NIST Safety and Health Plan Guidelines.pdf

SAFETY INSTRUCTIONS (April 2011)

Outline of a NIST Safety and Health Plan for a Specific Contract

The Contractor shall provide their Job-Specific Safety and Health Plan for both the prime and all subcontractors.

The following areas are typically addressed in a job -specific safety and health plan. The job-specific safety and health plan shall also address any unusual or unique aspects of the project or activity for which it is written.

1. SIGNATURE SHEET.

Title, signature, and phone number of the following:

a. Plan preparer (qualified person such as corporate safety staff person, QC).

b. Plan must be approved, by company/corporate officers authorized to obligate the company (e.g., owner, company president, regional vice president, etc.).

c. Plan concurrence (e.g., Chief of Operations, Corporate Chief of Safety, Corporate Industrial Hygienist, project manager or superintendent, project safety professional, project QC) (provide concurrence of other applicable corporate and project personnel (Contractor)).

2. BACKGROUND INFORMATION. List the following:

a Contractor;

b. Contract number;

c. Project name;

d. Brief project description, description of work to be performed, and location on NIST Gaithersburg site.

e. Contractor and sub-contractor accident experience (provide 2 years OSHA

300 Forms, corporate safety trend analyses); and any OSHA/STATE citations.

3. RESPONSIBILITIES AND LINES OF AUTHORITIES.

a. Identification and accountability of personnel responsible for safety - at both corporate and project level. (Contracts specifically requiring safety or industrial hygiene personnel should include a copy of their resume. The COTR will review the qualifications for acceptance.)

b. Lines of authority to include sub-contractors.

4. SUBCONTRACTORS AND SUPPLIERS.

Provide the following:

a. Identification of subcontractors and suppliers (if known);

b. Means for controlling and coordinating subcontractors and suppliers; and

c. Safety responsibilities of subcontractors and suppliers.

5. TRAINING.

a. List subjects to be discussed with employees in safety indoctrination.

b. List mandatory training and certifications that are applicable to this project (e.g., explosive actuated tools, confined space entry, crane operator, excavation, certification, NFPA 70E, PPE) and any requirements for periodic retraining/recertification.

All applicable training certifications shall be submitted to NIST prior to work proceeding.

c. Outline requirements (who attends, when given, who will conduct, etc.) for supervisory and employee safety meetings.

6. SAFETY AND HEALTH INSPECTIONS.

Provide details on:

a. Who will conduct safety inspections (e.g., PM, safety professional, QC, supervisors, employees), when inspections will be conducted, how the inspections will be recorded, deficiency tracking system, follow-up procedures, etc.

Copies of safety reports shall be submitted to the NIST COTR for review.

b. The names of competent and/or qualified person(s) and proof of competency/ qualification to meet specific OSHA competent/qualified person(s) requirements must be attached.

7. SAFETY AND HEALTH EXPECTATIONS, INCENTIVE PROGRAMS, AND COMPLIANCE.

a. The company's written safety program goals, objectives, and accident experience goals for this contract should be provided.

b. A brief description of the company's safety incentive programs (if any) should be provided.

c. Policies and procedures regarding noncompliance with safety requirements

(to include disciplinary actions for violation of safety requirements) should be identified.

d. Provide written company procedures for holding managers and supervisors accountable for safety.

Appendix A

ACCIDENT PREVENTION PROVISIONS FOR CONTRACTORS

1. Purpose. This appendix prescribes guidelines and requirements for implementing the Accident Prevention provisions for construction/service contracts and identified government activities.

2. Policy and Scope. This policy is applicable to all Contractor workforces within the NIST Gaithersburg and NIST Boulder Campus. The accident prevention provisions for NIST are essential to ensure applicable safety requirements are adhered to during contract operations. The prevention provisions for Contractor workforces are as much a part of the contract as any other provision set forth in the contract for control of work. After signing the contract, it is mandatory that the Contractor vigorously comply with all pertinent safety requirements during the duration of the contract.

3. General. The administration of the Safety and Accident Prevention requirements is necessary to ensure that NIST Contractor employees doing work within the NIST Campus provide controls for the protection of life and health of their employees, prevention of property damage, and for the avoidance of work interruptions in the performance of their work requirements. For contracts involving construction and dismantling, demolition, or removal of improvements, special attention is called to the contract clause 52.236-13 (Accident Prevention, Alternate I), which requires Architect/Engineer and other services contracts involving work of a long duration or of a hazardous character to comply with the applicable provisions of 29 CFR 1910 (OSHA industrial standards), 29 CFR 1926 (OSHA construction standards), guidance on developing an Accident Prevention Plan is located in Appendix B.

4. Contract Specifications. The specifications for all identified government activities and contract work will include such additional requirements as are necessary to insure a high standard of physical protection and safety performance by those individuals performing these operations.

5. Contractor's Accident Prevention Plan and Preconstruction Conference.

a. Upon award of a contract, the Contracting Officer will forward a letter to the Contractor calling his attention to the 52.236-13, Alternate I clause in the contract, which requires a written proposal for carrying out the accident prevention provisions of the contract. The letter will stress the importance of the contractual safety obligations of the contract. Special attention is called to Appendix B (Guide for preparation of Accident Prevention Plan) and Appendix C (Guide for preparation of an Activity Hazard Analysis), Appendix D (Sample Activity Hazard Analysis), and AMD Safety Form-04 (Contract Safety Analysis)

b. The Contractor will be informed when and where the proposed plan is to be submitted and with whom those arrangements should be made for the Preconstruction Conference. The Contractor must use the AMD- Safety-04 Form (Contract Safety Anaylsis) as the cover page of their Accident Prevention Plan. The Contractor’s written Accident Prevention Plan will be carefully reviewed by the CO, COTR and COSR before the Conference.

Following the review, prior to initiation of work, the preconstruction conference will be held. The Contractor must be prepared to discuss the Accident Prevention Plan, inherent and specific hazards of the contemplated activities, and other aspects of the contracted work as necessary. Written minutes containing the understanding reached at the Preconstruction Conference will be furnished to the Contractor and a copy will be provided to the Safety, Health and Environment Division (SHED). The Contractor will keep a copy of said minutes on file and readily available at the work site.

c. The SHED will be informed of all Preconstruction Conferences in sufficient time to permit their attendance.

d. The Preconstruction Conference agenda should be developed to meet the specific problems and unusual features of the job. The following safety topics are suggested for the agenda where applicable.

(1) Identification and accountability of Contractor personnel responsible for accident prevention.

(2) The establishment of a mutual understanding relating to the purpose and function of an activity hazard analysis.

(3) A review and discussion of the hazards and remedies the Contractor, leading to an agreement upon the methods used in recognition, evaluation, and methods to control the hazards.

(4) Purpose and advantages of the Safety Program.

(5) A review of the Accident Prevention clause in the contract and the General and Special Conditions of the specifications with special emphasis on the Contractor’s regular safety inspections and records required by General and Special Provisions of the contract.

(6) A list of local site specific requirements with which the contractor must comply (noise control, traffic problems, etc.).

(7) How the Contractor proposes controlling and coordinating work of his subcontractors.

(8) Discussion of overstatements, omissions, and irrelevant items in the Contractors proposed plan. Where not clearly indicated in the proposed plan, the following items should be developed as a minimum:

(a) Method(s) to be implemented by the Contractor to enforce safety on the construction site.

(b) Plans for dust control.

(c) Methods that the Contractor, or activity, proposes using to control and coordinate work with others having operations at the same location.

(d) Plans for layout of temporary construction buildings and facilities, including how Contractor plans to control those of his subcontractors.

(e) Plans for initial indoctrination and continued safety education for all employees.

(f) Plans for traffic control and marking of hazards to cover haul roads, highways, intersections, railroads, utilities, bridges, restricted areas, etc.

(g) Plans for maintaining continued job cleanup.

(h) Plans for fire protection and dealing with emergencies (ambulance service, fires, man overboard, etc.)

(i) Arrangements for providing adequate lighting, ventilation, personal protective equipment, and medical care.

(j) Plans for inspection of the job site by competent persons including reports to be kept, results of the inspections, and corrective actions taken.

(k) Plans for prompt action by the Contractor to correct deficiencies reported by Government representatives.

6. Activity Hazard Analysis (AHA).

a. A supplemental Activity Hazard Analysis (AHA) will be developed at the beginning of any "major phase" of construction that previously has not been reviewed with the Contractor and been documented. The AHA will be submitted to the Contracting Officer’s Safety Representative (COSR) for inclusion in the official contract safety file. The purpose of the activity hazard analysis will be to review the specific hazards anticipated and the specific measures planned to eliminate the hazard.

Guidance for developing an AHA is provided in Appendix C.

b. "Major Phase" pertains to items of work such as drilling, land clearing, excavation, tunneling, road relocations, pile driving, concrete placement, quarrying, building construction, installation of equipment, steel erection, use of hazardous materials, electrical work, installation of heating, ventilating and air conditioning, demolition, paving, use of explosives, cableway operations, etc.

7. Contract Safety Files.

a. The Acquisition Management Division (AMD) is required to maintain the official contract files within NIST. Copies of contract files relating to Safety and the Accident Prevention Program will be maintained by the COTR and COSR.

b. Safety and Accident Prevention Program documents to be maintained in the Contract Safety Files include, but are not limited to, notices of contract award, notice to proceed, contract changes, or modifications having implications on previously confirmed safety procedures or devices, correspondence to Contractor’s relating safety inadequacies or deficiencies, and Contractor Accident Prevention Plan submittals with any changes thereto and any documents changing or accepting the submitted plan.

8. Safety Inspection Checklist. The Safety Inspection Checklist, as appropriate, will be completed by the NIST COSR. Use the AMD Safety Form-07.

9. Use of "Stop Work Order." If all attempts to secure voluntary compliance with safety requirements are not successful, the COTR or CO may issue a "Stop Work Order”. It is important that the order applies only to that portion of the work that is affected by the actions of or lack of actions by the Contractor and that all of the facts of the proceedings be documented in writing; including notation of uncorrected safety violations. The Contractor shall be informed in writing of the extent of the stoppage of the work, the date and hour work should stop, the reason for the action, and the conditions under which work may proceed again.

10. Responsibility for Enforcement. Full and complete responsibility for enforcement of the safety provisions of all contracts rest within the Contracting Officer, COTR, COSR and SHED.

11. Responsibility of the Contractor’s Safety Representative in Cases of Immediate Hazard.

a. Whenever the Contractor’s Officer Safety Representative observes that a condition or work situation is being performed at the risk of life or limb, the Contractor’s Safety Representative will immediately take the following measures:

(1) Immediately remove workers from the area of danger and refrain from the dangerous practices.

(2) Inform the CO, COTR and COSR immediately.

(3) See that work is not resumed in the area of danger and the defective methods, SOPs, equipment, tools, scaffolds, etc., are not used further until recommended corrective action is taken.

(4) Immediately report any of the above actions and any noncompliance with his recommendations to his immediate supervisor and document actions on the AMD Safety Form-06 “Immediate Hazard Report”.

12. Reckless Employees. When a Contractors employee endangers his/her own well-being, or the well-being of others, by flagrant disregard of safety regulations, the Contractor will be requested to discharge the offender or to place the employee on work where his/her action will not constitute a hazard.

13. Forms. The following forms will be used by NIST and all contractors.

a. AMD Safety Form-01, Weekly Construction Safety Meeting

b. AMD Safety Form-02, Contractor’s Safety Meeting

c. AMD Safety Form-03, Safety Planning Sign-Off (THIS FORM CAN BE FOUND AT

THE END OF APPENDIX D (SAMPLE AHA)

d. AMD Safety Form-04, Contract Safety Analysis

e. AMD Safety Form-05, Contractor Accident Report

f. AMD Safety Form-06, Immediate Hazard Report

g. AMD Safety Form-07, Safety Inspection Log Sheet

Appendix B

GUIDE FOR PREPARATION OF ACCIDENT PREVENTION PLANS

1. Instruction and Training. Set forth initial indoctrination and continuing training, such as "tool boxll safety meetings. Such meetings to be recorded on reverse side of AMD Safety Form-03.

2. Accident Reporting.

a. The Plan must state that all OSHA recordable injuries, lost time injuries, claims exceeding $250, and property damage accidents (excluding on-the-road vehicle accidents) in which the property damage exceeds $2,000 will be reported to the COTR within 8 hours of the accident/incident, using the AMD Safety Form-05 “Contractor Accident Report”.

b. The Plan must also state that in the event of an employee being sent to the doctor for treatment, a release will be obtained from the doctor on the date of treatment stating either: (1) employee not fit for duty; (2) employee fit for light duty; or (3) employee fit for duty. Copy of this release must accompany accident report.

c. The following reporting procedures apply to all Contractors and their employees performing at NIST Gaithersburg or NIST Boulder.

(1) In the event of an accident which results in a lost work day or in property damage, an AMD Safety Form-05 will be completed and submitted within five (5) workdays.

(2) The following signature chain is to be used on the AMD Safety Form-05 on Construction accidents. After each signature the name must be typed or printed legibly.

(a) Superintendent

(b) COSR

(c) COR

(3) All AMD Safety Forms are included with the solicitation identified as an Attachment.

3. Sanitation.

a. The Plan must set forth where drinking water will be obtained, type of dispenser, and provisions for receptacle for disposable cups.

b. The Plan must include what type of toilets, how many will be provided and how will they be kept clean.

4. Medical Facilities.

a. The Plan must set forth name, address, and telephone number for doctor, hospital, and ambulance service to be used. These emergency numbers must be posted on the bulletin board. This information will be provided to the Contractor by the COSR.

b. First aid requirements for the Plan should show type and number of first aid kits and set forth requirement that at least two employees on each shift and at each differing location, will be qualified to administer First Aid and CPR (Cardiopulmonary Resuscitation). The minimum qualification for these employees is a current certification from American Red Cross, United States Bureau of Mines, or equivalent training that can be verified by documentary evidence.

5. Emergency Plans. The Plan must set forth provisions for preparation of action in the event of severe weather, i.e., hurricane, blizzard, high seas, etc.

6. Personal Protective Equipment.

a. The Plan must set forth requirement for all employees to wear a "T-shirt" as minimum on upper part of body. Shorts are not permitted. No sleeveless shirts, tennis/athletic shoes or sandals are permitted.

b. Hard hats must meet requirements for Type A or Type B as defined by American National Standards Institute. (No metal hard hats or bump caps.) How you plan to mark HARD HAT AREAS.

c. Provisions for other protective equipment.

7. Housekeeping.

a. Daily job site cleanup required. Large amounts of debris or debris that blocks aisle and exists are required to be removed immediately.

b. Nails must be pulled out or knocked down so they don’t protrude from scrap lumber.

c. All stairways, passageways, gangways, and access-ways must be kept free of material, supplies, and obstructions at all times.

8. Fire Prevention. The Plan must cover use of fire extinguishers, cleanup, heating devices, and flammable and combustible liquids (including safety cans and precautions to be taken with bulk gasoline storage).

9. Ropes, Slings, and Chains. The Plan must cover condition of same and usage; when slings and chains will be replaced, etc.

11. Floor and Wall Openings. If your contract covers erection, maintenance, or alteration of buildings, then your Plan must set forth precautions you will take to guard floor, wall or roof openings.

12. Noise Control. The Plan should include protection from loud noise (90 decibels or greater).

13. Hot Substances. Set forth measures to be used with tar kettles (temperature gauges, etc.).

14. Welding, Cutting and Grounding of Machinery. Cover precautions to be used in these operations (fire extinguishers, shields, grounding of electric welders, insulation of welding leads, etc.).

15. Electrical.

a. All temporary electrical work must be done in accordance 20 CFR 1926, Subpart K (special emphasis on weekly inspection, use of NEMA configuration on all plugs and connections, and type extension cords).

b. Portable generators must be grounded as required by the National Electric

Code (NEC).

c. The use of GFCls is required in addition to appropriate grounding.

16. Hand Tools and Power Tools. Cover condition of same and use safety lashing on pneumatic lines; and authorization for use of explosive actuated tools.

17. Compressed Gas Cylinders. The Plan must set forth the precautions you will utilize to prevent accidents from these cylinders.

a. Separation of different gases.

b. Protection of cylinders.

c. Utilization of valve caps.

d. Securing cylinders in upright position.

18. Ramps, Runways, Platforms, and Scaffolds. Include in this section of your Plan those items in that apply to work under your contract. Include requirements of 29 CFR 1926, Subpart L. This will include, but not be limited to:

a. Safety factors of all such devices.

b. Use of ladders as working platforms.

c. Method of erecting, supporting, and using scaffolding.

d. Means of access to working surfaces--climbing of end pieces of scaffolds is prohibited.

e. Roofing devices and practices

19. Excavations. If there will be excavation (footings, trenches, etc.) as part of your contract, then set forth procedures you will follow in accordance with 29 CFR 1926, Subpart P.

20. Clearing. The Plan must set forth actions you will take to assure safe operation of chain saws and other clearing devices.

21. Material Handling, Storage and Disposal. The Plan should address the location of storage facilities, compatibility of materials, and disposal of materials.

22. Hazardous Materials. The Plan should state method of providing workers with access to Material Safety Data Sheets, method of disposal, and compliance with federal, state, and local laws and regulations.

25. General. It is probable that all of the above areas will not apply to your contract. No attempt has been made to cover all eventualities. This guide is intended only to serve as just that -- a guide to assist you in preparing an Accident Prevention Plan that will be acceptable for work to be performed under your contract.

Appendix C

GUIDE FOR PREPARATION OF AN ACTIVITY HAZARD ANALYSIS (AHA)

1. Purpose. Provides guidance in preparing an Activity Hazard Analysis (AHA).

2. Applicability. This applies to all contracts for NIST Gaithersburg and NIST Boulder.

3. Policy. An AHA for each major phase of work is required. This analysis, utilized correctly, will have favorable effects on your safety record. This section provides guidance for preparing an AHA through a step-by-step procedure giving an example, explanations, and definitions. By showing this procedure, we hope to increase your understanding of how and why the analysis is used.

4. Overview.

a. An AHA is a procedure used to review job methods and identify hazards.

These hazards may have been overlooked from the start or they may have developed after production work has started. Once the hazards are known, the best solution or control can then be developed.

b. The person best suited to develop the analysis is the Contractor’s Superintendent. The Superintendent is best suited to develop the AHA because he is likely to have 5-10 years of experience doing the work to be analyzed. He has made the mistakes, seen the hazards, and probably has the best suggestions on how to make the job safer and most beneficial. In addition, he is best qualified to break the job down into successive steps.

c. Once the analysis' rough draft is completed, we recommend that it be reviewed by a safety person – someone within the organization that has safety responsibilities within their job duties. The safety person should review the analysis on a technical level, check to see that no hazards were overlooked, and examine the control measures to see that the most effective measures are being used.

5. Procedures.

A. Step 1 - Selecting An Activity To Analyze.

(1) An activity is a sequence of separate steps that together accomplish a work goal. Some activities can be too broadly defined in general terms of what is accomplished. Building a new dorm, , are examples.

Such broadly defined activities are not suitable for an activity hazard analysis. Similarly, an activity can be too narrowly defined in terms of a single action. Pulling a switch, tightening a screw, pushing a button are examples. Such narrowly defined activities are also not suitable for an AHA.

(2) Activities suitable for a hazard analysis are those assigned generally to a line supervisor and related to a particular phase of work. Erecting block walls, placing a roof and painting are good subjects for an activity hazard analysis.

(3) Once an activity or major phase has been selected we recommend completing the analysis using the format in Appendix D, “Sample Activity Hazard Analysis (AHA)”. Note that the activity chosen for the example is Interior Demolition of the US Army Reserve Center.

B. Step 2 - Break Activity Down Into Successive Steps

(1) Now the activity is broken down into its principal steps. Usually you, the line supervisor or foreman, will rely on past experience with the type of work being analyzed. You know your work goal (end point), the beginning point, and what you have to do to accomplish the work goal (steps). You should be able to visualize a logical procession step by step.

(2) Record the steps in their natural order of occurrence. Describe what is done, but not the details of how it is done. Usually three or four words are sufficient. Number the steps consecutively.

(3) In the example, our progression of principal steps include the following: remove furniture from office; remove plumbing, electrical and HVAC duct work from partitions; demolish interior; and clean up.

This shows a logical progression from point A (an old deteriorated interior) to point B (the state of final preparation for the next activity - Creating A New Interior).

C. Step 3 - Identify Hazards and Potential Accidents

(1) Once the principal steps have been identified and logged on the form, identify the potential hazards encountered in each of the principal steps listed. Once again past experience will be relied upon heavily. Also, talking with workers about past accidents or near misses will be of help to you. Checking with first aid logs or accident investigations will also help. At this point, evaluate hazards presented by other activities working adjacent to the activity being analyzed.

(2) The following is a list of questions that will also help you identify most of the hazards:

(a) Is there danger of striking against, being struck by or otherwise making injurious contact with the object?

(b) Can the employee be caught on, in, or between the object?

(c) Can the employee slip or trip? Can the employee fall on the same level or to another level?

(d) Can the employee strain themselves by pushing, pulling or lifting?

(e) Is there a possibility of electrical, health, or fire hazards associated with that principal step?

(3) It is estimated that with these questions you should be able to uncover 90% of the potential hazards. What about the other 10%? The other 10% is what makes the activity hazard analysis so unique. This is why the so called "generic analysis" is so incomplete. Factors which are unique to an activity (elevation, terrain, weather, etc.)

may add to or change the potential hazards. All this must be taken into consideration when doing the analysis.

(4) In the example, we have listed most of the hazards associated with the principal steps. These are very general due to the lack of specific project information. The purpose of this is to keep the analysis simple and easy to follow. Had the Contractor’s Superintendent prepared the analysis in accordance with all the specific information available, it would be more complete and extensive.

D. Step 4 - Develop a Control for Each Hazard Identified.

(1) This is where you come up with the methods of controlling the hazards identified in Step 3 of this procedure. There may be several solutions to controlling the hazard; we want the best solution (that which is most beneficial). Ask yourself "What are the benefits to this solution?" Sometimes the solution will solve that particular problem but create a new hazard for that step or another step. Once again it is useful to ask workers for suggestions.

(2) The following are suggestions to help you come up with ideas for the best solution to your particular hazard:

(a) Change the physical conditions that create the hazard. "What change in physical condition will eliminate the hazard or prevent the accident?" A good example of this would be changing the surface in a work area to a non-slip type surface. Supplying ear muffs to a worker who must travel through an area in which noise levels exceed the standard would be another.

(b) Change the procedures of the Steps in the AHA. "What should the employee do or not do to eliminate the hazard or prevent this potential accident?" For example, "Is there another way for the employee to reach the work station other than going through the noisy area?" If there is, will it be more or less hazardous for the employee? You should consider work saving tools or equipment.

For example, say an employee must lift and carry a heavy object to a workbench. All you need to do is supply the worker with a workbench that has casters. Also, if two workers were to lift the object, you would reduce the risk of back injury.

(c) Reduce the frequency that a task must be performed. Every task has some potential for an accident to occur. Therefore, when you increase the times that the task is performed, you increase the probability of an accident occurring.

(d) Training. If none of the previous suggestions are applicable, then the answer may be training the employees to do a task safely.

Quite often we hear of accidents caused by lack of knowledge of proper safe procedures. This could mean a simple instruction from the Contractor’s Superintendent or could involve specialized training from an outside source. The latter is recommended for irregular work which may be unique.

(3) We have found that special attention should be given to newer employees (1 to 1 1/2 years). These employees have proven to be among the most likely to have an accident. This is why it is good practice for employers to give new employees good initial safety training.

(4) Once you have decided on a control for the hazard, you must put it into a positive statement; i.e. Dust respirators will be supplied to the workmen. Electricity will be locked out by a mechanical device.

In other words you will be committing yourself to perform the action you chose to control the hazard.

(5) If you now turn to Appendix D, you will find a copy of our sample completed analysis. As an exercise, go back through Step 1 through Step 4 of the analysis. See if you can come up with anything that we left out.

6. Update as Needed. It should be noted that the completed analysis is not set in stone. We all know that field changes take place every day. With these changes a new hazard may arise. Also, a delay in a different activity could have you working next to that operation. This could add numerous hazards to your job. For an Activity Hazard Analysis to be most effective it must be updated as the activity progresses.

7. Benefits.

a. A properly completed activity hazard analysis will reap many rewards.

How much does your organization spend for worker’s compensation insurance premiums? What you pay in premiums largely depends on your past accident history. If you can reduce your number of accidents using the activity hazard analysis process, then you can expect to see a reduction in your worker's compensation premiums. With lower premiums follows a lower quotation or bid. This means that your organization could be more competitive for various jobs.

b. Accidents cost money. For every accident there are obvious costs

(doctor, hospitals, etc.) as well as hidden costs (training a new employee, drop in morale, wages lost in reacting to the accident, etc.).

By reducing the accidents, you can save money, thereby increasing your profit margins on each job.

c. Safety training benefits your organization. Establishing safety contacts between line supervisor and worker (one-on-one) promotes good safety awareness and increases morale. This is very important for new employees.

d. Training on the proper methods of performing certain tasks will in most cases increase productivity. An increase in productivity should turn into an increase in profits.

Appendix D

SAMPLE ACTIVITY HAZARD ANALYSIS (AHA)

ACTIVITY: ______________

ANALYZED BY/DATE: _________________ _

NOTE: For additional guidance see instructions

PRINCIPAL STEPS POTENTIAL SAFETY/ HEALTH

HAZARDS

RECOMMENDED CONTROLS

Identify the principal steps involved and the sequence of work activities

Analyze each principal step for potential hazards

Develop specific controls for potential hazard

EQUIPMENT TO BE USED INSPECTION REQUIREMENTS TRAINING REQUIREMENTS

List equipment/machinery to be used in the work activity

List inspection requirements for the work activity

List training requirements, including hazard communication

ACTIVITY: Interior Demolition, Army Reserve Center, Your City, FI ANALYZED BY/DATE: John Doe. Project Foreman 8/30/2004

NOTE: For additional guidance

PRINCIPAL STEPS POTENTIAL SAFETY/ HEALTH

HAZARDS

RECOMMENDED CONTROLS

1. Remove furniture from work area.

2. Disconnect plumbing, electrical, and HVAC duct work from interior

3. Demolish Interior

4. Clean Up

EQUIPMENT TO BE USED INSPECTION REQUIREMENTS TRAINING REQUIREMENTS

ACTIVITY: Interior Demolition, Army Reserve Center, Your City, FI ANALYZED BY/DATE: John Doe. Project Foreman 8/30/2004

PRINCIPAL STEPS POTENTIAL SAFETY/ HEALTH HAZARDS RECOMMENDED CONTROLS

1. Remove furniture from work area

1. Back injury

2. Foot injury

3. Hand injury

2. Disconnect plumbing, electrical, and HVAC ductwork from interior

1. Electrocution or shock from wires

2. Workers or tools falling from elevated work area

3. Asbestos from hot water pipe insulation

4. Slips, trips, or falls

5. Noise

6. Dust

7. Materials falling on workers

8. Fire/explosion

9. Cuts from pipes or ducts

3. Demolish Interior 1. Dust

2. Eye injury

3. Debris falling on workers

4. Workers, debris, or tools falling from elevated work area

5. Cuts/puncture wounds

6. Fire/explosion

7. Noise

4. Clean Up 1. Dust

2. Fire/explosion

ACTIVITY: Interior Demolition, Army Reserve Center, Your City, FI ANALYZED BY/DATE: John Doe.

Project Foreman 8/30/2004

PRINCIPAL STEPS POTENTIAL SAFETY/ HEALTH HAZARDS RECOMMENDED CONTROLS

1. Remove furniture from work area

1. Back injury 1. Use furniture dolly for large or bulky furniture. Two workers required for placing large or bulky furniture onto dolly and moving large furniture.

2. Workers to use proper lifting techniques to prevent back injury

2. Foot injury 1. Wear steel toed safety boots.

3. Hand injury 1. Wear leather gloves to prevent cuts and abrasions.

2. Disconnect plumbing, electrical, and HVAC duct work from interior

1. Electrocution or shock from wires

1. Have licensed electrician ensure electrical system is locked/tagged out.

2. Workers or tools falling from elevated work area

1. Provide scaffold with standard railing with toe boards.

3. Asbestos from hot water pipe insulation

1. Have asbestos removed by qualified licensed source prior to disconnecting hot water pipe.

4. Slips, trips, or falls 1. Ensure spills from removal of plumbing have been cleaned up to prevent slips and falls. Keep work areas such as aisles, stairs, and exits clear of debris.

5. Noise 1. Ensure earplugs are worn in designated areas.

6. Dust 1. Wear dust respirators and safety glasses with side-shields or dust goggles.

2. Provide fans for ventilation

ACTIVITY: Interior Demolition. Army Reserve Center. Your City. FI ANALYZED BY/DATE: John Doe.

Project Foreman 8/30/2004

PRINCIPAL STEPS RECOMMENDED CONTROLS

7. Material falling on workers

8. Fire/explosion

1. Wear hard hats at all times while in the construction zone.

1. Prohibit smoking in work area.

2. Ensure an adequate number of fire extinguishers of the correct size and type are provided and that workers are trained in using extinguishers.

9. Cuts from pipes and ducts

1. Wear leather gloves to prevent cuts and abrasions. Tape sharp edges if possible.

3. Demolish interior

1. Dust

1. Wear dust respirators and safety glasses with side-shields or dust goggles.

2. Eye injury

1. Wear safety glasses with side· shields or dust goggles. For more severe conditions, wear face shield over safety glasses or dust goggles.

3. Debris falling on workers

1. Rope off areas and post signs when demolition begins.

2. Post watch person during demolition.

3. Workers shall wear hard hats at all times while in the construction zone.

4. Workers or tools falling from elevated work area.

1. Provide scaffold with standard railing and toe boards.

2. Supply 15 gauge U.S. standard wire 1/4" mesh between toe board and guardrail around entire perimeter scaffold.

ACTIVITY: Interior Demolition, Army Reserve Center, Your City, FI ANALYZED BY/DATE: John Doe. Project Foreman 8/30/2004

PRINCIPAL STEPS

POTENTIAL SAFETY/ HEALTH

HAZARDS RECOMMENDED CONTROLS

5. Cuts/puncture wounds

1. Remove nails from scrap lumber.

2. Wear steel-toed safety boots.

3. Wear leather gloves.

6. Fire/explosion

1. Remove all scrap lumber after every shift.

2. Vacuum dust from work area after every shift.

3. Prohibit smoking in work area.

4. Ensure an adequate number of fire extinguishers of the correct size and type are provided and that workers are trained in using extinguishers.

7. Noise

1. Ensure earplugs are worn in designated areas.

4. Clean up 1. Dust

1. Wear dust respirators and safety glasses with side-shields or dust goggles. For more severe conditions, wear face shield over safety glasses or dust goggles.

2. Provide fans for ventilation.

2. Fire/explosion

1. Prohibit smoking in work area.

2. Vacuum dust from work area after every shift.

3. Ensure an adequate number of fire extinguishers of the correct size and type are provided and that workers are trained in using extinguishers.

WEEKLY CONSTRUCTION SAFETY MEETING

Each 30 minutes meeting should include:

1. Contracting Officer/Specialist

2. Contracting Officer’s Technical Representative (COTR)

3. Contracting Officer’s Safety Representative (COSR)

4. Contractor’s Safety Representative

5. Contractor’s Superintendent

6. Guest

AGENDA

I. INTRODUCTION

II. OLD BUSINESS

III. NEW BUSINESS (such as employee safety concerns, PPE, or coordination with other crafts)

A. Topics

B. Events/Occurrences

C. Injuries/Illnesses

D. Results of Safety Inspections/Walkthroughs

E. Construction Communiqués/Lessons Learned and Issues

IV. CONTRACTOR’S SAFETY REPRESENTATIVE

V. OTHER

Superintendent: Date:

COSR: Date:

COTR: Date:

AMD Safety Form-01 (Jan. 09)

CONTRACTOR’S SAFETY MEETING

Contract No.: Sign-In Roster Date:

Topics 1.

6._____________________________ 2.

7._____________________________ 3.

8._____________________________ 4.

9._____________________________ 5.

10._____________________________

Name (Signature) Badge No. Comments/Safety Concerns/Training

Requests

Superintendent Name (Print):

Superintendent Signature:

COSR Name (Print): COSR Signature:

COTR Name (Print): COTR Signature:

AMD Safety Form-02 (Jan. 09)

SAFETY PLANNING SIGN-OFF

I have read the attached Activity Hazard Analysis attachments and understand the hazards associated with this job.

Pre-job meeting – general Other (specify) ________ Energized work permit pre-job Confined space pre-entry meeting Fall protection work plan Asbestos work plan

Contract Number: Job Location:

Date

Contractor Name (Print)

Signature

Superintendent Name (Print):

COSR Name (Print):

COTR Name (Print):

AMD Safety Form-03 (Jan. 09)

CONTRACT SAFETY ANALYSIS

(Cover Page of Contractor’s Accident Prevention Plan)

DATE:

Prepared by:

Project No: Task Order/Contract No:

Area/Bldg:

Work Scope/Description:

Primary Secondary Emergency Contact Person(s) Emergency Radio/Phone No:

Specific Work Location(s) Various

Pre-job Walkthrough Conducted:

Yes

No Yes No Reference Yes No Reference

1. Radiological Area Work

10CFR 835

13. Electrical Hazard × ¤ □

29 CFR 1926,

Subpart K

2. Hazardous Waste Operations × ¤

29 CFR 1910.120

14. Asbestos Work

29 CFR

1926.1101

3. Confined Spaces

29 CFR 1910

Subpart J

15. Lead Work

1926.62

4. Hot Work

29 CFR 1926

Subparts F&J

16. Hazardous Materials ×

Subpart Z

5. Roof Work

17. Respiratory Hazards ×

Subpart E

6. Fall Hazards (>6 ft.)

Subpart M

18. Noise Dose

1910.95

7. Excavation/Trenching

Subpart P

19. Heat Stress

8. Scaffolding

Subpart L

20. Demolition

29 CFR 1926,

Subpart T

9. Aerial Lifts

Subpart N

× = Requires formal/special training

¤ = Requires a permit/form/report

□ = Requires certification or competent/qualified person designation

10. Heavy Equipment

Subpart O

11. Lock and Tag

Subpart G

12. Site/Vehicle Traffic

Subpart O

SPECIFIC HAZARD ANALYSIS AND SAFE WORK REQUIREMENTS

A detailed discussion of the unique hazards to the work activity/location, including those noted above, will be provided on the Activity Hazard Analysis (AHA). This discussion must include indentification of the work activity, the specific hazards present, and the safe work requirements/controls (including PPE) to be used to alleviate/control the hazard(s).

MINIMUM DRESS/PPE REQUIREMENTS:

Substantial Footwear, Long Pants, Shirt with Sleeves

Does further evaluation of the job steps, associated hazards, or safety measures need to be performed?

Yes No

Supervision:

Date:

Activity Hazard Analysis - Continuation page Project No:

Task Order/Contract No:

COSR Signature:

COTR Signature:

AMD Safety Form-04 (Jan. 09)

CONTRACTOR ACCIDENT REPORT

CONTRACTOR EMPLOYEE’S NAME: __________________________________________________________ Last First M.I.

NAME OF COMPANY: _______________________________________________________________________

ADDRESS: ________________________________________________________________________________

SUPERVISOR: _____________________________________________________________________________

DATE & TIME OF ACCIDENT:

DATE & TIME FIRST REPORTED: _____________________________________________________________

LOCATION OF ACCIDENT: ___________________________________________________________________

DESCRIPTION OF INJURIES__________________________________________________________________

MEDICAL SERVICES REQUIRED:_________YES________NO

NAME OF DOCTOR OR HOSPITAL:____________________________________________________________

ACCIDENT DETAILS (CONDITIONS, MACHINERY, EQUIPMENT, MATERIALS, WEATHER, OTHER

PERSONNEL INVOLVED) ____________________________________________________________________

WITNESSES _______________________________________________________________________________

Superintendent Signature Date COTR Signature Date

Contractor Safety Representative Date COSR Signature Date

(Original copy to Contractor, copy to CO, COTR, COSR)

AMD Safety Form-05 (Jan. 09)

IMMEDIATE HAZARD REPORT

Identified Hazard: Date:

Name of Employees Removed from Area

Badge No.

Recommended Corrective Action:

Action Taken

Hazard Resolved

□ YES □ NO

□ YES □ NO

Signatures: Date:

Contractor’s Safety Representative:

COSR:

COTR:

AMD Safety Form-06 (Jan. 09)

CFMO/EMSS/Plant Safety Inspection Log Sheet

Date/Time: ______________ If outdoors, weather & temp:

Contractor: ___________________

Project/Location:_______________________________

Contract Number: _____________________________

Inspected by (COTR/COSR signature): _______________________________________

VIOLATION: OSHA SAFETY PLAN EPA OTHER

Cite specific violation reference (i.e., OSHA 29 CFR 1926.100(a))

Contractor Safety Rep on jobsite (Y/N) ______ Contractor Superintendent on jobsite

(Y/N) _______

Contractor Rep (not a subcontractor rep) who received hand-delivered violation from COTR:

Name: _________________________________Date/time:_______________________________________

Remarks: ______________________________________________________________________________

Request corrective action in writing by (date): ______________________

Date/time that violation notice was hand delivered to Contracting Officer: ______________

REINSPECTION DATE: __________________ VIOLATION: Corrected Failed:

Remarks: _____________________________________________________________________________

Request corrective action by (date):______________________

2nd REINSPECTION DATE: ______________ VIOLATION: Corrected Failed:

Date/time that contractor was notified that violation has been corrected:

Date that “corrected” violation notice was hand delivered to Contracting Officer:

COTR’s Closeout signature: _________________________________Date: ____________________

AMD Safety Form-07 (Jan. 09)