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Site Specific Safety Plan0206500_CP_11_06_en_A6.2
Instructions: Complete the Site Specific Safety Plan Template below.
Project Title: Contract #:
Plan Author (name): Date:
Project Location:
Introduction
It is the responsibility of each contractor working on this project to implement, enforce and modify whennecessary the safety policies and procedures identified herein. Communication and training is anintegral part of the health and safety program, and should be emphasized over the duration of the job. Inorder to facilitate the above, every employee on site shall follow the established policies andprocedures, report hazardous conditions and take action to mitigate hazards before an illness, injury,near miss or other incident is experienced.
Subcontractors as well as other affected persons on this site are obligated to follow the rules andregulations of, but not limited to; the federal Environmental Protection Agency (EPA), the OccupationalSafety and Health Administration (OSHA), USACE EM 38511 (if working on a Federal project), andany other applicable State or local safety, health and environmental standards / regulations.
The goal of this Site Specific Safety Plan is to provide a healthy and safe working environment foreveryone as well as to protect the project site and the environment to the best of our ability. If a conflictis identified between the safety standards of the general contractor, subcontractor or the customer, themost stringent requirement shall be applied.
This document is to be used as a guide for a Site Specific Health, Safety and EnvironmentalRequirements. Certain sections of this document may not be necessary for all projects. Conversely,additional sections not covered herein may need to be added or amended as conditions change. Allparties involved should review and modify or add to this document accordingly to meet the requirementsof the project, making sure to include all necessary information. This Site Specific Safety Plan is aworking document. Modifications shall be made by the user to properly reflect the project for which thisplan is intended.
Personnel
Project Manager:
Superintendent:
Quality Control:
Project Safety Officer:
Competent Person:
Company:
Company:
Company:
Company:
Company:
Note: if more than 1 competent person is assigned, please attach a CP list to this plan.
CPR / First Aid Trained Personnel (list below)(minimum 2 persons on site certified in CPR/FA):
Name Title Company
Qualified Personnel ( if applicable, list below & attach credentials / certificates / etc.):
Name Title Company
Responsibilities
Every individual working on a Centennial project site has the responsibility to apply / enforce the safetyrequirements listed in this plan and any other auxiliary / supplemental safety plans at all times. Individuals who have unique/direct roles for enforcement of this site specific safety plan are identifiedbelow: Project Site Superintendent:
Project Safety Officer:
Competent Persons (as listed above)
Centennial Employees shall make all personnel on site, including subcontractors and or lower tiercontractors aware of this site specific safety plan prior to initiating work, by delivering an onsite safetyorientation. This orientation shall include; site specific program content, special project concerns andhazards, owner modifications, training requirements for the project, including the day and time of the “tool box” talks, the reporting of hazards, illnesses, injuries and “nearmisses”, anydangerous or outofservice equipment, and the location of all the safety, health and environmentalplans, AHAs, manuals and SDS. All reports, including accidents, incidents, outof service equipmentand other information related to this plan shall be submitted to the Centennial Superintendent listed above for corrective action and distribution.
Scope of Work
Insert the scope of work below. Be as detailed as possible (if more space is needed attached a separatescope of work to this plan) (Be as detailed as possible and include definable features of work):
Emergency Response
Emergency Contact Numbers:
Police Fire Ambulance
Additional or Site Specific Emergency Contact Number:
Location of First Aid Kit:
Location of Fire Extinguisher(s):
Note; Fire Extinguishers shall be conspicuously placed by the Exit on each floor within 75 feet of all work areas.
An appropriately sized ABC dry chemical fire extinguisher shall be conspicuously placed in appropriateareas of the construction project site to include (but not limited to): On all floors or levels of work. Within 75’ of all hot work activities and operations. Within 50’ of all flammable liquids.
Fire Extinguishers on site shall have the following; Annual (current) inspection tag 30 day inspection / Annual Gauge indicating fully charged Pin with security seal
Note; Fire extinguishers shall only be used by personnel who have been trained to use this equipment
FIRE
Fire Alarms – All employees and visitors are required to evacuate the building or site in the event of afire alarm, regardless of cause or time. For reasons of accountability, Centennial shall, before any workis initiated, identify a specific rally point / head count area / muster area / area of accountability.Accountability areas shall be > 50’ from the building. It is the responsibility of the individual group, (bycontractor, trade etc.), to determine whether or not all of their personnel evacuated the building, and ifnot, to report the names of the missing (or unaccounted person(s)) to the Centennial SiteSuperintendent and or the fire department Incident Commander.
Fires – In the event of an actual fire or smoke condition, the procedures identified above shall befollowed: Notify all persons in the immediate area of the fire and initiate evacuation. After occupants / workers have exited the space / room: 1. Close the door to the fire area/room to contain the fire and/or smoke condition. 2. Activate Alarm (fire alarm, horn or other suitable warning device) to initiate building evacuation.
Note: The warning signal on this project site will be 5 short blasts from a car / truck horn or a portable air horn unlessotherwise stated.
3. Phone Police or local Emergency Number (listed above).4. Evacuate the building or Extinguish the fire, if properly trained.
MEDICAL
Emergencies (including but not limited to significant lacerations, amputations, head, neck or backinjuries, loss of consciousness, allergic reactions, diabetic emergencies, seizures, difficulty breathing,stroke and any unknown illnesses or injuries) shall required the response of an ambulance. 911 or thelocal emergency number listed above should be contacted immediately. If applicable, a designatedperson shall be identified to meet the ambulance at a predetermined location, and direct theambulance crew into the area or building where the incident has occurred.
All minor injuries and illness shall be reported to the Centennial Project Site Superintendentimmediately.
Primary Medical Treatment Facility
Facility Name:
Address:
Phone:
Note: Directions to the nearest medical facility should be posted on site in a conspicuous location. Under no circumstancesshall an injured person escort himself / herself to the medical facility.
RALLY POINT
It is the responsibility of the Project Superintendent and each subcontractor competent person toidentify the best possible accountability system for the construction site, and to determine (in advance)a rally / meeting point for all employees on site. In case of emergency, such as a fire, location(s)outside of the building shall be identified as the rally point. The location(s) can be separated bysubcontractor(s), trade, or it could be allinclusive, provided the person in charge could account foreach employee. A checklist could be utilized for this purpose:
Rally Point / Meeting Area (describe below / attach map if necessary):
Rally Point Sample Checklist (to be filled out, on site in the event of an evacuation emergency)(if alarger checklist is needed use a separate sheet of paper):
Name & Company Present Y/ N Last Known Location
Incident Investigation, Reporting and Record Keeping
Emergency incidents should take precedence over all investigations, record keeping and reportingprocedures. Ill or injured employees shall be provided with the most appropriate medical response forthe incident, as soon as possible.
All incidents/accidents will be reported to the Centennial Superintendent immediately
After the ill or injured employee has been provided with the most appropriate first aid or medical care(ambulance, medical facility or onsite first aid), the Centennial superintendent will ensure that anincident investigation is initiated in order to correct hazards and prevent reoccurrence.
An incident report, with as much information as possible should be completed within 24 hours.Additional information can be added to the reports, as it becomes available, and when the injured or illemployee has returned to work or is capable of providing the necessary information.
State and Federal OSHA standards require employers to maintain accurate records of workrelatedillnesses, injuries and deaths. Only "recordable" illnesses and injuries (see below) shall be entered onthe OSHA 300 Log. A recordable illness or injury includes one of the following: Fatality = 1 lost work day(s) Transfer to another job Termination of employment Medical treatment, other than normal 1st aid Job restrictions Restriction of motion (ergonomics) Occupational illness (diagnosed)
The competent person shall correct all identified hazards immediately, and prevent reoccurrence ofthe incident and (when necessary) go over the incident and the corrective actions with the projectsupervisors and/or the employees.
Electrical Safety
All electrical power is considered to be energized until the responsible electrician or appropriatecompetent person has verified and tested the system to make sure that it has been deenergized.
Electrical Cords Must be protected from physical damage Flexible cords must be free of damage, splices and taps Flexible cords shall be properly maintained and stored Twisted cords shall be removed from service and destroyed to prevent future use Flexible cords should not be so placed that they are considered a trip and fall hazard Flexible cords shall have the appropriate grounding pins, or shall be doubleinsulate
Lighting shall be adequate for the job site lighting shall be of the appropriate wattage, and placed in fixtures, including temporary usage in a manner specified by the lighting manufacturer emergency lighting is required if work on the project will extend to after daylight hours emergency lighting is required for below grade areas of the project and other areas where natural lighting is not available, in the event of a power failure
NoYES
Power Tools portable electrical equipment and tools must be grounded or double insulated the tools shall be free of damage, and if not removed from service Any power tool removed from service, because of damage, shall be labeled outofservice by the person(s) who discover the deficiency.
Ground Fault Circuit Interrupters (GFCI)GFCI protected equipment and tools can be accomplished by one of the following; a GFCI outlet an outlet protected by a GFCI breaker, or a portable GFCI pigtail
GFCI protection for all power tools and flexible cords is required for the duration of the project. Whenpermanent wiring for the building / project or site has been completed, GFCI protection shall still berequired. All contractors on site shall either; obtain power from a permanently wired GFCI protected outlet, or utilize a GFCI adapter / pigtail between the power supply and the flexible cord or tool being used
Fall Protection
In accordance with the requirements of Federal, State and local standards, all employers are requiredto provide fall protection equipment and training to their employees when they are working at elevationsabove a lower level which meet or exceed the fall protection threshold heights stated in suchstandards. The competent person for fall protection on this project is responsible for identifying fallprotection hazards and implementing controls to mitigate the fall hazards for exposed employees.
Will fall protection be required on this project?
Give a brief description of the work activities which will require fall protection implementation and theheights at which the work will take place:
Work task / area:
Height of work area: in feet
Work task / area:
Height of work area: in feet
Note: The competent person for fall protection shall be named / listed on the AHA corresponding to work activities whichrequire any form of fall protection.
NOYES
Housekeeping
The competent person is responsible for the housekeeping practices on the site. As a minimum, theaisles, exits and other parts of the means of egress shall be properly maintained and free ofunnecessary storage and waste. Sawdust and other combustible materials such as cardboard andpaper shall be removed daily to reduce the risk of injury and fire. Trip and fall hazards shall beremoved as soon as possible, especially in areas considered to be walk / work surfaces.Housekeeping practices on this project are extremely important. In order to reduce the risk of fire,prevent injuries and reduce the risk of a regulatory inspection, housekeeping must be maintained andthe following shall be implemented:
Waste shall be discarded in a suitable container. Sawdust and rags should be placed in a metal (approved) container with tight lid. All waste containers (inside the building) shall be emptied at least daily. Corridors and other walk / work areas shall not be used for storage.
Hotwork (welding / torch cutting / grinding / ss drilling)
Brazing, cutting, heating, soldering, welding and other spark or flame producing work on this jobrequires the acquisition of a Hot Work Permit by the local fire authority, as required by the contract /installation and or Federal, State and local standards.
The basic requirements of a Hot Work Permit are; The area(s) in which the Hot Work will be performed must be inspected by the competent person. All combustible material shall be located at least 35’ away from the Hot Work area. Fireextinguishers must be of proper size and type for the Hot Work activity, and shall be located within 25’of the Hot Work area.
Will hot work activities be initiated on this project?
Hazard Communication / GHS / Right-to-Know
All contractors working on this project are required to have a written Hazard Communication Programas which incorporates the use of the Globally Harmonized System (OSHA Hazcom Standard). Thecompetent person shall have a binder with all of the Safety Data Sheets (SDS) for the products that willbe used on the job site. The binder shall be allinclusive and uptodate. An SDS index for each productwill be available in order to located the SDS in a relatively short time period. Every container on siteshall be properly labeled (including nonpotable water).
The following practices shall apply: The use of abbreviations or chemical symbols is not permitted. All container contents must be completely spelled out The labels must be suitable for the environment. Containers placed outdoors shall not have labels that fade or deteriorate because of exposure to rain, snow or sunlight. Every container shall identify the chemical hazard as well (i.e. corrosive, flammable, reactive or poison/toxic). All warning labels and placards must be in place, and of the correct size and color to warn employees of potential hazards. All labels and warnings shall face forward for purposes of inspection and emergency response.
NOYES
Ladders & Stairways
Ladders shall be a minimum of Type 1 (heavy duty rated) unless otherwise authorized. All laddersshall be inspected before use and shall be removed from service if damaged, broken or unsafe.Ladders shall be used in accordance with the Federal, State or local standards (apply the moststringent standard). The following applies to all ladders:
Damaged ladders shall be tagged "out of service DO NOT USE" if they are found to be defective or damaged in any way (report out of service ladders to the Centennial Superintendent immediately) Ladders shall not be painted or covered in any manner that will hide cracks and other defects Ladders shall have all of the appropriate warning and danger labels in place, maintained in legible condition Ladders must be utilized in a manner specified by the manufacturer The ANSI duty rating of ladders shall never be exceeded
Extension Ladders Shall be pitched at the required 1 : 4 ratio Shall be tied or otherwise secured to the structure or elevated surface to prevent tipping or falling (secured top and bottom) Shall be extended at least 3 (preferably 5) rungs or 36" above the elevated work surface Shall be inspected daily and before each use Defective ladders will be removed from site / destroyed
Step Ladders Shall be opened completely with spreaders locked in place Shall not be used as straight ladders Shall be tall enough to perform the necessary work The top 2 steps of a step ladder shall not be used for standing Shall not be used on scaffolding or next to guardrails unless the height of the guardrails has been adjusted.
Will the use of ladders be anticipated on this project?
Aerial Lifts / Scissor Lifts
Personnel lifts such as articulating booms, single person upright lifts (i.e. Genie, JLG and Uprights)and scissors lifts shall be used in a manner specified by the manufacturer, in accordance with therequirements of OSHA 29 CFR 1910.66 and any other applicable Federal, state, local or manufacturerspecific standards.
Any employee operating or working from an aerial lift equipment such as (articulating boom lift,including Genie lifts and truck mounted articulating booms, scissor lifts, JLG, Upright lifts, etc.) arerequired to be equipped with a personal fall protection equipment system (fall restraint), consisting ofapproved full body harness and lanyards.
Any person using a personnel lift must be properly trained, in accordance with manufacturer’sspecifications
All lifts shall bear the following manuals and warnings, in legible condition; The operators manual shall be located on the lift at all times, for ease of reference All danger and warning stickers shall be attached to the lift and shall be in legible condition
Personnel lifts shall be inspected before each use, and must be removed from service if a deficiency isnoted. The following shall apply to aerial lift inspections: All safety devices and related equipment shall by tested as part of the inspection for proper operation. The lift, if damaged or otherwise impaired shall be tagged “outofservice” to prevent use, until repaired.
Whenever a lift is utilized (exterior or interior), the area / site shall be inspected for hazards, whichinclude, but are not limited to; Overhead concerns / hazards (i.e. beams / columns / lights / sprinklers / electrical / etc.) Flooring and ground abnormalities / stability (i.e. holes / unstable ground / floor vents / grates / slopes / ditches / rough terrain / etc.)
Personnel who utilize one of the lifts referenced above can use such lifts to access a higher levelplatform, provided that the lift can be set on top of the elevated surface allowing the lift operator to exitthe swing gate of the the lift instead of climbing over the guardrails. Note: employees exiting lifts ontoan elevated surface must ensure that they are connected to a fall protection system before exiting theaerial lift equipment. DO NOT EXIT AN AERIAL LIFT UNPROTECTED!
Personal Protective Equipment (PPE)
Centennial is responsible and will enforce the implementation and use of PPE by employees andsubcontractors entering or working on the construction site which may be exposed to a hazardouscondition, or if regulations require the use of specified equipment to protect against the hazards onsite.
Hazard Assessment The Competent Person shall perform a hazard assessment for this project.During the assessment, the Competent Person(s) shall identify potential areas of concern, such as; Struck by hazards High and low temperatures Chemical Exposures Health related hazards Sources of nonionizing radiation, such as lasers and radio frequencies Falls (same surface / heights) Laceration hazards Electrical hazards
Employees shall be trained on the use, inspection, maintenance and storage of PPE. No employeeshall be required to don PPE for which he/she has not been adequately trained.
Subcontractor List
Use the space below to identify the subcontractors and lower tier subcontractors which will beperforming work for Centennial during the course of this project:
Training
The following employees have reviewed and have been trained on the Safety, Health andEnvironmental requirements contained in this Site Specific Safety Plan (SSSP). This list is to be filledout on site. This list is a living document and should be updated as new employees arrive on the projectsite. (if more space is needed use the back of this page for additional employees)
Name Date Name Date
Additional Information / Notes
Note: High Risk Activities may require the submittal of a separate specialized supplemental plan suchas, but not limited to, fall protection / excavation / scaffolding / crane picks / steel erection / confined space / hazardous material abatement / hazardous energy control (loto) / etc.. These plans will requireCentennial project staff approval and in some circumstances may require Centennial corporateapproval.
Use space below for any additional notes:
Plan Review / Approval
Centennial Superintendent:
Centennial PSO:
Centennial Project Manager:
Date:
Date:
Date:
