5.4. ERMUSR 02-12-2019 Elk River
Municipal Utilities UTILITIES COMMISSION MEETING
TO: FROM:
ERMU Commission Theresa Slominski—Finance & Office Manager
MEETING DATE: AGENDA ITEM NUMBER:
February 12, 2019 5.4
SUBJECT:
2018 Annual Safety Report
ACTION REQUESTED:
No action is requested.
BACKGROUND:
Minnesota Rules Chapter 7826 Public Utilities Commission Electric Utility Standards cover
safety, reliability, service, and reporting requirements. Per 7826.0100(A), municipal utilities are
exempt from these requirements. However, the Elk River Municipal Utilities Commission
adopted a number of parts of this chapter as a Distribution Reliability Standard policy. This
policy includes an Annual Safety Report requirement. The policy requires ERMU to "file an
annual safety performance report with its local governing body.The report will include
summaries of all reports files with OSHA and the Occupational Safety and Health Division of the
Minnesota Department of Labor and Industry during the calendar year."
DISCUSSION:
In 2018,there was one recordable case which resulted in 0 days away from work. Attached is
the OSHA Form 300A that has been filed. It is a summary of work related first report of injuries
and illnesses. Also attached is the OSHA Form 300A from 2017 for reference.
FINANCIAL IMPACT:
None
ATTACHMENTS:
• 2018 OSHA Form 300A—1/16/2019
• 2017 OHSA Form 300A—1/08/2018
Page 1 of 1
66
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•
OSHA's Form 300A (Rev.01(2004) Note:Yon ean type input into this foam and save it. Year 20 /8
Because the forms in this recordkeeping package are'fdlabWvaitable'
Summary of Work-Related Injuries and Illnesses Pen documents,i guts using type into free the Adobe PDF R form eeder. u s.Department of Labor
then save your inputs the PDF Reader. amone 40 fa.qw dt..na aeaa ar tho
y.'.••Form gpmvmj OMB so.121a017a
Ail establishments covered by Part 1904 must complete this Summary page,even if no work-related Injuries or illnesses occurred during the year.
Remember to review the Log to verify that the entries are Complete and accurate before completing this summary.
Using the Log,count the individual entries you made for each category.Then write the totals below,making sure you've added the entries from Establishment information
every page of the Log.If you had no cases,write 0.' v„„, •., ,,,,,,,Elk River Municipal Utilities
Employees,former employees.and thelrepresentatives have the right to review the OSHA Fonn 300 in its entirety.They also have limited access
to the OSHA Form 301 or its equivalent See 29 CFR Part 1904.35,in OSHA's recordkeeping rude,for further details on the access provisions for street 13069 Orono Pkwy
these roans.
CityElk River stag MN yip 55330
Number of Cases
Industry description(e.g..Mamfactare of motor truck trailers)
Total number of Total number of Total number of cases Total number of Electric&Water Utilities
deaths cases with days with job transfer or other recordable '
away from work restriction cases Standard Industrial Classification(SIC),if known(e.g.,3715)
0 0 0 1 9924
(0) (it) (If WIOR
North American Industrial Classification(NAICS),if known(e.g.,336212)
Number of Days 922190
Total number of days Total number of days of job Employment information ahem don't have them figures.see the
away from work transfer or restriction Workrhrer on the next page to estimate.)
Annual average number of employees 44
(R) (L)
79436
Total hams worked by all employees last
Injury and Illness Types Sign here
Total number of... Knowingly falsifying this document may result in a fine.
(M)
(t l Injuries 1 (4)Poisonings 0 I certify that I have examined this document and that to the best of
my Itpowledge the a re true,ap/curaattee,,�my complete. /�v,/i(�y-
(2)Skin disorders 0 (5)Hearing loss 0 C—','�r . LIA a r/�' Of&- "p-
(3)Respiratory conditions 0 (6)All other illnesses 0 CAP //eaecunve -��t Tian �/�� n
- Phone'W H�/1- 2-020 Date / l �II/ 2.011
Past this Summary page from February t to Apn s 30 at the year following the year covered by the teem _^ Ye4npVt
?Olio reportin.endT hmeu r«aba menu of enaoo.Rawlo umw..voKwmiw.d amm+oo^-f including hs it disays a000i onol,O control
ar..ce4ne .c:.a„
'ended about nthnuff eteCe or of myobaasm.rmem re collodot iredon,so ce o:USpond ep cellrtment ofIe ivf 6m vdw S euply.,onmey vond saco,wl Coo utionA if you msmr•
aMoa 021G,estimates ormyNhmaryshoses se as office.o,cello:VS Deportment oEL.bm,OSHA O&rs.r3ttle:._,AnJ.ri;Ro®t1.3aJ1.2na Constitution A.�a.NW,
Wmaiatma DC 2a21 a,Do not mad the completed foams so this office.
67
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OSHA's Form 300A (Rm..olr2dg4) Mtn You d° ' oto Mk dam i4 ma Year 2017
Beam packagaue'VinSblenelhWe
PORsdominants.nput angipe�obedtatuRend and OA 4pmlmaddLffiar
Summary of Work-Related Injuries and Illnesses thataaHsyarin�tgngsgtlielMAdobePOFReader. er�arbletsir
„w,Ae�,,,,,,
ResivrawedOMB.11114r16
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Employaesfivmarefp(oyeeRane Sag os theshawthedghtIo»viewIheOSHAFae$00InHoen**They&nohayS10)44aeoess
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Elk RiverCity &age MNp .85330
Washy• daw+iPdo (e.g,atemfzetrre qf atom buck troika)
Total mmbcrof Toed nwoberof Total comber Mosses Total amber of Eledrid&Water Mlles
debris oases widtdays with jobmaster or o meordabh >Naaaea ia►pss+iBadsa(ffiC)ff}mown tag-sylf)
away font work restriction ass
0 0 0 4 9924
OR
0 00 W (4 ,
Notett Amaiem btdmtrial C W dBadms(NAILS),If lmowe(e.g.,336212)
922100
Total=mbarofdays Total number of dais of job Women(kdomisew(Omdont lunwhasqlssuus,see de
away from work trwferorrestriction Worisheetaadcamap:etaeudmeta)
o 0 Annul mange eamobaofamployen 44
00 0.) - Total haws wcdwdby all employees last year 942.-9Z
SO hare
Total timber of... 3fnowlagy falsilog ads decemeat may rankle afne.
I aa6(}rrim I bmew document
a3ined�{s doment and that to the best of
(t)lhpm{as 8 (a)Poisoaiags 0 knowledge • are acdurata,end complete.
(2)Sldodisorders 0 (6)Honing lost 1 �'KC ����J�� �:Aet ut t OWL:c.Pts
00 Respimtoryconditians 0 (e)All other i illnesses 0 axeeudvo TMe
P6wel3,- 6.35-1325 Date $L/08/ZOIS
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