Attachment_8_-_385-43(1).pdf

MVN Form 385-43/1R Proponent MVN-SS September 29, 2009

Contractor’s Check List

ACCIDENT PREVENTION PLAN CHECKLIST

USACE New Orleans District

CONTRACT NO.

1- MVN Form 385-43, Accident Prevention Program, Administrative Plan

2- MVN Form 385-43(1), Accident Prevention Plan Checklist

3- MVN Form 385-43(2), Accident Prevention Program, Hazard Analysis

4- Company's Safety Policy Letter

5- MVN Form 385-10R Fuel Oil Transfer

6- First Aid/CPR Card Holders

7- Seaworthiness Certificates

8- Hurricane Plan

9- Substance Abuse Policy Program

10- Lockout/Tagout Program

11- Plan of Operation

12-12-Hour Shift Waiver

13- Trained Personnel Authorized to Operate Equipment (Explain Training)

14- Crane Certification, Crane/Derrick and Dragline Operator’s Certification Yearly

15- Physical Qualifications (Bi-Annual) for Crane/Derrick and Dragline Operators

16- Hazardous Chemical Communication Program

17- Confined Space

18- Dive Plan

19- Nuclear Density Meter Certification ___________

21- Health Plan (reviewed by competent person), (Industrial Hygienist) for painting blasting, working with creosote timbers, etc

22- Safety Plan for loading and dumping of trucks __________

23- Has the Site Safety and Health Officer been designated in writing and __________ has the OSHA 30 hr. training

Remarks: X= OMISSIONS FROM PLAN – SUBMIT

Signature: _____________________________________________ Safety Specialist Date

MVN Form 385-43/1R Proponent MVN-SS September 29, 2009

ACCIDENT PREVENTION PLAN CHECKLIST

ADMINISTRATIVE SECTION

(Forms must be submitted (7) days prior to start date for reviewing)

LOCATION: DATE:

CONTRACT: SIGNATURE:

Please check and submit copies of the following items that are applicable.

(Ref. EM385-1-1 (Sep 08) Paragraph 01.A.11 and Appendix A)

YES NO Location in Plan Page and Para.

1. Statement of safety and health policy (Ref. EM 385-1-1, Appendix A, Item 3)

2. Identification & accountability of personnel responsible for accident prevention

3. Means for coordinating and controlling work activities of contractors, subcontractors, and suppliers. (Ref. EM 385-1-1, Appendix A, Item 5)

4. Responsibilities of subcontractors in effecting the requirements of the accident prevention plan. (Ref. EM 385-1-1, Appendix A, Item 5)

5. Plans for safety indoctrination and continued safety training. (Ref. EM 385-1-1, Appendix A, Item 6 and Section 01.B)

6. Provisions for frequent safety inspections of work sites, material, & equipment to ensure compliance with accident prevention plan and safety manual. (Ref. EM 385-1-1, Appendix A, Item 7 and Paragraph 01.A.12)

7. Means of recording (in inspection reports) identified safety and health deficiencies. (Ref. EM 385-1-1, Paragraph 01.A.12)

8. Measures, timetable and individual responsible for correction of deficiencies listed above.

(Ref. EM 385-1-1, Paragraph 01.A.12)

9. Procedures for follow-up inspections to ensure correction of deficiencies. (Ref. EM 385-1-1, Paragraph 01.A.12)

10. Responsibility for investigating and reporting accidents; reporting exposure (Ref. EM 385-1- 1, Appendix A, Section 8 and Section 01.D)

11. Responsibility for maintaining accident and exposure data, reports, and logs (Ref. EM 385-1- 1, Appendix A, Section 8 and Section 01.D)

12. Emergency response capabilities to minimize the consequences of accidents or natural disaster (Ref. EM 385-1-1, Appendix A, Section 9 and Section 01.E)

13. Contingency plans for severe weather, e.g., windstorms, flooding, tornadoes, marine storms, etc. (Ref. EM 385-1-1, Appendix A, Section 9 and Section 01.E)

14. Plans for maintaining job cleanup and safe access (Ref. EM 385-1-1, Section 02.B)

15. Public safety requirements (e.g., fencing, signs) (Ref. EM 385-1-1, Paragraph 04.A.04)

16. Local requirements which must be addressed (Ref. EM 385-1-1, General Requirements 4(i)

17. Prevention of alcohol and drug abuse on the job (Ref. EM 385-1-1, Paragraph 01.C.02)

18. Plans for a hazard communication program (Ref. EM 385-1-1, Section 06.B)

19. Written program for the control of hazardous energy (Lockout/Tagout) (Ref. EM 385-1-1, Chapter 12)

20. Dive plans submitted to safety. (Ref. EM 385-1-1, Chapter 30)

21. List of trained/designated equipment operators. (Ref. EM 385-1-1, Chapter 16 and 18)

22. Copy of annual crane/derrick certification and a list of licensed crane operators. (Ref. EM 385-1-1, Section 16.B)

23. Written safety plans for the pit and dumping areas. (Ref. EM 385-1-1, Section 04.B)

24. Health Submittals (must be reviewed and signed by contractor's Industrial Hygienist or Occupational Health Physician before submittal) (Ref. EM 385-1-1, Section 06.B)

Note: Has the contractor designated a SSHO officer and provided proof that the site safety and health officer has completed the 30 hr OSHA 600 class or equivalent? See our new safety manual, EM385-1-1 revised 15 Sept. 08, page 11-12 paragraph 1.A.17. Yes ( ) No ( )