Safety Attachments.pdf

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PREPARED BY: PROBABILITY

(Previous Edition Obsolete) SO

PROJECT OR

ACTIVITY

1-May-06

LRB-AHA

B C

A B

Marginal

C

Catastrophic

Critical A B

Risk Accepted by:

Required Safety Equipment and Training

RAC CODESafety Controls - E=Engineering/Elimination A=Administrative PPE=Personal Protective Equipment

D

D

SE

VE

R

IT

Y

B C1 A

D

E 3 A

4 C Negligible

PRINCIPLE STEPS

E

DATE PREPARED:

POTENTIAL SAFETY & HEALTH

HAZARDS

ACTIVITY HAZARD ANALYSIS

D E

E 2

A = Frequent occurrence B = Likely to occur C = Occasional occurrence D = Seldom occurrence E U lik l

U. S. Army Corps of Engineers Safety and Occupational Health Office

Minimum Basic Outline for Accident Prevention Plan The APP is the Contractor Safety and Health Program Document. The following Site Specific Areas will be addressed:

NOTE: 1. Contractor will complete Checklist and Submit with their APP.

NOTE: 2. Contractor APP WILL be submitted in format below.

NOTE: 3. Safety Office will review Contractor APP and return to PM / COR.

NOTE: 4. Contractor APP's ARE NOT APPROVED by the USACE, only found as Acceptable or Non-Acceptable.

Safety Office Review Status: ACCEPTED BY/DATE: ________________ NOT ACCEPTED BY/DATE:________________

Contractor Name: Contract No:

Project Title & Location:

Yes No N/A Page(s)

ALL CHECKLIST ITEMS WILL BE COMPLETED !

1. SIGNATURE SHEET. Title, signature, and phone number of the following:

a. Plan Preparer (qualified person, Competent Person such as corporate safety staff person, QC).

b. Plan Approval 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; phases of work anticipated (these will require an AHA).

3. STATEMENT OF SAFETY AND HEALTH POLICY. Provide a copy of your current corporate/company Safety & Health Policy Statement, detailing commitment to providing a safe and healthful workplace for all employees. The Contractor’s written safety program goals, objectives, and accident experience goals for this contract should be provided.

4. RESPONSIBILITIES AND LINES OF AUTHORITIES. Provide the following:

a. A statement of the employer’s ultimate responsibility for the implementation of his SOH program;

b. Identification and accountability of personnel responsible for safety at both corporate and project level.

Contracts specifically requiring safety or industrial hygiene personnel shall include a copy of their resumes. Qualifications shall include the OSHA 30-hour course or equivalent course areas as listed here:

(1) OSH Act/General Duty Clause;

(2) 29 CFR 1904, Recordkeeping;

(3) Subpart C: General Safety and Health Provisions, Competent Person

(4) Subpart D: Occupational Health and Environmental Controls, Citations and Safety Programs;

(5) Subpart E: PPE, types and requirements for use;

(6) Subpart F: understanding fire protection in the workplace;

(7) Subpart K: Electrical;

Included ?

CONTRACTOR ACCIDENT PREVENTION PLAN (APP) CHECKLIST (EM 385-1-1, Appendix - A, dated; 15 Sept. 08)

POC: Keith Hall/Safety Office USACE Buffalo NY. District Ph:716-879-4406

Page 1 Last Updated 20 Jan 2009

Minimum Basic Outline for Accident Prevention Plan The APP is the Contractor Safety and Health Program Document. The following Site Specific Areas will be addressed:

NOTE: 1. Contractor will complete Checklist and Submit with their APP.

NOTE: 2. Contractor APP WILL be submitted in format below.

NOTE: 3. Safety Office will review Contractor APP and return to PM / COR.

NOTE: 4. Contractor APP's ARE NOT APPROVED by the USACE, only found as Acceptable or Non-Acceptable.

Safety Office Review Status: ACCEPTED BY/DATE: ________________ NOT ACCEPTED BY/DATE:________________

Contractor Name: Contract No:

Project Title & Location:

Yes No N/A Page(s)

Included ?

CONTRACTOR ACCIDENT PREVENTION PLAN (APP) CHECKLIST (EM 385-1-1, Appendix - A, dated; 15 Sept. 08)

(8)Subpart M: Fall Protection;

(9) Rigging, welding and cutting, scaffolding, excavations, concrete and masonry, demolition; health hazards in construction, materials handling, storage and disposal, hand and power tools, motor vehicles, mechanized equipment, marine operations, steel erection, stairways and ladders, confined spaces or any others that are applicable to the work being performed.

c. 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. The District SOHO will review the qualifications for acceptance;

d. Requirements that no work shall be performed unless a designated competent person is present on the job site;

e. Requirements for pre-task safety and health analysis;

f. Lines of authority;

g. Policies and procedures regarding noncompliance with safety requirements (to include disciplinary actions for violation of safety requirements) should be identified;

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

5. SUBCONTRACTORS AND SUPPLIERS. If applicable, provide procedures for coordinating SOH activities with other employers on the job site:

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

b. Safety responsibilities of subcontractors and suppliers.

6. TRAINING.

a. Requirements for new hire SOH orientation training at the time of initial hire of each new employee.

b. Requirements for mandatory training and certifications that are applicable to this project (e.g., explosive actuated tools, confined space entry, crane operator, diver, vehicle operator, HAZWOPER training and certification, PPE) and any requirements for periodic retraining/recertification.

c. Procedures for periodic safety and health training for supervisors and employees.

d. Requirements for emergency response training. > See 9.b. below for a list of requirements that may require emergency response training.

7. SAFETY AND HEALTH INSPECTIONS.

POC: Keith Hall/Safety Office USACE Buffalo NY. District

Page 2 Last Updated 20 Jan 2009

Minimum Basic Outline for Accident Prevention Plan The APP is the Contractor Safety and Health Program Document. The following Site Specific Areas will be addressed:

NOTE: 1. Contractor will complete Checklist and Submit with their APP.

NOTE: 2. Contractor APP WILL be submitted in format below.

NOTE: 3. Safety Office will review Contractor APP and return to PM / COR.

NOTE: 4. Contractor APP's ARE NOT APPROVED by the USACE, only found as Acceptable or Non-Acceptable.

Safety Office Review Status: ACCEPTED BY/DATE: ________________ NOT ACCEPTED BY/DATE:________________

Contractor Name: Contract No:

Project Title & Location:

Yes No N/A Page(s)

Included ?

CONTRACTOR ACCIDENT PREVENTION PLAN (APP) CHECKLIST (EM 385-1-1, Appendix - A, dated; 15 Sept. 08)

a. Specific assignment of responsibilities for a minimum daily job site safety and health inspection during periods of work activity: Who will conduct (e.g., SSHO, PM, safety professional, QC, supervisors, employees – depends on level of technical proficiency needed to perform said inspections), proof of inspector’s training/qualifications, when inspections will be conducted, procedures for documentation, deficiency tracking system, and follow-up procedures;

b. Any external inspections/certifications that may be required (e.g., USCG).

8. ACCIDENT REPORTING. The Contractor shall identify person(s) responsible to provide the following:

a. Exposure data (man-hours worked);

b. Accident investigations, reports, and logs: Report all accidents as soon as possible but not more than 24 hours afterwards to the Contracting Officer/Representative (CO/COR). The contractor shall thoroughly investigate the accident and submit the findings of the investigation along with appropriate corrective actions to the CO/COR in the prescribed format as soon as possible but no later than five (5) working days following the accident. Implement corrective actions as soon as reasonably possible;

c. The following require immediate accident notification:

(1) A fatal injury;

(2) A permanent total disability;

(3) A permanent partial disability;

(4) The hospitalization of three or more people resulting from a single occurrence;

(5) Property damage of $200,000 or more.

9. PLANS (PROGRAMS, PROCEDURES) REQUIRED BY THE SAFETY MANUAL. Based on a risk assessment of contracted activities and on mandatory OSHA compliance programs, the Contractor shall address all applicable occupational risks and compliance plans.

Using the EM 385-1-1 as a guide, plans may include but not be limited to:

a. Layout plans (04.A.01);

b. Emergency response plans:

(1) Procedures and tests (01.E.01);

(2) Spill plans (01.E.01, 06.A.02);

(3) Firefighting plan (01.E.01, Section 19);

(4) Posting of emergency telephone numbers (01.E.05);

(5) Man overboard/abandon ship (Section19.A.04);

POC: Keith Hall/Safety Office USACE Buffalo NY. District

Page 3 Last Updated 20 Jan 2009

Minimum Basic Outline for Accident Prevention Plan The APP is the Contractor Safety and Health Program Document. The following Site Specific Areas will be addressed:

NOTE: 1. Contractor will complete Checklist and Submit with their APP.

NOTE: 2. Contractor APP WILL be submitted in format below.

NOTE: 3. Safety Office will review Contractor APP and return to PM / COR.

NOTE: 4. Contractor APP's ARE NOT APPROVED by the USACE, only found as Acceptable or Non-Acceptable.

Safety Office Review Status: ACCEPTED BY/DATE: ________________ NOT ACCEPTED BY/DATE:________________

Contractor Name: Contract No:

Project Title & Location:

Yes No N/A Page(s)

Included ?

CONTRACTOR ACCIDENT PREVENTION PLAN (APP) CHECKLIST (EM 385-1-1, Appendix - A, dated; 15 Sept. 08)

(6) Medical Support. Outline on-site medical support and offsite medical arrangements including rescue and medical duties for those employees who are to perform them, and the name(s) of on-site Contractor personnel trained in first aid and CPR. A minimum of two employees shall be certified in CPR and firstaid per shift/site (Section 03.A.02; 03.D);

c. Plan for prevention of alcohol and drug abuse (01.C.02);

d. Site sanitation plan (Section 02);

e. Access and haul road plan (4.B);

f. Respiratory protection plan (05.G);

g. Health hazard control program (06.A);

h. Hazard communication program (06.B.01);

i. Process Safety Management Plan (06.B.04);

j. Lead abatement plan (06.B.05 & specifications);

k. Asbestos abatement plan (06.B.05 & specifications);

l. Radiation Safety Program (06.E.03.a);

m. Abrasive blasting (06.H.01);

n. Heat/Cold Stress Monitoring Plan (06.I.02)

o. Crystalline Silica Monitoring Plan (Assessment) (06.M) ;

p. Night operations lighting plan (07.A.08);

q. Fire Prevention Plan (09.A);

r. Wild Land Fire Management Plan (09.K);

s. Hazardous energy control plan (12.A.01);

t. Critical lift Plan (16.H);

u. Contingency plan for Floating Plants for severe weather (19.A.03);

v. Float Plan (19.F.04);

w. Site-Specific Fall Protection & Prevention Plan (21.C);

x. Demolition plan (to include engineering survey) (23.A.01);

y. Excavation/trenching plan (25.A.01);

z. Emergency rescue (tunneling) (26.A.);

aa. Underground construction fire prevention and protection plan (26.D.01);

bb. Compressed air plan (26.I.01);

cc. Formwork and shoring erection and removal plans (27.C);

dd. PreCast Concrete Plan (27.D);

ee. Lift slab plans (27.E);

ff. Steel erection plan (27.F.01);

gg. Site Safety and Health Plan for HTRW work (28.B);

POC: Keith Hall/Safety Office USACE Buffalo NY. District

Page 4 Last Updated 20 Jan 2009

Minimum Basic Outline for Accident Prevention Plan The APP is the Contractor Safety and Health Program Document. The following Site Specific Areas will be addressed:

NOTE: 1. Contractor will complete Checklist and Submit with their APP.

NOTE: 2. Contractor APP WILL be submitted in format below.

NOTE: 3. Safety Office will review Contractor APP and return to PM / COR.

NOTE: 4. Contractor APP's ARE NOT APPROVED by the USACE, only found as Acceptable or Non-Acceptable.

Safety Office Review Status: ACCEPTED BY/DATE: ________________ NOT ACCEPTED BY/DATE:________________

Contractor Name: Contract No:

Project Title & Location:

Yes No N/A Page(s)

Included ?

CONTRACTOR ACCIDENT PREVENTION PLAN (APP) CHECKLIST (EM 385-1-1, Appendix - A, dated; 15 Sept. 08)

hh. Blasting Safety Plan (29.A.01);

ii. Diving plan (30.A.13);

jj. Confined space Program (34.A).

10. RISK MANAGEMENT PROCESSES. Detailed project-specific hazards and controls shall be provided by an Activity Hazard Analysis (0I.A.13) for each major phase/activity of work.

11. ABBREVIATED APP for LIMITED-SCOPE SERVICE, SUPPLY AND R&D CONTRACTS. If service, supply and R&D contracts with limited scopes are awarded, the contractor may submit an abbreviated Accident Prevention Plan. This APP shall address the following areas at a minimum. If other areas of the EM 385-1-1 are pertinent to the contract, the contractor must assure these areas are addressed as well.

a. Title, signature, and phone number of the plan preparer.

b. Background Information to include: Contractor; Contract number; Project name; Brief project description, description of work to be performed, and location (map); The project description shall provide a means to evaluate the work being done (see AHA requirements in 01.A.13) and associated hazards involved. Contractor’s APP shall address the identified hazards involved and the control measures to be taken.

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

d. Responsibilities and Lines of Authorities – to include a statement of the employer’s ultimate responsibility for the implementation of his SOH program; Identification and accountability of personnel responsible for safety at all levels to include designated site safety and health officer (SSHO) and associated qualifications. The District SOHO will review the qualifications for acceptance.

e. Training - new hire SOH orientation training at the time of initial hire of each new employee and any periodic retraining/recertification requirements.

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

g. Procedures for reporting man-hours worked and reporting and investigating any accidents as soon as possible but not more than 24 hours afterwards to the Contracting Officer/Representative (CO/COR). An accident that results in a fatal injury, permanent partial or permanent total disability shall be immediately reported to the Contracting Officer.

h. Emergency Planning. Employees working alone shall be provided an effective 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.

i. Drinking Water provisions, toilet and washing facilities.

j. 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).

POC: Keith Hall/Safety Office USACE Buffalo NY. District

Page 5 Last Updated 20 Jan 2009

Minimum Basic Outline for Accident Prevention Plan The APP is the Contractor Safety and Health Program Document. The following Site Specific Areas will be addressed:

NOTE: 1. Contractor will complete Checklist and Submit with their APP.

NOTE: 2. Contractor APP WILL be submitted in format below.

NOTE: 3. Safety Office will review Contractor APP and return to PM / COR.

NOTE: 4. Contractor APP's ARE NOT APPROVED by the USACE, only found as Acceptable or Non-Acceptable.

Safety Office Review Status: ACCEPTED BY/DATE: ________________ NOT ACCEPTED BY/DATE:________________

Contractor Name: Contract No:

Project Title & Location:

Yes No N/A Page(s)

Included ?

CONTRACTOR ACCIDENT PREVENTION PLAN (APP) CHECKLIST (EM 385-1-1, Appendix - A, dated; 15 Sept. 08)

k. Personal Protective Equipment.

(1) WORK CLOTHING - Minimum Requirements. Employees shall wear clothing suitable for the weather however minimum requirements for work shall be short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes. If analysis determines that safety-toed (or other protective) footwear is necessary (i.e., mowing, weedeating, chain saw use, etc), they shall be worn.

(2) Eye and Face Protection. Eye and face protection shall be worn as determined by an analysis of the operations being performed HOWEVER, all involved in chain saw use, chipping, stump grinding, pruning operations, grass mowing, weedeating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

(3) Hearing Protection. Hearing protection must be worn by all those exposed to high noise activities (to include grass mowing and trimming, chainsaw operations, tree chipping, stump grinding and pruning).

(4) Head Protection. Hard hats shall comply with ANSI Z89.1 and shall be worn by all workers when a head hazard exists. At a minimum, hard hats shall be worn when performing activities identified in (2) above.

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

(6) Protective Leg chaps shall be worn by all chainsaw operators.

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

(8) If work is being performed around water and drowning is a hazard, PFDs must be provided and worn as appropriate.

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

m. Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a hazard communication program must be in effect and MSDSs 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.

n. Traffic control shall be accomplished in accordance with DOT’s MUTCD.

o. 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 this energy.

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

POC: Keith Hall/Safety Office USACE Buffalo NY. District

Page 6 Last Updated 20 Jan 2009

USACE - Monthy Man Hour Contractor Exposure Report (Ref. EM 385-1, page-10, para 01.D.04d)

MONTH:______ YEAR:______

PROJECT NAME TYPE OF OPERATION LOCATION CONTRACTOR CONTRACT MANHOURS # OF LOST WORK-DAYS # OF DAYS SINCE LAST

(City & State) NAME NUMBER WORKED DUE TO INJURY LOST WORK-DAY(since start of contract)

TOTALS >>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>>>>>>> >>>>>>>>>>>>>>>>

LRB-ContractorMonthlyManhourExposureForm.xls

CERTIFICATE OF COMPLIANCE

This certificate shall be signed by an official of the company that provides cranes for any application under this contract. Post a completed certificate on each crane utilized during this contract

CONTRACTING OFFICER’S POINT OF CONTACT PHONE

PRIME CONTRACTOR/PHONE

CONTRACT NUMBER

CRANE SUPPLIER/PHONE

(if different from prime contractor)

CRANE(S) NUMBER

(i.e., ID number)

CRANE MANUFACTURER/TYPE/CAPACITY

CRANE OPERATOR'S NAME(S)

I certify that

1. The above noted crane and associated rigging gear conform to applicable USACE & OSHA regulations and applicable ASME B30 standards. The following USACE, OSHA regulations and ASME standards apply: EM 385-1-1, 29 CFR 1910.180 & B30.8-2004

2. The operators noted above have been trained and are qualified for the operation of the above noted crane(s).

3. The operators noted above have been trained not to bypass safety devices during lifting operations.

COMPANY OFFICIAL SIGNATURE

DATE

COMPANY OFFICIAL NAME/TITLE

POST ON CRANE

(IN CAB OR VEHICLE)