Appendix A - G

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Appendix A

Sample Emergency Procedures Manual

By a printer member in Los Angeles, CA

Responsible Individuals

In the event of a fire, release or threatened release of a hazardous material or other emergency, the Facility Emergency Coordinators are responsible for initiating response actions by the business to include control and mitigation of the incident and evacuation of plant personnel. Shift Emergency Coordinators make departmental decisions until the Facility Emergency Coordinator arrives. The following persons are appointed as Emergency Coordinators and Alternates:

Emergency Coordinator (Facility)
Frank, Director EHS

Plant Tel. ## XXX-XXX-XXXX 24hr ## XXX-XXX-XXXX
Cellular ## XXX-XXX-XXXX Pager ## XXX-XXX-XXXX

Alternate Emergency Coordinator (Facility)
Ed, VP Manufacturing

Plant Tel. ## XXX-XXX-XXXX 24hr ## XXX-XXX-XXXX
Cellular ## XXX-XXX-XXXX Pager ## XXX-XXX-XXXX

Plant Emergency Coordinator (1st Shift)
Alan, VP Finance

Plant Tel. ## XXX-XXX-XXXX 24hr ## XXX-XXX-XXXX
Cellular ## XXX-XXX-XXXX Pager ## XXX-XXX-XXXX

Plant Emergency Coordinator (3rd Shift)
Kurt, Manager, Night Production

Plant Tel. ## XXX-XXX-XXXX 24hr ## XXX-XXX-XXXX
Cellular ## XXX-XXX-XXXX Pager ## XXX-XXX-XXXX

Medical Emergency

For severe injuries notify the paramedics by dialing 911. The nearest emergency hospital for severe injuries is: XYZ Hospital, 123 Main Street, Anywhere, USA XXX-XXX-XXXX.

For minor to moderately severe injuries:  
ABC Healthcare: 234 Main Street, Anywhere, US XXX-XXX-XXXX
USA Healthplace, 345 Main Street, Anywhere, US XXX-XXX-XXXX

Minor First Aid Treatment
First aid kits are stored in various locations throughout the facility. The first aid kits are available to employees that sustain an injury or are involved in an accident requiring minor first aid treatment. The supervisor will initiate the Accident Investigation Report and the Supervisor's First Report of Injury.

Non-Emergency Medical Treatment
For non-emergency work-related injuries requiring professional medical assistance other than first aid, management must first authorize treatment.

  • Inform your supervisor. The supervisor will Initiate the Accident Investigation Report and the Supervisor's First Report of Injury.
  • Proceed to the posted medical facility. Your supervisor will assist with transportation, if necessary.

Emergency Medical Treatment
If you sustain a severe injury requiring emergency medical treatment:

  • Call for help and seek assistance from a co-worker.
  • Use the emergency telephone numbers and instructions posted on this page of this pamphlet to request assistance and transportation to the local hospital emergency room.
  • The supervisor will initiate the Accident Investigation Report and the Supervisor's First Report of Injury.


Power Outage

In case of a power outage:

Remain Calm

Determine Extent
Contact the Emergency Coordinator and your Supervisor to report the extent of the outage.

Turn Off Equipment
Turn off power switches on equipment such as computers, processors, photo processing equipment, fax and imaging machines, power tools, and any other applicable equipment.

Wait for Instruction
Await instruction from your Supervisor and/or Emergency Coordinator.

Limit Phone Use
During an outage those phones that are still in operation will be utilized for essential calls only.

Evacuation Notice: Emergency lights are positioned throughout the facility to illuminate stairwells, hallways and exits in order to facilitate evacuations.


Hazardous Material Spill

Only those persons designated and properly trained may respond to an emergency involving a spill of hazardous materials. All other persons must evacuate the area or plant as requested by the Emergency Coordinator.

Identify Chemical
Identify the spilled chemical and notify the Emergency Coordinator and your Supervisor immediately.

Wear Proper Protective Equipment
Consult the specific procedure for the type of protective equipment to wear for different types of spills and/or check the container label for guidance. Consult with the Emergency Coordinator before entering any area affected by a spill to determine whether additional protective equipment will be required.

Stop Flow
As directed by the Emergency Coordinator or your Supervisor and without endangering yourself, try to stop the flow and prevent the spill from spreading.

Clear Aisles
Clear an aisle so other people do not step on or through the hazardous material. Keep the material away from drains.

Call for Help, If Necessary
If the spill is too large to handle, the Emergency Coordinator will be responsible to call and request assistance from the Fire Department HAZMAT Squad by dialing 911 in the event of an emergency or by calling the business line at XXX-XXX-XXXX.

Spill Cleanup
Once a spill has been contained, absorbed and placed in drums, and the drum has been properly labeled in accordance with regulations, provisions must be made with a licensed hazardous waste transporter to remove the accumulated hazardous waste from the site within 90 days.

Note: If the supervisor reports that the emergency is beyond the immediate control with spill control equipment, the EMERGENCY COORDINATOR will initiate an evacuation of the affected area or, if necessary, the entire plant.



Alert Others
In the case of fire immediately notify your Supervisor or the Emergency Coordinator. If the fire is small, attempt to extinguish it with a fire extinguisher.

Leave Area
If you cannot safely extinguish the fire after expending two (2) fire extinguishers, and you are not a member of the fire brigade leave the area immediately.

Evacuate if Advised
If the Emergency Coordinator orders an evacuation, follow the evacuation procedures. Evacuate to your assigned Evacuation Staging area and await further instruction. Evacuation maps are posted throughout the facility.

Wait for Clearance to Return
Do not return to the building until the "all clear" is given by the Fire Department or the Emergency Coordinator.

Emergency Action and Evacuation
Employees must report any emergency directly to their supervisor or the Emergency Coordinator.

  • The supervisor in the affected area will assess the situation. If the emergency involves fire the supervisor will immediately send persons to notify the Emergency Coordinator and, as appropriate, obtain fire extinguishers.
  • Based on reports from the supervisor as to the severity of the fire the Emergency Coordinator or Alternate will call the fire department by dialing 911 in the event of an emergency or by calling the business line at XXX-XXX-XXXX.

Note: If the supervisor reports that the emergency is beyond immediate control with fire extinguishers, the Emergency Coordinator will initiate an evacuation of the affected area or, if necessary, the entire plant.



Before the Quake
Know the danger spots within the building.

  • Glass windows and mirrors.
  • Unsecured equipment, stripping tables, files, books, etc.
  • The pressroom floor area and loading docks.

During the Quake
Get to a safe location or crawl under a desk.

  • Unsecured desks and tables will slide and move unpredictably. Be ready to move with them.
  • If you are indoors, stay indoors. Get to a safe location or crouch next to an interior wall.
  • If you are outdoors go to an open area away from the buildings, trees and electrical wires.

After the Quake
Report to your Supervisor for instructions.

  • The Emergency Coordinator in conjunction with the Department Supervisors will assess the situation and assign duties including:
    • Search and assist team for trapped and injured workers.
    • Hazard hunters to check for gas or water leaks, broken electrical wiring and glass hazards.
  • The Emergency Coordinator will pass out earthquake supplies and tune the am radio to a public address station for information.
  • The Emergency Coordinator will determine if any structural damage has occurred and if evacuation is necessary.
  • If evacuation is not necessary the Emergency Coordinator will determine whether or not it is safe to continue operations.

After the quake do not make local calls except to request emergency assistance. To know whether you are to report to work or for specific information regarding operations senior plant management will activate a pre-recorded emergency message mailbox which will be accessed by calling the main number.


Please give this number to others who would be concerned about your safety.


Bomb Threat

Bomb threats should be taken seriously. Do not assume that bomb threats are made only to management or executive personnel. Anyone can receive a bomb threat and everyone should be prepared.

In the Event of a Bomb Threat is Received
Call 911 and give the following information:

  • Your name and the nature of the emergency.
  • The building name and address:
    ABC Printing Company
    123 Main Street
    Anytown, State 10000
  • Your call back number

Do not hang up until the Emergency Coordinator does so. Immediately report the threat to your Supervisor and the Emergency Coordinator.

If a Suspicious Object is Found

  • Do not touch it.
  • Move everyone away from the affected area.
  • Notify the Police Department immediately by dialing 911.
  • Notify the Emergency Coordinator.
  • Open all doors in the area.
  • Do not allow two-way communication devices to be used.
  • Prepare to evacuate the area. The Police Department will advise you.
  • If evacuated immediately go to the Evacuation Staging area and await further instructions. Under no circumstances are you allowed to return to the building until the Police Department has given the "all clear" sign.

Most bomb threats are made by telephone. If you receive the call:

Ask Questions:
When will it go off?
Where is it located?
What type of device is it?
Why are you doing this?
Who are you?

Record All Information:
The exact time of the call.
The callers exact words.
Any background noises.
A description of the caller (sex, nationality, age, etc.)


Evacuation Procedures

If the Emergency Coordinator or your Supervisor directs you to evacuate:

Remain Calm

Gather with other employees

  • Know your posted evacuation route out of the building.
  • Go to the nearest clear exit and exit the building.
  • Walk single fire in an orderly manner.
  • Proceed immediately to the evacuation staging areas.


  • Follow the Emergency Coordinator or your Supervisor's instructions
  • The last person leaving each area should close the door if applicable and hit the red emergency stop buttons to shut down the equipment.
  • Assist handicapped individuals, visitors or new employees who may be unfamiliar with the building's emergency exists.
  • Keep noise to a minimum and listen for further instructions.

Make Room for Emergency Personnel

  • Allow room for the Fire Department or other emergency personnel to access the building unobstructed.

Go to the Evacuation Staging Area

  • Go to your department's evacuation staging area and await further instruction.
  • Do not socialize.
  • Keep noise to a minimum and cooperate with the emergency responders, Emergency Coordinator and your Supervisors' efforts to take a headcount.

Wait for "All Clear"

  • Do not return to the building or go to your vehicle until instructed to do so by the Emergency Coordinator or the emergency responders.

Inform Others Before Leaving

  • In the event of a major disaster where it will not be possible to resume work you may receive permission to go home. You must check with your Supervisor to receive permission to leave the site.

It is very important you become familiar with the Evacuation Maps posted throughout the facility. If you notice an area that is missing an Evacuation Map or notice that a map is in need of being updated, notify the Director, EHS (Ext. XXX) as soon as practicable.


Telephone System Failure

Determine the Extent of the Problem
Determine if the extent of the problem is localized to your area, widespread or external.

Report to Information Systems
Call or send a runner to the reception area to report the problem to the Information Systems Manager.

Report to the Senior Management
The Information Systems Manager should contact Ed or Alan at the plant or at home.

Call the Service Provider Only if the Problem is External
If the problem is found to be external, the repair department of the phone system service provider should be contacted to effect repairs as soon as possible.

Battery Backup Functions Automatically
The telephone system is connected to a battery backup which will keep the system operational for approximately 12 hours of normal use. With minimal use the system will remain operational longer.

Additional Phones Available Some telephones in the building are not connected to the phone system and should remain operational even if the entire phone system and backups fail (i.e. cell phones and pay telephones).

Dedicated Lines
The following "facsimile" and/or modem lines will be converted to manned phones during a telephone system outage:

Executive Secretary XXX-XXX-XXXX
Customer Lounge XXX-XXX-XXXX
Sales Department XXX-XXX-XXXX
Estimating XXX-XXX-XXXX
Production XXX-XXX-XXXX
Purchasing XXX-XXX-XXXX
Environmental XXX-XXX-XXXX
Sheetfed Pressroom XXX-XXX-XXXX
Production XXX-XXX-XXXX
Accounting XXX-XXX-XXXX
Receiving XXX-XXX-XXXX
Ink Systems XXX-XXX-XXXX
Web Pressroom XXX-XXX-XXXX

NOTE: During an earthquake or other disaster, service to pay telephones will be the first to be restored.


Appendix B

Safety Inspection Sheet

Inspected by:________________ Date:_____________
Submitted to manager on (date):_____________

Action Needed


Date Corrected
Exits unobstructed and clearly marked      
Fire Safety      
Access to extinguishers clear      
Extinguishers properly inspected      
Fire doors in proper working order      
Sprinkler system heads clean and clear      
Flammable Liquids      
Containers properly labeled and grounded      
Quantities greater than 120 gal. Kept in flammable liquid storage room      
Safety cans used for all flammables      
Combustible dust areas vacuumed frequently      
Rags kept in self-closing containers      
Work areas free of trash      
Inventory Storage      
Hazardous material properly labeled      
Loads stable      
Pallets properly stacked and in good repair      
All guards kept in place and undamaged      
Housekeeping OK      
All electrical cords undamaged      
All hand tools in good working order      
Cabinets and switchboards in good working order      
Conduit and armored cable adequately protected      
Motors clean      
Personal Protective Equipment      
Emergency eyewash stations in place      
Eye protection worn when necessary      
Gloves worn when necessary      
Hearing protection worn when necessary      
Safety shoes worn when necessary      
Walking and Working Surfaces      
Aisles marked      
Stairs clear and in good repair      
Surfaces clear      
Railings in place      


Appendix C

Industrial First Aid Kit

*The following is a checklist from the National Safety Council and only includes the minimum recommendations. You should request advice from your insurance companies and local first aid distributors for other items that should be included for specific needs within your company. You should also take into account the number of employees in your company to be assured that you have enough materials to deal with situations as they arise.





Burn Treatment

Hydrogel dressings      
Burn Spray      
Cold packs and sprays      

Cut Treatment

Compress bandages      
Roll gauze and pads      
Adhesives tapes and bandages      
Cut cleaners      
Infection prevention ointments      
Wipes and liquid antimicrobials      
Hydrogel dressings      

Eye Injuries

Eye washes      
Eye magnet for removing fragments      
Eye pads and dressings kits      
Eye ointment and drops      

Shock or Fainting

Ammonia inhalants      


Triangular bandages      


Cold packs      

Bee Stings

Sting Extracts      
Sting Swabs      







Splinter forceps      
Splinter out blades      

Contagion Control and Protection

One way valve mask      
Antimicrobial surface cleaner      
Skin cleaner and antimicrobial solutions      

General Wellness

Non-prescription cold medicine      
Headache remedies      
Stomachache remedies      
Sore throat lozenges      
Allergy remedies      
Breathing Stopped and Toxic Inhalation      
CPR mask      
Automated external defibrillator      


Appendix D

Other resources

On-Site Emergency Response Planning Guide: for Office, Manufacturing and Industrial Operations, (ISBN: 0-87912-218-8) published by the National Safety Council, (NSC Product Code: 12212-0000), to order call 1-800-621-3433.

"Disaster Clean-up Yellowpages"

The PR Crisis Bible: How to Take Charge of the Media When All Hell Breaks Loose. By Robin Cohn, St. Martin Press, 2000.

Federal Emergency Management Agency (FEMA)
FEMA Disaster Planning Information

"Workplace Violence Survey and White Paper" from the national American Society of Safety Engineers (ASSE)

OSHA's Revised "How to Plan for Workplace Emergencies and Evacuations." OSHA Publication 3088 (2001 Revised).

Disaster Plan Outline. Printing & Imaging Association of New York State. Amherst, NY. 716-691-3211

Disaster Recovery Guide: Developing a Disaster Recovery Plan. Printing & Imaging Association of MidAmerica, Inc. Dallas, Texas. 214-630-8871.

NFPA's 2007 Standard on Disaster/Emergency Management and Business Continuity Programs


Appendix E

Emergency Response Preparedness
Would your safety program pass muster with OSHA? Working safely means doing the job right with no accidents, which means dollars saved for your company. Unsafe work practices can expose your company to crippling liability suits and serious fines.

This advisory includes the basic elements of an effective safety program, all suggestions are from OSHA. Most companies should already have a program in place and those that don't need to implement one. Making this investment could be one of the most important decisions your company makes. On the reverse page you will find a sample inspection sheet that covers major areas of concern for OSHA that can guide you through developing a safety/health program or pinpoint problem areas in your plant.

There are six basic elements to ensuring a safe work environment.

First: Establish a Safety Philosophy
It should be the goal of your company to eliminate all accidents. With less of a demanding objective, accidents begin to become accepted. Make it known to every employee that his or her job depends on the ability to follow all safety procedures implemented by your company.

Second: Assign Responsibility
If you cannot run the safety program yourself, make someone with that accountable. Make certain it is someone you trust, remember unsafe practices and lax rules can result in injury to workers, which can lead to corporate exposure to tremendous liability.

Third: Identify and Control Hazards
Identify workplace hazards that exist or could develop and review workers' compensation reports to identify where accidents have occurred. From that, create a list along with a checklist similar to the on the back of this page to evaluate your plant. When accidents or even near accidents occur, make sure they are investigated thoroughly so that everyone understands the causes involved in order to prevent reoccurrence.

Fourth: Supervisor and Employee Training
As an owner or manager, you must, by law, ensure that all employees know how to safely use the materials and equipment with which they work. Consider sending your safety supervisor to a safety management training course. The National Safety Council and many PIA affiliates conduct safety management training courses throughout the country, as well as local community colleges. Pay special attention to training new employees, don't let your program get lax.

Fifth: Safety and Health Recordkeeping
Record each injury (other than those requiring only first aid) on the OSHA Form 200. Call PIA or your local OSHA office to obtain a copy. The law requires companies to post this form in the workplace each February and to keep it posted through the following March. It must be kept for five years. File all Material Safety Data Sheets (MSDS's) on chemicals in a place accessible to employees and train them on locating the right ones. Retain all correspondence you generate requesting Material Safety Data Sheets or labels from your suppliers.

Sixth: Inspect Your Plant
Use the "Inspection Sheet" on the reverse page to pinpoint safety problems. Add or delete items from the checklist in order to tailor it to your operation and then establish a regular procedure to use the sheet on a monthly basis.

Some other points that might be helpful in increasing employee safety that are not on the "Inspection Sheet" are listed below and can certainly be added as needed:

  • Develop and post a written safety policy for your workplace
  • Post emergency contacts and phone numbers
  • Post warning signs near potentially hazardous areas
  • Make sure that all employees use appropriate eye/face, foot, hand and head protection

Make certain that respiratory protection requirements are met and that there is someone trained in the latest respiratory first aid techniques, including the updated CPR techniques and use of Automated External Defibrillators (AEDs) in case of a heart attack.


Appendix F


Exact time of call:

Exact words of caller:


  1. When is bomb going to explode?
  2. Where is the bomb?
  3. What does it look like?
  4. What kind of bomb is it?
  5. What will cause it to explode?
  6. Did you place the bomb?
  7. Why?
  8. Where are you calling from?
  9. What is your address?
  10. What is your name?


Calm Slow Crying Slurred
Stutter Deep Loud Broken
Giggling Accent Angry Rapid
Stressed Nasal Lisp Excited
Disguised Sincere Squeaky Normal

If voice is familiar, whom did it sound like?

Were there any background noises?


Person receiving call:

Telephone number call received at:


Report call immediately to:

(Refer to bomb incident plan)

Appendix G

Additional Sample Disaster Plans

Published on Friday, May 19, 2006 (updated 08/01/2016)

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