Sample Programs and Information for General Industry

These Sample Written Programs are designed to help you create customized programs for your specific needs.  Most samples are in Word format so you can easily adapt them.

You might also like to visit Safety Writer, which is hosted by the consultation program at the University of South Florida.  Originally designed for OSHA employees, it is now available to the public for free. 


Confined Space Hazards

Here you will find a sample written program, as well as samples of the permits you might need.

1910.146 Permit Required Confined Spaces - OSHA Standard (website link)

Appendix F to 1910.146 Rescue Team or Rescue Service Evaluation Criteria (Word document)

OSHA Permit Required Confined Spaces Booklet (pdf)

Sample Permit Required Confined Space Program (Word document)

Confined Space and Permit Required Confined Space Recognition Form (pdf)

Permit Required Confined Space Decision Flow Chart (Word document)

Work Sheet for Reclassifying a Permit Space (Word document)

Entry Permit - Sample One (pdf)

Entry Permit - Sample Two (Word document)

Work Sheet for Alternative Procedures (Word document)

Sample Hot Work Permit (Excel document)


Crane Safety

Crane and Hoist Safety Sample Program (Word document)

Crane Inspection Sample Program (Word document)

OSHA Crane or Derrick Suspended Personnel Platforms Booklet (pdf)


Emergency Action/Fire Prevention

Sample Emergency Action/Fire Prevention Plan (Word document)

Vulnerability Work Sheet (Excel document)

1910 Subpart E AppExit Routes, Emergency Action Plans and Fire Prevention Plans OSHA Standard (website link)

Emergency Exit Routes (OSHA QuickCard) (website link)

Fire Extinguisher Guide (website link)

Sample Fire Extinguisher/Emergency Light Checklist (pdf)

Sample Fire Extinguisher/Emergency Light Checklist (Word document)


Energy Control Program (Lockout/Tagout)

1910.147 The Control of Hazardous Energy - OSHA Standard (website link)

Sample Energy Control Program - Short Version (Word document)

Sample Energy Control Program - Long Version (Word document)

Energy Source Determination Work Sheet (Word document)

List of Energy Control Procedures Template (Word document)

OSHA Control of Hazardous Energy Lockout/Tagout Booklet  (pdf)

OSHA Lockout/Tagout Interactive Training Program (website link)

Cut Lock or Removed Tag Report (pdf)



Ergonomics Program Requirements (Word document)


Expsoure Control (Bloodborne Pathogens)

Exposure Control Program - Sample A (Word document)

Exposure Control Program - Sample B (Word document)

Appendices for the sample plans are listed below:

A - 1910.1030 Bloodborne Pathogens Standard (website link)

B - Occupations at Risk  (Word document)

C - Sample Sharps Injury Log (Word document)

D - Written Opinion for Hepatitis B Vaccination (Word document)

E - Hepatitis B Vaccine Immunization Record (Word document)

F - Declination Statement (Word document)

G - Exposure Incident Report (Word document)

H - Employee Exposure Follow-Up Record (Word document)

I - Written Opinion for Poset-Exposure Evaluation and Follow-Up (Word document)

J - Documentation of Source Individual (Word document)

K - Request for Source Individual Evaluation - Letter and Form (Word document)

L - Employee Education and Training Record (Word document)

M - Evaluation Forms for Engineering Controls (Word document)

N - Resource List for Engineering Controls and Vaccine Safety (Word document)



Fall Prevention

Sample Fall Prevention Plan for General Industry (Word document)


Hazard Communication

1910.1200 Hazard Communication - OSHA Standard (website link)

Hazard Communication Overview (Word document)

OSHA Hazard Communication Booklet (pdf)

Hazard Communication Program - Sample A (Word document)

Hazard Communication Program - Sample B (Word document)

Notice to Other Employers  (Word document)


Hearing Conservation

Introduction to Hearing Conservation (Word document)

1910.95 Occupational Noise Exposure - OSHA Standard (website link)

Sample Hearing Conservation Program (Word document)

OSHA Hearing Conservation Booklet (pdf)


Ladder Safety

Ladder Safety Overview (Word document)

Sample Ladder Safety Inspection Checklist (Word document)


Personal Protective Equipment

Sample PPE Hazard Assessment (Word document)

OSHA Personal Protective Equipment Booklet (pdf)


Powered Industrial Vehicles (Forklifts)

Sample Training Program (Word document)

Sample Daily Checklist (Word document)



OSHA Injury and Illness Recordkeeping Information (website link)

What is First Aid? (pdf)

Recordkeeping Forms - pdf Version

Recordkeeping Forms - Excel Version


Respiratory Protection

Full Respiratory Protection Sample Program (Word document)

Limited Respiratory Protection Sample Program (Word document)

Medical Evaluation Questionnaire (Word document)

1910.134 Respiratory Protection - OSHA Standard (website link)

Appendix D to Sec 1910.134 (Word document)

Spanish Appendix D to Sec 1910.134 (Word document)

Note:  A copy of Appendix D must be given to people who wear respirators even though they aren't required to by the OSHA Standard.

OSHA Respiratory Protection Booklet (pdf)


Safety and Health Management

 Sample Safety and Health Management Plan  (Word document)

Alternative Sample Safety and Health Management Plan (Word document)

OSHA Safety and Health Management Systems E-Tool (website link)


Welding, Cutting and Brazing

Sample Hot Work Permit (Word document)

Sample Hot Work Permit (pdf)

Sample Hot Work Warning (Word document)

Sample Hot Work Warning (pdf)