Fill and Sign the Workplace Rules Form

Sample Workplace Safety Rules Modify to fit your company’s circumstances Your safety is the constant concern of this company. Every precaution has been taken to provide a safe workplace. Common sense and personal interest in safety are still the greatest guarantees of your safety at work, on the road, and at home. We take your safety seriously and any willful or habitual violation of safety rules will be considered cause for dismissal. { Insert Name of Company }is sincerely concerned for the health and well being of each member of the team. The cooperation of every employee is necessary to make this company a safe place in which to work. Help yourself and others by reporting unsafe conditions or hazards immediately to your supervisor. Accident reporting. Any injury at work—no matter how small—must be reported immediately to your supervisor and receive first aid attention. Serious conditions often arise from small injuries if they are not cared for at once. Specific safety rules and guidelines. To ensure your safety, and that of your coworkers, please observe and obey the following rules and guidelines:  Observe and practice the safety procedures established for the job.  In case of sickness or injury, no matter how slight, report at once to your supervisor. In no case should an employee treat his own or someone else's injuries or attempt to remove foreign particles from the eye.  In case of injury resulting in possible fracture to legs, back, or neck, or any accident resulting in an unconscious condition, or a severe head injury, the employee is not to be moved until medical attention has been given by authorized personnel.  Do not wear loose clothing or jewelry around machinery. It may catch on moving equipment and cause a serious injury.  Never distract the attention of another employee, as you might cause him or her to be injured. If necessary to get the attention of another employee, wait until it can be done safely.  Where required, you must wear protective equipment, such as goggles, safety glasses, masks, gloves, hair nets, etc.  Safety equipment such as restraints, pull backs, and two-hand devices are designed for your protection. Be sure such equipment is adjusted for you.  Pile materials, skids, bins, boxes, or other equipment so as not to block aisles, exits, fire fighting equipment, electric lighting or power panel, valves, etc. FIRE DOORS AND AISLES MUST BE KEPT CLEAR.  Keep your work area clean.  Use compressed air only for the job for which it is intended. Do not clean your clothes with it and do not fool with it.  Observe smoking regulations.  Shut down your machine before cleaning, repairing, or leaving.  Tow motors and lift trucks will be operated only by authorized personnel. Walk-type lift trucks will not be ridden and no one but the operator is permitted to ride the tow motors. Do not exceed a speed that is safe for existing conditions.  Running and horseplay are strictly forbidden.  Do not block access to fire extinguishers.  Do not tamper with electric controls or switches.  Do not operate machines or equipment until you have been properly instructed and authorized to do so by your supervisor.  Do not engage in such other practices as may be inconsistent with ordinary and reasonable common sense safety rules.  Report any UNSAFE condition or acts to your supervisor.  HELP TO PREVENT ACCIDENTS.  Use designated passages when moving from one place to another; never take hazardous shortcuts.  Lift properly—use your legs, not your back. For heavier loads, ask for assistance.  Do not adjust, clean, or oil moving machinery.  Keep machine guards in their intended place.  Do not throw objects.  Clean up spilled liquid, oil, or grease immediately.  Wear hard sole shoes and appropriate clothing. Shorts or mini dresses are not permitted.  Place trash and paper in proper containers and not in cans provided for cigarette butts. Safety checklist. It’s every employee’s responsibility to be on the lookout for possible hazards. If you spot one of the conditions on the following list—or any other possible hazardous situation—report it to your supervisor immediately.  Slippery floors and walkways  Tripping hazards, such as hose links, piping, etc.  Missing (or inoperative) entrance and exit signs and lighting  Poorly lighted stairs  Loose handrails or guard rails  Loose or broken windows  Dangerously piled supplies or equipment  Open or broken windows  Unlocked doors and gates  Electrical equipment left operating  Open doors on electrical panels  Leaks of steam, water, oil, etc.  Blocked aisles  Blocked fire extinguishers, hose sprinkler heads  Blocked fire doors  Evidence of any equipment running hot or overheating  Oily rags  Evidence of smoking in non-smoking areas  Roof leaks  Directional or warning signs not in place  Safety devices not operating properly  Machine, power transmission, or drive guards missing, damaged, loose, or improperly placed Safety equipment. Your supervisor will see that you receive the protective clothing and equipment required for your job. Use them as instructed and take care of them. You will be charged for loss or destruction of these articles only when it occurs through negligence. Safety shoes. The company will designate which jobs and work areas require safety shoes. Under no circumstances will an employee be permitted to work in sandals or open-toe shoes. A reliable safety shoe vendor will visit the company periodically. Notices will be posted prior to the visits. Safety glasses. The wearing of safety glasses by all shop employees is mandatory. Strict adherence to this policy can significantly reduce the risk of eye injuries. Seat belts. All employees must use seat belts and shoulder restraints (if available) whenever they operate a vehicle on company business. The driver is responsible for seeing that all passengers in front and rear seats are buckled up.