Attch_13_DOT_Contractor_Sample_Safety_Plan-Guide-Form.pdf

GUIDE FOR

CONTRACTOR'S SAFETY/ACCIDENT

PREVENTION PLAN

To insure compliance with the special contract requirements, this form shall be completed, and with any necessary attachments, be submitted to the CO at the date and place designated by the Contracting Office. The accepted plan, with all approved modifications and agreements, will become part of the contract. The completion of this form does not necessarily imply complete safety compliance. The Contractor or Subcontractors, at any time, will be required to comply with all phases of the construction safety and health regulations.

Space is provided after each section for answers. If additional space is needed, use plain paper sheets and attach hereto.

Contractor

Signature

Title Date

Approved by Title Date

Sheet 2 of 12

Section 1926 references can be found in the Occupational Safety and Health Administration's Safety and Health Regulations for Construction, Part 1926, Title 29, Code of Federal Regulations.

SUBPART A. GENERAL

Section 1926.2 Variations from Safety and Health Standards.

It is not anticipated any variations will be necessary. However, should any be requested from the Department of Labor, a copy of the requested variation and resulting approval or disapproval shall be furnished the Engineer.

SUBPART C. GENERAL SAFETY AND HEALTH PROVISIONS

Section 1926.20 General Safety and Health Provisions.

Paragraph (b) Accident prevention responsibilities.

Who will be designated to make frequent and regular inspections of the job site, equipment, and material for the purpose of accident prevention?

How frequently will these inspections be made?

Section 1926.21 Safety Training and Education.

Paragraph (b) Employer responsibility.

Briefly describe the training to be given employees in the recognition and avoidance of unsafe working conditions.

Sheet 3 of 12

Section 1926.28 Personal Protective Equipment.

Paragraph (a). Name the person who will be responsible for enforcing the wearing of appropriate personal protective equipment in all operations where there is an exposure to hazardous conditions.

SUBPART D. OCCUPATIONAL HEALTH AND ENVIRONMENTAL CONTROLS

Section 1926.50 Medical Services and First Aid.

Paragraph (a). Name and address of medical personnel available to advise and consult on matters of occupational health.

Paragraph (b). Briefly describe the provisions made for prompt medical attention in case of serious injury.

Paragraph (c). List names of first aid trained personnel.

Paragraph (d). Location and number of proposed first aid supplies and name of person designated to check and maintain first aid kits.

Paragraph (e). Describe equipment available for prompt transportation of injured persons to a physician or hospital, or the communication system available for contacting necessary ambulance service.

Sheet 4 of 12

Paragraph (f). Where will the emergency telephone numbers be conspicuously posted?

Section 1926.51 Sanitation.

Paragraph (a) Potable water. List procedures for furnishing and maintaining drinking water facilities.

Paragraph (c) Toilets at construction job sites. Describe sanitation facilities to be provided.

SUBPART E. PERSONAL PROTECTIVE AND LIFE SAVING EQUIPMENT

Section 1926.100 Head Protection.

Paragraph (a). Describe working areas or operations where protective helmets will be worn.

Section 1926.101 Hearing Protection.

Paragraph (a). Describe working areas or operations where protection from noise exposure will be provided and used.

Sheet 5 of 12

Section 1926.102 Eye and Face Protection.

Paragraph (a). Describe work areas or operations where protection for the eyes and face will be provided and used.

Section 1926.104 and 1926.105 Safety Belts, Lifelines, and Lanyards;

Safety Nets.

Describe work areas or operations where safety belts, lifelines, lanyards, and/or safety nets will be provided and used.

SUBPART F. FIRE PROTECTION AND PREVENTION

Section 1926.150 Fire Protection.

Paragraph (a). Briefly describe the fire protection program to be followed throughout all phases of the construction work.

Section 1926.151 Fire Prevention.

Briefly describe the fire prevention program to be followed throughout all phases of the construction work.

Section 1926.152 Flammable and Combustible Liquids.

Paragraph (a) General requirements.

Describe work areas or operations where the use of approved type safety cans for handling flammable and combustible liquids will be provided and used.

Sheet 6 of 12

Paragraph (c) Storage outside buildings.

Briefly describe methods used to store flammable and combustible liquids on projects.

SUBPART G. SIGNS, SIGNALS, AND BARRICADES

Section 1926.200 Accident Prevention Signs and Tags.

Paragraph (a) General.

Describe work areas or operations where signs and symbols required by this subsection will be provided and used.

Section 1926.201 Signaling.

Paragraphs (a) (1) thru (a) (4) Flaggers.

Name person designated to train flaggers on the project.

How often will flagger operations be reviewed to assure that such opera- tions are being conducted in a correct manner?

Briefly describe the contents of the training provided for on-the-job flaggers.

Sheet 7 of 12

SUBPART I. TOOLS - HAND AND POWER

Section 1926.300 General Requirements.

Paragraphs (a) (b) (c) and (d). List name of person who will inspect tools for compliance.

Section 1926.302 Power Operated Hand Tools.

Paragraph (b) Pneumatic power tools.

Describe method to be used for securing hose ends of pneumatic power tools.

SUBPART K. ELECTRICAL

Section 1926.400 General Requirements.

Paragraph (c) Protection of Employees.

Briefly describe work areas or operations where employees will be provided protection against electric shock.

Section 1926.401 Grounding and Bonding.

Briefly describe methods to be used for grounding and bonding equipment on the project.

SUBPART L. LADDERS AND SCAFFOLDING

Section 1926.450 Ladders.

Paragraph (a) General requirements.

Briefly describe the work areas or operations where ladders meeting the requirements will be provided and used to give safe access between working elevations.

Sheet 8 of 12

Section 1926.451 Scaffolding.

Paragraph (a) (1) thru (a) (21) General requirements.

Briefly describe work areas and operations where scaffolding meeting the requirements of this section will be provided and used.

SUBPART N. CRANES, DERRICKS, HOISTS, ELEVATORS AND CONVEYORS

Section 1926.550 Cranes and Derricks.

Paragraph (a) (4) thru (a) (6).

Name of competent person who shall inspect machinery and equipment prior to each use, and during use, to make sure it is in safe operating condition.

Location of record giving the date and results of inspections for each hoisting machine and piece of equipment.

Where will hand signals to crane and derrick operators be posted?

Section 1926.555 Conveyors.

Paragraph (a) (1) General requirements.

Briefly describe audible warning system which will be sounded immediately before starting up the conveyor.

Paragraph (a) (5). Briefly describe precautions that will be taken where a conveyor belt passes over work areas, aisles, or thoroughfares.

Sheet 9 of 12

SUBPART O. MOTOR VEHICLES, MECHANIZED EQUIPMENT AND MARINE OPERATIONS

Section 1926.600 Equipment.

Paragraph (a) (1) and (3) (ii) General requirements.

List precautions that will be taken after the work shift for parked unattended equipment.

Section 1926.601 Motor Vehicles.

Paragraph (b) (4) General requirements.

List precautions that will be initiated when motor vehicle equipment which has an obstructed view to the rear is used on the project.

Paragraph (b) (14). Name of person who will make before shift inspections of vehicles in accordance with this section and assure that vehicles with defects will be corrected before being placed in service.

Section 1926.602 Materials Handling Equipment.

Paragraph (a) (4) Earthmoving equipment: General.

Briefly describe procedures used to assure that earthmoving equipment described in this section will have a service brake system capable of stopping and holding the equipment fully loaded.

How often will service brake be tested?

Sheet 10 of 12

Paragraph (a) (9) (ii) Audible alarms.

List the precautions that will be initiated when earthmoving or compaction equipment with an obstructed view to the rear is used in reverse gear.

Section 1926.603 Pile Driving Equipment.

Paragraph (a) (8). Briefly describe provisions made for the protection of loft workers on pile driver leads.

SUBPART P. EXCAVATIONS, TRENCHING, AND SHORING

Section 1926.650 General Protection Requirements.

Paragraph (i). Name of qualified person who will make daily inspections of excavations for possible slides or cave-ins and initiate the necessary corrective actions required to safeguard the employees.

Section 1926.651 Specific Excavation Requirements.

Paragraph (c). Briefly describe the provisions made to assure that employees will not be exposed to the danger of moving ground.

Paragraph (d). Name person who will inspect excavation after rain or other hazard producing occurrence.

Sheet 11 of 12

Section 1926.652 Specific Trenching Requirements.

Briefly describe the provisions that will be made to provide protection from slides or cave-ins during trenching operations.

SUBPART Q. CONCRETE, CONCRETE FORMS AND SHORING

Section 1926.700 General Provisions.

Paragraph (b) (2). What provisions will be made to insure that vertically protruding reinforcing steel will not become an impalement hazard?

Section 1926.701 Forms and Shoring.

Paragraph (a) (3). General provisions.

Describe briefly what procedures will be initiated to remove the hazards of stripped forms and shoring.

SUBPART U. BLASTING AND THE USE OF EXPLOSIVES

Section 1926.900 - Paragraph (a) General Provisions; and Section 1926.901 - All

Names of persons authorized and qualified to handle and use explosives.

Section 1926.900

Paragraph (d). Location of the record maintained for the inventory and use of explosives.

Sheet 12 of 12

Paragraph (k) (3). Name of person responsible for placement of blasting signs meeting the requirements of this section.

Section 1926.902 Surface Transportation of Explosives.

Briefly describe vehicle that will be used to transport explosives on the project for project use.

MISCELLANEOUS

1. Describe any other precautionary plans contemplated, based on these safety and health standards, Part 1926.