Health & Safety Manual
Updated January 2025
Chapter 1 – General Safety Program & Responsibilities [pdf]
- Appendix A – PCC Board Policy B507 [pdf]
- Appendix B – Hazard Assessment Instructions [pdf]
- Appendix C – Academic Training Chart [pdf]
- Appendix D – Operational Training Chart [pdf]
- Appendix E – Chapter Applicability Guide [pdf]
- Form 1: New Employee Department Safety Checklist [pdf]
- Form 2: Hazard Assessment [pdf]
- Form 3: Job Safety Analysis [pdf]
- Form 4: Hazardous Condition Report [pdf]
- Form 5: Hazardous Condition Report Investigation [pdf]
Reference Documents
- National Safety Council – Example JSA and Instructions [pdf]
- National Safety Council Practical Tips [pdf]
Chapter 2 – Accident/Incident Investigation Plan [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – How to Conduct an Accident Investigation [pdf]
- Form 1: Supervisor Investigation Report [pdf]
- Form 2: Bloodborne Pathogens Incident Form [pdf]
Chapter 3 – Safety Committees Charter [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Meeting Format [pdf]
- Form 1: Safety Committee Agenda [pdf]
- Form 2: Safety Committee Minutes [pdf]
- Form 3: Inspection Audit Worksheet [pdf]
- Form 4: Safety Inspection Correction Recommendation Sheet [pdf]
- Form 5: New Member Checklist [pdf]
Chapter 4 – Bloodborne Pathogen (BBP) Exposure Control Plan [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Sharps Containers Use & Disposal [pdf]
- Appendix C- Student (Non-Employee) BBP Exposure Control Plan [pdf]
- Appendix D – Occupational Health Providers [pdf]
- Form 1: Hepatitis B Immunization Acceptance/Declination [pdf]
- Form 2: Sharps Injury Log [pdf]
- Form 3: Training Checklist [pdf]
Reference Documents
- Injury or Property Incident Report
- BBP Incident Report [pdf]
- Employee 801 Report & Pain Diagram – Available from Risk Services
- Center for Disease Control (CDC) Hepatitis B Vaccine Information Sheet [pdf]
- Kaiser Permanente Urgent Care Location Sheet [pdf]
- Kaiser Permanente Hepatitis B Full Series Immunization Program Instruction Sheet [pdf]
Chapter 5 – Confined Space Entry [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Space Determination Flowchart [pdf]
- Appendix C – Cascade [pdf]
- Appendix C – Climb [pdf]
- Appendix C – Downtown Center [pdf]
- Appendix C – Metro [pdf]
- Appendix C – Newberg [pdf]
- Appendix C – Rock Creek [pdf]
- Appendix C – Southeast [pdf]
- Appendix C – Swan Island [pdf]
- Appendix C – Sylvania [pdf]
- Appendix C – Willow Creek [pdf]
- Appendix D – Entry Team Duties [pdf]
- Appendix E – Multi-Gas Detector Usage and Calibration [pdf]
- Appendix F – Tripod Inspection [pdf]
- Appendix G – Rescue Plans [pdf]
- Appendix H – Utility Tunnel Safety [pdf]
- Form 1: Confined Space Assessment [pdf]
- Form 2: Confined Space Entry Permit [pdf]
- Form 3: Permit-Required Confined Space Rescue Plan [pdf]
- Form 4: Utility Tunnel Safety Work Plan [pdf]
Chapter 6 – Electrical Safety
(under reconstruction)
Chapter 7 – Hazardous Material Emergency Response Plan [pdf]
(Included as Annex P of PCC’s Emergency Operations Plan)
- Appendix A – Definitions [pdf]
- Form 1: Hazardous Release Assessment [pdf]
- Form 2: Site Work Plan [pdf]
Chapter 8 – Hazard Communication [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Global Harmonize System (GHS) Pictograms [pdf]
- Appendix C – MSDSonline Overview and Instructions Guide [pdf]
- Form 1: Chemical Prior Approval Form [pdf]
- Form 2: New Chemical or Non-Routine Exposure Training Document [pdf]
Chapter 9 – Chemical Hygiene Plan – Laboratories [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Laboratories & Storeroom Locations [pdf]
- Appendix C – GHS Reference Materials [pdf]
- Appendix D – Inventory of Carcinogens and Other Specific Hazards [pdf]
- Form 1: Laboratory & Storeroom Inspection Checklist [pdf]
Chapter 10 – Control of Hazardous Energy – Lockout/Tagout [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Lockout/Tagout Devices [pdf]
- Form 1: Lockout/Tagout Equipment Evaluation & Energy Control Procedure [pdf]
- Form 2: Lockout/Tagout Periodic Inspection [pdf]
Chapter 11 – Noise Exposure & Hearing Conservation Plan [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Evaluating Noise Reduction Ratings (NRR) of Hearing Protectors [pdf]
- Appendix C – Occupational Health Providers [pdf]
Reference Documents
- Online Injury/Illness/Near-Miss Report
- Example STS Notification Letter to Employee [pdf]
- Providence Occupational Medicine Bridgeport [pdf]
Chapter 12 – Personal Protective Equipment (PPE) [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – PPE Use by Department (as of May 2020) [pdf]
- Appendix C – Infectious Disease Hazard ID and Protection [pdf]
- Form 1: PPE Assessment & Training [pdf]
Chapter 13 – Hazardous Building Materials [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – PCC Building Inventory [pdf]
- Appendix C – Asbestos Containing Material (ACM) Examples [pdf]
Reference Documents
Chapter 14 – Powered Industrial Trucks, Material Handling Vehicles, and Powered Mobile Equipment [pdf]
- Appendix A – Definitions [pdf]
- Form 1: Powered Industrial Truck Operator Inspection Checklist [pdf]
- Form 2: Powered Industrial Truck Training Checklist Record [pdf]
- Form 3: Powered Industrial Truck Training Certification [pdf]
- Form 4: Scissor Lift & Elevated Work Platform Operator Inspection Checklist [pdf]
- Form 5: Utility Vehicle Operator Inspection Checklist [pdf]
- Form 6: Utility Vehicle Operator Department Training Log [pdf]
Chapter 15 – Mechanical Hazards – Controls and Facility Safety
(under reconstruction)
Chapter 16 – Hot Work [pdf]
Chapter 17 – Respiratory Protection Plan [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Respirator Selection Table [pdf]
- Appendix C – Respirator Program Elements [pdf]
- Appendix D – Occupational Health Providers [pdf]
- Appendix E – Respirator Voluntary Use [pdf]
- Form 1: Medical Clearance Request [pdf]
- Form 2: OSHA Medical Evaluation Questionnaire [pdf]
- Form 3: Respirator Assignment [pdf]
- Form 4: Cleaning and Storage [pdf]
- Form 5: Plan Evaluation [pdf]
Reference Documents
Chapter 18 – Contractor Hazard Notification (Multi-employer sites) [pdf]
- Appendix A – Definitions [pdf]
- Appendix B: Example Completed Form 1 [pdf]
- Form 1: Contractor Notification Project Hazard Assessment [pdf]
Chapter 19 – Industrial Hygiene Program & Air Monitoring Results
(under reconstruction)
Chapter 20 – Fall Protection Program [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Hierarchy of Fall Protection Controls [pdf]
- Appendix C – Requirements for Guardrail Systems and Hole Covers [pdf]
- Appendix D – Requirements for Designated Areas [pdf]
- Appendix E – Requirements for Personal Fall Restraint and Personal Fall Arrest Systems [pdf]
- Appendix F – Pre-Work Body Harness and Lanyard Inspection [pdf]
- Form 1: Fall Protection Work Plan (FPWP) [pdf]
- Form 2: Personal Fall Restraint System/ Personal Fall Arrest System Inspection [pdf]
Chapter 21 – Regulated Waste [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Lists of Hazardous Waste [pdf]
- Appendix C – Satellite Accumulation Log [pdf]
- Appendix D – Hazardous Waste Log [pdf]
- Appendix E – Sewer Discharge Log [pdf]
- Appendix F – Waste Labels Fact Sheet [pdf]
- Appendix G – Bulk Used Oil Tanks [pdf]
- Form 1: Satellite Accumulation Area Inspection [pdf]
Chapter 22 – Environmental Protection & Stewardship [pdf]
Chapter 23 – Cranes & Lifts [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – Sling Specifications by Type [pdf]
- Form 1 – Daily Inspection Checklist [pdf]
- Form 2 – Quarterly Inspection Checklist [pdf]
Chapter 24 – Heat Illness Prevention Plan [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – PCC Locations [pdf]
- Appendix C – Apparent Temperature Chart [pdf]
- Appendix D – Preventing Heat-Related Illnesses [pdf]
- Appendix E – Heat-Related Illnesses – Signs, Symptoms, and Responses [pdf]
- Appendix F – Acclimatization Practices [pdf]
- Appendix G – Work/Rest Schedule Options [pdf]
- Form 1 – Department Work Plan [pdf]
Chapter 25 – Wildfire Smoke Protection Plan [pdf]
- Appendix A – Definitions [pdf]
- Appendix B – PCC Locations [pdf]
- Appendix C – Employee Communication Template [pdf]
- Appendix D – Exposure Controls [pdf]
- Appendix E – Filtering Facepiece User Seal Checks [pdf]
- Appendix F – 5-3-1 Visibility Chart [pdf]
Chapter 26 – Scaffold Safety Plan [pdf]
Reference Documents
- Scaffold Code of Safe Practices [pdf]
- Procedures for Visual Inspection of Welded Tubular Frame Scaffolding Accessories [pdf]
- Rolling Towers/Mobile Scaffold: Inspection, Maintenance, and Use Tip Sheet [pdf]