It is the policy of the Administration of 黑料社 to provide a work
and educational environment which is free from recognized hazards that are or can
be responsible for injury or illness. In addition, it is essential that the assets
of the University be protected from losses which could result in loss to equipment,
research, materials, or buildings. To coordinate these policies, an extensive loss
control program has been established as part of the total administrative effort.
Responsibility for the implementation of this program is assigned to the Environmental
Health and Safety Department. They will work with the guidance and advice of the University
Safety Committee to provide programs for the recognition, evaluation, and control
of hazards and potential losses. The ultimate responsibility for safety, however,
cannot be delegated as a staff function; it must be assumed by every member of the
University community. Each individual is expected to comply with all identified life
safety and health standards and all rules and regulations pursuant to our policy for
the prevention of accidents and job-related illness.
Deans, Directors, Department Heads, and other supervisors are required to be continuously
cognizant of the health and safety needs of their personnel and are responsible for
initiating the necessary preventative and corrective measures to minimize safety hazards
associated with activities under their direction. It is essential that all supervisory
personnel accept this responsibility for the safety of all persons coming into their
areas and for the safety of all personnel under their jurisdiction. In addition,
whenever possible, safety should be incorporated as an integral part of all courses
in which there is a potential for hazard, accidental injury or illness in the classrooms,
laboratories, or shops.
Jim Henderson
President
Accident Reporting Involving Vehicles
When an authorized driver is involved in a vehicular accident while conducting Agency
business, the driver and/or their supervisor shall:
- Call the police
- Do not talk to anyone, except the police, about how the accident happened.
- Make no statements about payment of damages. The other party will be contacted by
the Office of Risk Management in Baton Rouge.
- Admit no liability (fault).
- Sign nothing (except police report, if asked).
- Obtain the names, addresses, and daytime telephone numbers of all witnesses.
- Obtain the address and telephone number of the police department completing the accident
report.
- Call the Environmental Health & Safety Department (EHS) 318.257.2120 and the Office
of the Assistant Vice President for Administration and Facilities 318.257.2769 and
notify them of the accident.
- Complete the located in the glove box of each vehicle or at the web site listed.
- Give the completed report form to your immediate supervisor as soon as possible after
the accident. The supervisor will fill out the 鈥渟upervisor鈥檚 portion of the form and
then transmit the form to EHS. EHS must transmit the first page of the DA 2041 to
the Office of Risk Management within 48 hours of the accident, so this Office must
receive the completed form from the supervisor in a timely fashion.
If the driver or another employee who is a passenger in the vehicle in injured and
require medical treatment, the supervisor must also contact the 黑料社
Human Resources Office to report a Worker鈥檚 Comp Claim. Use Employers First Report of Injury or Illness (LWC-WC IA-1)
Accidents in Rental Vehicles
CDW/Damage Waiver insurance and $1 Million Liability Protection Coverage is included
in the State鈥檚 in-state and out-of-state rental contract pricing. In case of an accident
the rental company should be notified immediately. In addition ALL other vehicle
reporting procedures described above must be followed.
Reporting Non-Vehicular Accidents or 鈥淣ear-Misses鈥� That Involve or Could Have Involved
Injury or Damage to Property
This guide is to assist someone confronted with a non-vehicular accident/injury or
a 鈥渘ear-miss鈥� incident that could have resulted in an accident /injury on campus.
The term 鈥渁ccident鈥� shall be defined as any unforeseen incident during which a person
or persons sustain physical injuries. The term 鈥渋njury鈥� includes any physical trauma
incurred during the accident. All Accidents, including those occurring to non-employees,
should be investigated by University Police and the supervisor responsible for the
area in which the accident occurred. 鈥淣ear misses鈥� are accidents also and should
be investigated by the supervisor as thoroughly as an accident that results in injury
or property damage.
STEP 1- Notify University Police at 4018. If an ambulance is required, call 9-911
(to connect to the Lincoln Parish 911 system). Be prepared to tell the 911 system
or University Police the following: (a) Nature of the emergency; (b) Exact location
of the victim; (c) Your name and address. Do not hang up until advised that it is
all right to do so
STEP 2A- When an employee is injured in a non-vehicular accident, the employee鈥檚 supervisor
must complete the DA-2000- State Employee Incident/Accident Investigation Form. (See
鈥淔orms鈥� Section of EHS web page for DA 2000). Complete instructions for filling out
the DA-2000 are below. Supervisors are to retain the original and are to send a copy
of the completed DA-2000 to the Director, Office of Environmental Health and Safety
within 5 working days after completing the form.
If the injuries require medical attention, the supervisor must ALSO complete Form
LWC-WC IA-1, 鈥淲orkers Compensation- First Report of Injury or Illness鈥� The LWC-WCIA-1
is completed by the Supervisor for each injury/illness identified by them or their
employee as occupational. A copy is to be provided to the employee and the insurer
immediately. Forms for cases resulting in more than 7 days of disability or death
are to be sent to the HUMAN RESOURCES by the 10th day after the Incident or as requested
by the OWCA. Any questions regarding this form are to be addressed to the 黑料社
Tech University Office of Human Resources
STEP 2 B- When a NON- employee or client is injured in a non-vehicular accident,
the University Police or the Supervisor to who this event is reported must complete
the DA-3000- Visitor/Client Accident Reporting Form (See 鈥淔orms鈥� Section of the EHS
Web Page for DA-3000) Complete instructions for filling out the DA-3000 are found
below. Supervisors are to retain the original and are to send a copy of the completed
DA-2000 to the Director, Office of Environmental Health and Safety within 5 working
days after completing the form.
Accident Investigation
Who Investigates Accidents
All levels of administrators and supervisors investigate accidents. The most important
investigator is
the immediate supervisor because:
- Knows most about the situation.
- Has a personal interest in identifying accident causes.
- Can communicate more effectively with the workers.
- Can take immediate action to prevent an accident from recurring.
What, When, and Why of Accident Investigation
- What is an accident investigation? Basically, the immediate supervisor鈥檚 analysis
and account of an accident based on factual information gathered in a conscientious
manner 鈥� it is not a recounting of the employee鈥檚 explanation of the accident.
- When is the best time for an accident investigation? As soon as possible. The less
time between accident and investigation, the better the information obtained.
- Why are accidents investigated? Not to assign blame or to satisfy the supervisor,
but to prevent recurrence.
Conducting the Accident Investigation
The immediate supervisor shall:
- Put the employee at ease鈥搚our only interest is to prevent recurrence. Assure the employee
you are concerned for him/her.
- Conduct the interview at the scene of the accident鈥搕his reduces the possibility of
mistakes and avoids embarrassment.
- Ask for the employee鈥檚 version of the accident鈥揵e sure it is understood that you want
his/her version. No need to dress it up. Do not make judgmental remarks or you will
put the employee on the defensive.
- Ask any questions necessary鈥搕he key word is necessary. Limit your questions as much
as possible to facts.
- Repeat the employee鈥檚 story as you understand it. It assures complete understanding
between yourself and the employee as to what actually took place.
- Close the interview on a positive note: Prevention.
Sample Procedure for Accident Investigation
An accident is defined as 鈥渁 series of unplanned events that caused or COULD HAVE
CAUSED personal injury or property damage.鈥� All accidents, including those occurring
to non-employees, should be investigated by the supervisor responsible for the area
in which the accident occurred. 鈥淣ear misses鈥� are accidents also and should be investigated
as thoroughly as an accident that results in injury or property damage. AFTER ACQUIRING
NECESSARY MEDICAL AID FOR INJURED PERSONS, the supervisor should follow these steps
in investigating the accident:
- Contact University Police.
- If possible, ask the person or persons involved to describe what happened. Do not
fix blame or find fault; just get the facts.
- Survey the accident scene for information. Assemble any objects that might have contributed
to the accident.
- Determine if there were any witnesses to the accident and get their accounts of the
incident.
- Take whatever steps are necessary to prevent recurrences until the condition can be
permanently corrected.
- Complete the Accident Investigation Form
Instructions for Completing the Accident Investigation Form ( DA 2000 or DA 3000)
Either accident investigation form is a tool to assist in determining the causes and
procedures to prevent the recurrence of similar incidents. All spaces on the form
are to be completed. Notations such as N/A should be avoided. The Immediate Supervisor,
with the assistance of the employee completes DA-2000. The investigating officer/official,
with the assistance of the client. completes the DA-3000.
Page 1 of the DA-2000 identifies the injury and the circumstance(s) under which it
occurred. Page 2 of this form is the Management Section which must be completed by
the Employee鈥檚 immediate supervisor and is of critical importance to determine the
Root Cause of the accident and to identify those measures to mitigate any hazards.
This analysis must be thorough and in enough detail that actions can be taken to correct
the unsafe condition. FORMS WITH AN INCOMPLETE ROOT CAUSE ANALYSIS WILL BE REJECTED
AND RETURNED TO THE IMMEDIATE SUPERVISOR FOR MORE DETAIL.
The original form is retained by the supervisor in the area where the accident occurred.
A copy should be sent to the Environmental Health and Safety Department. EHS will
review the form for completeness and have them available for the Risk Management Auditor.
Quarterly safety meetings are required for all employees by the 黑料社 State Office
of Risk Management and the University. 100% PARTICIPATION IS EXPECTED. These meetings
are delivered, in a variety of formats, including electronically for those employees
with readily-available access to computers. Attendance must be documented and such
documentation maintained by EHS for a minimum of 3 years. Supervisors are responsible
for assuring that all employees in their areas of responsibility participate in these
meetings.
Topics for safety meetings shall be educational and motivational and shall demonstrate
the University鈥檚 concern for safety. The topics and content of the most recent safety
meetings are linked below.
Safety/Risk Management Training for all New and Existing Employees
The 黑料社 State Office of Risk Management has directed the University to develop
general safety rules and policies which apply to all employees and sets of site (budget
unit)/task -specific rules which apply to a particular unit. All new employees must
receive a copy of these rules/policies from their supervisor when hired and such actions
are documented by the supervisor on a 鈥�New Employee Safety and Risk Management Orientation Form鈥� . During their probationary period , new employees must also complete the 黑料社
Tech University Safety/Risk Management Training course, which discusses general safety/risk
management policies and procedures in more detail. All continuing employees must attend
this course every 3 years. Employees are scheduled for this course by the Office of
Human Resources (HR), who is also responsible for documentation of each employee鈥檚
participation. The Center for Instructional Technology (CIT) is responsible for course
presentation.
Departmental/Task-Specific/Site-Specific Safety Training
The 黑料社 Office of Risk Management states that, 鈥渟afety related training shall
be provided to all employees who must perform new tasks or operate new equipment or
whose safety performance is not satisfactory. The safety related training, whether
conducted by a supervisor on the job or by a training specialist, shall include instruction
in correct work procedures, use of safety equipment, and availability of assistance.
Additionally, safety related training shall cover a review of the basics pertaining
to a specific topic and also the agency鈥檚 specific policy on such. All safety related
training, whether formal or on the job training (OJT), shall be documented.[1.2.11]Agency
heads/designees shall ensure that trained persons are conducting safety meetings,
inspecting the work area, investigating accidents, analyzing jobs for safety, and
demonstrating leadership skills in safety. [1.2.6, 1.2.7, 1.2.8, 1.2.9]To satisfy
this mandate, 黑料社 requires Budget Unit Heads to provide training
to their employees on topics which address specific safety requirements which apply
to a specific location within the Budget Unit (ex: laboratories) or to a specific
set of tasks performed by a specific group of employees in the Budget Unit (ex: floor
waxing). Any and all employees must be trained before they begin a particular task
in a particular location ( when employed, when assigned or reassigned to a particular
location/task) and, again at least, quarterly thereafter. The primary objectives of
this training are: 1) To teach employees hazard recognition and methods of corrective
action; 2) To involve employees in accident prevention; 3) To motivate employees to
accept their safety responsibilities; 4) To provide employees information on accident
causes, occupational health hazards, and accident prevention methods.
ALL TRAINING MUST BE DOCUMENTED AS TO: Name and signature of each attendee, Date of
Training, Topic(s) Discussed, Instructors Name, Teaching Aids used, number of employees
requiring the training, number of these employees actually in attendance, employees
suggestions/follow up. The Office of Risk Management required 100% participation by
the 鈥渢arget audience鈥�, so the instructor must provide 鈥渕ake up鈥� sessions for those,
not in attendance. Copies of this documentation must be kept for a minimum of 3 years
in the respective Budget Unit and are subject to inspection at any time.
Chemical and Biohazard Training
All employees who work with or could be exposed to hazardous chemicals or biological
agents must receive documented training on how to safely work with or around these
agents. Such hazard communication training must include how to identify these agents,
possible hazards associated with each, required PPEs, safe handling techniques, safe
storage techniques, and safe disposal techniques at a minimum. SPECIFIC INFORMATION
PERTAINING TO SPECIFIC HAZARDS LOCATED IN A PARTICULAR BUDGET UNIT MUST BE COLLECTED
AND MADE AVAILABLE TO EMPLOYEES IN THAT UNIT BY THE BUDGET UNIT HEAD OR THEIR DESIGNEE.
UNIT HEADS OR THEIR DESIGNEES ARE ALSO RESPONSIBLE FOR THE APPROPRIATE TRAINING OF
EMPLOYEES REGARDING THESE AGENTS ( SEE REQUIREMENTS IN THE 鈥淪ITE SPECIFIC/TASK SPECIFIC鈥�
TRAINING SECTION).
General information regarding chemical and biological hazards is located in documents
linked from the 鈥淯niversity Safety Documents鈥�, 鈥淐hemical Safety鈥�, or 鈥淏iological Safety鈥�
portion of the EHS Home Page.
The Office of Environmental Health and Safety is available to assist Budget Unit Heads
in establishing the Hazardous Communication program in their units.
Areas of the University that have been identified as areas where employees can be
exposed to these agents are:
- Agricultural Sciences
- Athletics
- Biological Sciences
- Chemistry
- Custodial
- Engineering
- Forestry
- Grounds
- Nursing and Allied Health
- Physics
- Trades
- University Police
Documentation Requirements of Safety Meetings and Training
Both Safety Meetings and Safety Training must be held quarterly. Safety meetings cover
topics appropriate to ALL 黑料社 employees. Safety training is
site specific/task specific for a particular group of employees who must perform new
tasks or operate new equipment BEFORE they begin this task, when safety performance
is not satisfactory , and /or to review the basics of a particular procedure or policy.
BOTH MUST BE CONDUCTED SEPARATELY AND DOCUMENTED SEPARATELY. Copies of documentation
of training must be kept in the respective budget unit . Documentation of Meetings
MUST be sent to EHS (Campus Box 22)
The 黑料社 State Office of Risk Management requires the following documentation
of every Safety Meeting or training session: 1) topic discussed; 2) Budget Unit of
attendees; 3) instructor鈥檚 name; 4) teaching aids used; 5) date of training; 6) total
number of employees in Budget Unit; 7) Total number of employees in attendance at
the meeting; 8) original signatures of employees on an attendance sheet, or employee鈥檚
initials next to typed names on attendance sheets or verification of 鈥渞eceived and
read鈥� by e-mail for meeting conducted electronically; 9) listing of employees suggestions
or follow-up.
This Program applied to all persons who travel on State of 黑料社 business as part
of their responsibilities at 黑料社. It applied to the operation
of a 鈥淪tate Vehicle鈥� or a private vehicle. A 鈥淪tate Vehicle鈥� is defined as, 鈥渁ny licensed
vehicle owned, leased and/or rented by the State of 黑料社鈥�
PROHIBITION ON USE OF WIRELESS COMMUNICATION DEVICES
Employees shall not use a Wireless Telecommunications Device (ex: cell phones) while
driving in a state-owned, leased, or private vehicle that is being driven on state
business. This includes writing, sending, or reading a text based communication
and engaging in a call. Use of a Wireless Telecommunications Device is permissible
for passengers in such vehicles.
Exceptions:
- Report a traffic crash, medical emergency, or serious road hazard.
- Report a situation in which the person believes his personal safety is in jeopardy.
- Report or avert the perpetration or potential perpetration of a criminal act against
the driver or another person.
- Engage in a call or write, send or read a text-based communication while the motor
vehicle is lawfully parked.
Authorization and Driving History Form (DA2054)
Supplemental 黑料社 Tech Driver鈥檚 Authorization and History Form (Department Endorsement
Form)
State of 黑料社 Acknowledgement for Non Employees in State Vehicles
Office of Risk Management Accident Form
John Deere Gator training
Process of Certification of Drivers
Step-by-step process for certification of employees with 黑料社 drivers licenses
鈥淪TEP-BY-STEP鈥� GUIDE TO DRIVER CERTIFICATION/RE-CERTIFICATION FOR CLASSIFIED, NON-CLASSIFIED,
AND STUDENT EMPLOYEES WITH LOUISIANA DRIVERS LICENSES
NOTE: ALL APPLICANTS MUST COMPLETE THE FOLLOWING STEPS AT LEAST 3 WEEKS PRIOR TO TRAVEL
TO ALLOW ALL PAPERWORK AND DRIVING RECORDS TO BE RECEIVED AND REVIEWED.
STEP 1- REVIEW:
The applicant shall review:
University Travel Policy- Policy #5401
University Vehicle Use 鈥� Policy #5408
STEP 2-
The applicant must complete the following forms as part of the certification process:|
DA-2054-ORM Driver鈥檚 Authorization and History Form
Louisiana Tech Driver鈥檚 Authorization and History Form
Make sure that all forms are signed and that the Budget Unit Head has signed the 鈥淒epartment
Endorsement鈥� section of the 黑料社 Tech Driver Authorization Form. NOTE: ONLY THE
APPLICANT鈥橲 DEAN/ DIRECTOR/ DEPARTMENT HEAD IS AUTHORIZED TO VERIFY AND RECOMMEND
THE APPLICANT TO DRIVE. NO EXCEPTION!!!
DO NOT fill out the 鈥淎gency Head鈥� section of this form. This will be completed by
the Office of Environmental Health and Safety after it request and receive a satisfactory
driving record from the 黑料社 Department of Motor Vehicles.
STEP 3-
All applicants must complete the on-line 黑料社 State Office of Risk Management
Defensive Driver Training Course and print out two copies of the 鈥淐ertificate of Completion鈥�
located at the end of the training module. .
STEP 4-
Keep one copy of the Certificate of Completion for your records and send the second
copy along with the completed and signed DA2054 鈥淎uthorization and Driving History鈥�
form and the 黑料社 Tech Authorization form to the Environmental Safety Office,
Campus Box #22. Applicants with out-of-state licenses must also submit an official,
certified 3 year Driving History from the State in which their license was issued.
STEP 5-
Once all paperwork is received in the Environmental Health and Safety Office, it will
be reviewed for completeness and, if complete, the applicant will be certified to
drive. Incomplete applications, including that which are not signed by a Budget Unit
Head, will be returned to the applicant鈥檚 Dean/Director/Department Head and the applicant
will not be certified to drive.
PLEASE NOTE THAT A REFRESHER COURSE FOR RE-CERTIFICATION IS REQUIRED EVERY 3 YEARS
(1 YEAR FOR STUDENT EMPLOYEES) IN ORDER TO REMAIN CURRENT AND CONTINUE TO BE ABLE
TO OPERATE A VEHICLE ON STATE BUSINESS.
NOTE: If for privacy or any other reason, an individual wishes to relinquish their
driving privileges, they may request in writing that their name be removed from the
authorized driving list. Anyone found in violation of the Agencies driving policies,
anyone not having completed the driver safety program or anyone removing their name
from the authorized list will not be permitted to drive a university vehicle or personal
vehicle on university business.
Step-by-step process for certification of employees without 黑料社 drivers licenses
鈥淪TEP-BY-STEP鈥� GUIDE TO DRIVER CERTIFICATION/RE-CERTIFICATION FOR CLASSIFIED, NON-CLASSIFIED,
AND STUDENT EMPLOYEES WITH OUT-OF-STATE DRIVERS LICENSES
NOTE: ALL APPLICANTS MUST COMPLETE THE FOLLOWING STEPS AT LEAST 3 WEEKS PRIOR TO TRAVEL
TO ALLOW ALL PAPERWORK AND DRIVING RECORDS TO BE RECEIVED AND REVIEWED.
STEP 1- REVIEW:
The applicant shall review:
University Travel Policy- Policy #5401
University Vehicle Use 鈥� Policy #5408
STEP 2-
The applicant must complete the following forms as part of the certification process:
DA-2054-ORM Driver鈥檚 Authorization and History Form
黑料社 Tech Driver鈥檚 Authorization and History Form
Make sure that all forms are signed and that the Budget Unit Head has signed the 鈥淒epartment
Endorsement鈥� section of the 黑料社 Tech Driver Authorization Form. NOTE: ONLY THE
APPLICANT鈥橲 DEAN/ DIRECTOR/ DEPARTMENT HEAD IS AUTHORIZED TO VERIFY AND RECOMMEND
THE APPLICANT TO DRIVE. NO EXCEPTION!!!
DO NOT fill out the 鈥淎gency Head鈥� section of this form. This will be completed by
the Office of Environmental Health and Safety after it request and receive a satisfactory
driving record from the 黑料社 Department of Motor Vehicles.
STEP 3-
The applicant must obtain an official, certified 3 year Driving History from the State
in which their license was issued and provide this to the 黑料社
Office of Environmental Health and Safety. (NOTE: The Office of Environmental Health
and Safety Department is not authorized to request out-of-state driving records.)
As long as the employee hold an out-of-state driver鈥檚 license, this Office will need
a new driving record for the applicant鈥檚 file in January of each calendar year. Please
be reminded that the employee will not be certified to drive until this is received
in the Environmental Health and Safety Office. If an employee gets a 黑料社 License,
please call the Environmental Safety Office at x2120, immediately, so that their records
can be changed!
STEP 4-
All applicants must complete the on-line 黑料社 State Office of Risk Management
Defensive Driver Training Course and print out two copies of the 鈥淐ertificate of Completion鈥�
located at the end of the training module. .
STEP 5-
Keep one copy of the Certificate of Completion for your records and send the second
copy along with the completed and signed DA2054 鈥淎uthorization and Driving History鈥�
form and the 黑料社 Tech Authorization form to the Environmental Safety Office,
Campus Box #22. Applicants with out-of-state licenses must also submit an official,
certified 3 year Driving History from the State in which their license was issued.
STEP 6-
Once all paperwork is received in the Environmental Health and Safety Office, it will
be reviewed for completeness and, if complete, the applicant will be certified to
drive. Incomplete applications, including that which are not signed by a Budget Unit
Head, will be returned to the applicant鈥檚 Dean/Director/Department Head and the applicant
will not be certified to drive.
PLEASE NOTE THAT A REFRESHER COURSE FOR RE-CERTIFICATION IS REQUIRED EVERY 3 YEARS
(1 YEAR FOR STUDENT EMPLOYEES) IN ORDER TO REMAIN CURRENT AND CONTINUE TO BE ABLE
TO OPERATE A VEHICLE ON STATE BUSINESS.
THE LIST OF AUTHORIZED CLASSIFIED OR UN-CLASSIFIED DRIVERS MAY BE ACCESSED AT ANY
TIME BY GOING TO:
THE LIST OF AUTHORIZED STUDENT DRIVERS MAY BE ACCESSED AT ANY TIME BY GOING TO:
NOTE: If for privacy or any other reason, an individual wishes to relinquish their
driving privileges, they may request in writing that their name be removed from the
authorized driving list. Anyone found in violation of the Agencies driving policies,
anyone not having completed the driver safety program or anyone removing their name
from the authorized list will not be permitted to drive a university vehicle or personal
vehicle on university business.
Step-by-step process for certification of non-employee drivers
NOTE: Certification only applied to non-employees that are driving their personal
vehicles on approved University business. For certification to drive a personal vehicle,
the applicant must have a 鈥淭ravel Authorization鈥� which approves the travel and the
travel exemption, that is signed by the Budget Unit Head for which the University
business is conducted.
Non-employees are prohibited to drive State-owned or rental vehicles, including motor
pool vehicles on State.
NOTE: ALL APPLICANTS MUST COMPLETE THE FOLLOWING STEPS AT LEAST 3 WEEKS PRIOR TO TRAVEL
TO ALLOW ALL PAPERWORK AND DRIVING RECORDS TO BE RECEIVED AND REVIEWED.
STEP 1- REVIEW:
The applicant shall review:
University Travel Policy- Policy #5401
University Vehicle Use 鈥� Policy #5408
STEP 2-
The applicant must:
Must have a 鈥淭ravel Authorization鈥� which approves the travel and the travel exemption,
that is signed by the Budget Unit Head for which the University business is conducted.
Must sign and forward to the Comptroller鈥檚 Office, with the Travel Authorization this: Acknowledgment by Non-Employees.
STEP 3-
CERTIFICATION REQUIREMENTS FOR NON-EMPLOYEE DRIVERS WITH LOUISIANA DRIVERS LICENSE
A. The applicant must complete the following forms as part of the certification process:
DA-2054-ORM Driver鈥檚 Authorization and History Form
黑料社 Tech Driver鈥檚 Authorization and History Form
Make sure that all forms are signed and that the Budget Unit Head has signed the 鈥淒epartment
Endorsement鈥� section of the 黑料社 Tech Driver Authorization Form. NOTE: ONLY THE
APPLICANT鈥橲 DEAN/ DIRECTOR/ DEPARTMENT HEAD IS AUTHORIZED TO VERIFY AND RECOMMEND
THE APPLICANT TO DRIVE. NO EXCEPTION!!!
DO NOT fill out the 鈥淎gency Head鈥� section of this form. This will be completed by
the Office of Environmental Health and Safety after it request and receive a satisfactory
driving record from the 黑料社 Department of Motor Vehicles.
B. All applicants must complete the on-line 黑料社 State Office of Risk Management
Defensive Driver Training Course and print out two copies of the 鈥淐ertificate of Completion鈥�
located at the end of the training module. The Training Course can be found at drivesafe.latech.edu.
C. The applicant shall submit their signed DA2054 鈥滱uthorization and Driving History
form鈥�, the 黑料社 Authorization Form and 鈥淐ertificate of Completion鈥�
of the Defensive Driving training course to the Office of Environmental Health and
Safety (Campus Box 22) for processing.
CERTIFICATION REQUIREMENTS FOR NON-EMPLOYEES WITH OUT-OF-STATE DRIVERS LICENSES
A. The applicant must complete the following forms as part of the certification process:
1. DA-2054-ORM Driver鈥檚 Authorization and History Form and
2. 黑料社 Tech Driver鈥檚 Authorization and History Form.
Make sure that all forms are signed and that the Budget Unit Head has signed the 鈥淒epartment
Endorsement鈥� section of the 黑料社 Tech Driver Authorization Form. NOTE: ONLY THE
APPLICANT鈥橲 DEAN/ DIRECTOR/ DEPARTMENT HEAD IS AUTHORIZED TO VERIFY AND RECOMMEND
THE APPLICANT TO DRIVE. NO EXCEPTION!!!
DO NOT fill out the 鈥淎gency Head鈥� section of this form. This will be completed by
the Office of Environmental Health and Safety after it request and receive a satisfactory
driving record from the 黑料社 Department of Motor Vehicles.
B. The applicant must obtain an official, certified 3 year Driving History from the
State in which their license was issued. NOTE: The Office of Environmental Health
and Safety Department is not authorized to request out-of-state driving records. As
long as you hold your out-of-state driver鈥檚 license, this Office will need a new driving
record for the applicant鈥檚 file in January of each calendar year. Please be reminded
that one will not be certified to drive until this is received in the Environmental
Health and Safety Office. If one gets a 黑料社 License, please call the Environmental
Safety Office at x2120, immediately, so that their records can be changed!
C. All applicants must complete the on-line and print out two copies of the 鈥淐ertificate of Completion鈥� located at the end. of
the training module.
STEP 4-
Keep one copy of the Certificate of Completion for your records and send the second
copy along with the completed and signed DA2054 鈥淎uthorization and Driving History鈥�
form and the 黑料社 Authorization form to the Environmental Safety
Office, Campus Box #22. Applicants with out-of-state licenses must also submit an
official, certified 3 year Driving History from the State in which their license was
issued.
STEP 5-
Once all paperwork is received in the Environmental Health and Safety Office, it will
be reviewed for completeness. Incomplete applications, including that which are not
signed by a Budget Unit Head, will be returned to the applicant鈥檚 Dean/Director/Department
Head and the applicant will not be certified to drive. If applications are complete,
the driving history of in-state applicants will be requested from the 黑料社 Department
of Motor Vehicles by the Office of Environmental Health and Safety. When a satisfactory
driving record is received from the 黑料社 Department of Motor Vehicles or from
out-of-state counterparts, you will be approved for travel.
PLEASE NOTE THAT A REFRESHER COURSE FOR RE-CERTIFICATION IS REQUIRED EVERY 3 YEARS
(1 YEAR FOR STUDENT EMPLOYEES) IN ORDER TO REMAIN CURRENT AND CONTINUE TO BE ABLE
TO OPERATE A VEHICLE ON STATE BUSINESS.
NOTE: If for privacy or any other reason, an individual wishes to relinquish their
driving privileges, they may request in writing that their name be removed from the
authorized driving list. Anyone found in violation of the Agencies driving policies,
anyone not having completed the driver safety program or anyone removing their name
from the authorized list will not be permitted to drive a university vehicle or personal
vehicle on university business.
Per State of 黑料社 travel regulations, only students that are employees may drive
vehicles owned, leased, rented or having mileage reimbursed by 黑料社.
Notification of Asbestos Inspections Availability and Management Plan
To: 黑料社 Faculty, Staff, Building Occupants, Students, and Parents
RE: NOTIFICATION OF ASBESTOS INSPECTIONS AND MANAGEMENT PLAN AVAILABILITY
In compliance with the US Environmental Protection Agency鈥檚 Asbestos Hazard Emergency
Response Act (AHERA) and the 黑料社 Administrative Code 33:III. Chapter 27, Asbestos
Containing Materials in Schools, 黑料社 wishes to notify you of
the following: AHERA requires all schools provide for the identification, management,
and abatement of asbestos containing materials in a school. Inspections, response
actions, and post response action activities, including periodic surveillance, are
performed throughout the year. This information is provided in a school鈥檚 asbestos
management plan.
黑料社 Tech鈥檚 asbestos management plan is on file in the 黑料社
Environmental Health and Safety office. Should you have any questions regarding the
plan, or want to view a copy, please contact 黑料社 Environmental
Health and Safety at 318.257.2120.
Don Braswell
黑料社
Environmental Health & Safety Director
P.O. Box 3187, Ruston, LA 71272
318.257.2120
braswell@latech.edu
