APPENDIX - Forms and Documents
Accident/Incident - FORM DA 2000 (pdf)
Annual Review (pdf)
Confined Space Required Permit - Example (66kb pdf)
Declination Statement for Hepatitis B Vaccination
Drug-Free Employee Policy Receipt (pdf)
Drug-Free Student Policy Receipt (pdf)
Drug Test Employee Policy Receipt (pdf)
Engineering Controls & Work Practices
Exposure Determination Log
Fire Drill Report (MS Word)
Fire Extinguisher Report (MS Word)
General Liability and Loss Form (pdf)
Harassment Form (10kb pdf)
Hazard Control Log (MS Word)
Hazard Control Log (pdf)
Hot Work Permit - Example Form (92kb pdf)
Job Safety Analysis Worksheet - JSA 1-00 (MS Word)
Job Safety Analysis - Example (pdf)
Safety Meeting Report (MS Word)
Safety Inspection Checklist - General (MS Word)
Vehicle Safety Checklist (MS Word)
Violence in the Workplace Checklist (56kb MS Word)
The most current ORM Loss Prevention sample forms and documents can be found at:
http://www.doa.la.gov/orm/lpforms.htm
Safety Checklist Program for Schools
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