AFPM Distinguished Safety Award Application

2014

AFPM Distinguished Safety Award Application

AFPM DISTINGUISHED SAFETY AWARD

DESCRIPTION

The AFPM Distinguished Safety Award (DSA) recognizes those refineries and petrochemical facilities* that have attained a superior level of safety performance in the domestic refining and petrochemical manufacturing industries[*]. Recipients are chosen by a selection committee represented by members of the AFPMSafety and Health Committee. It is the selection committee's responsibility to carefully examine the safety performance records of individual plant locations using the specific screening and selection criteria detailed below. The selection committee will meet the morning of February 18, 2015. The committee requests that the plant safety contact or someone else be available from your site in case the committee has additional questions or clarifications regarding your DSA application.

Selection will not be based on statistical measurement alone, but will also be determined by the candidate's written application which should include pertinent, non-statistical information relative to a facility's present and past history of safe operations. The DSA application is included on pages 4 through 13. It is imperative that both Part A and Part B be thoroughly completed and submitted in order to be considered.

Applicants who do not receive the DSA may be considered for the DSA Honorable Mention Award. The DSA Honorable Mention Award is presented to those DSA applicants that pass the DSA Screening Criteria and in the judgment of the Selection Committee, have exhibited exceptional safety performance and program innovation.

SCREENING CRITERIA (PART A)

In order to qualify for the DSA, a facility must first pass the following screening criteria.

1. A location must achieve the following requirements for the calendar year:
2. an employee total recordable incidence rate (TRIR) of 0.3 or less,
3. a contractor total recordable incidence rate (TRIR) of 0.3 or less,

1. A location must have had no employee workplace related fatalities and no non-employee (contractor, visitor, etc.) workplace related fatalities for the previous five consecutive years.

A location must answer NO to the following questions to pass the screening criteria and be eligible to apply for the DSA award:

1. Did the location experience a community evacuation or sheltering event, or worker/contractor hospitalization (admitted for treatment) during the evaluation period?

1. Did the location experience a recordable injury where any of the following caused or contributed to the injury during the evaluation year?
2. Failure to isolate hazardous energy (lockout/tagout)
3. Opening process equipment not properly prepared for maintenance
4. Improperly prepared or hazardous confined Space
5. Improperly prepared or hazardous excavation
6. Any falls from height (>4 feet)
7. Any Tier 1 of 2 Process Safety Event (PSE)
8. Contact/exposure to hazardous materials (physical and chemical)
9. H2S, HF, Hydrocarbons, Corrosives, Electricity, Radiation, Excessive Heat, etc.
10. Any crane or rigging failure

1. Did the location have any Process Safety Events (PSE) that required notification to the National Response Center during the evaluation year?

SELECTION CRITERIA (PART B)

After passing the screening criteria, the candidate facility's overall safety performance record will be evaluated by the selection committee based on the applicant’s written application.

DEADLINE

The DSA Application can be found on pages 4 through 15. The final date that applications for the Distinguished Safety Award can be accepted is January 30, 2015. Applications received after this date cannot be processed due to review committee scheduling restrictions. Please contactAFPM early if you anticipate any difficulty.

PRESENTATION

The Distinguished Safety Awards will be presented at the annual AFPM Safety Awards Celebration to be held during the Association’s National Safety Conference on Wednesday, May 13, 2015inAustin, TX. Special recognition will also be given to the refining recipients at the General Session of the AFPM Annual Meeting, and for petrochemical recipients at the International Petrochemical Conference.

PRESS

As an additional service, the AFPM will prepare press releases and photographs of the award presentation to be handed out at the celebration.

APPLICATION INSTRUCTIONS

Please complete all of the information requested in this document to be considered for the award. All applications must be emailed or mailed to the following address:

AFPM DSA, ATTN: Anna Scherer, 1667 K Street, NW, Suite 700, Washington, DC 20006

or fax to (202)457-0486

or email

For the written portion of this application please adhere to the page limit listed for each section with a maximum of 21 pages. Responses that go over the 21 page limit will be deducted one point from the applications overall score. It is recommended to bullet point responses where appropriate.

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COMPANY:

FACILITY NAME:

FACILITY ADDRESS:

SHIPPING ADDRESS:

Plant Safety Contact / Title:

Phone:

Email:

Plant Manager Name/ Title:

Phone:

Email:

Submit application to:

AFPM DSA

Attn: Anna Scherer

1667 K St., NW

Suite 700

Washington, DC20006

Or email

In order to be eligible to apply for the Distinguished Safety Award, a facility must first pass the following screening criteria.

1. A location must achieve the following requirements for the calendar year:
2. an employee total recordable incidence rate (TRIR) of 0.3 or less,
3. a contractor total recordable incidence rate (TRIR) of 0.3 or less,

1. A location must have had no employee workplace related fatalities and no non-employee (contractor, visitor, etc.) workplace related fatalities for the previous five consecutive years.

A location must answer NO to the following questions to pass the screening criteria and be eligible to apply for the DSA award:

1. Did the location experience a community evacuation or sheltering event, or worker/contractor hospitalization (admitted for treatment) during the evaluation period?

1. Did the location experience a recordable injury where any of the following caused or contributed to the injury during the evaluation year?
2. Failure to isolate hazardous energy (lockout/tagout)
3. Opening process equipment not properly prepared for maintenance
4. Improperly prepared or hazardous confined space
5. Improperly prepared or hazardous excavation
6. Any falls from height (>4 feet)
7. Any Tier 1 of 2 Process Safety Event (PSE)
8. Contact/exposure to hazardous materials (physical and chemical)
9. H2S, HF, Hydrocarbons, Corrosives, Electricity, Radiation, Excessive Heat, etc.
10. Any crane or rigging failure

1. Did the location have any Process Safety Events (PSE) that required notification to the National Response Center during the evaluation year?

Evaluation period refers to a single calendar year.

1. Employee Information:

1. Contractor Information:

3. Combined employee and contractor TRIR ______and DART rate ______

Combined TRIR = (Total # of Employee recordables + Total # of Contractor recordables)*(200000) / (Total Employee Hours Worked + Total Contractor Hours Worked)

Combined DART = (Total # of Employee DART cases + Total # of Contractor DART cases)*(200000) / (Total Employee Hours Worked + Total Contractor Hours Worked)

4.Date of last fatality: ______

5. Please provide a brief description of each Recordable casefor the past fivecalendar years:

TRIR = Total Recordable Incidence Rate

DART = A case involving a day away from work, restriction, or transfer

1.Safety Performance

1. Fire/Explosion/environmental performance – Describeany fires, explosions, hydrocarbon/chemical releases etc.(including those to water, land or air) over the last threeyears that resulted in a releasebeyond the property line. Please include; a description of the impact, material, quantity, impact area, number affected etc.

1. Process Safety Event (PSE) Rate – For reporting purposes, a Process Safety Event is an actual unplanned or uncontrolled Loss of Primary Containment (LOPC) event that either (1) had an effect on people, property, or the environment; or (2) was above a threshold amount as described in ANSI API RP 754. Refer to ANSI API RP 754 – Process Safety Performance Indicators for the Refining & Petrochemical Industries.

The PSE calculation is as follows: # of PSE Events x 200,000/Employee and Contractor Work hours

Please provide a brief description of each PSEfor both Tier 1 and Tier 2 incidents from the past three years.

1. Check all that apply:

VPP Star Site

VPP Star Contractor Company onsite

Responsible Care®

ISO 18000

1. AFPM/ API Advancing Process Safety participation:

Describe the location’s participation in the following Advancing Process Safety programs.

1. Submitted 2014 Tier1 and Tier 2 PSEs to AFPM 754 database (PSE data collection)
2. Describe your process for submitting all Tier 1 PSE events in the AFPM Event Sharing Database. Does the location review events submitted to the Event Sharing database?
3. Participating in AFPM Regional Networks
4. Does the location review AFPM Hazard Identification documents? How does the location share that information more broadly?
5. Has the location reviewed the API Process Safety Site Assessment protocols? Has a site assessment been conducted at the location? Are there plans to conduct an assessment at the location in the future?
6. Other forms of participation?

1. Enforcement History:

Please describe any final order OSHA citations and their classifications your site has received in the last 5 years.

INSTRUCTIONS:

- Do not Exceed 21 pages maximum for sections 2-4.

- Outline format recommended, please bullet point when appropriate.

- 1 point will be subtracted from your total scoring if you exceed 21 pages.

2. Overview of Health & Safety Program (Maximum 1Page)

Discuss the 2 or 3 things that make the difference with your safety program. What has made you stand out above the rest and led to your success.

Please include:

- How leaders are visible in the plant and how they communicate expectations.

- Any innovative practices that the facility has developed / used that have made a difference.

- What has led/contributed to your sustained success and continuous improvement?

- How do you evaluate your safety culture and what are you doing to improve the culture

- Describe the tools you use to assess the culture (surveys)

-Describe two innovative initiatives for Occupational and Process Safety that the location as implemented or has plans to implement.

PLEASE NOTE: If you have submitted a previous application in the past three reporting periods, please outline what you have done recently. What is different this year than last year? Please highlight what is new.

3. OCCUPATIONAL SAFETY PROGRAMS(Maximum 10 Pages, Sections a-h)

a. Resources and Responsibility

Outline how front line personnel and managers are committed and involved in your safety and health program. Discuss any corporate management support.

b. Management Systems and Measures of Performance

Outline the elements of your management system to include:

• Describe your management system and how your site integrates it into your day to day performance.
• How often is it assessed?
• How goals are established?
• Who is involved in assessments and goal setting?
• What KPI’s are tracked?
• What leading indicators/metrics do you maintain (near misses, behavioral observations, etc.)? How do you use these for performance improvement?

c. Employee Reports of Hazards/Pre-job hazard analysis – Outline how employees notify management of potential safety or health hazards and theprocedure for follow-up and tracking corrections to closure.

• What system do you have in place that provides a mechanism for employees/contractors to report hazards?
• How are near miss incidents reported and followed-up on?
• How does your site perform pre-job hazard analysis?
• Who is included in pre-job hazard analysis (maintenance and operations)?

d. Investigations – Explain your site’s accident investigation procedures.

• What training/guidance is given to investigators?
• How do you determine which incidentswarrant an investigation?
• Are near-miss incidents investigated and to what extent?
• What methodology do you use for investigations?
• How are items tracked to closure?
• How is the team make-up determined (hourly, management, contractors)?
• How do you share findings with both your site and your company?
• How do you determine potential consequences?

e. Training– Outline training programs you have available for employees, managers, and contractors. Please include your site’s training methodologies in your description.

• What kind of feedback mechanism does your site have regarding training?
• How do you verify that your employees understand the training given to them?

f. Safety Communication

• Outline how health and safety information is shared within the facility, company, corporation, and industry. Include a list of examples of communications (e.g. procedures, incidents, investigations, etc.) and what electronic systems are available for communication.

• How are supervisors and managers involved in safety communication?
• How are company H&S resources networked to share best practices?

g. Employee Health and Safety

g.(1).Describe your sites wellness programs - Please outline what your site is doing in regards to the following issues; off the job safety and illness, employee wellness.

g.(2).Describe your site’s Industrial Hygiene programs, training, and personal exposure monitoring.

g.(3).On-going safety and employee involvement programs – List the ways employees are involved in your safety and health program. Describe teams that are in place and the involvement of hourly employees in safety programs. Provide specific information about decision processes that employee’s impact.

g.(4). Current safety promotions – Describe your program.

4. PROCESS SAFETY MANAGEMENT PROGRAMS (Maximum 10 Pages)

a. Process Safety Management – In two pages or less, describe your overall Process Safety Management program and how it is integrated into your operations. Please include the following in your answer:

• Provide a copy of your site’s KPI/measures/scorecard for measuring and managing the key aspects of your PSM program.
• How do you audit and assess the effectiveness and compliance of your PSM program, and at what frequency?
• Describe the types of Process Safety unplanned events, incidents that require reporting and investigation
• How does the site train personnel (employees and contractors) to understand their roles and responsibilities regarding Process Safety?
• Explain how your site stays abreast of, evaluates, and complies with Recognized and Generally Accepted Good Engineering Practices (RAGAGEP).
• Describe your program for Fatigue Prevention.
• Describe how you evacuate non-essential personnel from operating areas during unit startup, shutdowns, or unstable conditions?
• What happens in the event a safety system requires by-passing?
• Describe what you believe to be best practices with your PSM program.

b. Mechanical Integrity– In two pages or less, describe your Mechanical Integrity Program. Include the following in your answer:

• What methodology do you use for equipment inspection?
• How are mechanical integrity deficiencies defined, measured, and tracked to closure?
• Describe any special emphasis programs in place such as Corrosion Under Insulation, Injection/Mixing Points, or Small Bore Piping.
• Describe your processes for Positive Material Identification.
• Describe how Safe Operating Limits (SOL) are implemented, communicated, and managed. If SOL’s are exceeded, how they are reported, investigated and actions taken?
• How does the site manage fit for service for equipment that has been subjected to temperatures, pressures, or conditions exceeding the SOL?
• How are Safety Instrumented Systems and Critical Equipment identified, inspected and maintained?
• Describe your practice of installing and removing temporary repairs and clamps.
• Describe your philosophy and some of your systems/layers of protection such as Emergency Isolation Valves, Safety Instrumented Systems, Interlocks, dual pump seals.

c. Hazard Analysis

• Describe the process, employee involvement, and methodology used for performing Process Hazards Analysis and Layers of Protection Analysis at your site.
• How are recommendations from PHA’s/LOPA’s tracked to closure?
• Describe your Facility Siting program?

d. Management of Change

• Briefly describe how management of change is implemented at your facility including hazard assessment, design review, Pre-Startup safety reviews, and personnel training.
• How do you manage Organizational or Personnel Change?

e. Contractor SafetyPerformance – Outline your program for ensuring that all contract workers who work at your site are provided the same quality protection and work environment as your regular employees.

• What are the Safety qualifications for contractor companies to work at your site?
• How are contractor companies periodically assessed?
• How are contractors involved in the PSM program?
• Describe how Process Hazards Overviews are provided to all site personnel.
• Do you have craft skill requirements in place, and how are employees evaluated to ensure they have the required skills.
• How are contractors trained on site safety procedures, and describe how workers have access to site procedures?
• How does your site manage non-English speaking workers?

f. Emergency Response/Preparedness – Outline your site’s emergency planning and preparedness program, including emergency or evacuation drills and coordination with local industry or agencies. How do you address potential impacts to the surrounding community?

• How does your site ensure personnel have access to emergency procedures, and have the knowledge and skill to respond to emergency situations?
• How do you perform personnel accountability drills?
• Does your Emergency Response program specify shelters in place, and/or safe havens?
• Describe your Incident Command System and who fills critical roles.
• Describe your drills processes (frequency, type of drill, critiques)
• How do you develop emergency pre-plans and what types of events do your emergency pre-plans cover?

g.Risk programs – Identification and mitigation

• Describe your program to identify and prioritize mitigation risk.
• What is your process to review and close these items?

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[*]A petrochemical facility is defined for this purpose as one which produces first and/or second level derivatives of the basic feedstock petrochemicals.