Att_9.1_APPSSHP_Checklist_SLDA_Remediation_RFP_upd_28Apr2015.docx

APP/SSHP Checklist CONTRACTOR ACCIDENT PREVENTION PLAN/ SITE SAFETY AND HEALTH PLAN (APP/SSHP) CHECKLIST (EM 385-1-1, Appendix - A, Section 33, dated 30 Nov 2014) Minimum Basic Outline for APP/SSHP The APP/SSHP 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/SSHP.

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

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

NOTE: 4. Contractor APP/SSHP'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: _________________________________

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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 (map); equipment to be used; anticipated high risk activities

e. Major phases of work anticipated and activities that 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 for his own employees, all sub-contractors and all others on the worksite.

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. Per EM 385-1-1 01.A.17, the SSHO is required to have as a minimum the OSHA 30-hour Construction Safety course and construction industry safety experience; and must be on-site at all times when work is 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 and details of the employers Risk Management Process (i.e.AHAs)

e. Requirements for activity specific AHAs to be submitted and accepted at preparatory meetings, prior to work being performed;

f. Requirements that no work by the Contractor shall be performed unless a designated CP/SSHO is present at the job site;

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

h. Lines of authority;

i. 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.

7. SAFETY AND HEALTH INSPECTIONS.

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. MISHAP REPORTING AND INVESTIGATION. 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/incidents as soon as possible but not more than 4 hours afterwards to the Contracting Officer/Representative (KO/COR). The contractor shall thoroughly investigate the incident/accident per Section 01.D and, if applicable, submit the findings of the investigation along with appropriate corrective actions to the KO/COR in the prescribed format as soon as possible. Implement corrective actions as soon as reasonably possible and provide notice to the KO/COR when corrective actions are completed;

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. Fatigue Management Plan (01.A.20);

b. Emergency Plans (01.E);

c. Site Sanitation/ Housekeeping Plan (Section 02.B);

d. Medical Support Agreement (03.A.01; 03.A.03);

e. Blood Borne Pathogen Program (03.A.05);

f. Exposure Control Plan (03.A.05);

g. Automatic External Defibrillator (AED) Program (03.B.04);

h. Site Layout Plan (04.A);

i. Access / Haul Road Plan (04.B);

j. Hearing Conservation Program (05.C);

k. Respiratory Protection Plan (05.G);

l. Health Hazard Control Program (06.A);

m. Hazard Communication Program (06.B.01);

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

o. Lead Compliance Plan (06.C.02 & specifications);

p. Asbestos Abatement Plan (06.C.03 & specifications);

q. Radiation Safety Program (06.F);

r. Abrasive Blasting Procedures (06.I.01);

s. Heat Stress Monitoring Plan (HSMP) (06.J.02);

t. Cold Stress Monitoring Plan (CSMP) (06.J.04);

u. Indoor Air Quality Management Plan (06.L);

v. Mold Remediation Plan (06.L.04);

w. Chromium (VI) Exposure Evaluation (06.M);

x. Crystalline Silica Evaluation (06.N.02) ;

y. Lighting Plan for Night Operations (07.A.06);

z. Traffic Control Plan (08.C.05);

aa. Fire Prevention Plan (09.A.01);

. Fire Prevention Plan (09.A);

bb. Wild Land Fire Management Plan (09.L);

cc. Arc Flash Hazard Analysis (11.B);

dd. Assured Equipment Grounding Control Program (AEGCP) (11.D.05, Appendix E);

ee. Hazardous Energy Control Program & Procedures (12.A.01);

ff. Standard Pre-Lift Plan – Load Handling Equipment (16.A.03);

gg. Critical Lift Plan – Load Handling Equipment (16.H);

hh. Naval Architecture Analysis – Load Handling Equipment (Floating) (16.L);

ii. Floating Plant Inspection and Certification (19.A.01);

jj. Severe Weather Plan for Marine Activities (19.A.03);

kk. Emergency Plan for Marine Activities (19.A.04);

ll. Man Overboard/Abandon Ship Procedures (19.A.04);

mm. Float Plan for Launches, Motorboats, and Skiffs (19.F.04);

nn. Fall Protection & Prevention Plan (21.D);

oo. Demolition/Renovation Plan (to include engineering survey) (23.A);

pp. Rope Access Work Plan (24.H2);

qq. Excavation / Trenching Plan (25.A.01);

rr. Fire Prevention and Protection Plan for Underground Construction (26.D.01);

ss. Compressed Air Work Plan for Underground Construction (26.D.01);

tt. Erection and Removal Plan for Formwork and Shoring (27.C);

uu. Precast Concrete Plan (27.D.01);

vv. Lift Slab Plans (27.E);

ww. Masonry Bracing Plan (27.F.01);

xx. Steel Erection Plan (28.B);

yy. Explosives Safety Site Plan (ESSP) (29.A);

zz. Blasting Safety Plan (29.A; 26.J);

aaa. Dive Operations Plan (30.A.14 & 30.A.16);

bbb. Safe Practices Manual for Diving Activities (30.A.15);

ccc. Emergency Management Plan for Diving (30.A.18);

ddd. Tree Felling and Maintenance Program (31.A.01);

eee. Aircraft/Airfield Construction Safety & Phasing Plan (CSPP) (32.A.02);

fff. Aircraft/Airfield Safety Plan Compliance Document (SPCD) (32.A.02);

ggg. Site Safety and Health Plan for HTRW (33.B);

hhh. Confined Space Entry Procedures (34.A.05);

iii. Confined Space Program (34.A.06);

jjj. Chronic Beryllium Disease Prevention Program (CBDPP)

10. RISK MANAGEMENT PROCESSES. Detailed project-specific hazards and controls shall be provided by an Activity Hazard Analysis (01.A.14, 01.A.15) for each major phase/activity of work.

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HTRW Projects - Additional Requirements (EM 385-1-1, Section 33 HAZWOPER):

SSHP (Site Safety and Health Plan) shall be attached to the APP as an Appendix. The SSHP shall cover the following in project-specific detail.

General information adequately covered in the APP need not be duplicated.

a. Site description and contamination characterization

b. Hazard/Risk Analysis - AHA for each task

c. Staff Organization; Qualifications; Responsibilities

d. Training - General, Supervisor and Project Specific

e. PPE Personal Protective Equipment

f. Medical Surveillance

g. Exposure Monitoring/ Air Sampling Program

h. Heat and Cold Stress - Procedures and Practices

i. SOPs Standard Operating Procedures; Engineering Controls; Work Practices:

(1) Site rules/prohibitions (buddy system, eating/drinking/smoking restrictions, etc.)

(2) Work permit requirements (rad work, excavation, hot work, confined space etc.)

(3) Material handling procedures (soil, liquid, rad materials, spill contingency)

(4) Drum/container/tank handling (opening, sampling, draining, removal, etc.)

(5) Comprehensive AHA of treatment technologies employed at site

j. Site Control Measures: Clearly Defined EZ, SZ, CRZ

k. Personal Hygiene and Decontamination

l. Equipment Decontamination

m. Emergency Equipment and First Aid

n. Emergency Response and Contingency Procedures:

(1) Pre-emergency planning

(2) Personnel and lines of authority for emergency situations

(3) Criteria and procedures for emergency recognition and site evacuation (alarms, etc.)

(4) Decontamination and medical treatment of injured personnel

(5) A route map to emergency medical facilities and phone numbers for emergency responders

(6) Criteria for alerting the local community responders

APP SSHP Checklist SLDA Remediation upd 29Apr2015 Page 5 of 5