A program of the following ag organizations

Montana Ag Safety  |  Updated July 2019

The following templates are for your use to assist you in establishing a written record that documents your operation's desire to be a safe place to work. You may copy and print all or parts of these templates.

These templates will help you create documents to use with your employees and create documents that you will have in your files as proof that you are addressing SAFETY as a key concern in your operation. You may need to download the free Adobe Acrobat Reader here.
 
REMEMBER:  the Montana Safety Culture Act requires records be kept for three (3) years.
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SECTION 1: Orientation

 

Safety Orientation  (1a)

English  |  Spanish

Safety Policy Statement (1b)

English  |  Spanish

Worker Orientation Form (1c)

English  |  Spanish

General Safety Rules with signature lines (3)

English  |  Spanish

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SECTION 2: Training and Responsibilities

Mechanic & Shop Work (2a)

English  |  Spanish

Lifting & Carrying (2b)

English  |  Spanish

Machinery Safety (2c)

English  |  Spanish

Tractors & Motorized Equipment (2d)

English  |  Spanish

Feed Handling, Grinding and Storage (2e)

English  |  Spanish

All Terrain Vehicles (ATVs - 4 Wheelers) (2f)

English  |  Spanish

Pickups (2g)

English  |  Spanish

Fencing (2h)

English  |  Spanish

Fire (2i)

English  |  Spanish

Wildlife & Other Animals (2j)

English  |  Spanish

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SECTION 3: Refresher Training

 

Ag Tailgate Safety Meeting Reports

English  |  Spanish (coming soon)

Chemical Safety Work Plan

English  |  Spanish (coming soon)

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SECTION 4: Provide Awareness and Appreciation for Safety

Eye Protection — Sign

English  |  Spanish (coming soon)

Machines Don't Have Brains — Sign

English  |  Spanish (coming soon)

Poison Control & Emergency #s — Sign

English  |  Spanish (coming soon)

Who To Call if You Think It Is Poisoning — Sign

English  |  Spanish (coming soon)

Slow Down! Think! — Sign

English  |  Spanish (coming soon)

Machines Don't Think... You Do! — Sign

English  |  Spanish (coming soon)

Safety Is Spoken Here! — Sign

English  |  Spanish (coming soon)

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SECTION 5: Periodic Self-Inspections and Assessments

Farm Safety Assessment form (5)

English  |  Spanish

Family Safety Intervention for Farms and Ranches

English  |  Spanish (coming soon)

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SECTION 6: Documentation

 

Include the following:

• Records of meetings (date, time, attendance, meeting topics)

• Record of all accidents and corresponding medical records (date)

• All Tailgate Safety Meeting forms