THE INDUSTRIAL COMMISSION OF ARIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH Lag-?lulu v.1 Ev, I-ri'h u?rlr rifl 1' P.O. Box 19070 JESSIE nuuon ?mac 1 un JOSEPH M. HENNELLY, JR., VICE CHAIR Phoenix, Arizona 05005-9070 PHONE: (602) 542-5795 SCOTT P. LEMARR, MEMBER FAX: (602) 542-1614 STEVEN J. KRENZEL, MEMBER JAMES ASHLEY, DIRECTOR November20, 2019 Mr. Eddrick Moreland 6515 Jackrabbit Trail Arlington, AZ 85322 Re: ADOSH Safety Inspection #1434709 Dear Mrs. Miller, On September 25, 2019 I conducted an inspection at the location of Hickman?s Egg Ranch, Inc. site located at 32425 Salome Hwy, Arlington, AZ 85322. The following items were included as part of the partial inspection; However, this letter is to inform you of the need to address them as necessaiy. Item 1) During the course of the inspection, it was discovered during the walk-around portion of the inspection that a guard cover to the feces conveyer located in Barn 19 was missing. Under 29 CFR Sprocket wheels and chains which were seven ?7 feet or less above ?oors or platforms were not enclosed. Although this condition was observed, the elements required for an OSHA violation were not present (met). At this time, citations are not recommended for this item. lHowever, I would strongly suggest that you consider con?ecting the conditions as they may expose your employees to potential injuries. Sincerel Cristian Teudan Safety Compliance Of?cer 1This letter of recommendation outlines only those conditions for which citations will not be issued. There may have been additional conditions noted during the inspection that will result in a citation and possible penalty. Such citations, if issued, either accompany this letter, or will be sent under a separate cover. 800 West Washington Street, Phoenix, Arizona 85007 THE INDUSTRIAL COMMISSION OF ARIZONA ARIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH MEMORANDUM: TO: Administrative Assistant Date: 11/20/2019 FROM: Compliance Officer Cristian Teudan SUBJECT: ADOSH Inspection: 1434709 Additional Instruction: Choose One: Letter of Recommendation Letter: Generate Letter Please print the letter from OIS and replace the copy on the left side of file. Then notate date and time letter was sent on the memo. Keep the memo on top of the copy on the left side. If you had mailed the letter please make a note on the copy page that the letter had been sent with date and time. THE INDUSTRIAL COMMISSION OF ARIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH ham-tine! 31. in: are theta-m . - starlets?, P.O. Box 19070 JESSIE ATENCIU, Micron ?mm. Lun JOSEPH M. HENNELLY, JR., VICE CHAIR Phoenix, Arizona 85005?9070 PHONE: (602) 542?5795 SCOTT P. LEMARR, MEMBER FAX: (602) 542-1614 STEVEN J. KRENZEL, MEMBER JAMES ASHLEY, DIRECTOR N0vember20, 20 19 Mr. Eddrick Moreland 6515 Jackrabbit Trail 0 Arlington, AZ 85322 Re: ADOSH Safety Inspection #1434709 Dear Mrs. Miller, 011 September 25, 2019 I conducted an inspection at the location of Hickman?s Egg Ranch, Inc. site located at 32425 Salome Hwy, Arlington, AZ 85322. The following items were included as part of the partial inspection; However, this letter is to inform you of the need to address them as necessary. Item 1) During the course of the inspection, it was discovered during the walk?around portion of the inspection that a guard cover to the feces conveyer located in Barn 19 was missing. Under 29 CFR Sprocket wheels and chains which were seven ?7 feet or less above ?oors or platforms were not enclosed. Although this condition was observed, the elements required for an OSHA violation were not present (met). At this time, citations are not recommended for this item. 1However, I would strongly suggest that you consider correcting the conditions as they may expose your employees to potential injuries. Sincerely, Cristian Teudan Safety Compliance Of?cer COPY 1This letter of recommendation outlines only those conditions for which citations will not be issued. There may have been additional conditions noted during the inspection that will result in a citation and possible penalty. Such citations, if issued, either accompany this letter, or will he sent under a separate cover. 800 West Washington Street, Phoenix, Arizona 85007 Inspection Back ViolationSummary Inopection Number: 1434709 Establishnient . Egg Ranch, All Items Final Order: No Inc. i 5 5 Opening Conference Date: 09/25/2019 Final Order Date: Chat-.5555- . - mum?. . . H: Data: '5 Page 1 of 1 Print Candidate For Follow Up: No Total Penalty Amount: $0.00 12/3/2019 605 213K Monsz A 7? cJM-qc M54. ".3630? To bends 354:0 Company Name ?66 Inspection Number /4 3 7 <9 amily Shane Jolicoeur Complex Manager Office 623) 872-2335 Cell sjolicoeur@hickmanseggs.com 12710 N. Murphy Rd. - Maricopa. AZ 85139 HICKMANS FAMILY FARMS ROBERT PHALEN ENVIRONMENTAL MANAGER 0: [623] 872- 2341 rphalen@hickmanseggs.com . i HICKMANS FAMILY FARMS EDDRICK MORELAND SAFETY COORDINATOR 0: [480] 645-1187 UNITED STATES DEPARTMENT OF LABOR OSHA English Espaiiol Find it in OSHA OSHA WORKER EMPLOYER STANDARDS CODBTRUCTION TOPIC DATA TRAINING Establishment Search Reflects inspection data through 09/20/2019 This page enables the user to search for OSHA enforcement inspections by the name of the establishment. Information may also be obtained for a speci?ed inspection or inspections within a speci?ed SIC. A Note: Please read important information below regarding interpreting search results before using. Search By: Your search did not return any results. Establishment EGG RANCH. 5 {This box can also-be used to search-fer a State Actr'wi'y Number for the following site res: NC, 5 C, Ki; 1M 01? and WA) State Arizona . 'Fed&state .. OSHA Of?ce All Of?ce-IS. .. .- I . Site Zip Code Case Status 6) All (2) Closed Open Violation Status All ti} With Violations 0 Without Violations Inspection Date Start Date September 25 2015 ,5 End Date ?5 September 25 2019 v5 Submit Reset 3 Can't find it? Wildcard use Basic Establishment Search Instructions Advanced Search Syntax USERS The Integrated Management Information System (IMIS) was designed as an information resource for in-house use by OSHA staff and management, and by state agencies which carry out federally-approved OSHA programs. 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It is critical that users of the data understand several aSpecls of the system in order to accurately use the information. 9/25/2019 Arizona Corporation Commission Entity Information Search Date and Time: 9/25/2019 8:17:32 AM Entity Details EGG RANCH, INC. 00682931 Domestic For-Profit (Business) Corporation Active 1/11/1966 In Good Standing 1/ 11/ 1966 1/11/1966 Perpetual AGRICULTURE 2018 Arizona 11/11/2019 Entity Name: Entity ID: Entity Type: Entity Status: Formation Date: Reason for Status: Approval Date: Status Date: Original Incorporation Date: Life Period: Business Type: Last Annual Report Filed: Domicile State: Annual Report Due Date: Years Due: Original Publish Date: Statu?dvyca?m?tm Contact Us 1/3 9/2512019 BRYAN Active Arizona Corporation Commission 702 OSBORN RD #200 BURCH 84 CRACCHIOLO, PHOENIX, AZ 85014, USA 12/ 27/ 2018 Maricopa Principal Information Title Name Attention Director GLENN HICKMAN . BILLY Director HICKMAN Shareholder GLENN HICKMAN BILLY Sh are older HICKMAN GLENN Presiden CEO t/ HICKMAN CLINTON Secretary HICKMAN LLY Vice-President I HICKMAN Entity Known Place of Business Attention: Date of Taking Office Address 6515 SOUTH JACKRABBIT TRAIL, BUCKEYE AZ, 85326, USA 6515 SOUTH JACKRABBIT TRAIL, BUCKEYE, AZ 85326, USA NOT REQUIRED, NOT REQUIRED, NOT REQUIRED, NOT REQUIRED, 6515 SOUTH JACKRABBIT TRAIL, BUCKEYE, AZ, 85326, USA 6515 SOUTH JACKRABBIT TRAIL, BUCKEYE, AZ, 85326, USA 6515 SOUTH JACKRABBIT TRAIL, BUCKEYE, AZ, 85326, USA Name: Appointed Status: Attention: Address: Agent Last Updated: E-mail: Attention: Mailing Address: County: Last Updated 15/ 2017 128/15/2017 12: 00: 00 AM 8/15/2017 12:00:00 AM 8/15/2017 12: 00: 00 AM . 8/15/2017 12:00:00 AM Ad oviPublicBusiness umber: 00682931 213 912522019 Arizona Corporation Commission Cou nty: MariCOpa Last Upd ated: 12/12/2012 Entity Principal Office Address Attention: Add ress: County: Last Updated: back ]LReturn to Search? Document History Name/Restructuring History Pending Documents Microfilm History Return to Results Privacy Policy Contact Us :f/ecorpazcc .g oWPubl icBusi nessSearclv?Publ icBusi ness lnfo?entityN umber=00682931 313 AIJOSH INSPECTION TRACK This form will remain on the top right of the his. all times Company Name: EGG agile. Inspection terse-7001 c9952. Pre-Cltatlon(s) Issued Post Citatlon(s) Issued Opening Conference: Citations Issued: Giles/I41 .ch Closing Conference: Date Citations Mailed: ti [Loin File to Supervisor for Review: USPS Tracking Number: Supervisor Reviews file: Place Tracing Number Sticker Here Returned to CSHO for Corrections: USPS Confirmation of Delivery Date: File to Supervisor for Review: Last Day to Contest: Supervisor Reviews file: Returned to CSHO for Corrections: Employer Reserved Rights Dates For Informal Conference: File to Supervisor for Review: For Formal Contestment: Supervisor Reviews file: Informal Conference . I lie to Assistant Director for Review: (in) Informal Conference Scheduled: Assistant Director Reviews file: (ii/?Vi Informal Conference Conducted: File to Supervisor for Revision: (le kit/?? Informal Settlement Agreement Sent: Returned to CSHO for Corrections: Informal Settlement Agreement Signed. File to Supervisor for Review: Formal Contestment File to Assistant Director for Review: File to Admin to Process to OAH: File to Director for Review: File to Front Desk for Scanning: Director Reviewed File: File Scanned Date: Admin Request Attorney?Assignment: File to Superwsor for Admin to Prep: File I Attorney Approval Date: File Prepared for Commission: File Transferred to QAH Date: File Submitted to Commission: Abatement Commission Date: Abatement Due Date: File Returned from Commission: Abatement Completed Date: File to Supervisor: File Incompliance Close Date: Citations Issued: File to Admin to Issue Citations: FatalitleatastropheInspection i ll Initial Penalty: Initial Condolence Letter Sent: Adjusted Penalty: Medical Exam Report Request Date: Penalty Received Date: Medical Exam Report Received Date: Penalty Amount Received: Police Report Request Date: Final Order Date: Police Report Received Date: Case File Closed Date: Fire Department Report Request Date: Fire Department Report Received Date: Inspection Notification Letter Sent: Inspection Report Tue Dec 03, 2019 10:33:01 AM RID CSHO ID Supervisor ID Inspection Number Optional Report Number Case Closed Date 0950411 K6582 Y8817 1434709 36 Establishment Name Hickman's Egg Ranch, Inc. Doing Business As (DBA) Ownership Type Private Sector Type of Business Corporation 112310 Primary NAICS Site Address 32425 Salome Hwy Site Phone (623)-386- Extn Site FAX ARLINGTON, AZ, 35322 1333 Business Address 32425 Salome Hwy Business Phone (623)-3 86-1333 Business FAX ARLINGTON, AZ, 85322 Mailing Address 6515 Jackrabbit Trail E-mail Mobile Phone BUCKEYE, AZ, 85326 Site Activity Egg Farm NAICS Inspected 112310 Days on Site 1 Federal EIN DUNS Temporary or Fixed Site? Fixed Site State Estab Id DUNS plus4 CAGE Code Construction Type Entry 25-SEP-2019 10:00 AM First Closing Conference 25-SEP-2019 02:20 PM Opening Conference 10:30 AM Second Closing Conference Walkaround 25-SEP-2019 10:45 AM Exit 25-SEP-2019 02:50 PM Inspection Initiating Type Referral Secondary Type Other Initiating Type Inspection Category Safety Scope of Inspection Partial Reason No Inspection Sampling Performed? ISVEP IN Expln. for No Insp. Federal Strategic Initiatives National Emphasis State Emphasis Local Emphasis Primary Emphasis Employed in Establishment 24 Walkaround? Advance Notice? Covered By Inspection 24 Interviewed? Flag for Follow-up Controlled By Employer 600 Union? Reason for Follow-up Is this Company a current federal contractor? Parent Company Legal Name Parent Comp Trade Parent Company Phone Extn Address Number TIN EIN DUNS CAGE Code DUNS plus4 Page 2 Hickman's Egg Ranch, Inc. Tue Dec 03, 2019 10:33:01 AM Inspection Nr. 1434709 Related Activity Activity Number Activity Type Satis?ed Establishment Name 1501968 Referral Health EGG RANCH, INC. Related Inspections Inspection Number Establishment Name Related Inspection Type Additional Codes Type ID Value Description . Employer RepresentatiVes Gentacted Name Eddrick Moreland Job Title Safety Coordinator Occupation Address 6515 S. Jackrabbit Trail Interviewed? BUCKEYE, AZ, 85326 Home Work 480-645-1 187 Mobile Fax Email emoreland@hickmanseggs.co Participation Walk Around, Credentials, 1n Closing Conference, Opening Conference Name Robert Phalen Job Title Enviromental Occupation Manager Address 6515 S. Jackrabbit Trail Interviewed? Home Work 623-872-2341 Mobile Fax Email rphalen@hickmanseggs.com Participation Walk Around, Credentials, Closing Conference, Opening Conference Name Shane Jolicoeur Job Title Complex Manager Occupation Address 6515 S. Jackrabbit Trail Interviewed? ARLINGTON, AZ, 85322 Home Work 623-872-2335 Mobile Fax Email sjolicoeur@hickmanseggs.co Participation Walk Around, Credentials, Closing Conference Name Sam Seagren Job Title HR Manager Occupation Address Interviewed? Home Work Mobile Fax Email Participation Closing Conference Name Daniel Milea Job Title Supervisor Occupation Address 6515 Jackrabbit Trail Interviewed? BUCKEYE, AZ, 85326 Page 3 Tue Dec 03, 2019 10:33:01 AM Hickman's Egg Ranch, lnc. Inspection Nr. 1434709 Home iWork 1480-6454187 [Mobile i Fax Email i I Participation Credentials Employees Contacted Name 1 Job Title IOceupation Address Interviewed? Ilome Mobile Fax Email l?artici ation Credentials Name Job Title Occupation Address 16515 Jackrabbit Trail Interviewed? AZ, 85326 Home Work 1 Mobile Fax Email Participation i Credentials .4 CSHO Signature .4 Date ?9 inspection Number 1434709 COVERAGE INFORMATION: This inspection on the Hickman's Egg Ranch, Inc. was the result ofa media referral received in the Phoenix ADOSH office and assigned to me by Supervisor Brooks Rogers on September 25, 2019. On September 12, 2019, Phoenix New Times, Elizabeth Whitman published an article regarding a Perryville Prison inmate that was injured in December 2019 at Hickman's Egg Ranch located at 32425 Salome Hwy, Arlington, AZ 85322. The referral revolved around a finger amputation with an auger, employees are not provided training, lock-out tag out training, smells and substances, respiratory masks and personal protective equipment. This inspection was conducted on the 25th of September 2019. In this report, the laborers! workers were referenced as employees. The laborers/ workers were not direct hires to the company, Hickman's Egg Ranch, Inc. The company had a work contract with Perryville Prison to provide laborers] workers who were provided training and an opportunity for employment following release from the prison. COMPANY INFORMATION: Hickman's Egg Ranch, Inc. was an egg farm in Arizona that had multiple locations in southern Arizona. The site visited was located at 32425 Salome Hwy, Arlington, AZ 85322. The farm raised poultry and collected, processed and distributed eggs to various grocery stores in southwest Arizona. The company had been in business for 75 years and operated various shifts with 540 employees in Arizona. The company currently had 24 employees at this site with a large number of employees provided from Perryville prison. The company works two shifts from 6:00 am. to 4:00 pm. and one shift for sanitation that worked from 4:00 pm. to 3:00 am. INSPECTION PARTICIPATION: Upon arriving at the site location, I was greeted by Safety Coordinator Eddrick and Environmental Manager Robert Phalen. I stated would be conducting an Opening Conference, Walk-around Inspection, and a Closing Conference with them and any other management or employee representative present. I further explained to them that we received a media referral from Phoenix New Times that revolved around a finger amputation with an auger, employees are not provided training. lock-out tag out training, smells and substances, respiratory masks and personal protective equipment (PPE). The walk?around inspection started at 10:45 am, and vacatedthe site at 2:50 pm. CLOSING CONFERENCE PARTICIPATION: A closing conference was completed on September 25, 2019 at 2:20 pm. with Safety Coordinator Eddrick, Environmental Manager Robert Phalen. Compiex Manager Shane Jolicoeur and HR Manager Sam Seagren who phoned into the closing conference . The closing conference was conducted on site. No apparent violations of the OSHA standards were observed. Finally, a copy of the ADOSH Consultation Brochure was provided so that the company may contact them independently following the file closure. FINDINGS (Mark the applicable boxes with an and explain findings) Complaint lte ms: Referral: Phoenix New Times, Elizabeth Whitman Item 1: Finger amputation from auger Findings: During the walk-around portion of the inspection, I was shown the area where the incident occurred with the employee. I was also provided a copy of the incident report that was completed by the company. It was explained to me that the employee who was injured had completed the company training which included augers, conveyers and machine guarding three days prior to the incident occurrence. According to management, it is believed that this incidentwas a result of employee error/ mis-conduct for placing her hand in the auger resulting in the injury as the employee was only to monitor the water system being emptied/ clean-out and not get involved with any servicing of the unit. The employee was tasked to notify the operator at the controls via radio if any problem arose during the clean-out process. No apparent violations of the OSHA standards were observed at this time. Item 2: Employees not provided training Findings: Following the opening conference with management, I was shown the training room where all training is conducted with new employees that are hired. Employees go through a one week training program that covers the company safety and health program, machinery, lock-out tag out, chemicals and sanitation, PPE and other relative safety and health trainings. This was confirmed with employees when conducting interviews who stated that training is provided regularly and they did not feel this was an issue or concern to safely conduct theirjob duties. Copies of the program and material covered during the orientation process were provided and included in the file for review. No apparent violations of OSHA standards were observed at this time. Item 3: Lock?out Tag-out (LOTO) Training Findings: During the interview process of the inspection I was informed by management that all employees were provided with lock-out tag-out training. Management provided me copies of the training documentation that was provided to employees and a copy of the training power point. When conducting interview with employees it was also identified that employees were trained in the company Lock-out Tag- out program. Employees stated that they are provided training courses and refresher training on a regular basis. The company also had specific LOTO procedures for various machinery onsite that included conveyers, augers and machinery used for product (eggs) sanitation, organizing, packaging and distribution. Copies of the LOTO training, program and procedures are included in the file for review. This condition did not represent an apparent OSHA violation at this time. Item 4: Smells and substances Findings: During the onsite walk-around portion of the inspection there was no smells or substance issues observed. The work areas that were visited wear clean and sanitary. The smells noted were from the poultry birds inside the barns, a fertilizer plant that was at another location near the premises. The barns had large exhaust fans on the east side that were functioning and offered continuous ventilation of the poultry lay barns. inside the barns break room the company had readily accessible for employees a copy of the SDS information. No substances or leaks of any sort were observed or noted during the walk- around process of the inspection. This condition did not represent an apparent OSHA violation. Item 5: Respiratory masks and PPE Findings: During the walk-around portion of the inspection the company provided me with required ty-vex suit, gloves and shoe booties along with a surgical style disposable dust mask. The PPE provided was both to offer protection to the employees from bird droppings and dust generated from the birds and also protect the poultry birds against outside contaminants. During my interview process with employees PPE was not a concern and was readily available for use. PPE is also required to be worn by management for sanitation purposes. This condition did not represent an apparent OSHA violation at this time. ADDITIONAL FINDINGS: During the walk-around portion of the inspection while onsite to investigate the referral items, I observed a guard missing on the bird feces conveyer in barn 19 chain and sprocket. When conducting interview with management and the?they were not aware of how the cover was removed or for how long it had been removed. was informed that the cover could have been inadvertently knocked off by the mortality cart that morning when walking the lines to remove deceased poultry. Though this was an apparent OSHA violation, not all elements were met for a citation and will be addressed to the employer with a Letter of Recommendation. Accident Investigation Summary Findings: Notification 8. Synopsis: Investigation Details: Conclusion: For fatality investigations, was next of kin contact info available? No Yes If available, note date condolence letter sent: Date: I OPENING CONFERENCE Presented credentials Presented a copy of the ACT and ADOSH Poster Explained reason for the inspection Explained scope of the inspection Are employees represented? No Yes Name of org. or rep.: If yes, did a representative participate in the inspection? Yes No Reason: Notes/comments regarding the opening conference: UNUSUAL CIRCUMSTANCES (Describe as appropriate) None Denial of entry (see denial memo) Delays in conducting the inspection Trade Secrets Other Comments: RECORDKEEPING is the employer completing the OSHA 300 log? Yes No Copy of og(s) included in file Not applicable for this employer Reason OSHA 300 Log information: The employer provided a copy of OSHA 300 Logs and OSHA 300A (Summary of Workplace Illnesses and Injuries) for the years 2016. 2017, 2018, and 2019. No deficiencies were identified. SAFETY AND HEALTH PROGRAM Does the employer have an overall safety and health program? No Yes If yes, type of program: Written Verbal Copy of program included in file Comments: The employer provided standard operating procedures that were used for training and communicating procedures during my onsite inspection. The programs were both verbal and in writing. The employer also conducted weekly safety talks with employees on various safety and health topics. Copies were included in the file for reference and review. EVALUATION OF SAFETY PROGRAMS (Check those programs that are in place and provide any relevant comments) Fall protection programlplan Fall protection training records Alternative fall protection methods Forklift program Forklift training/certification records Scaffold safety programltraining Lockout tagout program Punch press inspection Punch press injuries (reported in 30 days) Punch press maintenance and training records Crane inspections Crane training records Chain, wire rope, hook, sling inspections Comments: During the course of the inspection, the look-out tag out safety program was reviewed, as it did relate to the referral. The table of contents provided indicated the following safety sections: Scope, Policy Justification, Responsibility, Company Safety Rules- Employee training manual, Food Defense, Housekeeping, Fire Prevention, Industrial Hygiene and Occupational Health, Personal Protective Equipment, Lock-out Tag?out, Electrical, Guarding, Compressed Gas Cylinders, Ladders, Flammable and Combustible Liquids, Welding and Brazing, Tools, Safety Railings and Other Fall Protection, Forklifts, Aerial Lifts, Additional Safety Policies, and Training. The company has an onsite Safety Coordinator along with Safety Monitors who report to the Safety Coordinator any deficiencies or areas of concern when they conduct weekly facility inspections. A copy of the table of contents was included in the file for reference and review. EVALUATION OF HEALTH PROGRAMS (Check these programs that are in place and provide any relevant comments) Emergency action plan Emergency response plan Confined space program Permit required confined space training Non-permit required confined space training Hearing conservation program Bloodborne pathogens program Bloodborne pathogens training Personal protective equipment hazard assessment Personal protective equipment training Hazard communication program Respiratory protection program Comments: During the course of the inspection, following health programs were reviewed: PPE, Hazard Communication. The table of contents provided indicated the following safety sections: Scope, Policy Justification, Responsibility, Company Safety Rules? Employee training manual, Food Defense, Housekeeping, Fire Prevention, Industrial Hygiene and Occupational Health, Personal Protective Equipment, Lock?outTag-out, Electrical, Guarding, Compressed Gas Cylinders, Ladders, Flammable and Combustible Liquids, Welding and Brazing, Tools, Safety Railings and Other Fall Protection, Forklifts, Aerial Lifts, Additional Safety Policies, and Training. The company has an onsite Safety Coordinator along with Safety Monitors who report to the Safety Coordinator any deficiencies or areas of concern when they conduct weekly facility inspections. A copy of the table of contents was included in the file for reference and renew. ADOSH SAMPLING Was employee exposure sampling conducted by Yes xNo If yes, explain type: Sampling duration: Screening shift Comments regarding ADOSH sampling: MONITORING PROGRAM Is the employer conducting exposure sampling? Yes No If yes, explain type: Who conducted the sampling?: What sampling method was used?: What was the sampling frequency?: Were overexposures documented by the employer? Screening Full shift Comments: Were results obtained by Yes RATING THE SAFETY AND HEALTH PROGRAM (O=Nonexistent. 1=lnadequate, 2=Average, 3=Above Average) Written safety and health program Communication to employees Safety training program Health training program Training records Accident investigation program Preventive action taken Comments: The employer?s Health and Safety program was provided to all employees during the on-boarding orientation that is conducted in the office/ training room during the course of one week. Employees are also provided daily and weekly safety talk depending on the operation and work location, various topics are discussed. CLOSING CONFERENCE No violations were observed Reviewed apparent violations Discussed employer Provided employer a copy of employer rights pamphlet Discussedlencouraged informal conference Offered abatement assistance Discussed consultation programs Discussed employee rights and prohibition against discrimination Were any unusual circumstances encountered such as, but not limited to, abatement problems, negative employer attitude, etc.? Yes No Comments regarding the closing conference: See Coverage Information Above. Referral Report Reporting ID 0950411 Previous Activity Referral Number 1501968 Establishment Establishment EGG RANCH, INC. Employer Information Name Site Address 32425 Salome Hwy ARLINGTON, AZ 85322 Site Phone Site Fax: Mailing Address 32425 Salome Hwy Arlington, AZ 85322 Mailing Address Phone Fax: Industry Type of Business Primary 112310 No. of Ownership NAICS Employees Ownership Source Referred By Phoenix New Times Date Received Sep 24, 2019 3:00:00 PM Referral Classi?cation Hazard Description: Item 1: Finger amputation with an auger Item 2: Employee Training Item 3: Lock-out Tag-out Training Item 4: Smells and Substances Item 5: Respiratory masks and PPE OSHA-90 (81'14) 9124:2019 Barely Trained Inmate Loses ing er Working at Hickman's Phoenix New Times Ntiillmes The barns at Hickman's Family Farms in Tonepah. I Elizabeth Whitman Barely Trained Inmate Loses Finger Working at Hickman's Egg Farm ELIZABETH SEPTEMBER 12,2019 Last December, Mary Stinson was ?xing a chicken feeder inside I-lickman?s egg farm in Arlington, Arizona, when her left middle ?nger caught in the machinery. The auger, a moving coil that pushes feed around, kept rotating. As she used her right hand to free her left, her right index ?nger became trapped instead. In a panic, she literally tore her ?nger free. Someone called an ambulance. 1r?6 9i24l2019 BarelyTrained Inmate Loses Finger Working at Hickman's PhoenixNew Times Stinson, who is incarcera .i at Perryville prison, started Wk ring in sanitation at I-Iickman?s in November 2017. But on the day she lost her finger, Stinson had just switched to a maintenance job, and she was new to augers. It was her second week being around this piece of machinery. Supervisors at Hickman?s never told her to turn it off as she worked, nor did they give her much other training, she told PhoenixNew Times. ??Figure it out? that?s pretty much what they tell you,? she said in a phone interview from Perryville on Tuesday. ?They?ll show you something one time, but not in deep detail.? Stinson is now suing Hickman?s and the state of Arizona for negligence, alleging that they failed to provide a safe working environment. She is seeking $1 million from the state, according to a notice of claim, and asking a jury to determine damages from Hickman?s. Her partially amputated ?nger is one of at least four serious injuries that inmates appear to have suffered while working at I-Iickman?s. These injuries, Stinson's story, and state records suggest that Hickman?s is risking the safety and lives of the incarcerated people whom. the company pays sub-minimum wages to do a dirty, dangerous job. The state agency tasked with enforcing safety standards does not appear to have records showing that it regularly checks on this behemoth of industrial agriculture, whose vice president of sales and marketing, Clint Hickman, sits on the ?ve-member Maricopa County Board of Supervisors. I?Iickman?s Family Farms describes itself as the largest egg producer in the American Southwest, processing more than 750,000 eggs an hour. Cartons with the familiar logo of a chicken wearing sunglasses dominate the egg sections at seemingly any Fry?s, Safeway, or Bashas? in Arizona. The company has relied on incarcerated people for labor for nearly 25 years. It began in 1995 with 10 men from Perryville repairing and building chicken coops, according to Arizona Correctional Industries, the division of the Arizona Department of Corrections that organizes prison labor, a practice that some call "modern-day slavery." Since then, inmates have logged some 4.7 million hours of labor for Hickman?s. They drive forklifts, repair equipment as Stinson did and vaccinate birds, according to AC1. In 2015, nearly 300 incarcerated men and women were working at three different I?Iickman?s complexes. mewti mes.oomicontentipri ntViewii1354362 2/6 9i?2412019 Bareinrained Inmate Loses Finger Working at Hickman?s Phoenix NewTimes For Stinson, who has gor. sack to working in sanitation, si. .s lasted up to 12 hours a day, ?ve days a week, for an hourly wage of $4.25. AC1 describes the relationship as a triple win: I-Iickman?s gets cheap labor, inmates learn skills, and the Department of Corrections ?ful?lls its responsibility to provide inmates in its charge with meaningful work.? At the hospital, doctors could not ?x Stinson?s ?nger. Her nail and ?ngertip ?had no blood flow, were not viable, and could not be reattached,? states her complaint, ?led in Maricopa County Superior Court on August 22. She spent the night at the hospital, she told New Times, and upon returning to Perryville, was given Tylenol for the pain. Nearly nine months later, Stinson says she still suffers ?bone?deep? pain in her dominant hand. ?My hand will just go into spasms sometimes, from my ?nger into my thumb,? she said. The remaining three quarters of her right index ?nger don?t bend, and Stinson doesn?t think her ?nger ever will again. She asked the prison about starting physical therapy, and someone said they?d look into it, but it never happened. Gradually, she?s relearned daily activities like eating and brushing her teeth without a working right index ?nger. mes .coniicontent?printVi ewi11354362 924/2019 BarelyTrained Inmate Loses Finger Working at Hiclq?nan's Phoenix NewTimes a - 1* is Between barns, fountains aerate pools of manure! Elizabeth Whitman . A spokesperson for the Arizona Department of Corrections said that the department does i not comment on pending litigation, and it is prohibited by law from discussing inmates' medical information. The Arizona Attorney General's office did not accept Stinson's i notice of claim, spokesperson Ryan Anderson con?rmed. Two other women in prison were injured while working at Hiclqnan's, according to Stinson. One of them was impaled in the groin and airlifted to a hospital. Another was also hurt "in her private area," Stinson said. These graver injuries were separate from the usual "cuts here and there." Another inmate, Michael Gerhart, lost the use of one of his hands after it was crushed when he was replacing a belt on a machine at Hickman's, according to a notice of claim ?led with the state attorney general's office in June. Gerhart is awaiting multiple surgeries that would likely require breaking his knuckles and using skin grafts, the notice said. Joel Robbins, Stinson?s attorney, said that he'd been contacted by "multiple inmates" who described safety violations and injuries from working at Hickman's. ewm 354362 416 9f24!2019 Barely Trained Inmate Loses Finger at Hiclanan's Phoenix New Times ?They don't do a lot of trt. .ing,? Robbins said of the compa y. ?On the one hand, I really want Hickman?s to be able to use prisoners and get them the opportunity to work, but they just need to pay attention to the safety.? Hickman?s is required to report any injuries, including amputations, to the Arizona Department of Occupational Safety and Health, or ADOSH. These reports, along with complaints about or investigations into Hickman?s, are available only via public records request. New Times requested the information on Monday but has yet to receive these I I records. The inspection database of the federal Occupational Safety and Health Administration, which includes state inspections, appears to contains no records of such inspections at . Hickman's in the past five years. Searches for the Hickman name, of the egg industry in Arizona, and of the ZIP code for the Arlington factory where Stinson worked produced no results. Trevor Laky, spokesperson, con?rmed Tuesday that the company falls under jurisdiction, but he was not able to immediately answer questions about the frequency of inspections for Hickman?s facilities or about the company?s worker safety record. When asked why the federal database contained no records of Hickman?s inspections, he suggested that perhaps facilities were listed under another name. A spokesperson for Hickman's acknowledged but did not respond by deadline to New Times' questions for this story. In addition to the risk of injury, workers at Hickman's are exposed daily to sickening smells and sub stances. According to Stinson, they receive masks and safety glasses to wear while working. They are also issued cloth gloves, but most don?t bother wearing them, because the gloves don?t actually protect their hands. ?We?re working with the chicken feces, and it just soaks in,? Stinson said. ?There?s a lot of girls getting the 'chicken flu,? she added, referring informally to the diarrhea and vomiting that some of the workers suffer from. 516 9124/2019 BarelyTrained Inmate Loses Finger Working at Hickman's I PhoenixNew Times When people ?rst start v? King at Hickman?s, she added, 11. _1y of them react badly to the dander and other airborne particles. ?We call it the Hickman cough,? Stimson said. She herself had it, but eventually she, like most others, adjusted to the ?lthy air. RELATEDTD PICS: mews teases Lawsuits Use of this website constitutes acceptance of our terms of use, our cookies policy. and our privacy policy @2019 Phoenix New Times, LLC. All rights reserved. SIB THE INDUSTRIAL COMMISSION OF ARIZONA DIVISION OF OCCUPATIONAL SAFETY 81. HEALTH I?Inl uu'ano (IFI-?hzi?dyul' v.53? Adkh?nx?slmuw Interview Notes I Date: ng?/?j?J/Time: 452 CompaI?Iy Name: Jdm?m/?l FMLA I esA] No (?opy of Recorded Interview: Yesb No LI Name:_ Address - __3111 Phone: EIHome Email: . DepartmeII?I:_ Job Title 7% 5111?1113; am 5511mmlni? (370.1931 Mimi _1 1_ LQZO- Lag/#211: ?111}; ?Ideo; 516%:st Chm/?3 9/1 121 [Mm _Loo??I?Ij 111an works/3; ouwee?~ _Sug?p?L ~fem_l -1111 TIE/eff] g4, 021% opt/211411115 Somalm; 11W 01.? I've ggupmeMy/ma 1-6- _C?Si?fe 311mm b?n??q 01/ [eve/5 .. 503 wags/Ir gig i. (111.11;an 3? MELIO runs?M/_ [?lli?t'?LWLW? ?lm Sci-x ro/g?r 111,111 (1445/11/14 n6 gtugl ?42 1.3.11 - (11?1?1? 71214114- ZPL- THE INDUSTRIAL COMMISSION DIVISION OF OCCUPATIONAL SAFETY HEALTH gm :3.me Interview Notes fiW Datezg Time: 1 i: 52 Company Name: I ecord: Yes,& No Copy of Recorded Interview: Yes BN0 Name: 11? Mi v- Address: Ugi S). r3? ?rm: State: K11 Zip Code: Phone: .?JCell Ll Home Email: Job Titlez?How Long: Department: I 3i I {Ha got) 15' PM "7 w'ro #36" 0x to _\3 OO?LAwuwsn?A 9323245 Flo Maw. wagng 2 mm BC LIEQEQ (And 2 mamas. 0.21 MM gay/9.5 IQLMW _Mo?m.5t doom??i, 9&6? warm?? o- )02 THE INDUSTRIAL COMMISSION OF ARIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH Pull. than olSleloudp-a'ulim mm: 01h mu Interview Notes Date: ?q 7?5 T?imo: ?ng/2m Company Name; . Consent to Record: Yes I240 El Copy 0" Recorded Interview: Yes 'No Name: Address; 7 7% City:,_ Statezmr?f?; Zipbode:__ . _Cell LJ Home . [49% Phone: Job Tit kayo?. _J?amt? 946% in Safari-bar Jaw.? 3cmd'gilm ?Dcivinel T??s-f inane/Lat meek J3 .24 f? ?4 20M.- "?1310 Max:415 ?340%5_ wage-91w! MacMJv/Nlm?) is rim/#504 L1 #wb?u?n Mitt/2m! bywitg '00 - _ltg'g ??7818. on .1) Dad?) {69(me Mun/M .mM Maj/1;: m. We Pmpf?a??_y CMw?tcal RAM EL ?3113 __qg??sayd. low aka): hung 3 _fmws ?hgp Luigi; '0 :bjbp, 7H7 7 . F00033.AD02 THE .NDUSTRIAL COMMISSION 01? IIRIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH I amine dMIunax mm I nte I ew otes i Date: 4 14? Time: 't Company Namethom/MJ 0 Record: Yes El Copy of Recorded Interview: Yes W0 Na& Address: City: State: Zip Code: Phone: Home IEQ Lona - 1-100 WVQLAAJQ ?d?gl>t {1006?s, .Meuu 9?]er DAT 832 I 97309435 3 enzq?ru a. {27133: gram PM 04$ 3 (1.1m 7? ?Ms saute/6 ?1?ka we. else)? 49?: max-H - HApbvod_ Z: magi-??16 h3g3 Ad?f Crib-f Conan: gr) (Kw. 1?57 mowm>zur Uta/92.0.13" - mange?W5 L070 1&0 13319 wax-L Caz/w 909' 1N5 165 ON F00033.ADO2 THE INDUSTRIAL COMMISSION OF ARIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH no!? 2h:rlkn&:yml fmJ-umv MAN am Interview NoteS 79L ?1 Time: $5 Company Name: {$4.ka trams RLuOb/iam_ py Of Rec ()Ided InterVIew: Yes NO 81"11'82 _Al_ Zip Code: Jaw/mam mat/44h" - au?LJ?aw'?ar Jan?s {Wad/50pm? \Vk? AWE), I MSamtl ., "4399?;3 w?vA .Swwunc} d?watkl/ rat/(mild: ?1.11 . $5 0" {?atware i hr 7k, ?gxwz?z ??l?CLI/?fj _3b(2 kmg? I, ,udn?L 301,_ 1M5 Morm? $1,954 Wn3_, ?r??Jl?l?fI/llei?jh 3? ro?UJoLuergx' gr. grid!? Mai? 61/50 Cowl? Wb Eva??vb? 12mm Avg 11.530395 ?by opgmiag Ola-{c order r?u/Iw?l lazy/gzgm?nj #29854 hy_ choir 27442433; r_m_ ?aw-:7 1700033.AD02 THE 1NDUSTRIAL COMMISSION 014 ARIZONA DIVISION OF OCCUPATIONAL SAFETY HEALTH Interview Notes Date: quag?l? Time: izgv Company Name: MILKMAJ F-Amu??r ?7?th I Copy of Recorded Interview: Yes [7 Name: Address: City:? State: Art.- - Zip Code: Phone: Home Email: 9am" Job Title?How Lon- Departmen-__ Low. _mg ?94- . Mow? Mb? MIJLS 93?? Ta Loam 1t W41Jc-2?fEMLon?4?b (9?45 CvaiS?? ngoArak- 1th, bra 3m; Mrs-m an! mew? Mega figuration Go HOT 6-4 $2099.34: wan/.9 HAvoLn Most-7dr $01.16. 59qu LOWIOA 905 To: _fipza T744. mwdb?nm brute-T? We?) leafy" L. {Skiff- 1 21>le flow/C) Woes (Mama?? gym-0? ebfz?n [51 3)qu 6137 ems? :4,de (gimds 66 ,M324w A Document No. 018 Document ll NS SOP for Personal Safety Practices Company ?View? FAMILY r5 RMS 3-2-1 09-23-2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (6220-8724170 info@ hickma nseggscom Scope Hickman?s Family Farms has designed a formal safety program and has implemented this program with the intent of protecting their employees from job related illness or injury. This safety program can only be effective when all employees adhere to the company?s safety policies and procedures. Policy Justification This policy is to ensure employees know the rules of the plant and to ensure safety. Responsibility It is the responsibility of the Plant Manager, QA Technician, and SQF Practitioner to ensure that the following SOP is followed and enforced for all employees, contract service providers, visitors and anyone entering the food processing facility. IV. Company Safety Rules General Workplace Safety Rules Report all unsafe conditions and actions to your immediate supervisor. report security, safety, accidents or near-miss incidents to your immediate supervisor. Do not bypass or disable a safety device or system. Operate machines or other equipment only when all guards and safety devices are in place and in proper operating condition. The use of personal radios; cell phones, i-pods or other devices which have the potential to reduce hearing are ALLOWED. (Management, Supervisors ,Maintenance and QA are the only exception on this rule as far as phones are concerned) Only authorized and trained employees will operate company machinery and vehicles. Employees are NOT ALLOWED to send and/or receive text massages, connect and surf the internet, or receive e-mails while operating any company vehicles. Always wear your seatbelt while operating any company vehicles or equipment. Keep all equipment in safe working condition. Never use defective tools or equipment. Report any defective tools or equipment, and all equipment maintenance issues to your supervisor. Perform regular equipment and area inspections as required by supervisor. Maintain good housekeeping in your area at all times. Do not leave unnecessary litter or material in aisles, walkways, Stairways, work areas, or other points of egress; it must be kept clear. Use the appropriate tool for a job, as trained by your supervisor, JSA or manufacturers' instructions. Properly care for and be responsible for all personal protective equipment (PPE). Wear or use any such PPE when required. (Read your manuals) Use and face protection when there is danger from flying objects or particles, (such as when grinding, chipping, burning and weiding, etc.) or from hazardous chemical splashes (use double protection, safety glasses/goggles with a face shield, when operating a chop saw). Lockout, tag out or disconnect power on any equipment or machines before any maintenance, un-jamming, and adjustments are made. Follow the safety policies and procedures as outlined in individual Best Practice Programs. No use of illegal drugs or alcohol by the terms of the company?s Drug and Alcohol policy. Employees taking physician-prescribed medication that might impair their ability to operate certain equipment or perform various job tasks safely must report this to their immediate supervisor prior to the start of work. No firearms shall be present on the property, including the parking lot or on the jobsite. Dress appropriately. Wear appropriate work clothes, gloves, shoes or boots, and hair/beard nets. Loose clothing and jewelry shall not be worn (unless it is a wedding hand. If it has stones, gloves must be worn). No jeweled clothing to be worn at any time in processing plants. (If worn, a bio-suit or scrubs have to be worn) Work rules and exposure to equipment do not permit employees to work without long pants and shirts at any time or occasion. (No Short Pants ALLOWED) No shorts, capri's, no legging or workout pants No torn clothing and no jeans with jewels that pose a physical contamination risk allowed in processing plants unless covered by scrubs or lab coat. This includes all contract service providers and visitors. Refrain from horseplay that could endanger you or your co-workers. Page 1 of6 Document No. 018 Document NS SOP for Personal Safety Practices Company mm": FAMILY FARMS 3-2-1 09-23-2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170? Never engage in hostile actions against other employees. Report all hostile actions of co-workers to your supervisor. Smoke in designated areas only and throw cigarette butts in provided containers. Maintain good personal hygiene. NO GUM CHEWING or Chewing Tabacco ALLOWED EVER IN PROCESSING PLANTS. Comply with all governmental regulations/rules and all company safety rules in the following sections are required: Food Defense Employees are required to have their employee photo to enter the the facility. Shuttle drivers, managers and supervisors are able to identify if the employee in their assigned area by noting the color code system and the name of the facility on the employees badge. Schedules are posted to note if an employee scheduled off for the day is actually on the premice. Security Cameras are reviewed to see if activity was noted on the off hours or if suspicious activity has occurred. Housekeeping Proper housekeeping is the foundation for a safe work environment. It definitely helps prevent accidents and fire, as well as creating a professional appearance in the work area. All work areas, floors, aisles, and stairways must be kept clean and orderly, and free of tripping and slipping hazards. Oils, greases, and other liquids must be immediately cleaned up if spilled. Combustible scrap, debris, and garbage shall be removed from the work area at frequent and regular intervals. Stairways, walkways, exit doors, in front of electrical panels, or access to firefighting equipment must be kept clear of storage, materials, supplies, trash, and other debris at all times. Overhead storage areas will be marked as to maximum load rating. Good housekeeping practices must be maintained at all times. Employees must leave their places of work orderly and clean in the interest of safety. There are many days when the floors of the shell egg plant, breaker hard boil plant, laying barns, puliet barns, fertilizer plant, and maintenance shop are slippery due to egg spills, manure, water, oil and lubricants, When floors are wet, be extremely careful when walking. Clean all spills immediately with proper equipment (mop and bucket, wet vacuum, absorbent pads, etc.). Fire Prevention All portable fire extinguishers will be conspicuously located, accessible, and maintained in operating condition. Portable fire extinguishers will receive an annual service check and a visual inspection. These will be documented on the tag on the extinguisher or other form. All employees must know the location of firefighting equipment in the work area and have knowledge of its use and application. Exits will be marked as such by a readily visible sign. Other doors likely to be mistaken for an exit will be marked as to their character or ?Not an Exit?. Only approved safety cans shall be used for handling or storing flammable liquids in quantities greater than one gallon. For one or less gallon, only the original container or a safety container will be used. When heat producing equipment is used, the work area must be kept clear of all fire hazards and all sources of potential fires will be eliminated. Fire extinguishers will be available at all times when utilizing heat-producing equipment. Industrial Hygiene and Occupational Health When no medical facility is reasonably accessible (time and distance) to the workplace, a person who has a valid certificate of first aid training and first aid supplies will be available at the workplace to render first aid. Employees exposed to noise levels above the permissible noise level will be included into the hearing conservation program. Hazardous noise areas will be posted and hearing protection worn in those areas as required. (Ear plugs are available upon request) Employees exposed to harmful gases, fumes, dust, and similar airborne hazards will be furnished protection through proper ventilation or personal respiratory equipment. Any demolition, renovation, or self-help work will be assessed for lead exposure, particularly if drywall or any painted surfaces or abrasive blasting/grinding is involved, and asbestos exposure. Page 2 of 6 Document No. 018 Document NS SOP for Personal Safety Practices 8: Company ?mm ?View? FAMILY FARMS 3-2-1 09-23-2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 info@hickmanseggs.com Personal Protective and Related Equipment 0 Personal protective equipment must be worn as required for each job in all operations where there is an exposure to hazardous conditions. This exposure is determined by a personal protective equipment hazard assessment of the workplace by the supervisor and the safety 81 health coordinator. Equipment selection and wearing requirements are determined from this assessment. Safety glasses, goggles, or face shields will be worn in those areas where there is a reasonable probability of injury to the from dust, flying particles, molten metal, chemical, acids, caustics, or light radiation, or other hazards. Safety glasses must be worn all the times at the following locations: 3) Lay Pullet House areas b) Feed Mill c) Feed Drivers must wear safety glasses while delivering feed. d) Fertilizer Mill e) Special Projects crews f) Electricians/AC Maintenance g) Processing Maintenance h) Night Sanitation at all facilities i) Machine shop j) Truck shop or on service calls k) Liquid Hard Boil plant *Wear a face shield over your safety glasses] goggles while operating a chop saw or handling chemicals. Head protection (hard hats or bump caps) must be worn for protection from falling objects or work near energized electrical contact and must be used at the following locations: a) All processing plant personnel must wear bump caps while working with metal racks. b) Electricians Special projects Crews must wear hard hats while in construction and repair zones. c) Truck Drivers must wear hard hats at the feed mill while hauling feed or bump caps when loading or unloading metal racks. d) Feed Mill personnel must wear hard hats at all times. Fertilizer Personnel must wear hard hats at all times. Foot protection will be worn where there is danger to the foot from falling/rolling objects, objects piercing the sole or electrical hazards. Slip-resistance and/or steel/composite toe shoes or boots are required to be worn at all the times at the following locations: 1) Lay Pullet Houses areas steel /composite toe shoes 2) Feed Mill steel/composite toe shoes 3) Fertilizer Mill steel/composite toe shoes 4) Special Projects crews steel/com posite toe shoes 5) Shell Egg Plants: a) Processing slip-resistance shoes b) Dry Storage and Cooler Personnel - slip-resistance shoes with steel/composite toe c) Forklifts 8: Pallet Jacks Operators slip-resistance shoes with steel/com posite toe 6) Processing Maintenance slip-resistance shoes with steel/composite toe 7) MOBA Night Cleaning crew slip-resistance boots with steel/composite toe 8) Machine shop slip-resistance shoes with steel/composite toe 9) Truck shop or on service calls steel/composite toe shoes 10) Truck Drivers slip-resistance shoes with steel/composite toe 11) Liquid Hard Boil plant slip-resistance, waterproof with steel/composite toe shoes 12) Dry Storage Warehouse slip-resistance shoes with steel/com posite toe Hand protection is required when hands are exposed to severe cuts or abrasions, chemical or thermal burns, and/or chemical absorption. Appropriate gloves, aprons, splash goggles, face shields, and proper shoes will be used when necessary for protection against acids and other chemicals which could injure employees. Page 3 of6 Document No. 018 Document 1' NS SOP for Personal Safety Practices 8: Company ?Viewed FAMILY FARMS 3-2-1 09-23-2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 info@ ickmanseggscom Respiratory equipment in many cases is needed for protection against toxic and hazardous fumes/dusts. Only approved equipment will be used. The use of fall protection harnesses, and lanyards are required when working more than six feet above a floor or ground level and there are no guardrails or other form of fall protection, and on certain suspended scaffolds. Each employee will be on a separate safety line, and this line will be adjusted so that the employee cannot fall more than six feet. LockoutlTag out Program Before any work or maintenance is performed on any machine, equipment, tool, or electrical system, they will be made totally safe before work starts by removing any source of energy or power to them, such as electrical, air/hydraulic pressure, spring/stored energy, or thermal (heat/cold). The Lock out/Tag out Program provides for a safe method of working on, near, or in machinery or equipment that can cause serious injury. This program will be used by authorized employees to ensure that the machine or equipment is stopped, isolated from all potentially hazardous energy sources, and locked out before employees perform any servicing or maintenance where the unexpected energization or start-up of the machine or equipment, or release of stored energy, could cause injury. Electrical Live electrical parts shall be guarded against accidental contact by cabinets, enclosures, location, or guarding. Open circuit breaker openings or knock out holes, broken receptacles, switches, missing covering plates, etc., will be reported to supervisors for repair or replacement. Working and clear space around electric equipment and distribution boxes will be kept clear and assessable. Circuit breakers, switch boxes, etc. will be legibiy marked to indicate its purpose. All extension cords and electric powered tools (except double insulated) will be grounded. Ground prongs will not be removed. Electric cords and their strain relief devices will be in good condition, with no splices. Electric wiring cords entering or exiting any panel control junction box will be secured with clamps or other appropriate strain relief device. Extension cords and other flexible cords will not be used in lieu of permanent wiring and receptacles. Cords will not be run through holes in doors, walls, windows, nor will they be fastened to walls, poles, equipment, etc. All lamps below seven feet used for general illumination will have the bulbs protected against breakage. Guarding All shafts, pulleys, belts, gears, sprockets, chains, and fan blades must be guarded or enclosed when located below seven feet, above the floor or work platform. Guards installed on machinery and equipment, such as air compressors, conveyors, drill presses, etc., will not be removed when operating. Guards removed for servicing or other work on the machine or equipment will be immediately replaced upon completion of the work. Woodworking equipment, such as power saws, radial arm saws, table saws, nor portable abrasive grinders will not be operated unless all required guards are in place. Feather boards and push boards will be used when necessary. Compressed Gas Cylinders All gas cylinders shall have their contents clearly marked on the outside of each cylinder. Cylinders must be transported, stored, and secured in an upright position. They will never be left lying on the ground or floor, nor used as rollers or supports. Cylinder valves must be protected with caps and enclosed when not in use. Oxygen cylinders and fittings will be kept away from oil or grease. Oxygen cylinders will be stored at least 20 feet from any fuel gas cylinder, or separated by a fire barrier at least five feet high. When cylinders are hoisted, they will be secured in a cradle, sling-board, or pallet. Valve protection caps will not be used for lifting cylinders from one vertical level to another. Ladders Ladders will be inspected frequently to identify any unsafe conditions. Those ladders which have developed defects will be removed from service, and repaired or replaced. They will be tagged or marked as such. Page 4 of 6 Document No. 018 3 Document NS SOP for Personal Safety Practices Company mm": ?Viewed I LY w. a 3-2-1 09-23-2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 - (623)-872-1170 Portable ladders will be placed as to prevent slipping, or if used on other than stable, level, and dry surfaces, will be tied off or held. A simple rule for setting up a ladder at the proper angle is to place the base from the vertical wall equal to 1/4 the working length of the ladder. Portable ladders will extend at least three feet above the upper level to which the ladder is used to gain access. The top of a stepladder will not be used as step. Only one person will be on a ladder at a time. Flammable and Combustible Liquids Only approved safety cans, original containers, or portable tanks will be used to store flammable or combustible liquids. Above ground storage tanks will be separated from each other by a minimum of three feet or 1/6 the sum of their diameters, and to prevent accidental discharge from reaching adjoining property or waterways; spill containments will be provided. No more than 25 gallons of Class IA and 120 gallons of liquid Class IB, IC, II, or liquids may be stored outside a storage cabinet or an inside storage room. An emergency shut off switch is located 15 75 feet from the pumps and a fire extinguisher will be provided at company fuel servicing areas. Welding and Brazing Combustible material will be cleared for a radius of 35 feet from the area around cutting or welding operations. If the combustible material cannot be cleared or the work cannot be moved, then the welding/cutting will not be done. Welding helmets and goggles will be worn for protection and prevent flash burns. protection will be worn to guard against slag while chipping, grinding and dressing of welds. Welding gloves will be worn for hand protection while welding. Welding screens will be used and in proper position to protect nearby workers from welding rays. Cables, leads, hoses, and connections will be placed so that there is no fire or tripping hazards. Cables will not be wrapped around the welder?s body. Oxygen cylinders will be stored at least 20 feet from fuel gas cylinders, or separated by a noncombustible fire wall with a one?half hour rating at least five high. Valve protection caps will be in place on cylinders not in use. Ventilation is a prerequisite for welding in any confined space Tools Hand tools with broken or cracked handles, mushroomed heads, or other defects will not be used. Files will have handles installed. Take special precautions when using power tools. Defective tools will be removed from service. Power tools will be turned off and motion stopped before setting tool down. Tools will be disconnected from power source before changing drills, blades, bits, or attempting repair or adjustment. Never leave a running tool unattended. Power saws, table saws, and radial arm saws will have operational blade guards installed and used. Anti-kickback teeth and spreaders will be used when rip sawing. Portable abrasive side-winder grinders will have guards installed covering the upper and back portions of the abrasive wheel. Wheel speed ratings will never be less than the grinder RPM speed. Pedestal grinders must be permanently mounted, tool rests installed and adjusted to within 1/8 inch of the wheel, tongue guards installed and adjusted to within Mr inch of the wheel, and side spindle/nut guards installed. Air compressor receivers will be drained frequently to prevent buildup of water in the tank. Compressed air will not be used for cleaning purpose except when pressure is reduced to less than 30 psi by regulating or use of a safety nozzle, and then only with effective chip guarding and proper personal protective equipment. Any employee-furnished tools of any nature must meet all Safety and ANSI requirements. Safety Railing and Other Fall Protection All open sided floors and platforms four feet or more above adjacent floor/ground level will be guarded by a standard railing (top and mid rail, toe board). All stairways of four or more risers will be guarded by a handrail, or stair rails on the open side. Handrails or stair rails will be provided on both sides ofthe stairs are more than 44 inches wide. When a hole or floor opening is created during a work activity, a cover or a barricade must be installed immediately. Page 5 of6 Document No. 018 Document NS SOP for Personal Safety Practices 8: Company ?View? FAMILY FARMS 3-2-1 09-23-2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 - info@hickmanseggs.com 0 Safety harnesses, belts, lanyards, lines, and lifelines may be used in lieu of other fall protection systems to provide the required fall protection. 0 Adjustment of lanyards must provide not more than a six foot fall, and all tie off points must be at least waist high. we 0 Only authorized and trained employees will operate forklifts and other industrial trucks. 0 Safe speeds, load handling, turning, and other safe driving practices will be followed at all times. - Operators will ensure loads are stable and or secure before moving. 0 The operators will inspect the powered industrial trucks at the beginning of each work shift and completing the appropriate inspection forms. 0 Employees will not operate any forklift that is in need of repairs, defective, or unsafe. Such forklift will be removed from service for repair, and reported to their immediate supervisor. Aerial Lifts 0 Only trained employees will operate aerial lifts (cherry pickers, extendible and articulating boom platforms). 0 A body belt or harness will be worn and a lanyard attached to the boom or basket when working from an aerial lift. 0 Employees will stand firmly on the basket floor, and not sit, stand, or climb on the edge of the basket. Planks, ladders, or other devices will not be used for additional elevation. 0 Aerial lift trucks will not be moved with workers in an elevated basket. 0 The operators will inspect the Aerial lift trucks before each use and complete the appropriate inspection forms. Miscellaneous 0 Only trained employees will service large truck wheels. A cage or other restraining device plus an airline assembly consisting of a clip-on chuck, gauge, and hose will be used to inflate tires. 0 Any inspection, disassembly, or assembly of vehicle brakes or clutches must address the hazard of asbestos exposure. Additional Safety Policies: 0 Plants now have wheel Chocks and the signage to remind the drivers at each receiving bay. 0 Fire drills are now conducted at least twice a year to make sure employees can exit the buildings within 2 minutes and meet safely at the designated areas. - Included in their daily pre-op walk-through, QA and managers are required to do a daily safety walk through to identify any safety hazards prior to employees starting their shift. a Every employee that operates heavy equipment or fork lifts must be certified every 3 years by the safety coordinator prior to using the equipment. Each operator must complete a daily safety checklist log page on the piece of equipment needed prior to use. 0 Employees are to immediately take a drug test after causing an accident or incident on the job. Training: I New hires will spend their first day on the job viewing Hickman?s specific and OSHA topic videos on safety. These Videos include trips, slips, falls, fire and disaster safety, lifting techniques, fork lift and pallet jack certification, protection, machine guarding awareness and MSDA awareness. 0 awareness training and safety topic reviewing are now done in Spanish and English. All training is recorded with rosters and each employee must pass a quiz with 100% pass rate on the month?s topic. - Manager?s training on safety topics are now monitored and updated by the safety coordinator to make sure the necessary safety topics are covered at least twice a year. In accordance with the Hickman?s Family Farms Safety Health Program the following safety rules and regulations applicable to our Operations that must be complied with by our employees. ?Violation of these rules and regulations will result in disciplinary action, in accordance with the company disciplinary policy, and can result in penalties up to immediate termination of employment.? I have read the above Company Safety Rules and understand that if I do not comply with them I am subject to disciplinary and/or termination of employment. Name Date Manager Trainer Date Page 6 of 6 amily farms Pullet Facilities Lockout Tagout Safety Procedures OSHA 29 CFR 1910.147 FSIS Directive 4791.11 Index Pullet Facilities Lockout Tagout Safetv Procedures Diagrams Table of Contents 1: Index 11: Hickman?s Family Farms Lock-Out Tag-Out Procedures Equipment List Pullets IV: Pullets Location Identi?cation of Equipment V: Pullets Lockout Tagout Energy Control Procedures VI: Authorized Employee Cooperative Agreement II: Hickman?s Familv Farms Lock-Out Tag-Out Procedures Lockout/Tagout (Energy Control) Procedures Purpose: This procedure establishes the minimum requirements for the lockout/tagout of energy isolating devices including circuit breakers, switches, disconnects, valves, blocks, etc. It shall be used to ensure that the machine or equipment are isolated from all potentially hazardous energy, and locked out or tagged out before employees perform any servicing or maintenance activities where the unexpected energizing, startup or release ofstored energy could cause injury. This includes hazards due to electrical, mechanical, hydraulic, pneumatic, chemical, thermal, or other form of energy source. Responsibility: All authorized Hickman?s (maintenance) employees shall be instructed in the safety significance of the Lockout/ 'l?agout procedure. Each new or transferred affected employee and other employees whose work operations are or may be in the area shall be instructed in the purpose and use of the lockout/tagout procedure. ?All Hickman?s employees authorized to do lockout/tagout procedures, will be provide with a lock, key and tag, and no other person shall be allowed access to their keys and locks. No one is allowed to remove the employee?s lock except himself? The department manager and the maintenance supervisor will enforce lockout/tagout procedures, maintain lockout/tagout equipment, and control emergency spare lockout keys. The following employees have been authorized to lock out/tag out procedures: Lock-Out-Ta -Out Authorized Em lo ee Trainin Matrix 2/3/20l7 2/9/2017 3/3/2017 3/20/2017? 4/27/2_017 5/2/2017 ?8/2/2017 8/l_0__/_2017 8/17/2017_ 8724/2017 i/9/201i _1/25/2018 _2/6/2018 2/7/2018 2/21/2018 3/9/2018 4/4/2018 5/7/2018 5/29/2018 6/25/2018 8/2/2018 8/21/2018 8/24/2018 8/31/2018 9/6/2018 9/25/2018 10/24/2018 11/6/2018 1/11/2019 1/18/2019 1/22/2019 2/26/2019 6/26/2019 8/26/2019 10/1/2019 10/7/2019 10/01/2019 10/11/2019 Preparation for lockout or tagout: Ilickman?s Family Farms has sun/eyed all the facilities and identified all of the isolating devices such switches, or electrical circuits that must be locked or tagged out. Since some of the pieces of equipment have more than one type of energy source that must be isolated (electrical, mechanical, pneumatic or hydraulic). The following table is an example of specific pieces of equipment followed by the type of energy source, stored energy, and the location of the energy-isolating means: 10 Equipment Energy Source Stored Energy to be Location of Isolating Relieved or Isolated Means Over wrap machine Electrical outlet to Electrical Unplug and isolate with main circuit breaker switch and plug lockout Forklifts, Loaders, Ignition Key Propane or Diesel Con?scate ignition key and Backhoes and place ?Do Not Operate? tag Tractors on equipment Egg Belts Main circuit breaker Electrical Individual locks on main circuit panel Sequence for a Lockout or Taaout Procedure: The lockout procedure must be conducted in the following manner. No deviations will be tolerated. 1. 9. The Authorized Employee should know before beginning lockout procedures the type and magnitude of energy that the machine or equipment utilizes and understands the hazards. Notify all affected Employees when, where, and why a lockout or tagout system is going to be utilized. Post lockout sign in a visible position on the machine or equipment to be lockout. If the machine or equipment is operating, shut it down by normal stopping procedure (depress stop button, open toggle switch, etc.) The Authorized Employee shall lockout and tagout the energy isolating device of the equipment or machine with their individual assigned looks or tags (use yellow cylinder boxes to lock plugs, quick disconnects, or remote witches. Sign, date, and attach Lockout Identi?cation Tag through the lock pin) The Authorized Employee must operate the switch, valve or other energy-isolating device to make sure the equipment is isolated from its energy source. Stored energy (such as the energy found in springs, elevated machine members, rotating ?y wheels, hydraulic systems or compressed air, gas, steam, or water pressure, etc.) must be dissipated or restrained by either repositioning, blocking or bleeding down. After ensuring that no Employees are exposed, the Authorized Employee shall complete another check to make sure that all of the energy sources have been disconnected. The Authorized Employee should then once again operate the push button or other normal operating controls to make certain the equipment will not operate. CAUTION: Return operating control(s) to ?neutral? or ?off? position after the test. The equipment is now locked out or tagged out. Maintenance and seivicing can now begin. For equipment that cannot be locked out, a tag will be use in those cases. The tagout device must be attached on or as close as possible to the energy-isolating device. The tag must clearly indicate that the operation or start?up of the energy-isolating device from the safe or off position is prohibited. Testing/Positioning of Machine/Equipment under Loekout/Tagout: At times, some of the equipment must be tested while doing maintenance or repairs. The following procedure must be followed under those conditions: 1. Inspect the work area to ensure that nonessential tools and material have been removed and to ensure that the machine/equipment components are operationally intact. 11 Make sure that all of the Employees are clear of the machine/equipment and notify them that the machine will be energized. The Authorized Employee who applied the device shall remove the lockout devices. Energize and proceed with testing or positioning. De?energize all system; complete the shut down procedures and the sequences for initial lockout/tagout before continuing any maintenance or service. Removal of Lockout/Tagout Devices: (Restoring the machines or equipment to normal production operations) 1. After the servicing and maintenance is completed, and the equipment is ready for normal production operations, check the area around the machines or equipment to ensure that no one is exposed to any danger. After all the tools have been removed from the machine or equipment, guards have been reinstalled and Employees are in the clear, the individual applying the lockout device will remove all lockout devices, identification tags, and signs. Operate the energy isolating devices to restore energy to the machine or equipment. Procedure involving more than One Person: 1. In the preceding steps, if more than one individual is required to lockout or tagout equipment, each shall place his/her own personal lockout/tagout device on the energy isolating device(s). When an energy isolating device cannot accept multiple looks or tags, a multiple lockout or tagout device (hasp) may be used. Emergency Lockout Removal: 1. Maintenance Supervisor and Plant Manager must verify that the Authorized Employee who applied the device is not at the facility. The Plant Manager must be present at the machine/equipment before the Maintenance Supervisor can use the emergency spare key or look cutter to remove lockout device. All reasonable effort must be made to contact Authorized Employee to inform them that their lockout device has been removed. The Maintenance Supervisor will inform the Authorized Employee before they resume work at the facility that their lockout device has been removed. Hiekman?s Familv Farms Rules for Using Lockout/Tagout procedures: 1. All equipment must be locked out or tagged out to protect against accidental or inadvertent operation when the operation could cause injury to personnel. 2. Do not attempt to operate any switch, valve, or other energy isolating device where it is locked or a tagged out. 12 Contractors: Whenever outside servicing personnel are to be engaged in activities covered by this Lockout/tagout Program, the Plant Manager, Maintenance Supervisor, Special Project Manager, and the outside employer will inform each other of their respective Lockout/Tagout Procedures. An effective Lockout/Tagout procedure will be used by all persons working in the plant, employees and contractors. I, have read the above requirements and understand that I am required to comply with the Hickman ?s Family Farms Lockout agout policy and procedures. I also understand that failure to do this could result in serious harm or death to me, so negligence of this responsibility may result in disciplinary action. Employee Signature: Date: Employee?s Number: Hickman?s Family Farms? Location: Instructor Name: Instructor Signature: 13 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. Equipment List Pullets COOL CELLS FEED AUGERS FEED CARTS (IN-HOUSE) FEED SCREENERS FEED LEG EVELVATOR (FILL SYSTEM) MANURE BELTS CROSSOVER MANURE INCLINE DRY BARN - TRANSFER BELT CONVEYOR BELTS (NORTH CENTRAL SOUTH) FANS STIR FANS FEED CHAINS LOOP FILL AUGERS 14 IV: Pullet Facilities Location Identi?cation of Equipment 15 PDF MAPS GO HERE 16 V: Lockout Tagout Energv Control Procedures Pullet Facilities 17 01. Lockout/Tagout (Energy Control) Procedures for Cool Cells Power Source Switch, Contactor/Overload, and Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be performing work on the Cool Cell Turn Circuit Breaker and Contactor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels Verify with a Volt Meter that there is no Stored Energy at the Power Switch. . Verify that the energy source has been isolated by turning on the Power Switch on the PLC Panel and on the switch at the Cool Cell. If the motor doesn?t engage then the Energy Source has been isolated. Put the Power Switches in the off (PLC Panel switch will be the Auto position). Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Cool Cells 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the C001 Cell will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Tum Contactor/Overload and Circuit Breaker to the on position. Return to the C001 Cell and place the Power Switch in the on position. 18 02. Lockout/Tagout (Energy Control) Procedures for Feed Augers Power Source Switch, Plug, and Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be performing work on the Feed Line. Place the Switch on the control panel in the off position. Place Circuit Breaker for the Feed Line to the off position. Apply Lockout/Tagout Device to the Electrical Panels. Verify with a Volt Meter that there is no Stored Energy at the Power Switch. Verify that the Energy Source has been isolated by placing the switch at the control panel in the manual position and if the motors on both sides are not turning than the energy source has been isolated. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Feed Angers 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the Feed Line will be powerng 011. Remove Lockout/Tagout Device from The Electrical Panels. Place the Circuit Breaker to the on position. Place the Switch in the on position to check the repairs performed. If repairs are satisfactory then place switch in the Auto position. 19 03. Lockout/Tagout (Energy Control) Procedures for Feed Carts Power Source Switch, Contactor/Overload, and Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be perfonning work on the Feed Cart. Place the Switch on the control panel in the off position. Turn Circuit Breaker and Contactor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels Verify with a Volt Meter that there is no Stored Energy at the Power Switch. Verify that the Energy Source has been isolated by placing the switch at the control panel in the manual position and if the motor does not engage on the feed cart than the energy source has been isolated. Remove tension from the cable by releasing the tension with the manual crank on the cart. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Feed Carts 1. 995?.? Inspect Work Area, make sure employees are safe, and inform all affected employees that the Feed Cart will be powering on. Tighten Tension back to normal on the cable. Remove Lockout/Tagout Device from The Electrical Panels. Tum Contactor/Overload and Circuit Breaker to the on position. Place the Switch in the on position to check the repairs performed. If repairs are satisfactory then place switch in the Auto position. 20 04. Lockout/Tagout (Energy Control) Procedures for Screeners Power Source Switch, Contactor/Overload, and Main Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be performing work on the Screener. Place the Switch on the Switchbox in the off position. Tum Circuit Breaker and Contactor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the Control panel. Apply Lockout/Tagout Device to the Main Breaker Power Disconnect. Verify that the Energy Source has been isolated by placing the switch at the control panel in the on position and if the motors on the screeners don?t engage then the energy source has been isolated. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Screeners 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the Screener will be powering on. Place Contactor/Overload and Circuit Breaker to on position. Remove Lockout/Tagout Device from the Main Breaker Power Disconnect and turn to on position. Place the Switch on the control panel in the on position to check the repairs performed. If repairs are satisfactory then place switch in the Auto position. 21 05. Lockout/Tagout (Energy Control) Procedures for Feed Leg Elevator (Fill System) Power Source Switch, Contactor/Overload, Circuit Breaker Type of Energy Electrical Proper Shut down Procedure; 1. 749995.? >090 Notify all affected employees and inform them that you will be performing work on the Feed Hopper and Elevator Turn Circuit Breakers and Contactors/Overloads to the off position for the Feed Hopper and Elevator. When working on this equipment it is required to have the Energy Source Isolated for BOTH pieces of machinery. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panel. Place Main Power On/Off Switch in the off position. Verify with a Volt Meter that there is no Stored Energy at the Power Switches. Verify that the energy source has been isolated by turning the Power Switches to the on position. If the motors don?t engage then the Energy Source has been isolated. Put the Power Switches in the off position. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Feed Leg Elevator (Fill Svsten? 1. 999%) Inspect Work Area, make sure employees are safe, and inform all affected employees that the Feed Hooper and Elevator will be powering on. Remove Lockout/Tagout Device from the Electrical Panels. Turn Contactor/Overload and Circuit Breakers to the on position. Place the Main Power On/Off Switch in the on position. Place the switches on the Control Panel in the on position to test repairs. After testing the repairs place the switch in the off position. 22 06. Lockout/Tagout (Energy Control) Procedures for Manure Belts Power Source Switch, Contactor/Overload, and Breaker Type of Energy Electrical Proper Shut down Procedure; Notify all affected employees and inform them that you will be performing work on the Manure Belt/Motor Turn Circuit Breaker and Contractor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels Verify with a Volt Meter that there is no Stored Energy at the Power Switch. Verify that the energy source has been isolated by turning on the Power Switch. If the motors don?t engage then the Energy Source has been isolated. Put the Power Switch in the off position. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Manure Belts 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the Manure Belt/Motor will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Turn Contactor/Overload and Circuit Breaker to the on position. Return to the Manure Line and place the Power Switch in the on position. 23 07. Lockout/Tagout (Energy Control) Procedures for Crossover Manure Incline Power Source Switch, Contactor/Overload, Circuit Breaker, and Main Breaker Type of Energy Electrical Proper Shut down Procedure; 1. shear-w Notify all affected employees and inform them that you will be performing work on the Manure Incline Crossover Turn Circuit Breakers and Contactors Overloads to the off position for the Incline and Crossover. When working on this equipment it is required to have the Energy Source Isolated for BOTH pieces of machinery. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels and BOTH Main Power Cut off Breakers. Verify with a Volt Meter that there is no Stored Energy at the Power Switches. Verify that the energy source has been isolated by turning the Power Switches to the on position. If the motors don?t engage then the Energy Source has been isolated. Put the Power Switches in the off position. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Crossover Manure Incline 1. 5":th inspect Work Area, make sure employees are safe, and inform all affected employees that the Manure Incline Crossover will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Turn Contactor/Overload and Circuit Breakers to the on position. Remove Lockout/Tagout Devices from the Main Power Cut off Breakers Return to the Control Panel and place the switches in the on position to test repairs. After testing the repairs place the switch in the off position. 24 08. Dry Barn Transfer Belt Conveyor Belts (North Central South) Power Source Switch, Contactor/Overload, Circuit Breaker, and Main Breaker Type of Energy Electrical Proper Shut down Procedure; 1. Notify all affected employees and inform them that you will be performing work on the Manure Incline Crossover Tum Circuit Breakers and Contactors Overloads to the off position for the Incline and Crossover. When working on this equipment it is required to have the Energy Source Isolated for BOTH pieces of machinery. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels and BOTH Main Power Cut off Breakers. Verify with a Volt Meter that there is no Stored Energy at the Power Switches. Verify that the energy source has been isolated by turning the Power Switches to the on position. If the motors don?t engage then the Energy Source has been isolated. Put the Power Switches in the off position. Begin performing the needed repairs or maintenance on the unit. Restoring Energyr to Dry Barn Transfer Belt Conveyor Belts (North Central South) 1. 9:559.? Inspect Work Area, make sure employees are safe, and inform all affected employees that the Manure Incline Crossover will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Turn Contactor/Overload and Circuit Breakers to the on position. Remove Lockout/Tagout Devices from the Main Power Cut off Breakers Return to the Control Panel and place the switches in the on position to test repairs. After testing the repairs place the switch in the off position. 25 09. Loekout/Tagout (Energy Control) Procedures for Fans Power Source Plug, Contactor, and Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be performing work on the Fan Turn Breaker and Contactor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device t0 the Electrical Panels Unplug Fan from Receptacle . Verify with a Volt Meter that there is no Stored Energy at the Receptacle. If there is no voltage showing on the meter than the Energy Source has been isolated. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Fans 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the fan will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Turn Contactor/Overload and Circuit Breaker to the on position. Return to the fan and insert the plug into the Receptacle. 26 10. Lockout/Tagout (Energy Control) Procedures for Stir Fans Power Source Plug, Contactor, and Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be performing work on the Fan Turn Breaker and Contactor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels Unplug Fan from Receptacle . Verify with a Volt Meter that there is no Stored Energy at the Receptacle. If there is no voltage showing on the meter than the Energy Source has been isolated. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Stir Fans 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the fan will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Tum Contactor/Overload and Circuit Breaker to the on position. Return to the fan and insert the plug into the Receptacle. 27 11. Lockout/Tagout (Energy Control) Procedures for Feed Chains Power Source Switch, Contactor/Overload, Plug, and Breaker Type of Energy Electrical Proper Shut down Procedure: 1. Notify all affected employees and inform them that you will be performing work on the Feed Line. Place the Switch on the control panel in the off position and place the power cut off switch in the off position with the key. Turn Circuit Breaker and Contactor/Overload to the off position. Verify with a Volt Meter that there is no Stored Energy in the panel. Apply Lockout/Tagout Device to the Electrical Panels Verify with a Volt Meter that there is no Stored Energy at the Power Switch. Verify that the Energy Source has been isolated by placing the switch at the control panel in the manual position and if the motor on both sides isn?t turning than the energy source has been isolated. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Feed Chains 1. 9.4399!? Inspect Work Area, make sure employees are safe, and inform all affected employees that the Feed Line will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Turn Contactor/ Overload and Circuit Breaker to the on position. Return to Switch and place the power cut off switch to the on position with the key. Place the Switch in the on position to check the repairs performed. If repairs are satisfactory then place switch in the Auto position. 28 12. Lockout/Tagout (Energy Control) Procedures for Loop Fill Angers Power Source Switch, Plug, Contactor/Overload and Breaker Type of Energy Electrical Proper Shut down ProcedureNotify all affected employees and inform them that you will be performing work on the Feed Incline. Place the Switch on the control panel in the off position. Place Circuit Breaker for the Feed Incline to the off position. Apply Lockout/Tagout Device to the Electrical Panels. Unplug Feed Incline Motor Verify with a Volt Meter that there is no Stored Energy at the Power Switch. . Verify that the Energy Source has been isolated by placing the switch at the control panel in the manual position and if the motor is not turning than the energy source has been isolated. Begin performing the needed repairs or maintenance on the unit. Restoring Energy to Feed Inclines 1. Inspect Work Area, make sure employees are safe, and inform all affected employees that the Feed Line will be powering on. Remove Lockout/Tagout Device from The Electrical Panels. Place the Circuit Breaker to the on position. Plug the Feed Incline Motor back into the Receptacle. Place the Switch in the on position to check the repairs performed. If repairs are satisfactory then place switch in the Auto position. 29 Authorized Employee Cooperative Agreement The following Pullet Facility employees have been authorized to perform lock out tag out procedures at Hickman?s Family Farms. By signing below, you af?rm that you have reviewed and understand the requirements associated with the lliekman?s Family Farms Lock out Tag out Program, speci?cally designed for the Pullct Facilities. This includes, but is not limited to familiarity with the identified equipment, locations of the equipment, as well as the procedures associated with de-energizing, energizing, and informing affected employees prior to and after the Lock out Tag out process. Name Inmate Inmate Inmate Inmate Inmate Inmate Inmate Inmate Inmate Inmate Inmate Trainin Date Febma 3, 2017 Feb 3, 2017 Feb 6, 2018 Feb 7, 2018 Februa 9, 2017 October 24, 2018 October 24 2018 October 29, 2019 001999292 2019 October 29, 2019 2_9, 2019 Octobg29, 2019 October 29, 2019 October 29_,2019 October 29 2019 October 2019 October 29, 2019 October 29 2019 October 29, 2019 October 29, 2019 October 29, 2019 October 29, 2019 October 29 _2019 30 .mhzm?w.w .99: . :rzup': . Overview of LOTO Requested Documents 01. 02. 03. 04. Classroom PowerPoint Training Materials LOTO Written Program Specific Requested Equipment LOTO Written Procedures Authorized Employee LOTO Card Personalized Tag 01. Classroom PowerPoint Training Materials .. . Lockout/tagout (Authorized Employee) training Purpose of training This training reviews key elements of lockout/tagout necessary for all employees. l'?'uthor'ized employee: A person who locks out i or tags out machines to perform servicing or maintenance on. the. machines. ?Human? . . . 'l Types. or employees Affected employee: a An employee responsible for operating the equipment the area worm! ?Affected employee: 0 Cannot help authorized employees service machinery 0 Can be considered an authorized employee . . TYPesgfemployees; l'iill employees: Must understand importance of LOTO I. Must understand procedures if 11-.. Lockoutdefinition Process of preventing the flow of energy 4: Consists of installing a lock, block, or chain . Requires an authorized employee to apply/remove lock Tagbdt- definition Process of placing tag on power source Tag acts as a warning Tag must clearly state ?Do not operate? Tag used when machine won?t accept lock Tag must be applied/removed by an authorized employee . c. .1 Hazardousenergy sources Electrical Mechanical Pneumatic Hydraulic aux?H. . ?2 i 5 ll Chemical Thermal -, Water under pressure Gravity Potential energy Energy control program . Energy control procedures . Employee training hr'l'; 1""2??3?Ivluv? -- .. . T, i Energy =,ooritrol program - l'?nergy control procedure includes: . Intended use of the procedure - Specific steps to control hazardous energy My: .. .71 ?5 Energy control program Each type of machine needs Its OWl'l LOTO procedure . Lockout must be used unless device cannot be locked out Tagout must be used when unable 't 4t; MIR-?arctiimties Constructing Installing Setting up Adjusting Inspec?ng Modifying Repairing Cleaning equipment notionoo? Prepare? for shutdown "Procedures for controlling energy: . Prepare for shutdown - Shutdown - Isolate equipment from energy - Apply lockoutor tagout device. - Release of stored energy Verify Isolation Know the type and magnltude of energy Know the hazards of energy Know the methods 0 . g3 Shutdown Step two: i . Turn off equipment using normal controls - Use orderly shutdown .. Isolate I eqmpment Step three: 0 Isolate equipment from energy sources i? I Secure lock to energy isolating_ device . .. Apply devices ?Step four: . Notify affected employees 0 Attach iockout/tagout devices ill. Ap lehV-ices Only authorized employee can attach or remove lockout and tagout devices Devices must be durable Devices must identify person who applied them .5. Rel'e'a'oesetored energy Step five: - Relieve stored energy . Verify machine isolation from energy u, . .. . . Release stored energy . Steps to release stored energy: 0 Relieve pressure In compressed airline 0 Insert a block . Step six: . Verify machine ls deenergized - Verify machine is isolated . merge-devices . Authorized employee must have own device . Devlce must be used to control energy only .5 Logkuut~devices Devices could be:- - Locks Tags Chains Wedges Key blocks Adapter pins Self?locking fasten Lockout d??ic?es - Devices must have the following qualities: 0 Be durable a Be standardized in color, shape, or size . Be substantial 89,9 . "53,951 ETags must have the following qualities: Be durable Be standardized in print and format Be substantial enough to prevent removal 39. one-Jolene, environmental Include warning statements 5" Group lockouts - Each authorized employee must affix a personal lockout or tagout device . Each authorized employee must remove the device when works stops Shiftchanges 1 .I: - Lockout/tagout protection must be i con?nuous . Lockout/tagout protection must have an orderly transfer between employees- Ell?DevicegremOVal Lockout or tagout device must be removed by the authorized employee who applied it Device may be removed under . direction of. employer if authorized employee unavailable .. - 10 Device removal Steps employers must take before removing a lock or tag: - Verify that authorized employee who applied lock is not at the facility . Take all reasonable efforts to contact the authorized employee E'Restdri?g genergy . Inspect work area . Ensure employees are safe . Notify affected employees . .. . Summary EI'l?hree levels of employee responsibilities: - Authorized employee Affected employee 3" . Other employee Employee Handout Lockout/Tagout Refresher Training Lockout/Tagout Refresher Training Retraining must be provided for all authorized and affected employees whenever there is a change in their job assignments, machines, equipment or processes that present a new hazard, or when there is a change in the energy control procedures. It happened like this Louis headed to his next maintenance assignment. Steve, his supervisor, stopped him. ?Louis, that equipment you?re going to work on next had some refinements made to it since you last worked on it. Here is the new procedure for locking and tagging it out. The steps highlighted are the ones that have changed. It seems that there is an issue with residual electrical energy in the capacitors.? ?Okay Steve.? Louis went to the machine and followed the new procedure for locking and tagging it. Everything went smoothly and he removed his lock and tag. On the way to his next maintenance assignment, Louis couldn't find one of his screwdrivers. He immediately headed back to the first machine and found his screwdriver on the drip tray under the conveyor belt. Let?s talk about this, okay? What are the issues? What did Steve do right? What did Louis do right? Quiz - Loekout/Tagout - Refresher Training 1. Isolation device prevents: a. Lockout/tagout. b. The energy from its source reaching the equipment. 0. The worker from contacting the equipment. d. None of the above. The purpose of lockout/tagout is: a. To make it hard to service a piece of equipment. b. To keep all employees away from the equipment. 0. To prevent injuries due to the automatic startup of a piece of equipment. d. None of the above. The affected employee: a. Operates or uses a machine which may be locked or tagged out for servicing. b. Services a machine under lockout/tagout. 0. Works in an area where lockout/tagout is performed. d. Both a and c. Authorized employees are employees: a. Who can unlock the facility. b. Who can perform lockout/tagout on equipment/machinery when they service it. 0. Who only operate the equipment. (1. None of the above. The following step which is not included in the steps to lock a machine out is: a. Notifying the authorized employee. b. Locating of energy sources. c. Isolation of energy sources. 'cl. Application Of locks'aiid' tags. Locks must be: a. Removed by the affected employee. 1). Applied at the point of isolation and isolating device in off position. 0. Can be used for purpose. (1. Both a and c. 10. 11. 12. Tags should not be: a. Uniform in size. b. Readable. 0. Printed in any format. d. Attached with a 50 pound test nylon cable tie. Before reenergizing the equipment, the affected employee should: a. Notify the authorized employee. b. Remove locks and tags. 0. Notify ?other? employees (1. Be noti?ed by the authorized employee that the equipment is being reenergized. Applying each person's lock to a hasp on isolation point is: a. Single lockout. b. Group lockout. c. Group tagout. d. None of the above. The procedure when one employee places his lock on the isolating device before another removes his is: a. Group lockout. b. Shift change lockout. c. Singular lockout. d. Contract lockout. When an audit reveals that employees are not following energy control procedures: a. The employee(s) must be dismissed. b. The employee(s) need refresher training. 0. The employ_ee(s) need to be moved to another position. d. No action is necessary. The purpose of an audit system for energy control procedures is to: a. Detect changes in the equipment, processes, and employee's knowledge of procedures. b. Ensure that the pro?t margin for production remains the same. 0. Filter out unwanted procedures. None of the above. 13. 14. 15. 16. 17. 18. 19. 20. 21. OSHA regulations contain speci?c retraining requirements for lockout/tagout procedures. True or false? Retraining must be provided for all authorized and affected employees whenever: a. There is a change in theirjob assignments. b. There is a change in machines, equipment or processes that present a new hazard. c. There is a change in the energy control procedures. (1. All of the above. e. None of the above. The equipment in our facility that is subject to lockout/tagout procedures is: The type of energy isolating devices, locks and tags that are in use at our facility include: One general lockout/tagout procedure will be adequate for all the machines that require lockout/tagout. True or false? A written copy of the lockout/tagout procedures at our facility can be found: For purposes of lockout/tagout, employees whose work operations are or may be in an area where energy control procedures may be utilized are called: a. Affected employees. b. Authorized employees. 0. Other employees. d. Relative employees. . of the above. The person who distributes the locks for the machines at our facility is: The person at our facility responsible for the safety and health programs is: -.-.-., . . - .. .- h-m? M. 02. LOTO Written Program .LocivOuiJi?nngui' Certi?cation Cm Operator: Classi?cation: Date of Training: Instructor?s Signature: DO NOT OPERATE FAMILY FARMS NEW EMPLOYEES In keeping with Hickman?s Family Farms policy of maintaining a drug free atmosphere characterized by honesty and integrity, we conduct pre-employment drug screening as well as verify all applicants criminal and background history, education and previous employment. All applicants are required clearance from the Arizona Department of Corrections due to Hickman?s ACI inmate work program. Failure to disclose, or pass any of the above criteria will deny your application or terminate your employment. I understand and agree. EMPLOYEE PRINTED NAME DATE EMPLOYEE SIGNATURE HR SIGNATURE DATE Date of Application: Position applying for: First Name: Last Name: Email Address: Phone Number: Address: City: State: Zip: HICKMANS FAMILY FARMS Crack open the possibilities Apply today! Who referred you to this position? Do you have a valid driver?s license? Yes No Are you 18 years of age or older? Yes No What?s your citizenship employment eligibility? Q) What languages do you speak fluently? Earliest start date? U.S. Citizen/Permanent Resident Non?citizen allowed to work for any employer Non?citizen allowed to work for current employer Non?citizen seeking work authorization Canadian Citizen/Permanent Resident Other t?s your highest level of education completed? GED or Equivalent High School Some College College - Associates College - Bachelor College - Masters College Doctorate Other (602) 734-3631 8260 lndian School Rd, Phoenix, AZ 85033 HICKMANS FAMILY FARMS Can you work weekends? Yes No Can you work evenings? Yes No Can you work overtime? Yes No Have you ever been convicted of a felony? Yes No If ?Yes?, you have been convicted of a felony, please explain the circumstances around the conviction: References - Please enter names and contact information: In your residence, do you or anyone else own any birds or poultry? Yes No Have you worked for Hickman?s Family Farms before? Yes No Are any of your relatives currently employed with Hickman?s Family Farms? Yes No If yes, include their name here: As part of the hiring process, applicants who receive an offer of employment may be asked to submit a screening test to detect the presence of certain drugs or their metabolites. If you are asked to submit a drug test and you refuse to be tested, or do not pass, Hickman?s Family Farms will revoke any offer of employment. All drug tests will be conducted in accordance with applicable federal and state law. Therapeutic levels of medically-prescribed or over-the-counter medicines may lead to positive test results. Would you be willing to be screened for illegal drug use? Yes__ No (602) 734-3631 8260 Indian School Rd, Phoenix, AZ 85033 FAMILY FARMS lf offered a position, would you be willing to submit to a criminal background check, a previous employment verification check, and or an education verification check? Yes No STATEMENT AND AGREEMENT: On this day, by signing below, I certify that all the information provided by me is true, accurate and complete. I understand that the falsification, misrepresentation or omission of a fact on this application (or any other accompanying or required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered. I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation. Date: Signature: Printed Name: The following questions are entirely optional. To comply with government Equal Employment Opportunity Affirmative Action reporting regulations, we are requesting (but NOT requiring) that you enter this personal data. This information will not be used in connection with any employment decisions, and will be used solely as permitted by state and federal law. Your voluntary cooperation would be appreciated. Gender: Female Male Decline to answer Race Ethnicity: Hispanic or Latino White, not Hispanic or Latino Black or African American, not Hispanic or Latino Asian, not Hispanic or Latino Native Hawaiian or other Pacific Islander, not Hispanic or Latino American Indian or Alaskan native, not Hispanic or Latino Two or more races, not Hispanic or Latino Decline to answer Invitation for Job Applicants to Self?Identify as a U.S. Veteran (602) 734-3631 8260 Indian School Rd, Phoenix, AZ 85033 El ICKMANS FAMILY FARMS A "disabled veteran" is one of the following: a veteran of the US. military, ground, naval, or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service? connected disability. A "recently separated veteran" means any veteran during the three?year period beginning on the date of such veteran's discharge or release from active duty in the US. military, ground, naval, or air service. An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the US. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An ?Armed forces service medal veteran? means a veteran who, while serving on active duty in the US. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Veteran Status I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE I AM NOT A PROTECTED VETERAN El I DO NOT WISH TO ANSWER Voluntary Self-Identification of Disability Voluntary Self?Identification of Disability Form CC-305 OMB Control Number 1250?0005 Expires 1/31l2020 (602) 734?3631 8260 Indian School Rd, Phoenix, AZ 85033 ICKMANS FAMILY FARMS Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier. How do I know if I have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to: . Blindness . Muscular - Deafness I . Bipolar Disorder . Cancer . Major Depression . Diabetes . Multiple sclerosis (MS) . Epilepsy - Missing limbs or partially missing limbs . Autism - Post traumatic stress disorder (PTSD) . Cerebral Palsy . Obsessive compulsive disorder . HIV AIDS . Impairments requiring the use of wheelchair . Schizophrenia - Intellectual disability (previously called mental retardation) (602) 734-3631 8260 Indian School Rd, Phoenix, AZ 85033 HICKMANS FAMILY FARMS Please check one of the boxes below: El YES, I HAVE A DISABILITY (or previously had a disability) El NO, I HAVE A DISABILITY El I WISH TO ANSWER Your Name: Today?s Date: Reasonable Accommodation Notice Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a Sign language interpreter, or using Specialized equipment. Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the US. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete. No Yolk, You?re EGG-straordinary - Thank you for applying to Hickman?s Family Farms and we hope the rest of your day stays sunny-side up! Hickman's Family Farms and its brands are an Equal Opportunity Employer of all qualified individuals, including minoritiesI women, veterans and individuals with disabilities. Hickman's Family Farms will consider for employment qualified applicants with criminal histories in a manner consistent with all federal, state, and local ordinances. You are applying for a position with Hickman's Family Farms that is designated as a Safety Sensitive Position pursuant to A.R.S. ?23-493 et seq. You are ineligible for placement in a Safety Sensitive Position if you are engaged in the current use of any drug, whether legal, prescribed by a physician or otherwise, if it could cause an impairment or otherwise decrease or lessen yourjob performance or ability to perform your job duties. (602) 734-3631 I 8260 Indian School Rd, Phoenix, AZ 85033 HICKMANS FAMILY FARMS ATTACH RESUME HERE OR LIST THE LAST THREE JOBS HELD Company: From: To: (City) (State) Position: Company: From: To: (City) (State) Position: Company: From: To: (City) (State) Position: Skills, Certifications, etc.: (602) 734?3631 8260 Indian School Rd, Phoenix, AZ 85033 Applicant Self?Reported Convictions Have you ever been convicted of an offense against the law (including any conviction for driving under the in?uence) other than a minor traf?c violation? Do not disclose any conviction for which the records have been scaled, expunged or subject to deferred adjudication. Circle answer. Yes No Offense l: Offense Date: State: Disposition: Disposition Date: City: County: Name offense committed under (if different than current) First Middle Last Offense 2: Offense Date: ., . State: We? Disposition: Disposition Date: *C-ily: County: Name offense committed under (if different than current) First Middle Last Applicant Last Name J, First Middle Social Security No. ?Date of Birth* Present Address __From ?To City/State/Zip Prior Addresses From To Prior Addresses From To Driver?s License State Date . Applicant Signature . EGG RANCH, INC. CONSUMER DISCLOSURE AND AUTHORIZATION FORM Disclosure Regarding Background Investigation Hickman?s Egg Ranch, Inc. and all af?liates may request, for lawful employment purposes, background information about you from a consumer reperting agency in connection with your employment or application foi- employment (including independent contractor assignments, as applicable). This background information may be obtained in the form of consumer reports and/or investigative consumer reports (commonly known as ?background reports"). These background reports may be obtained at any time after receipt of your authorization and, if you are hired or engaged by the Company, throughout your employment or your contract period. HireRight, Inc., or another consumer reporting agency, will prepare or assemble the background reports for the Company. HireRight, Inc. is located and can be contacted by mail at 5151 California, Irvine, CA 92617, and HireRight can be contacted by phone at (800) 400?2761. The types of information that may be obtained include, but are not limited to: social security number veri?cations; address history; credit reports and history; criminal records and history; public court records; driving records; accident history; worker?s compensation claims; bankruptcy ?lings; educational history veri?cations dates of attendance, degrees obtained); employment history veri?cations dates of employment, salary information, reasons for termination, etc); personal and professional references checks; professional licensing and certi?cation checks; drug/alcohol testing results, and drug/alcohol history in violation of law and/or company policy; and other information bearing on your character, general reputation, personal characteristics, mode of living and credit standing. This information may be obtained from private and public record sources, including, as appropriate: government agencies and courthouses; educational institutions; former employers; personal interviews with sources such as neighbors, friends and associates; and other information sources. If the Company should obtain information bearing on your credit worthiness, credit standing or credit capacity for reasons other than as required by law, then the Company will use such credit information to evaluate whether you would present an unacceptable risk of theft or other dishonest behavior in thejob for which you are being evaluated. You may request more information about the nature and scope of any investigative consumer reports by contacting the Company at: Human Resources at 1-623?872-2311. A summary of your rights under the Fair Credit Reporting Act is also being provided to you. ADDITIONAL STATE LAW NOTICES [f you are a California, Maine, Massachusetts, New York or Washington State applicant, employee or contractor, please also note: CALIFORNIA: Pursuant to section 1786.22 of the California Civil Code, you may view the ?le maintained on you by HireRight during normal business hours. You may also obtain a copy of this ?le, upon submitting proper identi?cation and paying the costs of duplication services, by appearing at HireRight?s of?ces in person, during normal business hours and on reasonable notice, or by mail. You may also receive a summary of the ?le by telephone, upon submitting proper identi?cation. HireRight has trained personnel available to explain your ?le to you, including any coded information. If you appear in person, you may be accompanied by one other person,p_rovi_d_ed furnishes_pmporidenti?cation, MAINE: You have the right, upon request, to be informed of whether an investigative consumer report was requested, and if one was requested, the name and address of the consumer reporting agency furnishing the report. You may request and receive from the Company, within five business days of our receipt of your request, the name, address and telephone number of the nearest unit designated to handle inquiries for the consumer reporting agency issuing an investigative consumer report concerning you. You also have the right, under Maine law, to request and receive from all such agenciesi?ie?s of any__s1_10_h MASSACHUSETTS: If we request an investigative consumer report, you have the right, upon written request, to a copy of the repo_rt. NEW YORK: You have the right, upon request, to be informed of whether or not a consumer report Was requested. If a consumer report is requested, you will be provided with the name and address of the consumer reporting agency furnishing the report. You may inspect and receive a c0py of the report by contacting that ?3989?)? Attached below is additional information about New York law. WASHINGTON STATE: If the Company requests an investigative consumer report, you have the right, upon written request made within a reasonable period of time after your receipt of this disclosure, to receive from the Company a complete and accurate disclosure of the nature and scope of the investigation requested by the Company. You also have the right to request from the consumer reporting agency a written summary of your Lights andrerrledies under the Washington Fair Credit lie-pm ting Act. Authorization ofBackground Investigation I have carefully read and understand this Disclosure and Authorization form and the attached summary of rights under the Fair Credit Repoxting Act. By my signature below, I consent to preparation of background reports by a consumer reporting agency such as HireRight, Inc., and to the release of such background reports to the Company and its designated representatives and agents, for the purpose of assisting the Company in making a determination as to my eligibility for employment (including independent contractor assignments, as applicable), promotion, retention or for other lawful employment purposes. I understand that if the Company hires me or contracts for my services, my consent will apply, and the Company may obtain background reports, throughout my employment or contract period. I understand that information contained in my employment or contractor application, or otherwise disclosed by me before or during my employment or contract assignment, if any, may be used for the purpose of obtaining and evaluating background reports on me. I also understand that nothing herein shall be construed as an offer of employment or contract for services. I hereby authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency. By my signature below, I also certify the information I provided on and in connection with this form is true, accurate and complete. I agree that this form in original, faxed, photocopied or electronic (including electronically signed) form, will be valid for any background reports that may be requested by or on behalf of the Company. El California, Minnesota or Oklahoma applicants only: Please check this box if you would like to receive (whenever you have such right under the applicable state law) 3 COPY 0f your background report if one is obtained on ypu by the NEW YORK CORRECTION LAW ARTICLE LICENSURE AND EMPLOYMENT OF PERSONS PREVIOUSLY CONVICTED OF ONE OR MORE CRIMINAL OFFENSES Section 750. De?nitions. 75]. Applicability. 752. Unfair discrimination against persons previously convicted of one or more criminal offenses prohibited. 753. Factors to be considered concerning a previous criminal conviction; presumption. 754. Written statement upon denial of license or employment. 755. Enforcement. ?750. De?nitions. For the purposes of this article, the following terms shall have the following meanings: (1) ?Public agency" means the state or any local subdivision thereof, or any state or local department, agency, board or commission. (2) "Private employer" means any person, company, corporation, labor organization or association which employs ten or more persons. (3) "Direct relationship" means that the nature of criminal conduct for which the person was convicted has a direct bearing on his ?tness or ability to perform one or more of the duties or responsibilities necessarily related to the license, opportunity, or job in question. (4) ?License" means any certi?cate, license, permit or grant of permission required by the laws of this state, its political subdivisions or instrumentalities as a condition for the lawful practice of any occupation, employment, trade, vocation, business, or profession. Provided, however, that "license" shall not, for the purposes of this article, include any license or permit to own, possess, carry, or ?re any explosive, pistol, handgun, rifle, shotgun, or other ?rearm. (5) ?Employment" means any occupation, vocation or employment, or any form of vocational or educational training. Provided, however, that shall not, for the purposes of this article, include membership in any law enforcement agency. Applicability. The provisions of this article shall apply to any application by any person fora license or employment at any public or private employer, who has previously been convicted of one or more criminal offenses in this state or in any otherjurisdiction, and to any license or employment held by any person whose conviction of one or more criminal offenses in this state or in any other jurisdiction preceded or granting of a license, except where a mandatory forfeiture, disability or bar to employment is imposed by law, and has not been removed by an executive pardon, certificate of relief from disabilities or certificate of good conduct. Nothing in this article shall be construed to affect any right an employer may have with respect to an intentional misrepresentation in connection with an application for employment made by a prospective employee or previously made by a current employee. nvicted of one or more criminal offenses prohibited. ?752. Unfair discrimination against persons previously co . . . loyment or license held by an individual, to which the No application for any license or employment, and no emp provisions ofthis article are applicable, shall be denied or acted upon adversely by reason ofthe individual's having been previously convicted of one or more criminal offenses, or by reason of a ?nding of lack of "good moral character" when such ?nding is based upon the fact that the individual has previously been convicted of one or more criminal offenses, unless: (1) There is a direct relationship between one or more of the previous criminal offenses and the Speci?c license or employment sought or held by the individual; or the issuance or continuation of the license or the granting or continuation of the employment would involve an unreasonable risk to property or to the safety or welfare of speci?c individuals or the general public. ?753. Factors to be considered concerning a previous criminal conviction; presumption. 1. In making a determination pursuant to section seven hundred fifty-two of this chapter, the public agency or private employer shall consider the following factors: The public policy of this state, as expressed in this act, to encourage the licensure and employment of persons previously convicted of one or more criminal offenses. The Speci?c duties and responsibilities necessarily related to the license or employment sought or held by the person. (0) The bearing, if any, the criminal offense or offenses for which the person was previously convicted will have on his ?tness or ability to perform one or more such duties or reaponsibilities. The time which has elapsed since the occurrence of the criminal offense or offenses. The age of the person at the time of occurrence of the criminal offense or offenses. The seriousness of the offense or offenses. Any information produced by the person, or produced on his behalf, in regard to his rehabilitation and good conduct. The legitimate interest of the public agency or private employer in protecting property, and the safety and welfare of specific individuals or the general public. 2. In making a determination pursuant to section seven hundred ?fty-two of this chapter, the public agency or private employer shall also give consideration to a certi?cate of relief from disabilities or a certificate of good conduct issued to the applicant, which certi?cate shall create a presumption of rehabilitation in regard to the offense or offenses spec1fied therein. ?754. Written statement upon denial of license or em pioyment. At the request of any person previously convicted of one or more criminal offenses who has been denied a license or employment, a public agency or private employer shall provide, within thirty days of a request, a written statement setting forth the reasons for such denial. ?75 5. Enforcement. 1. In relation to actions by public agencies, the provisions ofthis article shall be enforceable by a proceeding brought pursuant to article seventy?eight of the civil practice law and rules. 2. In relation to actions by private employers, the provisions of this article shall be enforceable. by the division of human rights pursuant to the powers and procedures set forth in article ?fteen ofthe executive law, and, concurrently, by the New York city commission on human rights. ARIZONA DEPARTMENT OF CORRECTIONS Piease provide as much Information as possibie. You must be an authorized ACJIS criminaijustioe practitioner. or certified ACJIS operator, to receive oriminai justice information obtained via the neivmrk. Criminal History Information Request TO DATE FROM REQUESTOR NAME (Last, First Mi.) (Pieese JOB TITLE EMAIL ADDRESS WORK TELEPHONE NUMBER (with area code) QUERY Criminal History Vehicle Registration CI Driver's License Warrant Check Other REASON FOR REQUEST Visitor Vendor El Employment Employee Administrative Update Parole Piecement Suspicious Vehicle Absolute Discharge Community Supervision Sponsor [3 Prison Release Other COMMENT REQUESTOR SIGNATURE DATE SUBJECT INFORMATION (Provide information avaiiabie vie AIMS, Fire. i. D. 3. etc.) NAME (Last, First MI.) (Please print) EN (Last. FirsiMJ.) (Piease print) DATE OF BIRTH (mm/WW) SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EYE COLOR HAIR COLOR Male Female ADC NUMBER (iiappiicabie) FBI NUMBER (irappiicabie) SID NUMBER {ifappiioabie} LICENSE VEHICLE PLATE YEAR COMMENT ACJIS OPERATOR DATE OF INQUIRY CRIMINAL HISTORY REQUEST RESPONSE TO SUBJECT OF INQUIRY DATE FORWARDED (mm/mm; RESULTS No matching record based on information provided information forwarded via: Telephone interdepartmental mail Fax El Other El Email Address COMMENTS ADMINISTRATORANARDEN OR DESIGNEE SIGNATURE Approved Denied 121-1 5i16i17 Document Document No. 212 HFF Perm Hire Checklist Version: Reviewed 3.1 TAMILY mums 1/10/19 6515 Jackrabblt Trall? Buckeye, AZ 85326- -(623) 872- 1170? in fognililckm msogp a. com QRIJENTATIIQN Employee Name: Date: Employee ID Number: Department No.: New Hire Orientation - Discussion Attitude Eggcelient - Video Working Around inmates - Video Discussion Sexual Harrassment Video Quiz Drug and Alcohol Abuse Video Quiz Office Ergonomics Video Quiz Employee Signature: Instructors Signature? Dedicated Hours: Completion Date: Document Document No. 213 HICKMANS Attitude Eggcellent Versiom Reviewed 2-1 1/8/19 FAMILY FARMS 6515 S. Jackrabbit Trail Buckeye, AZ 85326 infogathickinaoSegg mm; AT TIT EGCELLENT Everyone gets respect! No one needs to ever yell 'or use speaking to an employee or - I .. (Jive it: your all! The time yen are scheduled to work should be l?or'?worki, Leave your personal life at home and stay focused on the job at hand. Distracted workers usually end up getting hurt. 6ch us some notice. if you are are not going i0 be able to. work please let supervisor knew/"24 hears in advance-so they'have time to ?nd a replacement. {Alstomer service that goes above-and-beyond oureompetltors. This includes, but is not limited to a firm hand shake, a friendly smile, answering the phone in a- professional manner, making each customer feel like they are our'?rst priority and providing our customers with the products they need when they need them. I i ..-very0nc is watching! Remember when you are wearing the company logo or driving a company vehicle you are representing this company, so please make us proud. end a hand. No one should say, ?That?s not my; job.? If you are able to help someone out, jump in and give them a hand. cave the door open. There is a reason the owners and supervisors keep theirdoors open? we want to hear from you. Come in and let?s talk. Error is to be human? lying about it is not. People make mistakes so please be honest with your supervisor if you damaged a piece of equipment, computer or some sort of Hickman?s property No excuse for being a slob! Littering the plant or of?ce grounds with cigarette butts or soda cans is not acceptable; neither is leaving the break room full of your trash and uneaten food. The bathrooms are to be clean at all times so please pick upafter-yom?self Teamwork is the only way we can make Hickman?s Family Farms the best place to work, so cooperate and work together to get the job done. Document No. 214 Document HICKMANS Sexual Harassment Quiz Ver5i?n= Reviewed 1-0 1/3/19 FAMILY FARMS 6515 5. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 QUIZ SEXUAL FOR NAME DATE 1. True or Most reported cases of sexual harassment involved female supervisors harassing male employees. True False 2. If they occur repeatedly, behaviors that might be considered sexual harassment include: Making obscene gestures Sexist remarks Commenting on a co-worker?s physical appearance Talking about sex 3. True or harassment victims sometimes feel that they are somehow responsible for the harassment. True False 4. True or language, conduct or other behavior is not offensive to most people, then it is not considered to be sexual harassment. True False 5. True or a harasser?s intended target can be considered a sexual harassment victim. True False 6. True or a poster or magazine is in your own office or locker, it cannot be considered to be harassing to other people. True False 7. True or you believe you have been sexually harassed, you should write down the particulars of the situation immediately. True False Document No. 215 Document Drug 8: Alcohol Quiz Verslom Reviewed 1-0 1/3/19 FARMS 6515 S. Jackrabbit Trail Buckeye, AZ 85326 ?nfog?lhickmanseg scorn WITH DRUG AND ALCOHOL FOR NAME . DATE True or Depressants such as alcohol and marijuana speed up brain activity. True False True or residual effect of a substance can cause a person to have an accident days after they have last used the substance. True False What is the most commonly used illegal drug? OxyContin Marijuana Cocaine What percentage of serious workplace accidents are caused by people drinking on the job? 10% 15% 25% 50% True or people build up a tolerance to a substance they generally become less dependent on it? True False True or to drugs and alcohol is a disease? True False True or are no known cures for alcoholism and drug addiction? True False I understand that Hickman's does not offer EAP or Rehab Programs and Hickman?s has a zero tolerance for drug alcohol abuse. YES NO (Circle one) Document Received at Orientation Checklist FAMILY FARMS Document No. 210 Verslon: 1.1 Reviewed 1/7/ 19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 - (623)-872-1170 Received at Orientation/ Recibido en Orieniaci?n Name/Nombre: Emp# Hickman?s T-shirt/Camiseta Qty: Water Bottle/Botella de agua Name Badge/Ingisnia de Identificaci?n Other/Otro: Other/Otro: Signature/Firma: Date/Fecha: Document Document No. 208 HICKMANS New Hire Comprehensive Test Response Ver5i?n= Reviewed 2.2.0 FARMS 02.15.19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 Name/Nombre: Date/Fecha: Dept: Mark the letter that best answers the corresponding question Marque la Ietra que major responder a la pregunta correspondiente. Working with Inmates Bio Security 3? Animal Welfare Occupational Safety Trabojando con Presos Bioseguridad 3? Bienestar d9 Seguridad Ocupaciona! 1. A Iasanimales 6.AB 5-AB 6.ABCD 7.ABCD 6.ABC 7.ABC 8.AB 7-AB 8.ABCD 9.ABCDE 8.AB 9.AB 10.AB 9- AB 10.ABC 10. A 11. A 11. Food 11A SeguridadyCah'dad de Comida 13 A 13' A . 14.A 1. A 14. A 15.A 2. A 15. A 16.A 3. A 16. A 17.A 4. A 17. A 18.A 5. A 18. A 19.A 6. A 19. A 20.A 7. A 20. A 21.A 3. A 21. A 22.A 9. A 22. A 23.A 10.A 23.A 24.A 11.A 24. A 25.A 12.A 25. A 26.A 13.A 14' A LOTO Affected 27' A 15' A LOTO Afectado 28' A 15.A 1. A 29.2 1710.A 11.A Document Document No. 208 New Hire Initial Orientation Cover Sheet Versiom Reviewed 3.1 MIMI-LY mum 1/4/19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 Name: Date: Position I Dept: I Emp#: Instructor: Trainee/Trainer 1. Working Around Inmates (Trabajando con PresosPresentation, video and Acknowledgement (Sign/Firma) b. PREA policy (Sign/Firma} cl Dress?code policy (Sign/Firma) 2. Bio-Security Training (Bio-SeguridadWhat is Bio?Security? Avian influenza 8L Travel Advisory Bio-Security Policy (Sign/Firma) Hickman?s Bio Security Training (Video) Freedom Flock Agreement (Sign/Firma) 3. Food Safety 8: Quality Training (Seguridad Calidad de ComidaHACCP, Food Quality, GMPs and SQF Training Management Policy Personnel Best Practices (Sign/Firma) Food Defense General Training (Sign/Firma) 4. occupational Safety 8: Health Training (Seguridad SaladManagement Commitment Safety Notice b. General Safety Responsibilities (Sign/Firma) (2. Chemical Safety SDS Overview cl. Chemical Safe Handling Practicies (Sign/Firma) e. Company Safety Rules Workplace Safety 101 (Video) 5. Lockout/Tagout (Bloqueo Etiqueta).. . . . . . . . . a. Lockout/Tagout Basics {Sign/Firma) b. Lockout/Tagout (Video) 6. a. NDA Speed Limit (Sign/Firma) Received at Orientation Checklist (Sign/Firma) 7. Department Specific Training (Departamento especi?co) a. BARNS - UEP Guidelines Code of Conduct (Video) b. DRIVERS Inspections, Defensive Driving, Injury Prevention (Video) c. FEED MILL "Don?t Go with the Flow?, ?Your Safety Matters? (Video) 2" d. FORKLIFT Presentation, Video, Quiz, 8t Performance Test SIGNATURE: Document Document No. 202 inmate Work Policy Version: Reviewed 1.1 ram-w 1/3/19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 mgr?!hickmansoggsmom 'Hickman?s Family Farms (HFF) employs inmates from the Arizona Department of Corrections (ADC). These are non?violent offenders who pose no threat to you or HFF. There are several important rules that must be followed by employees, contract laborers, interns, visitors, and anyone else at HFF. Please read through these rules carefully as some of them are based on law, meaning that failure to follow these rules may constitute a violation of state or federal law, and may lead to criminal prosecution. 1. powers-laser) 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. NAME SIGNATURE WITNESS SIG DATE Leave personal items, including cell phones and other electronics, locked securely in your locker or vehicle. HFF will not be responsible for loss or theft. When working around inmates, make sure you know who to contact in case of an emergency. Never leave inmates unattended with tools, equipment or your personal belongings. inmates wear orange and are counted periodically throughout the clay. Address inmates as "Inmate? and their last name. Do not use first names or full names with inmates. Do not allow inmates to address you by your first or full name If you are asking an inmate to do something, be direct, clear and unambiguous. Do not use sexual, vulgar, profane or abusive language toward an inmate and do not allow inmates to use such language toward you or anyone else. Report accidents to your supervisor or an ADC staff member immediately. You are not obligated to offer medical attention or any type of assistance to an inmate Unless there is a medical emergency, do not touch inmates. Do not allow inmates to touch you Do not give personal information to inmates, such as your full name, where you live, children/spouse names. Do not discuss these matters where an inmate might overhear. Do not become familiar with an inmate or inmate?s family. Keep your relationships with inmate strictly work-related. Do not transmit messages or allow inmates to have any contact with the outside world. Do not mail anything for inmate, do not allow inmates access to a cell phone, do not deliver messages to the outside world on behalf of an inmate Do not give anything to inmate unless it?s work-related. Do not give inmates food, cigarettes or gum. Inmates are assigned counselors to help them with routine matters within the prison. Do not offer inmates legal advice or any kind of legal work Do not discuss prison matters. Questions about the prison should be referred to ADC staff members. Do not allow inmates to possess alcohol, drugs, weapons, electronics, cameras, recording devices. Do not allow inmates to operate vehicles or ride in vehicles not designed for passenger use Do not use a personally owned vehicle to transport an inmate If you see inmates or co?workers behaving in a way that you believe is inappropriate, you are required to report it to your supervisor or an ADC Staff member Failure to follow these rules, including failure to report violations, may result in immediate dismissal from HFF and possible criminal prosecution. By signing below, I affirm that have read and understand the rules and I have been given the chance to ask questions. I will abide by these rules DATE Document Document No. 203 Vicarious Liability Prison Rape Elimination Act Versiom Reviewed r' a 1 1. m: 5 Overview 1'1 1/3/19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 - Hickman?s Family Farms (HFF) is contracted with Arizona Correctional Industries and the Arizona Department of Corrections (ADC) to employ inmates and ex-inmates serving parole. There are two important concepts that must be understood by all HFF employees, inmate workers, contract laborers, interns, visitors and anyone else at HFF: 1) Custodial Responsibility Every individual at HFF and the company itself is responsible for the care, management, safety, control general well-being of our inmate workers. This just means that we provide a safe, appropriate, professional working environment that is free from things that inmates shouldn?t access. 2) Vicarious Liability- Every individual at HFF and the company itself can be held responsible for the actions of an inmate worker, even if an individual isn?t directly involved. This means that you can be held criminally responsible for what an inmate does, even if you don?t directly approve. Example: An inmate asks to borrow your phone to call a family member and instead, without your knowledge, they use your phone to set up a drug deal. You could then be arrested and charged with dealing drugs and face possible jail time. Prison Rape. Elimination Act Overview The Prison Rape Elimination Act of 2003 (PREA) was enacted by the U.S. Congress to address the problem of sexual abuse of persons in the custody of U.S. correctional agencies. PREA is a broad-ranging law that covers all persons in custody, including, but not limited to police holding cells, local county jails, state federal prisons, and juvenile detention centers. Sexual contact with inmate or offenders on parole is strictly prohibited. Participation in sexual activity with inmates will result in the following: an investigation, suspension from work during the investigation and if found guilty, you will be immediately terminated by HFF and possible criminal penalties including 1.5 years in prison. What is sexual contact? According to ARS 13-1401, Sexual Contact is defined as touching, fondling or manipulating any part ofthe genitals, anus or female breast by any part of the body or any object causing a person to engage in such contact. Keep in mind that incidental contact can be considered sexual so make sure your actions around inmates are obvious and deliberate. This is why HFF does not allow physical contact of any kind between inmates and civilians. An action that is harmless and innocent to you could be mistaken as sexually motivated by one of your co-workers. If you have any questions about what is acceptable regarding inmate policy, please ask before you act. By signing below, I acknowledge that I understand the concepts of Vicarious Liability, Custodial Responsibility and the Prison Rape Elimination Act. I have been given the opportunity to ask questions about these matters. I will adhere to these rules at all times while working at Hickman?s Family Farms. NAME DATE SIGNATURE WITNESS SIG DATE FAMILY FARMS momma: MMW We love our chickens! We have a responsibility to make sure they stay happy, healthy and free from disease and illness. That?s what Bio-Security is all aboutil What causes disease and illness? Diseases are usually caused by tiny germs like viruses and bacteria. What is ?Bio~5ecurity"? The three main parts of Bio?Security are: 1. Sanitation - Keeping ourselves and our facilities clean and free from germs 2. Isolation Keeping our birds away from things that can harm them 3. Traffic Control? awav from our chickens Keeping pests and people They are much too small for us to see. We can bring these germs to work if we are not careful. was. 1. Keep personal vehicles away from the barns Personal vehicles may be carrying germs. We park far away and ride the shuttle to the facility. Personal vehicles are not allowed near our facilities. 2. Always shower and put on clean clothes before work Showering and washing clothes in hot water will destroy dangerous germs. Be sure to wash your hands often at work too. 3. No birds or poultry at your home Do not keep chickens or any other birds at your house. 4. No contact with birds or poultry Avoid birds at the park, 200, and pet stores. 5. Use every footbath you encounter Footbaths will kill germs on your shoes. Using the footbath is requued. 6. Report any unauthorized people near our facility People may be carrying germs that will hurt our birds If you have any questions about Bio-Security or your responsibilities, please ask your supervisor. WWS Bio-Security Travel Advisory Please avoid international travel, including to Mexico. Any worker at Hickman?s, regardless of their job/position. who travels outside the USA must take a 72 hour uarantine upon returning to the United States. within the If you are traveling to any place where live birds are kept (like a family member with. Chickens or a zoo), you may need to take time off to quarantine when you return. We are consistently monitoring the movement of diseases that can affect our chickens. Remember that rules for travel will change depending on the circumstances. Please speak with your manager when planning any travel outside the state of Arizona, as you may need to quarantine when you return. The health and well-being of our ?ocks is everyone?s business! We all have an important part to play to ensure that our chickens are happy healthy. Ask your supervisor if you have any questions. We LOVE our chickens! Bio-Security Quick Ref? Revised on 20170905 by A. Caston'na - Located in G:lanthony Castorinaldocs Document Document No. 062 Bio-Security Policy for Employees, Visitors, Reviewed 1.2 Laborers, Inmates and Interns 1/3/19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 inf 'o sconi At Hickman?s Family Farms (HFF), there are few things that we take more seriously than the health and happiness of our chickens. Before getting started at HFF, you must agree to comply with our Bio-Security Policy. All Employees, Inmate workers, Interns and Contract Laborers must: 0 Leave cell phone in vehicle, front office or secured in a locker. The only exception is workers who have been issued a company phone for work use or workers who have formal expressed approval from management to use phones or other electronic devices. No personal phones are allowed in the processing areas or lay houses. a Inform management if you have visited any places where birds/poultry are housed in the last 72 hours . Inform management of any travel to or near places where you might encounter live birds 0 HFF Ownership must decide to let someone enter who has been to other lay houses within 72 0 Inform managers if you have been in contact with any wild birds or poultry in the last 72 hr - Shower before work. Change into bio clothing as directed 0 Use: all foot-baths as directed a Do not-keen live birds or poultry at your home 0 Report any violations of bio?security policy to management 4 Inform management of any concerns which could impact the health and safety of our chickens 0 Follow any additional instruction from management regarding Bio-Security practices it Never give out gate codes to anyone. All information including gate codes is confidential. All visitors must: 6 Report to front gate associate to be announced to front office and sign the visitor log - Leave cell phone in car or with front office. Cell phones and other recording devices are not allowed in the processing area 0 Inform management if you have visited any lay houses or other places where birds or poultry are housed in the last two weeks. Managers can decline to allow a visitor based on their recent contact with birds/poultry. HFF Ownership must approve anyone who has been to a lay house within the last 72 hours 0' Inform management if you have been in contact with wild birds/poultry in the last 72 hours 0 Not enter the premises unless cleared by management, not go to any parts of the premises unless escorted by management, change into bio clothing or cover with an approved bio-suit as directed by management and use all footbaths as directed a Follow any additional instruction from management regarding bio-security By signing below, I affirm that I understand HFF Bio-Security policy and I commit to do my part to ensure that our chickens are happy and healthy. I acknowledge that I have been given the opportunity to ask questions now and any time in the future. I will adhere to these and any additional direction from my manager regarding proper Bio-Security practices. NAME EM DATE SIGNATURE WITNESS SIG 8L DATE Document Document No. 201 HICKMANS Freedom Flock Agreement Versiom Reviewed 1.1 FAMILY Mime 1/3/19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 - Our Employees and Laborers must be fully committed to providing the best care for our flocks. Throughout your work at Hickman's Family Farms, please be I mindful of these five principles: 1. Freedom from Hunger and Thirst - Access to fresh, nutritious food and clean water 2. Freedom from Discomfort Providing an appropriate environment including shelter and a comfortable resting area 3. Freedom from Pain, Injury and disease - Prevention or rapid diagnosis/treatment 4. Freedom to Express Normal Behavior - Providing proper space, facilities . and fellowship with the animals' own kind 5. Freedom from Fear and Distress - By ensuring conditions and treatment which do not promote mental suffering Anyone involved in actions that do not support these principles is subject to immediate termination and possible criminal prosecution. Anyone who witnesses inappropriate treatment of our birds and fails to report the observations is subject to the same consequences. . At Hickman?s Family Farms, we respect our chickens! . Hickman's has a ZERO TOLERANCE policy regarding abuse, mistreatment or neglect of our chickens. Hickman's will NEVER reveal the identity of or take any retaliatory action against an individual who reports abuse, mistreatment, neglect or any concerns regarding the health, safety and comfort of our chickens if you see or hear anything that leads you to believe that someone in our company does not share in these commitments, you are REQUIRED to report your observations to a supervisor immediately. NAME . DATE SIGNATURE WITNESS SIG DATE HECkman?s EBB Ranch 2019 Management Quality Commitment Policy a a? ?we I Hickman Family Farms is committed to their employees and will provide them the support and resources that allows every employee to be dedicated In producing a safe, wholesome and quality product for our customers. An industry leader in attaining the highest food and quality standards as designated by regulatory agencies and expected by our customers. We shall monitor our performance through internal and external audits to ensure we are continuously improving our food safety and food quality objectives. Hickman Family Farms esta cometido a sus empleados les dar? el apoyo Ios recursos que permite a cada empleado para ser dedicado en la producclon de producto de calidad seguro, saludable para nuestros clientes. Lider de la Industria en lograr Ios mas altos est?ndares de calidad alimentos como designada por Ias agencies reguladoras esperada por nuestros clientes. Debemos controlar nuestro desempei?io a trav?s de auditorlas internas externas para asegurar que continuamente estamos mejorando nuestra seguridad alimentaria objetivos de calidad de allmentos. rm Owner VP of Operations Page 1 of 1 Icarus HACCP soy <3 . r? i Types ofHazar .s i widely used I i I Hazard Types ofHazards M) 2. ChemIcal 1 oo sa i Anal 1 Physical Hazards Glass amends-caring 5 system. it's Metai Wood Plastic ?my . ?3 95: all about I: . . . wt 3. allergens finding ijj _m hazardsand eliminating I TYPES 0! Hazards 2 them before ygetlnto . 3. Biological Hazards?Bacteria. ourfnod Viruses, Mold Fungus, Parasites ,are following HACCP, our i Hazard Analysis? We look for any hazards ll food Should be free from hazards ll and completely safe to eat ll Critical Control Points We come up with ways to stop theml stunt-.Just like HACCP does for . Qualify Food Safety, the Food We want ourfood to be safe, . - QUHHW Program for but we also want it to taste problems and comes UP ?re?N-?wh-HH-?w-wma- - With Food Quality Program Quality is all about expectations. before they happen]! i If you bought Jumbo Grade AA eggs, how wouid I Lyou feel if they were mediums instead ofiumbos? i Remember: 5 0 Safety is all about ?is the food is going to hurt anyone". Quality is all about "is the food what the consumer i i. .. .. .. secs tabs-Be {20.2 as are stewardessGood Manufacturing Practices (or GMPs) Examples: - GMPS are the little habits that we get into to . Handwashing (at least 20 seconds) . . .. gogpart our Food Safety 83. uaiit-y. irograms when you enter processing area Wearing Hairnets Beardnets as directed Never put boxes of food on the ground Safeguaiitv Food SQF sends auditors to check our work once a year They check if we re following our Food Safety and Food Quality program. They look through our training records and watch our work processes. If we are missing anything, we lose points. If we lose too 0 many points. we will lose our certification. 9 Document Document No. 199 HICKMANS SQF Personnel Best Practices Versiom Reviewed 1.3 rams? rams 1/3/19 6515 S. Jackrabbit Trail - Buckeye, AZ 85326 info hickmanseygscoi'n' SQF (Safe Quality Food) HACCP (Hazard Analysis Critical Control Points) Handwashing required before handling eggs, upon entering the processing area, you must wash your hands, even if you just washed them in the restroom/breakroom. After using the restroom, using facial tissue, smoking, eating, drinking, handling tools or hoses Employees carrying infectious diseases such as in?uenza, ?the cold" and others should not handle eggs Employees must cover any cuts, sores or lesions must be bandaged. If cuts, sores or lesions are present on the hands, the employee must also wear gloves over their bandages Smoking, eating, drinking, chewing, spitting are prohibited in processing areas. Employees must shower/bathe before reporting to work Clothing 8: Jewel ry- SOP Code Employees must wear clean, laundered clothes and clean footwear Loose clothing and jewelry are prohibited in the processing area .l?ersonnel Processing Practices SOP Code All employees enter thru the employee entrance All doors kept closed No false ?ngernails or nail polish Food product and packaging material must not be on the ?oor Trash must be in waste bins and emptied when full Employees may not eat or taste food products All hoses must be stored on hose racks Foodeandii'ng Areas 301? Code 9 All food contact surfaces, tools, walls, ?oors and ceilings must be made of material that is easily cleaned and will not absorb water or support the growth of bacteria No wood in the processing area, other than pallets Suf?cient lighting in processing area, with shatterproof bulbs and enclosures Sealed doors, windows and docks to prevent dust and pest infestation All inedible egg containers clearly marked Hand sinks in breakroom and restroom Handwashing stations must have hot water, soap, single?use paper towels, trash receptacle and appropriate signage. If you notice any of these things missing from a handwashing station, please report it! No diesel or gas powered equipment in the processing area, cooler or storage Set the example for your co?workers when it-comes to food safety and oualitvi I understand our SQF and HACCP objectives. 1 will do my part to ensure that my facility is compliant with the SQF Code as it applies to my work. I understand that my decisions at work can impact the lives and health of many people. Iunderstand our Standard Operating Procedures (SOPS) and Good Manufacturing Practices (GMPs) and commit to following them in all I do at work. I understand that my manager and assistant manager are SQF Practitioners and I must report any food safety/quality concerns to an SQF Practitioner or my direct supervisor. I understand that if I have any questions about food safety and food quality, I should ask my supervisor. NAME SIGNATURE WITNESS DATE DATE Document Document No. 198 Food Defense General Training Basics Versiom Reviewed 1.1 rams? mums 1/2/19 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 Lr?Q?ihickmanseggsxang In 2002, the Public Health Security Bioterrorism Preparedness and Response Act aka the ?Bioterrorism Act" was signed into law. This law was implemented to safeguard against acts of Bioterrorism and mandates a principle known as Food Defense. A big part of this law involves protecting the food supply from contamination or adulteration. As a food producer, we have a responsibility to offer a product that is safe for consumers and their families. 6 Name: Signature: Witness Sig/Date: Our ranches are all surrounded by fences and gates. We have signs posted prohibiting unauthorized entry on to our property. Never give out the gate code to anyone. Report broken/detective gates or fences to management. Do not bring visitors to our ranches without prior approval from senior management. Delivery vehicles should not be entering our property outside designated times. and should always enter through the appropriate gate. A worker at the gate is reSponsible for confirming the validity of any vehicle trying to enter our property in accordance with our policies. Entrances are located at the front of each building. Emergency exits can only opened from the inside and may not be used to enter the building. Visitors must sign in at the front of the building before entering any area where food is handled. Visitors must wear bio-suits, foot covers. hair/beard?nets or any other equipment as directed by management. Shipping and Receiving dock doors are for deliveries only. Receiving doors must be locked when not in use. People who work in receiving are trained to inspect incoming loads for tampering and adulteration. All received loads must be logged. Logs will be reviewed by the Compliance Department Incoming mail is received by office personnel. who are trained on USPS guidelines for detecting and handling suspicious mail. Our facilities are registered under the and certificates are posted at each facility All facilities are under constant video surveillance and monitored by management. Emergency contact lists are posted at each facility, with access to a company phone nearby the list. Job applicants are required to complete E?Verify and comprehensive background check to screen for possible food defense threats Trailers will be inspected for adulterants before product is loaded. We require ?Letters of Guarantee" from reputable suppliers to ensure that outside product isn't contaminated or adulterated. All wells are fenced and checked regularly by security personnel for signs of tampering or attempted entry. USDA provides samples to third-party agency for testing. Maricopa Ranch: Water is tested by provider and USDA no less than anually Employees are trained in food defense practices and required to report anything suspicious to managem ent immediately . Be attentive and vigilant. We can't protect the food supply without everyone?s help. Date: . . Document Document No. 211 Management Commitment ReViewed mam:- 2'0 1/7/19 6515 S. Jackrabbit Trail - Buckeye, AZ 85326 (623)-872-1170 To: All Personnel (Employees, Inmates, Contract Laborers, Interns) Subject: Hickman?s Family Farms Safety 84 Health Policy It is the policy of Hickman?s Family Farms that all reasonable and practical efforts shall be made to provide a safe and healthy working environment for all of our workers; the minimize the possibility of injury; to protect our equipment and assets from accidental losses; to protect the public from injury or loss as a result of our operations; and to protect the environment during our operations. It is the policy of Hickman?s Family Farms to regard the requirement of the Occupational Safety Health Act of 1970 (OSHA) as well as other federal, state and local laws, codes and standards as minimum standards for our operations. The safety of our workers, our animals and our environment and the general public is paramount. When unusual circumstances arise and decisions must be made at any level, safety health will always take precedence over expediency. Hickman?s Family Farms expects all workers to work diligently to reduce injuries, property damage and other accidents. Management endorses the Company Safety Health Program and requires our supervisors to be familiar with safe work practices and to insist that those who work under them follow these practices at all times. As owners, we will continue to demand your sustained efforts to maintain safe working conditions and hazard awareness. All managers, supervisors and workers at all level must remember that safety is a line responsibility for performance in all areas. Remember: You have the right to be safe in your workplace. It?s never just part of your job to get an injury. Even a minor injury or ?near?miss? (aka ?Close call?) must be reported to a supervisor immediately. Practice good safety habits in all you do. Thank you, good luck and be safe! Sincerely, Glenn Hickman, President Billy Hickman, Vice-president . Document No. 170 ICKMA Document NS Occupational Safety Responsibilities ReVieWEd mums 4-0 1/2/19 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 info@hickmanseggs.com To ensure a properly functioning and safe workplace, Hickman's Family Farms employees, contract laborers, interns, vendors and visitors will adhere to the following responsibilities: 1. Adhere to all safety rules, signs, regulations and directions from management Understand and support management's interest in preventing accidents Follow instructions and comply with policies and procedures Report all accidents, injuries, illnesses and near-misses, no matter how minor, to a supervisor immediately Report any unsafe work conditions or equipment Wear appropriate clothing and Personal Protective Equipment (PPE) as required Do not operate any equipment until you have been properly trained. Do not operate Power Industrial Trucks (PITs) including forklifts 8. pallet-jacks until you have been certi?ed 9. Do not operate without carrying your valid certification card 10.Do no operate unsafe equipment. If a piece of equipment is damaged or unsafe. report it immediately ii.Maintain equipment as directed 12.Maintain a clean and orderly work station, free from debris and floor hazards 13.0n y use tools when you have been trained on how to use them safely. If you feel like you need additional training, tell your supervisor. 14. Communicate with your co-workers when you are going to be working near them. 15. Lift properly, using your legs and bending at the knees, not your back! 16. Don't distract other employees. Horseplaying is dangerous and grounds for dismissal 17.8ef a good example for your co-workers 18. Follow any additional instruction from management regarding safe work practices were have received a copy of the Company Safety Rules. Initial here: By signing below, I affirm that I have read and understand the Occupational Safety Responsibilities. I will refer any questions about safety to my supervisor. I will adhere to the Company Safety Rules. NAME DATE SIGNATURE WITNESS SIG DATE Page 1 of 1 Document Document No. 206 Chemical Safe Handling Procedures Versiom Reviewed 2-2-0 03/13/19 rams! mums 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 InfoQ: hicknlaiys?aggsmom At Hickman?s Family Farms, we use chemicals throughout our day for a number of different tasks. Here are some of the basic rules about chemical use in our facilities: All chemicals must be used in accordance with manufacturer?s instructions on the Safety Data Sheet (SDS) All chemicals must be stored in properly labeled, and easily identi?able containers Concentrated (undiluted) chemicals must be secured and locked away from untrained personnel. Only employees with proper training should handle concentrated (undiluted) chemicals 0 Employees must read the SDS and container label before using any chemical. Use all Personal Protective Equipment (PPE) specified on the SDS or chemical label, in addition to any instruction from your supervisor. This includes safety glasses, gloves, aprons, impervious gowns or any other form of PPE Smoking, eating, drinking, chewing, spitting are prohibited in chemical storage areas Chemical containers, including drums, jugs and any other containers, should not be used as stools, ladders, seats, etc. Do not switch scoops, pumps or containers from one chemical to another. Do not use chemicals in unmarked containers NEVER combine any acids with chlorinated cleaners like bleach. Mixing acid and bleach can create dangerous chlorine gas Know the location of ?rstwaid kits, chemical clean up procedures, eye-wash stations and emergency showers BEFORE using any chemicals. In case of chemical burns, rinse with large amounts of cool water. Immediately notify your supervisor. Follow any additional instruction from your supervisor regarding chemical safety I understand our Chemical Safe Handling Procedures. I understand the risks associated with the chemicals we use at Hickman?s Family Farms and I promise to do my part to ensure that chemicals are used safely and properly in my facility. I will immediately notify my supervisor if I observe anything that appears to be in violation of the Chemical Safe Handling Procedures. NAME SIGNATURE WITNESS SIG DATE DATE Document I Document No. 204 Lockout/Tagout for Affected Workers Versiom Reviewed 1-2 1/3/19 mm? i?ltRM? 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 imagehickmansegrgsamm To protect from energy related injuries, we have an Energy Control Plan. An important part of the plan is the Lockout/Tagout Process. 2 Types of Workers 1. ?Authorized? Mechanics, electricians, maintenance, managers, etc. 2. "Affected" Anyone who works around equipment that might be locked out Which are you? Write here: Only AUTHORIZED workers may perform Lockout/Tagout. Lockout/Tagout Process 1. Clear affected workers from the area Shut down the equipment Isolate the equipment from all power sources with a durable lock Release any stored energy (batteries, pressure lines, etc) Try to operate the equipment. It should not operate at this point. Apply a tag to inform others not to try and use the equipment Remember: - Tags DO NOT secure a machine without a lock. Equipment must be locked out AND tagged out. - Locks can only be removed by the worker that applied them. - .lf equipment is not working properly, immediately report it to your manager. It is everyone?s responsibility to work safely. If you have any questions about Lockout/Tagout, ask your supervisor. ewewrc Name: Date: Signature: Witness Signature: Document Document No. 207 Fire Extinguisher Certificate Versiom Reviewed 1.4.0 I?ll ?is? mum; 03.07.2019 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 g?g?y?ggnanseggscom Certificate of Training - Fire Extinguisher Use have reviewed and understand 'the Fire Extinguisher Policy. Not following this policy and procedure could result in disciplinary action, up to and including termination. Worker Signature: Employee No. (if applicable): - Date: Trainer/Supervisor Name:_ Trainer/Supervisor Signature: Notes: Original Form when signed will be provided to the Hickmon?s Family Farms HR Department for placement in worker?s training records. Certificado de Entrenamiento Uso de Extinguidor de lncendios Yo, he revisado entiendo la politica el procedimiento anterior. El no seguir esta politica procedimiento podria resultar en acci?n disciplinaria hasta incluyendo la terminaci?n. Fimra de Trabajador: Numero de Empleado: Fecha: Nombre de Entrenador: Firma de Entrenador: Notas: La forma original al firmar sera proporcianado al HR Dept de Hickman?s Family Farms para colocaci?n en el archivo de entrenamiento Document No. 205 Document Dress Code Version: Reviewed 2-0 1/3/19 1' LY 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 - info?nhickmariseggs.com To ensure a properly functioning and safe workplace, Hickman's Family Farms (HFF) employees, contract laborers, interns, vendors, and visitors will adhere to the following standards General Grooming: All workers at HFF will be well?groomed, clean and hygienic. Do not wear soiled or dirty clothes to work. Tattoos: Any tattoos from the neckline down to the ankle and to the wrist must be covered. If you have tattoos outside of these areas, you may be required to cover them with bandages or other temporary coverings at the discretion of management. Dress code: No dress code can possibly cover all contingencies, so use your best judgement. If you are unsure, please consult with your manager. Some general guidelines: Do: Dress professionally as your position requires. If you are in a position to represent the company to vendors, customers, partners or consumers, make sure you dress accordingly to put forth the appropriate professional image. We are a farm, so clean denim pants and clean work boots are usually a safe bet, unless you are meeting at a place that has different standards, in which case you should adhere to those standards. Wear clothes that are clean, unwrinkled and in good condition. Clothes with rips, tears, frays or holes are not acceptable, even if they were designed that way. Office personnel only: If you are wearing shorts or skirts, they must come down to within 3 inches of the knee and provide coverage and modesty while sitting. Skirts and dresses that are split below the knee are acceptable. If you are given a work uniform (T-shirts, jackets, etc), it is your responsibility to keep them clean. Please wear clean clothes to work every day. If your assigned work uniform needs to be replaced due to excessive wear and tear, please inform your supervisor. Do n_ot: Wear unclean, torn or ripped clothing. Wear any clothing that exposes the midriff, back, belly or cleavage. Shirts with buttons must be buttoned within one button of the collar. Page 1 of 2 HFF Dress Code Overview Please initial Here: Document DoCument No. 205 HICKMANS Dress Code Version: Reviewed 1/3/19 Hun?: 6515 S. Jackrabbit Trail Buckeye, AZ 85325 (623)-872-1170 irifofi?hickmanseggmm Do n_ot (continued): Wear sleeveless, backless, see-thru or excessively tight shirts or blouses. Apparel with straps must have straps at least 3 fingers wide and must completely cover any undergarments. Wear clothes that expose undergarments or skin. Clothes must be properly fitted so that they stay in place throughout the work day. Do not wear clothes that outline undergarments. Wear flip flops, thongs, slippers or heels exceeding 1.5 inches in height. Remember that many positions in our company require slip?resistant or safety-toe footwear. Check with your supervisor to know what footwear is acceptable in your position. Processing Plant, Barns, Coolers, Warehouse, Fertilizer, Feed Mill, Dry Storage: 0 Arrive to work in your department uniform. No shorts, debris or- skirts allowed! . Ask your supervisor or- a member of QA team if you?re not sure what you can and ca 11% wear to work. a Do not wearjewelry, including watches, rings, earrings, chains, necklaces, face/body piercings, other than a plain metal wedding band (no stones) in the work area. Medical info bands are allowed. a Cuts, sores, abrasions and lesions need to be covered by a bandage and gloves if on the hand a No cosmetics, make-up or other personal items allowed in the work area a No false nails. If you have nail polish, you must wear gloves to No scented lotions unless USDA approved Wear hairnets that cover all of your hair and beardnets if you have any facial hair Handle eggs and other products in an appropriate manner 0, All employees must wash hands upon entering the processing area Remember that these rules for dress code apply even in positions where you will dress out when arrive at work. This means you can?t disregard a dress code rule just because you are going to change into scrubs or another uniform when you arrive. You should always report to work in proper dress code, regardless of your position. By signing below, I affirm that I understand the dress code expectations and I have been given the opportunity to ask questions. I will adhere to these expectations and any other direction from my supervisor while working at HFF. NAME . EM DATE SIGNATURE WITNESS SIG DATE Document Document No. 162 Non-Disclosure of Trade Secrets 8: Speed Versiom Reviewed 2.1 mans Limit/Dust Free Zone 6515 S. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 1:319 Non-Disclosure of Trade Secrets Hickman?s Employees and Contract Laborers shall acknowledge that all information concerning Hickman?s Family Farms business, including, but not limited to, information regarding its operations and procedures, production, processing, compliance, business plans, customers and customer lists, software, listings, holdings, alliances, investments, transactions, financial records and other confidential matters, constitute valuable, special and/or unique assets and are regarded as proprietary trade secrets. Accordingly, at no time shall any employee or contract laborer, during or after the term of their employment or contract, disclose any such proprietary information or any part thereof to any person, firm, corporation, association or any other entity for any reason or purpose. Hickman?s employees or contract laborers further acknowledge that any and all recording devices, including but not limited to cameras, video cameras, cell phone cameras and audio recording devices, are expressly prohibited within the confines of Hickman?s property without the expressed written permission from Hickman?s ownership. Any employee/laborer who uses such a device or having any images, videos, or audio recordings will be subject to immediate termination. In addition, Hickman's also reserves the right to take legal action against any individual, firm or organization who violates this agreement. If any such legal action is brought for breach of this agreement, Hickman?s will seek an award of actual damages, consequential damages, attorney fees and any other incurred cost. Nothing about this agreement alters or modifies the employment?at-will relationship. I attest that have no affiliation with any animal rights activist group and lam not a reporter or freelance contributor to any news or media organization. I have read and understand the Non-Disclosure of Trade Secrets. Initials: Speed Limit and Dust-Free Zone Speed Limits on all facility access roads are 10 MPH, including paved roads. All dirt/aggregate roads are 10 MPG unless dust is being created, then lower speed to adjust for dust control. Speed Limits in employee parking lots are 5 MPH. Spinning of tires is prohibited. Aggressive driving is a violation of safety and Best Practice guidelines. Security cameras are in place at all Hickman?s locations and parking lots. All activity will be monitored, including driving habits. Violators of the speed limit or unsafe/aggressive drivers will be subject to discipline up to and including termination. Enforcement of the activity, Speed limits and safe driving habits are necessary for the safety and security of our staff and our chickens, and the overall welfare of our company. Do your part by complying with these policies. I have read and understand the Speed Limit and Dust-Free Zone. Initials: Name: EM Date: Signature: WITNESS SIG DATE I CKMA '1 Document Document No. 018 Hi Nb SOP for Personal Safety Practices Company versm? FAMILY FARMS 3-0-1 02.20.2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-372-1170 I. Scope Hickman?s Family Farms has designed a formal safety program and has implemented this program with the intent of protecting their employees from job related illness or injury. This safety program can only be effective when all employees adhere to the company?s safety policies and procedures. ll. Policy Justification This policy is to ensure employees know the rules of the plant and to ensure safety. Ill. Responsibility it is the responsibility of the Plant Manager, QA Technician, and SQF Practitioner to ensure that the following SOP is followed and enforced for all employees, contract service providers, visitors and anyone entering the food processing facility. IV. Company Safety Rules General Workplace Safety Rules 0 Report all unsafe conditions and actions to your immediate supervisor. - report security, safety, accidents or near-miss incidents to your immediate supervisor. - Do not bypass or disable a safety device or system. - Operate machines or other equipment only when all guards and safety devices are in place and in proper operating condition. a The use of personal radios; cell phones, i-pods or other devices which have the potential to reduce hearing are ALLOWED. (Management, Supervisors ,Maintenance and QA are the only exception on this rule as far as phones are concerned) a Only authorized and trained employees will operate company machinery and vehicles. 0 Employees are NOT ALLOWED to send and/or receive text massages, connect and surf the internet, or receive e-mails while operating any company vehicles. 0 Always wear your seatbelt while operating any company vehicles or equipment. 0 Keep all equipment in safe working condition. Never use defective tools or equipment. Report any defective tools or equipment, and all equipment maintenance issues to your supervisor. 0 Perform regular equipment and area inspections as required by supervisor. 0 Maintain good housekeeping in your area at all times. 0 Do not leave unnecessary litter or material in aisles, walkways, Stairways, work areas, or other points of egress; it must be kept clear. 0 Use the appropriate tool for a job, as trained by your supervisor, JSA or manufacturers? instructions. 0 Properly care for and be responsible for all personal protective equipment (PPE). Wear or use any such PPE when required. (Read your manuals) 0 Use and face protection when there is danger from flying objects or particles, (such as when grinding, chipping, burning and welding, etc.) or from hazardous chemical splashes (use double protection, safety glasses/goggles with a face shield, when operating a chop saw). - Lockout, tag out or disconnect power on any equipment or machines before any maintenance, tin-jamming, and adjustments are made. 0 Follow the safety policies and procedures as outlined in individual Best Practice Programs. 0 No use of illegal drugs or alcohol by the terms of the company?s Drug and Alcohol policy. 0 Employees taking physician-prescribed medication that might impair their ability to operate certain equipment or perform various job tasks safely must report this to their immediate supervisor prior to the start of work. a No firearms shall be present on the property, including the parking lot or on the jobsite. 0 Dress appropriately. Wear appropriate work clothes, gloves, shoes or boots, and hair/beard nets. Loose clothing and jewelry shall not be worn (unless it is a wedding band. if it has stones, gloves must be worn). . No jeweled clothing to be worn at any time in processing plants. (if worn, a bio-suit or scrubs have to be worn) 0 Work rules and exposure to equipment do not permit employees to work without long pants and shirts at any time or occasion. (No Short Pants ALLOWED) No shorts, capri?s, no legging or workout pants, and no jeans with rips or holes in them. 0 Refrain from horseplay that could endanger you or your co-workers. 0 Never engage in hostile actions against other employees. 0 Report all hostile actions of co-workers to your supervisor. Page 1 of 6 Document No. 018 Document NS SOP for Personal Safety Practices Company ?we?ve? FAMILY FARMS 3-0-1 02.20.2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85325 info@hickmanseggs.com Personal Protective and Related Equipment - Personal protective equipment must be worn as required for each job in all operations where there is an exposure to hazardous conditions. This exposure is determined by a personal protective equipment hazard assessment of the workplace by the supervisor and the safety health coordinator. Equipment selection and wearing requirements are determined from this assessment. Safety glasses, goggles, or face shields will be worn in those areas where there is a reasonable probability of injury to the from dust, flying particles, molten metal, chemical, acids, caustics, or light radiation, or other hazards. Safety glasses must be worn all the times at the following locations: 3) Lay Pullet House areas b) Feed Mill c) Feed Drivers must wear safety glasses while delivering feed. d) Fertilizer Mill e) Special Projects crews f) Electricians/AC Maintenance g) Processing Maintenance h) Night Sanitation at all facilities i) Machine shop j) Truck shop or on service calls k) Liquid Hard Boil plant *Wear a face shield over your safety glasses/goggles while operating a chop saw or handling chemicals. Head protection {hard hats or bump caps) must be worn for protection from falling objects or work near energized electrical contact and must be used at the following locations: 3) All processing plant personnel must wear bump caps while working with metal racks. b) Electricians Special projects Crews must wear hard hats while in construction and repair zones. c) Truck Drivers must wear hard hats at the feed mill while hauling feed or bump caps when loading or unloading metal racks. d) Feed Mill personnel must wear hard hats at all times. Fertilizer Personnel must wear hard hats at all times. Foot protection will be worn where there is danger to the foot from falling/rolling objects, objects piercing the sole or electrical hazards. Slip-resistance and/or steel/composite toe shoes or boots are required to be worn at all the times at the following locations: 1) Lay Pullet Houses areas steel/composite toe shoes 2) Feed Mill steel/composite toe shoes 3) Fertilizer Mill steel/composite toe shoes 4) Special Projects crews steel/composite toe shoes 5) Shell Egg Plants: a) Processing slip-resistance shoes b) Dry Storage and Cooler Personnel - slip-resistance shoes with steel/composite toe c) Forklifts Pallet Jacks Operators slip-resistance shoes with steel/composite toe 6) Processing Maintenance slip-resistance shoes with steel/ composite toe 7) MOBA Night Cleaning crew slip-resistance boots with steel/composite toe 8) Machine shop slip-resistance shoes with steel/composite toe 9) Truck shop or on service calls steel/composite toe shoes 10) Truck Drivers slip-resistance shoes with steel/composite toe 11) Liquid Hard Boil plant slip-resistance, waterproof with steel/composite toe shoes 12) Dry Storage Warehouse slip~resistance shoes with steel/composite toe Hand protection is required when hands are exposed to severe cuts or abrasions, chemical or thermal burns, and/or chemical absorption. Appropriate gloves, aprons, splash goggles, face shields, and proper shoes will be used when necessary for protection against acids and other chemicals which could injure employees. Respiratory equipment in many cases is needed for protection against toxic and hazardous fumes/dusts. Only approved equipment will be used. Page 3 of 6 Document No. 018 EEKMA Document NS SOP for Personal Safety Practices Company versm'? ?View? FAMILY FARMS 3-0-1 02.20.2019 Safety Rules 6515 s. Jackrabbit Trail Buckeye, AZ 85326 - (623)872-1170 info@hickmanseggs.com Portable ladders will extend at least three feet above the upper level to which the ladder is used to gain access. The top of a stepladder will not be used as step. Only one person will be on a ladder at a time. Flammable and Combustible Liquids Only approved safety cans, original containers, or portable tanks will be used to store flammable or combustible liquids. Above ground storage tanks will be separated from each other by a minimum of three feet or 1/6 the sum of their diameters, and to prevent accidental discharge from reaching adjoining property or waterways; spill containments will be provided. No more than 25 gallons of Class IA and 120 gallons of liquid Class IB, IC, II, or liquids may be stored outside a storage cabinet or an inside storage room. An emergency shut off switch is located 15 75 feet from the pumps and a fire extinguisher will be provided at company fuel servicing areas. Welding and Brazing Combustible material will be cleared for a radius of 35 feet from the area around cutting or welding operations. lfthe combustible material cannot be cleared or the work cannot be moved, then the welding/cutting will not be done. Welding helmets and goggles will be worn for protection and prevent flash burns. protection will be worn to guard against slag while chipping, grinding and dressing of welds. - Welding gloves will be worn for hand protection while welding. Welding screens will be used and in proper position to protect nearby workers from welding rays. Cables, leads, hoses, and connections will be placed so that there is no fire or tripping hazards. Cables will not be wrapped around the welder?s body. Oxygen cylinders will be stored at least 20 feet from fuel gas cylinders, or separated by a noncombustible fire wall with a one?half hour rating at least five high. Valve protection caps will be in place on cylinders not in use. Ventilation is a prerequisite for welding in any confined space Tools Hand tools with broken or cracked handles, mushroomed heads, or other defects will not be used. Files will have handles installed. Take special precautions when using pDWer tools. Defective tools will be removed from service. Power tools will be turned off and motion stopped before setting tool down. Tools will be disconnected from power source before changing drills, blades, bits, or attempting repair or adjustment. Never leave a running tool unattended. Power saws, table saws, and radial arm saws will have operational blade guards installed and used. Anti-kickback teeth and spreaders will be used when rip sawing. Portable abrasive side-winder grinders will have guards installed covering the upper and back portions ofthe abrasive wheel. Wheel speed ratings will never be less than the grinder RPM speed. Pedestal grinders must be permanently mounted, tool rests installed and adjusted to within 1/8 inch of the wheel, tongue guards installed and adjusted to within inch of the wheel, and side spindle/nut guards installed. Air compressor receivers will be drained frequently to prevent buildup of water in the tank. Compressed air will not be used for cleaning purpose except when pressure is reduced to less than 30 psi by regulating or use of a safety nozzle, and then only with effective chip guarding and proper personal protective equipment. Any employee-furnished tools of any nature must meet all Safety and ANSI requirements. Safety Railing and Other Fall Protection All open sided floors and platforms four feet or more above adjacent floor/ground level will be guarded by a standard railing (top and mid rail, toe board). All Stairways of four or more risers will be guarded by a handrail, or stair rails on the open side. Handrails or stair rails will be provided on both sides of the stairs are more than 44 inches wide. When a hole or floor opening is created during a work activity, a cover or a barricade must be installed immediately. Safety harnesses, belts, lanyards, lines, and lifelines may be used in lieu of other fall protection systems to provide the required fall protection. Page 5 of 6 Document Received at Orientation Checklist Document No. 210 Version: Reviewed 1.1 1/7/19 6515 s. Jackrabbit Trail Buckeye, AZ 85326 (623)-872-1170 garage): Received at Orientation Recibido en Orieniaci?n Name/Nombre: Emp# Hickman?s T-shirt/Camiseta Qty: Water Bottle/Botella de agua Name Badge/lngisnia de Identificaci?n Other/Otro: I Other/Otro: Signature/Firma: Date/Fecha: Witness/Testigo: Date/Fecha: Square Footage Here is a list of the square footage that was requested for our North and South facilities. North Processing: 55,450 North Barns 1?12: 34,880 each barn North Barns 13?14: 45,780 /each barn South Processing: 46,400 South Barns 1-7: 38,700 /each barn South Barns 8-10: 29,975/ each barn South Barns 11-12: 34,880/ each barn Man l?l'TOTAL Mon Tue 23-89;) 24-89.) OFF 7:30a It 7:30aor 7:00a 7:00a off mid off off 7:30a Wed Thur Fri 25-Sep 26-50;) 27-89;) OFF 6:30a - off off off 7:30aor 7:30aor off 7:00a 7:00a ow off 7:00a 7:00a 7:00a ac mid mid mid off off off 7:30a off 7:00a off 7:00a off off 7:00a 7:00a 7:30a 7:30a off 7:30a off 7:30a 7:308 off off Sat Sun 28-8ep 29-89;: OFF 7:30a 7:30a off 7:30aor off 7:30a It off 7:00a off off off off off 7:00a 7:00a off off off 7:00aqa 7:00a 7:30a off 7:30a off off 7:30a 7:30a off SC off off 7:30a 7:30a off 7:00a 12 10 22 22 6515 8. ?It? Buck Am" Pom (623) 872%! 1 Phone mm; (623) -63 92-th EQRM MLooatlomj/I I Dato:w g?rz 2 (7 Employee/I Dopumnont: NATURE OF . Violation of W01 Rules Violation of Company policy 0 Violation of Satbty Rules CJ Excessive Abaentoeiam Excessive Tat'dtnoss 1 Desorptionojg?a I ore 8532 Excessive early dopm turo C) Othor attendance Issue: C1 C1 1 Substandard Wozk Other (continue on book 11" account}; a Verbal a 1" Wm?: 21?? Written )4 Final Warming Warning Warning Supervisor Ctmu'ne ta: . lit/J a I Employan Comments; I understand that further disc! lino Employee/Inmate Signature: ?uporvlaor Signatum Witness li?ngnaturo Witness Printed Name; 5/ 7.7/50 Datotw man Resoumo Signature: "My? 65B Buckeye M85326 Mini Payroll (621i) 872~2311Pilonc whammym (623) 474-63924?? FORM Department: NATURE OF ON . Violation 01? W01 ir Rules Violation of Company policy Violation of Safety Rules C31 Excessive Absenteeism Ci Excessive 'iardinoss Description of in?ection: ?5 011111111111 1101111) 1121? /71?7? 1.1 171 112.111) 11/} 0491.21? . Excessive oar iy depmture Other attendance issues insubordinetion Substandard Work Other [301300 :(continuo on back if necessary) Verbal 1" Written 2??1 Written X/Flnel Warning Warning Warning Written2 Sup i visor ?eniments: 1' - 1/ 1.0 194' I /r 45731.4( Date: 1? 2/ ,5 [a "/15 Supervisor Signatu e: Employee wwm.w__ I understand that further dis alien Date: 3 cg if?? Witness i f? Signature Employee/Inmate Signatur ?upervlsor Signature: Witness Printed Name: Human Resource Signature: . . . . .. Signature: ., 'Date: Personal Protective Equipment (PPE) Policy or an: a ton rew Hickman?s family farms believes it is our obligation to provide a hazard free environment to our employees. Any employee encountering hazardous conditions must be protected against the potential hazards. The purpose of protective clothing and equipment (PPE) is to shield or isolate individuals from chemical, physical, biological, or other hazards that may be present in the workplace. It is the policy of this company that as a condition of employment, all regular full time, part time, and temporary employees working in designated work areas and/or job assignments are required to wear Personal Protective Equipment to help prevent injuries. PM Sanitation Crew must wear the following PPE: - Employees are required to wear *Slip-Resistant Waterproof Boots with Steel/Composite toe, and no open toe, open heel or shoes that are worn out. 0 Employees must wear Safety Glasses at all times. Employees have the option to wear Hearing Protection while using an air hose. 0 Employees must wear Safety Goggles or a Face Shield over their regular Safety Glasses while handling cleaning chemicals. . Employees must wear *Rubber Gloves while handling cleaning chemicals. 0 Employees must wear Chemical Apron with Sleeves while handling cleaning chemicals. 0 Head and facial hair must be restrained and wear a Hair Net/Beard Cover at all times 0 Employees may not wear any type ofjewelry 0 Employees must wear clean sanitized clothing at all times. 0 Employees' *clothing can never be tattered, tore or baggie (No Short Pants Allowed). *Notice: If any employee?s clothing, gloves, or shoes gets wet or drench with water or any chemical during their shift; the employee immediately must change either into dry clothing, gloves or shoes, and notify the superwsor. Cleaning and Maintenance It is important that all PPE be kept clean and properly maintained by the employee to whom it is assigned. PPE is to be inspected, cleaned, and maintained by employees at regular intervals as part of their normal Job duties so that the PPE provides the requisite protection. nce with cleaning responsibilities by employees. read and understand the above PPE policy. For my own ery day and report to the Department Manager/Supervisor or the Safety Health Coordinator whenever PPE is not available to me. I further understand that it is my responsibility to protect and care for the PPE given to me. Not following this program or intentional destruction of my PPE could result in an oral written warning, writt rmination and/or monetary reimbursem nt for equipment. Datezq Employee Signatur Dept. ti: Safety Manager: Signature: Date: Li:\lmnatc [ruining- Safety New hirc\dcpt speci?c pm sanitailon crew hearing optiondoc Created on 9/13/2016 10:14:00 AM. Revised on 3/5/2015 Employee Safety Responsibilities Each employee has the responsibility to themselves and his/her fellow workers to work in a safe manner. The e00peration of every employee will allow the Safety Health Program to achieve a high level of effectiveness. Employee safety responsibilities are. but not limited to, the following: 1. Adhere to all safety signs, rules and regulations. 2. Understand and support management?s interest in the prevention of accidents. Follow instructions and comply with policies and procedures. Ask your supervisor to clarify or explain any instructions, policy or procedure you do not understand. Report all injuries and ?near misses?, no matter how minor to'a supervisor immediately. Bring to the attention of management any unsafe acts, work practices. and conditions that could lead to an accident. 6. Wear appropriate clothing and us?epcrsonal protective equipment as required. 7. Do not operate any machine until you have been properly trained to do so. 8. Operate only equipment for which you have been trained and are authorized to use. 9. Do not operate unsafe equipment. 10. Maintain equipment in good condition. with all safety guards .in place when in operation. 11. Report all equipment damage to your supervisor immediately . 12. Use tools and equipment safely. in accordance with your training, and for the intended purpose. 13. Communicate With other workers prior to beginning any work that will be performed in close 16. 17. 18. proximity to their work area. . Maintain good housekeeping. Keep work areas clean and orderly. . Lift preperly. using your legs rather than your back. Always get help with heavy, hulky or awkward loads. Don?t distract other employees. Do not engage in ?horse play? or other inappropriate behavior or activities. Motivate your eo-workers to work safely! Set a good example for others to follow. The most important part of this program is the individual employee You! Without your weperation. the most stringent program can be ineffective. Protect yourself and your fellow worker by following the rules. REMEMBER: ?Work safely so you can go home to your family and friends they need you.? Don?t take chances - SAFETY FIRST . have read and understand the above Safety Responsi ilities. Violation 0 these Safety Responsibilities will result in disciplinary action, in accordance with the company disciplinary policy, and can result in penalties up to immediate termination of amp I 4?92"" Witness Name: Date: Witness Signature: fruiz Putt: - 6050.015 amt/V farms 1? Chemical Safe Handling Procedures At Hickman's Family Farms, we use chemicals throughout our day for a number of different tasks. Here are some of the basic rules about chemical use in our facilities: a All chemicals must be used in accordance with manufacturer?s instructions on the Safety Data Sheet (SDS) 0 All chemicals must be stored in properly labeled; and easily identi?able containers 0 Concentrated (undiluted) chemicals must be secured and locked away from untrained persoxmel. 0 Only employees with proper training should handle concentrated (undiluted) chemicals Employees must read the SDS and container label before-using any chemical - Use all Personal Protective Equipment (PPE) speci?ed on the SDS or chemical label, in addition to any instruction from your supervisor. This includes safety glasses, gloves, aprons, impervious g0wn's Or any other form of PPE 0 Smoking, eating, drinking, chewing, spitting are prohibited in chemical storage areas 0 Chemical containers, including drums, jugs and any other containers,.should not be used as stools, ladders, seats, etc. 0 Do not switch scoops, pumps or containers from one chemical to another". 0 Do not use chemicals in unmarked containers 0 NEVER combine any acids with chlorinated cleaners like bleach. Mixing acid and bleach can create dangerous chlorine gas Know the location of ?rst-aid kits, chemical clean up procedures, eye-wash stations and emergency showers BEFORE using any chemicals. 0 In case of chemical burns, rise with large amounts of cool water. Immediately notify your supervisor. ?0 ollcw any additional instruction'from ycur supervisor regarding chemical safety understand Sal. Handing Procedur s. I understand the risks associated. with the chemicals we use at Hickman?s Family Farms and I promise to do my part to ensure that chemicals are used safely and properly in my facility. I-will immediately notify my supervisor if I observe anything that appears to be in violation of the Chemical Safe Handlin xProcedures. Date: Signature: Witness name: Witness Signature: SDS Safety Data Sheets l?l?E - Personal Protective Equipment 1? VV A famw ?95 Employee's Weekly Safety Meeting Tepics Attendance Roster Course Title: 90" \rq CourseJ Hours: Instructor Name (P/e Dalt:7 Location: - Employee?s 5 Signature: Filcs\ConchIt Omluol I) Suful) meeting Topics l?ruiz Koslcr. doc ()Il (ill ?20] -12: 05; 00 PM Revised on 5/20/2014 Page 1 1/25/2018 741? 'mm'ly Employee?s Weekly Safety Meeting Topics Attendance Roster FCourse Title: Course Hours: Instructor Name (R?ase 1ngfm714wi>_ Employee?s Number Dept. No. Signatyre .ucch-iicmsu I?l?twil .doc (cviscd on 5/20/20 Instructor?s Signature: 4 3 1 ?(Wk ?1 JEix?amI/y fal? Empioyee's Weekly Safety Meeting Topics Attendance Roster Course Title: Course Hours: Instructor Name (Please print Dat?: Employee?s De t. No. \Um lulu Wuckly Safuly mwhm, Topics Attendance Roster.doc Created on ?2014 2:05:00 PM, Revised on 5/20/2014 fruiz Page ?25/2018 .%4W1uuva1 ufam/ly fa! Ins Employee's Weekly Safety Meetlng Topics Attendance Roster Course Hours: Instructor Course Title ?u 96-). '6/(11 m? Date: 12#?4? c' ocntlon (Pout Employee?s Instructor? 5 Signature Internet chl:1ySufcty meeting Tapics Attendance Rostcr?oc Created on 6/ 1 1/2014 on 5/20/2014 1'rui7. l?ugc ature 1/25/2018 am/ly farms?) Employee?s Weekly Safety Meeting Topics Attendance Roster, Course Title Course Hours: {pp/W 5L ?uqm 9062401 Instructor 0 ate: - - Location: ?ax (5 . Employee?s Name Number Dept. No. Si-n Weekly Safety meeting Topics Kostcr?oc Creutcd on 6/11/2014 2:05:00 PM, Revised on 5/20/2014 Instructor? 5 Signature: mm. Page 1 1/25/2018 gigamdy 1ar?ms' {g Employee Name: ee?s Trainin Lo Em lo Employee Numbe Department: am. No. Cou Title Employee Nam Employee No. Job Position: Manager/Supervisor: uideline for con ucting employee Departments, s: ow to Hickman?s Family Farms. Once comp! orientation has taken place. This checklist is a 5 Health orientation for employee Employee, it serves as documentat on the Welcome the New Employ a, Introduce the new em to their manag b. Show the new employ 0 around: i. Explain Where the estrooms and ii. Explain the variou areas Within the facility an Assign a locker to :te New Employee c. introduce the new em loyee to their co-workers Introduce the New Emplo cc to Job a. Explain the employee esponsibilit b. Explain to the new em the attendance procedures: i. Who to contact if ardy or absent; emergency contact info ii. Work hours/work our changes; How to request time off . c. introduce the new ployee to the department trainer d. Explain the use of co party telephone/cell phone (if applicabi e. EXplaln the use of co pany E?rnaii (if applicable) ales and Procedures personal cell phone policy cy and ACI ?Working with Inmates" Policy overview: aths, Hand washingStations and Hand es every day and hair nets booties and hair nets for Visit (Barn Personnel Only] dom Flock Agree5 i 1. er/supervisor their lnterr? . 2, Review the Company Pol a. Company Empioyees? b. Company Inmate poi c. Company Bio-Securit l. Disinfectant foot; ii. Use Clean ciotitin and sho Disposable cover ils, shoes d. UEP (United Egg Pro ucers) Guidelines i. Employee Code fConduct and the Free e. Food Safety and F00 Quality policy GMP's HACCP eolth procedures 4. Review of the Company ofety proced ures, metho a. General overview 0 operation, relate to the specifi Job b. Line of communicat on and reSponsibility l. When, How, and who to report an injury or a "near- ii. Location of the ?rst aid kit(s) at the facility Iii. Names of the First Aid, CPR 8L AED trained personnel ds and he for immediately re mis 1 ant Orientation Checklist to Location: . ated reak room areas are loci zlations TJ i lmatior OTS ment portln BiovSecurity', UEP ?etcd an ies and the supervisor oxpecitations guidelines sanitize ogram zards a incid? il EmpiOyees Pate: prtment No.: Lia i eiines, Food Safety, and Safety gned by Manager/Supervisor and INITIALS Employee Trainer Date they will. accidents and first ant 3-: 1311 c, s. d. Location ofthe fire extinguishers e. Hazardous materials and location of the 505 sheets binder (if applica ble?) f. Use and care of Person 1! ProtectiVe Equipment (Safety glasses, ,lovcs, etc) g. Vehicle safety (if appiic able) i L544. h. Personal work habits: 2 l. Serious consequences of horseplay i Li- ii. Fighting lnattentlon i iLi?JS-E?il iv. Smoking Policy Chewing/ Eating 1.15.1] V. Good houseke ping practices i vi. Proper lifting cimiques i H.134 i. Only selected employees will be trained and certi?ed before operating a . Forklift, Heavy Equipment and/or Farm Equipment (if applicabiri). i i 5. Training i a. On-the-Job-training i i 2.11:. b. Company training; Food safety, Bio?security, safety 8i health, otiher i Mi: 6. Introduce the New Employee to Products 8: Services, Customers, Cilents,a aJd Vendors 0pr 3. Explain your unique business approach to providing products service i b. Explain the products and services provide. 8i . i c. Explain company customers, clients and vendors i i Lim? Non: TO EMPLOYEES: Do not si satisfactorily answered. The signatures below document: parties. and that both the mana be sent to HR and the Safety 8t Evacuation Plans; Exit iicatlons, Routes Where to meet up if evacua that the appropriate elements have hieen dis gar/supervisor and the employee acc pt resp deaith Department. The original will b: keptil the department manager offi c, Employee?s Signature: Manager/Supervisor Signatur Dae gn document unless ALL applicable iterris are cred and all questions are ssed to the satisfaction of both A copy of this checklist will the employee's training records at ii iY? I7 Date: 1/ S. 7 . nu [Sel?sh will amily arm is Note: Chemicals used' 111 the rooessz'ngplants must be used in ace manufacturer recommendations 11131?" In the eonoentzations recom doownehzarlon can be found 11 the SDS log or on the container .9 Employees are given an over few ofthese procedures during their; Employees also must attend 1 ?asher training which will cover In accordance with the Hi kman?s Family farms Safety Heal: handling procedures appli able to our sanitation program that 1. Be aware of potential hemlcal hazards. Deve10p ahcalthy 8. 9. 10. Do not switch drum p1 ll. 12. 13. 14. sanitizers. cleaning chemical lab Read and understand ?1 the chemical container Follow chemical use 11 of a compound, do not Protect your eyes wit chemicals. Wear chemical resist (optional) and face sh Smoking and eating a: Chemical containers 8] Wipe up chemical epil? Do not use materials containers. Use chemicals only for Never mix an acid olee compounds will produ- may cause a heat and/o explosive reaction in addition to rel Slowly add the ohemic 113: labels. 1 use it until you ?nd out. ?elds before working with cleaning not permitted' 1n chemical storage lOuld not be used as stools, ladders, '1 0111 unmarked containers, and don?t their intended use. 1 I 1 dangerous chlorine gas. Addition emical Safe~Hand ing liroce ordanc 1113111171213)! 1 belpti vided by the manufacturer. 111 initial ire homing and orientation. 2. Precautionary stoteme ts are printed on all chemical cleaner coated istructions carefully. If you don? know or l1 safety glasses or goggles when bah ndlia ant rubber gloves, aprons, rain gear, rub or USO shelves, nor with a chlorinated cleaner. Mixing acic casing 11 cleaner to cold water. Never add {sister to. -. . with Safety Data Sheets (SD89 ythe manufacturer. This Program the following chemical safe- st be somplied with by our employees. reaped chem "eels. Imps or scoops ?'om one chemical co ntaine? to another one. for all chemical cleaners and nor labels. Read carefully all he Safety data Sheets (SDSs) on all ohemicsl 5 used and follow instructions on derstand the proper and safe use concentrated as well as diluted or (PVC) boots, and hard hats leave chemicals in marked and/or Open and chlorine or chlorine-hearing 1f acid to sodium hypochlorite (bleach) ff large amounts of chlorine gas. concentrated chemical cleaner. i i 15. Do uotmix acidic and alkaline chemicals or other chemical unless speci?cally instructed in writing by the chemical comp Fuy. 16. Never add concentrate caustic or alkaline chemicals to hot water The addition of concentrated caustic chemicals to 1 water will cause the mixture to ?ash or be in an extremely violent manner resulting in high poten ial for serious injury or death. 17. The First Aid instructions are found on the chemical container labels, and on the Safety Data Sheets (SDSs) and the Product Technical Bulletins. Read them and be aware of the location of the ?rst aid kits. 18. In case of chemical bu ms, rinse skin with large amounts of Cool water. Follow ?rst-aid instructions, notify supervisor and seek medical aid, if required. 19. For chemical splashes in the eye: Flush the thoroughly aian e) wash station with large amounts of cool, ?owing water. Seek medical attention. Notify supcj isor. i 20. Keep chemical stored in cool, dry area, out of direct exposu: to 81+ or heat. I ices even open tanks may be I 21. Be especially careful when working with chemicals in con?I hazardous. 22. Use caution when working with high-pressure water hose. ver 11 I int a high-pressure water hose at another person. i 23. Know where and how to use the eyewash and shower station. Checlc to insure they are operational You work th hazardous chemicals. i ccident. Work defensively, work safe! ll 1! ?t take chances-SAFETY I ST i I have read and under above safety procedures. 24. Chemical safety is no Do Violation of ti: procedures ill result in disciplinary action and can re It in penalties up (0 Immediate termination of ample meat. 1 Employee Signature: Employee Numbe Instructor?s Name: Instructor?s Signature: 3 3 Each employee has the resp The cooperation of every er effectiveness. Employee sa ety responsibilities are, 1. Adhere to all safety igns, rules and regulations. 2. Understand and sup on management?s interest in the pr 3. Follow instructions nd comply with poiicie explain any instructi as, policy or procedure you do not Report all injuries nd ?near misses? Bring to the attentio of management any unsafe acts, lead to an accident. Wear appropriate lothing and use pars Do not operate any aehine until you have 8. Operate only equip: cut for which you have 9. Do not operate unsa equipment. 10. Maintain equipment in good condition, 11. Report all equipmerr damage to your supervi 12. Use appropriate too and equipment safely, intended purpose. 13. Communicate with ther wor proximity to their rk area. 14. Maintain good hous keeping. Keep work are 15. Li? properly. using our legs rather than your awkward loads. 16. Don't distract other mployees. Do not engage in or activities. 17. Motivate your co-w rkers to work safely! 18. Set a good example or others to follow. loyee will allow the Safety Hon 4. 5. 6. 7. been proper] sor irmnedi back. Al The most important part of his program is the individual emplo the most stringent program an rules. REMEMBER: ?Wor safely so you can go home to your} Don? take chances - Responsibili 'es. Violation these Safety espon accordance with the comp uy disciplinary policy, and can res, termination of emplo men Employee Signature Witness Name: Witness Signatur fl'ulz Page I Employee Safety Respons onsibility to themselves and his/her ft 1% Prog but not limit to, ti e? ention and proced res. A iindersn ,no matter how wq pra onal protecth. been trained. with all safety gu, ds in kers prior to begimiing any; ?horseg play? be ineffective. Protect yourself Surety . ibilii llow lnor i (D rkers to work in a safe manner. at to achieve a high level of d. a supervisor immediately. a following: . of accidents. it your supervisor to clarify or equi traine at tely . orkt lee 0 family ices, and conditions that could i cut as required. ;to do so. authorized to use. lace when in operation. in accordance with our training, and for the 1 in will be performed in close as clean an order. . ays ge- elp with heavy, bulky or other inappropriate behavior i in! Without your cooperation, fellow worker by following the nd friends - they need you." FIRST 'the'above Safety disciplinary action, in bottles up to immediate 63/7 605/2015 ALL visitors must: Report to Front Gate ssociate to be announced to tronllofiic?. Employees must: Bio-Se urlty Policy for All Visitors, Vendors Report to front ofticet sign the visitor log and read visito poliq Leave cell phone In or with front otiice associate. i No cameras or cell ph nes allowed inside the facility or o;n the inform management? I they have visited any lay facilityl . the Managers can make ecision if entrance granted for ind viduo within the 2 weeks, on up to 72 hours. Owners must app: ove facility within the 72 urs. inform the plant man ger if they have come in contact otherwise' In the past Managers can make ecision if entrance granted for ind vidua within the 2 weeks, on up to 72 hours. Owners must approve facility within the 72 urs. Not enter the premise unless cleared by management a d/or Change into bio clothi or cover their outer garments an and a bonnet prior to nten?ng a lay house Follow Bio-Security poli for entering the Processing Plan. PrOperly use footbaths prior to entering either the main fq Leave cell phone in or in locked office, lock phone in as front office associate. (The only exception is an employef with has been issued comp ny phones.) No personal cameras personal cell phones allowed in house Phones must locked in a locker or in the car. Inform management if they have visited any other lay fa illty in Managers can make eclslon if entrance granted for ind- idua {t ?amnfi?iti? nd Employees y. farm. ast two weeks. Is that have been to another facility nyone that has been to another ith any chickens. domestic/wild birds or is that have been to another facility nyone that has been to another escorted by management. approved bio suit including booties and/or lay houses. signed locker or leave phone with management/supervisory roles and 1he processing plants or lay house or lay the past two weeks. 5 that have been to another facility within the 2 weeks, on up to 72 hours. Owners must appitove anyone that has been to another facility within the 72 ha rs. Inform the plant mana er it they have come in contact otherwise in the pastt 0 weeks. Managers can make ecision if entrance granted for lndiivldua facility within the 72 ho rs. Change into bio ciothi as provided by Hickman. ?ith ary chickens. domestic/wild birds or that have been to another facility within the 2 weeks. on up to 72 hours. Owners must appTve anyone that has been to another Properly use footbaths rlor to entering and leaving eithel the Employees must report any violation of the above policy Managers must meet owner. NEVER GIVE GATE COD 3 OUT TO ANYONE. ALL INFORMAT 0le CANNOT BE SHARED WI ANYONE THAT IS NOT Authorizeq. iI vendors/sales persons at the corporate aln facilities and/or lay houses. to Management immediately. office unless otherwise approved by Confidential and PROPRIETARY AND Employees MUST report any vi latlon ot the above policy to Man?rgemimt immediately. lfully understand the above policy and have 09 eed to all conditions, VIOLATION TERMINATION. Print Nam Signature I i rm. POLICY COULD RESULT IN Date H1 Date - 062620 I2 Version 3 Date 76/7 7 Policy? All gates 111 Faun location Gate combinations unauthorized dist1 considered a securit;l dc by upper management only, up( Approval will be ma form. This is a security i331 Procedure Upon completely. After d1 and secured with a locking device. If unable to complet< instruction but do no manager. If you have been ass gned to access a gate of which th comb given, call the mana er who assigned the task for instri information from an If a gate guard has entrance and exit. I have read and unde of failure to follow, FA Locked Gate Policy and rocc lkhi?. Hure inst be closed and secure (looked) a through gates, main gates and men gates which give acc a?d codes will be assigned on an ap ution, receiving or use of said co violation. 1e and failure to follow this policy 11te1ing or exiting any gate, the gate mum ving through or walking through 1y secure the gate, please call a tall ti ess to mbin ?l >11 sub may p1 oval mes, This includes all walk any Hickman?s Family basis only, any 10113 and codes will be nittal of provided request asult in teimination. i be unlocked and opened ie gat is to be closed completely ervis 1 or manager for leave the gate unattended until11ist1 uct to do so Any gate that is left pen or unsecured should be immediatel reported to a supervisor or ther source. hen assigned to a gate aiea, follow. Dater/i i rstand the Locked Gate Policy am;~ 101101). the in Proee nation or code was not Do not request this truction of the guard for ?l dures and the consequences i Sparboe Farms accident results in woman?s head injury A woman contracted to clean at Sparboe Farms facility airlifted to hospital after her hair got caught in egg grading equipment Release Date: 2014-08-28 i i A 26-year-old woman suffered severe head injuries after being involved in an August 26 accident involving egg grading equipment at a Sparboe Farms facility near Litchfield, Minnesota. The injured woman?s identity has not yet been .eleased. According to a report in the West Central Tribune, the woman was to be treated for injuries after her hair3became entangled in the machinery she was cleaning inside-a production building. She was an employee of JNS Cleaning Service of Litchfield, which was contracted by egg production company Sparboe Farms for cleaning services. 3 i Minnesota's Meeker County Sheriff's Office received a 911 emergency call that reported the accident around 6:32 pm. at the Sparboe Farms facility on US. Highway 12 outside of Litchfield. The egg production facility is located in;Dan~in Township, which is east of Litchfield. The injured woman was initially tra isported to Meeker County Memorial Hospital by way of a Gold Cross ambulance, but she was later flown by helicopter to a larger. hospital. North Memorial Hospital. Assisting at on scene were the Litchfield Rescue Squad and the Litchfield Police Departmeit. The Meeker County Sheriff?s Department is In the pri cess of conducting an investigation regarding the incident at the Sparboe Farms facility. Your signature below indicates that you have read this document and understand the importance of keeping your hair secured and away from any and all machinery within the facilities. Empiovee=_ Date ?9 74-1 4 ililii?i ami/yfa l?ullct and Layer House Employee def nployee Name . (Both employee and supcn isor must initial each statement as it is explained to employ - being trained) 1. Fresh feed I supervisor. ilable on a daily basisl lf nt, Conduct correct problem or contact 2. All lights shon If lights are not-iin Working order correct problem or contact supewi or. . . i 3. Air should be 1 ovlng through the house at all times. lit" working order, correct the problem or contact supervisfr. 4. Water should 3 available at a the attention of the supervisor. 5. UEP guidelines for hen?s shelter shall e31. appropriate maximum for each cage. 6. Biosecurity rules and standard animal welfare practicei ncet1 01 cells are not in We ues should be corrected or brought to Hens shall never exceed the to be curity rules are not be followed by other employees contact sup ervisoxm 7. Safety rules of the farm must fety ruler obeyed contact the supervisor. 5 8. Injured, sick or trapped birds need to be taken care of. questions about the action to be taken with such birdsc 9. Proper euthanasia of sick, injured or cull hens will be qondu Contact supervisor if procedwe is not being followed by all 10. Dead?hens will removed from living area on a dailyfbasis Contact supeivi or if procedures is not being followed; by all 11. All birds (live 0 dead) will be handled with respect anEd dign should be report to the supervisor. of the farm are not being if you have ted by a trained lo cc. .mployees. and proper] employees ity Proper handling and employee not adhering to this catching metho to minimize stress My I Signature of Employee Signature of Supervisor Date! if! ?i?i Date 7 Our Family and Employees are fully committed to provi othe best care for our ?ocks. Upon entrance of these barns and thro'orghg' work day, 1W0 please keep these ?ve principles in you?" oozed. '1 Iggtot all times. As an employee of Hickman? 8 Family Farms, 1yo 'ilg'r" 1. Freedom from hunger and thirst . fresh water not! feedto LFre?edoni? from di's'e'om'fort Byprovidingun env'imnm l-in~ . 3 Freedom from pain, 11121 ordisease . By prevention or rapid osis and atment. 4. Fogodom to express normal behavior We,? . By prowling suf?cient space. proper {ecilitiea aha . .. {55.5. Freedom from fear and distress . By ennui-in conditions and treatment which d'f? MEDIA BTERMI moi these? actions ?We. Will 14" ?up? flail: Hi him - Please sign and date and return this form to the pa roll department. Thank youDate: i? [Stiw Signature: .. mv? - -t?Qn . .. .. . em an; Regarding gonfldentia Family Farms may ive access to Hickman? "Confidential Information? Includes, but is not limited to, Hickman?s fina strategic plans; customer lsts; personnel and payroll and suppliers; trade secre s; and any other non-public documents or operations, services, ms, costs, procedures, or practices. Such inf. documents, and other so rces of Information maintained by Hickman";f i Information an Non-Solicitation (name) dnderst nd that my position at Hickma n's 5 ya ua confidential arid/or foprietary information. Such ncial cords; business, marketing, and records regardingpurrcn and former employees; vendors, Id ormat on regarding Hickman's business rmatlo Including all records, files, is to be considered confidential and/or proprietary and at all 5 remains the property of hickman?s Family arms. in consideration of my po itlon and employment with Hickman's my employment and at al times thereafter, i will not divulge such Con?l keep confidential during employment with Hickman?s and at all Farms I agree that, during the course of dentla information. agree to es ther after, all confidential or proprietary information i have acqulr relating to Hickman's business, customersipr supp Iers. Company records and file and other Confidential information are not? party without the express permission of the Company?s President (Gier of any Company lnformat on my own behelfor on behalf of others; Confidential information, authorization. In the eve that my employment Is terminated either by Hick to Hickman's all ocuments and other matertais In my posse proprietary Information. i also understand and agree that, during my careful to avoId accidenta disclosure of Con?dential information, ford papers and files are Iocke away at night. I agree that, ifl am confidential or proprieta I will discuss this matter with my superviso' whether Information can divulged, I will keep this Information confl While an employee of Hic man's, and during the one year period folio Ing ter ination 1 reason, I agree thati shall ot, on my behalf or on the behalf of anoth employment of any perso Who has been employed by Hickman's and. months of my departure 0 encourage any such employee to leave em' af?liates or subsidiaries. 7 i agree that the violation 0 any of the terms or conditions of this Agra disciplinary action against e, up to and Including the termination of benefit from the violation. i understand that If I breach this Agree-men of all legal or equitable re edles to prevent the impermissible use of . damages Incurred as a res It of the impermissible use of Confidential ll be di closed or provlded to any outside It Hick an). I agree that i will not make use ecords and ?les may not be removed from Fickman premises without express an?s, or me. i agree to return confidential and/or mpioy ent with Hickman?s, i must be ample by making sure all con?dential nciear sto wh therlnformation I possess ls . Furth r, i agree that Ifl am in doubt as to ential. my employment for any erso or entity, hire or soliclt the or its a fillates or subsidiaries within six ioyme with Hickman's or any of its ment ay lead Hickman's to take empl yment, even ifl do not personally Hick an?s reserves the right to avail itself onliden tlal Information or to recover aformat on. Oat Vaccination Administration and Safety Procedures - Rooster cages must be used at all times. This portable cage should be placed 10 cages ahead of the starting point. Once you have reached the Roostercage, time should be taken to check vaccine levels to ensure that both the tool being used to administer the vaccine is working properly and that enough vaccine is available to continue. At this point, the rooster cage should be moved another 10 cages so the process can be repeated. 0 Portable Cage doors or "Cage Flaps" help limit the amount of Pullets that get onto the floor and should always be in use. All Pullets on the floor need be vaccinated and picked up daily. 0 At no time should anything be placed or left in the fee' trough of any barn. 0 When vaccinating in a barn with a Traveling Hopper Fe: System it is important that any items (scaffolding, stools, vaccinating tools, rooster cages, ET) are never left unattended in a position that could possibly obstruct the feed Hoppers path. 0 When using step stools or Rolling Scaffolding, it is imperative that preper precaution be taken when climbing onto or off of this equipment. At no timf should more than one person be using the same stool or scaffolding. For the vaccination of the lower tiers we have manufa?tured what is commonly referred to as a "boogie boa rd?. Under no circumstances should this equipment be stood upon. They are specifically designed to sit on during vaccination or lal I upon while doing roundup. 192 other equipment used during vaccination is deemed safe to it upon while vaccinating. 0 Attention should be paid to all surrounding areas duri 1g vaccination. Hands should never be place in or around the trough during feedings. Under circumstances is ?racing" the Hoppers acceptable. Time should be taken to remove equipme from the Hoppers path. 0 In addition to Safety Glasses, the following PPE is ator for use when using the Thama Vaccinating Gun: Canvas Arm Sleeves for both arms an? a Fluorescent Colored Glove needs to be worn on the hand used for handling the Pullet. Dusgd Masks are available upon request. 0 Any self?injections and/or punctures need to be repor ?ed to the Supervisor on duty immediately. Pullets will be checked for accuracy regularly. Remem Ler, at no point will speed or quantity ever compensate for a low accuracy score. Proper Administ ation of all vaccinations is essential to insure all our Pullets stay Healthy and reach their full dotential. - It is important to stay hydrated throughout the work day. Once issued a Hickman?s Water Bottle, it is recommended to keep it with you between break 0 During emergency situations, the lights in the Pullet H: uses will be flashed on and off to make everyone aware. Please exit the barn in a timely mann: and make your way to the front of the facility. A map of Emergency routes is accessible at an 1 time. Fire Extinguishers are located in each Bio-Office, each Dog Run, and at the front and back of every barn. There is also an Emergency Wash Station located at every set of Pdllet Barns. Date: Employee Signature Pullct (Bird) Handlers i This Job Description includes activities assigned specifically to the Bird Handler's position at chkman?s Family Farms. All and SOP's should be followed In conjunction with all U59 and Salmonella requirements and guidelines. Maintenance will be responsible for ensuring that the following tasks are performed in a timely manner. il (There may be some instances where Managers and or Senior Management may ask for additional task to be performed outside of the standard ?job description" of this position.) i Bird Handlers will have to perform all duties of this position with the upmostgkespect and Regards for the flock. The proper mix, usage, waste and location of all these vaccinations must always be propgpriy recorded. You will need to work closely with the Puiiet Handler Record Keeping Associate Vaccination Associate to'*ensure proper documentation at cycle at vaccinations. . Chick Arrivals Split Chicks Beak Administer Pox vaccine Administer Killed vaccine .i Killed Coryza Vaccine (Brown Pullets) i Special project work . Bird Movement Barn Cleans layer Depopuiatlon 0000000000 i ii Bird Handlers must be cross trained with tho inmate Barn Associate 8: Barn Maintenance on occasion you will need to work on Mechanical Failures. i- i Sanitation of all equipment after use is your responsibility, logged and verified. Personal Protective Equipment: Gloves, Hard Hat, Goggles, Face Shleidginubber Boots, eody Harness, and/or Ear Plugs should always be worn when performing any tasks require all personal to do sol. All tasks should be performed In a safe timely manner. alrd Handler is responsible for cleanliness of all barn work areas along with k?eping ell lanes clear for safe access In 84 out of all these areas. Bird Handlers works closely with all personal to ensure mound of daily barn production. lfuliy understand the roles and responsibilities of my assigned positioh. Employee Signatur ate 1 l? Si '1 1 Personal Protective Equipment (PPE) Policy for De-pop and Re-pop Crew :kman?s family farms believes it is our obligation to provide a hazard free environment to our employees. Any employee encountering hazardous conditions must be protected against the potential hazards. The purpose of protective clothing and equipment (PPE) is to shield of isolate individuals from chemical, physical, biological, or other hazards that may be present In the workplace) It is the policy ofthis company that as a condition of employment, all regular full time, part time, and temporary employees working in designated work areas and/or Job assignments are required to wear Personal Protective Equipment to help prevent injuries. i Re-Pop and De-pop Crew must wear the following PPE: 0 Employees are required to wear *Slip-Resistant Shoes with Steel/Composite Toe, and no open toe, open heel or shoes that are worn out. (Once ordered.) 3 0 Employees must wear Safety Glasses at all time. 2 0 Employees must wear a Dust Mask at all times inside the Pallets Houses. (optional) The employees has the option to wear Canvas Arm Guard?s. Hearing Protection (Ear Plugs) are available to the employees upon request. Regular Gloves are available to the employees upon requ st. Employees? hair must be restrained at all times, and may not wear any type of jewelry. Employees must wear clean sanitized clothing at all times; 0 Employees? *clothing can never be tattered, tore or baggie (No Short Pants Allowed). Notice: if any employee?s clothing, gloves, or shoes gets wet or drench with water or any chemical during 2h shift; the employee immediately must change either into dry clothing, gloves or shoes, and notify the ervisor. i Cleaning and Maintenance 2 It is important that all PPE be kept clean and properly malntainedjby the employee to whom it is assigned. PPE is to be inspected, cleaned, and maintained by employees at fregular intervals as part of their normal Job duties so that the PPE provides the requisite protection. Su ervisors are responsible for ensuring compliance with cleaning responsibilities by employees. .0 have read and the above PPE policy. For my own personal pr tection, I will follow this rogram every day and repoh to the Department Manager/Supervisor or the Safety Health Coordinator whenever PPE Is not available to 'me. I further understand that it is my responsibility to protect and care for the PPE given to me. Not following this program or Intentional destruction of my PPE could result in an oral written warning, written reprimand, termination and/or monetary reimbur ate: $.17 Date: 3"le Date: Employee Signature: Mgr. /Superviso Signature: Safety Manager: Signature: i ?r FlIcs\Conicni.Ouilopk\U03 M23 dcpop and repopxioc Created on 3/ 1 0/20 i 5 1 i Bump Cap Policy I i l, acknowledge and understand that Bump Caps are now required and will be part of the employees PPE. They will be required to be worn when: 0 Cleaning pit area inside the ham 0 Cleaning pit area outside the barn 0 Cleaning area around outside feed bins 0 Standing on crossover to clean scrappers (maintenance) This goes for ALL CREWS. During cleans, repops, depops, barn maintenance and vaccinations. All personnel cleaning these areas or doing round ups in the pits will be required to wear bump caps. If seen not wearing caps while working In th designated areas, you will face disciplinary action accordingly. 7 i i 'l i Employee Signature i Date - MW Supervisor/Manager Signature . Date i i PROGRAM Certification of '?raining i I . . . I I?m, certify that I have been trained the Hickman at arms a on Program. the company?s written Hazard Communication the characteristics and personal protective equipment ls with potential exposure on the job site; This includes a review and understanding 0 Policy, which includes: Safety Data Sheets; that must be worn when handling hazardous materia and, appropriate emergency response procedures. I I am familiar with the location of the above referenced w1 ?itten program. and understand that the company grants me access to the Safety Data Sheets at all times when I am employed. I understand that my attendance in the training program is mandatory. I understand that I must be trained for each hazardous chemical that I use. If I encounter a hazardous material with which I am not familiar, I understand that I am to immediately 7 cntact my manager/supervisor and review the applicable SDS and emergency procedures before working with the hazardous substance. i i Chemicals which I have been trained to use: Hazardous Chemicals: Initials: aollavo Employee Signature Trainer?s Signature: Date: [21 Revised January 20l7 Employee?s Train mg Log Date (8) Topic Trained - New Employee Packet - Productioii Facilities Program, Employee Safety, Company Safety Rules, LOTO (Lock out Tag Out), Freedom Flock, Code of Conduct, EmplOyee Safety, Animal Husbandry and Welfarti Handbook, Handling, Euthanizing, Catching and Transport. By signing below, you understand the training performed and the importance of information provided. These policies are an extension of yourjob description and must be performed. Any violations to the policies could result in disciplinary a itions. Print Name Employee Number Hours of . - Instructor Training Slgnature 4.0 hours Trainer please highlight or circle the videos that were watched during this training. 1 \JelcomeTo-Hickmansavi .31 . 4 5 F0 Safety and Quality.avi .- Comp]iance\Barns\trainingi Training Roster.docx Certification: Statement of Training I Personal Protective Equipment Program ?e read and understand the above policy and procedure. Not following th policy and procedure could result in a verbal written warning, written reprimand, or termination. .. Employee Signature: Employee Date: Trainer Supervisor Name: Trainer Supervisor Signature: Date: Note: . Original form when signed will be provided to the Hickman?s iamily Farms Human Resources Department for placement in the employee?s personnel ?le tr ining record "if-"i .ft . a aw spat as; to?. bladed/tits:31,ng (2 fl I I FOR REPORTING OF ANIMAL RUBLTY, ABUSE, NBGLECT, on POSSIBLE lt is the responsibility of every employee t? continuously watch for employees or other persons who may engage in animal cruelty, abuse and/or neglect of the birds, and for signs of possible ?ock contamination, dividcnce of cross-contamination, or people treSpassing on Company property that 'y lead to contamination. TI . . in of any animal mister its page. Anyone who is .hvitnesscd doing so, or suspected of doing so, must be reported to the compani'y management immediately and the report. should include the person?s location and the time of the incident. The failure of an employee to report cases of animal abuse or neglect may result in that employee?s termination of Fmthemtoi'e, any employee who observes that may indicate .a bird or ?ock is or may be subject to contamination must al :0 notify management immediately. Possible contamination can be determined from an employee violating the bio-security policies, the physical appearance of a bird or a dock, or having knowledge that an employee has exposure to any other type of fowll outside the workplace, including keeping pet birds or a small ?ock of chickens. 'lso, trepassers on propexty pose a signi?cant risk of ?ock contamination. The potei tial damages from contamination or cross contamination can be disastrous for the'f animals and it is critical that all employees be aware of possible contamination orleross contamination. Again, all incidents of potential animal abuse; neglect, or cruelty, or possible contamination should be reported immediately; Company Safety Puies in accordance with the Hickman's Family Farms Safety 8. Health Program the following safety rules and regulations applicable ?e our operations that must be complied ih by our employees. in accordance with the company disciplinary policy. of these rules and regulations it result in disciplinary action. and can result in penalties up to immediate termination of empioymen General Workplace Safety Rules i. Report all unsafe conditions and actions to your immediate supervisor. 2. Prompiiy report all accidents or ne ar-miss incidents to your immediate supervisor. 3. Do not bypass or disable a safety device or system. I, 4. Operate machines or other equip menl only when all guards arid safely devices are in place and in proper operating condition. . 5. The use of ?Waikman"-type radios: i-pods or other devices which have the potential to reduce hearing are NOT ALLOWED. :6 6. Only authorized and trained emp oyees will operate company;-i machinery and vehicles. 7. is NOT ALLOWED to send and/or receive text massages. connect and surf the into-met. or receive e-mails while operating any company vehicles. 5 . . it 8. Always wear your seatbelt while operating any company vehicles or equipment. 9. Keep all equipment in safe working condition. Never use defebtive tools or equipment. Report any defective tools or equipment, and all equipment maintenance issues your supervisor. i 0. Perform regular equipment and area inspections as required by supervisor. vii. - Maintain good housekeeping in your area at all times. i 12. Do not leave unnecessary litter or material in aisles. walkwaysjistainvays. work areas, or other points of egress: it must be kept clear. 13. Use the appropriate tool for a job. as trained by your supervisor. JSA or manufacturers? instructions. 14. Property care for and be responsible for all personal protective equipment (PPE). Wear or use any such PPE when required. 15. Use and face protection where there is danger from flying; objects or particles. (such as when grinding. chipping, burning and welding, etc.) or from hazardous chemical splashes (use bioubie protection, safety glasses/goggies with a face shield. when operating a chap saw). 16. Lockout or Tagout or disconnect power on any equipment or?machines before any maintenance. un-jamming. and adjustments are made. 1! i 7. Follow the safety policies and pr cedures as outlined in individual Best Practice Programs. 18. No use of illegal drugs or aicoho by the terms of the compariy's Drug and Alcohol policy. 19. Employees taking physician-pro cribed medication that migt?t impair their ability to operate certain equipment or perform various job tasks safely must rep rt this to their immediate supfervisor prior to the start of work. 20. No firearms shall be present on the property. including the parking lot or on the jobsite. 21. Dress appropriately. Wear appr priate work clothes, gloves. and shoes or boots. Loose clothing and jewelry shall not be worn. Work rules and exposure to eq ipment do not permit empidiyees to work without long pants and shirts at any time or goccasion. (No Short Pants ALLOWED) 22. Refrain from horseptay that cou endanger you or your co-workers. . i . Personal Protective and Related Equip ent a. Personal protective equipment st be worn as required for each job in all operations where there is an exposure to hazardous conditions. This eXposure is det rmined by a personal protective equipment hazard assessment of the workplace by he supervisor and the safety 8. health cof?dinator. Equipment selection and wearing requirements are determined from this assessment. . to. Safety glasses. goggles. or face sllrields will be worn in those areas where there is a reasonable probability of injury to the eye'irom dust. flying particles. molten inelal. chemical/acids/caustics. or light radiation. or other hazards. Safety glasses must be worn all the time at the following localio?hs; a) Lay Fullet Houses areas bl Feed Mill it c) Fertilizer Milt d) Special Protects crews e) Electricians/AC Maintenance . fl Processing Maintenance ?i g) Moba Night Cleaning crew i h) Machine shop . . :5 i) Truck shop or on service calls Liquid Hard Boll plant c. *Wear a face shield over your so *ety glasses/goggles while op?erating a chap saw or handling chemicals. it. Head protection [hard hats or bump caps) must be worn for ?rotection from falling objects or work near energized electrical contact and must be use at the following locations: a) All processing plant personnel must wear bump cops white w?rking with metal racks. b) Electricians is Special projects Crew must worn hard hats white in construction and repair zones. at Truck Drivers must wear hard hats at the feed mill while hauling feed. d) Feed Mill personnel must wear hard hat all the time. e. Foot protection will be worn where there is danger to the foot: from faking/roiling objects. objects piercing the sole or electrical hazards. and slipiresistant shoes will be worn throughout theiicornpany. Hand protection is required when hands are exposed to severe cuts/abrasions. chemical/thermal burns. or chemical absorption. 9. Appropriate gloves. aprons. splash goggles. face shields. anquroper shoes will be used when necessary for protection against acids and other chemicals which could inlure employees. it h. Respiratory equipment in many cases is needed for protectioj'n against toxic and hazardous fumes/dusts. Only approved equipment will be used. it i. The use of fall protection homes res. and lanyards are required when working more than six feet above a floor or ground level and there are no guardrails or other form of fall protection. and on certain suspended scaffolds. Each employee will be on a separate safety line, and this line will be adjusted so that the employee cannot fall more than six feet. 5). Lockout/Tagoul Program ?i la. Before any work or maintenanc is performed on any machine. equipment. tool. or eiectrical system. they will be "wit?made totally safe before work starts by removing any source of energy or power to them. such as electrical. air/hydraulic pressure. spring/stored energy. or thermal [heat/cold}. Pedestal grinders must be perma . ngue guards lnstatled and adjusted to within V4 inch of the wheel. and side spindle/nut guards installed. tr. Portable adders will extend at lea st three feet above the upper.3ievel to which the ladder is used to gain accessstepiadder will not be 158d as step. Only one person will be on a ladder at a lime. 10). Flammable and Combustible Liquids cl containers. or portable tank's will be used to store flammable or combustible a. Only approved safety cans. origin liquids. . i 3 b. Above ground storage tanks will br? separated from each other?gby a minimum of three feet or 1/6 the sum of their arge from reaching adjoining property or waterways; spilt containments will be provided. diameters. and to prevent accidental disc 3 c. No more than 25 gallons of Class I cabinet or an inside storage room. fuel servicing areas. 11). Welding and Brazing 3 and 120 gallons of liquid Class IB. 16, ll. or liquids may be stored outside a storage a. An emergency shut off switch faulted i5 - 75 feet from the pumps and a fire extinguisher will be provided at company a. Combustible material will be clear a fora radius of 35 feet irons}: the area around cutting or welding operations. it the combustible material cannot be cleared the work cannot be moved; then the welding/cutting will not be done. b. Welding helmets and goggles will worn for protection prevent flash burns. protection will be worn to guard against slag while chipping. grindin and dressing of welds. 3 c. Welding gloves will be worn for he protection while welding. d. Welding screens will be used and proper position to protect nearby workers from welding rays. Cables, leads. hoses. and connections will be placed so that ttfere is no fire or tripping hazards. Cables will not be wrapped around the welder?s body. it f. Oxygen cylinders will be stored at least 20 feet from fuel gas cy3lnders. or separated by a noncombustible ?re wall with a one?half hour rating at least five high. tr g. Valve protection caps will be in place on cylinders not in use. n. Ventilation is a prerequisite for we ding in any confined spaces? 12). Tools a. Hand tools with broken/cracked handles. mushroomed heads33or other defects will not be used. Files will have handles installed. it b. Take special precautions when us ng power tools. Defective trials will be removed from service. c. Power tools will be turned off and motion stopped before setting foot down. a. Tools will be disconnected from Never leave a running tool unattended. oWer source before changing drills. blades or bits. or attempting repair or adjustment. ll e. Power saws. table saws. and radial arm saws will have operati?nal blade guards installed and used. Anti-kickback teeth and Spreaders will be used when rip t. Portable abrasive side-winder grir wheel. Wheel speed ratings will never be sawing. iders will have guards installed covering the upper and back portions of the abrasive less than the grinder RPM speed. tently mounted. tool rests installed and adjusted to within 1/8 inch of the-wheel. i Air compressor receivers will be d3dlned frequently to prevent buildup of water in the tank. the undersigned, (print name) Have read Hickman?s Animal Welfare lTralning Manual. I understand the requirements set before me by this doctiment and agree to abide by all the rules and regulations of this farm. Signature: Date: fl L3 FAMILY FARMS IQ TRAINING MANUAL Animal Welfare 2017?2018 ANIMAL HUSBANDRY HANDBOOK i TRAINING MANUAL FOR THE ANIMAL WELFARE EMPLOYEE Viv-err? 1 Page WELEFARE TRAINING HANDLING, CATCHING AND TRANSPORTATION 5E Leghorn hens tend to have relatively weak bones by the end of lay. Bones become weak when structural bone is broken down to obtain calcium forEeggshell formation. As a result there is a high risk of bone fractures when they are handled pripr to culling (push out) Hen movement is the primary source of Injury. EmploErees must take extra care when handling young birds Older birds commonly referred to as ?spent hens? must also be treated with extra care Birds must not be thrown kicked crushed or otijierwise mishandled. Escape and dropping of birds should be minimized. The ground floor of a EElayer house is not a safe place for hens Limited food and water sources heat cold moving? parts and stress can lead to increased mortalities or suffering. Additionally, mishandling henE can reduce productivity significantly ail-ariaassays; The-highest "id "arise aHEi {$36336 ?Hens humanely, compassionately with minimal stress. HFF employees have be:I screened and selected for their exceptional ability to be compassionate and disciplined when handling hens during push out or repopulation. PUSH-OUT REPOPULATON-E Removing a nd Replacing Hens Birds moving into or out of a cage production system should be handled as to minimize bone ibreakage' or injury. This is the primary goal of all bird'handlers. Failure to comply by the rules ?set forth by Hickman?s Family Farms (HFF) and the Ubited Egg Producers (UEP) may result in loss of employment or disciplinary action. Hickman EFamily Farms takes every precaution to ensure their hens are protected from abuse handled humanely and feed and water :5 provided at all times throughout their life cycle. Push out (De population)? ?spent hen? is consideredE to be at its weakest stage of its life cycle. The bones of a hen which has been in production and nearing the end of its productivity are weak due to calcium loss. Bird handlers must take eSEtra care to provide quick and humane transfers into MAK carts or MAK chambers. A MAK chaEnber Is a C02 device used to cull injured or sick birds and in some cases roosters which are in the hen population. These devices are located permanently in a lay house or pullet barn. Mass depopulation (Push outs) refers to methods by which large numbers of animals (spent hens) must be culled quickly and humanely with as much consideration given to the welfare of the animals as is practical but where the circumstances and tasks facing those doing the depopulation are understood to be extenuatingEuthanasia Involves tranSItIonIng an anImal to death In5ia manner that' Is as painless and stress? ee as possible. Lay?house Push out and re- populationE-Eemployees are specifically trained to be ?Sisciplined and to follow policies. Special consideration is given to individuals who hold the welfare of these animals In high regard. THE INI: COMMISSION OF DIVISION OF OCCUPATIONAL SAFETY HEALTH non ?mam. Maths: swdulan Field Notes Date: 25' Time: [0930 Company Name: Emit! gm 52924224 EMployeCB (m Q'l'q?A AW 4 acju. SWIHS -. 9. - New H4 42.0 ombl/W in 'an-lua?wu?EE' gnann?v Per 0?qu Slut-rs. 0236304de on ?ne/adv?: ?Icp Cow. ,r 4 AM 434% ?A/dr-/A 24r/Man4/I ?3 awwvaes I?mvwer) A th CLASS 2mm Comram Ms 0 loo/4402M 4a 1.32% 7?on 4 2?me95 pm: am 1? ?Dva/ lil?aldu Safety Ava-4 ?it" cur/am a? ?mwn?~ roam! aux/HS a} Sign/?0 git; [0/15 ?re/S?ch mm onsrk. pmohomns and no del?oncems mice? obserue?. 1" EC gamed home?s]. +yv6k. dlSpOSa?alL wk; gloves]. gages and Mask54 hOSpn?al fit/ye. 40am? arounJ wrS. mghv? 15/50:, 4} Look ow} fud- amt ?Pmam 142 L017) 7 Coaner a} barns? 4? pkg/mk?RUm/P WW5 ?42?on 7?)?ch -4- TNMMOI C0145 My 1404] 38.42/17? Sen/em Tr?ucw'suflmx Jpa?of' 451$;th Training Comes of El? frat/hm? barn bmkmoL' amt/able. ?r used ensue. a? In - mm mum? be, lo a, error- EW?y?e. 4mm! (34114115 lomor and madam!) was AoJr 1L0 only rvm?ru'lmL Pacino 4v [0415,4465 QM 159(16. Entry: Open: [03; Walk: [045 Close: [42" Exit: [1/50 F00034.AD02 11/20/2019 State of Arizona Mall - Stinson Incldent report . n} I I Ovldlu Teudan l'j( it is Stinson Incident report 9 messages Manos Wed, Nov 20, 2019 at 7:51 AM To: ?ovidiu.teudan@azdosh.goV' Cc: Robert Phalen Eddrick Moreland Shane Jolicoeur ?nancial nmcor 1 LY PA a 0: [623! 812-2315 6515 JACKRABBIT TRL BUCKEYE AZ85326 From: Jim Manos Sent: Wednesday, November 20, 2019 7:43 AM To: 'ovidiu.teudan@azdosh.gov Cc: Robert Phalen Eddrick Moreland Shane Jolicoeur Subject: RE: I will send you the training tile 0? the inmate who lost the tip of her finger in an auger accident and was the focus of the New Times or IC e. IS an extensive tile so it will take a few emails. The first is attached here. From: Jim Manos Sent: Tuesday. November 19, 2019 5:04 PM To: 'ovidiu.teudan@azdosh.gov Cc: Robert Phalen Eddrick Moreland Shane Jolicoeur Subject: . . 1/15 11/20/2019 State of Arizona Mail - Stinson Incident report Training for? 0 lost part of her finger a 4329_001.pdf 356K Ovidiu Teudan To: Jim Manos Wed, Nov 20, 2019 at 9:22 AM Mr. Manos, Thank you for all the documents provided. I have a couple of questions regarding the incident report and the Lock Out Tag Out/ Machine Guarding process: 1. Whe- was handling the feed auger, Why was the auger mnning? 2. Is the auger system not locked out and tagged out when servicing or working on the auger?? 3. Is there a guard over the auger? If so, why was it removed b-f not, why is there no cover over the auger? 4. What was -asked to do with the auger? (why was she near or around it) 5. Does the company have speci?c Look Out Tag Out procedures for the augers? If so, can you please provide me a copy. 6. Does the company have an "umbrella" Lock-out Tag-out program or speci?c procedures for each unit! machinery? 7. Please provide a copy of the training conducted on 12-16-18 Augor Safety" and 12-22-18 "Hopper and Auger Safety" instructor Autumn. [Quoted text hidden] Regards, Cristian Teudan Industrial Hygiene Of?cer Arizona Division of Occupational Safety and Health (ADOSH) 800 W. Washington Street Phoenix. AZ 85007-2934 Of?ce: (602) 542-1682; Fax (602)542-1614 Ovidiu.Teudan@azdosh.gov http:/ . ..-. a. Manos Wed, Nov 20, 2019 at 9:24 AM To: Ovidiu Teudan I am copyin this as he would be in a better position to answer than I would. .is the please supply answers to the below questions. http62/lmal .g 009 -f?/o3A1650732816676315163. . . 2115 11/20/2019 State of Arizona Mail - Slinson Incident report Manos Bhlol llnanclal a ICKMANS ll FAMILY FARMS 0: [023] 812-2 315 6515 JACKRABBIT TRL BUCKEYE A285326 [Quoted text hidden] Ovldlu Teudan To: Jim Manos Sounds good, thank you for your assistance. [Quoted text hiddon] Chris Pechac whickmanseggsoom> To: Jim Manos Ovidiu Teudan Good orning, Please see answers below. Let me know if there's anything else I can do to help. Thank you, .g 009 -f%3A165073281 6676315163. .. Wed, Nov 20, 2019 at 9:28 AM Wed, Nov 20, 2019 at 9:43 AM 3/15 11/20/2019 State of Arizona Mail - Slinson Incident report PA LY PA 11 8 II: [623] 812-2391 Fromzlim Manos Sent: Wednesday, November 20, 2019 9:25 AM To: Ovidiu Teudan Cc hickmanseggs.com> Subject: RE ncident report I am co in on this as he would be in a better position to answer than I would. I is the please supply answers to the below questions. limManos chlel ?nancial 0mm FAMILY mums 0: [62 3] 812-2315 6515 JACKRABBIT TRL BUCKEYE A285326 From: Ovidiu Teudan Sent: Wednesday, November 20, 2019 9:22 AM To: Jim Ma os@hickmanseggs.com> Subject: Rmncident re port Mr. Manos, Thank you for all the documents provided. .goog msg-f%3A1650732816676315163. .. 4/15 11/20/2019 State of Arizona Mail - Stinson Incident report I have a couple of questions regard; 1e incident report and the Lock Out Tag Out/ mine Guarding process: 1. When-Nae handling the feed auger, why was the auger running? The Auger as running to empty out old feed and water that was left over from cleaning the born, 2. Is the auger system not locked out and tagged out when servicing or working on the auger? it is. - was not servicing the Auger, the work she was doing on the Augers was monitoring the clean out process and reporting any issues to the person at the Auger control station via radio so power could be cut off if any problems arose. 3. Is there a guard over the auger? if so, why was It removed b-f not. why is there no cover over the auger? There is a cover that is removed in order to empty feed/water out of the system. She tried to replace the cover while it was in operation. 4. What was-asked to do with the auger? (why was she near or around it) See question 5. Does the company have speci?c Look Out Tag Out procedures for the augers? If so, can you please provide me a copy. See 6. Does the company have an "umbrella" Lock~out Tag-out program or speci?c procedures for each unit/ machinery? Attached is specific to Pullet Facilities. 7. Please provide a copy of the training conducted on 12-16-18 Augor Safety" and 12-22-18 "Hopper and Auger Safety" instructor Autumn. Can you please let me know what exactly you're looking for on this request? 2? mail .9 n'sg . . 5/15 11/20/2019 State of Arizona Mail - Stinson incident report [Quoted text hidden] Pullets Final.pdf 457K Ovidiu Teudan Wed, Nov 20, 2019 at 10:13 AM With regards to question number 7. I wanted to see a copy of the documents or power point slides that was provided as training on those days. The training sign-in sheets were prodded on a USB drive but there was not details as to what was covered/ or the material contents. [Quoted text hidden] Wed, Nov 20, 2019 at 10:48 AM Ovidiu Teudan To_mhickmanseggs.com> What cover wa-re-installing? Why was this cover removed? is removal of the cover part of the procedure and required? If the cover is required to be off/ open during the clean-out process, what is the control to prevent anyone from placing hand(s) inside the auger itself? I appreciate your help in this matter. as I am trying to provide details to my supervisor with regards to this process and howl why the incident occurred. Could you please provide a couple of pictures to explain the process of the auger and where the employee was? On Wed, Nov 20. 2019 at 9:43 wrote: [Quoted text hidden] [Quoted text hidden] hickmanseggs.com> Wed. Nov 20, 2019 at 11:08 AM To: Ovidiu Teudan Cc: Jim Manos Thank you for the clarification. In regards to these training topics, they are done in a group setting at the start of each shift. The training to be provided each day is determined based on the safety risks involved in the tasks required for completion on that specific day. No power points or documents are used for this type of training. Training is done via verbal communication between the group and the instructor. The instructor picks random staff members to contribute their personal experience and knowledge to each topic as well. Visual cues are also used in the barns at times to assist in this type of training. :llmai .g 009 16.0 om/mai llu/0? e690108a728ivi ew= 6507328166763151 - f?/?3A1650732816676315163. . . 6/15 11/20/2019 State of Arizona Mail - Stinson Incident report Thank you. - FAMILY FARMS 0: (623) 812-2391 From: Ovidiu Teudan Sent: Wednesday, November 20, 2019 10:13 AM To: hickmanseggs.com> Subject: Re nciden?r report With regards to question number 7. I wanted to see a copy of the documents or power point slides that was provided as training on those days. The training sign-in sheets were provided on a USB drive but there was not details as to what was covered/ or the material contents. On Wed, Nov 20, 2019 at 9:43 wrote: Good Morning, Please see answers below. Let me know if there's anything else I can do to help. Thank you. .goog -f?/o3A1650732816676315163. . . 7/15 11/20/2019 State of Arizona Mail - Stinson incident report - 0: [32313124391 From: Jim Manos Sent: Wednesday, November 20, 2019 9:25 AM 5 To: Ovidiu Teudan Cc . hickmanseggscom) Subject: RE Incident report I am copyin this as he would be in a better position to answer than I would. - is please supply answers to the below questions. llmlitanos (this! financial nlticor YAMILY PARMS I): [623] 812-2315 6515 JACKRABBIT TRL BUCKEYE A285326 [Quoted text hidden] [Quoted text hidden] -f%3A1650732816676315163. .. 8/15 11/20/2019 State of Arizona Mail - Stinson Incident report HICKMANS FAMILY FARMS 0: (623) 812-2315 5 6515 JACKRABBIT TRL BUCKEYE A285326 5 From: Jim Manos Sent: Wednesday, November 20, 2019 7:43 AM To: 'ovidiu.teudan@azdosh.gov . Cc: Robert Phalen Eddrick Moreland Shane i Jolicoeur Subject: RE: Iwill send you the training file on_ the inmate who lost the tip of her finger in an auger accident and was the focus of the New Times article. It is an extensive file so it will take a few emails. The first is attached here. From: Jim Manos Sent: Tuesday, November 19, 2019 5:04 PM To: 'oWdiu.teudan@azdosh.gov Cc: Robert Phalen Eddrick Moreland Shane . Jolicoeur Subject: Training fo_inmate who last part of her finger Regards, Cristian Teudan Industrial Hygiene Of?cer Arizona Division of Occupational Safety and Health (ADOSH) 800 W. Washington Street i httpe:/lmail .g oogle.com/mal meg -f%3A1650732816676315163. . . 9/15 11/20/2019 State of Arizona Mail - Sti nson Incident report Phoenix, AZ 85007-2934 Of?ce: (602) 542-1682; Fax (602) 542-1614 Ovidiu.Teudan@azdosh.gov Regards, Cristian Teudan Industrial Hygiene Of?cer Arizona Division of Occupational Safety and Health (ADOSH) 800 W. Washington Street Phoenix, AZ 85007-2934 Of?ce: (602) 5424682; Fax (602) 542-1614 Ovidiu.Teudan@azdosh.gov @hickmanseggs.com> Wed. Nov 20, 2019 at 11:37 AM To: Ovidiu Teudan See attached images per your request. The cover is removed in order to allow old wet feed to drop out of the auger while in motion. This is a requirement when the feed is wet due to clumping. the cover is replaced immediately after the clean out is completed. Our control is the visual inspection/monitoring of the system as it?s running to be certain that no issues occur and no staff member unaware of the removed cover comes near the system during this process. This was the tas-as completing at the time of the incident. Radio contact is .. 10/15 11/20/2019 State of Arizona Mail - Sti nson lnci dent report maintained during this procL oetween the person monitoring the :on out and 0 staff member located ol the pow er source. Please let me know if there is onything else you need. - I LY FA 0:l6231812-2391 From: Ovidiu Teudan Sent: Wednesda November 20, 2019 10:49 AM What cover wa-re-installing? Why was this cover removed? is removal of the cover part ofthe procedure and required? If the cover is required to be 0th open during the clean-out process, what is the control to prevent anyone from placing hand(s) inside the auger itself? I appreciate your help in this matter, as I am trying to provide details to my supervisor with regards to this process and how/ why the incident occurred. Could you please provide a couple of pictures to explain the process of the auger and where the employee was? .g -f%3A1650732816676315163. . . 11/15 11/20/2019 State of Arizona Mail - Stinson Incident report On Wed, Nov 20, 2019 at 9:43 AM - Good Morning. Please see answers below. Let me know if there's anything else I can do to help. Thank you, warms TAMMY FARMS 0: (62318124391 Fromzlim Manos Sent: Wednesday, November 20, 2019 9:25 AM To: Ovidiu Teudan . Squect: REzulncident report I am copying?on this as he would be in a better position to answer than I would. .is please supply answers to the below questions Manes chialflnanclal unmet .. 12/15 11/20/2019 State of Arizona Mall - Stinson Incident report FAMILY FARMS 0: [623] 812-2315 6515 JACKRABBIT TRL BUCKEYE AZ85326 [Quoted text hidden] [Quoted text hidden] 3 chlot?nanolalomoer i HICKMANS FARMS [623] 812-2315 6515 JACKRABBITTRL BUCKEYE A285326 From: Jim Manos Sent: Wednesday, November 20. 2019 7:43 AM To: 'ovidiu.teudan@azdosh.gov Cc: Robert Phalen Eddrick Moreland Shane Jolicoeur Subject: RE: I will send you the training tile 0- the inmate who lost the tip of her finger in an auger accident and was the focus of the New Times article. It is an extensive file so it will take a few emails. The first is attached here. From: Jim Manos Sent: Tuesday. November 19, 2019 5:04 PM To: 'ovidiu.teudan@azdosh.gov Cc: Robert Phalen Eddrick Moreland Shane Jolicoeur Subject: 13/15 11/20/2019 State of Arizona Mail - Stinson Incident report Training for- inmate who lost port of her finger . Regards, . Cristian Teudan Industrial Hygiene Of?cer Arizona Division of Occupational Safety and Health (ADOSH) 800 W. Washington Street Phoenix, AZ 85007-2934 Of?ce: (602) 542-1682; Fax (602)542-1614 Ovidiu.Teudan@azdosh.gov I Regards, Teudan Industrial Hygiene Officer Arizona Division of Occupational Safety and Health (ADOSH) 800 W. Washington Street Phoenix, AZ 85007-2934 Of?ce: (602) 542-1682; Fax (602) 542-1614 Ovidiu.Teudan@azdosh.gov [Quoted text hidden] ., .. .-. 2 attachments Clean Cut Cover in Placerg 2005K .g 009 le.com?mai I/u/0?ik= e690f0aa728M ew= pt&search= -f%3A1650732816676315163. . . 14/15 11!20l2019 State of Arizona Mail - Slinson Incident report Clean Out Cover Re moved.jpg 2316K :?mail .g 009 Ie.con?rnai HufO?i k= e690ana728wiew= pt&search= -f%3A1650732816676315163. . . 15f15 9/27/2019 State of Arizona Mail - ADOSH Inspection ?75/19 . . I I John Acosta I- ADOSH Inspection 9/25/19 1 message John Acosta Fri, Sep 27. 2019 at 1:41 PM To: emoreland@hickmanseggs.com, mhaien@hickmanseggs.com. Ou?diu Teudan Good afternoon Mr. Moreland, As you are aware, Arizona Division of Occupational Safety and Health (ADOSH) conducted an inspection with Hickman Family Farms at 32425 W. Salome Hwy, Arlington, AZ 85322 on September 25, 2019. There is some additional Information that we will need for our inspection. As the inspection progresses, it is possible I may need additional information than I've asked for in this e-mail, however, I will attempt to keep my requests to a minimum. - If your company has a written Safety Program please provide a copy - If your company has employed more than 10 employees at any one time during the past three years, including temporary laborers, please provide a copy of the 2016, 2017, 2018 300A summaries [29 CFR You have already provided the 300 Logs Lockout/Tagout Program speci?c to the following machinery: Conveyors at the barns, Overwrap Machine, Palletizer Hazcom Program Battery Acid Forklift Service Procedures PIT Training; Speci?c to Pallet Jack, Reach Square Footage North and South Areas combined In addition to the above requested items, please provide information on the following: If your company conducted Hazcom Training and PIT Training, please provide training records for the following emp oyees: 1. 2. 3. I am sure we would all like to expedite the remainder of this inspection, and the accumulation of this information will help. My contact information is listed below. This information can be sent either via facsimile, hand delivered, USPS or as an email attachment (although large files may need to be broken down into segments and emailed individually.) Please provide the requested information by October 4th, 2019. Thank you again for your cooperation, if you have any questions or concerns please do not hesitate to contact me. Respectfully, John Danle! Acosta Safety Compliance Of?cer Arizona Department of Occupational Safety and Health (ADOSH) 800 W. Washington Street Phoenix. AZ 85007-2934 Of?ce: (602) 542-1683 Fax: (602) 542-1614 lohn.acosta@adosh.gov n.aspx .g 009 b738587798&view= pt&search= all 108883280652324561 2&si mpl= - a%3Ar6469851964324737601 1/1 "-if Summary of Work-Related Injuries and Illnesses for: EGG RANCH, INC- Establishment ID: 1046298608 DEA: Fed'l :3me: 32425 Salome Hwy Duns Number' Primary NAICS: 112310 ARLINGTONARIZONA 85322 Corporation Private Sector Establishment Inj/Ill Log for: 2018 I I Page 1 of i Deaths I I II ll Cases with days away ??om work Cases with job transferfrestriction Other recordable cases 0 2 2 1 (G) (H) (I) (J) TotalReeor'dable Cases Total 5 4 Daysawayfromwork I .. I Days of Job Transfer or Restriction 10 27 (K) (L) (M) Total Number (1) Injuries: 5 (4) Poisoning: (2) Skin Disorders: 0 (5) Hearing Loss: (3) Respiratory Condition: 0 (6) All Other illnesses: Total Hours Worked: 102966 Average Number of 46 Employees: Total Recordable Case Rate 9.7 DART Rate 7.8 DAFWII Rate 3.9 1 1/19/20] 9 Form 300A (Rev. 01mm) Summary of Work-Related Injuries and Illnesses At! estabtishments oovered by Part 1904 must compteta this Summary page, even it no injuries or itinesses occurred during the year. Remember to review the Log to verity that the entries are complete Using the Log. count the indinduat entries you made for each category. Then write the rotate below. making sure you've added the entries from every page of the tog tfyou had no cases write Employees fom'terempioyees, and ther'rrepresenratives have the right to review the OSHA Form 300 in its entirety. Theyatso have timitoo? access to the OSHA Form 301 orits See 29 CFR 1904.35, in OSHA 's Recorokeeping rule, for further oataris on the aocese protalsr'ons for these toms Numberofcases A Year 2013 U.S. Department of Labor Occupationat Safety and Health Administration Fun-n approved 0M2 no 1218-01335 Establishment information Your establishment name Street 32425 W. SALOME HIGHWAY City ARLINGTON EGG RANCH. INC- - ARLINGTON SOUTH State ARIZO NA Zip 35322 Total number of deaths a (G) Number of Days Total number of days away from 0 (K) Total number of cases with days away from work Injury and Illness Types. Total number (M) (1) Injury (2) Skin Disorder Respiratory Condition 0 0 Total no mber of cases with job transfer or restriction 2 II) Total urn ber of other recordable cases Total nu mbor of days of job transfer or restriction 2? (4) Poisoning (5) Hearing Loss All Other Illnesses Post this Summary page from February 1 to April 30 ofthe year following the year covered by the form Public reporting burden for this calla-ciao oi?rnl'on'netion is os?malad lo average 58 minulex per response. including time Lo review the Iren'uction. search and gather the data needed. and complete and review the oolleclion of information Persons are not required to respond to the wllaclion of infonha?on unless it displays a currently valid OMB control number II you have any comm about these eslimales or any aspects not this data mllection. contact US Department of Labor. 01' Statistics. ?oom [$3614. 200 Constitution Ave. NW. Washinaton. DC 20210. Do not send the camoleted forms lo this once A . Indusby description {eg Manufacture of motor truck trailers) PRODUCERS OF SHELL EGGS Standard Industrial Classi?cation (SIC). if known (8.9.. SIC 3715} 0R North American Industrial Classi?cation (NAICS). it known to 9., 336212) Employment information Annual average number of employees #5 Total hours worked by all ampli- year 102 966 Sign here Knowingly falsifying this document may ?Bu In a ?ne. I certify that I have examined this document and that to the best of my knowledge the entries are true. accurate. and complete. Sam Seagren Company executive HR Manager Title {623) 691-6772 Phone ?2312019 Date EGG RANCH, INC. DBA: 32425 Salome Hwy Summary of Work-Related Injuries and Illnesses for: Page 1 of 1 Establishment ID: 1046298608 Fed'l Duns Number: Primary NAICS: 112310 ARLINGTONARIZONA 85322 Common Private Sector Establishment Inj/Ill Log for: 2017 Deaths_ Cases with days away from work Cases with job transfer/restriction Other recordable cases i 0 1 i (I) (J) Total Recordable Cases Total DART Cases 3 2 .. j??v?i?erf?f?avs Days away from work 20 (K) (1) Injuries: 3 (2) Skin Disorders: 0 (3) Resplratory Condition: 0 Employment {Information Days of Job Transfer or Restriction 0 (L) [M)T0ial Number (4) Poisoning: (5) Hearing Loss: .16) Other. "messes Total Hours Worked: 94248 Injury/InnessRateS . Total Recordable Case Rate DART Rate DAFWII Rate Average Number of Employees: 6.4 4.2 4.2 50 gov/portal/ server. pt/ gateway/PTARGS_0_O_223_20 .. 1 1/19/2019 Form 300A {Rev.0112004) Year 2?017 Summary of Work- Related Injuries and illnesses U.S. Department of Labor Occupational Safety and Health Administration All establishments covered by Part 1904' mus! complete this Summary page, even if no injuries or Form aacrovod OMB no 1215-31 ?e illnesses occurred during the year. Remember to renew the Log to verify that the entries are complete Using the Log, count the individual entries you made foreach category. Then white the totals beinw, Establishment information making sure you?ve added the entries from eveiypage ofthe log. had no cases write '0 Employees ionner empioyees. and theirreoreseniatives have the right to review the OSHA Form 300 in Your establishment name EGG RANCH, INC. -ARLINGTON SOUTH its entirety. They arso have limited access to the OSHA Form 301 orits equivalent. See 29 CFR 1994 35, in Recordireeping rare. for further detaiis on the access nrow?sr?ons farthese fen-as. Street 32425 w. SALOME HIGHWAY Number of Case's: - . City ARLINGTON State ARIZONA Zip 85322 industry description (e 9.. Manufacture of motor truck trailers) Total number of Total umber of Total number of cases Total number of HARDSHELL EGG PRODUCTION deaths cases with days with job transfer or other recordable away from work restriction wees Standard industrial Classi?cation (are). if known (e . SIC 3715North American industrial Classi?cation (NAICS). if known (eg. 336212) . . Numberofnays Employment information Total number of Total number of days of days away from job transfer or restriction Annual average number of employees 50 Total hours worked by all employees last 20 0 248 (L) injury'and Illness Types Sign he In :1 rue. Total number Knowingly falsifying this document (M) i (1) Injury 3 (4) Poisoning (2) $an P?sorder (5) Heanng LOSS I certify that I have examined this document and that to the best of my knowledge the entries are true. accurate. and (3) Respiratory complete. Condition 0 All Other Illnesses 0 Sam Seagren HR Manager Company executive Title 691-ETTZ 1232015 Post this Summary page from February 1 to April 30 ofthe year following the year covered by the form Phone Date Public reporting burden [or this oollecLiort of lni'nrmalion is estimated to average 53 minutes per response, Including lime to review the instruction, search and gather the data needed. and complete and review the coi'eciion ct information Persons are not required lo respond to Ihe collection of inforrnalien unless it displays a amenity valid OMB cannot number If you have any cements about tress estimates or any aspects of this data contact Us Department of Labor. OSHA O?'ce ol Sta?siim Room N- 3644. 200 Constitution Ave NW. Washinulion. DC 20210 Do not send [he comnleled terms 1.0 this ol?ce. . i? . . Y-- Page 1 of 1 ..- if Summary of Work-Related Injuries and Illnesses for: EGG RANCH: INC- Establishment ID: 1046298608 DBA: Fed'l Duns Number: Primary NAICS: 112310 32425 Salome Hwy 85322 Corporation Private Sector Establishment Log for: 2016 Death?s .. I Cases with days away from work Cases with job transferl?restriction Other recordable cases Total Recordable Cases I - I I I I Total DART Cases "umberofnavs . Days away fromwork I I. I I I I Days of Job Transfer or Restriction 26 0 (K) (L) Twas .. (M) Total Number (1) Injuries: 10 (4) Poisoning: Skin Disorders: 1 (5) Hearing Loss: (3) Besnirstow Conditicm Total Hours Worked: 109282 Average Number of 48 Employees: Injury/Illness Rates Total Recordable Case Rate 23.8 DART Rate 3.7 DAFWII Rate 3.7 1 1/19/2019 Form 300A (Rev. 01.2004) Summary. ?fW9FK?fil?t?q "Flies?? "lnesses_ AH establishments covered by Part 1904 must complete this Summary page own if no injuries or illnesses occurrad during the year. Remember to review the Log to verify that the entries are camplete and accurate before completing this summanr. Using the Log. count the individual entries you made for each category, Then write the totats below. making sure you?ve added the entries from ovary page cases write '13 Employees Fonnorompl?oyeos, and their representatives have the right to roln'ew the OSHA Form 300 in its entirety. They also have limited access to the OSHA Form 301 orits equivatont See 29 CFR 1904.35, in OSHA's Recordireeping mle, fortuntrer details on the access provisions torthose forms. Us. Deparh'nentof Labor Occupational Sifotyand Health Administration Form approved 0MB no Establishment information City ARUNGTON Street 32425 W. EALOME HIGHWAY Your establishment name EGG RANCH. INC. - ARLINGTON SOUTH Zip 85322 Humberto? oases - Total number of deaths 0 Total number of cases with days away from work 2 Total number of cases with job transfer or restriction 0 Total number of other recordable cases 1 1 (G) Numberof Days Total number of days away from work 25 (Kl and llmessz?'ypes' Total number (1) injury (2) Skin Disorder (3) Respiratory Condition (H) 10 Total number of days of job transfer or restriction Ll Poisoning Hearing Loss All Other illnesses (J) industry description (e 9 Manufacture of motor truck trailers) PRODUCER OF HARD SHELL EGGS Standard Industrial Classi?cation (SIC). if known (e . SK: 3?15) 0R North American industrial Classification if known (rag. 333212) Employment information Annual average number of employees 113 Total hours worked by all employees last year 109,232 Sign here (if Knowingly falsifying this dOCument may result in I certify that have examined this document and that to the. best of my knowledge the entries are true aocurale? and complete Post this Summary page from February 1 to April 30 of the year following the year covered by the form Public reporting burden for ll?s collection or inlormalion is eslimaled to average 58 minulas par rasponoa. including lime to review the instructor}. search and gamer me data needed. and and review we milec?on ofinlormalion Parsons are not required to respond to ma colloc?on of Won-nation unless l1 displays a 0MB mnlrol number. If you have anyI comments about these estimates or any aspecls of this dala oo?ocllon. contact US Department of Labor. OSHA Ollice of Statistics. Room Mass-1.2m Conslilullon Ave. NW. Washinolon. DC 20210. Do not send the camololod forms lo [his o?oa Sam Soagren Company executive [623} 691-6772 Phone HR Manager . Title 1mr201s Date A - fl - - .. . Date: aha/rt Opening Conference Time: was Opening Conferen ce Attendees; First Name Last Name . Company I Title Robert Finale? Human; cqgj! Jag ?own. NHL scratch Mar-slam! Madame Fac'a ?Edna on; gray Does the company have any union employees? YES No If Yes, Union Representative Name Address Phone . . . Participate in the inspection WHO Bend copies of citations YES GSHU Initials of Presented credentials (A. RS. 23408 84 0 ?Authority for inspection?) (if Presented copy of Act-and ADOSH Poster (it requestedfnecessary) Option Email a copy of the ACT and ADOSH Poster err Discussed reason for inspection (accident complaint referral programmed planned etc.) Discussed scope oi the inspection Wompreheesive) 4221;. Discussed walk around proceduresfrepresentative(s) . Discussed management and employee interviews in private 4:2" Discussed photographs and Discussed referrals gr Dismissed trade secrets gr Discussed discrimination (A S. 23 425) Protected Activity (AAC 5 680) Requested Company? hazard assessment Does the company have-a safety committee If YES, management only YES or management 8; empioyee YES Does the company have an Safety and Health Program YES NO If YES is the program written or verbal written 3; verbal QT Has the company been required to maintain OSHA recordkeeping for the previous 3 YES NO If NC) reason if YES a copy of the previous 3 years of OSHA 300 Logs and 300A Summaries were requested? NO it NO reason 02/16/2018 Ens Mm Division of Occupational APOSH FORM 100 Safety and Health Inspection Date: - Time: Jar /06 AM. [/0510 :3 Years in Business 2 Site Phone: Company Name: (legal) /7 jC/?/H?lff 549? /%54 73/724,; Site Address: Company Address: 6?7? 4 7? x601 #72 2; Busigess Phone: {423?} 7 .1 W??ext: Fax: 3 Corresponrlence to the Attention of: 1049127420 5 59%? ?15 i147,? Title: 4522 >5 (29 g; ?ag-42" 4 Management Of?cials: I Title: Walltoaround Representative: Title: Nature of Business/Type of work: Parent Company: Company Address: Worker?s Compensation Carrier: ljt/A/??A/j . 5'2. . Number of Employees at this Job Site: EZV Number Covered by this Inspection: :2 Number of Employees in Arizona: Number of Employees in USA: 5.5% Employee Repi'gfentatiue: Yes E: No Name: Union: Yes No Steward Name: - Local Number: Union Name and Address: Safety Program: Written 12/ Verbal El Non? existent Accident Prevention Program: Do you have a Safety Committee with employee participation? l:l Reprimand Policy (Circle one): Written Dre! N'ene See other side of form to specify any speci?c safety] health programs in place. Personal Protective Equipment Required: Your Name (print): ?051,945? - 15 Job Title: Signature: f?n e-mail address: DO NOT WRITE BELOW THIS LINE watts" . Data Not 2: 1" it h" . . 2&1! um. $119.39: . Available . i . lYear: OSHA 1300 Log of Injuries Injury and Illness Types ILWDII Rate1?45 M6 Year: Year: Year: OSHA-101 Sample Cases or Workers Compensation Insurance Records [3 m9}: In" ill?? 3 (records must be present within 6 workdays after the knowledge of incident) - Date Date DART Name Injury [Illness . -Backto Injured Work . Days lClil?lAN? amily farms ark. Forklift Safety Policy Manual OSHA 29 CFR 1910.178 Powered Industrial Trucks . 1 - Revised on 11-9-16 - Robert Phalen, Hickman?s Family Farms - Environmental Program Manager Table of Contents 1. Introduction 3 2. Scope 3 3. Policy 3 4. Definitions 3 5. Responsibilities 3 a. Supervisors 3 b. Trainer 3 c. Operators 3 d. Training 4 e. Equipment Security 4 f. Changes or Modi?cations to Original Equipment Design 4 g. Personal Protective Equipment 4 h. Maintenance of Equipment 5 i. Contractors 5 6. References 5 Appendix A - Maintenance Request Form for Forklifts 6 Appendix - Performance Test for Forklift Operators 7 Appendix - Enforcement of the Use of Seat Belts on a Power Industrial Truck 8 Appendix - Wheel Chock Policy 9 Appendix - Electric Forklift Truck Pre-Shift Inspection Checklist 10 Appendix - Electric Pallet Jack Pre-Shift Inspection Checklist 11 Appendix - Internal Combustion Forklift Pre-Shift Inspection Checklist 12 . - Revised on 11-9-16 - Robert Phalen, Hickman's Family Farms - Environmental Program Manager Introduction The purpose ofthis program is to define the requirements for safely operating a powered industrial truck on Hickman?s Family Farms facilities. All employees and contract personnel shall operate these devices in accordance with this policy. Scope This policy shall cover all powered industrial trucks used on the Hickman?s facilities and all employees, and contractors under the direct supervision of a designated Hickman?s employee. Policy All departments using powered industrial trucks shall ensure that all operators are trained, evaluated and certified in the safe operation of a powered industrial truck in accordance with this policy, the manufacturer's recommendations, OSHA 29 CFR 1910.178, ANSI 92.2, and that these devices are maintained in accordance with the manufacturer?s recommendations and sound safety practices. Contractors not under direct supervision of a Hickman?s Family Farms employee are responsible for the inspection of their own equipment and the training and certification of their own operators in conformance with this policy and OSHA 29 CFR 1910.178 and ANSI 92.2. Proof of conformance shall be required. De?nitions 0 Powered Industrial Trucks/Lift truck: is an electric motor or internal combustion engine forklift, electric pallet jack. 0 Authorized Operator: An employee who has satisfactorily completed both classroom and operation training on material-handling equipment at the company?s facilities. Responsibilities Supervisors are responsible for the following: 0 Ensuring employees attend and pass the powered industrial truck safety training, and once every three years. 0 And that the powered industrial trucks are repaired when malfunctioning. Trainer is responsible for the training, evaluation and certification of the operator Operators are responsible for the following: Are required to attend and pass the powered industrial truck safety training, once every three years. 0 Operating all powered industrial trucks in a safe manner consistent with safe rules of operation. 0 Inspecting powered industrial trucks at the beginning of each work shift and completing the appropriate inspection forms. In the event that a problem is observed while operating or during a pre-shift inspection, Hickman's Family Farms requires that the operator performs the following: 0 Immediately reports all equipment malfunctions and/or maintenance needs to their supervisors. 0 Completes and submits the Maintenance Request Form for Forklifts to their supervisors. Isolates and parks lift truck in safe place (removing the equipment from service), removes key, tags or notes problem on equipment. 0 If necessary, utilize ?xed jacks to support a semitrailer and prevent upending during the loading or unloading when the trailer is not coupled to a tractor (OSHA 29 CFR . 3 . Revised on 11-9-16 - Robert Phalen, Hickman?s Family Farms - Environmental Program Manager Training All employees who operate a power industrial truck shall be trained in the safe operation of the specific device they will operate. This training will be provided by a Hickman?s Family Farms certified trainer, or an outside qualified trainer. This training will include, but not be limited to: Classroom training on the specific powered industrial truck. A hands on test to prove competency. Instructions on pre-use inspection. Record keeping requirements. Training must conform to all OSHA requirements. All employees who receive training will be issued a personal wallet size license card stating the equipment he/she is authorized to operate, the signature of the trainer and expiration date of the license. The trainer will submit documentation to the employee?s supervisor verifying that the employee has successfully completed the training. Each employee will fill out and sign the following forms entitled: 0 Performance Test for Forklift Operators (See Appendix B) 0 Enforcement of the Use of Seat Belts on a Power Industrial Truck (See Appendix C) 0 Wheel Chock Policy (See Appendix D) These documents will be forwarded to the Department of Human Resources, which will maintain a copy of the records in the employee?s file. The employee?s supervisor will also maintain records of the training. Refresher training is required every three years, whenever a new or different type of lift truck is purchased, whenever the employee demonstrates a need for retraining, or when new personnel are hired. A copy of the manufacturer?s operating and maintenance manual shall be kept in a pouch or compartment on the lift truck so that the operator may easily consult the manual Equipment Security If the key is to be left in the device, the lift truck must be locked in a secure area in order to prevent unauthorized use. In the event that anyone unauthorized to use the lift truck operates the device, result will include a verbal written warning, a written reprimand, and or termination. Changes or Modifications to Original Equipment Design No changes or modi?cations to the original equipment design shall be made without the written permission of the manufacturer and the Hickman?s Compliance Department. This written permission from the manufacturer shall be kept on file in the equipment records. Personal Protective Equipment (PPE) The seat belt provided in the forklift operator?s compartment shall be worn at all times while operating the lift truck. The Hickman?s Family Compliance Department should be consulted on a case-by-case basis to determine if additional personal protective equipment or other safety equipment is required when operating the lift truck. - 4 - Revised on 11-9-16 - Robert Phalen, Hickman?s Family Farms - Environmental Program Manager - Maintenance of Equipment The maintenance manager shall ensure that all lift trucks are maintained in accordance with the manufacturer?s recommendations. All maintenance records shall be maintained by the maintenance department for as long as Hickman?s owns the equipment. The Pre-Shift Inspection Checklists shall be kept on file by the department using the lift truck for a minimum of one year. These records shall physically be maintained on site of the responsible department in an individual file for each unit easily accessed for inspection purposes. Any lift truck found not to be in proper operating conditions shall be immediately taken out of service and reported using the form Appendle of this policy to the appropriate department supervisor. The lift truck may be placed into service ONLY after the necessary repairs have been made, and the repairing mechanic has signed off on the repairs to allow it to be returned to service. The operator(s) shall perform pre-shift inspections on the lift trucks using the forms Appendixes E, of this policy. Such forms will be maintained by the responsible department. The operator(s) shall also conduct a work area inspection to ensure that the area in which the device will be operated is free of unsafe conditions, such as debris, floor or overhead obstructions, or the presence of unauthorized personnel. Contractors Department are responsible for conveying certain information to contractors who use Hickman?s Family Farms owned lift trucks to ensure compliance with this policy, OSHA Standards, and safety on Hickman?s properties. The following criteria shall be met when contractors operate Hickman?s lift devices: 1. Only employees of contractors who are approved to perform work on Hickman?s properties may be permitted to operate lift trucks. 2. The contracting company must be informed that only operators with OSHA compliant training may operate a lift truck on Hickman?s properties. 3. The Contractor shall be responsible for his employee?s personal protective equipment as necessary to be used by lift truck operating personnel. 4. The contractor's employee must at all times adhere to these policy regulations. References OSHA 29 CFR 1910. Subpart F, General Industry Standard OSHA 29 CFR 1910.178, Powered Industrial Trucks ANSI 92.2, Powered Industrial Trucks . 5 - Revised on 11-9-16 - Robert Phalen, Hickman?s Family Farms - Environmental Program Manager Appendix A 4? I ?s I ms . amlly Ear Maintenance Request Form for Forklifts Request priority type: Urgent Normal Date Reported: Time: Location: Fee/ta: Hora: Localidad.? Shift: 2"d Department: Turno (primero Segundo) Deparlamemo: Reported by: Employee/Inmate Reportado pors Nzimero de/ Type of Equipment: Make: Tipo de Equipo: Marca: Model: Serial Unit Mode/0: Ntimero de Serie: N12mer0 de [a Unidad: Is the Equipment Unsafe to Operate: *Yes or No El eqm?po no esta' seguro para operarlo (si 0 no): *If yes, Do Not Operate Equipment. Remove keys, and provide the keys to your immediate supervisor. Par 31' en caso de un a?rmativo, No opere [a unidad, Quitale [as Haves del encendido, desconecta [as baterias. enlre'gale [as llaves de la unidad a (u supen'isor. Explain the Malfunction of the Equipment in Detail: Explique detalladamente e! problema del eqm?po: Signed by: Date: Firma: echa: Attention Manager: If you have heavy equipment or an internal combustion forkli? (diesel, gasoline or LP gas) that needs maintenance. Please ?ll the Shop Service Request on the server ?les under shop and send it to David Goss. For Electric Forklifts or Pallet Jacks use this form and give it to any processing maintenance personnel or Richard Robinson. Maintenance Requested by: Title: Contact details: Phone #2 E-mail: Manager/Supervisor Signature: Date: JVIaintcnancc Department Request received by: Signature: Date: Comments: Out of Service: Yes No Work assigned to: On Date: Completed on: Signature: Out of Service Release Authorization: Name: Signature: Comments: Note: A?er completion, a copy of this Maintenance Request form must be retained for documentation for at least one year. Keep this copy ?le in the unit?s Pre-Shi? Inspection Checklist binder. Revised on 11-9-16 - Robert Phalen, Hickman?s Family Farms - Environmental Program Manager Appendix WW5 PERFORMANCE TEST FOR FORKLIFT OPERATORS Operator: Employee?s Dept: Evaluator: Date: Renewal Date: Type of Equipment: _Class I, _Class II, _Class _Class IV, _Class V, _Class VII Instructions: Please print clearly, and complete each blank. Mark each task as a pass or fail. If the item does not apply, mark the item as Once completed, place a copy of this form in the employee?s file, and retain the original in the Safety Health Coordinator?s Forklift Pro 'rum File. Task Pass Fail Shows familiarity with truck controls. Gave proper signals when turning. Slowed down at intersections. Sounded horn at intersections. Obeyed signs. Kept a clear view of direction. Turned corners correctly - was aware of rear end swing. Yielded to pedestrians. Drove under control and within proper traffic aisles. . Approached load properly. . Lifted load properly. . Maneuvered properly. . Traveled with load at proper height. . Lowered load smoothly/slowly. . Stops smoothly/completely. . Load balanced properly. . Forks under load all the way. . Wore all necessary Personal Protective Equipment (PPE), and restrain system (if applicable) Parked properly; out of the way, forks on the ?oor, in neutral, parking brake engaged, and power off. . Checked dock plates/ramps. . Drive backward when required. . Check load weights. . Handled on-site hazards properly. Understands how to properly change a propane cylinder. 25. Understands proper charging, ?lling and changing procedures for batteries. 26. Operated the forklift safely and cautiously. 27. Followed proper instructions for maintenance checked both at beginning and end. 28. POWERED ROUGH TERRAIN un mucx for cousrkucnon omv a Practiced general safe pre-operating procedures. Proficiency demonstrated in safe handling of construction, rough terrain lift truck. c. Safe travel habits exercised in operating of lift truck. d. Awareness of mechanical components and their functionhandle mechanical emergencies while operating equipment. Safe loading and unloading procedures. Practiced general safe post-operating procedures: a) Travel loaded, steering, stacking or placing loads, load leveling, and dropping loads h. Inspection of equipment to determine safe operating conditions at the beginning and at the end of shift. Overall Performance (circle one) Pass Fail Comments: Operator Signature: Evaluator Signature: Revised on 11-9-16 - Robert Phalen, chkman?s Family Farms - Environmental Program Manager Appendix ?t limits Enforcement of the Use of Seat Belts on Powered Industrial Trucks All Hickman?s Family Farms employees who operate a forklift/powered industrial truck during their employment must utilize the available restraint system or seatbelt on applicable forklifts or Powered Industrial Trucks as required by OSHA. OSHA Section of the OSH Act requires employers to protect employees from serious and recognized hazards. Recognition of the hazard of powered industrial truck tip over and the need for the use of an operator restraint system is evidenced by certain requirements in the more current versions of ANSI BS6. 1. In addition, seat belts have been supplied by many manufacturers of counterbalanced, center control, high lift trucks which have a sit-down nonelevating operator position. Also, some manufacturers have instituted retro?t programs for the installation of operator restraint systems to older powered industrial trucks. OSHA's enforcement policy relative to the use of seat belts on powered industrial trucks is that employers are obligated to require operators of powered industrial trucks which are equipped with operator restraint devices or seat belts to use the devices. OSHA should enforce the use of such devices under Section of the OSH Act. After consultation with the Regional Solicitor, OSHA may also cite Section of the OSH Act if an employer has not taken advantage of a manufacturer operator restraint system or seat belt retro?t program. Section 5(b) of the OSH Act states ?each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct?. I, have read the above requirements and understand that 1 am required to utilize the available restraint system or seatbelt on applicable forklifts/powered industrial trucks as required by OSHA and the Hickman ?s Family Farms. 1 also understand that failure to do this could result in serious harm or death to me, so negligence of this responsibility may result in disciplinary action. Employee Signature: Date: Employee?s Number: Hickman?s Family Farms? Location: Instructor Name: Signature: Revised on ll-9-l6 - Robert Phalen, Hickman?s Family Fars - Environmental Program Manager Appendix amily farms - Wheel Chock Policy and Procedure Policy It is the policy of the Hickman's Family Farms that all highway and powered industrial trucks shall have the brakes set and wheel chocks placed under the rear wheels of trucks or trailers that are backed into any Hickman?s loading docks. In compliance with the OSHA standard Powered Industrial Trucks 29 CFR 1910.178. Procedure 1. Any highway trucks that are backed into any Hickman's loading docks are to have the brakes set and the wheel chocks placed under the rear tires prior to loading or unloading, by the truck driver. 2. The forklift/pallet jack operator shall be responsible to verify that the truck?s brakes are set, and 3. The wheel chocks are under the rear tires to prevent the movement of the truck or trailer while loading or unloading. 4. Also, the forklift/pallet jack operator will educate the owner operator and drivers from other companies of Hickman's wheel chock policy. I . have read and understand the above policy and procedure. Not following this policy and procedure could result in a verbal written warning, written reprimand, or termination. Employee Signature: Employee ti: Date: Instructor?s Name: Signature: La Poliza Procedimiento del Uso de la Cuiia Poliza Es Ia poliza de [05 granjas de la familia Hickman que todos los camiones de carga camiones industriales motorizados los frenos fijos la cu?a de la rueda colocada debajo del neumdtico posterior de los camiones remolques que se acoplan hacia atrds en los muelles de cargas. De acuerdo con el de la OSHA 29 CFR 1910.1 78. Procedimiento 1. Cualquier cami?n de carga que se acople hacia atrcis en los muelles de carga de lafami/ia Hickman que tener los frenos fijos la cu?a de la rueda colocada debajo del neumdtico de la parte posterior antes de cargar descargar, por el chofer del camidn. 2. El operador del montacargas sera responsable de verificar que los frenos del camidn est?n fijos, 3. la cu?a de la rueda estdn debajo del neumatico posterior para prevenir el movimiento del camion remolque mientras que se carga descarga. 4. Tambi?n, el operador del montacargas Ies explicara Ia poliza el procedimiento del uso de la cu?a de la rueda a/ due?o de cami?n a los ch?feres de otras compa?fas. Yo, he ler?do entendido Ia po/iza el procedimiento antedicho. AI no seguir esta poliza procedimiento pod/an dar lugar a una advertencia verbal escrita, la terminacion del emp/eo. Firma: No. de Empleo: Fecha: Instructor?s Name: Signature: Revised on I l-9-16 - Robcrl Phalcn. Hickman?s Family Fars - Environmental Program Manager Appendix ?9 ?st Electric Pallet Truck Pre-Shift Inspection Checklist Check one: Electric Rider Pallet Jack Electric Walking Pallet Jack Make: Model: Serial Truck #2 Marca: Mode/o: Nzimero dc Scrle: Numero de la Unidad: Week beginning Comienso de la Semana: Li? Trucks must be inspected prior to use before each shift and immediately a?cr service, maintenance or repair. This checklist is to be completed to document the inspection. Checklist must be kept on ?le at the department using the Lift Truck for a minimum of one year. Note: Certain items are not included on some models. Check all items applicable to unit noted above. Satisfactory. for any defective item. - Not Applicable Date: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY VISUAL INSPECTION 2m: lnspeccion Visual Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Main Switch Key Switch Spec. Plate Location Directional/Speed Control Emergency Reverse Control Lift/Lower Button/ Lever Horn Button (Claxon) Battery Forks Wheels SAFETY NOTICE: If you find any discrepancies during your visual inspection, 00 NOT operate Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately OPERATIONAL INSPECTION Hour Meter Reading Listen for Unusual Noise Lifting Control Forward Driving: Accelerator Steering Braking Reverse Driving Accelerator Steering Braking Backup Alarm (Optional) Horn Gauges Oil Spots on Floor SAFETY NOTICE: If you find any discrepancies during start-up, SHUT-OFF and DO NOT operate the Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately Operator's Initials: Supervisor?s Initials: CAUTION: This is not a complete list of all items which may require attention. Operators are responsible for ensuring that the lift truck is in proper working condition in accordance with the manufacturer?s speci?cations. Revised on 11-9-16 - Robert Phalen, Hickman's Family Farms - Environmental Program Manager Appendix ?9 ?"158 Electric Forklift Truck Pre-Shift Inspection Checklist Check one: Electric Sit-down Forklift Electric Stand-Up Forklift Electric Reach Forklift Make: Model: Serial #1 Truck Marco: Modelo.? Nu?mero dc Series Niimero de [a Unidad: Week beginning Comiensa de la Semana: Li? Trucks must be inspected prior to use before each shift and immediately after service, maintenance or repair. This checklist is to be completed to document the inspection. Checklist must be kept on ?le at the department using the Lift Truck for a minimum ol?onc year. Note: Certain items are not included on some models. Check all items applicable to unit noted above. 8 Satisfactory. for any defective item. MA Not Applicable Date: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY VISUAL INSPECTION 1? 1? 1St 1? 1? 2'?1 2nd 2nd Key Switch Spec. Plate Location Overhead Guard Hydraulic Cylinders Mast Assembly Lift Chains and Rollers Forks Wheels Battery Cables Hydraulic Fluid SAFETY NOTICE: If you find any discrepancies during your visual inspection, 00 NOT operate Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately OPERATIONAL INSPECTION cwecmemesg 0 Hour Meter Read"; 0 Battery Discharge Indicator Listen for Unusual Noise Forward/Reverse Driving: Accelerator 0 Steering Braking 0 Backup Alarm 0 Rotary Light Test the Control Lever . Load-Handling Attachments Front, tail Brake Lights Horn Seat Belt Safety Switch (Stand-Ups) Oil Spots on Floor SAFETY NOTICE: If you find any discrepancies during start-up, SHUT-OFF and DO NOT operate the Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately Operator's Initials: Supervisor?s Initials: CAUTION: This is not a complete list of all items which may require attention. Operators are responsible for ensuring that the lift truck is in proper working condition in accordance with the manufacturer?s speci?cations. Revised on 11-9-16 - Robert Phalen, Hickman?s Family Farms Environmental Program Manager Appendix a Imqnni ?it?s Internal Combustion Forklift Pre-Shift Inspection Checklist Internal Combustion Lift Truck: Diesel Gasoline LP Gas (Propane) Make: Model: Serial Truck Mai-ca: Mode/o: Nu'mcro de Serie: Nzimero de la Unidad: Week beginning omienso de la Semana: Lift Trucks must be inspected prior to use before each shift and immediately a?er service, maintenance or repair. This checklist is to be completed to document the inspection. Checklist must he kept on ?le at the department using the Lift Truck for a minimum of one year. Note: Certain items are not included on some models. Check all items applicable to unit noted above. Satisfactory. for any defective item, MA Not Applicable Date: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY VISUAL INSPECTION lnspeccion Visual Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Overhead Guard Hydraulic Cylinders Hoses Mast Assembly Lift Chains and Rollers Load Backrest and Forks Tires LP Gas Tank Assembly Fuel System Engine Oil Level Belts Hydraulic Fluid Level Engine Coolant Level Battery Seat Belt Data Plate Warning Labels Leaks Operator?s Compartment Lift Truck Damage SAFETY NOTICE: If you find any discrepancies during your visual inspection, 00 NOT operate Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately OPERATIONAL INSPECTION - HourMeterReading 0 Oil Pressure Indicator Ammeter Indicator - Water Temperature - Fuel (if Diesel or Gas.) Drive Control (Forwa rd/Reverse) Steering Operation Braking Parking Brakes Backup Alarm, Rotary Lights, and Horn Load-Handling Attachments Front, tail Brake Lights Listen for Unusual Noise SAFETY NOTICE: if you find any discrepancies during start-up, SHUT-OFF and DO NOT operate the Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately Operator's Initials: Supervisor?s Initials: CAUTION: This is not a complete?list of all items which may require attention. Operators are responsible for ensuring that the lift truck is in proper working condition in accordance with the manufacturer?s specifications. Revised on 11-9-16 - Robert Phalen, Hickman's Family Farms - Environmental Program Manager Forklift Quiz FORKLIFT BASICS 1. Because forklifts steer from the rear, they: A. B. C. D. Can?t turn as tight a circle as a car Are much easier to steer than a car Can turn a much tighter circle than a car Don?t have power steering 2. Forklifts often weigh: A. B. C. D. Less than half as much as a car Two to three times more than a car Ten times more than a car Twenty times more than a car 3. The primary source of information for how much a forklift can carry can be found: A. B. C. D. On the forklift?s nameplate On the inspection checklist Under the forks On the overhead guard 4. A forklift?s rated load capacity is partially based on: A. B. C. D. Weight of the operator Forklift speed and stability triangle Line of action and center of gravity Load center and lifting height 5. Center of gravity is: A. B. C. D. The same as the stability triangle Always 24 inches The point within an object where all the weight is concentrated The three points of suspension 6. Which of these is NOT a common forklift control: A. B. C. D. Acceleration pedal Reverse directional control Scale control Lift control INSPECTING YOUR FORKLIFT 7. When inspecting your forklift, you should always: 9.0.03.) Follow the inspection guidelines from the forklift manufacturer and your employer Start up the unit and give it a test drive before beginning the inspection Assume that if something was working the previous day, it will be working today as well Make sure that the manufacturer?s recommended maintenance measures have been completed 8. Which of these do NOT need to be examined as part of the pre-operatlonal inspection: .39 9.0.5? Tires Cables Forks Controls Forklift Quiz 9. Three points of contact refer to: A. The stability triangle B. Mounting and dismounting C. Inspecting spark plugs D. Who to call in an emergency 10. Leaks under the forklift could indicate a problem with: A. The coffee holder B. The hydraulics C. The brake shoes D. The emergency brake PICKING UP A LOAD 11. In a tipover, you should hang on to the steering wheel and lean away from the direction you?re falling if you?re driving: A. A sit-down, counterbalanced forklift B. A stand-up, counterbalanced forklift C. A powered hand truck D. An order picker 12. If the load is an uneven shape, you should before picking it up: A. Set the forks closer together B. Remove the unit?s overhead guard C. Beware of any special stacking requirements D. Weigh the load 13. The reason you should set the forks as far apart as possible under the load is to: A. Reduce the center of gravity B. Balance the weight to one side C. Evenly distribute the weight D. Maximize the load capacity TRAVELING WITH A LOAD 14. When traveling with or without a load, the forks should always be: A. 4 inches off the ground B. 8 inches off the ground C. 12 inches off the ground D. At the lowest safe height 15. If you have a large load that blocks your view and you can't split the load, you should: A. Travel in reverse, use a spotter, or both B. Have a passenger stand on your forklift and direct you C. Use two forklifts D. Approach the load from the side 16. When turning a corner, the rear of the forklift will: Swing in a complete circle Swing wide Swing narrow Swing low 9.0.00.) Forklift Quiz 17. When driving with a load on an incline, keep the load: A. At the end of the forks B. In the direction of travel C. On the uphill side D. On the downhill side 18. When traveling with other forklifts, keep a distance of forklift in front of and behind you19. When a person is standing in front of a bench, wall or ?xed object, you should: A. Approach them head on B. Travel in reverse C. Approach parallel D. Use a spotter PLACING A LOAD 20. When placing a load, make sure the surface where the load is to be placed is: A. Flat, sturdy and free from damage B. Made of metal C. At least 60 inches deep D. At least 6 inches off the ground 21. Never place loads on top of loads. A. Square, round B. Light, heavy C. Slip sheet, pallet D. Heavy, light PARKING A FORKLIFT 22. Never park a forklift: A. Without letting your supervisor know where it will be B. In front of walkways, stairs or ?re exits C. In front of a loading dock D. Before your shift is over 23. When you leave your forklift, you need to shut the engine off ifconfined space C. You will be more than 25 feet away or you won?t be able to see the vehicle D. You will be more than 10 feet away or you won?t be able to see the vehicle WORKING IN A TRUCK, TRAILER OR RAILCAR 24. Before you load a truck, trailer or rail car, you should: A. Drive into it to test how sturdy the floor is B. Talk to the driver or engineer; if they say it?s good to go, start loading C. Put on specialized personal protective equipment made for loading trailers D. Inspect the interior to make sure it is clean and safe Forklift Quiz 25. You may need a to bridge the gap between dock and trailer. A. Pallet jack B. Dock plate C. Slip sheet D. Hand truck 26. Trailer creep is more of a problem with: A. Trailers left at the dock without a tractor B. Trailers that still have the tractor attached C. Trailers that are secured with a restraining system D. Trailers that are pointing up hill 27. Don't operate forklifts inside vehicles or other enclosed spaces without: A. Posting a sign B. A spotter C. Proper ventilation D. Telling a co-worker where you will be CHARGING AND REFUELING 28. If a battery is being charged ON the forklift, you should: A. Stand clear as the battery is moved in and out of position B. Uncover the battery compartment to prevent heat or oxygen build up C. Use a properly maintained hoist D. Let the vehicle run until the battery is fully discharged 29. For gasoline or diesel forklifts, it?s important to make sure: A. You have the proper fuel B. The battery is secure C. There are no leaks in the valve D. The locating pin is engaged MAINTENANCE AND MODIFICATIONS 30. If your forklift has any modifications that might affect safe operation or capacity, those changes must be: Approved by your supervisor Made within 6 months ofthe vehicle being put into service Made within 12 months of the vehicle being put into service Printed on the unit?s nameplate and in the operating instructions after receiving the manufacturer?s approval .0093.) lClil?lAN? 0?11?dest Class VII Forklift Safety Policy Manual OSHA 29 CFR 1910.178 Powered Industrial Trucks Table of Contents Introduction Scope Policy Definitions 5"?ri Responsibilities a. Supervisors b. Trainer Operators Training Equipment Security regexp Changes or Modi?cations to Original Equigment Design g. Personal Protective Equipment h. Maintenance of Equipment i. Contractors References Hickman?s Family Farms Class VII Equipment 9?99? Occupational Safety Health Administration Class VI I: Rough Terrain Forkli? Trucks 9. Additional Diagrams 10 Most Common Violations Cited on Industrial Trucks Appendix A- Enforcement of the Use of Seat Belts on a Power Industrial Truck Appendix - Wheel Chock Policy Procedure Appendix - Rough Terrain Telehandler Forklift Pre-Shi? Inspection Checklist Appendix - Internal Combustion Forkli?? Pre-Shi'? Inspection Checklist Appendix Maintenance Request Form for Forklifts Appendix Forklift Workshop for Construction Quiz Appendix - Performance Test for Forkli? Operators Appendix A?idavit of Training Revised on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager Introduction The purpose of this program is to de?ne the requirements for safely operating a powered industrial truck on Hickman?s Family Farms facilities. All employees and contract personnel shall operate these devices in accordance with this policy. Scope This policy shall cover all powered industrial trucks used on the Hickman?s facilities and all employees, and contractors under the direct supervision of a designated Hickman?s employee. Policy All departments using powered industrial trucks shall ensure that all operators are trained, evaluated and certified in the safe operation of a powered industrial truck in accordance with this policy, the manufacturer?s recommendations, OSHA 29 CFR 1910.178, ANSI 92.2, and that these devices are maintained in accordance with the manufacturer?s recommendations and sound safety practices. Contractors not under direct supervision of a Hickman?s Family Farms employee are responsible for the inspection of their own equipment and the training and certi?cation of their own operators in conformance with this policy and OSHA 29 CFR 1910.178 and ANSI 92.2. Proof of conformance shall be required. De?nitions 0 Powered Industrial Trucks/Lift truck: is an electric motor or internal combustion engine forklift, electric palletjack. Authorized Operator: An employee who has satisfactorily completed both classroom and operation training on material-handling equipment at the company?s facilities. Responsibilities Supervisors are responsible for the following: 0 Ensuring employees attend and pass the powered industrial truck safety training, and once every three years. 0 And that the powered industrial trucks are repaired when malfunctioning. Trainer is responsible for the training, evaluation and certi?cation of the operator Operators are responsible for the following: Are required to attend and pass the powered industrial truck safety training, once every three years. 0 Operating all powered industrial trucks in a safe manner consistent with safe rules of operation. - Inspecting powered industrial trucks at the beginning of each work shift and completing the appropriate inspection forms. In the event that a problem is observed while operating or during a pre-shift inspection, Hickman?s Family Farms requires that the operator performs the following: 0 Immediately reports all equipment malfunctions and/or maintenance needs to their supervisors. 0 Completes and submits the Maintenance Request Form for Forklifts to their supervisors. - Isolates and parks lift truck in safe place (removing the equipment from service), removes key, tags or notes problem on equipment. 0 If necessary, utilize fixed jacks to support a semitrailer and prevent upcnding during the loading or unloading when the trailer is not coupled to a tractor (OSHA 29 CFR Revised on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager Training All employees who operate a power industrial truck shall be trained in the safe operation of the speci?c device they will operate. This training will be provided by a Hickman?s Family Farms certi?ed trainer, or an outside quali?ed trainer. This training will include, but not be limited to: 0 Classroom training on the speci?c powered industrial truck. 0 A hands-on test to prove competency. 0 Instructions on pre-use inspection. 0 Record keeping requirements. Training must conform to all OSHA requirements. All employees who receive training will be issued a personal wallet size license card stating the equipment he/she is authorized to operate, the signature of the trainer and expiration date of the license. The trainer will submit documentation to the employee?s supervisor verifying that the employee has successfully completed the training. Each employee will ?ll out and sign the following forms entitled: 0 Performance Test for orkli? Operators (See Appendix F) 0 Enforcement of the Use of Seat Belts on a Power Industrial Truck (See Appendix A) 0 Wheel Chock Policy (See Appendix B) These documents will be forwarded to the Department of Human Resources, which will maintain a copy of the records in the employee?s ?le. The employee?s supervisor will also maintain records ofthe training. Refresher training is required every three years, whenever a new or different type of lift truck is purchased, whenever the employee demonstrates a need for retraining, or when new personnel are hired. A copy of the manufacturer?s operating and maintenance manual shall be kept in a pouch or compartment on the lift truck so that the operator may easily consult the manual Equipment Security If the key is to be left in the device, the lift truck must be locked in a secure area in order to prevent unauthorized use. In the event that anyone unauthorized to use the lift truck operates the device, result will include a verbal written warning, a written reprimand, and or termination. Changes or Modi?cations to Original Equipment Design No changes or modi?cations to the original equipment design shall be made without the written permission of the manufacturer and the I-liekman?s Compliance Department. This written permission from the manufacturer shall be kept on ?le in the equipment records. Personal Protective Equipment (PPE) The seat belt provided in the forklift operator?s compartment shall be worn at all times while operating the lift truck. The Hickman?s Family Compliance Department should be consulted on a case-by-case basis to determine if additional personal protective equipment or other safety equipment is required when operating the lift truck. Revised on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager Maintenance of Equipment The maintenance manager shall ensure that all lift trucks are maintained in accordance with the manufacturer?s recommendations. All maintenance records shall be maintained by the maintenance department for as long as Hickman?s owns the equipment. The Pre-Shift Inspection Checklists shall be kept on ?le by the department using the lift truck for a minimum ofone year. These records shall physically be maintained on site ofthe responsible department in an individual file for each unit easily accessed for inspection purposes. Any lift truck found not to be in proper operating conditions shall be immediately taken out of service and reported using the form Appendix of this policy to the appropriate department supervisor. The lift truck may be placed into service ONLY after the necessary repairs have been made, and the repairing mechanic has signed off on the repairs to allow it to be returned to service. The operator(s) shall perform pre-shi? inspections on the lift trucks using the forms Appendixes of this policy. Such forms will be maintained by the responsible department. The operator(s) shall also conduct a work area inspection to ensure that the area in which the device will be operated is free of unsafe conditions, such as debris, ?oor or overhead obstructions, or the presence of unauthorized personnel. Contractors Department are responsible for conveying certain information to contractors who use Hickman?s Family Farms owned lift trucks to ensure compliance with this policy, OSHA Standards, and safety on Hickman?s properties. The following criteria shall be met when contractors operate Hiekman?s lift devices: 1. Only employees of contractors who are approved to perform work on Hickman?s properties may be permitted to operate lift trucks. 2. The contracting company must be informed that only operators with OSHA compliant training may operate a lift truck on Hickman?s properties. 3. The Contractor shall be responsible for his employee?s personal protective equipment as necessary to be used by lift truck operating personnel. 4. The contractor?s employee must at all times adhere to these policy regulations. References OSHA 29 CFR 1910. Subpart F, General Industry Standard OSHA 29 CFR l9]0.l78, Powered Industrial Trucks ANSI 92.2, Powered Industrial Trucks Revised on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager Hickman?s Family'Far?ms Facilities Class Eguipmenl Rough Terrain Teichandler Frond End Loader Bobcat Loader (Skid Steer) Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms - Env ronmental Program Manager OSHA Rough Terrain Forklifts Cass VII: Rood! Terrain Forklift Trude anbo safelyopenbed onmyconceivabietype ofberrain. ?there are three basic hip-5 of rough terrain forklift: Cass VII - Rough terrain forklift is a generk term used to dacribe forklifts typically intended for use on unimproved natural terrain and cisturbed terrain oonstuction sits. However, the term ?rough terrain? does not impiy that the forklift Thisisan exarnpleofa used primariiy outdoors. misisan exampleofavehide emippedw?rabelosoopingboom which onablsitto piacenuntofaload. ?isisan exanpleofa portable self-propelled road: terrain foridi??'iatistypicaily buddtnier mounted foddi?sare Wterrain forklifts. Tmcirlaler mama. Class 7 Rough Terrain Truck 'J'l?fi rut-?w r? or Wind. Diver: i -.. ?1 rev-l (moms 111?? I t? 13.1mm Mae! Hour)? Iona." Roam I. .e .nu-n? on:- Revised on 1-13-18~ Robert Phalen, Hickman's Family Farms - Environmental Program Manager Additional Diagrams Rough Terrain Telchandler Diagram TIT AIM . . Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager Most Common Violations Cited on Powered Industrial Trucks 1. 1910.178 Safe Operations 2. 1910.178 Evaluation of operator?s performance 3. 1910.] Certi?cation 4. 1910.173 Truck repair and maintenance 5. 191 0.1 Training shall consist of a combination of formal instruction, practical training and evaluation of the operator?s performance 58 E) 6 '7 '7 commune US. Postal Service mcxnon: Sa ndston, VA (OSHA Region 3) wsuulss 1798: Mall sorting and delivery mucosa: Worker complaint avenn OSHA cited the U5. Postal Service eight times during fiscal year 2016. Penalties ranged from 544.000 to $120,000. For the largest penalty. investigators at a process? ing and distribution center in Sandston. VA, found that USPS allowed workers to use powered Industrial equipment that was not Inspected or examinod for defects after each shift; permitted workers to operate powered Industrial vehicles without wearing a seat belt; exposed workers. to struck-by or caught-between hazards by allowing wo rk- ers to operate powered industrial equip- m-ent in aisles clearly ma rked for wheeled mail carts; and other problems. MAJOR cwxnous: Four repeat citations and one other-than serious violations at the Virginia distribution site. ?Every year. thousands of workers are injured - some fora ?y while oporottmg powered indusrnaf equipment. It is every employo": responsibility to provide its employees with sale and healthful workplaces. Prompt and effective corrective action must be taken.? STAN DU AREA DIRECTOR 1N NORFOLK, VA safetyandhea mag 32 ine.com Revised on 1-13-18- Robert Phalen, Hickman's Famlly Farms - Environmental Program Manager Appendix A Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager -10- -11- ll'ml?s amily Enforcement of the Use of Seat Belts on Powered Industrial Trucks All Hickman?s Family Farms employees who operate a forklift/powered industrial truck during their employment must utilize the available restraint system or seatbelt on applicable forkli?s or Powered Industrial Trucks as required by OSHA. OSHA Section of the OSH Act requires employers to protect employees from serious and recognized hazards. Recognition of the hazard of powered industrial truck tip over and the need for the use of an operator restraint system is evidenced by certain requirements in the more current versions of ANSI 356.]. In addition, seat belts have been supplied by many manufacturers of counterbalanced, center control, high lift trucks which have a sit-down non- elevating operator position. Also, some manufacturers have instituted retro?t programs for the installation of operator restraint systems to older powered industrial trucks. OSHA's enforcement policy relative to the use of seat belts on powered industrial trucks is that employers are obligated to require operators of powered industrial trucks which are equipped with operator restraint devices or seat belts to use the devices. OSHA should enforce the use of such devices under Section of the OSH Act. After consultation with the Regional Solicitor, OSHA may also cite Section of the OSH Act if an employer has not taken advantage of a manufacturer operator restraint system or seat belt retrofit program. Section 5(b) of the OSH Act states ?each emgloyee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct?. 1, have read the above requirements and understand that 1 am required to utilize the available restraint system or seatbelt 0n applicable forklifts/powered industrial trucks as required by OSHA and the Hickman ?3 Family Farms. 1 also understand that failure to do this could result in serious harm or death to me, so negligence of this responsibility may result in disciplinary action. Employee Signature: Date: Employee?s Number: Hickman?s Family Farms? Location: Instructor Name: Signature: Revlsed on 1-13-18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager Apgendix Revused on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager -12- 13 <3 ?lint News A It is the policy of the Hickman?s Family Farms that all highway trucks shall have the brakes set and wheel chocks Wheel Chock Policy and Procedure Policy placed under the rear wheels of trucks or trailers that are backed into any Hickman?s loading docks. In compliance with the OSHA standard Powered Industrial Trucks 29 CFR 1910.178. Procedure 1. Any highway trucks that are backed into any Hickman?s loading docks are to have the brakes set and the wheel chocks placed under the rear tires prior to loading or unloading, by the truck driver. 2. The forklift/pallet jack operator shall be responsible to verify that the truck?s brakes are set, and 3. The wheel chocks are under the rear tires to prevent the movement of the truck or trailer while loading or unloading. 4. Also, the forklift/palletjack operator will educate the owner operator and drivers from other companies of Hickman?s wheel chock policy. I have read and understand the above policy and procedure. Not following this policy and procedure could result in a verbal written warning, written reprimand, or termination. Employee Signature: Employee Date: instructor?s Name: Signature: Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager -14- Appendix Revised on 1-13-18? Robert Phalen. chkman?s Famlly Farms - Environmental Program Manager -15- ?laws ?3 Rough Terrain Telehandler Forklift Pre-Shift Inspection Checklist Make: Model: Serial ll: Unitil: 7 . Marco: Mode/a: :Vtintero dc Seric: Nrimero de la Umdad.? Week beginning: omienzo de la Semana.? Lift Trucks must be inspected prior to use before each shill and immediately alter service, maintenance or repair This checklist is to be completed to document the inspection Checklist must be kept on ?le at the department using the Lift Truck for a minimum ol?onc year. Note: Certain items are not included on some models. Check all items applicable to unit General vehicle condition Clear away all collected debris. check for general damaged, loose, missing, broken parts and leaks - Satisfactory. for any defective itc NA Not Applicable Date: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY VISUAL INSPECTION 1st 2nd 1st 2nd 1st 2nd 111 2nd 2nd ls: 2nd 131 2nd Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Walk-around inspection (warning decals, capacity plate, etc.) Forks/locking pins, carriage, mast or boom Wheels, tires 8t lug nuts (condition/pressure) Engine (check all level for leaks) Transmission (check all level for leaks) Engine belts (checkfor adjustmen t/wear) Air cleaner (check indicator) Radiator (check coolant level for leaks) Hydraulic tank (check oil level for leaks) Fuel tank (secure, valve open fuel level) Overhead guard/ROPS (no damage) Seat Belt (no damage) SAFETY NOTICE: if you ?nd any discrepancies during your visual inspection, DO NOT operate Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately OPERATIONAL INSPECTION Hour Meter Reading Engine (does it sound normal?) Instruments (check for normal readings) Exhaust system (check for leaks excessive smoke) Wipers lights (spotlights, turn signals, etc.) Horn backup alarm (strobe lights) All hydraulic controls (normal operation-lift tilt, etc. Transmission clutch (direction speed range) Brakes (parking service brakes) Steering (all modes) SAFETY if you ?nd any discrepancies during start-up, SHUT-OFF and DO NOT operate the Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately Operator?s Initials: Stmervisor's Initials: CAUTION: This is not a complete list of all items which may require attention. Operators are responsible for ensuring that the lift truck is in proper working condition in accordance with the ma nufacturer?s specifications. Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms Environmental Program Manager Apgendix Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager -16- -17- ?3 an?? Internal Combustion Forklift Pre-Shift Inspection Checklist Internal Combustion Lift Truck: Diesel Gasoline LP Gas (Propane) Make: Model: Serial . Truck Marco: Mode/0' Niiniero de .S'erie: Mime/?0 do [a Unidad: Week beginning omienso de la Semana: Lift Trucks must be inspected prior to use before each shill and immediately after service, maintenance or repair. This checklist is to be completed to document the inspection. Checklist must be kept on ?le at the department using the Lift Truck for a minimum ofone year. Note: Certain items are not included on some models. Check all items applicable to unit noted above. S: ?attery. for any defective item - Not Applicable Date: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY VISUAL INSPECTION ,nspeccion WSW, Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Shift Overhead Guard Hydraulic Cylinders Hoses Mast Assembly Lift Chains and Rollers Load Backrest and Forks Tires LP Gas Tank Assembly Fuel System Engine Oil Level 8t Belts Hydraulic Fluid Level Engine Coolant Level Battery Seat Belt Data Plate Warning Labels Lea ks Operator's Compartment Lift Truck Damage SAFETY NOTICE: If you find any discrepancies during your visual Inspection, DO NOT operate Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately OPERATIONAL INSPECTION Check the Gauge52__ 0 Hour Meter Reading 0 Oil Pressure Indicator . Ammeter Indicator 0 Water Temperature 0 Fuel (if Diesel or Gas.) Drive Control (Forward/Reverse) Steering Operation Braking Parking Brakes Backup Alarm, Rotary Lights, and Horn Load-Handling Attachments Front, tail Brake Lights Listen for Unusual Noise SAFETY NOTICE: If you find any discrepancies during start-up, SHUT-OFF and DO NOT operate the Lift Truck. Any discrepancies found should be made on the Maintenance Request Form in detail and handed to the supervisor immediately Operator?s Initials: Supervisor?s Initials: CAUTION: This is not a complete list of all items which may require attention. Operators are responsible for ensuring that the lift truck is in proper working condition in accordance with the manufacturer?s specifications. Revised on 1-13-18? Robert Phalen, Hickman?s Family Farms - Environmental Program Manager -13- Agpendix Revised on 1-13-18? Robert Phalen, chkman?s Family Farms - Environmental Program Manager -19- is ?tting 0.. M_aintenance Request Form for Forklifts? Requestnriority Normal . Date Repurtcd:_ Timc:_ Location: licclm: Ham: Lomhdad Shift: 1"l Department: . 74mg (primal 0 a Segundo,- Reported by: . Employee/Inmate it: Roporlacln pal. Niinmro do! Type ol?l?quipmcut: Make: Tipo dc liqmpo: Mat-ca" Model: Serial fl: . .. . . Unit it: . Modclo.? Naimcro dc Svrie: N?mem (It In Unit/ad: is the Equipment Unsafe to Operate: "ch or No cqm?po no and rcgura para opemrlo no): ?lf yes, Do Not Operate Equipment. Remove keys, and provide the keys to your immediate supervisor. Par mm do my a?tmativo. No opera to unidad. inlalc [as [lavas dc! desconuclu lax hater-ins. cnlr?galr to: Have: dc Ia WIin a In alm'lsar. Explain the Malfunction of the Equipment in Detail: [ixplt'quc detalladammle el problema def equipa: Signed by: Date: l'i'rma.? calla.- Attention Manager: if you have heavy equipment or an internal combustion forklift (diesel, gasoline orLP gas) that needs maintenance. Please till the Shop Service Request on the server 0 ?les under shop and send it to David 0055. For Electric Forklifts or Pallet Jacks use this form it to any min; maintenance personnel or Richard Robinson. Maintenance Requested by: Title: Contact details: Phone E-mail: Manager/Supervisor Signature: Date: Request received by: Signature: Date: Comments: . .. Out of Service: Yes No Completed on: Signature: Out of Service Release Authorization: Name: Signature: Comments: - Work assigned to: On Date: Note: After completion. in copy of this Maintenance Request form must be retained for documentation for at least one year. Keep this copy ?le in the unit?s Pie-Shift Inspection Checklist binder. Revised on 1-13-18- Robert Phalen, Family Farms - Environmental Program Manager -20- Appendix Revised on 1-13-18- Robert Phalen, chkman?s Famlly Farms - Environmental Program Manager 01FORKLIFT WORKSHOP FOR CONSTRUCTION QUIZ FORKLIFT BASICS Only a trained authorized operator can drive a forklift. A: True B. False Rough terrain forklifts that fall under regulation l926.602(c) include: A. Telescopic Handlers B. Scissor lifts C. Graders D. Hoists Rough terrain forklifts are different than automobiles because they: A. Can make sharp turns sudden stops more easily B. Have a wider turning radius C. Usually weigh less D. Steer with the rear wheels The center of gravity is: A. Always at the center of the load B. The point within an object where all weight is distributed equally C. Greatest at the pivot point D. Always 24 inches The combined center of gravity is: A. Affects the stability of the forklift B. Can cause a tip over if mismanaged C. Consists of the forklift?s center of gravity the load?s center of gravity D. All of the above If the combined center of gravity moves past the front axle: A The load will become unbalanced B. A back or side tip over may occur C. A front tip over will occur The rear wheels may be li?ed off the ground All of the above FORKLIFT INSPEQ I IQN MAINTENANCE Operators should read the operator?s manual because: A. It provides forklift speci?c information you cannot ?nd elsewhere B. It provides manufacturer?s recommendations individual load capacity information C. All rough terrain forklifts ae not created equal D. All ofthe above Information about the load capacity of the forklift can be found: A. In your company policy B. On the MSDS SDS C. On the identi?cation plate and in the operator?s manual D. All ofthe above Pre-operation inspections include: A. Electrical systems B. Hydraulics C. Physical condition of the forklift 10All ofthe above Operators should inspect their vehicles: A. Before every shift B. Once every week C. Once every three years D. Before every performance evaluation Three points of contact refer to: A. The stability triangle B. Mounting and dismounting the forklift C. Key inspection points D. Key emergency contacts Who must approve modifications to the forklift that affect capacity and safe operation: A. A supervisor B. Plant safety manager C. The forklift manufacturer D. OSHA QPERATING THE FORKLIFT Common hazards on the jobsite include: A. Pedestrians B. Overhead power lines C. Uneven grade and changing surface conditions D. All of the above Pedestrians are allowed to: A. Stand under raised forks, if they are helping the driver B. Take a ride on the forklift C. be lifted on the forks id they are standing on a strong pallet D. None of the above If the forklift that you are operating begins to tip, the safest thing you can do is to jump off of it: A. True B. False Rear wheel steering: A. Gives rough terrain forkli?s good traction in snow B. Makes the front end of a forklift swing wide during a turn C. Makes the back end of a forkli? swing wide during a turn D. Can cause the back tires to wear out quicker than the front tires Rough terrain forklifts typically have: A. Multiple booms B. Masts instead of booms C. Automobile like handling D. Multiple steering modes When navigating an incline: A. Have a spotter guide you no matter what Tilt the carriage back and raise itjust enough to clear the ground C. Raise the forks a minimum of six feet from the ground Approach the slope at an angle 22 19You should get under a raised load: A. To assess the weight ofthe load B. To check for fallen debris C. To check the landing zone D. Never Only manufacturer approves safety platforms can be used to lift people: A. True B. False Before picking up a load, you should: A. Tilt the forks back B. Remove the load backrest extension C. Back out slowly until you have cleared the rack and any other obstruction D. Know that the load is within the capacity limits of your unit. If a load obstructs your view, you should: A. Drive with extreme care B. Drive in reverse if appropriate C. Use a spotter, and company approved hand signals D. All of the above A good rule of thumb is to: A. Drive with the forks raised at a slow speed B. Keep the load close to the forklift and as low to the ground as possible, but high enough so you can see under the boom ann C. Position the forklift first, then chock the wheels D. Shoot the boom slowly as you position the forklift close to the landing zone The forklift is less stable with a raised load because: A. The center of gravity shifts toward the pivot point B. The front tires come off the ground C. The rear wheels are elevated D. None ofthe above The reason you should set the forks as far apart as possible under the load is to: Reduce the center of gravity Valance the weight to one side Evenly distribute the weight Maximize the load capacity DELIVERING A LOAD com? Before you deliver a load, you must know: Weight ofthe load, height of the landing zone, distance from the forklift to the landing zone, forklift capacity Weight of the forklift and the correct angle and extension of the boom Height ofthe landing zone and maximum capacity ofthe boom Weight of the load and capacity of the forklift .39 good technique is to: Level the forklift before raising the boom Tilt the frame with a raised load Raise the boom, then level the forklift All of the above .005? 28. 29. 30. 31. 32. 33. 34. REFUELING THE FORKLIFT 2? Smoking while refueling is okay as long as you are outside and not in an enclosed space: A. True B. False For gasoline or diesel forklifts, it?s important to make sure: A. The unit is left on while refueling B. You never run with less than tank of fuel C. You have the proper fuel D. Make sure spilled fuel has evaporated prop to starting the engine If you dismount a forklift and walk to a place where it is no longer in your view: A. Lower the forks, and set the brakes B. Lower the forks, put the controls in neutral and set the brake C. Lower the forks, put the controls in neutral, set the brakes, and shut off the power D. Lower the forks, put the controls in neutral, set the brake, and chock the wheels If you park a forklift on a slope or incline, which of the following occurs ?rst: A. Chock the wheels Let your supervisor know where the forklift will be parked C. Make sure you take the keys with you All of the above TRAINING Operators of rough terrain forklifts require speci?c training because: A. All rough terrain forkli?s are not the same B. Jobsites pose unique hazards C. Jobsites have rugged, uneven terrain D. All of the above If you have previous forklift training, it?s important that your employer: A. Gives you the most challenging forklift to operate B. Makes sure you get higher pay than operators with less experience C. Make sure you receive forklift speci?c and jobsite speci?c training D. Gives you proof of training, like a wallet card or certi?cate A qualified operator: A. Has been fully trained and evaluated in accordance with OSHA required training topics requirements Knows the general design and function of the forklift Follows required safety inspections and safe driving rules. All of the above .5097 Apnendix Revised on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager -25- -26- PERFORMANCE TEST FOR FORKLIFT OPERATORS Operator: Employee?s Dept.: Evaluator: Date: Renewal Date: Type oquuipment: Class instructions: Please print clearly, and complete each blank. Mark each task as a pass or fail. If the item does not apply, mark the item as Once completed, place a copy of this form in the employee?s file. and retain the original in the Safety Health Coordinator?s Forklift Program File. Task Pass Fall Shows familiarity with truck controls. Gave proper signals when turning. Slowed down at intersections. Sounded horn at intersections. Obeyed signs. Kept a clear view of direction. Turned corners correctly - was aware of rear end swing. Yielded to pedestrians. Drove under control and within proper traffic aisles. . Approached load properly. . Lifted load properly. . Maneuvered properly. U) . Traveled with load at proper height. Lowered load smoothly/slowly. . Stops smoothly/completely. (h . Load balanced properly. \l . Forks under load all the way. g?s 0? . Wore all necessary Personal Protective Equipment (PPE), and restrain system (if applicable) U) . Parked properly; out of the way, forks on the floor, in neutral, parking brake engaged, and power off. . Checked dock plates/ramps. . Drive backward when required. . Check load weights. . Handled on-site hazards properly. . Understands how to properly change a propane cylinder. 25. Understands proper charging, filling and changing procedures for batteries. Operated the forklift safely and cautiously. . Followed proper instructions for maintenance - checked both at beginning and end. . POWERED ROUGH TERRAIN LIFT TRUCK for CONSTRUCTION ONLY Practiced general safe pre-operating procedures. Proficiency demonstrated in safe handling of construction, rough terrain lift truck. Safe travel habits exercised in operating of lift truck. Awareness of mechanical components and their function. How to handle mechanical emergencies while operating equipment. Safe loading and unloading procedures. Practiced general safe post-operating procedures: a) Travel loaded, steering, stacking or placing loads, load leveling, and dropping loads Inspection of equipment to determine safe operating conditions at the beginning and at the end of shift. Overall Performance (circle one): Pass Fail Comments: Operator Signature: Evaluator Signature: Revised on 1-13?18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager MM Revised on 1-13-18- Robert Phalen, Hickman?s Family Farms - Environmental Program Manager -27- -23- Hickman?s Family Farms Af?davit of Class Forklift Training understand the procedures associated with proper operating procedures and safety requirements associated with the Class operation forklift at Hickman?s Family Farms. These procedures were explained and demonstrated by the Hickman?s Family Farms trainer supervisor listed below. Not following these procedures could result in a verbal written warning, written reprimand, or termination. Employee Signature: Employee Date: Trainer Supervisor Name: Trainer Supervisor Signature: Revised on 1-13-18- Robert Phalen, Hickman's Family Farms - Environmental Program Manager amilyf farmss Ar Powered Industrial Truck Training Course What we will cover • OSHA’s Powered Industrial Truck Standard • Truck Properties • Loads, Center of Gravity, Stability • Safe Operating Practices • Vehicle Inspections • Propane, Battery, and Gas Safety • Review What A ?Powered Industrial Truck?? mobile, power-propelled truck used to carry, push, pull, lift, stack, or tier materials. Powered industrial trucks are also commonly known as forklifts, pallet trucks, rider trucks, fork trucks, or lift trucks.? [American ?ociety of Mechanical Engineers -- Why do we need training? To help prevent accidents To help reduce product, equipment, and property damage Federal and State OSHA requires it It?s a good idea ACCIDENTS CAN WILL Since a large percentage of accidents and fatalities were due to operator inexperience, OSHA mandated that operators shall be trained and competent. Result! OSHA says that YOU have the right to be safe at work • Government Instituted New Regulations (Dec 1.1999) *1910.178 Powered Industrial Trucks • Manufactures *Additional Warning Decals *Additional Safety Features *More Training material • Employers *Training for Operators What can OSHA do to employers who don’t train/certify? • U.S. Postal Service fined in 2016 • Worker filed complaint to OSHA. • Eight citations results from the complaint • Uncertified workers using equipment • No record of pre-shift inspections • Permitted operators to skip using the seat-belt • Permitted use of powered equipment in areas clearly designated as pedestrian-only areas (walkways, aisles, etc) • The result? USPS in Sandston, VA was fined $667,057 • Do we want a fine like this? Do YOU want to be the reason it happens? Discuss Accidents / Incidents • Examples: • Products dropped • Semi / Dock Incidents • Hitting objects (poles, lights, fans, doors, etc) • Tip overs • Pedestrians injured • Other ALL BAD THINGS! Accident and Injury Statistics - 20.000/0 - vaers Struck Falhg Load Elev EE Off Dock Inp Ma'nt Lost (htrl Struck Mat (1) LP Fatality Statistics 450/0 - 400/0 - 350/0 - 300/0 - 250/0 - 200/0 - 150/0 - 100/0 - 50/0 - 00/0 - Tip Fall Act over 2V's Truck Load Contr What is OSHA and what do they have to say? Occupational Safety and Health Administration Every employer has an obligation to provide safe working conditions, practices, and protection AND to follow regulations Every employee has an obligation to follow all company policies and rules to protect themselves and others What is a ?Powered Industrial Truck?? must be power operated must be used in the workplace is not licensed to operate on highway - is not primarily for earthmoving ?The Law? 29 CFR 1910.178 Operator training shall be presented to all new operators regardless of previous experience. Training shall include Formal (classroom); Practical training; and Evaluation of the operators performance in the workplace. The Employer shall provide site specific and truck specific training. Employers shall establish a pass/fail requirement for such a test. Employers may delegate such testing to others but shall remain responsible for the testing. Appropriate records shall be kept. ?The Law? OSHA 1910.178 Operators shall be retrained when new equipment is introduced. Powered industrial trucks are classified according to their individual characteristics. There are seven classes of powered industrial trucks. To be most effective, training must address the unique characteristics of each. Refresher training required at least years, and sooner if there is cause. (accident or near miss) OSHA 1910.178 L2 - All operator training and evaluation shall be conducted by persons who have the knowledge, training and experience to train powered industrial truck operators and evaluate their competence. “The Law” 1910.178 L 3 i Truck Related Topics • Operating instructions & warnings for the type of truck. • Difference truck and the auto • Truck controls instrumentation. • Engine or motor operation • Steering and maneuvering • Visibility • Fork & Attachments • Vehicle capacity • Vehicle stability • Vehicle inspection & maintenance by operator • Refueling / Charging • Operating Limitations • Any other operating instructions or warnings listed in manual “The Law” 1910.178 L 3 ii Workplace-Related Topics • Surface condition • Composition of loads and stability • Load manipulation stacking & un-stacking • Pedestrian Traffic Areas • Narrow Aisles and restricted areas • Hazardous locations • Ramps & Slopes • Closed environments / ventilation • Other unique or potentially hazardous areas “The Law” 1910.178 L 4 ii Refresher Training • Operating in unsafe manner • Accident or near miss • Evaluation reveals operating in unsafe manner • Different type of truck • A condition changes in workplace “The Law” 1910.178 L 6 Certification The employer shall certify that each operator has been trained and evaluated as required by this paragraph (L). SEVEN CLASSES of Forklifts • I - ELECTRIC Counter-Balanced RIDER • With Cushion Tires = Solid Tires • II - ELECTRIC, NARROW AISLE • III - ELECTRIC, PALLET TRUCKS • IV - I/C COUNTER-BALANCED(solid tires) • V - I/C COUNTER-BALANCED(pneumatics) • VI - TOW TRACTORS • VII - ROUGH TERRAIN ( pneumatics ) Class Electric Motor 1m. i! Class II Electric Motor, Narrow Aisle Class Electric Motor, Hand Trucks Class IV Internal Combustion, Cushion Tire Class Internal Combustion, Pneumatic Tire Class VI Electric Motor Internal Combustion Tractors ?0 v.5. xx?k. . . t? . ., It: Similarities to and differences from an Automobile Steering Steer from the rear. Can turn much tighter than a car Weight Average sit-down rider weighs about 2-3 times as much as an average car VS Seatbelt Still required, but serves a (somewhat) different function Controls Every PIT is different, whereas automobiles are generally the same Lift Controls Cars don?t have controls for forks Familiar Measurements Collapsed Height Free Lift Maximum Fork Height Overall Height What Height Must Be on the Data Plate? Maximum Fork Height Lift Truck Terminology Terminologia del Montecargas Overhead . . Guard Cylnolder Chaln Load Backrest Counterweighh 5 Extension Carriage Truck Properties • Nameplate Information • Attachments – Must be approved by the manufacturer • Limitations – On the nameplate • Modifications – Must be approved by the manufacturer Lift Truck Capacity Plate AWARNING MODEL SERIAL No.? TYPE TRUCK WT._lbs CAPACITY OF STANDARD TRUCK WITH SIMPLEX MAST AND FORKS wm-o AT 24 IN. LOAD CENTER WITH MAXIMUM HEIGHT 130 IN. RATED CAPACITY WITH OPTIONAL MAST ATTACHMENT LISTE BELOW. MAST VERTICAL A FORKS ONLY ATTACH 4?9ij 130m i2'14 4.533 a II (Agimum or elgt - Capamty V. Truck Characteristics Weights and Capacities Average Counterbalanced truck weighs 9000 and lifts about 5000 lbs. How much does your equipment weigh and lift? What affects that lifting capacity? -Where can we find this info? I Load Center/Center of Gravity (COG) The center of gravity of the load The point in an object where all weight is concentrated Load Center Distance The distance from the face of the forks (or back of the attachment) to the Load Center Center of Gravity for Truck and Load 4000 lb. Load Fulcrum Point Stability Triangle - Figure 1 Vehicle Center of Gravity (U nloaded) Center of Gravity of Vehicle and Maximum Load (Theoretical) Notes: 1. When the vehicle is loaded, the combined center of gravity (CG) shifts toward line B-C. Theoretically the maximum load will result in the CG at the line B-C. In actual practice, the combined CG should never be at line B-C. 2. The addition of additional counterweight will cause the truck CG to shift toward point A and result in a truck that is less stable laterally. Combined Center of Gravity The ?Combined Center of Gravity? is formed by the truck?s center of gravity and the load?s center of gravity Combined Center of Gravity, 3-D What happens to the CCOG when the load is raised? Why is carrying the load low safer? How high should the load be carried? Why is driving fast unsafe? OSHA’s Safe Operating Practices • Lights • Alarms • Carbon Monoxide (IC trucks) • Only trained and authorized operators • Do not put people between truck and fixed objects • No one should pass under raised loads or forks • No Riders!! • Use lift baskets • Use restraint system • Keep inside of operator compartment • Tip-over Prevention • Wear all required PPE • Obey all the rules of the road • Proper parking procedures • Attended verses Unattended • Intended uses only • Adequate overhead clearance • Emergency equipment accessible OSHA’s Safe Operating Practices (cont) • Drive slow enough for surface conditions and loads • Maintain safe distances • Slow down and sound horn at blind spots and intersections • Travel with loads as low as possible • Face direction of travel • Cross RR tracks slowly and diagonally • Do not turn on ramps or grades • Keep loads uphill on counterbalance trucks • Keep loads downhill on pallet trucks • Turn slowly and smoothly • Stay to the inside of the turn to accommodate for rearend swing • Do not operate a truck in need of repair • Give the right-of-way to pedestrians • Do not operate any piece of equipment for which you have not received training or are not authorized to operate • Must be 18 or older Wham wmng? A Driving Your Truck Keep hands off Tilt Back Keep feet inside Keep Load lowest Safe height! Executing Turns ?Approach turn slowly ?Sound horn Stay close to inside corner Watch rear end swing Rear Wheel Steering Swings the rear of the truck Front Wheel Steering The rear follows the front end Forklift Automobile I I I is ?elBraking Plugging Braking One Truck Length 12 to 15 Feet When traveling behind another for lift how far shall you follow behind it for safe braking? OSHA 11116; 3 Rules for Ramps -Without a Load: Forks pointing down the grade -With a Load Load pointing up the grade Traveling or Down? the grade Before you drive your truck, you should: •Walk Facility, look for Dangerous: -Intersections -Pedestrian Traffic Areas -Overhead Obstructions -Rack Condition and Weight Limits -Surface Conditions / Inclines -Refueling / Charging Areas -Dock Areas Intersections Pedestrian Traf?c Before turning a corner, check convex mirrors Rack Condition? Surface Conditions Any bumps/floor hazards to watch for? Overhead Obstacles What?s wrong with this picture Unattended Forklift - More than 25? or out of sight Lower Forks -Ti t Forward ?Set the hand Brake -Turn off the key - Return to Neutral Trailer and Dock Safety Dock Boards Wheel Chocks Dock Locks Floor and Truck conditions Semi Drivers re-shift Inspections: PRESHIFT VEHICLE INSPECTION SHEET of: . . Truck; l. ..- I!qn_z_n__ Mon l'lr Wed Thur l?ri Comments :,0,9551}. .. _cggl?elds. etc. 1 Must Lubrication - Chaim much. on not; 5 Hldxaulic Cilindgn I Hmcs- ?hcucks, lamaFmis?f?iinp- Chicks, mdx, bI'mE wear. bulger-'_Cdoditiuu . .. .. . Lue Nuts loweounissiqg i ke I No mammal mapped urOuml 5 i Rim bond I'ailulc 5 i Fluids 1071? - REQUIRED bylaw ?like I'Iuid . . Once per shIft . - . Pnrkin Hulk}: Ste-Wins. . I. ..-.. Rescue _?glm mm Iigyls . - - i?lJt_ I 3 i up?. alarm I -. -- -..- .-. ..- ..- I - - -- I - Nam}! my}; 15;? Q: i luspculor Initials: . I i - I Noun note: A ny rah-writs, dt?fclx. or probh'ms shank? be rcpm'ml I'mmt'diaa'I'y to Any mark in new! of repair may! he serum. ?wk 5mm not put brick info urn-fur mud is (Earned _vqu to than/ugh Impcz?r?ono truck dual! be: 5y .1 or Imbam'c. Any ?pair: mode, corn-0th? ?aim mica. m? prabkmx?zed Irbma'd he ?Marked to than? madman. Pre-Shift Inspection Lift Truck Terminology Load Backrest Forks Lift Cylinders Chains Overhead Guard Mast Load Wheels Drive Wheel Pre-Shift Vehicle Inspections • Must be done prior to each shift or use • Must be documented • Problems should be reported to supervisor • Bring up problems that occur during the shift • Why do them? • Ensure equipment is safe • Small problems cost less to repair than big ones • OSHA requires it • It is a visual inspection, not time consuming Labels - "Proper Label Locations? are in the Operators Manuals. - It shall be the Operator?s responsibility to read the Operators manual. Warning labels are there for a reason! - Warning labels shall be in legible conditi0n(readable) - Part of the pre-shift inspection Parking Brake MUST BE INSPECTED AWARMNG (D 4..) :r?1 Look for gashes/scratches that may impact the safety of the PI ?1.335.: .H . .1 LillyFork Inspection Check Point Fork length 2/3 103/4 o?ftheway under the lead 6 to 8 inches off the ?oor for travel. -I . Hazards . IT Gauge . mm": Personal Protective . 399% . EQUipment Liquid Propane Gas LiqUid . Properties of Propane . Proper procedure for changing a cylinder 0 Storage (N PA) . Emergency procedures Internal Combustion Truck Inspection Check All propane connections. -Sme l and listen for leaks. Check Fan Shroud Area for Deb?s Gas and Diesel Safety Properties Hazards Personal Protective Equipment - Proper procedures for filling Storage Emergency procedures Lead Acid Batteries Properties of lead acid batteries Hazards Personal Protective Equipment . proper filling and charging procedures Emergency procedures What: ea In g0 if we don?t take this stuff seriously U.S. Forklift Accidents ?In Just 1 Year!? 110 Fatalities 76,000 Serious Accidents 61,000 Non-Serious Accidents Injuries Fatalities Tipover Struck by lift truck Struck by falling load Elevated Employee Ran off loading dock lm proper maintenance 0% 5% 10% 15% 20% 25% 30% This is a class two forklift to be used on smooth level concrete floors only. What happened? Cleaning Security Camera? . .8 It?: . \2494 . 9.9.. .95 9.99% .. - a! .9. .uha . OSHA File ,?nmw u. - - Operator was crushed by the rail; What might have . Z. . I. . prevented this accidentu? .- Learn to let ?9 It only takes a little .. Leakl - Speeding and Daydreaming are two of the causes most often at fault. Know your truck and stay alert! enance 0% Questions and Review • Truck Properties • Classes • Forks, Backrests, Mast, etc. • Load Centers and Capacity • Stability and Load Handling • Stability Triangle • Safe Operating Practices • Use the Seatbelt!!! • Honk horn to alert pedestrians • Vehicle Inspections • Once per shift. It’s the law! • Fuel Safety Hazard Communication Program 29 CFR 1910.1200 General The following written hazard communication program has been established for Hickman’s Family Farms (HFF). A copy of the Hazard Communication Program will be available within the Safety Program Binder and the SDS Binder located at each facility. In addition, an electronic copy will be available on the company server for direct access from any Hickman’s Family Farms computer network location. The purpose of this notice is to inform you that Hickman’s Family Farms is complying with the OSHA Hazard Communication (HazCom) Standard 2012, Title 29 Code of Federal Regulations 1910.1200. As required, basic HazCom training must include:  Methods and observations that may be used to detect the presence or release of a hazardous chemical or material in the work area.  Measures employees can take to protect themselves from these hazards, and  Details of the hazard communication program developed by the Compliance and Enforcement Office with input from employees, including an explanation of the labels received on shipped containers, and how employees can access the appropriate hazard information. The company will compile a hazardous chemical and hazardous material list, using Safety Data Sheets as a guidance reference, ensuring that containers are properly labeled. Employees will receive training on how the Comprehensive Written Program is to be implemented. The HFF Compliance and Enforcement Office, as well as HFF Certified OSHA Trainers will review and update the plan as necessary. 1. Responsibilities Managers & Supervisors Managers and supervisors will receive the basic training plus an annual refresher class. Managers and supervisors will be responsible for ensuring that all employees they supervise are made aware of all components of this Hazard Communication Program and the necessary training is provided for employees to handle potentially hazardous chemicals/materials. All HFF managers/ supervisors, will receive training in the sixteen part Safety Data Sheet (SDS) so they will be able to train their employees on the use and understanding of the on-site SDS’s. Managers and supervisors will ensure that the proper receipt, labeling, handling, use, storage, and disposal of known or potentially hazardous chemicals and materials under their jurisdiction are known by employees that will be exposed to these chemicals and materials. Managers and supervisors will ensure that employees are aware of what the container labels mean and the measures the employee can take to protect themselves from spills and leaks. Employees Responsible for understanding, complying and executing all phases of the Hazard Communication Program. Compliance and Enforcement Office Responsible for program development, implementation, and compliance including provisions for employee training and conducting periodic audits to ensure facilities maintain current and accessible chemical inventories and current SDSs. 2. Container Labeling In 2012, the final Global Harmonized System (GHS) was implemented. By June 1, 2016, all workplaces were to have updated labeling and employee training on the new GHS system was to be implemented. All hazardous chemicals, materials, and physical hazards must be properly labeled, tagged or marked. Hickman’s Family Farms policy mandates that containers of hazardous substances will not be issued or released until the following written label information is verified in English and Spanish. A. Containers are clearly labeled with the GHS labels and placards applicable to its contents. B. Appropriate hazard warnings are noted using the revised sixteen part SDS system. Labels on containers must not be removed or defaced. If chemicals from a labeled container are placed into another container that is only intended for immediate use, no labels are required on the portable container. However, if chemicals are transferred to a portable container for long term use (more than a single shift), or more than one person is going to use the chemical, the proper label must be transferred to the portable container. If labeling of the portable container is not feasible, the container must be triple rinsed with clean water after every use. *It is each department manager and supervisor’s responsibility to ensure this process is followed. The GHS placards used are as follows: Explosives     Unstable explosives Explosives, divisions 1.1, 1.2, 1.3, 1.4 Self-reactive substances and mixtures, types A, B Organic peroxides, types A, B Flammable          Flammable gases, category 1 Flammable aerosols, categories 1, 2 Flammable liquids, categories 1, 2, 3 Flammable solids, categories 1, 2 Self-reactive substances and mixtures, types B, C, D, E, F Pyrophoric liquids, category 1 Pyrophoric solids, category 1 Self-heating substances and mixtures, categories 1, 2 Substances and mixtures, which in contact with water, emit flammable gases, categories 1, 2, 3 Organic peroxides, types B, C, D, E, F Oxidizing Gases    Oxidizing gases, category 1 Oxidizing liquids, categories 1, 2, 3 Oxidizing solids, categories 1, 2, 3 Compressed Gases     Compressed gases Liquefied gases Refrigerated liquefied gases Dissolved gases Corrosive    Corrosive to metals, category 1 Organic compounds Living tissue Toxic  Acute toxicity (oral, dermal, inhalation), categories 1, 2, 3 Usage      Acute toxicity (oral, dermal, inhalation), category 4 Skin irritation, categories 2, 3 Eye irritation, category 2A Skin sensitization, category 1 Specific target organ toxicity following single exposure, category 3 o Respiratory tract irritation o Narcotic effects Health Hazard        Respiratory sensitization, category 1 Germ cell mutagenicity, categories 1A, 1B, 2 Carcinogenicity, categories 1A, 1B, 2 Reproductive toxicity, categories 1A, 1B, 2 Specific target organ toxicity following single exposure, categories 1, 2 Specific target organ toxicity following repeated exposure, categories 1, 2 Aspiration hazard, categories 1, 2 Environmental Hazard   Acute hazards to the aquatic environment, category 1 Chronic hazards to the aquatic environment, categories 1, 2 Sample Label The GHS label example above includes these six elements: 1. Signal Word. The signal word indicates hazard level. It's like a safety sign header for your chemicals. "Danger" is used for the most severe instances, while "Warning" is less severe. 2. GHS Symbols (Hazard Pictograms). These are used to identify hazardous products and are commonly grouped by chemical/physical risk, health risk and environmental risk. 3. Manufacturer Information. This identifies the manufacturer's company name, address and telephone number. 4. Precautionary Statements/First Aid. These are phrases that are tied to each hazard statement. They describe general preventative, response, storage or disposal precautions. These statements will be found on the chemical's Safety Data Sheet. Similar to Hazard Statements, Precautionary Statements can be identified by a P-Code (like P100). 5. Hazard Statements. These are phrases that describe the nature of hazardous products and the degree of hazard. Hazard statements should be found on the chemical's Safety Data Sheet (SDS) and identified by an H-Code (like H100). 6. Product Name or Identifiers. Simply identify the product or chemical name. Additional identifiers can be noted to the right of the Manufacturer's information (#1). On site managers and supervisors are responsible for supervision of the container labeling program. If there is no label on the container, the Compliance and Enforcement Office should be notified before the container is opened. The container will not be opened until it has been properly labeled The following is a list of the respective departments: Department Arlington North Processing Plant Manager Arlington North Plant Maintenance Arlington North Barns Manager Arlington North Plant Manager Arlington South Plant Manager Arlington South Barns Manager Arlington South Maintenance Arlington South Barns Manager Breaker Plant Manager Breaker Plant Assistant Manager Fertilizer Pellet Mill Manager Hard Boil Plant Manager Jackrabbit Shop Manager Jackrabbit Machine Shop Manager Maricopa Shipping & Receiving Manager Maricopa Plant Manager Maricopa Barns Manager Maricopa Barns Assistant Manager Pullets Barns Manager Pullets Barns Assistant Manager Special Projects Manager Special Projects Assistant Manager Pest Control Manager Pest Control Assistant Manager Environmental Manager Compliance Manager Transportation Manager Transportation Assistant Manager Production Manager (Arlington/Maricopa) Production Manager (Tonopah) 3. Safety Data Sheets The Compliance and Enforcement Office will be responsible for obtaining and maintaining copies of the forms and notebooks for the company in all locations. The following system will assure receipt of these SDS’s. 1. All departments purchasing chemicals will be responsible in requiring SDS Sheets on all products ordered that are subject to The Hazard Communication Act. If SDS sheets are missing from the HazCom notebook, the Compliance and Enforcement Office must be alerted and new SDS sheets will be provided. 2. All department managers and supervisors must inform the receiving department of chemicals ordered, and approximate delivery date. A list of chemicals ordered will be provided to the receiving department (staff) and notice given to the Compliance and Enforcement Office which will maintain a list of all of the chemicals at each facility. 3. Dry Storage warehouse personnel (the receiving department) has the authority to reject any shipment of chemicals without prior approval. Under the GHS system, the SDS is a sixteen part information sheet including: 1. Identification of the substance/mixture and of the company 2. Hazard Identification 3. Composition/Information on Ingredients 4. First Aid Measures 5. Fire Fighting Measures 6. Accidental Release Measures 7. Handling and Storage 8. Exposure Controls/Personal Protection 9. Physical and Chemical Properties 10. Stability and Reactivity 11. Toxicological Information 12. Ecological Information 13. Disposal Considerations 14. Transport Information 15. Regulatory Information 16. Other Information Copies of SDS’s for all chemicals and hazardous substances to which employees of this company are exposed will be maintained in the following locations: 1. Complete file of SDS’s will be located in a binder on the safety board or in the manager’s office in every facility. 2. A highly visible copy of the SDS sheets will be kept at/near the chemical storage locker (flammable locker) or cage of every facility. 3. Electronic copies are available on the company server for direct access from any Hickman Family Farm network location. The Compliance and Enforcement Office will review all incoming Data Sheets to determine any significant safety and health information, and ensure that all affected department supervisors are aware of these new substances and their SDS in hard copy form. Managers and supervisors will inform all employees who are exposed to these substances of handling procedures, health/safety hazards regarding usage, first aid procedures and personal protective equipment. SDS’s will be made available to all employees at all times for their work department or for the company as a whole. If a department does not have an SDS for a chemical used in the work area, the manager or supervisor must notify the Compliance and Enforcement Office immediately. 4. Employee Training and Information All managers and supervisors who work with or may be exposed to hazardous chemicals will receive initial training on the Hazard Communication Program and the safe use of those hazardous chemicals by the Compliance and Enforcement Office. Whenever a new hazardous material is introduced, additional training will be provided immediately before that material is opened and put into service. Managers and supervisors will conduct regular safety meetings will be conducted and hazardous materials use and safety will be discussed. Periodically, the Compliance and Enforcement Office and/or HFF Certified OSHA Trainer will attend these safety meetings. The initial training plan for Hazard Communication will include: 1. Summary of the standard and the written program. 2. Chemical and physical properties of hazardous materials and methods that can be used to detect the presence or release of chemicals (e.g., odor, appearance, monitors). 3. Physical hazards of materials (e.g., potential for fire, off-gassing, etc). 4. Health hazards, including signs and symptoms of exposure and any medical condition that may be aggravated by exposure to the chemical. 5. Procedures used to protect against hazards (e.g., personal protective equipment required and its proper use and maintenance; work practices or methods to assure proper use and handling of chemicals; and procedures for emergency response). 6. Work procedures to follow to assure protection when detecting and/or cleaning hazardous chemical spills and leaks. 7. Where all hazardous material SDS information is located and how to read and interpret the information on labels. Following a successful training, employees will be required to sign and date a certificate of training from an OSHA Certified trainer who has evaluated the employee on their knowledge of the training sessions. 5. Non-Routine Tasks If the employee is required to perform non-routine tasks involving a hazardous material, the employee will first be trained on the handling of the hazardous material, and the proper precautions and personal protective equipment to reduce or avoid exposure. 6. Contractor Employees Prior to the start of a work day, the manager or supervisor will advise outside contractors in person, of any chemical or physical hazards that may be encountered in the normal course of their work on the premises, the labeling system in use, the protective measures to be taken, and the safe handling procedures to be used. In addition, these individuals will be shown the location and availability of the SDS information. Each contractor bringing chemicals on-site must provide Hickman’s Family Farm with the appropriate hazard information on these substances, including the labels used and the precautionary measures to be taken in working with these chemicals prior to bringing them on the property. 7. List of Hazardous Chemicals Hickman’s Family Farms Compliance and Enforcement Office will maintain a master list of all the hazardous chemicals and materials and their associated SDS forms used on the premises Managers and supervisors will maintain a list of all hazardous chemicals and materials at their facility and be able to demonstrate a knowledge of the work practices used to keep employees safe. HAZARD COMMUNICATION PROGRAM Certification of Training I, _____________________________________, certify that I have been trained in the Hickman’s family Farms Hazard Communication Program. This includes a review and understanding of the company’s written Hazard Communication Policy, which includes: Safety Data Sheets; the characteristics and personal protective equipment that must be worn when handling hazardous materials with potential exposure on the job site; and, appropriate emergency response procedures. I am familiar with the location of the above referenced written program, and understand that the company grants me access to the Safety Data Sheets at all times when I am employed. I understand that my attendance in the training program is mandatory. I understand that I must be trained for each hazardous chemical that I use. If I encounter a hazardous material with which I am not familiar, I understand that I am to immediately contact my manager/supervisor and review the applicable SDS and emergency procedures before working with the hazardous substance. Chemicals which I have been trained to use: Hazardous Chemicals: Employee Initials: Employee Signature: _____________________________________ Trainer’s Signature: ______________________________________ Date: _____________ Revised January 2017 Personal Protective Equipment Program Hickman’s Family Farms (HFF) has developed this document to establish our Personal Protective Equipment (PPE) safety plan and specify the protective equipment necessary to protect our employees in instances where the work-related hazards of their jobs cannot be eliminated. The HFF Compliance and Enforcement Department (HFF CED) has overall responsibility for the PPE program, and the HFF Certified OSHA Trainers (COT) and individual Managers/Supervisors shall assist in training employees and monitoring their use of PPE. This written plan is kept in the each Manager’s/Supervisor’s office, and is available electronically on the HFF company database for review. The HFF CED will review and/or update the program annually. HFF believes it is our obligation to provide a hazard free environment to our employees. Any employee encountering hazardous conditions must be protected against the potential hazards. The purpose of protective clothing and equipment (PPE) is to shield or isolate individuals from chemical, physical, biological, or other hazards that may be present in the workplace. (See a separate document for respiratory protection program.) Establishing an overall written PPE program detailing how employees use PPE makes it easier to ensure that they use PPE properly in the workplace and document our PPE efforts in the event of an OSHA inspection. HFF PPE program covers: • • • • • • Purpose Hazard assessment PPE selection guidelines Employee training Cleaning and maintenance of PPE PPE specific information. We encourage all suggestions to this document because we are committed to the success of our PPE Program. We strive for clear understanding, safe behavior, and involvement in the program from every level of the company. As appendix to this program, HFF has attached copies of hazard assessments. Program Purpose The basic element of any PPE program is an in depth evaluation of the equipment needed to protect against the hazards at the workplace. This is the initial hazard assessment for which written documentation is required. The basic objective of any PPE program should be to protect the wearer from incorrect use and/or malfunction of PPE. When recognized, means of protection are insufficient. The purpose of this PPE Program is to document the hazard assessment, protective measures in place, and PPE in use at this company. PPE devices are not to be relied on as the only means to provide protection against hazards. They are to be used in conjunction with recognized means of protection. Such as machine guards, engineering controls, and sound manufacturing practices. If possible, personnel will try to remove hazards first through engineering controls. Then using PPE to provide protection against hazards that cannot reasonably be removed. 2 Hazard Assessment To assess the need for PPE, the following steps are to be taken: The HFF CED, HFF COT, Managers/Supervisors, with other appropriate employees, will need to identify job classifications where exposures occur. The following records are to be used to identify and rank jobs according to exposure hazards: • Injury/illness records and workers’ compensation claims • First aid logs • Near-miss records The HFF CED conducts a walk-through survey of areas where hazards may exist to identify hazard sources. The basic hazard categories observed based on: • Impact • Heat or extreme cold • Penetration • Harmful dust • Compression (roll over) • Light radiation (optical) • Chemical • Electrical During the walk-through, the HFF CED observes and records the following hazards along with PPE currently in use (type and purpose): • Sources of motion; i.e., machinery or processes where any movement of tools, machine elements or particles could exist, or movement of personnel that could result in collision with stationary objects • Sources of high temperatures that could result in burns, eye injury or ignition of protective equipment • Type of chemical exposures • Sources of harmful dust • Sources of light radiation, i.e., welding, brazing, cutting, furnaces, heat treating, high intensity lights • Sources of falling objects or potential for dropping objects • Sources of sharp objects that might pierce the feet or cut the hands • Sources of rolling or pinching objects that could crush the feet • Layout of workplace and location of coworkers • Electrical hazards such as electric shock or burns from electric arcs, blasts, or heat Following the walk-through survey, the HFF CED organizes the data and information used in the hazard assessment to ensure proper selection of protective equipment. An estimate of the potential for injuries is made. Each of the basic hazards are reviewed. The determination is made as to the frequency, type, level and seriousness of potential injury from each of the hazards found. The existence of any situations where multiple exposures that could occur are further evaluated. 3 The HFF CED documents the hazard assessment with a written certification that identifies the workplace areas were evaluated. Certifying that the evaluation has been performed and the date(s) of the hazard assessment are documented. PPE Selection Guidelines Once hazards have been identified and evaluated, the general procedure for selecting protective equipment is as followed: • Become familiar with the potential hazards and the type of PPE that is available • Compare equipment to the hazards associated with the work environment • Select the PPE that meets selection requirements found in the OSHA regulations (29 CFR 1910.132) and ensures a level of protection greater than the minimum required to protect employees from the hazards • Fit the user with proper, comfortable, well-fitting protection • Instruct employees on use and care of the PPE. It is very important that the users are aware of all warning labels for and limitations of their PPE It is the responsibility of the HFF CED, HFF COT, and Managers/Supervisors to repeat the assessment as necessary. To identify/evaluate new equipment and processes. As well as, to review accident records, and reevaluate the suitability of previously selected PPE. This reassessment must take place at least annually. However, reassessment can take place as needed. Elements that follow should be considered in the reassessment: • Adequacy of PPE program • Accidents and illness experience • Levels of exposure (this implies appropriate exposure monitoring) • Adequacy of equipment selection • Number of person hours that workers wear various protective ensembles • Adequacy of training/fitting of PPE • Program costs • The adequacy of program records • Recommendation for program improvement and modification • Coordination with overall safety and health program Employee Training The HFF CED, HFF COT, Managers/Supervisors provide training for each employee who is required to use PPE. Training includes: • When PPE is necessary • What PPE is necessary • How to wear assigned PPE • Limitations of PPE • The proper care, maintenance, life, and disposal of assigned PPE 4 Employees must demonstrate an understanding of the training and the ability to use the PPE properly before they are allowed to perform work requiring the use of the equipment. Employees are prohibited from performing work without wearing appropriate PPE to protect them from the hazards they will encounter in the course of that work. If the HFF CED, HFF COT, or Managers/Supervisors have reason to believe an employee does not have the understanding or skill required, the employee must be retrained. Since an employee’s supervisor is in the best position to observe any problems with PPE use by individual employees, the HFF CED will seek this person’s input when making this decision. Circumstances where retraining may be required include: changes in the workplace, changes in the type of PPE to be used, and inadequacies in an affected employee’s knowledge or use of the assigned PPE. Which could render previous training obsolete. Also, could indicate that the employee has not retained the necessary understanding or skills. With this Program the HFF CED certifies in writing that the employee has received and understands the PPE training. Failure to comply with company policy concerning PPE can result in OSHA citations and fines. As well as, employee injury. An employee who does not comply with this program will be disciplined for noncompliance as follows: • Verbal warning for the first offense accompanied by retraining • Written reprimand for the second offense that goes in the employee’s permanent record • Suspension without pay for a third offense and documentation in the permanent record • Dismissal as a last resort Cleaning and Maintenance It is important that all PPE be kept clean and properly maintained by the employee to whom it is assigned. Cleaning is particularly important for eye and face protection where dirty or fogged lenses could impair vision. PPE is to be inspected, cleaned, and maintained by employees at regular intervals as part of their normal job duties. To ensure that the PPE is capable of providing the necessary protection. Supervisors are responsible for ensuring compliance with cleaning responsibilities by employees. If PPE is for general use, the HFF CED has responsibility for cleaning and maintenance procedures. If a piece of PPE is in need of repair or replacement it is the responsibility of the employee to bring it to the immediate attention of his or her supervisor or the HFF CED. It is against work rules to use PPE that is in need of repair or not able to perform its intended function. Contaminated PPE that cannot be decontaminated must be disposed of in a manner that protects employees from exposure to hazards. 5 PPE Specific Information Eye and face protection – Glasses, Goggles and face shields It is the policy of the company that as a condition of employment, all regular full time, part time, and temporary employees working in designated work areas and/or job assignments are required to wear American National Standards Institute (ANSI) approved glasses/goggles/face shields. To help prevent eye and face injuries. Examples including; flying particles, molten metal, liquid chemicals, acid or caustic liquids, chemical gases or vapors, or light radiation. Employees from temporary work agencies and contractors are required to wear glasses/goggles/face shields if assigned to job tasks in the designated work areas. All supervisors and managers are responsible for ensuring employees under their charge are in compliance with this policy. All employees who work in designated work areas and/or job assignments are responsible for wearing company provided glasses/goggles/face shields to comply with this policy. Failure to comply will result in disciplinary action up to and including discharge. All employees required to wear glasses/goggles/face shields must routinely inspect and properly care for their glasses/goggles/face shields. Foot protection – Safety shoes and foot protectors It is the policy of this company that as a condition of employment, all regular full time, part time, and temporary employees working in designated work areas and/or job assignments are required to wear safety shoes to help prevent foot injuries, ankle injuries, slips, and falls. Employees in designated work areas are required to wear ANSI or American Society for Testing and Materials (ASTM) approved safety shoes or safety shoes that have been demonstrated to be equally effective. Employees from temporary work agencies and contractors are required to wear foot protection if assigned to job tasks in the designated work areas. It is the responsibility of the agency and/or contractor to ensure the employee reports to his/her temporary assignment at this company wearing approved safety shoes. Those employees who work in non-designated areas of the company, vendors and visitors will be allowed to walk through the designated work areas without safety shoes as long as they remain in outlined aisles or walkways. All employees who work in designated work areas and/or job assignments are responsible for purchasing and wearing foot protection to comply with this policy. Failure to comply will result in disciplinary action up to and including discharge. Purchase of foot protection can be done by the HFF CED, the HFF COT and individual Managers/Supervisors. HFF Human Resources is responsible for the selection and implementation of an on-site shoe vendor twice a year. HFF Human Resources coordinates and addresses any shoe/foot protection complaints, returns, or replacements for employees. During initial new employee training, HFF Human Resources is responsible for informing new employees who are assigned to the designated work areas of the safety shoe/foot protection policy and the procedures for obtaining the equipment. The new employee is responsible for reporting to his/her first day of work wearing approved shoes/foot protectors. 6 Hand protection – Gloves It is the policy of the company that as a condition of employment, all regular full time, part time, and temporary employees working in designated work areas and/or job assignments are required to wear gloves to help prevent hand injuries, skin absorption of harmful substances, severe cuts or lacerations, punctures, chemical burns, thermal burns, and harmful temperature extremes. Employees from temporary work agencies and contractors are required to wear protective gloves if assigned to job tasks in the designated work areas. All supervisors and managers are responsible for ensuring employees under their charge are in compliance with this policy. All employees who work in designated work areas and/or job assignments are responsible for wearing gloves to comply with this policy. Failure to comply will result in disciplinary action up to and including discharge. All employees required to wear protective gloves must routinely inspect and properly care for their assigned gloves (if the gloves are not disposable). Head protection – Hard Hats/ Bump Caps It is the policy of the company that as a condition of employment, all regular full time, part time, and temporary employees working in designated work areas and/or job assignments are required to wear ANSI approved hard hats/bump caps to help prevent head injuries. Including those resulting from falling objects, bumping the head against a fixed object, or electrical shock. Employees from temporary work agencies and contractors are required to wear helmets if assigned to job tasks in the designated work areas. All supervisors and managers are responsible for ensuring employees under their charge are in compliance with this policy. All employees who work in designated work areas and/or job assignments are responsible for wearing company provided helmets to comply with this policy. Failure to comply will result in disciplinary action up to and including discharge. All employees required to wear protective helmets must routinely inspect and properly care for the equipment. Hearing Conservation – Ear plugs / Ear Muffs / Medical Surveillance Under the current OSHA Standard for Occupational Noise Exposure (29 CFR 1910.95) all workers exposed to an 85 A-weighted decibels (dBA) Time Weighted-Average (TWA) are to be included in a hearing conservation program. It is important to note that for work shifts in excess of 8 hours, the 85 dBA TWA is reduced. For example, exposures in excess of 83.4 dBA for a 10-hour work shift and exposures in excess of 82.1 dBA for a 12 hour work shift necessitate inclusion in a hearing conservation program. An effective hearing conservation program is defined to include: • An assessment of noise exposure • Annual audiometric tests of exposed workers • Maintenance of noise and hearing data records • Abatement noise and/or administrative controls • Availability of hearing protectors • Employee training and education 7 An ongoing noise exposure evaluation program is required under the OSHA Standard for Occupational Noise Exposure (29 CFR 1910.95) when “information indicates that any employee’s exposure may equal or exceed an 8 hour Time-Weighted Average of 85 dBA. Monitoring shall be repeated whenever there is a change in production, process, equipment or control increases noise exposure to the extent that: • Additional employees may be exposed at or above the action level, or • The attenuation provided by the hearing protectors being used by the employees may be rendered inadequate A complete sound survey of the plant is recommended at least every two years. After determining the noise level, and if it is 85 dBA TWA, then it is required that employers provide to the employees the following: • Annual hearing tests • Annual hearing conservation training • Hearing protection (optional or mandatory) • The OSHA Noise Standard (29 CFR 1910.95) posted • Notification of the results of the sound survey If the Noise level exceeds 90 dBA, the OSHA Noise Standard requires that engineering and administrative control measures must be investigated, evaluated and where feasible, utilized to reduce employee exposures. It is important that any measure investigated, utilized, or evaluated to reduce the noise levels be documented. Engineering Measures to Reduce Noise: • Contact with the manufacturer for noise abatement suggestions • The purchase of quieter equipment or routine maintenance to reduce noise levels • Reduction of noise level at the source, via: • Substitution of materials (i.e., plastic for metal) • Dampening or reducing surface vibration • Increasing the distance between the employee and the noise source • Enclosures or sound insulation material, or • Relocation of job tasks which may be completed out of high noise areas Administrative Measures to Reduce Noise: When engineering measures alone cannot reduce the noise below 90 dBA, administrative methods may be used to minimize employee exposure such as worker rotation from high noise levels to quiet areas. Managing the Hearing Conservation Program: All employees at Hickman’s Family Farms who are exposed to a noise level of 85 dBA or above will be in the hearing conservation program and have their hearing checked annually by Concentra or other hearing conservationist. All results of the hearing tests will be kept in/at the Human Resources office. Hazardous noise areas will be posted and hearing protection worn in those areas as required. The HFF CED conducts ambient noise measurements throughout each facility to determine the dBA TWA on a minimum yearly basis, or whenever new machinery is added that may change the noise levels already recorded. 8 This measurement is conducted utilizing an Extech Digital Sound Level Meter (range: 40 to 130 dB) in areas identified as potential environments where workers may be exposed to an 85 A-weighted decibels (dBA) Time Weighted-Average (TWA). In areas identified, hearing protection including ear plugs and ear muffs are required. These employees are subject to HFF’s Hearing Conservation program, which includes audiometric annual testing and classroom instruction. However, all employees may utilize ear plugs, available upon request, and located outside of identified areas based upon job requirements, as well as individual choice. Such employees that voluntarily wear ear protection, are not subject to audiometric testing and classroom instruction. However, the HFF CED, HFF COT, and individual Managers/Supervisors are responsible for ensuring employees under their charge are in compliance with this policy. All employees who work in designated work areas and/or job assignments are responsible for wearing company provided hearing protection to comply with this policy. Failure to comply will result in disciplinary action up to and including discharge. All employees required to wear hearing protection must routinely inspect and properly care for or replace the equipment if it is not disposable. Respirators At HFF, respiratory protection may be needed to reduce employee’s exposure to chemicals, dust, or gases in the work environment. It will assist properly trained personnel to work safely in potentially hazardous work environments. All personnel required to wear a respirator at HFF are subject to medical evaluation, approval, classroom instruction, and proper care and maintenance procedures. Due to the extensive requirements associated with respirator use, HFF has written an additional Respiratory Protection Program to coordinate the use and maintenance of respiratory protective equipment. All employees using respirators [except for those voluntarily using filtering face pieces (dust masks)] must pass a medical evaluation before being allowed to wear respiratory equipment. Any employee that refuses the medical evaluation will not be allowed to wear a respirator. The medical evaluation will be done confidentially through the use of a medical evaluation by a physician or other licensed health care professional at Concentra Medical Center or MBI Occupational Healthcare. HFF Human Resources and individual Managers/Supervisors will ensure that employees who wear respiratory equipment receive a medical evaluation before its use. All approvals and scheduling for medical evaluations will be coordinated with the individual Managers/Supervisors, and HFF Human Resources. The medical questionnaire listed in Appendix C of OSHA’s Respiratory Protection standard will be used for the evaluation. The physician or other licensed health care professional will be provided with the following information prior to the evaluation. Medical evaluation will be repeated whenever: • An employee reports medical signs or symptoms that are related to ability to use a respirator • A physician or other licensed health care professional, supervisor, the HFF CED, or the HFF COT, informs HFF Human Resources that an employee needs to be reevaluated • Information from the respiratory protection program, including observations made during fit-testing and program evaluation, indicates a need for employee re-evaluation • A change occurs in workplace conditions (e.g., physical work effort, protective clothing, and temperature) that may result a substantial increase in the physiological burden placed on an employee 9 At HFF, two basic types of air purifying respirators are used at each facility. • Filter respirators that remove particulates from the air (N95) • Chemical cartridge respirators that remove gases or vapors (Half face and full face) Chemical cartridge respirators utilize specific cartridges to best protect the employee against the specific chemical or chemicals found in the area of respirators use. Based upon operational conditions, chemical hazards and corresponding cartridges are as follows: Hazard Specific cartridge utilized for protection Dust Purple cartridges or dust respirators Solvents Black cartridges Ammonia Green cartridges Acid Gas Yellow cartridges Welding Fumes Purple cartridges, or fume mask Fit-Testing It is important that the respiratory protective equipment be properly fitted to the employee when it is used. The HFF Human Resources Department and individual Managers/Supervisors will ensure that fit-testing is conducted by Concentra Medical Center or MBI Occupational Healthcare before employees are allowed to wear respirators on HFF property. In the event that fit testing is not performed by Concentra Medical Center or MBI Occupational Healthcare, fit-testing can be performed by HFF COT. If the employee has been approved to wear a respirator by Concentra Medical Center or MBI Occupational Healthcare, fit-testing will be conducted in accordance with the procedures listed in Appendix A of OSHA’s respiratory protection standard. Training HFF COT will provide training to respirator user and their Manager/supervisor before respirators are used by the employee. Training will include the following topics: • Hickman’s Family Farms Respiratory Protection Program • The requirements of OSHA’s Respiratory Protection standard • Respiratory hazards encountered at Hickman’s Family Farms and their health effects • Proper selection and use of respirators • Limitations of respirators • Respirator wearing and user seal (fit) checks • Fit-testing • Emergency use procedures • Inspection, maintenance and storage • Medical signs and symptoms limiting the effective use of respirators Training will be given annually to all employees required to use respirators. Employees must demonstrate their understanding of the topics covered in the training through hands-on exercises and a written test. Additional training will be given when there are changes in the workplace or the type of respirator used or when there are indications that the employee’s use of or knowledge of the respirator is inadequate. 10 Shell Facilities: Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Shell Facilities: Head Protection Eye Protection Ear protection Foot Protection Hand Protection Facility Not Required AM sanitation In designated areas Slip Resistant and/or steel/composite toe. Gloves- Packing/AM sanitation Not Required Dry Storage Not Required Glasses- Bailers and trash compactors. Goggles-when handling chemicals Not Required Slip resistant with steel/composite toe Not Required Respirator Other Breaker Plant Head Protection Eye Protection Ear Protection Foot Protection Hand Protection Respirator Other Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator N/A N/A Facility Not Required Glasses- In designated area. Goggles-Chemicals In designated areas Water proof, Slip resistant with steel/composite toe Food Handling Available upon request N/A Cooler Bump caps- ONLY when working with collapsible Costco metal racks Not Required Not Required Slip Resistant with steel/composite toe Not Required Not Required PM sanitation Not required Glasses-all times, Goggles-Chemicals, Face shield-Foamer When using Compressed air Waterproof, slip resistant, steel/composite toe Regular-Scraping /air hose, Chemical gloveschemicals N/A Sleeves and aprons for chemicals Cooler Bump Cap- ONLY when working with collapsible Costco metal racks Not Required Not Required Slip resistant with steel/composite toe Not Required Not Required N/A Dry Storage Not Required Goggles/Glasses for Chemical handling Not Required Slip Resistant with steel/composite toe With Polyethylene Terephthalate (PET) Not Required Sanitation Not Required Goggles and face shield with chemicals. Glasses at other times Not Required Water proof Slip resistant with steel/composite toe Chemical protecting gloves Available upon request Apron/Suit when working with chemicals Protein Plant In designated areas In designated areas In designated areas Slip Resistant with steel/composite toe Not Required Not Required 11 Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Commodities (Inedible Plant) Bump Cap recommended Recommended but not required Not Required Slip Resistant with steel/composite toe Available upon request Not Required Feed mill Hard Hat at all times In designated areas Not Required Steel/composite toe Not Required N95, Half face, Full Face Head Protection Eye Protection Fertilizer Hard Hats in specific area In specific areas Ear protection Foot Protection Hand Protection Respirator Other In specific areas Steel/composite toe In Designated areas N95- Plant. Half Face –Manure Pit N/A Maintenance In designated areas Glasses-working on machines. Face shieldgrinding In designated areas of maintenance work Slip resistant with steel/composite toe In designated area Not Required Harness during specific tasks (Maintenance) Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Barns (Caged) Not Required Glasses Not Required Slip resistant with Steel/Composite Toe Latex and cotton N95, half face Barns (Cage free) Not Required Glasses Not Required Slip resistance with Steel/Composite Toe Latex and cotton Half face Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Other Electrical Department Hard Hat-specific to project, Welders cap-specific to project Safety glasses-Daily, Face shield- specific to project, Welders helmet –specific to project Job specific Electrical rated Composite toe-Daily Leather gloves-Daily, Welders glove-Specific to project Not Required Fall Protection Harness- specific to job HVAC Crew Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Other Hard hat- job specific Glasses- Daily, Face shield- Job specific, Chemical Rates face shield- Job specific Job specific Steel toe boots-Daily, Chemical boots-job specific Leather gloves- Daily Not Required Chemical rates suit- Job specific 12 Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Other General Special Projects Hard Hat- specific to job Glasses- Daily, Hot suit face shield- job specific, Hot suit face cover-job specific Job Specific Steel toe boots Leather gloved- Daily, Hot suit gloves- job specific Not Required Fall protection harness- job specific, Hot suit shirt and pants-job specific Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Other General Construction Hard Hat- Daily Safety glasses-Daily, Face shield- Job specific Job Specific Steel toe boots Leather gloves- Daily Not Required Fall Protection harness- job specific Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Other Pest control: Weed control & prevention Not required Not required Not required Work boots (slip-resistant not required) Rubber/latex gloves Full face/half face Long sleeve shirt Pest control: Insect control & prevention Not Required Goggles Not Required Work boots (non-slip not required) Latex /rubber gloves Light duty mask optional Long sleeve shirt (mandatory) Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Pest control: Rodent control & prevention Not required Interior-mandatory, Exterior-optional Not required Work boots mandatory (slip resistant not required) Not required Light duty mask ( interior-mandatory, exterior-optional) Head Protection Eye Protection Ear protection Foot Protection Hand Protection Respirator Other Pest control: Barn Disinfectant Procedures Phase 1 & Phase 2 Not required Not required Not required Work boots (slip-resistant not required) Chemical rated rubber gloves Full face Long sleeve shirt, TyVek chemical resistant suit with hoodie 13 Certification Statement of Training-Personal Protective Equipment Program I __________________________, have read and understand the above policy and procedure. Not following this policy and procedure could result in a verbal written warning, written reprimand, or termination. Employee Signature: ______________________________________ Employee #: ______________________________________ Date: ______________________________________ Trainer / Supervisor Name: ______________________________________ Trainer / Supervisor Signature: ______________________________________ Date: ______________________________________ Note: Original form when signed will be provided to the Hickman’s Family Farms Human Resources Department for placement in the employee’s personnel file / training record farm MS i Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title; Hour x/Wt set; 5 077:4; 7 9? Location: xt/Imtn Wee Employee?s Name Number Si nature Instructor?s Signature: as .thIt. 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Rcviscd on 5/20/2014 fruiz Page I l/25/20l8 Hhhf?ii Employee?s _Weekly Safety Meeting Topics Attendance Roster Course Title: Course Hours: . pig-.. instructor i Location: Instructor?s Sinature: \Miuosol?it ?\'mm\\s\Tunpnan inurut i ?3 :mp oycca zict) cl ng lopics Kustc: clue 5/70/2014 Page i/25i20l8 321% mm Lf?am/Iy ?arms 4..) Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title; Course Hours: E?rnployee?s .n - Signature . Instructor's Signature: Internet "s Sulety 10pm Attendance 2 22 5 0115/20/2014 (wand on MU UM 0!"ch 1/25/20l8 Lil-I [ler?bh I farmfs 3/ Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title: Course Hours: 6.. ?mg. 1 Instr? 0 -c orint: Date: l0 L2 Locat1011: -. Employee? 5 Name Si.nature Instructor's Signature: 11111111. 1: l.11cr.1ct i ilcs?Coman O111l110k"l Weekl) Rusm doc Revised 01 Page I (?ll 111117. 1/25/2018 11 1111111111 ?53? 1 1 amily fms\/ Employee?s Weekly Safety Meeting Topics Attendance Roster I 1? . .. ?Ins?tructor Name (Please? pm Location: {/11 Number . . igrrature Instructor? 3 Sig?natu - 1? 111110115 11113111111 1L51L 11111L111 0111101111" \chkl) 1'opiLs 111mm 1111c (1/1 1/1014 PM. Revised Page 1 1/25/2018 - Employee?s Weekly Safety Meeting Topics Attendance Roster ??Course Title; . t: f) - . Course Hours: Instructor Date: Location; Af . Employee?s Instructor?s Signature: 4m ch rs? nu I .vucnl\.? licr ost It Internet 1 Attendance doc L't?callcd 0110/1 1'20} 1 2.05: RM Rev iscd on 5/20/2011! Page I uir i nature onto: 11. Weekly Safety meeting 'l'upica 1/2 5/20! 8 ami/y arms Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title:( . . Course Hours: [113/ . . Instructor Name (Please print): L?ocatien-z [[072 Name nature Instructor' 5 Signature: 'm I NC Tcmporan F-ilcs?l Out 00kt topics AllClIdimCC (10C t'rcIllcuun b.4171] Rm.- iscd 520/2011 Page I I has CICCIHC Fill]! lx?25x'20 8 PSI: 111 111111 .1 i; amt/y farms . 1 Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title: . ,11 ourse Hours. 0/ .. - Instructor Name (Please prin Date: 1 LocationEmployee 5 Name 1 I n- .No. Sinature 'Ij (1 ullmk?ll?ASRKY451131np10yee's Weekly Safety meeting 'l'oplcs Attendance Roster doc Created on (ail 1.2014 2: Revised 01: 5/20/2014 Page 1 instructor?s Signatur moso - 1. 1111.7 1/25/2018 LLfamlly farms\?) Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title: BC 7 7 .. Course Hours:/ I I Instructor Name (Please print): Date' yam/72075? I f?CL?ocation: . - U7 Employee?s Name in_st_ructor? Signatur . Weekly Safety meeting Topics - Attendance . Crcutcd on of] 1/2014 2:05:00 PM. Revised on 5/20/2014 . . . 1/25/2018 I 43;} ?l Lfamily farms} Employee?s Weekly Safety Meeting Topics Attendance Roster lCourse Title: - W12: 2 Course Hoursr/ hT?EtI?Llctor NaIne (Please print 7/ Y45?i?mel03cc's Weekly Safety loplcs . . - 12:05:00 PM. Revised on Iultul 0 HI mm? 1 1/35/2018 fruw &o ?l 4A q. A J. Attendance Roster Course Hours: Datezj 1 p, Employee?s Weekly Safety Meeting Topics ?7 '11 I Name (PI use pr/n Location: Employee? 5 I -- De_pt. No. 'I-nature Instructor? 5 Signature: Weekly Safety meeting Topics Cil Incc Rostcx doc Created 011 (I. 11/2015 2105?. 00 PM .sed on 5/ 20?2014 l?ugc 1/25/2018 II I: i r. 1 (If ii tilfamI/y farm-.35 Employee?s Weekly Safety Meeting Topics Attendance Roster Course Title: Course Hoursinstructor Name 'as- pri Location: 42% 2/ Employee?s . . . Si_nature Instiuctor? _S__ignatur Weekly Safety meeting Topics Attendance L?ruutcd on of] l/2Jl4 2:05:00 PM, Revised on 5/20?2014 1mg..- 1 1/25/2018 IN, tJamI/y farms}; I Instructor Name (Please min I . I'Location: Employee?s I - Dept. No. Signaturg,? i Instructor? 5 Si_gnature: scrs' cchuc IApp UCHI cmpormy Inc: ilcs? Cont-cm. Out. IA3RKY 45?15 mploycc's Weekly Safety meeting 'I?Opics Alter. dance KosIcI. doc L?mIch: 0/1 1/2014 2:05:00 PM. Revised on 5?20/2014 Page I 1/25/2013 .. I 1.2 as; I I 31:) amt/y farms Employee?s Wee?Igly Safety Meeting Topics Attendance Roster CourseTitIe: . .. ourse Hours: Siam, llIbtl uctor? 5 Signature: Weekly Topics A Icndumc Rosin. doc (leaned on 0/ I HUN- NUS: 00 PM Raised on 5/20/2014 my I 1/25/2018 .. 3 I- . a 4L [an'm'y far Employee?s Weekly Safety Meeting Topics Attendance Roster M. - Course Hours: MSW Dept. No. Signature Inature: mcnt.Outlook\ n} . r.doc . A I I. - l7 - Created on 6/11/2014 IIN, Ru md on -014 1/25/2018 Cl" t?rui'l Course Titre? 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Revised on 5/20/2014 1/25/2018 Page 1 111117 11-31: 1% Ljamlly farmSJ Employee?s Weekly Safety Meeting Topics Attendance Roster Course Titl Course Hours: an! rl?Stl?UCtOl - 1' .. . . - I Date. 301% 1 Il" . '13 Employee?s 1 1 Deut.No. 1 Location: _1g?nature I Instructor?s SignatureRevised 0:15/20/2014 u/ LJIIAJL. \l fami/Y far:m> I, Emponee?s Weekly Safety Meeting Topics Attendance Roster . I Course itIe: z/ n. Course Hours: I Insrructor \Iarne {Please prmt? I :lL'l .. Emponee?s Number I nature I. "or? .) I I'icI'RIcpI-duc chkI) Safety mccting Topics Attendance Created on 1/2014 2:05. Rcviacd 5/20/2014 I [1/25/2018 [\519 (Q 51?9" L- an; ?may Emp?oyee?s Weekiy Safety Meeting Topics Attendance Roster i wurse 1 Course Hours: Insi'ructor' a :nsrructor?s Signature: 1 Internet waly Safety meeting Topics Crculcd 0116/1 1/2014 2.0511111 on 5/20/2014 mm. Page 1 1/25/2018 . t5. ?rmly Employee?s Weekty Safety Meeting Topics Attendance Roster Course Title: Course Hours: mstrucmr Name (I- Location: I Employee?s Number 299?? No. Rummadoc (S 5:00 PM, Revised 5/20/1101 Page I 0093 Employee?s Weekiy Safety Meeting Topics Attendance Roster Course Title: Course Hours: I I . Instructor Name {Please mm) 4 Date: 87 i Lacation: Employee?s Number nature Instructor?s Signature: Weekly Sat?cty meeting Topics Attendance Rostcr?oc Cxcutcd on 6/ 1/2014 2:05:00 PM, Revised 0115/20/2014 :?ruiz Page I 1/25/2018 . L) HEEL) I L3, fami/ farmst/I Employee?s Weekly Safety Meeting Topics Attendance Roster ,g I Course Title; 5 - Course Hours: H: w, 5 L. Date: . Location: 1' Si nature Instructor's Signature: I1 I chkIySufcly111ccting'1?opics Attendance Rusk-awe Crculcd 01': 6/ 1/2014 2:05:00 PM, Revised on 5/20/2014 9:11;: 1 1/25/2018 t?ruiz ??199 1,359" Empioyee?s Weekiy Safety Meeting Topics Attendance Roster Course Title: . ourse OUFS: Employee?s Number Signature instructor?s Signature: Safety 1:1chng Topics Attendance Restcwoc Cicutcd on 6/1 1/2014 2:05:00 PM. Revised on 5/20/2014 Page 1 1/25/2018 (ii fr/C: Lfam/ly arms Employee?s Weekiy Safety Meeting Topics Attendance mm Roster Course Hours: Course Title: Signature Instructor'sSIgnature: Fif 011?. cm cc '5 Ifcly nucting Topics Attendance Rm?tcr. doc Created on 6/1 1/2014 2:05:00 PM, Revised on 5/20/2014 I?Iuiz Page 1 1/25/2018 I 55555 5 I. LI. 72-} 5.5. 32y family farm5.\\ 5 Employee?s Weekly Safety Meeting Topics Aitendance Roster 5 Course Tit5e: I I1 Course Hours: 5 . MSCIUCIOI ?IF?Employee?s on.- _nature Instructor?s Signature: awed.- I F55CSICOIHCIILOU5 Satcty meeting Topics we Roster. doc CI?cuch on 5/2014 2:05:00 PM, Revised on 5/20/2014 ?uiz Page I 5/25/2018 vv L1 55) i Ii [310((0 Employee?s Weekly Safety Meeting Topics Attendance Roster 5 Course Title: 11 Course Hours: i113t1 1cto1Nai11 Employee?s 5 Signature: Inlemc! Safety meeting 'I'op1cs Attendance Created on [/2014 2:05:00 PM, Revised on 5/20/2014 fruiz Page 1 1/25/2018 1 944?? 1.1L. JLI family ermsQ Employee?s Weekiy Safety Meeting Topics Attendance Roster . Course Tl . tle :L/klr.? . Course Hours: 1 I ll'1s'uucu0rl- Location: I Instructor?s Signature: WKIUHS. 'Icmpmun) lcn1. OutlooM?l'ASRK YJS'Employcc's Surely meeting Topics on 6/1 1/2014 2:05:00 PM, Rcviscd on {z'uiz Page 1 1/25/2013 l?il?lAN?g ami/r farms Employee?s Weekly Safety Meeting Topics Attendance Roster? Course Hours: Name . . Signature Instructor?s Signature: Weekly Safety meeting Topics Attendance Created on 6/1 l/2014 2:05:00 PM. Revised on 5/20/2014 l?ruiz Page i ll; . 1mm "Itmum. IIEE I A kl!- 1 IL I ill I. ill! i 2% 'Il. .311 phi-illl?l Ill?! 1? I ll i . .. Safety Data Sheet UHODIICI BKJDUCT AND h? "he" I: r?t gout; bweet valley Drive I?m?n- Jade, VICVV, unlu ?+4155 (216) 901-5800 (216)901?5801fax widen-J: pl Uduuscum 24 Hour emergency contact: Chemtrec (800) 424-9300 -COMPOSITIONIINFORMATION ON . -- Hazar?oous ingrem?ents Percent exposure Limits - 1' I I . 2" ?475,141? 0 ?Qtii? naus- fisa?t- ACGIH not established . A. n2 4 A AL 'u HAZARDS IDENTIFICATION it i a Route of Entry: Eyes, skin, inhalation, ingestion a Target Organs: . inhalation: Inhalation of spray mist may cause irritation to the respiratory tract. . Skin Contact: Repeated or prolonged contact with skin may cause mild irritation and possibly dementia. 5 Contact: Likely to cause immediate or delayed irritaion. irritation will show as redness andlor swelling of the EIW I I I, Mm . 31,11,322I'L'glIlulEU .?Illul'lx'l [no] rep iratiun I I I 2:5 '21]ng we: putv I1 I, all ll il .-. luau?: HH- Ilc?.v.7? lI-I?l?' I?lln?l-?Iun (?an "Han-u ?533 Dd 340 IF rennve person to fresh an and keep omfmlable for hrealhing 5" h? 13W iN WES watet for minutes Remove maniac! bnses. if present and easy to dc (immune rinsing PBOHP IF SWALLOWED Cal! 3 POISON doctor if you feel unwc?. P313 IF exposed or conoemed Get medical adhrcelatfen?P5?1olsposeofcommslomumm amdanoem bcalr- II 9125WMWSIWONRNFORMARQN QNINGREDIENTS attenuation .-. i ?5 it?\ .m-x-s .l I ?1'an ?1 - . Ouisnje US and anao a {North America) call 13 hemirec 03- 527-3887 -- - annrs 2? Air Sanitizer. This 808 is designed for workplace employees, emergency personnel and for other conditions and situations where there is greater potential for large-scale or prolonged exposure, in accordance with the requirements of 03001. Occupational Safety and Health Administration. This 808 is not applicable for consumer use of our products. For consumer use, a" precautionary?and ??ta It! ianguage Is prowded on the product label In accordance with the applicable government man": . -. .. - in Section 15 of this 808. ii?hz?hioi'?'m': ?Dunn?s o-I a My. . 1 . s: 43.1Irv. . I I II e. I II I303CII I INII HILII II.. I. . TTUCK a II I I I II.IIM