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Risk-Specific Hazard Plan Templates

[CompanyName]Risk-specific Hazard Plan Templates


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TABLE OF CONTENTS[CompanyName] Layout Plan (04.A.01)..................................................................................................3[CompanyName] Emergency Response Plan...........................................................................................5[CompanyName] Man Overboard/Abandon Ship (19.A.04)....................................................................9[CompanyName] Medical Support Plan................................................................................................11[CompanyName] Alcohol and Drug Abuse Prevention Program (01.C.02).............................................13[CompanyName] Site Sanitation Plan (Section 02)................................................................................15[CompanyName] Access and Haul Road Plan (04.B)..............................................................................19[CompanyName] Dewatering Plan (05.A.06)........................................................................................21[CompanyName] Respiratory Protection Plan (05.G)............................................................................23[CompanyName] Health Hazard Control Program (06.A)......................................................................26[CompanyName] Health Hazard Communication Program (06.B)..........................................................29[CompanyName] Process Safety Management Plan (06.B.04)...............................................................31[CompanyName] Lead Abatement Plan (06.B.05).................................................................................32[CompanyName] Asbestos Abatement Plan (06.B.05)..........................................................................35[CompanyName] Radiation Safety Program (06.E.03.A)........................................................................38[CompanyName] Abrasive Blasting Plan (06.H.01)................................................................................41[CompanyName] Heat/Cold Stress Monitoring Plan (06.I.02)................................................................44[CompanyName] Crystalline Silica Monitoring Plan (06.M)...................................................................47[CompanyName] Night Operations Lighting Plan (07.A.08)...................................................................49[CompanyName] Fire Prevention Plan (09.A).......................................................................................51[CompanyName] Wild Land Fire Management Plan (09.K)....................................................................53[CompanyName] Hazardous Energy Control Plan (12.A.01)..................................................................56[CompanyName] Housekeeping Plan (14.C).........................................................................................59Version 20131215................................................................................................................................. 59[CompanyName] Critical Lift Plan (16.H.02)..........................................................................................61[CompanyName] Contingency Plan for Severe Weather (19.A.03)........................................................65[CompanyName] Float Plan (19.F.04)...................................................................................................67[CompanyName] Site-Specific Fall Protection & Prevention Plan (21.C)................................................68[CompanyName] Demolition Plan (23.A.01)........................................................................................71[CompanyName] Excavation/Trenching Plan (25.A.01).........................................................................73[CompanyName] Emergency Rescue (Tunneling) (26.A.05)...................................................................76[CompanyName] Underground Construction Fire prevention and Protection Plan (26.D.01).................80[CompanyName] Compressed Air Plan (26.I.02)...................................................................................82[CompanyName] Formwork and Shoring Erection and Removal Plans (27.C)........................................84[CompanyName] Precast Concrete Plan (27.D).....................................................................................87[CompanyName] Lift Slab Plan (27.E)...................................................................................................88[CompanyName] Steel Erection Plan (27.F.01)......................................................................................90[CompanyName] Site Safety and Health Plan for HTRW Work (28.B)....................................................92[CompanyName] Blasting Safety Plan (29.A.01)....................................................................................96[CompanyName] Diving Operations Plan (30.A.17)...............................................................................99[CompanyName] Confined Space Program (34.A.06)..........................................................................102[CompanyName] Personnel Protective Equipment (Section 05)..........................................................108


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[CompanyName]Layout Plan (04.A.01)

Version 20131215

Project Name Project Number Prepared By: Date:

[ProjectName] [ProjectNumber]

04.A.01 Plans for the layout of temporary construction buildings, facilities, fencing, and access routes and anchoring systems for temporary structures

This Layout Plan includes temporary structures:

[Insert listing of temporary structures, add rows as necessary]

[insert site map showing location of each temporary structure]

04.A.02 The design and construction of temporary structures

The design and construction of temporary structures meets the requirements set forth in section 04.A.02.

04.A.03 Trailers and other temporary structures used as field offices, as personnel housing, or for storage

Anchoring meets applicable state and local standards of anchoring mobile trailer homes (manufactured housing).

[Describe or diagram each unique anchoring design]

04.A.04 Fencing and warning signs.

[Describe, diagram, and/or insert picture for each unique type of fence and/or sign, one per row.] \

[insert site map showing location of each temporary fence and sign]

04.A.05 Temporary Work Camps (Floating plants excluded).

Not applicable to this project.

04.B Access/haul roads


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This Layout Plan includes access/haul roads

[Insert map of haul road]

[See requirements for Access and Haul Road Plan in Section 04.B]


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[CompanyName]Emergency Response Plan

Version 20131215



01.E.01.a.1 Escape procedures:

In the event of an emergency evacuation, [describe procedures for escape from the emergency area].

01.E.01.a.2 Escape routes:

Routes of escape will depend upon the emergency. In general, [describe escape routes]. [include site maps if applicable]

01.E.01.a.3 Critical plant operations:

Not applicable

01.E.01.a.4 Employee accounting following an emergency evacuation:

After meeting at the designated emergency evacuation area, employees will be accounted for by [describe employee accounting method here, i.e.: attendance taken from time sheets used that day]

01.E.01.a.5 Rescue and medical duties:

[If using internal rescue and medical team, describe their duties here.]

[If using external rescue and medical team, i.e.: plant rescue team or emergency medical services, note that here. You may be using a combination of the two depending on the tasks.]

01.E.01.a.6 Means of reporting emergencies:

Emergencies will be reported to the GDA after first aid or other emergency services are rendered. Reporting will be done within the timeline specified by the contract.

[include any specific emergency reporting details here, i.e.: who is responsible for reporting emergencies to the emergency medical services and the GDA, including timeline for reporting per contract]

01.E.01.a.7 Persons to be contacted for information or clarification:


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[Names of those who can be reached for information on project emergencies, i.e.: project manager, superintendent, SSHO or other responsible person. Include their phone numbers if applicable.]

01.E.01.b.1 Names, training organization, and training dates for personnel certified in first-aid/CPR/blood borne pathogens.

[list this information here or include as separate attachment with copies of certifications]

01.E.01.b.2 Location of list(s) identifying personnel trained in first-aid/CPR/blood borne pathogens.

A list of trained personnel is available at [note project location here].

01.E.01.b.3 Rescue and medical duties for those employees who perform them.

[if your onsite employees are to be responsible for rescue and medical duties, list those duties here]

01.E.01.b.4 Location of first-aid kits.

First aid kits will be provided on the project at [list locations here]. [include site map if applicable]

01.E.01.b.5 Location of list(s) identifying emergency telephone numbers.

Emergency telephone numbers will be posted [note posting location here, i.e.: near all jobsite phones and designated posting areas.]

01.E.04 Emergency alert systems

In the event of an emergency, employees on the project will be notified by [note notification method here, i.e.: air horn or public address system announcement].

The project emergency alert system will be tested [note testing timeline here, i.e. monthly or quarterly].

01.E.05 Emergency telephone numbers and reporting instructions for ambulance, physician, hospital, fire, and police


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These phone numbers will be posted conspicuously on the project. [list the emergency telephone numbers applicable to your project here]

Employees will be instructed on how to report emergencies to these authorities. [include details on how employees will be trained, i.e.: employees will understand how to give clear instructions to emergency responders for how to access jobsite, or only designated employees are allowed to report emergencies]

01.E.06 Provisions an effective means of emergency communications for employees working alone in a remote location or away from other workers.

[If applicable, list the means of emergency communications employees working alone or remotely are to use, i.e.: cell phone, two-way radio, hardline phones, or other method.]

[if applicable, describe the employee check-in/check-out procedures to be used for employees working alone or remotely]

01.E.01.b.2 Emergency services provider

[If coordinating emergency services with an off-site service, describe how this coordination will occur. Include provisions for orienting the off-site provider to the jobsite]

03.A.02. First-aid and cardiopulmonary resuscitation (CPR) availability.

[If a medical facility or physician is not accessible within 5 minutes of an injury to two or more employees, at least 2 employees on each shift shall be qualified to give first-aid and CPR. If applicable, list those employees and their qualifications, include documentation as necessary]

Employees working alone in remote areas will have an effective means of communication [list communication method here] to call for help in the event of an emergency.

03.D On-site Licensed Physician

Not applicable

Q.1.) Method for reviewing plans with all affected employees.

The emergency plan will be reviewed with employees [describe when this review will take place, i.e.: new worker orientation and monthly thereafter or other interval].

Q.2.) Test procedures to ensure the plan’s effectiveness.

The procedures described in this plan will be tested [describe testing method here, i.e.: emergency drills].


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Q.3 Description of off-site medical support

1.) Address/phone number of nearest medical facility/emergency physician.

2.) Address/phone number of ambulance service (if different from item 1.)

3.) Address/phone number/description of medivac services (if applicable).

4.) Complete description of any other emergency services (if applicable).

Q.5.) Location of emergency phone numbers.

Emergency phone numbers will be posted [describe where phone numbers will be posted, same as section 1.E.05]

Q.6.) Persons to be contacted for additional information or clarification.

[Names of those who can be reached for information on project emergencies, i.e.: project manager, superintendent, SSHO or other responsible person. Include their phone numbers if applicable.]


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[CompanyName]Spill Control Plan (1.7.2.j)

Version 20131215



1.7.2.j. (a) Instructions, procedures, and reports for use during an unexpected spill of a substance. Regulated by a) 40 CFR 68, 40 CFR 302, 40 CFR 355, and/or b) State or Local laws and regulations.

1.7.2.j. (1). Name(s) of the individual(s) who report and follow up with spills/hazardous substance release.

1.7.2.j. (1). A If spills/hazardous substance is released, this individual Immediately notifies the Contracting Officer and [the local Fire Department] [Facility Fire Department] [Facility Response Personnel] [Facility Environmental Office] in addition to the legally required Federal, State, and local reporting channels (including the National Response Center 1-800-424-8802)

Contact information and reporting channels for each of the above:

1.7.2.j. (2). Individual(s) responsible for the supervision of the spills/hazardous substance containment and removal

1.7.2.j. (3). Training requirements and training methods used for contractor’s personnel.

1.7.2.j. (4). Materials and equipment for immediate use in the potential event of the identified hazard(s)


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1.7.2.j. (5).a Names and locations of containment materials suppliers.

a) Additional fuel oil recovery , cleanup, restoration, and material-placement equipment

1.7.2.j. (5).b Names and locations of additional fuel oil recovery , cleanup, restoration, and material-placement equipment

1.7.2.j. (6). Methods and procedures used in the event of spills/hazardous substance


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[CompanyName]Man Overboard/Abandon Ship (19.A.04)

Version 20131215



19.A.04.a Marine emergencies (potential)

Marine emergencies that could be expected on this project include: [list potential emergencies here, i.e. fire, sinking, man overboard]

19.A.04. b. Station bill

The station bill will describe any special duties and duty station for the emergencies listed in section 19.A.4.a. It will be posted [describe where station bill will be posted throughout the vessel].

19.A.04. c. Written description of emergency duties for each crew member

Each crew member will be given the description of their duties to become familiar with as listed below:

[list emergency duties for each crewmember and emergency signals to be used on the vessel]

19.A.04. d. Instructions for mustering personnel.

“Abandon ship/boat” and “person overboard” require [list instructions for mustering personnel].

19.A.04. e. Drills for: abandon ship/boat drills, fire drills, and person overboard or rescue.

Monthly drills will be held for each shift for these operations. [describe the details of monthly drills or if drills are to be held more frequently under USCG regulations]

19.A.04. f. Person overboard or rescue drills

[describe other locations where person overboard or rescue drills will need to be conducted, i.e.: boat yards, locks, dams or other locations where marine rescue equipment is required]

19.A.04. g. Emergency lighting and power systems


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Emergency lighting and power systems will be operated and inspected monthly.

19.A.04. h. Records of all drills and emergency system checks

Records will be maintained [describe where records will be kept] and will include deficiencies and corrective actions.


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[CompanyName]Medical Support Plan

Version 20131215



Q. a. Description of on-site medical support1.) Names, training organization, and training dates for personnel certified in first-aid/CPR/blood borne pathogens.

Q. . a. Description of on-site medical support

2.) Location of list(s) identifying personnel trained in first-aid/CPR/blood borne pathogens.


3.) Rescue and medical duties for those employees who perform them.


4.) Location of first-aid kits.


5.) Location of list(s) identifying emergency telephone numbers.

Q. . a. Description of on-site medical support 6.) Approximate driving-time to nearest medical facility/emergency physician.


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Q. b. Description of off-site medical support





3.) Address/phone number/description of medevac services (if applicable).




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[CompanyName]Alcohol and Drug Abuse Prevention Program (01.C.02)

Version 20131215



01.C.02 Policy for use or under the influence of alcohol, narcotics, intoxicants, or similar mind-altering substances.

While on duty, employees shall not use or be under the influence of alcohol, narcotics, intoxicants, or similar mind-altering substances.

01.C.02. a. Policy for employees found to be under the influence of or consuming such substances

Employees found to be under the influence of or consuming such substances will be immediately removed from the job site. Contractors shall enforce the drug-free workplace requirements.

01.C.02 b. Policy for any employee under a physician's treatment and taking prescribed narcotics or any medication

Any employee under a physician's treatment and taking prescribed narcotics or any medication that may prevent one being ready, willing and able to safely perform position duties shall provide a medical clearance statement to his supervisor.

Q. 1.) Employee assistance programs emphasizing high-level direction, education, counseling, rehabilitation, and coordination with available community resources.

[list any employee assistance programs applicable to the project]

Q. 2.) Supervisory training to assist in identifying and addressing illegal drug use.

Supervisors will be trained to address illegal drug use issues on the project [describe any supervisory training that will be conducted on the project, i.e.: reasonable suspicion testing procedures].

Q. 3.) Provisions for self-referrals as well as supervisory referrals to treatment.


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If employees need assistance, they can [list how an employee can self-refer to a treatment program].

If a supervisor deems a referral necessary for an employee to get treatment, they can [list how a supervisor can refer an employee for treatment].

Q. 4.) Provisions for identifying illegal drug users including testing on a controlled and carefully monitored basis.

[describe or attach your drug testing program]

Q. 5.) Personnel procedures to deal with employees who are found to be using drugs illegally. (Provisions of this clause pertaining to drug testing programs do not apply to the extent they are inconsistent with state or local law, or with an existing collective bargaining agreement. If with respect to thelatter, the contractor agrees that those issues that are in conflict will be a subject of negotiation at the next collective bargaining session).

[describe your policy for handling positive drug test results or observation of personnel under the influence]


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[CompanyName]Site Sanitation Plan (Section 02)

Version 20131215



Project site:

Employers will establish practices and procedures that ensure that hygienic standards are maintained for all employees in all places of employment.

02.B Housekeeping

A clean jobsite will be maintained. :

Trash bin(s) will be placed on the jobsite, their number determined by site size as well as frequency of use.

Hazardous debris, such as sharp edges or protruding nails, will be placed directly into a trash bin Within reason, mud tracked in will be swept up when dry and disposed of Spills on floors will be mopped up immediately Floors will be swept and mopped on a regular basis Where wet processes are used, false floors, platforms, mats, or other dry standing places will be

provided, when possible General debris will be placed in piles and moved to the trash bin when work in the area is

completed.

A general pickup will be made daily to remove all trash and debris and place it in a trash bin

02.C Drinking Water

Supplies of potable water for drinking and personal care will be maintained. A supply of bottled water will be available in the construction office, eating areas, and in

construction passenger vehicles. Cool drinking water will be provided during hot weather. For installed water systems, only approved potable water systems may be used for the

distribution of drinking water. Use of a common cup (a cup shared by more than one worker) as well as other common utensils is

prohibited. Unused disposable cups will be kept in sanitary containers and a waste receptacle will be provided

for used cups


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02.D Non-Potable Water

If sources of non-potable water are utilized for whatever reason, outlets dispensing non-potable water will be posted as such, with no cross connection with potable water sources.

02.E Toilets

Toilets will be present in all places of employment, except for mobile crews or infrequently used work sites. Toilets will meet standard requirements and sufficient in number to accommodate the number of personnel of both sexes regularly on site.

Toilets for this project are as follows: [Describe type of toilet(s) and location (s)]

Where sanitary sewers are not available, job sites will be provided with standard chemical toilets, re-circulating toilets, or combustion toilets unless prohibited by state/local codes. Such portatoilets will be supplied and cleaned on a regular basis.

02.F Washing Facilities

Washing facilities will be provided to maintain healthful and sanitary conditions. They will be provided with running water, soap, and individual means of drying. If it is not practical to provide running water, hand sanitizers may be used as a substitute.

Washing facilities will be provided at toilet facilities and as needed to maintain healthful and sanitary conditions.

Washing facilities provided for this project are as follows:

[Describe Washing facilities and location (s)]

02.G Showers

Showers will be provided for those engaged in the application of paints, coatings, herbicides, insecticides, or other operations where contaminants may be harmful. T hey will be provided with hot and cold running water, soap, and clean towels.

Showers provided for this project are as follows:

[Describe shower facilities and location (s)]

02.H Changing Rooms


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Whenever employees are required by a particular standard to wear protective clothing, changing rooms will be equipped with separate storage facilities for both street clothes and protective clothing.

Changing rooms provided for this project are as follows:

[Describe changing rooms and location (s)]

02.I Clothes Drying Facilities

Working clothes provided by the employer may become contaminated or wet. Such clothing must be decontaminated, cleaned, and dried before reuse.

Clothes Drying Facilities provided for this project are as follows:

[Describe Clothes Drying Facilities and location (s)]

02.J Food Service

All employee food service facilities and operations will be conducted in accordance with sound hygienic principles. The food dispensed will be wholesome, free from spoilage, and will be processed, prepared, handled, and stored in such a manner as to be protected against contamination. Food or beverages may not be stored in toilet rooms or in an area exposed to a toxic material.

Food Service Facilities provided for this project are as follows:

[Describe Food Service Facilities, location (s), and measures taken to prevent spoilage and contamination]

02.K Waste Disposal

Waste receptacles that comply with standards will be provided in a food service area. They will have tight-fitting covers and be emptied on a regular basis.

Food Waste Disposal provided for this project are as follows: [Describe Food Waste Disposal Methods and location (s)]

02.L Vermin Control

Workplace will be constructed, equipped, and maintained to prevent the entrance or establishment of vermin. When vermin are detected, the use of a licensed exterminator/pest control is required.

Name of licensed exterminator who will be utilized:


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[CompanyName]Access and Haul Road Plan (04.B)

Version 20131215



Project site:

Prior to construction, furnish the GDA with a copy of the Access/Haul Road plan for review and acceptance. Work on the haul road will not commence until the GDA has accepted the plan. [include site map if applicable]

04.B.01. a. Equipment usage, traffic density, and hours of operation;

Below is an estimate of total traffic usage over the normal period of operation on the Haul Road, with peak periods indicated:

Normal hours of operation: [insert project-specific data] Estimated total vehicles by weight class during hours of operation: [insert project-specific data]

Periods over a 24-hour day where usage will increase significantly: [insert project-specific data]

04.B.01. b. Road layout and widths, horizontal and vertical curve data, and sight distances;

Planned road layout is as follows:

[Attach drawings and other engineering data to clearly portray Road layout, widths, horizontal and vertical curve data, sight distances, grades, turnouts, traffic control systems]

04.B.01. c. Sign and signalperson requirements, road markings, and traffic control devices;

Planned signage is as follows:

[Describe, diagram, and/or insert picture for each unique type of sign, one per row. ] \[insert site map showing location of each sign]

Sign and signalperson requirements, road markings, and traffic control devices will meet the provisions of State law. All roads, including haul roads, will be posted with maximum speed limits.

04.B.01. d. Drainage controls;


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Drainage controls meet local, state, and federal regulations. Drainage controls are as follows:

[Indicate drainage controls on the drawings and other engineering data in 04.B.01, or attach as a separate drawing.]

04.B.01. e. Points of contact between vehicles and the public, and safety controls at these points of contact;

Traffic control lights, barricades, road markings, signs, and signalpersons for the safe movement of traffic will be provided in accordance with the DOT Federal Highway Administration's “Manual on Uniform Traffic Control Devices”.

[Insert project-specific information showing the locations of the above items]

04.B.01. f. Maintenance requirements, including roadway hardness and smoothness and dust control;

Maintenance of roadways include

Dust abatement will be employed as needed to maintain visibility.

Snowplows and de-icing products will be employed to maintain driving safety.

04.B.01. g. Hazards adjacent to the road, such as bodies of water, steep embankments, etc.

Hazards adjacent to the road and their controls are as follows:

[Insert project-specific information, including location of berms, barricades, or curbs]


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[CompanyName]Dewatering Plan (05.A.06)

Version 20131215



Planned excavation:

05.A.06.a Diversion ditches, dikes, or other means to prevent surface water entering an excavation and to provide good drainage of the area adjacent to the excavation:

05.A.06.b Employees shall not work in excavations in which there is accumulated water or in which water is accumulating.

Work will stop work in excavations in which water accumulation exceeds the following conditions:

05.A.06.b (1) Existing moisture balances in surrounding soils:

05.A.06.b (1) Effects on foundations and structures by the excavation:

05.A.06.b Water hazards control measures (freezing, pumping, drainage, or similar):Note if control requires continuous operation.


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05.A.06.b (2) When continuous operation of ground water control equipment is necessary, an emergency power source provided:

05.A.06.b (2) Water control equipment and operations monitoring by a Competent Person to ensure proper operation:


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[CompanyName]Respiratory Protection Plan (05.G)

Version 20131215



05.G.03.c.(1) Methods used to identify and evaluate workplace respiratory hazards;

The project will be evaluated for respiratory hazards by reviewing project documents and scope for work that will create dusts, mists, fumes, vapors and other respiratory hazards. If respiratory hazards are identified, testing will be conducted to aid in the selection of respirators.

05.G.03.c.(2) Procedures for selecting respirators for use in the workplace;

For identified respiratory hazards, testing will be conducted to evaluate the exposure concentration so that the appropriate respirators will be used.

05.G.03.c.(3) Medical evaluations of employees required to use respirators;

Employees who will wear respirators will be subject to [describe the method for medical evaluation of employees, i.e.: medical questionnaire or consultation with medical provider].

05.G.03.c.(4) Fit testing procedures for tight-fitting respirators;

Fit testing will be conducted by [who will conduct testing] by using the [describe method, i.e.: irritant smoke].

05.G.03.c.(5) Procedures for proper use of respirators in routine and reasonably foreseeable emergency situations;Employees will be instructed in the use, donning, doffing and limitations of the respirators they are required to use.

05.G.03.c.(6) Procedures and schedules for cleaning, disinfecting, storing, inspecting, repairing, discarding, and otherwise maintaining respirators;Respirators will be maintained per manufacturer’s instructions, Employees will be trained on these instructions including [list specific instructions here for the respirators to be used].

05.G.03.c.(7) Procedures to ensure adequate air quality, quantity, and flow of breathing air for atmosphere-supplying respirators;


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[if using air-supplied respirators, describe procedures to ensure breathing air]

05.G.03.c.(8) Training of employees in the respiratory hazards to which they are potentially exposed during routine and emergency situations;Employees will be trained on the hazards to be expected by [list training method or combination, i.e.: site orientation, review of AHA]

05.G.03.c. (9) Training of employees in the proper use of respirators, including putting on and removing them, any limitations on their use, and their maintenance;Employees will be instructed in the use, donning, doffing of the respirators they are required to use. [describe training timelines or method of training here]

05.G.03.c. (10) Procedures for regularly evaluating the effectiveness of the program.

The respiratory protection program will be evaluated [when] to determine effectiveness.

05.G.03.c. (11) Project/facility specific voluntary use guidelines and a requirement for voluntary users to learn and understand the contents of 29 CFR 1910.134 Appendix D, Information for Employees Using [if voluntary use will be allowed on the project, describe the training methods here]

Q. 1.) Address voluntary use of respiratory protective equipment.

[if voluntary use will be allowed, describe your policy]

Q. 2.) Address selection of respiratory protective equipment.

For identified respiratory hazards, testing will be conducted to evaluate the exposure concentration so that the appropriate respirators will be used.

Q.8.) Address identification of filter, cartridges, and canisters.

[list which filters/cartridges/canisters will be used on the project in relation to the hazards identified]

Q.9.) Address training and information.

For employees required to wear respirators, training will occur as follows: [list training methods and timelines]

Q.11.) Address record keeping.


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A copy of the written respiratory program, training records, and applicable medical records will be maintained on the jobsite. [describe location of records]


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[CompanyName]Health Hazard Control Program (06.A)

Version 20131215



Hazardous Or Toxic Agent Or Environment

The project [may include / includes] work in which employees could be exposed to the following hazardous or toxic agents or environments:

[list toxic agents or environments]

06.A.01 Exposure standards.

Where exposures to hazardous substances, agents, and environments are expected, the most stringent of the following exposure standards apply:

ACGIH TLV OSHA PEL

06.A.02 Hazard evaluation. Reference specific to AHA and/or PHA used for the evaluation.

AHAs that include information on hazard evaluation and control measures as they apply to the specific definable feature of work are as follows:

[List the hazard and the related feature(s) of work. An AHA is required for each feature of work]

06.A.03 Testing and monitoring.

The following testing and monitoring will be performed:

Daily follow-up inspections will monitor presence of the hazard and general compliance to hazard controls

[“No tests are required” OR “Test that will be performed are listed on the attached Safety Inspection and Test form attached” OR list tests that will be performed]


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06.A.04 Methods for the control of exposure to hazardous or toxic agents and environments (substitution, engineering control, work practice control, PPE):

Where a hazardous or toxic agent or environment is identified, engineering and administrative controls will be used first; where they are not feasible, appropriate PPE will be used.

The following methods will be used to control of exposure to hazardous or toxic agents and environments:

[list hazard, and then one of substitution/engineering control/PPE, and a short description of the control)

Q. 1.) Hazardous substances

[List hazardous substances (not included in items below. If not EM-385 remove this question)]

Q. 2.) Hot substances.

[list hot substances (If not EM-385 remove this question)]

Q. 3.) Harmful plants, animals, and insects.

Where work includes exposure to hazards from animals and insects, control measures such as PPE and repellents will be used per 06.D. These hazards will be addressed in the AHA.

• [list items (If not EM-385 remove this question)]

Q. 4.) Ionizing radiation.


Q. 5.) Non-ionizing radiation and magnetic and electric fields.


Q. 6.) Ventilation and exhaust systems.



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Q. 7.) Inclement weather and environmental hazards.


Q. 8.) Cumulative trauma prevention.


Q. 9.) Indoor air quality management.

[Describe what you will do to assure indoor air quality during construction. (If not EM-385 remove this question)]


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[CompanyName]Health Hazard Communication Program (06.B)

Version 20131215



O6.B.01a. Hazardous or Toxic Agent Inventory

Hazardous or toxic agent (1)How the agents are to be used at the project. (2)Approximate quantities that will be on site

[list hazardous or toxic agents that are expected to be at the jobsite]

[indicate the specific definable feature of work that the hazardous or toxic agent will be used for]

[indicate how much of each agent you plan to have at the jobsite]

06.B.01.a. (3) A site map will be attached to the inventory showing where inventoried substances are stored.

[attach a site map with markings to note where substances listed in 06.B.01a will be kept]

06.B.01. b. Hazardous or Toxic Agent Labeling.

Containers used to store and transport hazardous or toxic agents will have the original labels maintained or [insert other temporary labeling system here].

06.B.01. c. Material Safety Data Sheet (MSDS) Management.

MSDSs will be maintained at [describe where MSDSs will be kept, i.e.: in the project office] and will be available for review by employees.

06.B.01. d. Employee Information and Training

Employees will be trained initially and periodically regarding the use of hazardous or toxic agents on the site. [describe any specific training delivery methods here, i.e.: site orientation, tailgate meetings]


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Q.1.) Description of training to include potential safety/health effects from exposure.

Q.2.) Address OSHA-compliant labeling of containers.

Q.5.) Method to ensure the inventory and site map will be updated as frequently as necessary to ensure accuracy.

Q.7.) Address how all employees potentially exposed to hazardous substances are advised of information in the substance’s MSDs when they are brought onto the job site.

Q.8.) Method to ensure a copy of each hazardous substance’s MSDS on the project will be maintained in an inventory, provided to the GDA, and made available to all potentially exposed employees.


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[CompanyName]Process Safety Management Plan (06.B.04)

Version 20131215



06.B.04Highly hazardous chemical:

[List the highly hazardous chemical(s) that will be used on the project per 29 CFR 1910.119 or 1926.64]

Process Safety Management Plan

[if applicable, describe your PSM plan here in compliance with 1910.119 or 1926.64]


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[CompanyName]Lead Abatement Plan (06.B.05)

Version 20131215



Project site and location of lead hazard:

[describe the specific area of the lead hazard on the jobsite, attach a site map if applicable]

06.B.05 .a.(1) Work activity in which lead is emitted, including equipment and materials used, controls in place, crew size, job responsibilities, operating procedures, and maintenance practices, work activity locations and lead containing components keyed to the project drawings;

[follow the directions for each work activity that involves lead emission]

06.B.05 .a. (2) Description of means to be used to achieve exposure compliance, including any engineering controls;

[list engineering, substitution and PPE controls you will use to control lead exposure]

06.B.05 .a. (3) Employee exposure assessment procedures to monitor and document employee lead exposure (a) Initial determination

[Note how you will conduct the initial exposure monitoring, or, list the objective or historical data that shows action level compliance.]

06.B.05 .a. (3) Employee exposure assessment procedures to monitor and document employee lead exposure (b) Continued exposure monitoring required as a result of initial exposure determinations.

[describe how continued exposure monitoring will be conducted]

06.B.05 .a. (4) Protective clothing, housekeeping procedures to prevent spread of lead contamination both in and beyond the lead hazard control area, and hygiene facilities and practices to prevent employees from inadvertent ingestion of lead;


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[list all protective clothing employees will wear when exposed to lead; list all housekeeping procedures that will be used to prevent spread of lead contamination in the immediate work area and the rest of the work site; list hygiene facilities and practices to prevent ingestion of lead]

06.B.05 .a. (5) Administrative controls to limit employee exposure to lead, including employee rotation schedule to be employed, if engineering controls or PPE fail to eliminate exposures exceeding the PEL;

[list any administrative controls you plan to use to control exposure]

06.B.05 .a. (6) Medical surveillance procedures to monitor employee exposures and ensure fitness for wearing respiratory protection;

[describe your medical surveillance procedure and respiratory protection program for lead exposure]

06.B.05 .a. (7) Competent person and employee training required;

[attach applicable training records for the competent person and the crew who will be working in the lead exposure area]

06.B.05 .a.8) Detailed sketches identifying lead hazard control areas, including decontamination areas and facilities, critical barriers, and physical and air distribution boundaries;

[attach sketches or project drawings and maps that show where the specific areas are]

06.B.05 .a. (9) Perimeter or other area air monitoring outside or adjacent to the regulated area;

[describe air monitoring that will occur outside of the immediate work area where lead exposure is expected]

06.B.05 .a. (10) Security required for each lead hazard control area;

[describe security measures for controlling entry to the lead hazard area]

06.B.05 .a. (11) Waste generation, characterization, transportation, and disposal (including recordkeeping).

[list details for how you will maintain records related to lead exposure, waste generation, characterization, transportation and disposal]


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[CompanyName]Asbestos Abatement Plan (06.B.05)

Version 20131215



Project site and location of asbestos hazard:

[describe the area of the asbestos hazard, include project maps if applicable]

(1) A description of each activity where asbestos will be disturbed, to include the OSHA class of work, equipment required, controls to be used, crew size, job responsibilities, maintenance practices, and locations keyed to the project drawings;

[follow the directions for each work activity that involves asbestos hazards]

(2) Method of notification of other employers at the worksite;

[list how you will notify other contractors on the site of the asbestos hazard]

(3) Description of regulated areas, types of containment, decontamination unit plan, and engineering controls;

(4) Air monitoring: (a) An initial determination

Initial air monitoring will meet OSHA requirements. [if using sufficient objective or historical data, list note that here]

(4) Air monitoring: (b) Continued exposure monitoring may be required as a result of initial exposure determinations;

[if continued monitoring is required, describe how that will be done]

(4) Air monitoring: (c) Environmental monitoring shall demonstrate the absence of asbestos fiber migration outside the regulated area;


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[describe how environmental monitoring will be done]

(4) Air monitoring: (d) Clearance monitoring to document that the area has met specified clearance criteria.

[describe how clearance monitoring will be done and method for documentation of that data]

(5) PPE, including respirators and clothing;

[list the specific PPE employees must wear when exposed to asbestos containing materials]

(6) Housekeeping procedures addressing prevention of spread of contamination both in and beyond the regulated area;

[list specific housekeeping procedures employees will need to follow in the immediate area of the asbestos hazard and on the project site]

(7) Hygiene facilities and practices;

[describe hygiene facilities and practices that will be used to prevent contamination, include project maps if applicable]

(8) Competent person and employee training required;

[attach applicable training records for the competent person and the crew who will be working in the asbestos hazard area]

(9) Medical surveillance, as required, to assess exposure and to monitor employee fitness to perform work tasks while wearing PPE to include respiratory protection devices;

[describe your medical surveillance procedure and respiratory protection program for asbestos exposure]

(10) Waste generation, containerization, transportation, and disposal (including recordkeeping);

[list details for how you will maintain records related to asbestos exposure, waste generation, characterization, transportation and disposal]

(11) Security, fire, and medical emergency response procedures.


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[list contacts and procedures for emergency response]


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[CompanyName]Radiation Safety Program (06.E.03.A)

Version 20131215



Project site and location of radiation hazard:

[describe the location of the radiation hazard, include project maps if applicable]

06.E.01.a Nature of the material or device

[describe the radioactive material(s) or radiation generating device(s)]

06.E.01.a Description of intended use

06.E.01.aLocation of use and storage

06.E.02 Radiation Safety Officer (RSO),

Work will be performed under the direct supervision of the Radiation Safety Officer (RSO) [list that person’s name here]. [include applicable support materials to demonstrate that the RSO meets the qualifications for experience, training and education of 06.E.02.b]

06.E.03a.(3) Instruction to be provided to all personnel entering an area

[describe the training authorized personnel will be given]

Plans and procedures for handling credible emergencies

[describe your emergency plan including coordination with civilian and/or military emergency response organizations]


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06.E.05 Radiation Monitoring, Surveys, and Dosimetry.

[List the instruments to be used for radiation monitoring and surveying. Describe how they will be calibrated and checked before use]

[describe how visitors/personnel in affected area will coordinate with the RSO for dosimetry]

06.E.06 Access, Storage, and Control.

During any task involving radiological devices and radioactive materials, personnel exposure will be kept as low as reasonably possible.

Signs will be posted in areas of radiation exposure.

[describe any specific engineering, shield, access limitation or physical separation controls to be used]

[describe how radioactive material and devices will be protected from theft or unauthorized use]

06.E.07 Respiratory Protection and other Controls.

[describe engineering controls that will be used to limit concentrations of radioactive materials in the air]

Where engineering controls are unable to control airborne concentrations of radioactive materials, [describe access control, limitation of exposure times and use of respiratory protection or any other controls that will be used]

06.E.08 Signs, Labels, and Posting Requirements.

Standard radiation signs, labels and postings will be used according to this section.

06.E.09 Radioactive Waste Disposal.

[describe how radioactive waste will be disposed in coordination with the GDA]

06.E.10 Records.


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Records related to this section will be maintained for at least 3 years after termination of the license or permit.

[describe how individual exposure records and public exposure records will be maintained]

06.E.11 Reports.

Loss, theft, damage or overexposure, a report will be immediately filed with NRC. Annual reports for individuals per 06.E.11.b

06.E.12 Transportation.

Interstate or intrastate transportation will comply with the DOT, 49 CFR.

06.E.13 Medical surveillance.

Medical exams for USACE personnel per physician, RSO or other regulations. Overexposure and suspected ingestion or inhalation of radioactive materials


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[CompanyName]Abrasive Blasting Plan (06.H.01)

Version 20131215



Project site and location of abrasive blasting hazard:

[describe locations of abrasive blasting on the project, include site maps if applicable]

06.H.01.a Composition and toxicity of the abrasive and the dust or fume generated by the blasted material, including surface coatings.

Evaluation of the abrasive blasting operations, abrasive, dust, or fume generated by blasted material, and surface coatings will be documented in the AHA for the definable feature(s) of work.

06.H.01.b Written operating procedures implemented for abrasive blasting operations.

[describe abrasive blasting procedures including procedures for filling, pressurizing, depressurizing, maintaining and inspecting the pressurized pot]

06.H.02 Blast Cleaning Enclosures and Rooms:

[describe ventilation methods for any blasting enclosures including pressure, exhaust, cleaning, and minimum PPE for personnel inside the enclosure]

06.H.03 Blasting without Enclosures.

[list portable engineering control devices and respiratory protection to be used]

Work will be stopped in areas in which visibility becomes difficult until the airborne dust is removed by exhaust ventilation and settled dust has been removed from the area. [describe respiratory protection to be used if work is to continue in such areas]

06.H.05 Blasting Outdoors.


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[Describe how dust cloud will be kept from spreading to other work areas. Include references to local and state requirements where applicable]

[list hearing and respiratory protection to be used by other personnel in the blasting area if applicable]

06.H.06 Personal Protective Equipment (PPE).

[list PPE to be used for abrasive-blasting]

[list procedures for cleaning and maintaining respiratory equipment]

[describe how personnel will perform daily checks of PPE]

Q. 1.) Address employee monitoring.

Depending on the composition and toxicity of the abrasive or the dust or fume generated by the blasted material, employee monitoring may be required.

Q. 2.) Address air monitoring.

Depending on the composition and toxicity of the abrasive or the dust or fume generated by the blasted material, air monitoring may be required.

Q. 3.) Address medical surveillance.

If medical surveillance is required, follow applicable OSHA and EM385-1-1 requirements.

Q. 4.) Address training requirements.

Prior to the start of work, the AHA will be reviewed with personnel performing abrasive-blasting work.

Q. 6.) Address protective clothing.

Safety boots or toe guards, durable coveralls closeable at wrists and ankles and other openings.

Q. 7.) Address personal hygiene facilities and practices.

[describe specific hygiene facilities and practices available at the site, include site maps if applicable]


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Q. 8.) Address engineering controls.

[list engineering controls to be used during abrasive-blasting work]

Q. 9.) Address itinerant work practices.

[list work practice controls that include rotation of workers to limit exposure]

Q. 10.) Address a housekeeping program.

[list the site procedures and rules for housekeeping]


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[CompanyName]Heat/Cold Stress Monitoring Plan (06.I.02)

Version 20131215



06.I.03 In hot environments, the following guidelines will be followed to prevent heat related injury.

Cool drinking water will be available to employees, [describe specific procedures for encouraging employees to drink water, specific time frames etc]

[describe tool box training topics related to heat illness prevention] [describe any scheduling changes to work during cooler parts of the day] [describe breaks and buddy system to be used] [describe how SSHO will monitor susceptible individuals] [describe breaks allowed for personnel who are not acclimatized to the heat]

06.I.04 In situations where heat stress may impact employee safety and health, employee acclimatization and workloads shall be assessed and work/rest regimens shall be established.

[procedures for monitoring and establishing work/rest periods for workers in permeable clothing] [procedures for monitoring and establishing work/rest periods for workers in impermeable

clothing]

06.I.05 Where employees are exposed to solar radiation for short periods and there is the potential for sunburn or exposure

[describe how sunscreen will be provided]

06.I.06 Employees working in air temperatures of -15 °F (-26 °C ) or less:

Use the work-/warm-up regimen specified in the ACGIH "Threshold Limit Values and Biological Exposure Indices."

06.I.07 At air temperatures of 36 °F (2 °C) or less, employees who become immersed in water or whose clothing becomes wet

Personnel should change immediately into dry clothing or be covered with blankets and be treated for hypothermia. Blankets should be available as part of the first aid equipment. Encourage employees to have a change of clothing on the site.


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06.I.08/06.I.09 Use of thermally protective gloves

Appropriate gloves will be selected depending on the manual dexterity required for the work task. [describe gloves employees will wear or how their hands will be kept warm if fine work is required]

06.I.10 Metal handles and control bar covering (at temperatures below 30 °F (–1 °C).

Metal handles and controls bars shall be covered by thermal insulating material.

06.I.11 Cold weather sheltering and clothing

If wind chill is a factor, an AHA or PHA will be prepared to address cold-stress monitoring and specific controls to minimize exposure to extreme cold.

The following will be implemented:

If wind chill is a factor at a work location, install shielding of the work area and/or require employees to wear an outer windbreak layer garment.

extremities, ears, toes, and nose will be protected from extreme cold by requiring] [if clothing could become wet, describe appropriate outer layer of clothing employees should wear

proper clothing such as hats, gloves, masks, etc .]. When the hazard of an employee getting wet exists, those employees will wear an outer

impermeable layer of clothing. Outer garments must provide for ventilation to prevent wetting of inner clothing by sweat. If clothing becomes wet, employee shall change into dry clothes before entering a cold

environment. Employees should change socks and removable felt insoles at regular intervals or use vapor barrier

boots. [if handling evaporative liquid at air temperatures below 40F, describe precautions to avoid

soaking of clothing or skin contact] [describe eyewear to be worn to protect against UV light, glare and blowing ice crystals]

06.I.12 Environmental monitoring (temperature and wind speed)

Environmental monitoring will be conducted as follows:

At air temperatures below 45F/7C every 8 hours or as warranted. At temperatures below 45F/7C and above 30F/-1C every four hours or as warranted. At air temperatures below 30F/-1C, the temperature and wind speed every 4 hours or more if

temperature drops.


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[CompanyName]Crystalline Silica Monitoring Plan (06.M)

Version 20131215



Project site and location of hazard:

[describe location of crystalline silica hazard, include site maps if applicable]

06.M.01 Occupational Standards

Employee exposure will not exceed the 8-hour TWA limit as specified by ACGIH TLVs or OSHA PELs, whichever is more stringent.

Engineering controls will be implemented first. If engineering controls are not sufficient, employees will be rotated to reduce exposure. If engineering and rotation controls are not sufficient, a respiratory protection program meeting Section 5E and 1910.134 will be followed.

06.M.02 Monitoring (a. workplace and work operation. air monitoring and analysis)

Exposure will be evaluated and documented in an AHA for the definable feature of work.

06.M.03 Medical Surveillance.

[if employees will be exposed over the OEL, describe the medical surveillance program to meet the requirements of this section]

06.M.04 Training

Employees who may be potentially exposed to silica will be trained prior to working in the exposure area.

06.M.05 Respiratory Protection

[if exposure limits cannot be met through engineering and administrative controls, describe the respiratory protection program that will be used including respiratory selection according to 1910.134 and Section 5G]

06.M.06 Protective Clothing


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Clothing used in areas where exposure is over the OEL shall be HEPA vacuumed before removal unless it is wet. Clothes shall not be cleaned by blowing or shaking.

06.M.07 Housekeeping

[describe housekeeping procedures to minimize dust]

06.M.08 Personal Hygiene Facilities and Practices

[describe hygiene facilities and practices for the site]

06.M.09 Engineering Controls.

[describe engineering controls to be used at the site]

06.M.10 Itinerant Work.

[describe employee rotation controls]


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[CompanyName]Night Operations Lighting Plan (07.A.08)

Version 20131215



Project site and location of night operations:

If work is to be performed at night, a night operations lighting plan will be developed to ensure that all activities, areas and operations are adequately illuminated to perform work safely. The plan should be attached to this section of the document.

Work performed at night:

While work is in progress, offices, facilities, access ways, working areas, construction roads, etc., will be lighted by at least the minimum light intensities specified in Table 7-1 of EM-385 (9/15/08).

If lighting provided is questionable as to intensity, light monitoring will be performed to insure proper light intensities are provided.

Activities, areas, and operations illuminated:

Areas requiring illumination include offices, facilities, access ways, working areas, construction roads, etc.,

07.A.03 Roadway lighting

Roadway lighting will be in accordance with ANSI/IESNA RP-8.

07.A.04 Marine lighting

Marine lighting will be in accordance with ANSI/IESNA RP-12.

07.A.05 Means of egress.

Means of egress will be illuminated, with emergency and non-emergency lighting, according to the requirements in NFPA 101. The lightning arrangement will be such that even if one bulb burns out, the area illuminated by that light will still be lit sufficiently by adjacent bulb(s) to allow safe egress.

07.A.06 Lamps and fixtures will be guarded and secured


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The intent is that lighting sources be guarded and secured to preclude injury to personnel.

Open fluorescent fixtures will be provided with wire guards, lenses, tube guards and locks, or safety sockets that require force in the horizontal axis to remove the lamp.

Office lighting will be in accordance with ANSI/Illuminating Engineering Society of North America (IESNA) RP-1.

07.A.07 Lamps for general illumination shall be protected from accidental contact or breakage

Lamps for general illumination will be protected from accidental contact or breakage by elevating lights a minimum of ft (2.1 m) from normal working surface. The lighting fixtures will be a suitable fixture or lamp holder with a guard according to Section 07.A.06 above.

If the building is equipped with overhead sprinkler systems, light fixtures will be minimum 18 in (0.5 m) from sprinkler fixtures.


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[CompanyName]Fire Prevention Plan (09.A)

Version 20131215



Facility or production site:

This fire protection plan is for the project jobsite located at [insert location].

09.A.01.a.1 major workplace fire hazards; potential ignition sources;

This Fire Prevention Plan addresses the following fire hazards and potential ignition sources:

[Insert a numbered listing of major workplace fire hazards and potential ignition sources]

[when appropriate insert site map showing location of each major workplace fire hazard]

09.A.01.a.2 types of fire suppression equipment or systems appropriate to the control of fire

Firefighting equipment shall be provided and installed in accordance with applicable NFPA and OSHA regulations. Fire suppression equipment or systems appropriate to the control of fire include:

[Insert numbered listing of major fire suppression equipment or systems appropriate to the control of fire][when appropriate insert site map showing location of each]

09.A.01.a.3 Assignments of responsibilities for maintaining the equipment and systems

Assignments of responsibilities for maintaining the equipment and systems are as follows:

[Insert listing of personnel by name or title and a reference to the equipment they are responsible for maintaining. For example:John Doe is responsible for maintaining equipment and systems 1,2,3 listed in 09.A.01.a.2 above. ]

09.A.01 personnel responsible for controlling the fuel source hazards


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Assignments of responsibilities for controlling the fuel source hazards are as follows”

[Insert listing of personnel by name or title and a reference to the fuel sources they are responsible for controlling. For example, John Doe is responsible for controlling fuel source hazards 1,2,3 listed in 09.A.01.a.1 above.]

09.A.01 housekeeping procedures

Prompt removal and disposal of accumulations of combustible scrap and debris will be implemented on the site. Self-closing containers will be used to collect waste saturated with flammable or combustible liquids. Only non-combustible or UL labeled nonmetallic containers may be used to dispose of waste and rubbish.


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[CompanyName]Wild Land Fire Management Plan (09.K)

Version 20131215




A wild land fire management plan shall be developed for all areas with potential exposure to wild land fire, whether prescribed or planned.

09.K.01.a. An individual prescribed fire burn plan procedure, as outlined in EP 1130-2-540, that requires individual burn plans to include an AHA and an on-site safety meeting to include discussion of predicted weather patterns, escape route(s), and safety zone(s);

An individual prescribed fire burn plan procedure, if applicable, will be developed using the expertise of wildland fire professional(s). The format is outlined in as outlined in EP 1130-2-540, but will include an AHA and an on-site safety meeting to include discussion of predicted weather patterns, escape route(s), and safety zone(s).

[Insert prescribed fire burn plan procedure]

09.K.01. b. An analysis of wild land fire causes and special wild fire hazards and risks;

The Wild Land Fire Management Plan will analyze wild land fire causes and special wild fire hazards and risks

[Insert listing of wild land fire causes and special wild fire hazards and risks]

09.K.01. c. Proposed measures to reduce wild fire occurrence and decrease fire damage;

The Wild Land Fire Management Plan will discuss proposed measures to reduce wild fire occurrence and decrease fire damage

09.K.01. d. Procedures for public education and wild fire prevention sign posting (including procedures for keeping the public informed of the current fire danger rating);


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The Wild Land Fire Management Plan will discuss procedures for public education.

[Insert listing of public education procedures]

The Wild Land Fire Management Plan will provide for wild fire prevention sign posting (including procedures for keeping the public informed of the current fire danger rating). One or more individuals who are familiar with the National Fire Danger Rating System (NFDRS) will be assigned the task of accessing NFDRS data daily.

[Insert map showing location of signage]

09.K.01. e. Provisions for cooperative efforts with all other neighboring wild land fire management protection agencies;

The Wild Land Fire Management Plan will list cooperating agencies and 24/7 contact numbers.

[Insert list of cooperating agencies, points of contact, and phone numbers.]

09.K.01. f. The in-house wild land fire management or control team organization and personnel roster, training and equipment requirements, and notification procedures;

The Wild Land Fire Management Plan will list the in-house wild land fire management or control team organization and personnel roster.

[Insert personnel list, qualifications, and phone numbers.]

[Insert equipment list and location(s).]

Training records and documentation will be kept in a secure area.

09.K.01. g. A listing of cooperating agencies and notification procedures, (including any mutual aid agreements with adjacent fire departments and agencies);

The Wild Land Fire Management Plan will list cooperating agencies and 24/7 contact numbers.

[Insert list of cooperating agencies, points of contact, and phone numbers.]

Any mutual aid agreements should be documented in writing and incorporated as an Appendix to the Plan.

09.K.01. h. A listing of additional available resources for work force, equipment, supplies, and facilities, and contracting or procurement information;


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The Wild Land Fire Management Plan will list additional contract or government agencies available if need be.

[Insert list of backup contract or government agencies, personnel or equipment available, points of contact, and phone numbers.]

09.K.01. i. An up-to-date map(s) of the managed and/or protected area(s) that shows boundaries, roads, and other means of access, heliports, airports, water sources, special hazards, and special fire risks;

The Wild Land Fire Management Plan will contain a Pre-Attack Plan shows boundaries, roads, and other means of access, heliports, airports, water sources, special hazards, and special fire risks.

[Insert site map with above items depicted.]

09.K.01. j. A listing of weather information sources;

The Wild Land Fire Management Plan will include electronic or voice contact information for the National Weather Service responsible for the area. Weather updates will be obtained by the personnel assigned to the NFDRS task.

09.K.01. k. Procedures for public notification;

The Wild Land Fire Management Plan will include procedures for public information that are developed with local fire authorities to ensure that accurate information is disseminated.

09.K.01. l. A pre-attack fire suppression plan as outlined in EP 1130-2- 540.

The aforementioned pre-attack plan will be supplemented with items as specified in in EP 1130-2- 540.


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[CompanyName]Hazardous Energy Control Plan (12.A.01)

Version 20131215




This Hazardous Energy Control Plan covers operations [describe the location(s) on the project that this plan will cover].

Hazardous energy to be controlled:

[list types of hazardous energy to be controlled, i.e.: mechanical, hydraulic, electrical, etc]

12.A.12.b. (1) A statement of the intended use of the procedure;

This procedure will be used for the specific activities described above. The program, in conjunction with AHAs developed for the work will be used to identify hazards and their controls; and serve as the basis for training for employees before performing this type of work.

12.A.12.b. (2) Means of coordinating and communicating HEC activities;

HEC activities will be coordinated with [describe whom you need to coordinate with on the project, i.e.: GDA, facilities management, etc].

Communication of HEC activities will occur within timelines required by the project specifications and other agreed upon documents.

12.A.12.b. (3) Procedural steps and responsibilities for shutting down, isolating, blocking, and securing systems to control hazardous energy;

Depending on the energy source to be controlled, steps and responsibilities will vary. [Describe any specific steps or responsibilities you are aware of at this time. If unsure, leave blank]

12.A.12.b. (4) Procedural steps and responsibilities for the placement, removal, and transfer of lockout and tagout devices;


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[Describe any specific steps or responsibilities you are aware of at this time. If unsure, use this language]

Refer to AHA pertaining to specific activities for details on lockout and tagout devices.

12.A.12.b. (5) Procedural steps, responsibilities and a means of accounting for placing and removing personal protective grounds;


Refer to AHA pertaining to specific activities for details on personal protective grounds.

12.A.12.b. (6) Procedural steps, responsibilities and requirements for testing the system to verify the effectiveness of isolation and lockout and tagout devices;


Refer to AHA pertaining to specific activities for details on verifying isolation.

12.A.12.b. (7) Procedural steps and responsibilities for transfer of clearances when and if necessary;


Refer to AHA pertaining to specific activities for details on transfer of clearances.

12.A.12.b. (8) Procedural steps and responsibilities for Multi-Shift Safe Clearances;


Refer to AHA pertaining to specific activities for details on multi-shift safe clearances.

12.A.12.b. (9) A description of any emergencies that may occur during system lockout/tagout and procedures for safely responding to those emergencies;

The following emergencies could occur based on the type of work to be performed on this project. Emergency response procedures are listed with the emergency.

[Describe emergencies that could occur based on the type of work to be performed. Briefly describe emergency procedures that would take place in the situation]


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12.A.12.b. (10) The means to enforce compliance with the procedures.

Personnel who do not comply with the Hazardous Energy Control Plan will be subject to the project’s discipline program. [Describe specifics, i.e.: personnel who remove lockout/tagout devices that do not belong to them will be removed from the project.]


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[CompanyName]Housekeeping Plan (14.C)

Version 20131215


[ProjectNumber] [ProjectName]Work areas, stairways, passageways, gangways, and access ways subject to this housekeeping plan (insert diagram when applicable):

Areas where combustible liquids are stored, handled, or processed include:

Waste container type, size, and locations :

14.C.01 Work areas and means of access will be maintained safe and orderly.

Policy applies to all project work areas at all times.

14.C.01 a. Personnel and equipment that will be provided to ensure compliance with all housekeeping requirements include:

14.C.01.b. Work areas will be inspected by daily for adequate housekeeping and findings will be recorded on daily inspection reports.


14.C.01c. Work will not be allowed in those areas that do not comply with the requirements of this Section.


14.C.02 All stairways, passageways, gangways, and access ways will be kept free of materials, supplies, and obstructions at all times.


14.C.03 Loose or light material will not be stored or left on roofs or floors that are not closed in, unless it is safely secured.


14.C.04 Tools, materials, extension cords, hoses, or debris will not cause tripping or other hazards.


14.C.05 Tools, materials, and equipment subject to displacement or falling will be adequately secured.


14.C.06 Empty bags having contained lime, cement, and other dust-producing material will be removed on this schedule:

Daily removal to waste container.


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14.C.07 Form and scrap lumber and debris will be cleared from work areas and access ways in and around building storage yards and other structures on this schedule:

Daily removal to waste container.

14.C.08 Protruding nails in scrap boards, planks, and timbers will be removed, hammered in, or bent over flush with the wood.


14.C.09 Storage and construction sites will be kept free from the accumulation of combustible materials.


14.C.09.a. Weeds and grass will be kept down on this schedule:

Inspected weekly and cut when necessary.

14.C.09.b. Combustible materials will be cleaned up on this schedule:

Daily removal to waste container approved for combustible materials.

14.C.09.c. Rubbish, brush, long grass, or other combustible material will be kept from areas where flammable and combustible liquids are stored, handled, or processed.Policy applies to all project work areas at all times.

14.C.10 Accumulation of liquids, particularly flammable and combustible liquids, on floors, walls, etc., is prohibited. All spills of flammable and combustible liquids will be cleaned up immediately.



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[CompanyName]Critical Lift Plan (16.H.02)

Version 20131215




A critical lift(s) will take place [describe where the critical lift will take place and at what point during the project, if known]

Critical lift:

A separate critical lift plan will be completed for each identified critical lift to take place on this project:

[list lifts that will meet the criteria of section 16.H on this project]

16.H.02.d. (1) The specific make and model of the cranes, the line, boom, and swing speeds;

Make and model of crane:

Line speed:

Boom speed:

Swing speed:

16.H.02.d. (2) The exact size and weight of the load to be lifted and all crane and rigging components that add to the weight. The manufacturer's maximum load limits for the entire range of the lift, as listed in the load charts, will also be specified;


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[describe the load to be lifted – what is it, what brand if applicable, other defining features]

Weight of the load:

[list crane and rigging components to be used and their weights, i.e.: jib, hook, block, sheaves, parts of line]

Manufacturer’s Maximum Load Limits for entire range of the lift: [identify if there are different max limits over the side, front, back or other specified quadrant of the crane per the load chart]

16.H.02.d. (3) Lift geometry and procedures, including the crane position, height of the lift, the load radius, and the boom length and angle, for the entire range of the lift;

[describe how the crane will be set up, i.e.: on outriggers 100%, lifting over the corner]

Height of the lift:

Load radius:

Boom length and corresponding angle for entire range of lift:

16.H.02.d. (4) Placement/location(s) of crane, adjacent equipment and/or facilities, etc.;

The crane will be setup [describe where the crane will be setup for the lift, list any equipment or operations nearby that could be affected by the lift]

16.H.02.d. (5) Designated crane operator, lift supervisor and rigger and their qualifications;

The following personnel will be required for the lift: [attach certifications if necessary to illustrate qualifications]

Crane Operator:

Lift Supervisor [i.e.: foreman or superintendent]

Rigger:

Signalperson:


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16.H.02.d. (6) Rigging plan that shows the lift points and describes rigging procedures and hardware requirements;

The lift will be rigged using [describe the hardware you will use to rig the load and the lift points you will use, i.e.: rig using chain slings to the manufacturer supplied pick points]

16.H.02.d. (7) Description of ground conditions, outrigger or crawler track requirements, and, if necessary, the design of mats, necessary to achieve a level, stable foundation of sufficient bearing capacity for the lift;

Ground conditions for the critical pick are [describe the ground that the crane will be setup on, reference the soils report if applicable].

Per the manufacturer’s load chart, outriggers [will/will not] be used [and mats will be placed under the outrigger pads to transmit the load of the lift across the ground].

16.H.02.d. (8) For floating crane or derricks, the description of the operating base (platform) condition and any potential maximum list / trim;

[if the crane will be setup on a barge or other floating platform, describe that platform and reference the manufacturer’s load chart for maximum list/trim]

16.H.02.d. (9) Environmental conditions under which lift operations are to be stopped;

Per the manufacturer’s load chart, the lift will be stopped if the wind exceeds [__mph]. Per the EM385-1-1, cranes shall not be operated when wind speeds at the site are greater than 20mph.

[describe any other environmental conditions in which the lift would be stopped]

16.H.02.d. (10) Coordination and communication requirements for the lift operation;

Communication between the operator and signalperson will be by [voice, radio, hand, or combination].

[describe any other coordination or communication that will take place for the lift, including with the GDA]

16.H.02.d. (11) For tandem or tailing crane lifts, the requirements for an equalizer beam if applicable.

[if performing a tandem crane lift, describe if you will be using an equalizer beam]


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[CompanyName]Contingency Plan for Severe Weather (19.A.03)

Version 20131215



Floating plant that may be endangered by severe weather:

[list and describe the floating plant(s) that will be used on the project]

19.A.03.a. (1) A description of the types of severe weather hazards the plant may potentially be exposed to and the steps that will be taken to guard against the hazards;

The following types of weather could be expected on the plant and controls are noted:

[list weather and controls, i.e.: high winds – secure down materials that could become airborne]

19.A.03.a. (2) The time frame for implementing the plan (using as a reference the number of hours remaining for the storm to reach the work site if it continues at the predicted speed and direction), including the estimated time to move the plant to safe harbor after movement is started;

The plan will be implemented [note number of hours for the storm to reach the work site] to allow sufficient time to move to the plant.

19.A.03.a. (3) The name and location of the safe location(s);

19.A.03.a. (4) The name of the vessel(s), type, capacity, speed, and availability that will be used to move any non-self-propelled plant;

[list the vessels and their type, capacity, speed and availability]


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19.A.03.a. (5) River/tide gage readings at which floating plant must be moved away from dams, river structures, etc., to safe areas;

[river gage reading]

[tide gage reading]

19.A.03.a. (6) Method for securing equipment if not moved.

If the plant will not be moved, the following procedures will be used to secure equipment:


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[CompanyName]Float Plan (19.F.04)

Version 20131215



19.F.04. a. Vessel information (make/model or local identifier);

[Vessel make/model]

[or local identifier]

19.F.04. b. Personnel on-board;

19.F.04. c. Activity to be performed;

[list the activity to be performed, i.e.: surveying, patrolling, inspection]

19.F.04. d. Expected time of departure, route, and time of return;

Time of departure:

Route: [describe specific details about the route to be taken, include maps as necessary]

Time of return:

19.F.04. e. Means of communication (adequate means of communication will be provided).

[describe how the operator of a launch or motorboat will communicate with other personnel]


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[CompanyName]Site-Specific Fall Protection & Prevention Plan (21.C)

Version 20131215




[describe work sites where falls of over 6’ could be expected, i.e.: access ways, platforms, unprotected sides or edges]

21.C.01. a. Duties and responsibilities. Identify Competent and Qualified Persons for fall protection and their responsibilities and qualifications;

Competent Person(s):

Qualified Person(s):

[attach certifications or other proof of qualification as necessary]

21.C.01. b. Description of the project or task performed;

[describe projects or tasks that are to be performed with a 6’ or greater exposure to falling]

21.C.01. c. Training requirements to include the safe use of fall protection equipment;

[describe training methods for personnel, i.e.: site orientation, AHA review, classroom training]

21.C.01. d. Anticipated hazards and fall hazard prevention and control;

The following hazards could be present on this project, controls are noted:

[list the hazards and their controls, i.e.: unprotected sides and edges – guardrails will be erected]

21.C.01. e. Rescue plan and procedures;

Based on the exposures on the project, the following rescue procedures will be used:

[list methods of rescue, i.e.: extension ladder]


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21.C.01. f. Design of anchorages/fall arrest and horizontal lifeline systems:

Anchor points used on this project will be capable of supporting 5000 pounds. Some examples include:

[list examples of anchor points you may use on this project, i.e.: structural steel beams]

[if horizontal lifeline systems will be used, note the manufacturer for any pre-engineered systems or list the engineering specifications for project-engineered systems]

21.C.01. g. Inspection, maintenance and storage of fall protection equipment;

Fall protection equipment will be inspected, maintained and stored per manufacturers’ specifications.

[note any specific inspection, maintenance, or storage details]

21.C.01. h. Incident investigation procedures;

Fall protection incidents will be investigated per GDA requirements.

[note any company-specific incident investigation details, including timelines for reporting specific to the project]

21.C.01. i. Evaluation of program effectiveness

The program will be evaluated [monthly, quarterly, annually].

21.C.01. j. Inspection and oversight methods employed

The worksite will be inspected [daily, weekly] for compliance with this program.

[describe specific oversight methods including who will conduct inspections, how they will be documented, and how often they will be conducted]

Q. Protection measures that will be used on the job site. 1.) On access ways (excluding ladders), work platforms, or walking/working surfaces from which they may fall 6 ft (1.8 m) or more.

Q. Protection measures that will be used on the job site. 2.) On access ways or work platforms over water, machinery, or dangerous operations.


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Q. Protection measures that will be used on the job site. 3.) On runways from which they may fall 4 ft (1.2 m) or more.

Q. Protection measures that will be used on the job site. 4.) On installing or removing sheet pile, h-piles, cofferdams, or other interlocking materials from which they may fall 6ft (1.8 m) or more.

Q. Protection measures that will be used on the job site. 4.) On installing or removing sheet pile, h-piles, cofferdams, or other interlocking materials from which they may fall 6ft (1.8 m) or more.


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[CompanyName] Demolition Plan (23.A.01)

Version 20131215



Project site and location of demolition hazard:

[describe work sites where demolition will take place]

23.A.01.a. (1) An engineering survey:

[attach engineering survey pertaining to demolition work to this plan, list below the Registered Professional Engineer who performed the survey if applicable]

23.A.02 Plan for electric, gas, water, steam, sewer, and other service lines to be shut off, capped, or otherwise controlled outside the building line before demolition is started.

b. Engineering drawing (e.g., site plans, utility plans) that indicates the location of all service lines and the means for their control.

An engineering drawing with site plans and utility plans with location of service lines is attached. Means for the control of utilities and services is noted on the drawing.

[attach the engineering drawing]

23.A.03 Determination of any hazardous building materials, hazardous chemicals, gases, explosives, flammable materials, or dangerous substances have been used in any building construction, pipes, tanks, or other equipment on the property.

b. How hazards will be controlled or eliminated before demolition is started.

The following hazardous building materials, chemicals etc have been identified on the building to be demolished:

[list any materials that meet the criteria of 23.A.03 and how they will be controlled or eliminated]

23.A.04 Walls or floor bracing


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[describe any wall or floor bracing that you will be using due to the structure being previously damaged by fire, flood, explosion or other cause]

23.A.05 Work progression plan

The demolition of floors and exterior walls will proceed from the top of the structure and downward.

[describe any exception to this work progression]

23.A.06 Control of hazards to anyone from the fragmentation of glass

[if fragmented glass will be a hazard, describe how it will be controlled, i.e.: blocking of area to unauthorized personnel]

23.A.08 Protection of employee entrances to multistory structures being demolished

Employee entrances will be protected by [sidewalk sheds/canopies/both] per section 23.A.08.a and 23.A.08b]

23.A.09.a The designated means of access

Designated access points are [list access points, attach jobsite map if necessary]

23.A.10 During demolition, continuing inspections by a competent person

Competent Person: [list competent person, attach their qualification if applicable]

The competent person will conduct inspections [hourly, daily].


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[CompanyName]Excavation/Trenching Plan (25.A.01)

Version 20131215



Project site and location of trench hazards:

Trenching will occur on the following locations on the project site:

[list specific locations of trench work]

25.A.01. a. Conditions:

An AHA will be prepared for all excavations/trenches. When excavations/trenches will be deeper than 5’, a plan will be developed per 25.A.01.a.

25.A.01. b. Identification and credentials of Competent Person;

[List the Competent Person(s) and describe their credentials. Attach certifications and other documents as applicable]

25.A.01. c. Diagram or sketch of the area where the work is to be done, with adjacent and nearby structures shown;

[Attach computer-generated drawing with utilities and structures that could affect the excavation noted. A sketch could be provided in this space in lieu of a computer drawing]

25.A.01. d. Projected depth of the excavation;

The excavation’s maximum depth will be [insert depth].

[Describe other depths if the excavation varies.]

25.A.01. e. Projected soil type and method of testing to determine soil type;


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The soil type is [insert soil type here, i.e.: A, B or C] and was determined by [describe how the soil type was determined here, i.e.: boring samples, penetrometer; reference the project’s soils report if applicable]

25.A.01. f. Planned method of shoring, sloping and/or benching;

The excavation will be protected from cave-ins by [describe method here, attach an engineered plan if applicable]

25.A.01. g. Planned method for confined space entry, trench access and egress and atmospheric monitoring processes;

Trench access/egress will be done by [describe method here, i.e.: ladders, dirt ramps].

[If atmospheric hazards can be expected, describe how they will be monitored for; reference your confined space entry plan if applicable]

25.A.01. h. Location of utility shut offs (if required);

[if a utility service will need to be shut off for work in the trench, list which utilities will be shut off and note their locations on your excavation drawing from this plan]

25.A.01. i. Proposed methods for preventing damage to overhead utility lines, trees designated to remain, and other man-made facilities or natural features designated to remain within or adjacent to the construction rights-of-way;

Where overhead utility lines will impact the excavation, [describe your damage prevention method here, i.e.: the utility company will be contacted to shut down the line, the utility company will be contacted to put insulation on the line, a spotter will be used].

[if trees or other man-made features will impact the trench, describe how they will be removed or supported]

25.A.01. j. Plan for management of excavated soil/asphalt/concrete;

Excavated soil/asphalt/concrete will be [describe how it will be managed, i.e.: hauled to a recycling facility]

25.A.01. k. Plan for traffic control;


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Where traffic will be impacted by the trench, [describe your traffic control plan – reference a plan that is approved by the GDA or other method]

25.A.01. l. Digging permits (Excavation permits).

Prior to the start of excavation [describe any notifications that must be made, i.e.: One-Call or 811. List individual utilities that will be contacted if applicable. List permits that must be obtained by Army Corps authorities if applicable]

25.A.01. m. Certification of UXO clearance.

[if your excavation will be in an area known to have UXO or could contain UXO, describe how you will obtain clearance from qualified UXO personnel]

25.A.01. n. For Cofferdams: Controlled flooding plan, Fall protection, Access/egress; Evacuation procedures.

[if cofferdam work will be conducted, describe your procedures for each component:

Controlled Flooding Plan:

Fall Protection Plan:

Access/Egress Plan:

Evacuation Procedures:]

[CompanyName]Emergency Rescue (Tunneling) (26.A.05)

Version 20131215



Tunnel location:

[describe the location of the tunnel on your project, attach project drawings if applicable]

26.A.01 Access.


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Access to the tunnel will be controlled to prevent unauthorized entry. The tunnel openings and any completed or unused sections will be covered or barricaded and warning signs will be posted.

26.A.02 Check-in/check-out system

Access points will have a check-in/out system to ensure all personnel working underground are accounted for.

26.A.03 Oncoming shifts will be informed

If any hazardous situations or conditions might affect employee safety, the oncoming shifts will be notified by [describe communication to oncoming shifts]

26.A.04 Communications

At least two effective means of communication will be provided where personnel are present: [list the two or methods of communication to be used]

Powered communication systems will run on an independent power supply.

Communication methods will be tested on entry of each shift.

Employees working alone underground will be provided with [describe communication methods here] and will check in with their supervisor at least once each hour.

26.A.05.3.b. Emergency equipment

The following emergency equipment will be provided within 15mins of each entry point and will be inspected monthly:

[list equipment]

26.A.06 Rescue teams.


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[if the project has less than 25 persons underground at one time] One five-person rescue team will be [onsite or within 30mins of travel time] from the underground access point. The rescue team is [in house or provided by local emergency response services, list specific details of the rescue team and where they are from]

[if the project has more than 25 persons underground at one time] There will be at least two five-person rescue teams with one team [onsite or within 30mins travel time from the access point] and the other team will be within 2 hours of travel time]. The rescue team is [in house or provided by local emergency response services, list specific details of the rescue team and where they are from]

26.A.07 Boots

In wet underground areas, personnel will wear rubber boots and rain gear as necessary.

[describe any other specific footwear]

26.A.08 First-aid facilities.

First aid stations will be provided and maintained at all access points within 5 miles or 15 minutes of travel time.

[describe any specific details of the first aid supplies or stations]

26.A.09 Electrical and lighting

[if the tunnel is a hazardous location requiring specific electrical systems, describe that here, i.e.: Class 1 Division 1 atmosphere safe tools, non-sparking tools]

Lighting fixtures and portable lighting equipment will be provided and mounted safely.

[describe any specific details about lighting and electrical, include project drawings if applicable]

26.A.10 Inspections and testing.


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Rock bolts, roof, face and walls of the work area will be inspected at the beginning of each shift and frequently thereafter. [describe specific details of the testing program]

Ground conditions will be inspected [describe frequency and method]

Drilling operations and equipment will be inspected by a competent person prior to each shift.

Haulage equipment will be inspected by a competent person prior to each shift.

Any unsafe conditions identified by the competent person(s) will be corrected before activity begins or continues.

[attach certifications or other materials as applicable for competent person(s)]

26.A.11 Protection from falling material

Personnel will be protected from falling materials at portal openings and access areas. [describe specific methods of protection such as guarding, fencing, shoring, shotcreting or removal of materials]

26.A.12 Tunneling in soil.

[if tunneling in soil, describe how the tunnel will be protected from cave-in]

26.A.13 Ground support systems.

Where rock bolts will be used for ground support, frequent testing will be conducted to ensure bolts meet the required torque. [describe testing frequency and qualified person(s) responsible for design and inspection]

26.A.14 Material handling equipment

Material handling equipment will have audible warning devices to alert personnel to stay clear of the vehicle. All vehicles and mobile equipment in the underground construction area will have a revolving, flashing amber light, mounted so it is visible in all directions whenever the vehicle is in motion. Safety equipment – headlights, backup lights, and alarms – must be maintained.

All required guards and extinguishers will be maintained on conveyors.

Personnel will not be allowed to ride on haulage equipment unless there is seating.


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26.A.15 Vehicles not directly involved in work

Vehicles not directly involved in work will be kept away from portals and separated from construction activities.

26.A.16 Caution sign

A caution sign reading “BURIED LINE” (or similar wording) shall be posted where air lines are buried or otherwise hidden by water or debris.

26.A.17 Underground openings are located adjacent to sources of water: measures shall be taken to ensure that the underground area cannot be flooded.

[describe specific flood-prevention methods]


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[CompanyName]Underground Construction Fire prevention and Protection Plan

(26.D.01)Version 20131215




[describe location of underground construction affected by this plan, attach project maps if applicable]

26.D.01.a. (1) The specific work practices to be implemented for preventing fires;

Safe work practices will be employed to prevent fires:

the provisions of the Hot Work Permit will be followed [describe specific fire prevention methods, i.e.: fire watch, housekeeping]

26.D.01.a. (2) Response measures to be taken in case of fire to control and extinguish the fire;

[describe specific fire response measures, i.e.: portable fire extinguishers should be used on small fires]

26.D.01.a. (3) Equipment required for fire prevention and protection;

The following equipment will be maintained on the site for fire prevention and protection:

Portable fire extinguishers will be mounted on all equipment as required [other fire prevention/protection equipment, i.e. fire blankets]

26.D.01.a. (4) Personnel requirements and responsibilities for fire prevention and protection;

Personnel are to follow fire prevention and protection responsibilities as required by the Hot Work Permit. These responsibilities include:

[list specific responsibilities, i.e.: 2-hour fire watch after spark-generating work]

26.D.01.a. (5) Requirements for daily and weekly fire prevention and protection inspections.

[if applicable, list requirements and their frequencies. Refer to the project or task Hot Work Permit]


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[CompanyName]Compressed Air Plan (26.I.02)

Version 20131215




[describe where the compressed air work will take place, include project drawings if applicable]

26.I.02. a. Requirements for a medical lock and its operation,

[if applicable, provide details on medical lock and how to use it]

26.I.02. b. An identification system for compressed air workers,

Compressed air workers will be identified by [list identification method, i.e.: different color hard hat]

26.I.02. c. Communications system requirements,

Compressed air workers will use [voice communication, two-way radios, or other method]

26.I.02. d. Requirements for signs and recordkeeping,

The compressed air work area will be identified by signs [if applicable, describe the signs to be used and recordkeeping to be done]

26.I.02. e. Special compression and decompression requirements,

[if applicable, describe precautions and procedures for compression]

[if applicable, describe precautions and procedures for decompression]

26.I.02. f. Man lock and decompression chamber requirements,

[describe mechanics of man lock and decompression chamber, inspection and testing, and other procedures]


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26.I.02. g. Requirements for compressor systems and air supply,

[describe details of the air supply to be used including any initial testing, daily inspection and recordkeeping]

26.I.02. h. Ventilation requirements,

[describe how ventilation will be provided including initial testing, daily inspection and monitoring]

26.I.02. i. Electrical power requirements,

[describe any specific electrical power requirements for the chamber including testing and inspection frequencies]

26.I.02. j. Sanitation considerations,

[describe how sanitation will be provided for personnel in the chamber]

26.I.02. k. Fire prevention and fire protection considerations,

[reference the jobsite or task Hot Work Permit]

26.I.02. l. Requirements for bulkheads and safety screens.

[if needed, describe the equipment that is in the chamber and how it is to be used and/or maintained]


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[CompanyName]Formwork and Shoring Erection and Removal Plans (27.C)

Version 20131215




[describe where the formwork or shoring work will take place, include project maps if applicable]

27.C.02 Planning and design

This plan is in accordance with American Concrete Institute Publication 347 and will be submitted for GDA review prior to the start of work.

Manufacturer’s specifications will be available on the job site.

27.C.03 Base support.

The ground or other surface, sills, base plates and other materials for support will be of adequate strength for the vertical and lateral loads to be imposed on them.

[describe any specific base support methods and materials]

27.C.04 Splices

Splices will be designed and constructed so that shoring does not buckle or bend.

[describe any specific splicing methods and materials]

27.C.05 Diagonal bracing

Diagonal bracing will be provided in vertical and horizontal planes.

[describe any specific diagonal bracing methods and materials]

27.C.06 Inspection.


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Shoring equipment will be inspected prior to erection. Damaged equipment will not be used.

Inspection of erected shoring equipment will be done immediately before, during and after concrete placement. Damaged equipment will be reinforced or reshored.

[describe any specific inspection methods, timelines or personnel]

27.C.07 Re-shoring

Where construction loads will be expected, reshoring will be provided.

[describe any specific reshoring methods and materials]

27.C.09 Single post shores.

[if single post shores will be used on more than one tier, use this language:

Layout of single post shores will be designed and inspected by an RPE qualified in structural design (insert personnel here and attach qualifications as necessary). Use of single post shores will comply with Section 27.C.09 a-h.]

27.C.10 Tube and coupler shoring.

Tube and coupler shoring will be made of structural types as described in Section 27.C.10 with no mismatched metals used together.

Couplers that are deficient will not be used.

Spacing and installation of posts will be checked to ensure it is per plan.

27.C.11 Tubular welded-frame shoring.

All materials will be in good working order and checked for spacing to not exceed design.

27.C.12 Vertical slip forms.


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Steel rods or pipe used for climbing jacks or lifting forms will not be used for any other operations. The rods will be encased in concrete or braced.

Vertical loads will be distributed equally and not exceed the capacity of the jacks.

[describe any details about the jacks or other lifting devices to be used]

27.C.13 Removal of formwork.

When the responsible person [insert their name or title here] determines the concrete is of sufficient strength, forms and shores may be removed. The determination will be made based on [conditions in the plans and specifications / concrete testing in accordance with ASTM].

Reshoring [if used] will be removed when the concrete has attained the required strength to support its weight and all loads to be placed on it.

27.C.14 Fall Protection

Personnel will be protected from falling 6’ or more.

[describe the fall protection system to be used, i.e.: guardrails, safety net, engineered system, personal fall arrest, positioning, restraint, or combination of methods]


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[CompanyName]Precast Concrete Plan (27.D)

Version 20131215




[describe the location of the precast operation, include jobsite maps if applicable]

27.D.01 Registered Professional Engineer

Precast operations will be under the planning and direction of an RPE. [list who the RPE is and include their qualifications if necessary]

27.D.01 Detailed instructions and sketches

[describe the method of erection and sequencing to be used on the project, include detailed drawings]

[include any specific details regarding timelines for submitting the plan to the GDA for review]

27.D.02 Precast concrete members support

Precast members will be supported until the connections are completed.

[describe any specific methods or materials for supporting precast concrete members]

27.D.03 Lifting inserts and hardware

Lifting inserts embedded or attached to tilt-up members will support at least two times the maximum expected load; for non-tilt-up members they must support four times the maximum expected load.

Lifting hardware must support at least five times the maximum expected load.


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[CompanyName]Lift Slab Plan (27.E)

Version 20131215




[describe the locations of lift slab work, include jobsite maps if necessary]

27.E.01 Registered Professional Engineer

Lift slab operations will be under the planning and direction of an RPE. [list who the RPE is and include their qualifications if necessary]

27.E.01 Detailed instructions and sketches indicating the prescribed method of erection

[describe the method of erection and sequencing to be used on the project, include detailed drawings]

[include any specific details regarding timelines for submitting the plan to the GDA for review]

27.E.02 Jacking equipment

All jacks will have the rated capacity legibly marked. The jacks will not be capable of continuing to lift when overloaded with a positive stop to prevent overtravel.

Threaded rods and other jack support will have a minimum safety factor of 2.5.

[describe any specific jacking equipment or methods]

27.E.03 Jacking operations

Jacking operations, equipment and controls will comply with section 27.E.03.

[describe if leveling will be automatically or manually controlled]

No personnel will be permitted under the slab during jacking operations.


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[CompanyName]Steel Erection Plan (27.F.01)

Version 20131215




[describe the locations of steel erection work, include jobsite maps if necessary]

27.F.01. a. The sequence of erection activity

Material deliveries will be coordinated [include any specific details about material delivery including dates].

Materials will be staged and stored [include specifics about areas of the project that are used for staging and storing of materials, relate the staging and storing to the sequence of work]

Coordination with other trades and activities will be accomplished by [i.e.: daily supervisor/foremen meetings, weekly progress meetings, or other notification specific to your project]. The intent of coordination is to prevent unauthorized personnel exposure to the erection activity.

27.F.01. b. A description of the crane and derrick selection and placement procedures

[name the crane or derrick to be used for the work, i.e.: Link Belt 110C]

The crane will be setup on level ground at [describe more details about where the crane will sit]. The path of travel for overhead loads [will/will not] go over personnel.

Critical lifts [are/are not] expected. [A separate critical lift plan will be prepared and submitted for each critical lift identified by this plan.]

27.F.01. c. A description of steel erection activities and procedures

[describe the steel erection activities included in this work, i.e.: bracing, guying, anchor bolts, columns, beams, connections, decking, ornamental iron]

27.F.01. d. A description of the fall protection procedures that will be used;


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Fall protection will be required for work over 6’. [describe the fall protection methods to be used, i.e.: cable guardrails will be installed, horizontal lifelines will be engineered and installed. You may choose or be required to refer to a separate fall protection plan]

27.F.01. e. A description of the procedures that will be used to comply with this section

The AHA, fall protection plan and sequence of work will be reviewed prior to the start of work with all affected personnel.

27.F.01. f. Activity hazard analysis

An AHA will be prepared to address the steps, hazards and controls of steel erection work.

27.F.01. g. A certification for each employee who has received training for performing steel erection operations

[attach applicable certifications for each employee who will be performing steel erection work and is required to have training]

27.F.01. h. A list of the Qualified and Competent Persons

The following personnel have been identified as Qualified and Competent Person(s):

Qualified Person: [list person here – this could be the superintendent or other supervisor who will oversee steel erection work and make decisions]

Competent Person(s): [list person(s) here – this would typically be foremen or other lead personnel in charge of crews who are performing steel erection work]

27.F.01. i. A description of the procedures that will be utilized in the event of rescue or emergency response

In case of rescue or emergency response, [describe your procedures here or reference your project’s emergency plan. You may need to include or reference procedures already included in the fall protection plan]


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[CompanyName]Site Safety and Health Plan for HTRW Work (28.B)

Version 20131215




[describe the location of the HAZWOPER work expected on the project, include jobsite maps as necessary]

28.B.02. a. Site description and contamination characterization

Exposure to [name or list contaminant here] is expected at [describe location]. Exposure levels are expected within the range of [note the PPM or other unit of measure and the range here, if known].

[describe other details of the contaminant, i.e.: chemical properties, what specific tasks and trades will be affected]

28.B.02. b. Hazard/Risk analysis

The AHA will be used to further describe the details of the task, hazards and controls. The AHA will be reviewed with affected personnel prior to the start of HAZWOPER work.

28.B.02. c. Staff organization, qualifications, and responsibilities

Safety and Health Manager (SHM): [name the SHM here, include their certification and training materials as required by the GDA as an attachment to this plan or describe here].

Site Safety and Health Officer (SSHO): [name the SSHO here, include their certification and training materials as required by the GDA as an attachment to this plan or describe here].

28.B.02. d. Training, general and project-specific


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General Training will be provided for personnel exposed to the contaminant [or name contaminant] including:

40 hours of offsite or computer-based hazardous waste site instruction 3 days of on the job training 8 hour annual refresher training

Supervisors will have at least 8 hours of training.

Project-specific training will include training on other aspects of the task including:

[list other training that will be provided, i.e.: use of specific tools and equipment]

28.B.02. e. PPE used to protect workers from site-related hazards

PPE to be used by affected personnel include:

[list PPE to be used, i.e.: hard hat, safety glasses, specific clothing like Tyvek suits]

28.B.02. f. Medical surveillance

Medical surveillance [will / will not] be required for this task.

[if medical surveillance is required, the program must be attached to this plan]

28.B.02. g. Exposure monitoring/Air sampling program

Exposure monitoring and air sampling will be conducted for this work to ensure effectiveness of required PPE.

[describe any specific details, i.e.: instruments to be used, frequency of monitoring, responsible person]

28.B.02. h. Heat and cold stress

Heat and cold stress precautions will follow Section 6.I.02 of this plan.

28.B.02.i.(1) Site rules/prohibitions (buddy system, eating/drinking/smoking restrictions, etc.);

[describe any specific site rules if any]


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28.B.02.i. (2) Work permit requirements

[if work includes any of the following, address each: radioactive work, excavation, hot work, confined space, or other specific work permits required by the GDA]

28.B.02.i. (3) Material handling procedures

[describe how soil, liquids, radioactive materials, and spills will be handled – reference other plans if applicable]

28.B.02.i. (4) Drum/container/tank handling

Drums, containers and tanks will be handled per this plan. Specific procedures include [describe any opening, sampling, overpacking, draining, pumping, purging, inserting, or other handling procedures]

28.B.02.i. (5) Comprehensive AHA of treatment technologies employed at the site;

For any treatment technologies used at the site, an AHA will be prepared to address the work steps, hazards and controls. [if not applicable, leave this language out. If applicable, reference and attach the AHAs]

28.B.02. j. Site control measures

Work zones will be established to ensure no spreading of contamination. Exclusion, Support and Contamination Reduction Zones [are noted on the attached jobsite map or described below]

28.B.02. k. Personal hygiene and decontamination

A personal hygiene and decontamination area will be setup in the Contamination Reduction Zone so personnel can remove contaminated clothing and wash. [describe any other details about the decontamination area or CRZ including location and what will be provided]

28.B.02. l. Equipment decontamination

An equipment decontamination area will also be setup in the CRZ. [describe specific equipment decontamination procedures as required by the GDA or local rules]

28.B.02. m. Emergency equipment and first aid


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Emergency equipment and first aid will be provided to match the emergencies that could be expected at the site. [list the emergencies that could be expected on the site, i.e.: spill, fire, leak and how they would be controlled]

28.B.02. n. Emergency response and contingency procedures

Pre-emergency planning will be conducted between the contractor and GDA, emergency responders and the medical facility to determine responses in the case of an emergency.

Personnel and lines of authority are [listed below or noted on the attached chart].

Emergencies will be identified and communicated per this plan. [describe your alarm systems, evacuation routes and reporting locations – include project maps where applicable to illustrate]

A route map to emergency facilities and their phone numbers is attached to this plan. [describe when emergency responders will be notified and how]


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[CompanyName]Blasting Safety Plan (29.A.01)

Version 20131215




[describe the location of the blasting work, attach a project map if necessary]

29.A.01.b.(1) List the names, qualifications, and responsibilities of personnel involved with explosives;

The list will be reviewed by the GDA, then maintained in a secure area well away from blasting operations.

No blasting operation will occur with personnel not on the list approved by the GDA

29.A.01.b. (2) Handling, transportation, and storage of explosives

Procedures for the handling, transportation, and storage of explosives will be documented and will be in accordance with applicable federal and State regulations

29.A.01.b. (2) Employee training programs and certifications

Training and certification attended by personnel participating in and having responsibility for blasting operations will be maintained in a secure area with the list the names, qualifications, and responsibilities of personnel involved with explosives

29.A.01.b. (2) Types of explosives

Types of explosives anticipated to be used will be designated in the Blasting Plan, along with any special handling requirements for certain explosives (only if applicable).

29.A.01.b. (2) Schedule of activities and loading procedures;

A schedule of activities involving explosives will be included in the Blasting Plan. Loading procedures will be covered in the section that addresses handling, transportation, and storage of explosives

29.A.01.b. (2) Detailed blasting schedule

A detailed schedule of activities involving blasting operations will be included in the Blasting Plan


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29.A.01.b. (2) Explosives transportation route

Any routes internal to the project site will be included on the site map

29.A.01.b. (2) Safety signals methods and locations

Warning signs will be provided at points of access to blasting area. The location of safety signals, signalperson, or other traffic control devices will be indicated on the site map.

[Describe, diagram, and/or insert picture for each unique type of sign. ]

[insert site map showing location of each temporary or semi-permanent sign]

29.A.01.b. (2) Danger area clearance

A plan will be developed that address potential lightning, overhead power lines, communications lines, utility services, or other structures.

Pre-blast clearance procedures will be addressed.

29.A.01.b. (2) Methods for securing the site

The storage of explosives will be in accordance with requirements of the Bureau of Alcohol, Tobacco, and Firearms (as outlined in 27 CFR 555, Subpart K) or the state in which they are stored, whichever is more restrictive.

The site map will indicate explosives storage areas and methods (fences, etc.) for explosives security.

An accurate running inventory of all explosives and blasting agents stored at the project will be maintained according to specifications.

The area will be guarded to control access.

29.A.01.b. (2) Test shots

29.A.01.b. (2) Postblast inspection and misfire procedures


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The plan will include procedures for post-blast inspection and misfires.

29.A.01.b. (2) Provisions for disposal of explosives

Explosives will not be abandoned and will be disposed of in accordance with the requirements of the Bureau of Alcohol, Tobacco, and Firearms (as outlined in 27 CFR 555, Subpart K) or the State in which they are stored, whichever is more restrictive

29.A.01.b. (2) blasting agents

The Contractor will report all blasting agents anticipated to be used. For this purpose, a blasting agent is defined as any material or mixture, consisting of a fuel and oxidizer, intended for blasting, not otherwise classified as an explosive and in which none of the ingredients are classified as an explosive, provided that the finished product, as mixed and packaged for use or shipment, cannot be detonated by means of a No. 8 test blasting cap when unconfined.

29.A.01.b. (2) unused and associated material

All remaining explosive materials and detonators will be immediately returned to an authorized magazine.

29.A.01.b. (2) post-blast ventilation requirements

Procedures for testing and ventilating atmospheres in confined areas will be outlined in the Blasting Plan.

29.A.01.b. (3) Public relations requirements before and after blasting

Public relations requirements will be met before and after blasting. These include community communications that will provide adequate pre-blast warning as well as post-blast All Clear notification, as well as any measures necessary to protect structures and personnel.


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[CompanyName]Diving Operations Plan (30.A.17)

Version 20131215



Project site:

The Contractor will submit a Dive Operations Plan that provides a general overview of all tasks to be performed, dive modes and equipment, site access, etc. Complex projects involving more than one work task, location, and/or dive team require task-specific dive plans as part of the overall Dive Operations Plan. As a minimum the Dive Operations Plan will contain the items specified below.

30.A.17. a. Date of dive plan submission;

A dive plan will be submitted for review and approval well in advance of intended start date, as specified by the GDA.

30.A.17. b. Name and contact information for diving supervisor preparing the dive plan;

The dive plan will provide the name and contact information for the diving supervisor preparing the dive plan. If someone other the diving supervisor is preparing the plan, that person’s name and contact information will be furnished along with that of the diving supervisor.

30.A.17. c. Names and duties of on-site dive team members, including diving supervisor;

Names and duties of on-site dive team members, including diving supervisor, will be specified in the diving plan.

30.A.17. d. List of diving equipment to be used;

List of diving equipment to be used will be specified in the diving plan.

30.A.17. e. Type of diving platform to be used;

The type(s) of diving platform to be used will be described, with pictures attached.

30.A.17. f. Detailed description of the mission; Identify how/ if work will be divided into separate tasks or phases of work;


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A detailed description of the mission and sequence of diving operations and associated tasks will be incorporated in the diving plan.

30.A.17. g. Date(s), time(s), duration, and location of operation;

Date(s), time(s), duration, and location of operation will be listed in the diving plan.

A map depicting the diving area with area(s) of diving operations will be incorporated in the diving plan.

30.A.17. h. Diving mode used (SCUBA, SSA, and snorkeling) including a description of the backup air supply, as required;

The diving mode to be used, including a description of the backup air supply, will be described in the diving plan.

30.A.17. i. Nature of work to be performed by the divers, including tools used and materials to be handled or installed;

A description of the work to be performed will be included.

Tools and materials to be handled or installed will be listed.

30.A.17. j. Anticipated surface and underwater conditions,

Data regarding anticipated surface and underwater conditions will be gathered from appropriate sources (NOAA, USCG) and included in the diving plan.

30.A.17. k. Maximum single dive bottom time for the planned depth of dive for each diver.

A list of the maximum single dive bottom time for the planned depth of dive for each diver will be included in the diving plan.

30.A.17. l. Identification of topside assistance/support to the dive team

Topside assistance/support to the dive team will identified and their duties known.

30.A.17. m. Means of direct communication

The means of direct communication, including backup in the event of failure of the primary communications system, will be identified in the diving plan.


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30.A.17. Name of Contractor (and diving subcontractor if applicable), Contract number, and names and contact information for key personnel.

The name of the Contractor (and diving subcontractor if applicable), their contract number(s) will be included in the diving plan. The names and contact information for key personnel will also be included.


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[CompanyName]Confined Space Program (34.A.06)

Version 20131215




Provide a list of all confined area sites on the project site.

Attach a map that shows:

The project site in total, and The area(s) of confined space in which personnel will be working.

If other areas of confined space are identified in the future, an update to this map will be furnished.

34.A.06. a. Identification and Labeling

The following will be described:

Inspection process for facilities/sites The work tasks performed at them to identify confined spaces; The labeling and enforcement procedures that will assure personnel do not enter confined spaces

in an unauthorized fashion.

Labeling and, if applicable, enforcement procedures will be indicated on the map.

34.A.06. b. Confined space hazard identification

Describe the air monitoring or ventilation monitoring conducted to identify the space as a PRCS or a NPRCS.

34.A.06. c. Safe confined space entry conditions

Practices and procedures to assure that confined spaces will be entered safely will be described.

34.A.06. d. Equipment (and equipment maintenance procedures)

Equipment and equipment maintenance procedures for confined space entry as well as rescue will be described.


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34.A.06. e. Procedures for evaluating PRCS conditions when entry is conducted.

Equipment for evaluating PRCS conditions when entry is conducted will be described.

Procedures for evaluating PRCS conditions when entry is conducted will be described:

Atmosphere conditions required to be maintained during entry;

Testing PRCS atmosphere

34.A.06. f. Policies and procedures to assure that at least one attendant is available outside the PRCS during entry to respond to emergencies;

That attendant will be:

Trained and briefed on duties and responsibilities in the event of an emergency.

Made known to all personnel involved and

34.A.06. g. Personnel at the facility/site with active roles in confined space entry and their responsibilities for PRCS entry.

Those personnel at the facility/site with active roles in confined space entry will be designated by name.

Their responsibilities for PRCS entry will be specified in the Confined Entry Plan.

34.A.06. h. Procedures and agreements with local emergency responders for summoning rescue and emergency services for rescuing PRCS entrants;

The CSCP will develop or establish rescue and emergency services for PRCS entry.

Prior contact with emergency responders and other rescue services should be made to inform them of planned PRCS operations. The procedures for notification will be written and all personnel involved should be knowledgeable of said procedures.



3.) Address/phone number/description of medivac services (if applicable).


34.A.06. i. Procedure for preparing, issuing, using and canceling PRCS entry permits;


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A procedure for preparing, issuing, using and canceling PRCS entry permits will be developed and documented.

34.A.06. j. Procedures for coordinating with employees from outside organizations who will be participating in PRCS entry;

Those procedures will be specified, including but not limited to training, procedures, and rescue operations that will be utilized for personnel from outside organizations participating in PRCS entry.

34.A.06. k. Procedures for concluding an entry after entry operations have been completed;

Procedures for concluding an entry will be addressed.

34.A.06. l. Procedures for reviewing PRCS entries and documenting lessons learned from them;

An After Action Review (AAR) will be conducted after each entry to determine lessons learned. The AAR will be documented in writing. Adjustments and changes will be made to the Confined Space Entry Plan as necessary.

34.A.06. m. Policy to review cancelled permits to modify the PRCS entry procedures.

Procedures will be refined or modified in response to cancelled permits

Q. 1.) Location of list identifying confined spaces

The project site map and list will identify all confined spaces, along with any aboveground hazards on or near the confined space. A listing will also be generated. Both will be kept in a secure area, e.g., office trailer

Q. 2.) Address how confined spaces will be reevaluated whenever they or their characteristics change in a way that could lead to reclassification

The After Action Review process will identify when such reevaluation is necessary. Follow-up by trained, knowledgeable personnel should occur.


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Q. 3.) Address how the contractor, as part of its PRCS program, will provide, maintain, and assure the proper use of the following:

-Testing and monitoring equipment.

- Ventilating equipment needed to obtain acceptable entry conditions.

- Communications equipment.

- PPE used where engineering controls and work practices do not adequately protect personnel

- Lighting equipment.

- Equipment such as ladders needed for safe ingress and egress by authorized entrants.

- Rescue and emergency equipment.

- Any other equipment necessary for safe entry into, and rescue from, permit spaces.

Testing and monitoring equipment will be stored in a secure, dry area. This location will be identified.

Project personnel will assess and document the ventilating equipment needed to obtain acceptable entry conditions.

Communications equipment will be identified and furnished that meets the needs of the project or of a particular entry.

If engineering controls and work practices do not adequately protect personnel, the use of PPE will be reviewed and, if insufficient, other means of providing PPE will be addressed.

Lighting equipment and its maintenance will be addressed.

Equipment such as ladders needed for safe ingress and egress by authorized entrants, as well as rescue and emergency equipment, will be identified and furnished. Storage requirements will be identified.

Any other equipment necessary for safe entry into, and rescue from, permit spaces will be identified.

Q. 4.) Address the procedures for the preparation, issuance, use, and cancellation of PRCS entry permits

The procedures for the preparation, issuance, use, and cancellation of PRCS entry permits will be identified in the Project Plan.

Q. 5.) Address the procedures for summoning rescue and emergency services, for rescuing entrants from PRCSs, and for preventing unauthorized personnel from attempting a rescue.


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The person responsible for notifying rescue/medevac services will be either pre-designated or designated in the pre-entry briefing.

If trained and qualified, contractor rescue personnel will be identified.

It will be made known, generally by contractor policy, and specifically in pre-entry briefings, that unless authorized, personnel other than those designated will not attempt a rescue.

Q. 6.) Address employee-training requirements and documentation that will include instructor certification, personnel receiving the training, and date(s) of training.

This documentation will be addressed in the Project Plan and records will be maintained in a secure area

Q. 7.) Address practice training whereby each member of the rescue/emergency team practices PRCS rescues at least once every 12 months.

The training schedule of simulated rescues will be addressed in the Project Plan.


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[CompanyName]Personnel Protective Equipment (Section 05)

Version 20131215



Project site:

[describe the project site in which PPE will be used, attach a jobsite map if necessary]

05.A.01 Responsibilities

Where engineering and administrative controls do not adequately minimize a hazard, personal protective equipment will be selected to protect employees from the identified hazards.

It is the supervisors’ responsibility to identify the hazards and select the appropriate PPE.

Employees will be responsible to use the PPE as directed by their supervisor.

05.A.02 Employees training in the use and care of all required PPE and safety equipment.

Employees will be trained in the use, care and maintenance of all PPE they are required to use. [describe any specific details about PPE training, i.e.: PPE training will occur at site orientation]

05.A.04 Personal protective and safety equipment testing, inspecting, and maintenance

PPE will be inspected per the manufacturer and jobsite rules. Defective or damaged PPE will be taken out of service.

05.A.06 Minimum requirements.

(1) Short sleeve shirt; (2) Long pants (excessively long or baggy pants are prohibited); and (3) Leather or other protective work shoes or boots.

05.b Eye and face protection

Eye and face PPE will meet ANSI Z87.1 and have side protection. Where the AHA identifies specific eye hazards, the appropriate protection will be selected.

05.c Hearing protection and noise control


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Practical engineering and administrative controls will be employed for noise hazards. Where the controls do not bring noise levels to specified levels, PPE will be used to bring exposure below an 8-hour TWA of 85dBA.

Employees will be trained on the proper use of hearing protection devices.

Noise hazard areas will be marked with caution signs to indicate the noise levels and the need for hearing protection devices.

05.d Head protection

[if you require head protection 100% of the time, note that here]

Head protection will be required per the AHA, APP or other analysis. Signs will be posted at the entry to hard hat areas to warn of the requirement to wear hard hats.

05.e Protective footwear

Personnel will wear at minimum, safety-toed boots meeting ASTM Standards F2412 and F2413 while working on construction sites. Additional protective footwear will be identified in the AHA for specific tasks.

05.f High-visibility apparel

At minimum, ANSI Class 2 high-visibility apparel will be worn by workers per Section 05.F.01 a-d.

[if Class 2 vests are to be worn 100% of the time, note that here]

05.g Respiratory protection

If respirators are to be worn for specific tasks, a separate respiratory protection plan will be submitted per 05.G.03.

05.h Full body harnesses, lanyards, and lifelines

If fall protection equipment is to be worn, a fall protection plan will be developed, which includes details on the PPE to be worn and used.

05.i Electrical protective equipment


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Electrical PPE [if required] will be inspected, tested and maintained per Table 5-5 in Section 05.I.

Electrical arc flash protection will be worn by personnel who enter the flash protection zone.

05.j Personal flotation devices

If working in situations listed in 05.J, Type III, Type V work vests or better shall be provided and properly worn (zipped, tied, laced, etc.). Refer to the AHA for the specific activity for selection of PFDs.

05.k Lifesaving and safety skiffs

At least one skiff will be immediately available at all locations personnel are working over or immediately next to water. Personnel will be trained in the launching and operating of the skiff for each shift of work.

Q. a. Name and title of person(s) who conducts hazard assessments.

Q.b. Timeframe for conducting hazard assessments.

Q.c. Description of how hazard assessments are conducted.

Q.d. Procedure for assuring the proper selection, use, and maintenance of PPE and lifesaving equipment.

Q.e. Procedures for retraining when the employer has reason to believe an affected trained employee does not have the required understanding and skill.

Q.f. Written certification (individual or group) that identifies the name of the employee(s)trained, training date(s), and the subject(s) taught.


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