Sample Workplace Safety and Health Programs
These resources are provided by the Maine Department of Labor SafetyWorks! program as a guide to assist employer in compliance with safety and heath regulations. It is the responsiblity of the employer to modify these documents to meet site-specific hazards.
Respiratory Plan for Fire Departments - This sample plan concerns respirator use in general industry and construction workplaces as regulated in 29 CFR §1910.134 .
General Respiratory Plan - Sample respiratory plan for general industry and construction workplaces (not for fire departments.)
Emergency Action Plan - Workplaces must have an emergency action plan to ensure employee safety in case of emergency. Companies with 10 or more employees must have this plan in writing.
Hazard Communication Plan - Any workplace that has hazardous materials must have a written Hazard Communication program. Because most chemical products, even cleaning products, are consider hazardous, most workplaces need a Hazard Communication program.
Control of Hazardous Energy Sources (Lockout/Tagout) - Workplaces where employees do maintenance or repair work need a written Lockout/Tagout program to protect against unexpected startup of equipment.
Volunteer Firefighter Model Policy - Public Law 296 provides volunteer firefighters protection from discipline or discharge, in certain employment situations, on the grounds that the volunteer firefighter arrives late or does not arrive to work because the volunteer firefighter is responding to certain emergencies to which the fire department is called to respond. The law allows written agreements between employees and employers to supersede the terms of the proposed law. This model policy / agreement has been developed as an option for employers to use.
Responding to Domestic Violence Abusers in the Workplace - This toolkit was designed to help employers and workers create a comprehensive response to domestic violence in the workplace.
Chemical Hygiene Plan - Non-production laboratories where small scale chemical experiments are conducted must have a chemical hygiene plan, under OSHA's Laboratory Standard (29 CFR 1910.1450). This sample plan is for secondary schools.
Fire Prevention Plans - Plan to assist employers in fire prevention.
Fire Department and EMS Blood Borne Exposure Plan - Provides fire department and EMS with a guide for all areas that are required to be part of a BBP exposure plan.
Silica Program - Model program to assist employers with high levels of Silica exposures with monitoring,record keeping and training
Hearing Conservation Program (Construction) - Assists employers in devoloping a hearing conservation program
Asbestos Exposure Program - This Asbestos Operations and Maintenance Program has been developed to eliminate and control hazards associated with asbestos containing materials located at your site.
Lock Out / Tag Out Program - Program to assist employers in ensuring employees are using procedures to isolate energy sources prior to maintenance and other duties of equipment in the workplace.
Confined Space Program - Sample Permit Required Confined Space program. Itentifying spaces, equipment used, employee responsibilities ...
Bloodborne Pathogen Plan - Provides employers who have employees with BBP exposures, a guide for all areas that are required to be part of a BBP exposure plan.
Flammable Liquids Storage - An employer guide to proper storage procedures for flammable liquids.
N-95 RESPIRATORY PROTECTION PROGRAM - State of Maine public sector employers who require n-95 respirators to be used are required to have this program in place. This is a guide to be in compliance.
Lockout Procedure for Dump Body Trucks - Example Lockout Procedure for Maintenance on Dump Body Truck
Sample Lockout Procedure for Front Loader - Lockout Procedure for Maintenance on Front Loader
Lockout Procedure for Water Pump - Detailed sample lock out procedure for a waste water pump.
Lock out procedure annual review form. - Annual Lockout - Tagout Administrative review of detailed writen procedures of lockouts for equipment.
Lockout Tagout Training Form - Ensures that training has been received on the Mandatory Lockout - Tagout Program. Provides checklist of items to be trained on.
Hearing Conservation Program (General Industry) - Policy to assist employers who are required to have a hearing conservation in general industry.
Hepatitis B Vaccine Declination Form - Sample Hepatits B Vaccine Declination form the employer shall have a signed copy on file, if an employee chooses not have the Hepatitis B Vaccine.
Hepatitis B Vaccination Employer Record - Employer record of employee hepatitis B vaccinations or declination.