Attachment 2 MATOC Accident Prevention Plan Review Checklist.docx

Accident Prevention Plan Review Checklist

This checklist serves as a guide only. It does not replace or eliminate the need to comply with the requirements set forth in the specifications, federal regulations and policy.

1. Signature sheet

a. Includes the name, signature, and title of the Plan Preparer (Qualified person, i.e. corporate safety staff person, QC)

b. Includes the name, signature, and title of the Plan Approver {e.g. owner, company president, regional vice president

c. Includes the name{s), signature(s), and title{s) for Competent Persons including areas of expertise (Ex – Competent Person for Fall Protection, Competent Person for Scaffolding, etc.)

2. Background information

a. Includes the Contractor Name.

b. Includes the Contract Number.

c. Includes the Project Name.

d. Includes the Brief Project Description. Include enough detail to understand the work being accomplished. For example, if putting in a sewer line, how deep. If installing a tower, how tall?

e. Includes the Location of the Project {map}.

3. Responsibilities and Lines of Authorities.

a. Includes the identification and job responsibilities of personnel responsible for safety - at both corporate and project level.

b. Includes the lines of authority.

4. Statement of Safety and Health Policy detailing their commitment to providing a safe and healthful workplace for all employees.

5. Whistleblower Protections.

6. Workplace Violence.

7. Discuss safety meetings.

8. Housekeeping

9. Discuss visitor safety/site security.

10. Drug Free Workplace

11. Includes a means to evaluate the work being done and associated hazards involved. Addresses the identified hazards involved and the control measures to be taken. Should follow hierarchy of controls (engineering controls first – PPE last). Identified hazards need to be controlled. For example:

a. Excavations – Sloping, benching, or shoring

b. Respiratory – Type of protection and type of engineering controls

c. Silica – Dust control measures

d. Lightning – Strategy for avoiding lightning strikes

e. Hazardous Chemicals – Substitute less hazardous chemicals

f. Etc.

12. Procedures for job site inspections - assignment of responsibilities and frequency

a. Includes the name(s) of individual(s) responsible for conducting safety inspections. (e.g., PM, safety professional, QC, supervisors, employees)

b. Includes proof of inspector's training / qualifications.

c. Indicates when inspections will be conducted.

d. Includes the names of competent and / or qualified person(s) and proof of competency / qualification to meet specific OSHA competent / qualified person(s) requirements.

13. Procedures for reporting and investigating any accidents as soon as possible but not more than 24 hours afterwards to the Contracting of Fort Carson Representative.

14. Emergency Planning. Employees working alone shall be provided proven communication devices which work at the/all project sites for means of emergency communication. This may be cellular phone, two-way radio or other acceptable means. The selected means of communication must be readily available and must be in working condition.

a. Discuss off-site medical arrangements including rescue and medical duties,

b. Outline:

a. How EMS/Fire responders will be contacted,

b. The contractor will verify the availability, capacity, and capability of EMS/Fire responders

c. On-site medical support and off-site medical arrangements including rescue and medical duties for those employees who are to perform them, the name(s) of on-site Contractor personnel trained in first aid and CPR.

i. First Aid and CPR training (at least two employees on each shift shall be qualified/certified to administer first aid and CPR) and provision of first aid kit (types/size).

15. Hygiene – Drinking Water provisions, toilet and washing facilities. Lunch and sleeping facilities if required

16. Personal Protective Equipment, (PPE) – The contractor should define through a hazard analysis the required PPE, not simply say, “Wear as appropriate”. Typical types of PPE include:

a. Work Clothing, for example – Clothing suitable for the weather might be defined as short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes.

b. Safety-toed (or other protective) footwear,

c. Eye and Face Protection,

d. Hearing Protection,

e. Head Protection,

f. High Visibility Apparel compliant with ANSI/ISEA 107, Class 2 requirements at a minimum shall be worn by all workers exposed to vehicular or equipment traffic.

g. Protective Leg chaps shall be worn by all chainsaw operators.

h. Gloves of the proper type shall be worn by persons involved in activities that expose the hands to cuts, abrasions, punctures, bums and chemical irritants.

i. If work is being performed around water and drowning is a hazard, PFD's must be provided and worn as appropriate.

17. Machine Guards and safety devices. Lawn maintenance equipment must have appropriate guards and safety devices in place and operational.

18. Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a hazard communication program must be in effect and SDSs shall be available at the worksite. Employees shall have received training in hazardous substances being used. When the eyes or body of any person may be exposed to corrosives, irritants or toxic chemicals, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within 10 seconds of the worksite.

19. Traffic control shall be accomplished in accordance with the MUTCD.

20. Control of Hazardous Energy (Lockout/Tagout). Before an employee performs any servicing or maintenance on any equipment where the unexpected energizing or startup of the equipment could occur, procedures must be in place to ensure adequate control of

21. Driving, working on (i.e., working with equipment and mowers) while on slopes, working from/in boats/skiffs, etc shall also be considered and dealt with accordingly.

22. Cranes

a. Lifting plan

b. Laydown plan

c. Crane and rigging gear inspections