exposures is mandatory.
Employees are responsible for notifying their supervisor of the
accident/incident as soon as possible after it has occurred, and
supervisors shall notify Safety Officers and the applicable
Department Head/Elected Official .
II . Supervisors shall take appropriate emergency steps to
stabilize the situation (call 911 for emergency assistance, order
evacuation, provide first aid, etc) .
III . If the accident involves a life threatening situation
(no respiration, no pulse, serious bleeding, or shock) call 911
and provide first aid.
IV. Call 911 for broken bones and keep victim
comfortable . Avoid moving victim unless absolutely necessary.
V. For minor injuries requiring treatment beyond first
aid, a county representative may take the injured to the hospital .
VI . If the accident results in a death or hospitalization
of two or more employees, do not move any involved equipment
(unless required to avoid further accidents or to remove the
injured) .
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VII . Start the accident investigation.
VIII . Restore normal conditions and resume work.
7 . County Accident/Incident Reports.
a. Employees will complete a County Accident/Incident
Report form for all occupational injuries, accidents, exposures,
or illnesses and submit it to their immediate supervisor within 24
hours . All occupational injuries or illnesses are required by law
to be reported regardless of the degree of the accident .
b. Supervisors will investigate all accidents, minor
injuries or illness (requiring doctor or outpatient treatment) ,
and near misses . using the attached accident investigation form.
c . An investigation under direction of the safety
officer will be conducted for major injuries or occupational
illness (those involving fatalities or requiring hospitalization)
using the attached accident investigation form. The supervisor of
the injured person, the Risk Manager, Human Resources Director,
and a Safety Committee member will also be members of major
investigations .
8 . Vehicle Accident Procedures
In the event that a County employee is involved in an accident
while operating a County vehicle or their personal vehicle and
conducting County business, the employee shall :
a. Immediately provide first aid (if possible and if
necessary) to any injured person. It is recommended that
employees providing First Aid/CPR have a valid First Aid/CPR card.
b. The County driver shall then immediately notify his
supervisor and the appropriate law enforcement agency. No
vehicles shall be moved from the accident scene until law
enforcement arrives unless a greater safety hazard would be
created by not moving the vehicle (s) .
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c . The County employee/driver shall exchange information
regarding driver' s license, vehicle registration, and insurance
information with the operator (s) of the other vehicle (s) .
d. If possible, the County employee/driver shall gather the
names and addresses of all potential witnesses including
passengers in all vehicles involved.
e . The County employee/driver shall complete the Vehicle
Accident Checklist located in the glove compartment of each County
vehicle . If the accident results in death, personal injury, or
property damage in excess of $500, complete the State of
Washington Uniform Collision Report Form (WSP-161) within 24 hours
of the accident . This report form and the checklist form are
provided by the Risk Manager.
9 . Safety Program Incentives.
a. Recognition. The Safety Committee will nominate an employee
each quarter for recognition as the County Safety Person of the
Quarter. The committee will attempt to rotate this award among
county departments using appropriate selection criteria such as
value of suggestions, support of safety policy, accident records,
etc .
b. Program Enforcement. Willful violations of county safety
procedures are not acceptable . Violations of safety procedures may
result in disciplinary actions against the employee, up to and
including discharge .
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Department Orientation
Employee Safety Check List
Employee Name Position
Circle numbers and letters of subjects covered:
1. On-the-Job Training
2 . Care and use of personal protective equipment.
3 . Prompt reporting of accidents or close calls.
a. Completing accident records
b. Assisting in investigations
4. General overview of operations, procedures, hazards and safety procedures
Related to work area (as applicable)
a. Office safety
b. Field operations
c. Vehicle safety (county seat belt policy)
d. Lock-out/tag-out program
e. Hazardous communication program
f. Exposure protection plan
S. First aid supplies, equipment, and assistance
a. Obtaining treatment
b. Location of first aid kit and emergency equipment
c. Names of first aid/CPR trained personnel
6 . Emergency plan.
a. Emergency warnings and signals
b. Exit locations and posted evacuation plan
c. Evacuation assembly areas
d. Use of firefighting equipment
e. Assistance to injured or disabled employees or clients
7. Personal work habits
a. Seriousness of horseplay, fighting, inattention
b. No smoking policy
c. Good housekeeping practices
d. Proper lifting techniques
Date Employee's Signature
Date Supervisor's Signature
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Human Resources
Employee Orientation
General Safety
Employee Name Position
Circle numbers and letters of subjects covered:
1. Mason County Safety Program, including:
a. Orientation
b. Safety Meetings and the Safety Committee
C. Accident Reporting
Other:
Employee' s Signature Date
Human Resources Dept Date
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Employee Responsibility Information Sheet
As an employee of Mason County, I understand I am responsible to:
1. Study and observe county safety rules and apply common sense in preventing
accidents in my day-to-day duties.
2 . Report any job-related injury, illness or property damage to my supervisor
and promptly seek treatment.
3 . Promptly report unsafe conditions and acts to my supervisor. Offer safety
suggestions to improve the work environment.
4 . Observe all hazard warnings and no smoking signs.
S . Keep aisles, walkways, ramps, stairs, and working areas clear of slipping
and tripping hazards.
6 . Know the location of fire/safety exits and evacuation procedures.
7. Keep all emergency equipment such as fire extinguishers, fire alarms, fire
hoses, exit doors, and stairways clear of obstacles.
8. Not report to work under the influence of alcoholic beverages or drugs nor
to consume them while on company premises.
9. Refrain from fighting, horseplay, or distracting fellow employees.
10. Use and care for safety and personal protective equipment that the county
requires to be used.
11. Operate only the equipment for which I am authorized and properly trained.
Observe all safe operating procedures.
12 . Follow proper lifting procedures at all times.
13 . Ride as a passenger in a vehicle only if it has a rider's seat.
14. Be alert to see that all guards and other protective devices are in place
before operating equipment.
15. Do not wear frayed, torn or loose clothing, jewelry, or long unrestrained
hair near moving machinery or other sources of entanglement, or around
electrical equipment.
(Employee) (Date) (Supervisor)
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Safety Inspection Check List
1. Facility Entry/Client Service Areas: Handrails on entrance ramps and
stairways present and secure; door handles functional; no trip/snag hazards; no
smoking/warning/exit/braille signs posted as required; employee only
access/entrances posted or lockable; emergency evacuation plan posted; public
access toilet facilities posted and sanitary, parking areas and ramp/crosswalk
areas marked.
Discrepancies•
2. Emergency Signs and Equipment: Fire extinguishers in place, charged and
tagged; exits unblocked and posted; emergency evacuation plans posted.
Discrepancies•
3. First Aid Kits: Kits stocked, opened sanitary items (gauze, eye/skin wash,
antibiotic packets, etc. ) discarded, first aid booklet available, biohazard
protection supplies available.
Discrepancies:
4. office areas: Electrical equipment wires and plugs in good condition; no
unauthorized electrical appliances or flammable liquids; no bump or trip
hazards; good housekeeping evident; adequate, clean trash containers available;
windows/doors in good condition with locks and handles operable; no unmounted,
heavy weights stored above desk level; equipment guards and safety shields in
place and in good condition.
Discrepancies•
5. Employee Toilets: Cleanliness and supply checks (paper products, soap,
etc. ) , hygiene/sanitation reminder posted.
Discrepancies•
6. Lunch/Break Room: Cleanliness of room, operability and sanitation of any
appliances, waste receptacle available.
Discrepancies•
7. Safety Bulletin Boards: Posted with employee health and safety act and
contact point, minutes of safety meetings, lists of first aid/CPR certified
employees and safety committee members, copy of accident prevention program.
Discrepancies•
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SON COUNTY
ACCIDENT/INCIDENT AND INVESTIGATION REPORT
This form must be completed by any Mason County employee who is involved in an
accident, whether or not injuries were sustained. The purpose of this form is to
ensure immediate documentation and communication of an accident/incident to the
department, Human Resources, Risk Manager, and others involved in general safety and
health standards. It also serves to assist in identifying potential problems in the
county and take corrective measures if necessary. This form must be completed
within 24 hours of the accident/incident and submitted to the supervisor; and a copy
should be submitted immediately to the Human Resources Department.
Employee Name Date of Birth
SSN Job Title
Department Supervisor
Date & Time of Accident at Location of Accident
Date & Time Reported at Reported to
Witnesses Names, Addresses, Phone Numbers:
Description of how the Accident Occurred (include type of duties performed at the
time and any tools/machinery involved)
Part (s) of Body Injured and Description of Injuries
Name of Doctor/Hospital providing Treatment
Will there be time loss from work? [ ] Yes [ ] No Anticipated Time Loss : Days
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REMARKS AND/OR RECOMMENDATIONS
(To be completed by Supervisor and/or Investigator)
Supervisor:
Signature Date
Investigator:
Signature Date
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Please attach any additional documentation (i.e. witness statements, vehicle accident reports,
photographs, etc.)