Technical Exhibit 02_Safety Plan Review Checklist.pdf
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- HVAC/DUCT Cleaning Service Cp Humphreys
- Solicitation number
- W91QVN24R0112
About this file
This document is a Technical Exhibit 02_Safety Plan Review Checklist that outlines the minimum requirements for an Accident Prevention Plan (APP) to be submitted by contractors for projects at USAG Humphreys. The checklist covers key elements such as:
Signature sheet with preparer and approver information, Background information on the contractor and project, Safety responsibilities and training requirements, Safety inspections and competent/qualified personnel, Accident reporting and investigation, and Plans/programs required by the EM 385-1-1 safety manual (e.g. emergency response, hazard communication, fall protection, etc.). The checklist serves as a guide for contractors to ensure their APP addresses all necessary safety elements for the project. It references applicable OSHA standards and EM 385-1-1 requirements.
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Text version
Reviewed by:
Yes No N/A
a. Name, signature, and phone number of the plan preparer (SSOH or QC)
b. Name, signature and the plan approver (e.g. owner or company president / representatives)
c. Name(s), signature(s) and title(s) for the plan concurrence
a. Contractor name
b. Contract number
c. Project name
d. Brief project description, shall provide a means to evaluate the work being done and associated hazards involved
e. Description of work to be performed
f. Location of work
- Provide a copy of your current corporate / company Safety & Health Policy Statement for a safe and healthful workplace for all employees
a. A statement of the employer’s ultimate responsibility for the implementation of his Safety & Health program; Qualifications shall include the OSHA 30-hour or 10-hour course (as applicable) certificate for Construction or General Industry
b. Identification and accountability of personnel responsible for safety at all levels to include designated site safety and health officer and associated qualifications
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 & Garrison Safety Office will review the qualifications for acceptance
a. Identification of subcontractors and suppliers (if known)
3. Statement of Safety and Health Policy.
4. Responsibilities and Lines of Authorities – to include:
5. Subcontractors and Suppliers. Provide the following:
USAG Humphreys Safety Office Accident Prevention Plan (APP) / Safety Plan Review Checklist for Contractors Projects
(OSHA 29CFR 1926 and EM 385
1, Appendix
A, Dated; 30 November 2014) Minimum Basic Outline for Accident Prevention Plan
Date:
Contractor Name:
Contractor No:
Project Title and Location:
1. Signature Sheet:
Notes:
This checklist serves as a guide only. If service, supply, maintenance and construction contracts with limited scopes are awarded, the contractor shall 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 & 29CFR 1926 are pertinent to the contract, the contractor must assure these areas are addressed as well
Acceptable?Item Description Page(s)
2. Background Information to include:
b. Safety responsibilities of subcontractors and suppliers.
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
a. Includes the name of individual responsible for conducting safety inspections.
(e.g., PM, QC, SSHO)
b. Includes proof of inspector's training/qualifications.
c. Indicates when inspections will be conducted.
d. Includes the names of competent and/or qualified person(s) and proof of competency/qualification to meet specific OSHA competent/qualified person(s) requirements.
- Accident investigations, reports and logs; Report all accidents immediately or as soon as possible but not more than 24 hours afterwards to the Contracting Officer/Representative (CO/COR) and Garrison Safety. The contractor shall thoroughly investigate the accident and submit the findings of the investigation along with appropriate corrective actions to the CO/COR as soon as possible
a. Layout Plans (EM Sec 04.A.01)
b. Emergency Response Plans
1. Spill response plans (29 CFR 1926.65 & EM Sec 01.E.01, 06.A.02)
2. Fire prevention plan (29 CFR 1926.24 & EM Sec 01.E.01, 19)
3. Posting of emergency telephone numbers (EM Sec 01.E.05)
4. Emergency action plan (29 CFR 1926.35)
5. Medical Support. Outline on site medical support and off-site 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 first aid per shift/site (EM Section 03.A.02; 03.D)
c. Plan for prevention of alcohol and drug abuse (EM Sec 01.C.02)
d. Site sanitation plan (29 CFR 1926.51 & EM Sec 02)
e. Respiratory Protection Plan (29 CFR 1926.28, 1910.132, 1910.134 & EM Sec 05.G)
f. Hazard Communication Program (29 CFR 1910.1200 & Sec 06.B.01)
g. Heat/Cold stress monitoring plan (General Duty Clause & EM Sec 06.I.02)
h. Crystalline silica handling/monitoring plan (29 CFR 1926.55 & EM Sec 06.M)
8. Accident / Mishap Reporting (OSHA 29 CFR 1904 & Sec D1.21) The contractor shall identify who, how, and when the following will be completed:
6. Training:
7. Safety and Health Inspections. Provide details on
9. Plans (Programs, Procedures) Required by the Safety Manual.
Based on a risk assessment of contracted activities and on mandatory OSHA compliance programs and EM385-1-1, the Contractor shall address all applicable occupational risks and compliance plan
i. Hazardous energy control plan - Lock Out Tag Out (LOTO) (29 CFR 1910.147 & EM Sec 12.A.01)
j. Crane safety / critical lift procedures (29 CFR 1926.550 & EM Sec 16.H)
k. Contingency Plan for Severe Weather (29 CFR 1926.550 & EM Sec 19.A.03)
l. Site-Specific Fall Protection & Prevention Plan (29 CFR 1926.500-503 & EM Sec 21.C)
m. Excavation/trenching plan (29 CFR 1926.650-652 & EM Sec 25.A.01)
n. Confined Space Program (29 CFR 1910.146 & EM Sec 34.A)
- 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
- Types and requirements for use
- Detailed project-specific hazards and controls shall be provided by an Activity Hazard Analysis (OSHA Publication 3071) for each major phase/activity of work.
- Shall address the identified hazards involved and the control measures to be taken. This can be accomplished by providing a Activity Hazard Analysis (AHA) for each job process.
14. Other:
Reviewed by Safety Rep:
11. Personal Protective Equipment
12. Risk Management Process.
13. The Contractor’s APP
10. Emergency Planning.
Note:
Date:
Comments:
Sheet1
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