Attachment_J.11_A002_-_SOH_Plan_and_Reporting.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

A. SOH program plan shall be submitted NLT 30 days prior to the start of full performance for the first submission. Changes to the SOH Plan that address the Contractor’s approach to conform to applicable Safety and Occupational Health Standards shall be submitted within 30 calendar days of the change. The SOH Plan shall address the Contractor’s approach:

1. Developing and implementing systems to effectively identify, evaluate, prevent, and control occupational hazards to prevent employee injuries and illnesses through: management leadership and employee involvement; worksite analysis; hazard prevention and control; and safety and health training.

2. For the Safety and Occupational Health Representative(s) to perform safety and occupational health management, surveillance, inspections, and safety program enforcement and how integrated into the Contractor's Quality Control Plan (QCP)

3. To establish a Hazard Reporting Program and HAZ/COM IAW DoD 6050.5.

4. Conforming to the SOH standards consistent with the most stringent of applicable Federal, State, local regulations and DLA policies/procedures.

5. To use ESAMS

B. On a quarterly basis (date to be provided by the COR), the contractor shall provide the following data for the previous three (3) month period:

1. Date OSHA 300 Log Posted

2. Date the Abatement log was last reviewed

3. Date of Last Annual Self Assessment

4. Date of Last Quarterly Council Meeting

5. Date of Last Quarterly Supervisor Inspection

6. TCIR

7. DART

8. Percent of Hazards identified in ESAMs by the Contractor w/ Interim Controls

Block 7 - Inspection and acceptance requirements:

The Contract Specialist will review and accept the SOH plans and updates after coordination with the COR and Installation Support Safety Office review and comments. The COR will review and accept the quarterly information.

Block 14 - Distribution - Contractor to submit original to the Contract Specialist and copy to the COR.