Hatchery Annual Assessment

• Document # - Date

• Audit Title

• Hatchery / Site

• City

• Prepared by

• Personnel attending assessment

• Conducted on

  Date

FACILITY INFORMATION

• Form completed

  Date

• Annual Inspection

• One time inspection

• Hatchery Name

• Hatchery Manager

• Number of FTE

• Phone Number

• Regional Safety Coordinator

PROGRAM MANAGEMENT

• Do you have a written Hatchery Safety & Health Manual signed by the Chief of Hatcheries?

  Yes

  No

  N/A

• Is the manual up-to-date with the most recent revisions, including the revision record?

  Yes

  No

  N/A

• Do you have a site specific Hatchery Safety Plan (Appendix)?

  Yes

  No

  N/A

• Has the plan been updated within the year?

  Yes

  No

  N/A

• Have you contacted and discussed safety related items with your Regional Safety Coordinator?

  Yes

  No

  N/A

• Did you communicate with your Regional Safety Coordinatorany hazards that couldn't be closed in 30 days of your submittal of the report?

  Yes

  No

  N/A

SAFETY TRAINING

• Have all employees, including part-time, FTE, temporaries and volunteers, received applicable and documented safety orientation and training?

  Yes

  No

  N/A

• Was a Temporary/Volunteer Safety Orientation Checklist completed for all those applicable?

  Yes

  No

  N/A

• Have all applicable employees received special-skills training for hazardous work activities (e.g., heavy equipment operators, welders, chainsaw operators, crane operators, etc)?

  Yes

  No

  N/A

• Is this training reproducible and documented?

  Yes

  No

  N/A

• Do all employees know how to access the Basicsafe website and its components?

  Yes

  No

  N/A

• On a scale of 1 to 10, how many trainings of the available trainings have been completed by all employees?

• On a scale of 1 to 10, how many manager-led trainings have been conducted for all employees?

• Do you document all training and can you produce those records?

  Yes

  No

  N/A

• Do all employees receive additional training following incidents and near-hits?

  Yes

  No

  N/A

• Have employees been trained in proper lifting techniques?

  Yes

  No

  N/A

HAZARD AND INCIDENT REPORTING

• Are employees given a briefing on the specific hazards and risks involved in their work activies?

  Yes

  No

  N/A

• Is the briefing documented?

  Yes

  No

  N/A

• Are employees encouraged to make reports of unsafe and/or unhealthful work conditions, and know that they can do so without reprisal?

  Yes

  No

  N/A

• When a hazard is identified, it it abated right away?

  Yes

  No

  N/A

• Any examples?

• Are all incidents and near-hits reported promptly through the online Origami link?

  Yes

  No

  N/A

• Are all injury incidents investigated promptly by the manager?

  Yes

  No

  N/A

FIELD SAFETY

• Do employees who conduct work activities in the field file a "trip plan" or "float plan" verbally or in writing before leaving?

  Yes

  No

  N/A

• When possible, do employees conducting work activities in remote locations work in pairs?

  Yes

  No

  N/A

• Are emergency communication equipment provided for employees working in remote location?

  Yes

  No

  N/A

• Type of communication?

• Does the facility have written protocols in place for responding to an overdue employee situation?

  Yes

  No

  N/A

LAB SAFETY

• Are annual lab inspections conducted and documented? Informal inspections conducted monthly.

  Yes

  No

  N/A

• Is all food for human consumption kept out of lab areas, including in refridgerators?

  Yes

  No

  N/A

• Has a Chemical Hygiene Plan been developed as specified in the manual?

  Yes

  No

  N/A

• Are all production systems and waste water systems routinely inspected and maintained?

  Yes

  No

  N/A

DISCHARGE PERMITS

• Do you have a Discharge Permit?

  Yes

  No

  N/A

• Is all of your associated instrumentation calibrated?

  Yes

  No

  N/A

• Do you maintain a calibration log?

  Yes

  No

  N/A

• Are employees trained in spill prevention, the proper response to a spill, proper clean-up and disposal of materials?

  Yes

  No

  N/A

• Are employees trained on the proper operation and cleaning of production and waste water systems, including feeding procedures and proper use of equipment?

  Yes

  No

  N/A

• Records are maintained of frequency of cleaning, inspections, maintenance and repair, and training on spill prevention?

  Yes

  No

  N/A

ENVIRONMENTAL MANAGEMENT

• Are all chemicals stored in a manner to prevent spills, especially into water ways?

  Yes

  No

  N/A

• All unknown containers of chemicals or material have been properly disposed?

  Yes

  No

  N/A

• Are you properly managing any hazardous waste materials? Including rechargeable batteries, auto batteries, fluorescent light bulbs, lab wastes, and ANY electronics?

  Yes

  No

  N/A

• Is it properly disposed by a qualified contractor?

  Yes

  No

  N/A

• Are your bone-yards and/or bulk-waste storage being actively managed?

  Yes

  No

  N/A

• What is the source of your drinking water?

  municipal

  spring

  well

  other

• Do you test your water for e-coli, nitrates, nitrites, copper and lead?

  Yes

  No

  N/A

JOB SAFETY ANALYSIS/ JOB HAZARD ANALYSIS

• Have any JSAs been developed that are applicable to the work at this or all hatcheries?

  Yes

  No

  N/A

• Have supervisors assessed workplaces for hazards?

  Yes

  No

  N/A

• Have any JSAs been developed by the time of this inspection?

  Yes

  No

  N/A

COMPRESSED GASSES

• Are compressed gasses stored correctly?

  Yes

  No

  N/A

• Are fuel gasses separated from oxygen by either a 5 foot half hour fire wall or 20 feet? (Oxyacetylene separated if used rarely).

  Yes

  No

  N/A

• Are hoses bled down at the end of use?

  Yes

  No

  N/A

• Are all air compressors, including small portable units, drained regularly? (Daily)

  Yes

  No

  N/A

• Are liquid oxygen tanks grounded with adequate size and length grounding rod?

  Yes

  No

  N/A

CONFINED SPACES

• Are confined spaces identified on the Hatchery Plan (Appendix)?

  Yes

  No

  N/A

• How are spaces identified? Photo, map, description, list?

• Are there any permit-required confined spaces at the hatchery?

  Yes

  No

  N/A

• Are entrances to these spaces secured by either a lock, device or weight?

  Yes

  No

  N/A

• Are the physical spaces signed as "Danger - Confined Space -Authorized (or No) Entry Only?"

  Yes

  No

  N/A

• Are employees that enter these spaces identified and trained?

  Yes

  No

  N/A

ELECTRICAL

• Do all electrical boxes, outlets, junction boxes and switches have proper covers?

  Yes

  No

  N/A

• Do all electrical installations meet UL and NEC requirements?

  Yes

  No

  N/A

• Are electrical breakers and switches labeled as to their purpose, when the purpose is not obvious?

  Yes

  No

  N/A

• Is there at least 36" of clearance maintained around all breaker panels?

  Yes

  No

  N/A

• Are GFCI's installed outdoors or within 6' of wet areas?

  Yes

  No

  N/A

• Are all electrical cords, extension cords, power tool cords free from cracks, breaks or strain damage?

  Yes

  No

  N/A

• Are all extension cords rated for heavy-duty use? Flat household cords and those without a grounding prong are not permitted.

  Yes

  No

  N/A

• Are all extension cords used for only temporary purposes?

  Yes

  No

  N/A

• Are all above ground storage tanks, including liquid oxygen, electrically grounded?

  Yes

  No

  N/A

• Are electrical tools either grounded with a grounding prong or double insulated?

  Yes

  No

  N/A

• Are surge protectors used solely for low draw electric equipment?

  Yes

  No

  N/A

FIRE PREVENTION

• Are all portable fire extinguishers mounted properly and signed so that they are easy to locate?

  Yes

  No

  N/A

• Are all fire extinguishers readily/immediately accessible?

  Yes

  No

  N/A

• Are fire extinguishers maintained in good working order and inspected monthly by employee?

  Yes

  No

  N/A

• Are fire extinguishers serviced annually by a qualified contractor?

  Yes

  No

  N/A

• Are employees trained annually in the use of portable fire extinguishers?

  Yes

  No

  N/A

• Do you discuss the fire drill procedure at least annually?

  Yes

  No

  N/A

• Does the fire plan including family members when they live on the hatchery?

  Yes

  No

  N/A

• Are smoke detectors used near kitchens and sleeping areas (including in state-owned housing), are they in good working order?

  Yes

  No

  N/A

• Are areas under stairwells, furnace or electrical rooms kept free from flammable and/or combustible materials?

  Yes

  No

  N/A

• Are firearms, ammunition and pyrotechnics stored properly? Locked and in red magazine box.

  Yes

  No

  N/A

• Is an inventory of all firearms, ammunition and pyrotechnics maintained?

  Yes

  No

  N/A

• Are only flammable and combustible liquids stored in flammable containers?

  Yes

  No

  N/A

• Is gasoline and diesel stored in approved safety cans or cans that are effectively closed?

  Yes

  No

  N/A

• Is an emergency shut-off switch provided for all fuel storage tanks, that is greater than 20' but less than 100' away?

  Yes

  No

  N/A

• Is the emergency shut-off switch easily accessible, clearly labeled, and visible from the tank(s)?

  Yes

  No

  N/A

• Are tanks protected from vehicular traffic by bollards of other barriers? Bollards have very specific installation requirements.

  Yes

  No

  N/A

HAZARD COMMUNICATION

• Do you have or know how to access your current chemical inventory?

  Yes

  No

  N/A

• Does each chemical container have a complete, legible label indicating the contents and primary hazard?

  Yes

  No

  N/A

• Are above ground storage tanks and propane tanks labeled as:<br>Gasoline: No Smoking, Flammable, Gasoline<br>Diesel: No Smoking, Combustible, Diesel<br>Propane: No Smoking, Flammable, Propane

  Yes

  No

  N/A

LIFE SAFETY

• Do all emergency exits function properly?

  Yes

  No

  N/A

• Are all emergency exits properly signed with the words EXIT?

  Yes

  No

  N/A

• Are either glow-in-the-dark or lighted EXIT signs are used?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are the batteries/ light bulbs in working order?

  Yes

  No

  N/A

• Are all emergency exit doors unlocked for egress from the inside and without the need for any device (keys, tools, etc.)?

  Yes

  No

  N/A

• Are all means of egress free from obstructions?

  Yes

  No

  N/A

• Do stairwells have adequate lighting, including emergency lighting?

  Yes

  No

  N/A

• Is a railing provided for all stairways with four or more risers?

  Yes

  No

  N/A

• Are handrails and stair treads in good condition, meeting the minimum requirements?

  Yes

  No

  N/A

LOCKOUT-TAGOUT

• Do you have any equipment specific LOTO procedures developed and maintained with the Hatchery Plan (Appendix)?

  Yes

  No

  N/A

• Does the appendix identify all machines with a LOTO procedure?

  Yes

  No

  N/A

• Are all employees who are affected by and authorized for LOTO properly trained?

  Yes

  No

  N/A

• Identify employees that are Authorized.

PERSONAL PROTECTIVE EQUIPMENT

• Are all employees observed at the time of assessment wearing proper, approved PPE?

  Yes

  No

  N/A

• Is PPE provided to all employees and is available at no cost? (Supplies distributed?)

  Yes

  No

  N/A

• Have employees been trained on the specific PPE required for each common task, how to properly don, care and maintain it?

  Yes

  No

  N/A

• Are protective goggles, face shields or safety glasses worn in areas where there is a risk to eye injuries?

  Yes

  No

  N/A

• Are protective gloves, aprons, shields provided where employees are exposed to cuts, burns, chemicals?

  Yes

  No

  N/A

• Is protective foot wear provided where there is risk of foot injuries from common Hatchery work including crushing, falling objects, chemical splash, slippery surfaces?

  Yes

  No

  N/A

• Are hard hats provided and worn when operating and working around heavy equipment including fish loaders and construction equipment? Hard hats not required if operating equipment that is equipped with proper roll cage.

  Yes

  No

  N/A

• Is PPE inspected at least annually and maintained in proper condition?

  Yes

  No

  N/A

• Do you have emergency eyewash facilities within the work area where employees are exposed to injurious corrosive materials including formalin and disinfectants?

  Yes

  No

  N/A

• Are eyewash stations inspected at least monthly? (Documented)

  Yes

  No

  N/A

• Are eyewash stations located within a 10 second travel distance and without any complicated route?

  Yes

  No

  N/A

• Does the eyewash station provide tepid (lukewarm) water and flush for at least 15 minutes?

  Yes

  No

  N/A

RESPIRATORY PROTECTION

• Have all employees that voluntarily wear a "filtering face-piece" (dust mask) read and signed Appendix D, Voluntary Respirator Use form, located at the end of the respiratory section in the manual?

  Yes

  No

  N/A

• Are all respirators kept in sanitary condition, and stored to protect them from excessive temperatures, dust, damage, contamination, and to prevent deformation.

  Yes

  No

  N/A

• Are employees wearing tight fitting respirators (half-face, full-face)?

  Yes

  No

  N/A

• For what chemicals/processes?

SHOP SAFETY

• Do employees wear personal protective equipment when using hand tools?

  Yes

  No

  N/A

• Do you periodically go through hand tools and repair or replace defective tools?

  Yes

  No

  N/A

• Are tools that should be sharp, kept sharp?

  Yes

  No

  N/A

• Are all tools used for their designated purpose? Screw drivers are not chisels.

  Yes

  No

  N/A

• If compressed air is used for cleaning, are safety nozzles used or is air regulated below 30 psi?

  Yes

  No

  N/A

• Are all hoists, lifts, and cranes clearly marked as to their load capacity? (In units clearly understood)

  Yes

  No

  N/A

• Are oxygen bottles lifted by an approved means?

  Yes

  No

  N/A

POWER TOOLS

• No tools are altered to be permanently locked in the on position?

  Yes

  No

  N/A

• Are all manufacturer and machine guards in place so that all nip/crushing points are effectively controlled?

  Yes

  No

  N/A

• Are all portable power tools and components in good condition?

  Yes

  No

  N/A

• Are all machines that are designed for fixed location operation anchored to prevent "walking" during operation?

  Yes

  No

  N/A

• Are large woodworking machines equipped with kickback resistant devices?

  Yes

  No

  N/A

• No pneumatic or powder actuated tool left unattended and connected/loaded?

  Yes

  No

  N/A

• Do all portable generators meet the requirements identified in the manual?

  Yes

  No

  N/A

• Are all solid grinder wheels inspected before use and periodically dressed?

  Yes

  No

  N/A

• Are bench grinders adjusted so the work rest is 1/8" and tongue guard is 1/4"?

  Yes

  No

  N/A

WELDING OPERATIONS

• Have all welders received proper and documented training?

  Yes

  No

  N/A

• Does each welder wear all required PPE when welding?

  Yes

  No

  N/A

• Is the welding kit (torch) equipped with anti-flashback devices?

  Yes

  No

  N/A

• Is adequate ventilation provided for welding operations?

  Yes

  No

  N/A

• Is a fire extinguisher immediately accessible to welding operations? This must be true no matter where welding occurs.

  Yes

  No

  N/A

• Are all flammable/combustible materials removed or covered/screened to prevent fire during welding activities?

  Yes

  No

  N/A

• Are welding screens available to protect the eyes of those not actively welding? Or does another control exist including signage?

  Yes

  No

  N/A

• Is the area where welding occurred inspected for fire 30 minutes following activity?

  Yes

  No

  N/A

• Is all welding equipment, hoses, wire leads, electrical cords, etc., in good working condition?

  Yes

  No

  N/A

WALKING WORKING SURFACES

• Are all areas maintained in a sanitary, clean and orderly condition?

  Yes

  No

  N/A

• Are all work areas and paths of travel free from tripping hazards?

  Yes

  No

  N/A

• Are carpeted areas and common areas free from rips, bumps, torn edges or loose tiles that can cause a tripping hazard?

  Yes

  No

  N/A

• Are break areas and food kitchens kept clean and sanitary?

  Yes

  No

  N/A

• Are ladders rated for the purpose and at least heavy duty or industrial grade?

  Yes

  No

  N/A

• Are ladders being inspected on a periodic basis?

  Yes

  No

  N/A

• If work areas are over 6' without a standard railing or off a ladder, is fall protection provided?

  Yes

  No

  N/A

• If your facility has a mezzanine or storage area above an occupied room, is the floor rating marked in a conspicuous location and visible from the main floor?

  Yes

  No

  N/A

• Does the mezzanine(s) have a standard railing along the perimeter?

  Yes

  No

  N/A

• Do employees with offices have ergonomically correct furniture and set up?

  Yes

  No

  N/A

• How likely (1-10) are you to wear ice/snow foot traction devices during the winter months? Manager must establish expectation of use?

• Full traction

• Heel only traction

VEHICLES

• Is the Vehicle Policy signed by, on file and available for all hatchery drivers?

  Yes

  No

  N/A

• Have all drivers completed the Defensive Driving Course within the last 4 years?

  Yes

  No

  N/A

• Are pre-trip inspections being performed before departure?

  Yes

  No

  N/A

• Has each vehicle been equipped with a fire extinguisher?

• Has each vehicle been equipped with a first aid kit?

• Has each vehicle been equipped with appropriate documentation including registration, insurance, inspections, etc?

• Are vehicles equipped with headache rack when cargo is stored above the bed wall, on a regular basis?

  Yes

  No

  N/A

SPECIALIZED VEHICLES

• Are forklift operators certified in each type of forklift they use?

  Yes

  No

  N/A

• Have all off-road vehicle operators been through service-approved training?

  Yes

  No

  N/A

• Does each operator wear all necessary PPE (helmets) and/or seat belts at all times?

  Yes

  No

  N/A

• Are there any specific operator rules relating to these requirements? i.e., speed limits, activities, on/off hatchery use.

• Are all employees who operate heavy equipment trained, tested and authorized in writing by the Hatchery Manager?

  Yes

  No

  N/A

• Does each piece of equipment have back-up alarms, lights, safety equipment?

  Yes

  No

  N/A

• Are all roll protection and seat belts in good working order and per manufacturer requirements?

  Yes

  No

  N/A

OTHER DEFICIENCIES, NOT SPECIFIED

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ANNUAL GOALS (Self-Assessment Only)

• What are your three top Safety, Health and/or Environmental issues or concerns that will addressed this year?.

• 1.

• 2.

• 3.

SIGNATURES

• This assessment represents an evaluation of the safety, health and environmental conditions at the time of assessment. By signing below, you only acknowledge that the deficiencies were discussed with you. Any follow-up questions or comments should be directed to the Statewide Safety Coordinator.

• Hatchery Manager

  Sign

• Regional Safety Coordinator

  Sign

• Statewide Safety Coordinator

  Sign

• State Risk Safety and Loss Control Specialist

  Sign