Sample of Accident Prevention Plan.docx

ACCIDENT PREVENTION PLAN

Contract Description Contract Number Contractor Name

This sample plan does not fully meet the requirements associated with HTRW projects.

1. SIGNATURE SHEET.

This Accident Prevention Plan was

Prepared By:

Name Title of corporate safety staff person

Approved By:

Name President

2. BACKGROUND INFORMATION

b. Contract Number W911WN-##-#-####

c. Project Name: Enter Name of Project

d. Project Description: Enter description of work

e. Name of Company’s recent accident history is included as Attachment # to this Accident Prevention Plan. Information included includes EMR, OSHA 200 Forms and corporate safety trend analyses.

f. The Major definable features of work are listed in the Quality Control Plan. An Activity Hazard Analysis (AHA) will be prepared for each Major Definable Feature of Work. AHAs will be prepared in accordance with the format shown on page 4 of EM 385-1-1 and will be presented and discussed at the Preparatory Phase Inspection for the applicable feature of work.

3. STATEMENT OF SAFETY AND HEALTH POLICY

Enter statement which describes the company‘s commitment to safety.

4. RESPONSIBILITIES AND LINES OF AUTHORITIES

a. Name - Describe responsibility and accountability of personnel responsible for safety at corporate level.

b. Name - Describe responsibility and accountability of personnel responsible for safety at project level.

c. Lines of authority - Describe lines of authority (as related to safety) for this project.

5. SUBCONTRACTORS AND SUPPLIERS.

a. The following subcontractors will be working on this project:

1. List

b. The CQC System Manger (if someone else, identify) will be responsible for controlling and coordinating subcontractors and suppliers.

c. All subcontractors and suppliers performing work on site will be expected to conform to the requirements of this Accident Prevention Plan and to the requirements of EM 385-1-1.

6. TRAINING.

a. Each employee will receive a safety indoctrination consisting of a thorough review of applicable AHA’s.

b. The following is a list of mandatory training and certifications which are applicable to this project:

c. The following identifies requirements for periodic retraining or recertification relating to item b above.

1. List

d. The following individuals shall be trained in the contents of the Emergency Response Plan discussed in Section 12 of this Accident Prevention Plan:

1. List

e. Weekly toolbox safety meeting will be conducted at TIME every ENTER DAY OF WEEK. Each on site worker will be required to attend. Attendance will be documented. Name will be responsible for conducting these meetings.

7. SAFETY AND HEALTH INSPECTIONS.

a. Name will conduct site safety inspections on a daily basis. Any noted deficiencies will be identified on that day’s CQC Report. Deficiencies will be tracked using the table included as Attachment # to this Accident Prevention Plan.

b. The following external inspections/certifications are required for this project:

List or enter “None Required”.

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

a. Provide a statement or statements describing the company's written safety program goals, objectives, and accident experience goals for this contract.

b. Provide a brief description of the company's safety incentive programs (if any). If none, so state.

c. Provide a discussion of the company’s policies and procedures regarding noncompliance with safety requirements (to include disciplinary actions for violation of safety requirements).

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

9. ACCIDENT REPORTING

a. Name will submit Monthly Manhour Exposure Reports to the Contracting Officer no later than the 5th work day of each month. The report encompasses on-site work including all hourly and salaried employees. The report will include all subcontractors working on this project.

b. Name will complete the report and submit it to the Contracting Officer within five (5) workdays.

c. Name will immediately notify the Contracting Officer and District Safety Officer of any incidents involving a fatality or permanent total disability, accidents in which three or more persons are hospitalized, accidents that result in property damage in excess of $100,000 or any accident regardless of the consequences, if it is suspected that it will result in unfavorable criticism of the Corps of Engineers..

10. MEDICAL SUPPORT

a. A list of emergency telephone numbers and a map of directions to the nearest hospital(s) is included in the Emergency Response Plan section of this Accident Prevention Plan.

b. First aid kits will be maintained on site as required in Section 3 of EM 385-1-1.

c. At least two employees on each shift will be qualified to administer first aid and CPR. Individuals who are required to work alone in remote areas shall be trained in first aid. The following employees are certified in First Aid and CPR and a copy of their current certificates are included as Attachment # to this Accident Prevention Plan:

1. List

11. PERSONAL PROTECTIVE EQUIPMENT.

a. Outline procedures (who, when, how) for conducting hazard assessments and written certifications for use of personal protective equipment.

12. PLANS (PROGRAMS, PROCEDURES) REQUIRED BY THE SAFETY MANUAL (as applicable)

a. Hazard Communication (HAZCOM) Program (01.B.04)

Included as Attachment # to this Accident Prevention Plan is a written hazard communication program addressing as a minimum, the following: training (to include potential safety and health effects from exposure), labeling, current inventory of hazardous chemicals on site, and the location and use of Material Safety Data Sheets (MSDSs).

b. Emergency Response Plans (01.E.01, 01.E.05, 06.A.02, 19.A.04, 09.K.01 and 09.K.02)

An Emergency Response Plan is included as Attachment # to this Accident Prevention Plan. This Emergency Response Plan includes:

An Emergency Response Plan to ensure employee safety in case of fire or other emergency.

A Spill Response Plan including organizations with telephone numbers of individuals to contact in the event of a spill.

A Plan for responses to marine emergencies such as fire, sinking, flooding, severe weather, man overboard, hazardous material incidents, etc.

Emergency telephone numbers and reporting instructions for ambulance, physician, hospital, fire, and police. Also included is a map of directions to the nearest hospital(s). This list and map shall be conspicuously posted at the work site.

A wildfire prevention plan and a wildfire control plan for work at all facilities and areas with potential exposure to wildfire

c. Layout plans (04.A.01)

Plans for the layout of temporary construction buildings, facilities, fencing and access routes and anchoring systems for temporary structure are included as Attachment # to this Accident Prevention Plan.

d. Respiratory Protection Plan (05.E.01)

Name of Company‘s Respiratory Protection Plan is included as Attachment # to this Accident Prevention Plan.

e. Health Hazard Control Program (06.A.02)

Activity Hazard Analyses (AHA’s) shall consider all substances, agents and environments that present a hazard and will recommend hazard control measures. Engineering and administrative controls shall be used to control hazards. In cases where engineering or administrative controls are not feasible, PPE may be used. The AHA shall serve as certification that a hazard assessment has been conducted.

Operations, materials, and equipment involving potential exposure to hazardous substances, agents or environments will be evaluated by a qualified industrial hygenist, or other competent person, to formulate a hazard control program. The following hazardous substances, agents or environments have been identified:

List

This list may be revised during the performance of work on this project.

f. Lead Abatement Plan (06.B.05)

Before initiation of activities where there is an identified lead hazard, a written plan detailing compliance with OSHA and EPA lead abatement requirements shall be submitted to the Government for review and approval.

OR

A written plan detailing compliance with OSHA and EPA lead abatement requirements is included as Attachment # to this Accident Prevention Plan.

g. Asbestos Abatement Plan (06.B.05)

Before initiation of activities where there is an identified asbestos hazard, a written plan detailing compliance with OSHA and EPA asbestos abatement requirements shall be submitted to the Government for review and approval.

OR

A written plan detailing compliance with OSHA and EPA asbestos abatement requirements is included as Attachment # to this Accident Prevention Plan.

h. Abrasive Blasting (06.H.01)

Operational procedures for abrasive blasting operations are included as Attachment # to this Accident Prevention Plan. Employees will be trained in these procedures and will be advised where these written procedures and health information are available on the premises for review.

i. Confined Space (06.I)

Name will inspect the work area and evaluate the potential for permit-required confined spaces (PRCSs). This inspection will occur before work begins, whenever the characteristics of spaces change in a way that could lead to a reclassification as a PRCS and at least annually. A list of confined spaces (permit required and non-permit required) will be maintained on site.

Name of Company‘s Permit-Required Confined Space Program is included as Attachment # to this Accident Prevention Plan.

j. Hazardous Energy Control Plan (12.A.07)

A Hazardous Energy Control Plan meeting the requirements of section 12.A.07 of EM 385-1-1 is included as Attachment # to this Accident Prevention Plan.

k. Critical Lift Procedures (16.C.18)

A critical lift is defined as a non-routine lift requiring detailed planning and additional or unusual safety precautions. Critical lifts include lifts made when the load weight is 75% of the rated capacity of the crane; lifts which require the load will be lifted , swung, or placed out of the operators view; lifts made with more than one crane; lifts involving non-routine or technically difficult rigging arrangement; hoisting personnel with a crane or derrick; or any lift which the lift or crane operator believe should be considered critical.

As required by Section 16.C.18 of EM 385-1-1, a Critical Lift Plan shall be prepared and submitted to the Government prior to making any critical lift.

l. Contingency Plan for Severe Weather (19.A.03)

A severe weather plan for floating plant is included as Attachment # to this Accident Prevention Plan.

m. Access and Haul Road Plan (21.I.10)

An access and haul road plan meeting the requirements of section 21.I.10 of EM 385-1-1 is included as Attachment # to this Accident Prevention Plan.

n. Demolition Plan (engineering and asbestos surveys) (23.A.01)

An engineering survey, asbestos survey (if determined necessary) and a demolition plan for each structure to be demolished will be prepared and submitted to the Government for approval. The engineering survey will be prepared by a registered Structural Engineer.

o. Emergency Rescue (tunneling) (26.A.05)

An emergency rescue plan for workers who may become injured or incapacitated while underground or in a shaft or caisson will be developed and submitted to the Government prior to beginning work on that activity.

p. Underground Construction Fire Prevention and Protection Plan (26.D.01)

A fire prevention and protection plan for underground construction meeting the requirements of section 26.D.01 of EM 385-1-1 is included as Attachment # to this Accident Prevention Plan.

q. Compressed Air Plan (26.I.01)

A compressed air work plan is required when work activities place workers in compressed air chambers. A plan, meeting the requirements of section 26.I of EM 385-1-1, is included as Attachment # to this Accident Prevention Plan.

r. Formwork and Shoring Erection and Removal Plans (27.B.02)

A formwork and shoring plan will be submitted prior to initiating work on related construction activities.

s. Lift Slab Plans (27.D.01)

A Lift Slab Plan will be planned and designed by a registered engineer or architect and submitted to the Government prior to initiating related work activities.

t. Blasting Plan (29.A.01)

A Blasting Plan will be submitted to the Government for review and approval prior to initiating related work activities.

u. Diving Plan (30.A.13)

It is recognized that a Dive Plan is required for each separate diving operation. The Dive Plan will be prepared and submitted to the Government for review and approval a sufficient time in advance of each required dive. Diving will not occur until the Dive Plan is approved by the Government.

v. Plan for Prevention of Alcohol and Drug Abuse (Defense Federal Acquisition Regulation Supplement Subpart 252.223-7004, Drug-Free Work Force)

Name of Company‘s plan for prevention of Alcohol and Drug Abuse is included as Attachment # to the Accident Prevention Plan. This plan meets the minimum requirements of DFAR 252.223-7004.

13. Detailed site specific hazards and controls will be provided in the activity hazard analysis (AHA) for each phase of the operation (each Major Definable Feature of Work as defined by the Contractor Quality Control Plan). The AHA’s will provide information on how the requirements of major sections of EM 385-1-1 will be met. Particular attention shall be paid to excavations, scaffolding, medical and first aid requirements, sanitation, personal protective equipment, fire prevention, machinery and mechanized equipment, electrical safety, public safety requirements, and chemical, physical agent, and biological occupational exposure prevention requirements. AHA’s will be prepared utilizing the format shown on page 4 of EM 385-1-1.

Attachments Attachment # - Accident History Attachment # - Safety Deficiency Tracking Table Attachment # - Emergency Response Plan Attachment # - First Aid and CPR certificates Attachment # - Hazard Communication (HAZCOM) Program Attachment # - Emergency Response Plan Attachment # - Layout plans Attachment # - Respiratory Protection Plan Attachment # - Lead Abatement Plan Attachment # - Asbestos Abatement Plan Attachment # - Abrasive Blasting Plan Attachment # - Permit-Required Confined Space Program Attachment # - Hazardous Energy Control Plan Attachment # - Severe Weather Plan Attachment # - Access and Haul Road Plan Attachment # - Underground Construction Fire Prevention and Protection Plan Attachment # - Compressed Air Plan Attachment # - Plan for Prevention of Alcohol and Drug Abuse