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<br /> <br />2. CONTRACTOR SAFETY PROGRAMS <br /> <br />Safety Programs Necessary to <br />Complete Work1 <br />Written <br />Program?2 <br />Employees <br />Are Trained?3 <br />Reviewed?4 <br /> Lock Out – Tag Out <br /> Hot Work <br /> Confined Space Entry <br /> Line or Equipment Opening <br /> Plant Entry and Security <br /> Emergency Action Plan <br /> Trained to Defensive <br />Response <br /> Trained to Offensive <br />Response <br /> <br /> Fire Prevention Plan <br /> Forklift Driver Safety <br /> Injury & Illness Prevention <br />Program <br /> <br /> Respirator Program <br /> Known Hazards5 <br /> <br />Is your company willing to allow Leprino Foods - Tracy to review all written safety <br />programs that are applicable to performing work on or near the ammonia <br />Refrigeration system? <br /> <br />Yes No <br />(A contractor who answers “no” is subject to further review) <br /> <br />1 The Process Safety Management (PSM) Program Implementer will check each program that is <br />necessary to complete the work. <br />2 The contractor will initial in the block beside each checked box to certify that the contractor has <br />a written safety program. <br />3 The contractor will initial in the block beside each checked box to certify that the contractor can <br />provide documentation that employees have been trained in the indicated safety program. <br />4 The Process Safety Management (PSM) Program Implementer may spot check the safety <br />programs of the contractor by reviewing the written program, observing employees as they work, <br />or questioning employees as to their knowledge of the programs. <br />5 Other than anhydrous ammonia there are no known potential fire, explosion or toxic release <br />hazards related to the work of the contractor and to the process where the work is taking place. <br />