26-012 Revised Forms for the Injury & Illness Prevention Program and Code of Safe Practices
Department Notice
This document is not an official representation of the published policy. To access the official signed policy, please submit a request through our Public Records Request Portal.
On June 3, 2025, the Injury and Illness Prevention Program (IIPP) and Code of Safe Practices was emailed to members. Since then, the eight forms associated with this program have been updated and condensed down to two forms.
New IIPP SFPD Forms:
SFPD 435A Quarterly Facility Hazard Inspection Form
SFPD 435B Report of Workplace Hazard Form
Members shall immediately begin use of the new SFPD 435A and 435B and recycle the following outdated forms:
SFPD 435A Periodic Hazard Inspection
SFPD 435B-1 Hazard Abatement Response Form
SFPD 435B-2 Hazard Abatement Response Instructions
SFPD 435C-1 Hazard Evaluation Request Form
SFPD 435C-2 Hazard Evaluation Request Instructions
SFPD 435C Report of Unsafe/Unhealthy Work Condition Hazard Evaluation Request
SFPD 435D Safety Meeting Report
SFPD 435E IIPP Training Log
A copy of the updated SFPD 435A and 435B can be located in the desktop file "SFPD Forms New" and in the PowerDMS folder titled "Forms".
/s/
DERRICK J. LEW
Chief of Police