HomeMy WebLinkAbout4280 Resolution - Phase 1 Zone 2 Water Storage Reservoir Project DBIA GMP-Lump Sum AmendmentGMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
1.Pursuant to Section 6.6.1 of the Agreement, this GMP Amendment incorporates the
following terms into the Agreement. To the extent any terms set forth in this GMP Amendment
conflict with the Agreement, the terms in this GMP Amendment shall govern.
2.The Design-Builder has submitted to Owner the GMP Proposal pursuant to Section
6.6.1.9 of the Agreement.
3.The Owner has reviewed the GMP Proposal, the parties have reconciled the Owner’s
Comments pursuant to Section 6.6.1.7 of the Agreement, and the Owner has accepted the
GMP Proposal as reconciled. The deliverables with the GMP Proposal are set forth in the
exhibits attached hereto are incorporated as if fully set forth herein.
4.The Owner has decided to exercise its option to enter into Phase 2 of the Agreement
pursuant to Section 6.6.1.9.b of the Agreement.
5.The parties have decided, pursuant to Section 6.6.2.3 of the Agreement to convert the
Guaranteed Maximum Price (“GMP”) into a Lump Sum. The Lump Sum Amount shall be
referred to as the “Contract Price”. Where in the Agreement or General Conditions the terms
“GMP” or “Guaranteed Maximum Price” appears, the terms shall be defined as the “Contract
Price”.
6.Consistent with the GMP Proposal, the parties hereby establish the following
Commercial Terms:
Contract Price $17,058,362.60
Ready for Water Milestone Date April 24, 2024
Substantial Completion Date June 7, 2024
Final Completion Date August 30, 2024
7.Other Commercial Terms are set forth below:
a.Liquidated Damages as provided in Section 5.4 – 5.6 of the Agreement are
established at $7,500.00 per calendar day from the Ready for Water Milestone
Completion Date set forth in Item 6 of this agreement until Design-Builder
achieves the Ready for Water Milestone Completion.
b.Liquidated Damages as provided in Section 5.4 – 5.6 of the Agreement are
established at the following schedule for each calendar day from the Substantial
Completion Date set forth in the Schedule (Scheduled Substantial Completion
Date”) until Design-Builder achieves Substantial Completion
For days 1 – 10 after the Scheduled Substantial Completion Date: $3,750 per
calendar day
For days 11-20 after the Scheduled Substantial Completion Date: $5,625 per
calendar day
EXHIBIT A
For days 21-30 after the Scheduled Substantial Completion Date: $7,500 per
calendar day
For every day beyond day 30 after the Scheduled Substantial Completion Date:
$9,325 per calendar day.”
c. Notwithstanding Section 1.2.31 of the General Conditions, the parties have
agreed to the following definition of “Ready for Water Milestone” and “Substantial
Completion” set forth in Exhibit H to this Amendment.
d. Should the contractor not meet the requirements to satisfy the “Ready for Water”
milestone by the date identified as the substantial completion date, liquidated
damages will not be assessed cumulatively. However, should the requirements
of the “Ready for Water” milestone not be reached by the 30th calendar day
beyond the substantial completion date, liquidated damages will be assessed at
the rate of $9,325 per calendar day.
8. Pursuant to Section 10.2 of the Agreement, Design-Builder shall provide a Payment and
Performance Bond pursuant to RCW Chapter 39.08 equal to one hundred percent (100%) of the
amount of the Contract Price set forth above.
9. With the establishment of the Lump Sum rather than a GMP as the Contract Price, Design-
Builder shall be compensated pursuant to Section 6.4.3 of the Agreement rather than Section
6.6.2.1. In addition, the following provisions apply:
a. The provisions of the Agreement and General Conditions regarding compensation
based on any basis other than the Lump Sum Contract Price established above shall not
apply to the Design-Builder’s compensation. Such provisions include, but are not limited
to the following:
i. Section 6.2 of the Agreement;
ii. Section 6.3 of the Agreement;
iii. Sections 6.4.1, 6.4.2, 6.4.4, 6.4.5, and 6.4.6 of the Agreement;
iv. Section 6.6.2 of the Agreement; and
v. Section 6.6.3 of the Agreement.
b. The Contract Price shall include all compensation for the Work as set forth in this
Amendment, including all compensation for the Work associated with Phase 1 and Phase
2, and including all sales, use, consumer and other taxes mandated by applicable Legal
Requirements. Design-Builder shall not be entitled to any additional compensation for the
Work in excess of the Contract Price, unless the Design-Builder is entitled to a Change
Order pursuant to Article 9 of the General Conditions.
c. Design-Builder affirms Section 6.6.1.6 of the Agreement that Design-Builder
represents and agrees that it has adequately investigated the site and the project
parameters, the Project is adequately defined, the Final Basis of Design Documents are
sufficiently defined to provide an accurate Contract Price and Project Schedule, and
subject to the assumptions and clarifications in Exhibit E to this Amendment, the Project
is sufficiently clear and understandable for the Design-Builder to perform the Work in
accordance with the Contract Documents for an amount that will not exceed the Original
Contract Price.
EXHIBIT A
LIST OF DELIVERABLES
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
Pursuant to Section 2.01.C of Exhibit C to the Agreement, the parties hereby incorporate the
Design-Builder’s Proposal as set forth below into the Contract Documents as if fully set forth
herein.
1. Contract Price (set forth in the GMP Amendment) pursuant to Section 2.04.C of Exhibit C to
the Agreement.
2. Exhibit B to this Amendment: Final Basis of Design Documents pursuant to Section 2.03.B
of Exhibit C to the Agreement.
3. Exhibit C to this Amendment: Project Schedule pursuant to Section 2.02.D of Exhibit C to
the Agreement.
4. Exhibit D to this Amendment: Schedule of Values pursuant to Section 2.04.B of Exhibit C to
the Agreement. Note that because the Contract Price is a Lump Sum, the Design-Builder
has not submitted a Cost Model with its GMP Proposal.
5. Exhibit E to this Amendment: A list of the assumptions and clarifications made by the
Design-Builder in preparation of the GMP Proposal.
6. Exhibit F to this Amendment: Project Safety and Job Site Hazard Analysis pursuant to
Section 2.06.B of Exhibit C to the Agreement.
7. Project Phasing/Staging Analysis pursuant to 2.07 of Exhibit C to the Agreement is not
Applicable.
8. Exhibit G to this Amendment: Permitting Strategy Plan pursuant to Section 2.08 of Exhibit C
to the Agreement.
9. Exhibit H to this Amendment: QA/QC Plans pursuant to 2.9 of Exhibit C to the Agreement.
10. Exhibit I to this Amendment: Contract Close-Out Plan pursuant to Section 2.10 of Exhibit C
to the Agreement.
11. Exhibit J to this Amendment: Differing Site Conditions Report pursuant to Section 2.11 of
Exhibit C to the Agreement.
EXHIBIT B
FINAL BASIS OF DESIGN DOCUMENTS
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The following documents constitute the Final Basis of Design Documents:
Name of Document Date of Document
Zone 3 Reservoir Basis of Design Report February, 2022
Engineering Geology Report June 10, 2022
60% Plan Set August 18, 2022
EXHIBIT C
PROJECT SCHEDULE
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The Design-Builder shall comply with the attached Schedule, which shall be updated pursuant
to Exhibit C of the Agreement.
ID Task Name Duration Start Finish Predecessors1Contract Time Phase 1 (includes CO's 1‐3)329 daysFri 11/12/21Wed 2/15/232Contract Time Phase 2500 daysMon 10/3/22Fri 8/30/243Mobilization5 daysMon 10/3/22Fri 10/7/224Strip vegitation2 daysMon 10/10/22Tue 10/11/2235Erosion Control3 daysWed 10/12/22Fri 10/14/226Cut and fill/level site5 daysWed 10/12/22Tue 10/18/2247Utlility delivery1 dayMon 10/17/22Mon 10/17/228Mass Excavation10 daysWed 10/19/22Tue 11/1/2269Grade fill and stockpile20 daysMon 11/7/22Fri 12/2/2210Access Road from Rd 90 to site4 daysMon 10/31/22Thu 11/3/2211Backfill overexcavation for foundation12 daysWed 11/2/22Thu 11/17/22812Armor laydown area3 daysFri 11/18/22Tue 11/22/221113Foundation forming 5 daysMon 11/28/22Fri 12/2/2214Rebar delivery and installation for mat foundation15 daysMon 12/5/22Fri 12/23/221315Mat foundation concrete placement1 dayThu 12/29/22Thu 12/29/2214FS+3 days16Form columns and ringwall9 daysMon 1/2/23Thu 1/12/2315FS+1 day17Pour Columns and ringwall1 dayFri 1/13/23Fri 1/13/231618Strip forms ringwall and collumns4 daysThu 1/19/23Tue 1/24/2317FS+3 days19Install inlet piping and drain in foundation footprint4 daysMon 1/16/23Thu 1/19/231720Pipe encasement3 daysFri 1/20/23Tue 1/24/231921Backfill foundation12 daysWed 1/25/23Thu 2/9/232022Electrical in foundation foot print3 daysWed 2/1/23Fri 2/3/2323Reservoir Erection195 daysMon 2/13/23Fri 11/10/232124Utility piping to site15 daysMon 3/27/23Fri 4/14/2325Retention pond5 daysMon 2/6/23Fri 2/10/232226Paint Reservoir110 daysMon 11/13/23Fri 4/12/242327Site grading 5 daysMon 4/15/24Fri 4/19/242628Fencing20 daysMon 4/15/24Fri 5/10/242629Site Electrical 60 daysMon 1/1/24Fri 3/22/2430Start up/Tank on line10 daysThu 3/28/24Wed 4/10/2426FS‐12 days31Site Access Rd.5 daysMon 3/18/24Fri 3/22/2432Seed site1 dayMon 4/22/24Mon 4/22/242733Paving 1 dayWed 5/1/24Wed 5/1/2434Tank ready for Water0 daysWed 4/10/24Wed 4/10/243035Substantial Completion0 daysFri 6/7/24Fri 6/7/2436Final Completion0 daysFri 8/30/24Fri 8/30/244/106/78/310/210/910/1610/2310/3011/611/1311/2011/2712/412/1112/1812/251/11/81/151/221/292/52/122/192/263/53/123/193/264/24/94/164/234/305/75/145/215/286/46/116/186/257/27/97/167/237/308/68/138/208/279/39/109/179/2410/110/810/1510/2210/2911/511/1211/1911/2612/312/1012/1712/2412/311/71/141/211/282/42/112/182/253/33/103/173/243/314/74/144/214/285/55/125/195/266/26/96/166/236/307/77/147/217/288/48/118/188/259/1OctoberNovemberDecemberJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptCity of PascoZone 3 Reservoir Storage TankPreliminary Anticipated Construction SequenceTue 11/8/22Page 1 of 1
EXHIBIT D
SCHEDULE OF VALUES
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The Design-Builder shall comply with the attached Schedule of Values, which shall be updated
pursuant to Exhibit C of the Agreement.
See attached Schedule of Values
T BAILEY, INC.
Zone 3 Reservoir Storage Tank - Phase 1 FINAL 10/31/22
City of Pasco Project #21252
ITEM NO.DESCRIPTION OF ITEM QUANTITIES CO3 GMP
# OF UNITS UNIT PRICE PRICE
1.0 MOB, DEMOB, CLEANUP 1 LS 262,200.00$ 1,117,800.00$ 1,380,000.00$
EQUIPMENT/MATERIALS MOBE/DEMOBE 1 LS -$ 135,000.00$
SITE MANAGEMENT/SUPERVISION 1 LS -$ 305,000.00$
FACILITIES/SITE UTILITIES/SECURITY 1 LS -$ 100,000.00$
SUPERVISION HOUSING/SUBSITANCE 1 LS -$ 104,500.00$
MAINTENANCE/REPAIR/SERVICES/ EQUIPMENT 1 LS -$ 86,000.00$
OUTSIDE SERVICES 1 LS -$ 90,000.00$
PROJECT MANAGEMENT 1 LS -$ 170,500.00$
INSURANCE/BOND/B&O 1 LS -$ 389,000.00$
2.0 TEMP EROSION & SEDIMENTATION CONTROL 1 LS 147,250.00$ 7,750.00$ 155,000.00$
SILT FENCE, SEED, 1 LS -$ 45,000.00$
TEMP CONSTRUCTION ACCESS/ENTRANCE 1 LS -$ 75,000.00$
SITE GRADING 1 LS 35,000.00$
3.0 TRENCH SAFETY & SHORING 1 LS -$ 5,000.00$ 5,000.00$
4.0 SITE WORK 1 LS 148,750.00$ 276,250.00$ 425,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 113,000.00$
CLEARING, GRUBBING, GRADING, SEEDING 1 LS -$ 127,000.00$
BLOCK WALL AND ACCESS GATE 1 LS -$ 138,750.00$
PAVE ROAD TO SITE HMA 1 LS -$ 46,250.00$
CONTINGENCY 1 LS 35,000.00$ 15,000.00$ 50,000.00$
5.0 EXCAVATION 1 LS 315,000.00$ 35,000.00$ 350,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 22,000.00$
EXCAVATION AND GRADING 1 LS -$ 185,100.00$
QUARRY SPALLS 1 LS -$ 67,000.00$
SEPARATE/HAUL/STOCK PILE BLACK SAND 1 LS -$ 38,900.00$
OVERFLOW POND 1 LS 37,000.00$
CONTINGENCY 1 LS 90,000.00$ (40,000.00)$ 50,000.00$
6.0 BACKFILL 1 LS 427,500.00$ 22,500.00$ 450,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 33,000.00$
IMPORT/STOCKPILE/PLACE/WATER/COMPACT 1 LS -$ 285,000.00$
NATIVE LOAD/HAUL/PLACE/WATER/COMPACT 1 LS -$ 132,000.00$
CONTINGENCY 1 LS 142,500.00$ (42,500.00)$ 100,000.00$
7.0 CRUSHED ROCK 1 LS -$ 120,000.00$ 120,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 22,000.00$
CSBC ACCESS ROAD RD 90 TO SITE 1 LS -$ 66,000.00$
CSTC ACCESS ROAD/ RD 90 TO SITE 1 LS -$ 20,000.00$
GRADING/COMPACTION/SURVEY 1 LS 12,000.00$
8.0 SITE UTILITIES 1 LS -$ 75,000.00$ 75,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 22,000.00$
EXPANSION JOINTS AND VALVES 1 LS -$ 30,500.00$
DRAINAGE PIPING AND BASINS 1 LS -$ 22,500.00$
9.0 OFFSITE IMPROVEMENTS 1 LS 268,650.00$ 726,350.00$ 995,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 43,000.00$
WATER LINE 1 LS -$ 402,000.00$
SAFETY/SHORING 1 LS -$ 15,000.00$
FLUSHING/PRESSURE TEST/PURITY 1 LS -$ 20,000.00$
ACCESS ROAD 1 LS -$ 105,000.00$
SITE GRADING/STRIP/HAUL/COMPACT 1 LS -$ 185,000.00$
CONTROL/SURVEY/LAYOUT 1 LS -$ 15,000.00$
EROSION CONTROL 1 LS -$ 10,000.00$
ELECTRICAL (PLUG)1 LS -$ 200,000.00$
CONTINGENCY 1 LS 54,000.00$ (54,000.00)$ -$
10.0 CONNECT TO WATER MAIN 1 LS -$ 12,000.00$ 12,000.00$
11.0 CATHODIC PROTECTION 1 LS -$ 68,000.00$ 68,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 15,000.00$
TANK MODIFICATIONS, MATERIAL/LABOR 1 LS -$ 3,000.00$
CATHODIC PROTECTION SUBCONTRACT (PLUG)1 LS -$ 50,000.00$
CONTINGENCY 1 LS -$ -$ -$
12.0 RESERVOIR CALCS & DWGS 1 LS -$ 40,000.00$ 40,000.00$
13.0 RESERVOIR FOUNDATION 1 LS 1,116,955.00$ 34,545.00$ 1,151,500.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 29,000.00$
MAT SLAB 1 LS -$ 408,500.00$
REBAR 1 LS -$ 365,000.00$
ANCHORS 1 LS -$ 86,000.00$
RINGWALLS 1 LS -$ 148,000.00$
COLUMNS 1 LS -$ 85,000.00$
FLOOR SLAB 1 LS -$ 20,000.00$
GROUT 1 LS -$ 10,000.00$
CONTINGENCY 1 LS 48,500.00$ (48,500.00)$ -$
14.0 RESERVOIR STRUCTURE & APPURT 1 LS 1,839,926.40$ 5,920,073.60$ 7,760,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 44,000.00$
RESERVOIR FABRICATION 1 LS -$ 4,371,000.00$
FIELD ERECT RESERVOIR 1 LS -$ 2,745,000.00$
WHEEL & PRIME 1 LS -$ 400,000.00$
SET ROOF/SET BOWL 1 LS -$ 200,000.00$
CONTINGENCY 1 LS -$ 50,000.00$ 50,000.00$
15.0 RESERVOIR MECHANICAL 1 LS 30,000.00$ 70,000.00$ 100,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 44,000.00$
TOTAL COST
Schedule of Values
T BAILEY, INC.
Zone 3 Reservoir Storage Tank - Phase 1 FINAL 10/31/22
City of Pasco Project #21252
ITEM NO.DESCRIPTION OF ITEM QUANTITIES CO3 GMP
# OF UNITS UNIT PRICE PRICE
TOTAL COST
Schedule of Values
RESERVOIR PIPING IN FOUNDATION 1 LS -$ 25,000.00$
ALTITUDE/METER/FITTINGS 1 LS -$ 21,000.00$
FLUSHING AND STARTUP EQUIPMENT 1 LS -$ 10,000.00$
CONTINGENCY 1 LS 6,000.00$ (6,000.00)$ -$
16.0 RESERVOIR FINISHES 1 LS -$ 800,000.00$ 800,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 22,000.00$
FIELD COATING INTERIOR AND EXTERIOR 1 LS -$ 778,000.00$
CONTINGENCY 1 LS -$ 200,000.00$ 200,000.00$
17.0 ELECTRICAL 1 LS 31,500.00$ 178,500.00$ 210,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 99,000.00$
ELECTRICAL SITE WORK (PLUG)1 LS -$ 111,000.00$
CONTINGENCY 1 LS 6,000.00$ (6,000.00)$ -$
18.0 AUTOMATIC CONTROL 1 LS -$ 90,000.00$ 90,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 33,000.00$
CONTROL CONTRACTOR (PLUG)1 LS -$ 57,000.00$
CONTINGENCY 1 LS -$ -$ -$
19.0 RECORDS & O&M'S 1 LS -$ 22,000.00$ 22,000.00$
ENGINEERING (DESIGN & CONSTRUCTION) 1 LS -$ 11,000.00$
RED LINES 1 LS -$ 11,000.00$
20.0 TESTING, START UP & TRAINING 1 LS -$ 15,000.00$ 15,000.00$
21.0 MINOR CHANGES 1 LS -$ 150,000.00$ -$ 150,000.00$
SUBTOTALS 4,587,731.40$ 9,785,768.60$ 14,373,500.00$
CONTINGENCY 382,000.00$ 68,000.00$ 450,000.00$ 3.13%
SALES TAX 432,366.63$ 857,277.87$ 1,289,644.50$
5,402,098.03$ 10,711,046.47$ 16,113,144.50$
Cost of Work Steel Allowance DB Fee Contingency Sales Tax
Original Ph1 Contract 325,600.00$ -$ 32,560.00$ 30,801.76$ 388,961.76$
Change Order #1 Long Lead Utility Purchase 449,760.20$ 18,088.91$ 101,395.65$ 39,129.14$ 608,373.90$
Change Order #2 Time Extension -$ -$ -$ -$ -$ -$
Change Order #3 2,747,805.00$ 1,839,926.40$ 382,000.00$ 432,366.64$ 5,402,098.04$
Proposed GMP 9,785,768.60$ -$ 68,000.00$ 857,277.87$ 10,711,046.47$
Subtotal 17,110,480.17$
Phase 1 contingency not used (21,315.81)$
Phase 1 non-taxable (30,801.76)$
Adjusted Total 17,058,362.60$
Adjustments
EXHIBIT E
LIST OF ASSUMPTIONS AND CLARIFICATIONS
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The parties agree that the Contract Price incorporates the following assumptions and
clarifications:
1. Any unused contingency amount in Change Order 1 will be returned to the City and will
reduce the overall Adjusted Total due accordingly.
2. Line Item 21.0 (Minor Changes) must have prior approval from the City to be charged
against.
EXHIBIT F
PROJECT SAFETY AND JOB SITE HAZARD ANALYSIS
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The Design-Builder shall comply with the attached Zone 3 Reservoir Storage Tank Site
Specific Health and Safety Plan #678.
ZONE 3 RESERVOIR STORAGE TANK
SITE SPECIFIC
HEALTH & SAFETY
PLAN # 678
Design build project for a new 3.5MG water tank
SITE SPECIFIC
HEALTH & SAFETY
PLAN
Note: This Site Specific Health & Safety Plan must be re-evaluated and updated annually or when site conditions or
scope of work changes.
CONSTRUCTION ACTIVITIES
Client Name:
Site Location: Project:
HASP Disclaimer –“This HASP has been designed for the methods presently contemplated by
the company for execution of the proposed work. Therefore, the HASP may not be appropriate if
the work is not performed by or using the methods presently contemplated by the company. In
addition, as the work is performed, conditions different from those anticipated may be
encountered and the HASP may have to be modified. Therefore, the company only makes
representations of warranties as to the adequacy of this HASP for currently anticipated activities
and conditions as of date of issue.”
Prepared by:
Chad Kean
T Bailey, Inc.
9628 S March's Point Rd.
Anacortes, WA 98221
Revision:
Date:
T BAILEY CONTACT INFO
NAME OFFICE PHONE CELL PHONE
SAFETY Director
PROJECT MANAGER
SITE SUPERVISOR
CLIENT AND PROJECT INFORMATION
PROJECT NUMBERPROJECT NAME
CLIENT NAME
OCCUPATIONAL HEALTH ADDRESS
SCOPE OF WORK
CLIENT CONTACT
HASP creation date
CLIENT
ADDRE
SSS
CLIENT PHONE
NUMBER
CLIENT FAX
HOSPITAL
ADDRESS
PHONE
EYE CARE
PHONE
ADDRESS
URGENT
CARE
ADDRESS
PHONE
REVISION NUMBER
CHANGE THE LAST NUMBER TO THE NEXT CONSECTIVE NUMBER FOR EACH JOB 8.3.1-->8.3.2
CHANGE THE MIDDLE TO THE NEXT CONSECTIVE NUMBER FOR EACH CORRECTION FROM SAFETY OR OTHER PARTY to the template8.3-->8.4
(DOCUMENT CHANGE ON REVISION HISTORY
CHANGE THE FIRST NUMBER TO THE NEXT CONSECTIVE NUMBER FOR EACH TEMPLATE CHANGE (ie adding
a new form)8.4-->9.0.0 (DOCUMENT CHANGE ON REVISION HISTORY
SITE HEALTH AND SAFETY PLAN ACKNOWLEDGMENT
I understand and agree to abide by the provisions as detailed in the TBI Safety and Health Plan
and this Project Site Health and Safety Plan (HASP) for the activities described in the
Project Work Plans and the AHA as outlined in section 4.4. Failure to comply with these
provisions may lead to disciplinary action, which may include dismissal from the work site,
termination of employment or, for subcontractors, termination of the work contract. (Make
additional copies as needed)
Printed Name Company Signature Date
TABLE OF CONTENTS
SITE HEALTH AND SAFETY PLAN REVIEW AND APPROVALS ii
SITE HEALTH AND SAFETY PLAN ACKNOWLEDGMENT iii
1 1-1
1-1
1-1
1-1
INTRODUCTION
1.1 Purpose
1.2 Pre-Job Briefing & Safety Meetings
1.3 Key Personnel and Management
1.4 Training Requirements 1-4
2 SITE INFORMATION 2-1
2.1 Site Information 2-1
3 SCOPE OF WORK 3-3
4 HAZARD EVALUATION 4-1
4.1 Chemical Hazards 4-1
4.2 Physical Hazards 4-6
4.3 Natural and Biological Hazards 4-14
4.4 Job Hazard Analysis 4-15
5 5-1
5-1
5-2
ACCIDENT PREVENTION
5.1 Safe Work Practices
5.2 Safety Meetings
5.3 Safety Data Inventory 5-3
6 PERSONAL PROTECTIVE EQUIPMENT 6-1
6.1 General 6-1
6.2 Hearing Protection 6-2
6.3 Air-Purifying Respirators 6-2
7 CONFINED SPACE 7-1
7.1 Workplace Evaluation 7-1
7.2 Designation of Confined Spaces 7-1
7.3 Determining Non-Permit and Alternate Entry Confined Space 7-2
8 EXCAVATION AND TRENCHING 8-1
8.1 Excavation and Development 8-1
9 FALL PROTECTION PLANNING 9-1
9.1 Fall Protection 9-1
10 TANK SCAFFOLDING 10-1
10.1 Procedures 10-1
10.2 Tagging 10-2
11 FORKLIFT OPERATION 11-1
12 AERIAL WORK PLATFORMS 12-1
12.1 Operation SAFETY WARNINGS AND CAUTIONS 12-1
12.2 Training 12-3
12.3 Inspection 12-3
12.4 Maintenance 12-4
13 LADDERS 13-1
13.1 Fixed Ladder Inspection 13-1
13.2 Setup 13-2
13.3 Use 13-3
13.4 Portable Ladder Use 13-4
13.5 Training 13-5
14 AUTOMATIC GIRTH WELDER 14-1
14.1 Single Head Automatic Girth Welder 14-1
15 AIR SAMPLING EXPOSURE MONITORING 15-1
15.1 Exposure Monitoring 15-1
16 SITE CONTROL AND WORK ZONES 16-1
16.1 Work Zones 16-1
16.2 Communication 16-1
16.3 Buddy System 16-2
17 17-1 MOBILE CRANES
17.1 Crane Operators
17.2 Swing-Away Boom extension 17-2
18 CRANE LIFTED WORK BASKET 18-1
18.1 Work Basket Operations 18-1
19 EMERGENCY RESPONSE CONTINGENCY PROCEDURES 19-5
19.1 On-Site Emergencies 19-5
19.2 Chemical or Petroleum Product Spill Response Procedures 19-6
19.3 Site Evacuation 19-9
20 TABLES 20-1
Table 4-1 Properties of Potential Site Contaminants 20-2
Table 5-1 Heat Index Guide 20-3
Table 5-2 Heat Stress Rest Breaks 20-4
Table 5-3 Outdoor Temperature Action Levels 20-4
Table 5-4 Cold Stress Guidelines 20-5
Table 5-5 Wind Chill Chart 20-6
Table 7-1 Action Levels for Field Activities 20-7
APPENDIX A FORMS A-1 Thru 29
APPENDIX B EMERGENCY CONTACT INFORMATION B-1 Thru 10
APPENDIX C SAFETY DATA SHEETS C-1
17-1
1 INTRODUCTION
1.1 Purpose
The purpose of this Site-Specific Health and Safety Plan (HASP) is to provide specific
guidelines and establish procedures for the protection of personnel performing the scope of
activities, as described in Section 3 — Scope of Work, of this HASP. The information in this
HASP has been developed in accordance with applicable standards and is, to the extent possible,
based on previous studies and information available to date. This HASP is intended to be a living
document in that it must continually evolve as site conditions and knowledge of the site work
activities develops further. Adherence to the HASP as drafted alone will only provide the guidance
necessary to initiate the work and allow monitoring of site conditions to determine the required
protection. Continual updating of the HASP, based upon consistent monitoring and
implementation of the HASP adjustments, will provide for the required results.
1.2 Pre-Job Briefing & Safety Meetings
Prior to the start of the project, all personnel will participate in an initial pre-job briefing. A
pre-job briefing shall be given by the Project Manager (PM) or the Site Supervisor (SS), which
will serve to familiarize on-site personnel with the procedures, requirements, and provisions of
this HASP. Upon completion of the pre-job briefing, employees will sign the Health and Safety
Plan Acknowledgment Form located on page iii. The PM will ensure that the anticipated site
hazards are summarized and explained to all personnel, and that those personnel are aware of the
precautions they must take to minimize their exposure to those hazards. Specific topic areas to
be covered during the pre-job briefing are discussed in Section 1.4.1 of this plan.
Safety meetings will be held weekly prior to the start of the work week shift. Safety meetings
will be held at any time during the project when there is a need to address specific safety and
health concerns. All new employees must attend the meeting and be familiar with this HASP.
The Safety Meeting form is also included in Appendix A of this plan. Attendance records and
meeting notes shall be maintained with the project file.
1.3 Key Personnel and Management
Personnel conducting activities on site for which potential exposure exists must be in compliance
with all applicable Federal/State rules and regulations, including OSHA 29 CFR 1910, and
OSHA 29 CFR 1926. On-site personnel must also be familiar with the procedures and
requirements of this HASP. In the event of conflicting safety procedures/requirements,
personnel must implement those safety practices which afford the highest level of protection.
Safety Director – (SD)
The SD is responsible for administering TBI’s Safety and Health Program.
The Safety Director is responsible for the preparation and modification (as necessary) of this
HASP. Any significant changes in site operations, conditions, or other issues that may require
alterations to the HASP, shall be discussed and approved by the SD. The SD will advise the PM
and SS on safety and health issues which may have an impact on project operations.
Project Manager - (PM)
The PM shall be responsible for the overall implementation of the HASP, and for ensuring that
all safety and health responsibilities are carried out in conjunction with this project. This shall
include, but is not limited to, review and approval of the HASP, communication of site
requirements to Subcontractor personnel, consultation with the Client/Owner regarding
appropriate changes to the HASP, and relating any changes to the site personnel. Specific items
that the PM is responsible for include:
•Ensure that the HASP is read and signed by all field personnel on the project.
•Ensure that all provisions of the HASP are followed.
•Ensure that safety meetings are conducted weekly, and signed by all field workers.
•Ensure correction of any reported or observed safety hazard.
•Report all near miss, injury, illness and vehicle accident incidents according to the
Incident Reporting System Checklist (included in Appendix B) within 24-hours.
•Immediately notify the SD upon receiving notice of any regulatory agency inspection.
Site Supervisor - (SS)
The SS shall be appointed by the PM prior to the commencement of field activities. When
possible, the SS shall be the senior-most person with the highest level of safety and health
training on the site. During this project the SS will act as the site safety officer when a SSO is
not required on site or assigned to the project.
The SS is the person who, under the supervision of the PM, is responsible for carrying out the
safety and health responsibilities by making sure that: 1) all necessary clean-up and maintenance
of safety equipment is conducted by field personnel; 2) if any emergency occurs on site, shall
contact local emergency services; and, 3) all the forms attached to the HASP are completed and
submitted to the PM upon completion of field activities including the Health and Safety Plan
Acknowledgment Forms, and the Safety Meeting Forms. Medical Data Sheets for employees are
to be completed and maintained at the site.
The SS has responsibility for all field activities and enforces safe work practices by all
employees. The SS is the designated competent person for the project site. The SS watches for
any ill effects on any crewmember, especially those symptoms caused by heat/cold stress or
chemical exposure. The SS oversees the safety of any visitors who enter the site. The SS
maintains communication with client representative(s).
Specific duties of the Site Supervisor include:
•Orders the immediate shutdown of site activities in the case of a medical emergency,
unsafe condition, or unsafe practice.
•Provide the safety equipment, personal protective equipment, and other items necessary
for employees.
•Enforce the use of required safety equipment, personal protective equipment, and other
items necessary for employee or community safety.
•Conduct job site safety and health inspections.
•Report safety and health concerns to management as necessary.
Site Safety Officer - (SSO)
The SSO is the site health and safety representative of TBI and is present during fieldwork
activities. The SSO has authority to take immediate action, including stopping work, to correct
safety violations or other unsafe conditions. The SSO will perform the following tasks:
Note: The SSO is not required on site when less than twenty-five employees are on site or the
potential for exposure to hazards requiring 40 hour training is not a concern.
•Daily inspections of the job site and work-in-progress to verify compliance with the
HASP, and other occupational health and safety requirements of the contract;
•Verify that all site personnel, including subcontractors, comply with the HASP
requirements;
•Assess the site daily for any physical hazards;
•Implement the air monitoring program described in this plan to determine the nature
and extent of airborne chemical hazards on site; Asbestos or Lead monitoring to be
conducted by a Certified Asbestos or Lead Consultant or abatement company;
•Attend weekly site operations meetings to communicate the above findings. Solicit
input from other site personnel and subcontractors regarding any necessary
modifications to the site safety plan, site hazards, or near misses witnessed that might
not have been identified; and
•Conduct weekly safety briefings, at the beginning of each work week shift, to inform
on-site personnel of a change(s) in site conditions.
The SSO has the following responsibilities:
•Inventory of on-site H&S supplies and equipment;
•Conducts weekly (or as appropriate) site H&S meetings and briefings;
•Reports accidents, illnesses, and near misses to the PM and the SD;
•Establishes and maintains work zones;
•Supervises personnel and equipment clean-up and maintenance;
•Performs on-site monitoring, both area and personnel;
•Establishes work and rest regimens when heat/cold stress is a concern, and monitors
active project personnel for heat/cold stress;
•Verifies that site-specific H&S plans are implemented;
•Reviews or modifies the site-specific H&S plans, when required, with review and
approval from the Safety Director; and
•Suspends work activities when safety is a concern.
Employee Safety Responsibility
All employees are responsible for their own safety as well as the safety of those around them.
All employees shall use any equipment provided in a safe and responsible manner, as directed by
his supervisor. All project personnel will follow the policies set forth in the HASP.
Employees are directed to take the following actions when appropriate:
•Suspend any operations which may cause an imminent health hazard to employees,
subcontractors, or others.
•Correct jobsite hazards when possible to do so, without endangering life or health.
•Report all incidents, unsafe conditions, or other safety and health concerns to the Site
Supervisor.
Equipment Operators
All equipment operators are responsible for the safe operation of heavy equipment. Operators
are responsible for inspecting their equipment to ensure safe performance. Brakes, hydraulic
lines, and backup alarms must be inspected during site mobilization. Equipment will be taken
out of service if an unsafe condition occurs.
1.4 Training Requirements
All project personnel conducting work at this site shall have completed at least TBI’s health and
safety training and confined space training, as required by the client.
In addition, all equipment operators shall provide photo copies of required licenses and current
training certificates. For confined space the SS or PM shall have received an additional 4 hours
of supervisory confined space training. All site employees shall receive client site training
before entering the work area.
1.4.1 Site-Specific Training
An initial site-specific training session or briefing shall be conducted by the SS prior to
commencement of work and/or entering the site. During this initial training session, employees
shall be instructed on the following topics:
•Personnel responsibilities
•Content and implementation of the HASP
•Site hazards and controls
•Site-specific hazardous procedures (i.e., work activities, etc.)
•Medical and training requirements
•Use of direct reading monitoring equipment
•Levels of protection
•Action levels for upgrading/downgrading levels of PPE
•Emergency information, including local emergency response team phone numbers,
route to nearest hospital, and emergency response procedures
•Instruction in the completion of required forms
In addition to the initial site briefing conducted at the commencement of the project,
supplemental brief safety meetings shall be conducted by the SS to discuss potential health and
safety hazards associated with upcoming tasks, and necessary precautions to be taken.
Client safety requirements not specifically address by T BAILEY in this HASP shall comply
with the client’s safety policy.
Subcontractors and Visitors
Subcontractors and authorized visitors will be provided with all known information with respect
to the site operations and hazards covered in this plan.
1.4.2 Records
OSHA-required records, including the OSHA 300 log, medical surveillance records and training
documentation, are maintained at TBI’s corporate office in Anacortes, WA.
2 SITE INFORMATION
2.1 Site Information
The job site is located at:
3 SCOPE OF WORK
This Health and Safety plan covers work done by T Bailey, Inc. employees for:
4 HAZARD EVALUATION
This section identifies and evaluates the potential chemical, physical, and biological hazards
which may be encountered during all field-related activities.
4.1 Chemical Hazards
The possible hazards found on this site may occur at any time during work activities. The routes
of exposure from these contaminants are primarily through inhalation of organic vapors and
dusts, and by direct contact with contaminated media.
The potential hazards of concern (HOCs) at excavation sites include components of gas and oil
vapors and liquid chemicals. These hazards may include methane, hydrogen sulfide, and other
organic vapors due to the presence of natural organic decay or petroleum distillates and
hydrocarbons.
A summary of the potential contaminant properties and their associated exposure limits
and symptoms of exposure is included below. An inventory of hazardous materials and Safety
Data Sheets (SDS) can be found in Appendix C.
Carbon Monoxide
Carbon Monoxide, chemical compound of carbon and oxygen with the formula CO. It is a
colorless, odorless gas, about 3 percent lighter than air, and is poisonous to all warm-blooded
animals and to many other forms of life. When inhaled it combines with hemoglobin in the
blood, preventing absorption of oxygen and resulting in asphyxiation. Red blood cells pick up
CO quicker than they pick up oxygen. If there is a lot of CO in the air, your body may replace
oxygen in your blood with CO. This can damage tissues in your body, and it can kill you.
Knowing where CO is found and how to avoid it can protect you from serious injury or death.
Carbon monoxide is formed whenever carbon or substances containing carbon are burned with
an insufficient air supply. Even when the amount of air is theoretically sufficient, the reaction is
not always complete, so that the combustion gases contain some free oxygen and some carbon
monoxide.
An incomplete reaction is especially probable when it takes place quickly, as in an automobile
engine; for this reason, automobile-exhaust gases contain harmful quantities of carbon
monoxide, sometimes several percent, although antipollution devices are intended to keep the
level below 1 percent. As little as 1/1000 of 1 percent of carbon monoxide in air may produce
symptoms of poisoning, and as little as 1/2 of 1 percent may prove fatal in less than 30 min.
Carbon monoxide is a major ingredient of the air pollution in urban areas.
Because it is odorless, carbon monoxide is an insidious poison. The initial symptoms of CO
poisoning are similar to the flu (but without the fever). They include:
Headache
Fatigue
Shortness of breath
Nausea
Dizziness
Many people with CO poisoning mistake their symptoms for the flu or are misdiagnosed by
physicians, which sometimes results in unconsciousness then into a tragic death.
Do not use gasoline-powered tools and engines indoors. If use is unavoidable, ensure that
adequate ventilation is available and place engine unit outdoors.
If you think you are experiencing any of the symptoms of CO poisoning, get fresh air
immediately. It is also important to contact a doctor immediately for a proper diagnosis. Tell
your supervisor that you suspect CO poisoning is causing your problems. Prompt medical
attention is important if you are experiencing any symptoms of CO poisoning when you are
operating fuel-burning appliances.
Many people using gasoline-powered tools such as high-pressure washers, concrete cutting saws
(walk-behind/hand-held), power trowels, floor buffers, welders, pumps, compressors, and
generators in buildings or semi-enclosed spaces have been poisoned by carbon monoxide (CO).
CO can rapidly accumulate (even in areas that appear to be well ventilated) and build up to
dangerous or fatal concentrations within minutes.
It is not widely known that small gasoline-powered engines and tools present a serious health
hazard. They produce high concentrations of CO. CO can overcome exposed persons without
warning. Often there is little time before they experience symptoms that inhibit their ability to
seek help.
Prior use of equipment without incident has sometimes given users a false sense of safety; such
users have been poisoned on subsequent occasions.
Recommendations for preventing CO poisoning are provided below:
All Employees and Equipment Users Should:
NOT use of or operate gasoline-powered engines or tools inside buildings or in partially enclosed
areas unless gasoline engine unit can be located outside and away from air intakes.
Learn to recognize the symptoms and signs of CO overexposure; headache, nausea, weakness,
dizziness, visual disturbances, changes in personality, and loss of consciousness. Any of these
symptoms and signs can occur within minutes of usage.
Always place the pump and power unit of high-pressure washers outdoors and away from air
intakes so that engine exhaust is not drawn indoors where the work is being done. Run only the
high pressure wash line inside.
Consider the use of tools powered by electricity or compressed air if they are available and can
be used safely. For example, electric-powered tools present an electrocution hazard and require
specific precautions for safety.
If compressed air is used, place the gasoline-powered compressor outdoors and away from air
intakes so that engine exhaust is not drawn indoors where the work is being done.
Use CO monitors where potential sources of CO exist. These monitors should be equipped with
audible alarms to warn workers when CO concentrations are too high.
Employer supervisor:
Conduct a workplace survey to identify all potential sources of CO exposure.
Educate workers about the sources and conditions that may result in CO poisoning as well as the
symptoms and control of CO exposure.
Always substitute less hazardous equipment if possible.
Use equipment that allows for the placement of gasoline-powered engines outdoors at a safe
distance from air entering the building.
Monitor employee CO exposure to determine the extent of the hazard.
Employees Should Also:
Substitute less hazardous equipment whenever possible. Use electric tools or tools with engines
that are separate from the tool and can be located outside and away from air intakes.
Learn to recognize the warning symptoms of CO poisoning.
If you have any symptoms, immediately turn off equipment and go outdoors or to a place with
uncontaminated air.
Tell your supervisor have them call 911 or another local emergency number for medical attention
or assistance if symptoms occur. Do NOT drive a motor vehicle -- get someone else to drive you
to a health care facility.
Stay away from the work area until the tool has been deactivated and measured CO
concentrations are below accepted guidelines and standards.
Watch coworkers for the signs of CO toxicity.
Methane
Pure methane is a colorless and odorless gas. It has practically no toxic effects below the
flammable limits. While methane has no noticeable toxic effects, high concentrations can
displace oxygen and serve as a simple asphyxiant.
OSHA does not regulate exposure to methane by a specific standard. However, methane is a
flammable gas and must be controlled at least 20 percent below its lower explosive limit (LEL).
Hydrogen Sulfide
Hydrogen sulfide is a colorless, toxic gas that is identified by the offensive odor of rotten eggs.
It is heavier than air, flammable, and is generally a component of landfill gas. Hydrogen sulfide
can cause irritation of eyes, nose and throat, beginning at approximately 10 ppm. Long-term
exposure (30 minutes or longer) to high concentrations can cause drowsiness, staggering, and
nausea which can lead to death, due to respiratory system failure.
The odor of hydrogen sulfide can be detected at approximately 0.03 ppm and become offensive
at 3 ppm, and causes irritation at 10 ppm. An especially dangerous situation is brief exposure to
concentrations of 50 ppm, which can cause a person to lose the sense of smell. This has been
described in accident reports as “I first smelled hydrogen sulfide, then it went away.” This is
called olfactory fatigue. The toxic effect of hydrogen sulfide paralyzes the respiratory control
center, which leads to suffocation and then death.
Hydrogen sulfide has a wide flammable range (LEL 4.0%, UEL 44.0 %). This property, coupled
with its heavier-than-air density, makes it a hazard in trenches and low-lying areas.
Hydrogen sulfide is regulated by OSHA on a 20 ppm ceiling concentration. A ceiling
concentration means that this level cannot be exceeded during any part of the work period.
OSHA has also established a Permissible Exposure Limit (PEL) concentration at 10 ppm, and an
Immediately Dangerous to Life or Health (IDLH) concentration of 100 ppm.
Employees are directed to shut down ignition sources and leave the area if hydrogen sulfide is
detected above 10 ppm. Generally, natural cross-ventilation will reduce hydrogen sulfide to
acceptable levels. Re-entry and continuation of work may be done only under controlled
conditions involving monitoring equipment and in supplied air respirators if levels exceed, or are
likely to exceed, 10 ppm.
Organic Solvents
Organic solvents constitute a chemically diverse group of liquids characterized by their ability to
dissolve oils, fats, resins, rubber, and plastics. Solvents may be divided into a number of
categories based on their chemical structures. Most solvents produce irritant effects on the
mucous membranes of the eyes, nose, and throat. In general aromatic solvents are more potent
irritants than aliphatic solvents. Heavy exposures are commonly associated with cough, chest
tightness, and feeling of breathlessness. At very high exposures, a number of common solvents,
such as toluene, xylene, and methylene chloride, can induce pulmonary edema or chemical
pneumonitis. Short-term high exposures to organic solvents produce narcotic effects. Acute
symptoms include headache, dizziness, confusion, a feeling of drunkenness, and if the exposure
continues, unconsciousness and death. Acute symptoms are reversible after the discontinuation
of exposure but may increase the sensitivity to future exposures. Studies involving chronic
exposure to organic solvents have discovered a number of central nervous system effects.
Chronic exposure symptoms include memory problems, concentration difficulties, affective
changes (such as aggressiveness and depression), fatigue, vertigo, decreased libido, sleeping
problems, and vegetative symptoms (such as palpitations and increased sweating). At least
several years of exposure seem to be required for the symptoms to become chronic, even in
heavily exposed occupations. Dermal contact should be avoided since solvents have a defatting
action on the skin. Alcohols are claimed to be less irritating than the aldehydes or ketones. The
potential to cause irritation decreases as the molecular size increases. The alcohols act as drying
agents and provide irritant contact dermatitis. Ketones are mild skin irritants. Esters are, in
general, more potent skin irritants than the corresponding alcohols. Specific organic solvents
have their own exposure limits. For example, toluene has an OR-OSHA PEL of 100 ppm, with a
ceiling concentration of 300 ppm. When the types of solvents are unknown, it is common to
refer to the exposure limits developed for petroleum distillates (naphtha, Rubber Solvent), which
have an OR-OSHA PEL of 500 ppm (2000 mg/m3). The NIOSH REL for petroleum distillates is
350 mg/m3 (87.5 ppm) , with a 15-min ceiling limit of 1800 mg/m3 (450 ppm). NIOSH also
publishes an IDLH value of 1100 ppm, based on the 10% LEL of petroleum distillates.
Hexavalent Chromium Cr6
Hexavalent chromium or Cr(VI) compounds are those which contain the element chromium in
the +6 oxidation state. They are used for stainless steel production, as anti-corrosion and as
corrosion inhibitors. Hexavalent chromium is recognized as a human carcinogen via inhalation.
Workers in metal working occupations are exposed to hexavalent chromium. Occupational
exposures occur mainly among workers who:
•weld, cut or grind chromium-containing metals such as stainless steel.
Permissible Exposure Limit (PEL or OSHA PEL)
The OSHA PEL for Hexavalent Chromium is 5 µg/m3 (0.005 mg/m3).
Health Effects
Workers who breathe hexavalent chromium compounds at their jobs for many years may be at
increased risk of developing lung cancer. Breathing high levels of hexavalent chromium can
irritate or damage the nose, throat, and lungs. Irritation or damage to the eyes and skin can occur
if hexavalent chromium contacts these organs in high concentrations or for a prolonged period of
time.
How hexavalent chromium affects the nose, throat and lungs
Breathing in high levels of hexavalent chromium can cause irritation to the nose and throat.
Symptoms may include runny nose, sneezing, coughing, itching and a burning sensation.
Repeated or prolonged exposure can cause sores to develop in the nose and result in nosebleeds.
If the damage is severe, the nasal septum (wall separating the nasal passages) develops a hole in
it (perforation).
Breathing small amounts of hexavalent chromium even for long periods does not cause
respiratory tract irritation in most people. Some employees become allergic to hexavalent
chromium so that inhaling chromate compounds can cause asthma symptoms such as wheezing
and shortness of breath.
How hexavalent chromium affects the skin
Some employees can also develop an allergic skin reaction, called allergic contact dermatitis.
This occurs from handling liquids or solids containing hexavalent chromium. Once an employee
becomes allergic, brief skin contact causes swelling and a red, itchy rash that becomes crusty and
thickened with prolonged exposure. Allergic contact dermatitis is long-lasting and more severe
with repeated skin contact. Direct skin contact with hexavalent chromium can cause a non-
allergic skin irritation. Contact with non-intact skin can also lead to chrome ulcers. These are
small crusted skin sores with a rounded border. They heal slowly and leave scars.
How employees can be exposed to hexavalent chromium
Employees can inhale airborne hexavalent chromium as a dust, fume or mist while:
• producing chromate pigments and powders; chromic acid; chromium catalysts, dyes, and
coatings
•working near chrome electroplating
• welding and hot working stainless steel, high chrome alloys and chrome-coated metal
• applying and removing chromate-containing paints and other surface coatings.
Skin exposure can occur during direct handling of hexavalent chromium-containing solutions,
coatings, and cements.
4.1.1 Chemical Hazard Controls
Exposure to gas vapors and chemicals shall be controlled by:
•Monitoring air concentrations for atmosphere gas components shall be conducted in the
breathing zone with an O 2 /LEL/CO/H 2 S meter. Hot work on Stainless Steel (Cr6) air
monitoring shall be done from the beginning of the hot work process with sufficient
samples to determine the need for continued and additional required progressive safety
and health procedures.
•Using respiratory protection as appropriate, in areas known to have concentrations
above the specified action level for each containment. All hot work on Stainless Steel
requires a minimum of a half face respirator with P-100 Hepa filters. Additional
requirement maybe implemented after initial air monitoring is complete.
•Engineering controls, such as working up wind from exposure sources, the use of
portable blowers to reduce breathing zone concentrations, or wetting of soils to
minimize dust production, shall be employed prior to using respiratory protection
devices. Hot work on Stainless Steel requires a minimum of a Half Face respirator with
a P-100 Hepa Filter.
Monitoring can reduce risks by indicating when action levels have been exceeded, and personal
protective equipment must be upgraded. Action levels are located in Table 7-1 of this Plan.
4.1.2 Skin Contact and Absorption
Skin contact with contaminants may be controlled by use of the proper personnel equipment
(PPE) and good housekeeping procedures. The proper PPE (e.g., Tyvek, gloves) as described in
Section 6, shall be worn for all activities where contact with potentially contaminated media or
materials are expected.
4.1.3 Steps to protect employees from health hazards caused by hexavalent chromium
The new OSHA workplace standard requires employers to:
•limit eight-hour time-weighted average hexavalent chromium exposure in the workplace
to 5 micrograms or less per cubic meter of air.
•perform periodic monitoring at least every 6 months if initial monitoring shows employee
exposure at or above the action level (2.5 micrograms per cubic meter of air calculated as
an 8-hour time-weighted average).
•provide appropriate personal protective clothing and equipment when there is likely to be
a hazard present from skin or eye contact.
•implement good personal hygiene and housekeeping practices to prevent hexavalent
chromium exposure.
•prohibit employee rotation as a method to achieve compliance with the exposure limit
(PEL).
•provide respiratory protection as specified in the standard.
•make available medical examinations to employees within 30 days of initial assignment,
annually, to those exposed in an emergency situation, to those who experience signs or
symptoms of adverse health effects associated with hexavalent chromium exposure, to
those who are or may be exposed at or above the action level for 30 or more days a year,
and at termination of employment.
Local Exhaust
Ventilation (LEV)
or Respiratory
Protection (RP)
not necessary
LEV or RP may
be necessary
LEV or RP may
be necessary
LEV and/or RP
may be neces-
sary
LEV or RP may
be necessary
LEV and/or RP
required
LEV and/or RP
required
LEV and/or RP
required
LEV and/or RP
required
GTAW
(TIG)
GMAW
(MIG)
FCAW
(Flux Core)
SMAW
(Stick)
CAC/PAC
(Carbon arc
cutting, plasma
arc cutting)
Outdoor
Open
Restricted
Confined
WORK
SPACE
PROCESS
Exposure Assessment Tool for Stainless Steel Welders
HexChEC: Hexavalent Chromium E xposure C ontrol
This exposure assessment tool is only a guideline and is not to be solely relied upon for regulatory compliance purposes
Funding and support for this project have been provided by the Washington State Department of Labor & Industries’ Safety & Health Investment Projects.
LEV and RP
required
LEV or RP
may be
necessary
Natural or
general
ventilation
is adequate
Chrome 6 exposure increases
Chrome 6 exposure increasesSAW
(Sub Arc)
+
+
Local Exhaust
Ventilation = LEV
Respiratory
Protection = RP
Field ReseaRch and consultation GRoup
department of environmental and occupational health sciences
school of public health
4.1.4 OSHA's Globally Harmonized System of Hazardous Chemical Identification (GHS)
In accordance with OSHA’s globally harmonized system of hazardous chemical identification, a list of
products used at this site and their safety data sheets are provided in Appendix C. The following
document details the format and information provided in a standardized manner within each Safety Data
Sheet (SDS) and on chemical labels. Pictograms are also used in this system to quickly identify the
nature of a hazard in a consistent and visual format. A list of the pictograms and their associated hazards
are also provided below.
Labels
•Product identifier gives a name or number that enables you to identify
the chemical and cross-reference the label to the SDS.
•Supplier information tells you the name, address, and phone number
of the manufacturer, importer, or other responsible party.
•First aid information can help you act quickly and effectively in an
emergency.
•In case of fire, the label tells you how to extinguish it.
•Signal word indicates the severity of the hazard.
•Hazard statements describe the nature of the hazards.
•Pictograms convey specific hazard information using symbols or
graphics.
•Precautionary statements describe recommended measures to
minimize or prevent injury or illness due to exposure to the chemical or
fromimproper handling or storage.
Globally Harmonized System
Of Hazardous Chemical Identification
Safety Data Sheets
•Section 1—Identification—includes product identifier, manufacturer
or distributor name, address, phone number, emergency phone
number, recommended use, and restrictions on use
•Section 2—Hazard(s) identification—includes all hazards regarding
the chemical and required label elements
•Section 3—Composition/Information on ingredients—includes
information on chemical ingredients and trade secret claims
•Section 4—First-aid measures—includes important immediate or
delayed symptoms of exposure to a chemical and the required first aid
treatment
•Section 5—Fire-fighting measures—lists suitable extinguishing
techniques, equipment, and chemical hazards from fire
•Section 6—Accidental release measures—lists emergency
procedures, protective equipment, and proper methods of containment
and cleanup
•Section 7—Handling and storage—lists precautions for safe
handling and storage, including incompatibilities
•Section 8—Exposure controls/Personal protection—lists OSHA's
permissible exposure limits (PELs), threshold limit values (TLVs),
appropriate engineering controls, and personal protective equipment
(PPE)
•Section 9—Physical and chemical properties—lists the chemical’s
characteristics
•Section 10—Stability and reactivity—lists chemical stability and
possible hazardous reactions
•Section 11—Toxicological information—includes routes of
exposure (inhalation, ingestion, or absorption contact), symptoms,
acute and chronic effects, and numerical measures of toxicity
•Section 12—Ecological information—how the chemical might affect
the environment and the duration of the effect
•Section 13—Disposal considerations—describes safe handling of
wastes and methods of disposal, including the disposal of any
contaminated packaging
•Section 14—Transportation information—includes packing,
marking, and labeling requirements for hazardous chemical shipments
•Section 15—Regulatory information—indicates regulations that
apply to chemical
•Section 16—Other information—includes date of preparation or last
revision
utilities, slip/trip/hit/fall injuries, heat or cold stress, and other potential adverse weather
conditions. In addition, personnel must be aware that the protective equipment worn may limit
dexterity, visibility and may increase the difficulty of performing some tasks.
4.2.1 Heavy Equipment
Heavy equipment that will potentially be utilized at the site includes cranes, backhoes, and
trucks. (Ref. TBI policies HS820 & HS822)
The following practices shall be followed when using heavy equipment:
•Equipment shall be inspected daily by the operator to ensure there are no operational
problems. Complete operator’s daily report.
•When not in use, hydraulic and pneumatic components shall be left in down or "dead"
position. The “dead” position can include mechanically blocked / supported load. (zero
pressure in hydraulic/pneumatic system)
•Roll-over protection shall be provided on all sites.
•No riding on vehicles or equipment except in fixed seats. Seat belts shall be worn.
•Foot traffic shall be restricted while heavy equipment is in operation. Workers
remaining around any heavy equipment shall be kept to a minimum.
•Operators are responsible for knowing the location and communicating with ground
personnel working in the area of the equipment.
•Ground personnel are responsible for being visible to and communicating with
equipment operators working in the area.
4.2.2 Utility Clearances
•Elevated superstructures (e.g., drill rigs, cranes) shall remain a distance of 10 feet away
from utility lines and 20 feet away from power lines.
•Prior to all intrusive activities (e.g., excavating), locator line services will be contacted
to mark underground lines.
•Personnel involved in intrusive work shall determine the minimum distance from
marked utilities which work can be conducted with the assistance of the Local Agency.
•Ref. TBI policy HS308
4.2 Physical Hazards
Physical hazards that may be present during these site activities include potential for close
proximity to heavy equipment; excavator, backhoe, dozer and haul truck activities, noise,
4.2.3 Heavy Lifting
When lifting objects, use the following proper lifting techniques:
•Keep your feet shoulder width apart to get the best footing possible.
•Bend at the knees, not at the waist.
•Tighten stomach muscles to offset the force of the load.
•Grasp the object at opposite corners.
•Lift with the legs instead of the back muscles.
•Keep the back upright and avoid twisting.
•Most importantly, think before lifting.
•Maximum weight is 70 lbs. Two persons shall handle all awkward or large items
regardless of the weight.
4.2.4 Electrical Hazards
No employee shall be permitted to work on any part of an electrical power circuit unless the
person is protected against electric shock by de-energizing the circuit and grounding it, or has
been locked and tagged out:
•All electrical wiring and equipment shall be intrinsically safe for use in potentially
explosive environments and atmospheres.
•All electrical wiring and equipment shall be a type listed by Underwriters’ Laboratories
(UL) or Factory Mutual (FM) for the specific application.
•All installations shall comply with the National Electric Code (NEC) and the National
Electric Safety Code (NESC).
•All electrical circuits shall be grounded according to NEC and NESC Code. Ground
fault circuit interrupters shall be used in the absence of properly grounded circuitry or
when portable tools must be used around wet areas.
•All live wiring or equipment shall be guarded to protect all persons or objects from
harm.
•No work will be permitted during any type of electrical storm.
•Ref. TBI policy HS315
4.2.5 Adverse Weather Conditions
The SS shall decide on the continuation or discontinuation of work based on current and pending
weather conditions. Electrical storms and strong winds are examples of conditions that would
call for the discontinuation of work and evacuation of site.
4.2.6 Slip/Trip/Hit/Fall
Slip/trip/hit/fall (S/T/H/F) injuries are the most frequent of all injuries to workers. They occur
for a wide variety of reasons, but can be minimized by the following prudent practices:
•Spot check the work area to identify hazards.
•Establish and utilize a pathway which is most free of slip and trip hazards.
•Beware of trip hazards such as wet floors, slippery floors, slopped and uneven surfaces
or terrain.
•Carry only loads which you can see over.
•Keep work areas clean and free of clutter, especially in storage rooms and walkways.
•Communicate hazards to on-site personnel.
•Secure all loose clothing, ties, and remove jewelry while around machinery.
•Report and/or remove hazards.
•Keeps a safe buffer zone between workers using equipment and tools.
4.2.7 Heat Stress
Training for this section must be completed at the beginning of this project or by
the first of May 1st each year when the project started before May 1st
Outdoor Temperature Action Levels
Requirements of this section apply from May 1 through September 30 and any other time the
outdoor temperature reaches the action levels in Table 5-3
Recognition and Symptoms
Heat-related illness cause physical discomfort, loss of efficiency and attention to safety and
personal injury. Age, weight, degree of physical fitness, degree of acclimatization, metabolism,
use of alcohol or drugs and a variety of medical conditions such as hypertension all affect a
person’s sensitivity to heat. The older workers are at higher risk because of impaired cardiac
output and decreased ability to sweat. Even the type of clothing worn must be considered. Prior
heat injury predisposes an individual to additional injury.
(Ref. TBI policy HS400) See Table 5-1 Heat Index Guide
The fluid loss and dehydration resulting from physical activity puts outdoor laborers at particular
risk. Certain medications predispose individuals to heat stress, such as drugs that alter sweat
production (antihistamines, anti-psychotics, antidepressants) or interfere with the body’s ability
to regulate temperature. Persons with heart or circulatory diseases or those who are on “low
salt” diets should consult with their physicians prior to working in hot environments.
It is difficult to predict just who will be affected and when, because individual susceptibility
varies. In addition, environmental factors include more than the ambient air temperature.
Radiant heat, air movement, conduction, and relative humidity all affect an individual’s response
to heat.
Heat Rash
Heat rash can be caused by continuous exposure to hot and humid air and skin abrasion
from sweat soaked clothing.
Signs and Symptoms: The condition is characterized by a localized red skin rash and
reduced sweating. Aside from being a nuisance, the ability to tolerate heat is reduced.
Treatment: Keep skin hygienically clean and allow it to dry thoroughly after using chemical
protective clothing.
Heat Cramps
Heat cramps are caused by profuse perspiration with inadequate electrolytic fluid
replacement. This often robs the larger muscle groups (stomach and quadriceps) of blood
which can cause painful muscle spasms and pain.
Signs and Symptoms: Muscle spasms and pain in the extremities and abdomen.
Treatment: Remove employee to a cool place and give sips of water or an electrolytic
drink. Watch for signs of heat exhaustion or stroke.
Heat Exhaustion
Heat exhaustion is a mild form of shock caused by increased stress on various organs to
meet increased demand to cool the body. Onset is gradual and symptoms should subside
within one hour.
Signs and Symptoms: Weak pulse; shallow breathing; pale, cool, moist skin; profuse
sweating; dizziness; fatigue.
Treatment: Remove employee to a cool place and remove as much clothing as possible.
Give sips of water or electrolytic solution and fan the person continually to remove heat by
convection. CAUTION: Do not allow the affected person to become chilled treat for
shock if necessary.
Heat Stroke
Heat stroke is the most severe form of heat stress; the body must be cooled immediately to
prevent severe injury and/or death. THIS IS A MEDICAL EMERGENCY!
Signs and Symptoms: Red, hot, dry skin (skin may be wet from previous perspiration
particularly when evaporation-preventing clothing is worn); body temperature of 105
degrees Fahrenheit (0F) or higher; no perspiration; nausea; dizziness and confusion;
strong, rapid pulse.
Treatment: Heat stroke is a true medical emergency. Transportation of the victim to a
medical facility must not be delayed. Prior to transport, remove as much clothing as
possible and wrap the victim in a sheet soaked with water. Fan vigorously while
transporting to help reduce body temperature. Apply cold packs, if available; place under
the arms, around the neck, or any other place where they can cool large surface blood
vessels. If transportation to a medical facility is delayed, reduce body temperature by
immersing victim in a cool water bath (however, be careful not to over-chill the victim
once body temperature is reduced below 102 0F). If this is not possible, keep victim
wrapped in a sheet and continuously douse with water and fan.
Prevention
The implementation of preventative measures is the most effective way to limit the effects of
heat-related illnesses. During periods of high heat, adequate liquids must be provided to
replace lost body fluids. When the temperature is above 80oF, supervisors shall:
Insure a minimum of one quart of drinking water is available for each employee per hour
and encourage workers to drink the quart of water over the hour. It is recommended to
drink a minimum of eight ounces every fifteen minutes. Replacement fluids can be a
commercial mix such as Gatorade, Sqwincher, etc. or a combination of these with fresh
water. The replacement fluid temperature should be kept cool, 500F to 600F, and should
be placed close to the work area. Employees must be encouraged to drink more than the
amount required to satisfy thirst. Employees should also be encouraged to salt their foods
during hot times of the year. Unless medically required to limit salt intake.
Provide shaded areas to work or allow workers to seek shade to cool and consume their
water. Cooling devices such as vortex tubes or cooling vests, head and or neck bands can be
worn beneath impermeable clothing. Use Appendix B Tables 5-2 to assist in setting up
rest breaks and work assignment schedules.
The supervisor must monitor new or newly assigned employees every thirty minutes
during the acclimatization period. All workers are to rest when any symptoms of heat
stress are noticed. Rest breaks are to be taken in a cool, shaded rest area. Employees shall
remove chemical protective, welding and other work related garments during rest periods
and must not be assigned other tasks.
All employees shall be informed of the importance of adequate rest and proper diet in the
prevention of heat stress and the adverse effects of excessive alcohol and caffeine
consumption. Supervisors need to know about prescription drugs and any adverse effects
the employee could suffer from direct sun light and/or hot work environment.
Monitoring
The initiation of heat stress monitoring will be required when employees are working in
environments exceeding 800F ambient air temperature. If employees are wearing
impermeable clothing, this monitoring will begin at 780F. There are two general types of
monitoring that the health and safety representative can designate to be used: wet bulb globe
temperature (WBGT) and physiological. Supervisors shall be tasked with monitoring
workers for physiological symptoms. Safety and Health will monitor program compliance.
Appendix A “Heat Stress Monitoring Record” will be used to record the results.
Monitor Atmospheric Conditions
The temperature and humidity can be obtained from the local weather service office or
maintain an instrument capable of providing real time temperature and humidity readings.
Log the readings on the form provided in attachment 3.
Wet Bulb Globe Temperature
The WBGT index is only mentioned as an alternative method for measurement of
environmental factors, which most nearly correlate with core body temperature and other
physiological responses to heat. When WBGT method is used, follow the procedures in
the latest edition of the American Conference of Governmental Industrial Hygiene
(ACGIH) Threshold Limit Value (TLV) Booklet section Heat Stress and Heat Strain.
Physiological
For this procedure, Physiological Monitoring is used. Once training is complete, the
employees can accomplish self-monitoring along with supervisor oversight. Since
individuals vary in their susceptibility to heat, this type of monitoring has its advantages.
Monitoring the two parameters at the beginning of each rest period are:
•Heart Rate - Each individual will count his/her radial (wrist) pulse as early as possible
during each rest period. If the heart rate of any individual exceeds 75 percent of their
calculated maximum heart rate (MHR = 180 - age) at the beginning of the rest period,
then the work cycle must be decreased by one-third. The rest period will remain the
same. An individual must not return to work until his/her sustained heart rate is below
75 percent of their calculated maximum heart rate.
•Temperature - Each individual will measure his/her oral temperature with a disposable
thermometer for one minute as early as possible in the first rest period. If the
temperature exceeds 99.60F at the beginning of the rest period, then the work cycle
must decrease by one-third. The rest period will remain the same.
An individual must not return to work if his/her temperature exceeds 100.40F
See Table 5-1 Heat Index Guide
If you think someone has heat related injury. Move the person to the shade, wipe
his/her skin with cool water, and loosen his/her clothes. Use a piece of cardboard or
other material to fan them. Call for medical aid.
4.2.8 Cold Stress
Recognition and Symptoms
Cold temperatures can also pose health hazards to site workers. Exposure to cold is classified
into two categories: local or general. Local injuries include frostnip, frostbite, chilblain and
trench foot. General injuries include hypothermia and blood vessel abnormalities (genetically or
chemically induced). Major factors contributing to cold injury are exposure to humidity and
high winds, contact with wetness or metal, inadequate clothing, age and general health.
Allergies, vascular disease, excessive smoking or drinking, and certain drugs and medicines are
physical conditions that can compound the effects of exposure to a cold environment. A cold
stress guidelines table is included at the end of this section for quick reference. (Ref. TBI policy
HS401)
SIGNS AND SYMPTOMS
Hypothermia. Hypothermia is a condition of reduced body temperature. Most cases develop in
air temperatures between 30-500 F, not taking wind-chill factor into consideration. Symptoms of
hypothermia include personality changes, reduced mental alertness, irrationality, and
uncontrollable shivering. The heartbeat slows and sometimes becomes irregular, weakening the
pulse and changing blood pressure. Changes in the body chemistry cause severe shaking or rigid
muscles, vague or slow speech, memory lapses, incoherence, and drowsiness. Cool skin, slow
irregular breathing, low blood pressure, apparent exhaustion, and fatigue after rest may precede
complete collapse.
As the core body temperature drops, the victim can become listless, confused, and make little or
no effort to keep warm. Pain in the extremities can be the first warning of dangerous exposures
to cold. At a core body temperature of about 850 F, serious problems develop due to significant
drops in blood pressure, pulse rate and respiration.
Sedative drugs and alcohol increase the risk of hypothermia. Sedative drugs interfere with the
transmission of impulses to the brain. Alcohol dilates blood vessels near the skin’s surface,
increasing heat loss and lowering body temperature.
First aid treatment includes removal of the victim to a warm and dry location, removal of cold
and damp clothing, wrapping the victim in warm blankets or clothing, and rewarming the victim
from the core, not from the extremities. Severe hypothermia must be treated by a medical
professional
Symptoms of frostbite include numbness and whitening of the skin. First aid treatment includes
warming with blankets, warm compresses, or lukewarm water. Severe frostbite must be treated
by a medical professional.
Raynaud’s Phenomenon. Raynaud’s Phenomenon is the abnormal constriction of the blood
vessels of the finger on exposure to cold temperatures, resulting in blanching of the fingertips.
Numbness, itching, tingling, or a burning sensation may occur during related attacks. The
disease is also associated with the use of vibrating hand tools in a condition sometimes called
White Finger Disease. Persistent cold sensitivity, ulceration, and amputations can occur in
severe cases.
Frostnip occurs when the face or extremities are exposed to a cold wind, causing the skin to turn
white.
Frostbite is the freezing of the body tissues due to exposure to extremely low temperatures,
resulting in damage to and loss of tissue. Frostbite occurs because of inadequate circulation or
insulation, resulting in freezing of fluids around the cells of the body tissues. Most vulnerable
parts of the body are the nose, cheeks, ears, fingers, and toes.
Frostbite can affect outer layers of skin or can include the tissues beneath. Damage can be
serious, with permanent loss of movement in the affected parts, scarring, necrotic tissue, and
amputation resulting. Skin and nails that slough off may grow back.
The freezing point of the skin is about 300 F. As wind velocity increases, heat loss is greater and
frostbite will set in more rapidly.
There are three degrees of frostbite. First degree is freezing without blistering and peeling;
second degree is freezing with blistering and peeling; and third degree is freezing with death of
skin tissues and possibly the deeper tissues.
The following are symptoms of frostbite:
•Skin changes color to white or grayish-yellow, progresses to reddish-violet, and finally
turn black as the tissue dies.
•Pain may be felt at first, but subsides.
•Blisters may appear.
•Affected part is cold and numb.
The first symptom of frostbite is usually an uncomfortable sensation of coldness, followed by
numbness. Tingling, stinging, cramping and aching feelings will follow. Frostbite of the outer
layer of the skin has a waxy or whitish look and is firm to the touch. Cases of deep frostbite
cause severe injury. The victim is often unaware of the frostbite until someone else observes
these symptoms. It is therefore important to use the “buddy system” when working in cold
environments, so that symptoms of overexposure can be monitored.
Cold stress guidelines are provided in Tables 5-4 & 5.
4.3 Natural and Biological Hazards
Vegetation is scarce on the Site, so animals will probably also be scarce. Natural hazards include
slip/trip/fall hazards due to uneven terrain, insects and spiders. Other natural hazards include
slip/trip/fall hazards due to uneven terrain. Employees who are known to be allergic to insect or
spider bites should make this fact known to the SS, and should seek medical attention
immediately if bitten. Workers with a known allergic reaction to insect bites must inform the SS
and maintain their own allergy kit.
Workers will minimize any contact with refinery products and wear appropriate personal
protective equipment. The minimum level of personal protection for working on this site is fire
retardant coveralls, safety boots, glasses and hard hat.
4.3.1 Blood Poisoning
Blood poisoning is a term used to indicate a large number of bacteria present in the circulating
blood. The most common symptom of blood poisoning is the reddening of skin which advances
towards the heart. For example, if the point of contact is the hand than a red line will appear at
the hand and extended up the arm.
Personnel protective equipment shall be worn to prevent direct contact with media which may be
contaminated with bacteria or viral agents.
Signs and symptoms include swelling, stiffness and tenderness in the affected area, fatigue, chills
and fever, pustules, and abscesses. If allowed to progress, the organisms may multiply and cause
an overwhelming infection and death.
4.4 Job Hazard Analysis
Activity Hazard Analysis (AHA)
Activity/Work Task: Overall Risk Assessment Code (RAC) (Use highest code) M
Project Location:Risk Assessment Code (RAC) Matrix
Contract Number:Severity Probability
Date Prepared:
Frequent Likely Occasional Seldom Unlikely
Prepared by:
Catastrophic E E H H M
Critical E H H M L
Reviewed by: Justin
Rawls, VP
Marginal H M M L L
Negligible M L L L L
Notes: (Field Notes, Review
Comments, etc.)
Step 1: Review each “Hazard” with identified safety “Controls” and determine RAC (See above)
“Probability” is the likelihood to cause an incident, near miss, or accident and
identified as: Frequent, Likely, Occasional, Seldom or Unlikely. RAC Chart
“Severity” is the outcome/degree if an incident, near miss, or accident did occur
and identified as: Catastrophic, Critical, Marginal, or Negligible
E = Extremely High
Risk
H = High Risk
Step 2: Identify the RAC (Probability/Severity) as E, H, M, or L for each
“Hazard” on AHA. Annotate the overall highest RAC at the top of AHA.
M = Moderate Risk
L = Low Risk
HAZARDOUS MATERIAL FIRST AID
Material: Health Hazard: First Aid: RAC
Welding Electrode Long term (chronic) over exposure to
fumes can lead to iron deposits in lungs;
exposure may cause calcification of the
bone. May cause skin rash. L
Gasoline Causes slight eye irritation, can cause
redness, edema or drying of the skin.
May cause dizziness or vomiting
Eyes - flush with cold water for 15 min.
After 15 min rinse Wash skin areas
with soap L
Diesel Fuel
Hydraulic Oil
Motor Oils
Propane
Minimally irritating to eyes, irritating to
skin, burns and blisters possible.
Inhalation of fumes can cause
drowsiness.
Remove to fresh air. Flush eyes with
cold water. After 15 min rinse Wash
exposed skin with soap and water. L
Antifreeze Causes slight eye irritation. May be
slightly irritating upon prolonged
contact.
Flush eyes with cold water. After 15
min rinse Wash exposed areas with
soap and water.
L
Acetylene Non-Toxic, can cause un-consciousness
and death if present in quantities to
reduce oxygen in air below 19%
Remove to fresh air; give artificial
respiration if breathing has stopped.
Obtain medical attention. L
Oxygen Non-toxic, liquid can cause burns
accelerates combustion
Treat as frostbite. Do not use to blow
off clothing or to cool off. L
Move worker of fresh air. Welding on
Stainless steel (Hexavalent Chromium)
and/or metal with high Manganese must
be Respirator trained and fit tested;
proper ventilation shall be used in PR
confined spaces.
HAZARDOUS MATERIAL STORAGE
Material: Method of Storage:
Diesel Fuel Store in OSHA approved and labeled containers with appropriate spill
protection. Store away from potential physical damage.
Gasoline, Propane Store in OSHA approved and labeled containers with appropriate spill
protection. Store away from sources of ignition and protected from
physical damage.
Hydraulic Oil, Motor Oils
Antifreeze / coolant
Acetylene
Store in original containers in a cool, dry area protected from physical
damage. Containers will be appropriately labeled.
Abrasive Wheels
Welding rod and Flux
Store in dry area protected from physical damage.
Safety Equipment Required Tools and Equipment Required Hazardous Materials
Safety Glasses
Hard Hats
Hearing Protection
Foot Protection
Hand Protection
Respiratory Protection
Full Body Harness/Lanyard
Railings
GFCI
Fire Extinguishers
Backup Alarms
Tool Guards
Hand Tools – Electric
Hand Tools - Manual
Air Operated Tools
Respirators
Welding/Cutting Equipment
Generator w/ distribution stand
Compressor
Crane
Trucks
Gasoline/Diesel
Motor Oils
Hydraulic Oil
Antifreeze
Oxygen
Acetylene
Propane
Welding Electrodes
(See On Site SDS for all
Hazardous Materials on Site)
Activity Hazard Analysis
Activity Potential Hazards Precautionary Action & Control to be Taken RAC
1. Any operations in
the operations area.
1A. General jobsite
hazards
1A1.Work permits may be required by the client.
1A2.All employees will be given orientation
including specific task safety guidelines.
1A3.All employees and visitors must wear hard hats,
eye protection, hearing protection (where required),
high visibility vests, and leather safety toe footwear.
1A4. Operations areas must be cordoned off with
caution tape, to reduce the opportunity of
unauthorized persons walking into a hazardous work
zone.
1A5. Employees performing, or in the vicinity of,
welding or operations of portable electrical
equipment may work within the operations area
without a high visibility vest. The vest is mandatory
PPE outside the operations area.
L
L
L
L
M
2.Hoisting
Operations
Mobile Crane
2A. Operator
Certification
2B. Inspections
2C. Rigging & Signaling
personnel
2D. Upsetting Crane
2E. Breaking of boom or
cable
2F. Collisions with
moving crane
2G. Contact with
overhead power
2H Critical Lifts
2A. Required NCCCO Certified - High visibility
vest
2B. Operator complete daily crane inspection
2C. Requires union or state certification - High
visibility vest
2D. All lifting will be kept within the allowable
limits of the crane. (Manufacture’s specifications)
2E. Daily inspections of both the cables and the
booms will be made to check for excessive wear or
minor breaks and frays. Repairs will be made as
necessary.
2F. Crane will travel at slow speeds while in motion.
Maintenance checks will be made daily to assure
that the horn and other safety equipment are
operational.
2G. Locate overhead utilities prior to crane use,
relocate or shut down power or keep proper distance
of 20’ away from lines. Proper training of operator
and rigger is required.
2H. Critical lifts are over 85% of crane capacity or
15,000 pounds the lift must have a written plan and
personnel review prior to commencing the lift. See
Section 15 of this plan
L
L
L
L
L
L
L
L
Activity Potential Hazards Precautionary Action & Control to be Taken RAC
2.Hoisting
Operations
Mobile Crane
2I.Winds loads
2J. Lightning
2I. Winds at 20 miles per hour and above all tank
ring steel crane operations shall stop. 30 mph all
crane ops stop
2J. Forecast lightning within a 10 mile radius all
crane operations Supervisors shall maintain a visual
watch on the weather. Lightning within 3 mile radius
all tank work shall stop.
M
L
3 Rigging 3. Rigging equipment 3. Visually inspect all rigging equipment and slings
used for lifting, daily and before each use by
certified rigger. Any damaged or broken equipment
or slings must be removed from service.
Riggers/Signalman shall be Certified and follow the
crane operator’s direction and maintain direct
contact at all times.
L
4 Hand tools 4A. Portable electrical
equipment
4B. Manual tools and
equipment.
4A1. All portable electrical tools must have three
wire plugs or be double insolated. Electrical
equipment will be inspected prior to arrival on the
project and prior to use thereafter. The inspection
will include, as a minimum, inspection of the leads
for tight connection, lines for damage to insulation,
connections ground pin on three wire system. When
in use they shall be connected to a GFCI through
Assured Grounding cords. All non-usable tools shall
be tagged and turned in for replacement.
4A2. Remove high visibility vests when operating
power hand tools that can catch loose clothing
(grinders, drills, etc.).
4B. Tools and equipment will be inspected prior to
arrival on the project and prior to use thereafter.
The inspection will include, as a minimum. Inspect
of bent, misshapen, mushroom edges, cracks, and
loose connections. All non-usable tools or
equipment shall be tagged and turned in for
replacement.
L
L
L
Activity Potential Hazards Precautionary Action & Control to be Taken RAC
5 Temperature Extremes
Hot Weather
5. Heat Stress 5. Increase water intake, step-up rest breaks.
Follow OSHA Heat Index Guide. See Section
4.2.7 of this HASP
L
6 General Construction 6A. Personal cuts &
injuries
6B. Fire
6C. Falls
6D.Puncture Wounds
6E.Head Injuries
6A. Maintain a clean and orderly work area at all
times. Ensure that saw guards and other safety
shields and protection are in place on all small
power tools.
6B. Provide easy access to 10 lb. extinguishers.
6C. Provide guardrails on all scaffolding over 4
feet. 100% Tie off when climbing on ladders
above guardrail height
6D. Provide padding or guards on rebar ends.
Maintain first aid kits in close proximity to the
work area.
6E. Wear hard-hats.
L
L
L
L
L
7 Welding, Structural
Welding, Gas flame
cutting, Portable
Grinders w/grinding
wheel, wire wheel and
sanding disks for work
on any fabricating
material that can cause
sparks, chips, dust
and/or flying debris.
Tanks, Casing, Wind
Towers and
appurtenance.
Note:
These phases have
similar activities and
hazards, so are
considered together
7. Fire or Explosion 7. All Hot Work requires a permit.
7A. Prior to any welding or cutting, an area within
a 100' radius of the site of the work will be
surveyed for potential sources of explosive or
flammable material. Any such material will be
removed or screened, including removal of high
visibility vests working in the immediate vicinity
of welding activity.
7A1. Fire watch is required for all hot work and
continue 30 minutes after hot work is complete.
Firewatchers must review the work area whenever
welding or cutting is performed in locations where
Class A combustibles are part of the general
construction and cannot be removed from the
work area. All other combustibles and flammable
materials must be removed from the area.
L
M
M
Cold Weather Cold Stress Warm fluids & rest breaks. Insulated clothing as
required.
Weather information may be obtained from
By calling local weather stations.
Activity Potential Hazards Precautionary Action & Control to be Taken RAC
7 Welding, Structural
Welding, Tanks
(Continued)
Note:
These phases have
similar activities and
hazards, so are
considered together.
Painted or unpainted
uneven or sloped
walking and working
surface
7. Fire or Explosion
(Continued)
7B. Flash or eye &
skin injuries
7C. Employee falls
7D. Wet surface
7A2. All personnel will be trained in fire
extinguisher use, and will be instructed as to the
means and methods of reporting an emergency
most efficiently for each work area.
7A3. Gas cutting equipment will be inspected
prior to being brought to the project and prior to
use thereafter. The inspection will include, as a
minimum, inspection of hoses and fittings for
leaks, wear spots, or burn spots, regulators for
proper diaphragm operation, cutting heads and
valves for proper sealing, and to ensure that back
flow valves are in place at the cutting head and
diaphragm end of each valve.
7A4. Portable welding and electrical equipment
will be inspected prior to arrival on the project and
prior to use thereafter. The inspection will include,
as a minimum, inspection of welding leads for
tight connection, inspection of lines for damage to
insulation, inspection of connections of the
electrical equipment for tightness, inspection of
ground clamps and electrode holders for spring
tension and insulation.
7B. Welders, welder's helpers, and other personnel
in the area of work activity will be required to
wear eye protection at all times. Welders and
helpers are required to wear a welding hood for
welding or faceshield, when grinding, long cuff
welding gloves and clothing that covers arms and
body adequately to protect against burns from the
welding arc, splatter, slag chips, grinding, sanding
sparks, wire wheel debris and dust. Welding
screens when practical, must be used to separate
welding and non-welding work areas.
7C. Scaffolding and railings as well as harnesses
and lifelines will be provided to prevent falling
while working above the ground surface. All
employees working above scaffolding railing
shall attach fall protection above shoulder level.
Safety equipment must comply with Safety
Standards and company policies.
7D. Use of anti-skid paint surface, cleated surface
(chicken ladder), slip resistant shoe soles and
handrails, rope grab, ladder. Use any combination
of fall protection.
L
L
L
L
M
L
Activity Potential Hazards Precautionary Action & Control to be Taken RAC
7 Welding, Structural
Welding, Tanks
(Continued)
Note:
These Phases Have Similar
Activities And Hazards, So
Are Considered Together.
7E. Exposure to X-rays
7F. Shock & Burns
7G. Breathing Zone
Air Hazards
7E. Only certified laboratory technicians
experienced in this endeavor will accomplish non-
Destructive testing of welds. Hazard signage must
be posted. Unauthorized Personnel shall not be in
the area when testing is in progress.
7F. Utilize insulated gloves and grounded systems
to avoid shorts and shock. When electrical power
tools in wet or potentially wet locations GFCI’s
shall be used even with double insulated electrical
tools.
7G. Use engineering procedures to minimize
the breathing air hazards. Work in a well-
ventilated space or use fans or other equipment
designed to remove fumes and other breathing air
hazards from the point of operation caused by the
work task. If ventilation is inadequate personnel
must use respiratory protection designed to protect
from the breathing air hazard.
L
L
L
8 Arc Gouging
Note:
This phase has similar
activities to welding so
they are considered to be
together.
8. Fire & Explosion
8A.Potential Hearing Loss,
8B. Dust & Fume
exposure
8C. Electrical Shock
8D. Employee Falls
8E. Burns (Eyes & Skin)
8.Hot Work Permit May Be Required.
Prior to any arc gouging in a 100' radius of the site
of the work will be surveyed for potential sources
of explosive or flammable material. A fire watch
shall be required whenever arc gouging is
performed in areas where Class A combustibles
are part of the general construction and cannot be
removed from the work area. All other
combustibles and flammable materials must be
removed from the area.
8A.All personnel working within a 50’ radius of
the arc gouging process being performed shall
wear hearing protection.
8B. The use of local exhaust or a blower fan
should be used to minimize the breathing air
hazard. If ventilation is inadequate personnel must
use respiratory protection designed to protect from
the breathing air hazard while arc gouging.
8C. Employees that arc gouge shall wear dry
protective clothing.
8D. Scaffolding and railings as well as harnesses
and lanyards will be provided to prevent falling
while working above the ground surface.
8E. Employees shall wear correct personal
protective equipment (gloves, safety glasses,
welding hood, no frayed clothing, proper foot
wear, etc.)
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7H. Hexavalent
Chromium Exposure
7H. When performing hot work on stainless steel,
guidelines must be followed in accordance with
section 4.1.3.
Activity Potential Hazards Precautionary Action & control to be Taken RAC
8
Arc Gouging
(Continued)
Note:
This phase has similar
activities to welding so
they are considered to
be together
8F. Falling debris 8F. Signs shall be posted indicating
MEN WORKING ABOVE
To warn of danger of
Falling debris.
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9
Scaffolding
Note:
See Scaffold procedure
section 8 of this
manual.
9. Employee falls.
9A. Injury from falling
objects.
9. All scaffolding four foot above a lower
permanent level shall have standard railing with a
mid-rail.
9A. Employees who will erect and dismantle
staging when above the four-foot level shall wear
harnesses and lifelines.
9A1. Signs shall be posted in conspicuous areas
indicating:
MEN WORKING ABOVE
In addition a Competent person shall watch from
a safe distance to insure that no person
inadvertently walks under a scaffold erection or
dismantling operation.
9A2. Barricades should be used as a warning for
employees and personnel entering the construction
area that overhead work is in progress.
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10 Excavation & Hauling
This AHA is provided
for two reasons. When
T Bailey is engaged in
this task by contract or
it is used as a reminder
for company employees
when working in an
area when work done
by others and the
activity is in progress.
10. Open excavations
and back slopes
10A. Improper
equipment and safety
devices
10B. Loading of
vehicles
10C. Haul roads
10. Provide open excavations with proper warning
signs and devices
10A. Maintain backup alarms, operating lights,
and provide fire extinguishers for equipment.
Provide ground guide when needed.
10B. When vehicles are being loaded, personnel
should stay clear of operations.
10C. Post warning signs to alert vehicular traffic
to on-going construction.
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Activity Potential Hazards Precautionary Action & control to be Taken RAC
11 Hauling, Hoisting and
Form Erection
This AHA is provided
for two reasons. When
T Bailey is engaged in
this task by contract or
it is used as a
reminder for company
employees when
working in an area
when work done by
others and the activity
is in progress.
11. Faulty form work
11A. Littered work
areas
11B. Unstable
structural excavation
back-slopes
11C. Unstable wall-
forms
11D. Unstable man-
ways and poor footing
11E. Faulty power
saws and accessories
11F. Unguarded
electrical conductors
11G. Faulty bracing
11H. Falling materials
11. Insure form work can withstand the loads
which will be imposed
11A. Maintain cleanliness of work areas.
11B. Check back-slopes to assure stability,
Review with the competent person
11C. Guy and brace all forms to avoid
overturning
11D. Provide best possible walkways and grades.
Void of trip hazards and has edge fall protection
11E. Maintain guards on saws. Warn personnel
of hazards due to improper use of power tools.
11F. Inspect and maintain power cords. Replace
damaged electrical cords.
11G. Provide and maintain properly erected
braces
11H. Employ proper and adequate warning signs
to alert all personnel of such possible danger.
Clear the area immediately below an on-going
hoisting operation. Maintain clear viewing
access between operator and signal during all
hoisting.
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12 Trenching, Pipe-laying
and backfilling
This AHA is provided
for two reasons. When
T Bailey is engaged in
this task by contract or
it is used as a
reminder for company
employees when
working in an area
when work done by
others and the activity
is in progress.
12. Unsafe back slopes
at trenches
12A. Poor access to
open excavation
12B. Excavating and
backfilling equipment
not in safe operating
condition
12C. Loose rock
fragments or
consolidated earth
pieces adjacent to
occupied trenches
12D. Poor Visibility
12E. Open excavations
adjacent to stored
materials or
construction features
12. Excavate to safe angles of repose to avoid
cave-ins
12A. Provide ladders for all occupied open
excavations
12B. Maintain all equipment in safe operating
condition
12C. Remove loose fragments adjacent to
excavation before occupancy.
12D. Work only in conditions of adequate
lighting
12E. Avoid open excavations adjacent to existing
facilities or provide safe shoring. Insure
excavations are well marked or barricaded when
left open to preclude personnel injury.
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5 ACCIDENT PREVENTION
A vital element of the Site and Health and Safety program is the implementation of an accident
prevention program. An accident prevention program, as applicable to this site, includes the
following measures:
•Communicate the contents of this HASP to all personnel who work on the site.
•Educate personnel as to the requirements of the HASP.
•Eliminate unsafe conditions. Efforts must be initiated to identify conditions that can
contribute to an accident and to remove exposure to these conditions.
•Reduce unsafe acts. Personnel shall make a conscious efforts to work safely. A high
degree of safety awareness must be maintained so that safety factors involved in a task
become an integral part of the task.
•Inspect frequently. Regular safety inspections of the work site, materials, and
equipment by qualified persons ensures early detection of unsafe conditions. Safety and
health deficiencies shall be correct as soon as possible, or site activities shall be
suspended.
•The discovery of any condition that would suggest the existence of a situation more
hazardous than anticipated shall result in the evacuation of site personnel and
re-evaluation of the hazard and the level of protection.
5.1 Safe Work Practices
Field operations for this project shall be conducted in accordance with the minimum safety
practices described below required for all employees:
•Eating, drinking, chewing gum or tobacco, smoking, or any practice that increases the
probability of hand-to-mouth transfer and ingestion of materials is prohibited in any
area where the possibility of contamination exists.
•Hands must be thoroughly washed when leaving the work area or suspected
contaminated area before eating, drinking, or any other activities.
•Avoid activities which may cause dust. Removal of materials from protective clothing
or equipment by blowing, shaking, or any means which may disperse materials into the
air is prohibited.
•Personnel must use the “buddy system” when wearing any respiratory protective
devices for other than localized work. Communications between members must be
maintained at all times. Emergency communications shall be prearranged in case
unexpected situations arise. Visual contact must be maintained between pairs on site,
and team members should stay close enough to assist each other in the event of an
emergency.
•Personnel should be cautioned to inform each other of subjective symptoms of chemical
exposure such as headache, dizziness, nausea, and irritation of the respiratory tract.
•The selection, use, and maintenance of respiratory protective shall meet the
requirements of established TBI procedures HS601, recognized consensus standards
(AIHA, ANSI, NIOSH), and shall comply with the requirements set forth in 29 CFR
1910.134. Washington WAC 296-841 through 842
•Personnel are to be thoroughly briefed on the anticipated hazards, equipment
requirements, safety practices, emergency procedures, and communications methods,
both initially and in daily briefings.
•Company vehicles shall contain a type 10 pack first aid kit and multipurpose ABC
portable fire extinguisher.
•Subsurface work shall not be performed at any location until the area has been cleared
by a utility locator firm to be free of underground utilities or other obstructions.
Personnel are specifically prohibited from entering into excavations, trenches, or other confined
spaces deeper than 4 feet unless proper shoring, sloping or benching techniques are applied, and
air monitoring performed to access the potential for a hazardous atmosphere. Unattended
excavations/holes must be properly covered or protected.
5.2 Safety Meetings
The project supervisor or his/her designee conducts a safety meeting at the beginning of
each week or whenever work processes are changed and new employees arrive at the
work site. The topics discussed at the safety meeting should cover the work assignments
for the project, the expected hazard(s) presented by the work, and an explanation on how
employees will protect themselves from those hazards.
The meetings are to be documented by the completion of a Daily Walk Through and
Safety Meeting Form. The project supervisor will assure that the form is properly
completed and signed by all attendees. Completed forms must be maintained in the
project files on site.
See Appendix A for the Daily Walk Through and Safety Meeting Form
Safety Topics Ideas
1.Physical Hazards - Address physical hazards associated with the work site,
such as slipping/tripping/falling hazards, pinch points, overhead hazards,
and nearby operations that could pose a hazard.
2.Personal Protective Equipment - Specify levels of protective clothing and
protective devices to be used by employees for each of the week's activities.
3.New Equipment - Indicate proper work techniques and any hazards
associated with new or unfamiliar equipment.
4.Atmospheric Hazards - Specific to non-permit confined spaces caused by
work activity. (Hot work (welding, cutting, grinding, heating) equipment
exhaust, etc.)
5.Chemical Hazards - Specific chemical name and adverse properties of all
chemicals to be encountered on the job that day. A Safety Data Sheet (SDS)
for each must be available and discussed.
Other Safety Topic(s) - List any remaining safety topics pertinent to the
potential hazards of the job for that week. This is an area where different,
unique subjects can be introduced to make the safety meeting more interesting
6 PERSONAL PROTECTIVE EQUIPMENT
6.1 General
This section shall cover the applicable PPE requirements under the Personal Protective
Equipment Standards OSHA 29 CFR 1910.132-138 and Washington WAC 296-800-160, 296-
817 and 296-841 through -842 which include eye, face, head, foot, hearing and respiratory
protection.
The purpose of personal protective equipment (PPE) is to shield or isolate individuals from the
chemical and physical hazards that may be encountered during work activities. Full-faced
respirators protect lungs, gastrointestinal tract, and eyes against airborne contaminants.
Chemical and fire resistant clothing protects the skin from contact with destructive and
absorbable materials. (Ref. TBI H&S policy HS600)
The level of protection must correspond to the level of hazard known, or suspected, in the
specific work area. PPE has been selected with specific considerations to the hazards associated
with work activities. The specific PPE to be used for each level of protection is located in
Table 6-1.
6.1.1 Eye Protection
All associates engaged in or working in areas adjacent to eye-hazardous activities or operations
shall wear appropriate eye protection.
*Safety glasses are required for eye protection at all times, including under face shields
and welding helmets while in an eye hazard work area, and shall meet ANSI Standard
Z87.1 requirements.
*Face shields or welding helmets are required for face protection from flying particles,
debris and dust during all grinding, sanding and wire wheel operations and are not a
substitute for safety glasses eye protection.
*Full-face respirators can provide eye and face protection in lieu of safety glasses,
goggles, or face shields.
6.1.2 Foot Protection
Safety-toed boots/shoes (ANSI Z41) is required for all construction job sites. Specialized
footwear is personally provided as required by the nature of the work. Special foot protection
may include, but is not limited to, chemically resistant, thermally shielded, metatarsal guards,
etc.
6.1.3 Head Protection
Hard hats meeting ANSI Z89.1 shall be provided to protect workers from impact, penetration,
falling objects, and/or limited electrical shock and burn, as appropriate for work site hazards.
6.1.4 Body Protection
Protection clothing, gloves, boots, and other protective equipment shall be provided as
appropriate for the hazards associated with the tasks being performed.
6.2 Hearing Protection
Employees shall use hearing protection during all phases of tank construction, maintenance and
during earth and foundation work requiring the use of power and heavy equipment. Noise
surveys done during the construction and work inside tanks show noise levels exceed the 85 dBA
TWA 8 . For your safety, wear your hearing protection at all times.
6.2.1 Audiometric Testing
Audiometric Testing shall be completed on initial hire and once annually thereafter.
(Ref. TBI policy 401)
6.3 Air -Purifying Respirators
The air-purifying respirator cartridges selected for use during work at this site are HEPA filter
which will protect against dust mist and fumes having a TWA greater than 0.05 mg/m3,
asbestos-containing dusts, welding fumes mists, and radionuclides. The 3M 2097/07184 filter
also contain a nuisance level organic vapor relief built into the filter which do not have the
ability to protect against OSHA PEL’s for organic vapor concentration.
6.3.1 Respirator Fit Test
All personnel who may be required to wear a negative-pressure, air-purifying respirator shall be
fitted properly and tested (Ref. TBI H&S policy HS601). Employees shall have the opportunity
to handle the respirators, and wear them in normal air for a long familiarity period. Following
the familiarity period, employees shall test the piece-to-face seal by use of the positive and
negative pressure tests:
*Positive Pressure Test — with the exhaust port(s) blocked, the positive pressure of
slight exhalation should remain consistent for several seconds.
*Negative Pressure Test — with the intake ports blocked, the negative pressure of
slight inhalation should remain constant for several seconds.
Air-purifying respirators shall not be worn when conditions prevent a seal of the respirator to the
wearer. Such conditions may be the growth of a beard, sideburns, a skull cap that projects under
the face-piece, or temple pieces on glasses. No employee may wear a beard if it interferes with
the fit of the respirator. Also, the absence of one or both dentures can seriously affect the fit of a
face-piece, and should be worn at all times that respirators are being used. The worker's
diligence in observing these factors shall be evaluated by periodic checks.
6.3.2 Cartridge/Filter Changes
All cartridges/filters must be changed a minimum of once daily. Changes will also be made
when personnel begin to experience increased inhalation resistance or breakthrough of a
chemical warning property.
6.3.3 Respirator Cleaning, Maintenance, and Inspection
All respirators used on site shall be cleaned and maintained in the following manner:
*Remove filters and cartridges.
*Visually inspect face piece and parts, discard faulty items.
*Remove all elastic headbands.
* Remove exhalation cover and inhalation valves.
*Wash, sanitize, and rinse face piece. Wash any parts that were removed separately.
*Dry the mask. Wipe face pieces and valves.
*Disassemble and clean the exhalation valve.
*Visually inspect face piece and all parts for deterioration, distortion, or other faults that
might affect the performance of the respirator.
*Replace any questionable or faulty parts.
*Reassemble mask and visually inspect completed assembly.
*Seal mask in plastic bag.
7 CONFINED SPACE
This procedure defines the responsibilities, requirements and system for controlling the entry
and work in confined spaces for supervisors, employees and subcontractors. To eliminate all
injuries / mishaps resulting from entry into confined spaces during construction of steel tanks and
applicable steel structures. This program has been developed to ensure compliance with the
Occupational Safety and Health Administration (OSHA) and Washington Administrative Codes
(WAC) permit-required confined spaces regulation.
Air monitoring is key to minimizing the potential for a hazardous atmosphere buildup in the
tank. Ventilation fans may be required to help minimize or reduce the hazard.
Key provisions of this procedure include:
Workplace Evaluation
Training
Non-Permit-Required Confined Spaces
Retention of Inspection and Test Logs
Program Review
All persons working in confined spaces (tanks, pipes and trenches) must read this procedure
before work is to begin. Supervisors will insure that this procedure is followed by all employees
/ subcontractors.
7.1 Workplace Evaluation
All project locations will be evaluated by the project/location supervisor or an entry supervisor to
determine if the tank under construction is a non-permit or permit-required confined space
(PRCS). All permit-required spaces will be posted with a sign bearing the following or similar
warning: “DANGER PERMIT-REQUIRED CONFINED SPACE. DO NOT ENTER.” This
workplace evaluation will be documented using Appendix A-3 & 4. (Example A-5 & 6)
Entry into confined spaces determined during the workplace evaluation as non-permit space shall
have air monitoring tests done a minimum of twice per work shift. These confined spaces must
be re-evaluated whenever the use or configuration of the space changes in any way that might
change its classification.
If permit or alternate entry is required, the TBI HS300 Confined Space program shall be
implemented.
7.2 Designation of Confined Spaces
All confined spaces must be initially evaluated for known and potential hazards.
Each confined space shall be designated as a non-PRCS or a PRCS using the
criteria set forth in the OSHA and WISHA codes. If a confined space is
designated as a PRCS, the space may be reclassified as non-permit-required
confined spaces by the entry supervisor and project supervisor under the following
conditions:
• All contaminants have been isolated or removed.
•All actual or potential atmospheric hazards have been eliminated, with
testing verification.
• Ventilation is not required to maintain control of atmospheric hazards.
•All recognized hazards, including engulfment, within the space have been
eliminated.
•The space will be re-evaluated (and reclassified to permit-required, if
needed) whenever the use or configuration of the space changes in any way
that might increase the hazards to the entrants. All entrants will exit the
space immediately when hazards are noted.
•To verify atmospheric hazards are not present, an air-monitoring log shall be
maintained from the installation of the first wall sheets to the completion of
the project. Minimum testing shall be at the start of each shift and once
daily during welding, cutting or arc gouging activities. The supervisor
should schedule additional testing as deemed necessary to insure no buildup
of hazards in the air. Each test shall log two separate readings, one within
12 inches of the floor and one in the breathing zone. Include the following
and be conducted in the listed order:
• Oxygen level 19.5 – 22.5% -- normal 20.9%
•Flammable vapor/gas (LEL) level -- max. 10%
• Carbon Monoxide (CO) level -- max. 35 ppm
•Any additional Toxins -- (see SDS for PEL (Permissible Exposure
Limit))
•The site supervisor will make the certification that all hazards have been
eliminated on the Confined Space Hazard Evaluation form.
•The Confined Space Hazard Evaluation form will be posted at the entrance
to the confined space.
•When the alternate entry procedures are used for controlling a hazardous
atmosphere, all procedures in the WAC and OSHA codes shall be followed.
(see TBI HS300 section 5.2)
•If the confined space is designated as Permit-Required, the supervisor shall
comply with TBI’s Confined Space Program (HS300) starting at section
(6.0) General Requirements
7.3 Determining Non-Permit and Alternate Entry Confined Space
The following procedure complies with the OSHA CFR 29 1910.146 and WAC 296-
809.
A confined space may be classified as a non-permit-confined space under the
following conditions and procedures:
If the confined space poses no actual or potential atmospheric hazards.
If the confined space has no other recognized health or safety hazards including
engulfment in solid or liquid material, electrical shock, or moving parts.
If all hazards within the space are eliminated without entry into the space, the
confined space may be classified as a non-permit confined space for as long as the
hazards remain eliminated.
If it is necessary to enter the confined space to eliminate hazards, it must be
assumed a permit space and such entry must be performed following TBI’s
Confined Space Program (section 6.0). If testing and inspection during that entry
demonstrate that the hazards within the permit space have been eliminated, the
permit space may be reclassified as, a non-permit confined space for as long as
the hazards remain eliminated.
Control of atmospheric hazards through forced air ventilation does not constitute
elimination of the hazards.
The supervisor must document that all hazards in a permit space have been
eliminated, using the CONFINED SPACE HAZARD EVALUATION form
insuring the;
date,
location of the space, and
signature of the person making the determination is on the completed form.
Post the completed form at the entry to the confined space and a copy maintained
with the air-monitoring log.
When there are changes in the use or configuration of a non-permit confined
space that might increase the hazards to entrants, the supervisor must reevaluate
that space and, if necessary, reclassify it as a permit-required confined space.
If hazards arise within a confined space that has been classified as a non-permit
space, each employee in the space must exit the space. The supervisor must then
reevaluate the space and determine whether it must be reclassified as a permit
space, using the CONFINED SPACE HAZARD EVALUATION form.
8 EXCAVATION AND TRENCHING
All excavation and trenching operations shall be in compliance with OSHA 29 CFR
1926.650 through 652. Washington WAC 296-155-650 through 66411 and TBI policy
HS307
8.1 Excavation and Development
The following safety guidelines shall be adhered to while conducting excavation
development and landfill pipe installation:
*Prior to opening an excavation, effort shall be made to determine soil type and whether
underground installation (i.e., sewer, telephone, water, fuel electric lines, etc.), will be
encountered and the estimated location. When the excavation approaches the estimated
location of such installation, the exact location shall be determined and when it is
uncovered, proper supports shall be provided for the existing installation. Utility
companies shall be contacted and advised of proposed work prior to the start of actual
excavation.
*Ladders will be used in any trench greater than 4 feet in depth, and must be available
with every 25 feet of lateral travel. The ladders must extend above the trench at least
3 feet or greater. (confined space)
*Protective systems (i.e., shoring/bracing, sloping or benching) shall be used if personnel
are to enter an excavation with a depth greater than 5 feet. (confined space)
*Sloping or benching shall be in accordance with the OSHA standard and shall
correspond to the proper ratio (i.e., 1½:1) as per soil type. See Appendix A
*Air monitoring for hazardous atmospheres (i.e., combustible gases and volatile
organics, oxygen deficient environments) shall be conducted prior to personnel entering
the trench with a depth at 4 feet or greater.
*Barriers shall be erected around excavations in remote work locations. Backfill all
excavations, temporary wells, pit, and shafts when work is completed.
*Vehicular traffic and heavy equipment shall remain at least 4 feet from the face of the
excavation. All excavated or other materials shall be stored and retained at least 2 feet
from excavation.
*The excavation shall be inspected by the selected competent person throughout the
work day, during any change in conditions (i.e., rain, cracking/fissures), and at a
minimum twice daily. See Inspection form in Appendix A
9 FALL PROTECTION PLANNING
9.1 Fall Protection
This program has been developed to comply with applicable standards. T Bailey, Inc. will
identify fall hazards and institute the elements of this fall protection work plan to provide the
most effective means.
(The site supervisor must evaluate all job tasks for potential fall hazards at the job site and
complete this job site fall protection plan.)
9.1.1 Fall Hazard Identification
Elevations greater than 4 feet
Staging erection
Staging over 4 feet
Shell openings
Ladders
Roof Edge
Steel erection
Rolling Staging
9.1.2 Methods of Fall Protection
Eliminate fall hazard
Full body safety harness with shock absorbing lanyard
Standard Railings
Staging
Practice ladder safety
Static lines/Life lines
Snorkel (boom) lifts
Scissors lifts
Man baskets when warranted
Minimize fall hazard
9.1.3 Fall Protection Equipment
Full body harness
Locking snap hook
Lanyard
Buggy lanyards
Lifeline
Restraint line
Static line
Work position lanyards
Rope grab
Staging
Standard railings
9.1.4 Assembly, Maintenance, Inspections, Disassembly Procedures
Assembly and disassembly of all equipment will be done according to manufacturers
recommended procedures.
Conduct a visual inspection of all safety equipment on a daily basis or before each
use. Any defective equipment shall be tagged and removed from use immediately.
The manufacturer’s recommendations for maintenance and inspection shall be
followed.
9.1.5 Equipment Handling and Storage
Equipment will be issued daily. It should be stored in a dry place. Each worker is
accountable for returning safety equipment to the tool room or the designated storage
area.
9.1.6 Overhead protection
Hard hats required at all times
Barricade area below and restrict access
Post warning signs
Use containers with lanyards
Install protection at manholes
9.1.7 Emergency Rescue Procedures
In the event of a fire, medical or other emergency, help may be summoned in several
ways.
1. Contact the field supervisor (See Appendix B-9)
2.Emergency contact, work site location and medical facility information is in
Appendix B-3
3.A LIFT PLATFORM or man lift will be used to lower an injured person to
ground level if appropriate. Injured work hanging in a fall harness MUST be
retrieved within 5 minutes to stop Suspension Trauma.
4.In case of serious injury, injured worker (not hanging in a harness) should not be
moved wait for trained medical personnel and assist them in lift operations.
5.When requesting medical via phone give the location where the ambulance is
needed and any additional information which would prove useful, such as number
of persons injured, a loss of breathing, etc. STAY ON THE PHONE UNTIL
ASSISTANCE ARRIVES!
9.1.8 Training
Each T Bailey, Inc. new-hire will review with the Supervisor the written Fall Protection
Work Plan as part of the employee site orientation. Continued fall protection training
will be provided via weekly safety meetings and fall protection demonstration. A copy
of this plan will be posted in the job shack.
Workers requiring the use of fall protection will receive instruction on the proper use and
maintenance of selected fall protection equipment. This program will be reviewed again
in a training session before the work actually begins. Each worker must sign the
attendance sheet to document training, and a copy will be kept on file.
All documentation forms are in Appendix A
10 TANK SCAFFOLDING
This section defines the process of inspection and erection of tank Builders Scaffolding
used by TBI during the construction of above ground steel storage tanks. To prevent all
injuries / accidents from occurring during the set-up/tear down and use of field erected
tank builders scaffolding.
It will be the responsibility of the site competent person to oversee and insure that all employees
involved in the erection or dismantling of scaffolding understand and work under the restrictions
of this procedure.
10.1 Procedures
•Only after the identification of all hazards and the completion of training based on this
procedure and the TBI Safety Manual may scaffolding of the tank begin. Mandatory
100% tie off, 100% of the time with full body harness may be required.
•The maximum distance between the brackets to which the scaffold support and guardrail supports
are attached will be no more than 10’-0”. No more than three employees shall occupy any 10’-0”
span of scaffold planking at any time. Scaffold bracket clips shall be attached by welding both
sides of the top edge for a minimum of 1.5” using E7018 electrodes.
•Planking shall be laminated engineered scaffold planks 1-1/2” thick 10” wide and 12’-0” long.
The planks shall be inspected for damage before they are installed. Planks shall be placed three
wide across the scaffold supports. The next set of planks shall be placed so that they overlap the
first set and are supported by the scaffold bracket under the first set of planks with a minimum of
12”of overlap. This procedure will continue the rest of the way around the tank until the complete
circumference is staged. Planks that do not overlap by 12” shall be nailed together or secured
using chains and binders attached to the support bracket.
•First level of scaffold is typically 48” off the ground and may or may not have the hand line
installed. All other levels shall have the hand line. The hand line shall consist of a 1” pipe vertical
station 48” in height attached to each of the scaffold brackets. The 1” pipe shall have two 3/8” x
5/8” radius rings attached to it, spaced 1’-2” apart, starting from the top. A 3/8” wire rope is put
through each of the rings and pulled tight around the circumference then clamped with 3/8” cable
clamps completing the safety rail.
•A taut 3/8” wire rope supported on the scaffold brackets shall be installed at the scaffold plank
level between the innermost edge of the scaffold platform and the curved plate structure of the
tank shell to serve as a safety line. This is in lieu of an inner guardrail assembly where the space
between the scaffold platform and the tank exceeds 12 inches. In the event, the open space on
either side of the rope exceeds 12 inches, a second wire rope appropriately placed, or guardrails
shall be installed in order to reduce that open space to less than 12 inches.
•In lieu of toe boards, loose tool containers will be used. These containers will be placed at the
stanchion post area and tied off to prevent inadvertent tipping or falling. No loose tools will be
allowed on the scaffold area and housekeeping shall be maintained at all times.
•An overhead barrier will be installed at the man-way or point of entry for the protection of people
entering the tank. In an effort to heighten awareness to the overhead hazard Danger Workers
above signs will be posted in clear view, yellow barrier tape may also be used.
10.2 Tagging
•Only scaffolds displaying a signed tag may be used. Limitations on tags will be strictly
adhered to.
o Green Tag - This scaffold meets applicable regulations and complies with this
policy. Employees will wear fall protection equipment at all times, however tie-
off is not required.
o Yellow Tag - WARNING — This scaffold does not comply with applicable
regulations or with this policy. 100% tie off 100% of the time is required.
o Red Tag - DANGER — This scaffold is not to be used. Scaffold being moved shall
be marked with a Red Tag only personnel involved with scaffold move are
allowed. 100% tie off 100% of the time is required. A competent person is
required to supervise this operation at all times
•A TBI competent person shall inspect and sign all scaffolds prior to use each day. Any
deviation from regulations and this procedure shall be cause for the scaffold to be
retagged to an appropriate color.
•Employees will read the instructions / restrictions on the tags prior to each days use.
•Workers are not allowed to work under scaffold at any time.
o Exception: During short-term work for laying or adjustment of welding cables,
gas hoses or movement of equipment the area of the scaffolding above the work
area shall be vacated along with any pry bars, key plates, key channels. The
scaffold section above the work area shall be cordoned off for 10’ on both
directions.
•Loose tools and equipment shall be kept in the loose tool containers. This does not
include, which due their size and weight do not lend themselves as a hazard if resting on
the scaffold planks.
•Keep all equipment in good repair and inspect prior to each use. Do not use equipment
that is damaged or deteriorated. Report any questionable equipment to your supervisor
immediately.
11 FORKLIFT OPERATION
T Bailey Forklift training or union forklift operator training certificate is required to operate
forklifts on or for T Bailey projects.
Project supervisor must verify operator’s certification or provide the required training before an
employee operates a forklift.
See appendix ‘A’ Forklift Training
12 AERIAL WORK PLATFORMS
This section defines the process for the safe operation, maintenance, and inspection of
Vehicle Mounted Elevating and Rotation Work Platforms on the job site. It address the
requirements of the company policy (HS818) which regulates the operation and
maintenance of aerial work platforms.
12.1 Operation SAFETY WARNINGS AND CAUTIONS
Only employees who are actively participating in training or have been trained in
accordance with Section 12.2 of this procedure will be permitted to operate company
owned, rented, or leased aerial work platforms. The following operational rules will
be observed by all company employees operating an aerial work platform:
The following safety information is vitally important for safe aerial lift operation.
Failure to follow these instructions can result in possible personal injury and/or
DEATH.
•Most aerial lifts are all metal booms NON-INSULATED aerial work platform.
DO NOT operate near ELECTRICAL conductors. Regard all conductors as being
energized.
•All platform occupants MUST wear and use an approved full body safety harness as
required by OSHA. Attach safety harness to platform attachment points.
Always wear hard hat and any other protective clothing or equipment as required by
your specific job.
•When driving or moving the platform, check clearance around the aerial lift to avoid
contact with structures or other hazards. Always look in the direction of motion.
•Keep ground personnel from under platform when it is in the elevated position.
•When absolutely necessary to transfer from the platform to another structure or vice
versa, use extreme caution, attaching safety harness lanyard immediately upon
transferring to another surface or entering the platform. Do Not attach lanyard to
outside work area and platform at the same time.
•A good safety practice is to have personnel that are trained to provide operator
support, working in the immediate area of the aerial lift to assist the platform operator
in the event of an emergency.
•DO NOT exceed the unrestricted platform capacity as indicated on the capacity
placards at the platform and ground control station.
•DO NOT allow wires, cables, hoses, rope or other materials to trail down from
platform when moving the aerial lift.
•DO NOT operate the aerial lift unless you are completely familiar with operating
characteristics and have inspected and tested all functions to be sure they are in
proper working order.
•DO NOT operate an aerial lift that is not functioning properly, or that has been
damaged until the unit has been repaired by qualified maintenance personnel.
•DO NOT operate the aerial lift on soft ground, or on a slope in excess of 5%, (6 inch
rise in 10 feet).
•DO NOT operate an aerial lift that does not have all safety and instruction, warning
or caution decals and placards attached and legible. (Refer to your "Operator's
Manual" for proper decals and placards and their locations).
•DO NOT use ladders, planks or other devices to extend or increase work range from
the platform.
•DO NOT sit or climb on platform railing. Keep feet on platform floor at all times.
•DO NOT jerk controls. Move controls slowly and deliberately.
•DO NOT use boom for any purpose other than to position personnel and their tools
and equipment.
•DO NOT use the boom to raise the aerial lift from the ground.
•DO NOT use the aerial lift as a crane.
•DO NOT engage in any form of 'Horseplay' while operating the unit.
•DO NOT operate aerial lift in high wind conditions. (Wind or wind gusts of 25 MPH
or more).
•DO NOT operate out of doors during thunderstorms.
•DO NOT raise or extend boom, (extendable axle unit), unless axles are extended and
locked.
•DO NOT retract axles, (extendable axle unit), unless boom is down and retracted.
•DO NOT fill fuel tank while engine is running. Refuel slowly to prevent spillage
which is a fire hazard.
•DO NOT operate inside a building unless it is well ventilated.
•DO NOT kill hot engine while operating at high RPM. - idle before stopping.
•DO NOT modify the aerial lift in any way without prior factory approval.
•DO NOT override any of the safety features of the unit.
•All service adjustments and maintenance MUST be performed in accordance with
factory recommendations contained in the aerial lift "Operation, Maintenance and
Repair Parts" manual.
•If a safety or an operational problem is encountered, which is not covered in the
aerial lift manuals, you are urged to consult your dealer or the factory for
recommendations.
12.2 Training
Every employee that operates an aerial lift shall be informed of the operating instructions
contained in Section 12.1 and in the aerial lift's operating manual. Other practices dictated
by the particular workplace in which the aerial lift will be used will also be covered.
Training shall be provided at the time of initial assignment. Training will also be
refreshed whenever:
•The operator is involved in an accident or near-miss incident while operating an aerial lift;
•The operator has been observed operating an aerial lift in an unsafe manner;
•There are changes in the workplace that could affect safe operation; or
•The operator is assigned to a different type of aerial lift.
Training will be conducted by a qualified trainer or outside training resource familiar with
aerial lift operations and will consist of a review of this procedure, the aerial lift's operating
manual and a demonstration of operational skills. The evaluation of operational skills will
be tailored to the employee's anticipated work environment. The employee will have to
demonstrate that he/she knows and understands the aerial lift's functional features, is
familiar with safety rules and regulatory requirements, and can demonstrate overall safe
aerial lift operational skills. The trainer and employee will acknowledge completion of this
training by signing the aerial lift training record provided in appendix A.
12.3 Inspection
The aerial lift operator is required to perform a daily pre-use inspection of the aerial lift
they will be operating. If an unsafe condition is identified, a supervisor shall be
immediately informed of the condition and the aerial lift not operated until adequate repairs
have been made. Most aerial lift operation and maintenance manuals contain inspection
checklists that can be used as a guide for the inspection. In the event that a particular aerial
lift manual does not contain an inspection checklist, the form provided in appendix A can
be used. (see project form binder) All manufacturer-recommended procedures shall be
followed during inspections.
12.3.1 CHECK LIST BEFORE USING
Before beginning each day's work, perform the following inspection of the unit.
•Check fluid levels in hydraulic oil reservoir, fuel tank, engine crankcase and
battery.
•Inspect chassis, booms and platform for loose or missing parts and/or fasteners,
wear, weld cracks, dents, bends or other signs of damage.
•Check hydraulic components - pump, motors, filters, valves, cylinders, flexible
and metal lines and all fittings for leaks.
•Check tire inflation pressure, (Pneumatic tires only). Proper inflation pressure is
indicated on tire inflation placard. Check tires for cuts or damage.
•Check wheel lug nuts for any missing or loose nuts. Torque loose nuts with
torque wrench to proper torque as indicated on placard located on each wheel.
•Check that engine compartment is free of debris or materials that could interfere
with engine operation.
•Check all function and emergency controls for proper operation.
•Check all safety devices for proper operation.
•Check wiring cables and harnesses for proper installation and tightness.
•Check that all placards and decals are attached and are legible.
•Check your personal protective equipment.
12.3.2 Standard Aerial Lift Safety Features
The use of standard safety features is an important factor in safe aerial lift operation.
Although aerial lifts need not be equipped alike, there are some mandated safety
features that are required to be on all company owned or operated aerial lifts. These
required safety features include:
•Travel alarm
•Portable fire extinguisher
•Horn
12.4 Maintenance
Only authorized personnel shall perform maintenance or repair activities on aerial lifts.
Guidelines for the maintenance of aerial lifts are contained in the operations and
maintenance manual developed for the specific make and model of aerial lift being
maintained. All work shall be done in accordance with the manufacturer's guidelines.
Because aerial lifts are typically used every day, it is particularly important for personnel
to follow these manufacturer-established maintenance, lubrication, and inspection
schedules. Special attention should be given to aerial lift boom controls and features such
as brakes, steering, lift overload devices, tilt mechanism, and safety features.
13 LADDERS
This procedure establishes the minimum safety standards required for the inspection, setup, and
use of Fixed and Portable ladders and Fall Protection. It is not intended to address the
requirements for scaffolds as specified in Subpart L of 29 CFR 1926.
13.1 Fixed Ladder Inspection
The ladder user is required to perform an inspection of a ladder prior to use and after any
event that could result in ladder damage. Ladders, which have been determined to be
defective, will be placed “out of service” and will be repaired to a condition meeting their
original design or replaced. A supervisor will be immediately informed of the condition of
any defective ladder. The following guidelines will be followed during ladder inspections.
13.1.1 Pre-use inspection
•Ladders shall be inspected by a competent person for visible defects on a periodic basis
and after any occurrence that could affect their safe use.
•Ladders are clean, free from grease, oil, mud, snow, ice, wet paint, and other slippery
materials.
• Ladders with structural defects, such as, but not limited to, broken or missing rungs,
cleats, or steps, broken or split rails, or corroded components, shall be withdrawn from
service until repaired.
•The requirement to withdraw a defective ladder from service is satisfied if the ladder is
either.
•Immediately tag with "do not use" or similar language marked in a manner that readily
identifies it as defective or blocked (such as with a plywood attachment that spans several
rungs).
•Ladder repairs shall restore the ladder to a condition meeting its original design criteria,
before the ladder is returned to use.
13.1.2 Fall Protection Inspection
•Ladder safety devices, and related support systems, for fixed ladders shall be inspected for
but, not limited to the following:
•Activates within 2 feet after a fall occurs
•The connection between the carrier or lifeline and the point of attachment to the body belt
or harness shall not exceed 9 inches in length.
•Rigid carriers shall be attached at each end of the carrier, with intermediate mountings, as
necessary, spaced along the entire length of the carrier, to provide the strength necessary
to stop employees' falls.
•Flexible carriers shall be attached at each end of the carrier. When the system is exposed
to wind, cable guides for flexible carriers shall be installed at a minimum spacing of 25
feet and maximum spacing of 40 feet along the entire length of the carrier, to prevent wind
damage to the system.
•Side rails of through or side-step fixed ladders shall extend 42 inches above the top of the
access level or landing platform served by the ladder.
•Make sure all rivets, joints, mounting hardware, nuts, and bolts are tight, in good condition
and functioning properly.
• Ropes, cables, and grabs will be checked to ensure proper operation and will be replaced if
worn or defective.
13.1.3 Storage
Ladders will be stored in such a manner as to provide for ease of access or inspection, and
to prevent danger of an accident when withdrawing a ladder for use.
13.2 Setup
When setting up ladders they must conform to and be capable of support the following
loads.
13.2.1 Fixed Ladder
•At least two loads of 250 pounds (114 kg) each, concentrated between any two
consecutive attachments plus anticipated loads caused by ice buildup, winds, rigging, and
impact loads resulting from the use of ladder safety devices. Each step or rung shall be
capable of supporting a single concentrated load of at least 250 pounds (114 kg) applied in
the middle of the step or rung.
• Ladders rungs shall be parallel, level, and uniformly spaced not less than 10 inches apart,
nor more than 14 inches apart, as measured between centerlines of the rungs.
• Minimum clear distance between the side rails of fixed ladders shall be 16 inches.
•The rungs of fixed metal ladders shall be corrugated, knurled, dimpled, coated with skid-
resistant material, or otherwise treated to minimize slipping.
•Splicing sections to obtain a given length, the resulting side rail must be at least equivalent
in strength to a one-piece side rail made of the same material.
•Minimum perpendicular clearance between the center line of fixed ladder rungs and any
obstruction on the climbing side of the ladder shall be 30 inches, except as provided in
OSHA or WISHA codes. (WAC 296-155-480 (o))
•Minimum perpendicular clearance between fixed ladder rungs and any obstruction behind
the ladder shall be 7 inches.
•Point of access/egress shall have a step-across distance of not less than 7 inches nor more
than 12 inches as measured from the centerline of the rungs to the nearest edge of the
landing area.
•Ladders shall have a clear width to the nearest permanent object of at least 15 inches on
each side of the centerline of the ladder.
•Side rails of through or side-step fixed ladders shall extend 42 inches above the top of the
access level or landing platform served by the ladder.
•Ladders shall be provided with ladder safety devices, or self-retracting lifelines where the
top of the ladder is at a distance greater than 24 feet above lowest level.
13.2.2 Fall Protection Setup
• Safety device shall be capable of withstanding without failure a drop test consisting of an
18-inch drop of a 500-pound weight.
•Permit the employee using the device to ascend or descend without continually having to
hold, push or pull any part of the device, leaving both hands free for climbing.
•Activated within 2 feet after a fall occurs, and limit the descending velocity of an
employee to 7 feet/sec. or less.
•Connection between the carrier or lifeline and the point of attachment to the harness shall
not exceed 9 inches (23 cm) in length.
• Mounting of ladder safety devices for fixed ladders shall conform to the following:
•Mountings for rigid carriers shall be attached at each end of the carrier, with intermediate
mountings, as necessary, spaced along the entire length of the carrier, to provide the
strength necessary to stop employees' falls.
•Mountings for flexible carriers shall be attached at each end of the carrier. When the
system is exposed to wind, cable guides for flexible carriers shall be installed at a
minimum spacing of 25 feet and maximum spacing of 40 feet along the entire length of
the carrier, to prevent wind damage to the system.
•Mountings and cable guides shall not reduce the design strength of the ladder.
13.3 Use
Only employees who have been trained in accordance with Section 10.5 of this
procedure will be permitted to use fixed ladders. The following operational rules
will be observed by company employees.
13.3.1 Using a Fixed Ladder
• As in climbing or descending any ladder maintain a three-point contact at all times.
• Connect the ladder safety device to your harness before stepping onto the ladder.
• Face the ladder while climbing up or down and keep body centered between side rails.
•Employees shall not ascend or descend ladders while carrying tools or materials that might
interfere with the free use of both hands.
• Working from a ladder, the ladder shall be secured at both top and bottom.
•No type of work shall be performed on a ladder that requires the use of both hands to
perform the work, unless a positioning safety harness is worn and the safety lanyard is
secured to the ladder.
- Work only within arm’s length of the ladder.
-Use rope to raise or lower materials and tools.
13.3.2 Using Fall Protection
•Follow all hazard warnings and safety instructions for fixed ladders.
• Do not use ladders in high winds.
•Employees using fixed ladders must:
- Connect the ladder safety device to your harness before stepping onto the ladder.
- Face the ladder while climbing up or down and keep body centered between side
rails.
- Work only within arm’s length of the ladder.
- Use both hands when ascending or descending while maintaining a firm grip.
- Allow no other person on the same ladder section.
- Use rope to raise or lower materials and tools.
13.4 Portable Ladder Use
Only employees who have been trained in accordance with Section 13.5 of this procedure
will be permitted to use portable step, straight, or extension ladders. Only Type 1
“Industrial” and Type 1A “Heavy Duty Industrial” wooden or composite will be authorized
for use. The following operational rules will be observed by company employees.
13.4.1 Stepladders
• Follow all manufacturer hazard warnings and safety use instructions affixed to ladder.
• Do not use stepladders in high winds.
• The top two steps of stepladders are not to be used as steps.
•Personnel using stepladders must:
•Face the ladder while climbing up or down and keep body centered between side
rails.
• Work only within arm’s length of the ladder.
• Use both hands when ascending or descending while maintaining a firm grip.
•Allow no other person on the ladder.
•Use rope to raise or lower materials and tools.
•A portable stepladder is designed as a one-person working ladder. The ladder base
sections are to be placed with a secure footing.
13.4.2 Straight and Extension Ladders
•Follow all manufacturer hazard warnings and safety use instructions affixed to ladder.
• Ladders must be attended by either another employee, or tied off when in use.
• Do not use ladders in high winds.
•Employees using ladders must:
•Face the ladder while climbing up or down and keep body centered between side
rails.
• Work only within arm’s length of the ladder.
• Use both hands when ascending or descending while maintaining a firm grip.
• Allow no other person on the ladder.
•Use rope to raise or lower materials and tools.
•Portable ladders are designed as a one-person working ladder. The ladder base
section is to be placed with a secure footing. Safety shoes or feet of good substantial
design are to be installed on all ladders.
13.5 Training
Employees will be trained to recognize hazards related to fixed and portable ladder use
and the fall protection procedures to follow that minimize these hazards. Training on the
safe use of ladders and fall protection will be conducted prior to an employee being
allowed to use fixed and portable ladders. This training will be conducted by site
supervisor familiar with safe ladder and fall protection use. Training will include a review
of this procedure, applicable OSHA or WISHA standards, and a demonstration of correct
ladder and fall protection usage. (Ref. HS 301 & 302) The evaluation of correct usage will
be tailored to the employee’s anticipated work situation. The employee will have to
demonstrate that he/she knows and understands how to safely use the ladder, is familiar
with the content of this procedure, and can demonstrate overall ladder use skills.
Employees will acknowledge receiving this training by signing the ladder training record
provided in Appendix A.
14 AUTOMATIC GIRTH WELDER
Notice: This manual is designed specifically for use with T Bailey, Inc. built and owned single
head Automatic Girth Welding (AGW) equipment. Any other use or reference of this manual is
not authorized without written permission from T Bailey, Inc.
Warning: Do Not use this manual to setup and operate an AGW built by any other company. This
manual may not address all their safety concerns and may not provide for all setup and operational
procedures or known hazard of commercially built AGW’s.
For safe equipment operation, use the operations manual provided by the manufacture.
14.1 Single Head Automatic Girth Welder
Operational procedures for mounting an AGW on a tank structure.
See Appendix A for Setup Checklist
1. Unload Horizontal from truck and place on ground or floor of tank
2.Assemble fragile parts (curtain, electrical controls, welding wire, hoses, wire leads, etc.)
3. Stand up vertical using top pad eye
4. Remove shipping supports form safety arms
5. Adjust height spacing to height of sheet
Setting AGW on inside of tank
6.Caution: Before placing AGW on the new ring /course ensure all Vertical Seams are
Secure/Dogged
7. Set on inside of tank shell / second or subsequent course Two men on hook ladders, one on
each side of the AGW to assist in positioning AGW.
CAUTION: Place Automatic in location on tank where welding will start
(Do not transit automatic around tank to welding start point)
8. When AGW is mounted on the inside of the tank, climbing and working on the AGW any
distance above the operator’s cage floor, the worker shall use 100% tie-off fall protection.
Exception: When worker is standing on the AGW safety cage floor.
9. Adjust wheel radius for travel on inside of tank
10. Remove all obstacles from path of flux belt and lower support wheel (approximately 10”
above to 20” below the seam to be welded).
11. Position welding leads and hoses to ensure they do not hang up or cause side tension on
AGW
12. Setup welder, stow the lower support wheel and weld inside of tank (see welding procedures)
Moving AGW to outside of tank
1. Before moving AGW to outside of tank ensure, adequate slack in leads and hoses.
2. Using top pad eye lift vertically and rotate Automatic 180 degrees and place on the outside of
tank
CAUTION: Place Automatic in location on tank where welding will start
(Do not transit automatic around tank to welding start point)
3. Two men on hook ladders, one on each side of AGW on the inside of the tank to assist in
positioning AGW.
4. Adjust wheel radius for travel on outside of tank.
5. When the AGW is set on the outside of the tank workers shall use 100% tie-off fall
protection. Exception: When the operator is inside the AGW safety cage with access safety
chains secured across access openings, the retractable lanyard may be unhooked from body
harness.
6. Ensure all obstacles are removed from path of flux belt and lower support wheel
(approximately 10” above to 20” below the seam to be welded).
7. Position welding leads and hoses to ensure they do not hang up or cause side tension on
AGW
8.Setup welder and weld outside of tank (see welding procedures)
9. When inside and outside seam welding is complete the AGW shall be removed from the tank
and stored on the ground during the installation of the next ring / course.
Travel Operations of AGW
1.During setup and pre-positioning adjustments, forward and reverse travel is required. The
operator should use the JOG switch for any AGW travel.
2.When the AGW is in motion the operator shall remain inside the operator’s station with
ready access to the travel controls.
15 AIR SAMPLING EXPOSURE MONITORING
Inhalation hazards are caused from the intake of vapors and contaminated dust. Air monitoring
shall be performed while intrusive activities are taking place to detect the presence and relative
level of those air contaminants which are inhalation hazards.
The data collected throughout the monitoring effort shall be used to determine the appropriate
levels of protection. (Ref. TBI policy HS104)
15.1 Exposure Monitoring
Air monitoring equipment to be used during site activities, shall consist of an oxygen/
combustible gas/carbon monoxide/hydrogen sulfide (0 2 /LEL/CO/H 2 S) meter. All air monitoring
equipment will be maintained in accordance with, at a minimum, specific manufacturer's
instructions. Calibration will occur before and after each use. All direct reading instrumentation
calibrations should be conducted under the approximate environmental conditions the instrument
will be used. All air monitoring equipment calibrations and maintenance activities shall be
documented on a direct reading monitoring form, or equivalent.
15.1.1 O2/LEL/CO/H2S Meter
The 0 2 /LEL/CO/H 2 S Meter has the ability to determine the level of explosive vapors and
oxygen-deficient environments. The combustible gas indicator scales read from 0 to 100 percent
of the Lower Explosive Limit (LEL). The oxygen meter scales read from 0 to 25 percent oxygen
levels. All LEL monitoring shall be conducted in the work area directly above the emission
source. All oxygen monitoring will be conducted in the breathing zone.
The Carbon Monoxide and Hydrogen Sulfide components of this meter are direct reading which
measures the concentration of carbon monoxide and hydrogen sulfide within 10 seconds of each
gas detection.
15.1.2 Monitoring Frequency
A summary of the monitoring equipment and frequency for each work activity is presented in
Table 7-1. As noted in the table, the monitoring equipment listed per work activity relates to the
initial level of protection. The monitoring frequency may be decreased if the work areas and
activities are unchanging, the result of the first hour of monitoring indicates contaminant
concentrations are non-detect, and no differing conditions are observed.
15.1.3 Health and Safety Action Levels
An action level is a point at which increased protection or termination of activities is required
due to the concentration of contaminants in the work area.
Action is required if:
* Any symptoms occur, as described in Section 4-1.
* Requested by an individual performing the task.
* Any irritation to eye, nose, throat, or skin occurs.
* CO levels exceed 35 ppm in the breathing zone.
* H 2 S levels exceed 10 ppm in the breathing zone
*When airborne concentrations of hazardous materials exceed or are expected to exceed
twice the OSHA PEL in the worker’s breathing zone.
Work zone airborne concentrations which would require work stoppage and evacuation (cease
and desist) are detailed in Table 7-1.
16 SITE CONTROL AND WORK ZONES
The purpose of site control is to minimize potential injury of workers and protect the public from
hazards found on site. Site control is especially important in emergency situations.
16.1 Work Zones
Prior to starting work on the Site the SS, PM and Client will establish work zone boundaries
based on conditions at each work location at the time of the fieldwork. The crane, field vehicles,
portable barricades and caution tape, if necessary, will be used to identify the secure work zone.
Only site workers will be allowed in the established work zone while work is in progress.
A central construction office will be established on site for new workers and visitors arriving at
the site. Because of the use of a central office and the lack of public access to this project site, it
is not anticipated that a physical boundary fence to the construction site will be required.
16.1.1 The Work Zone
The Work Zone shall be designated during mobilization activities, and prior to the
commencement of construction activities. The size of the Work Zone shall contain all
construction activities. If necessary, the size of the work zone may be increased to allow more
working area or to incorporate greater area for higher levels of protection due to outside
activities.
Prior to entering the Work Zone, the following conditions must be met: personnel shall be suited
in the required personal protection.
16.1.2 The Support Zone
The Support Zone is a Non-hazard zone, which is the location of administrative and other
support functions such as first aid, telephones, equipment supply, and emergency information.
The Support Zone would have negligible potential for exposure to hazards except that of the
refinery.
The majority of site operations will be controlled from this field office trailer as well as access
to the site. The support trailers will provide for team communications and emergency response,
and sanitary facilities (i.e., Porta-John). Appropriate safety and support equipment also will be
located in this zone.
The support trailer will be located between the access road and work zone, if possible, and would
be used as a potential evacuation point, if appropriate.
16.2 Communication
Each member of TBI’s work crew will be able to communicate with another entry team member
at all times. Communications will be by two-way radio, telephone and hand signals.
The primary means for external communication on this project are telephones. The primary
team member (SS) must:
*Have the necessary telephone numbers readily available in the Support Zone.
*(Optional) Two way radios, at least one per crew team. (crew team = one or more
employees working on the same job/task.)
The following standard hand signals will be mandatory for all employees to understand
regardless of other means of communication:
* Hand gripping throat — Out of air, cannot breathe.
* Hands on top of head — Need assistance.
* Thumbs up— OK, I'm all right, I understand.
* Thumbs down — No, negative.
*Gripping partner's wrist, or gripping both of your own hands on wrist (if partner is out
of reach) - Leave area immediately.
16.3 Buddy System
16.3.1 Responsibilities
A buddy system shall be implemented when conducting Permit Confined Space activities on this
site. This buddy shall be able to:
* Provide his or her partner with assistance.
* Observe his or her partner for signs of chemical exposure or temperature stress.
*Periodically check the integrity of his or her partner's protective clothing.
Notify attendant personnel if emergency help is needed.
17 MOBILE CRANES
Crane safety is a key issue at T Bailey, Inc. project sites. Proper qualification of operators is
the key element in proper crane operation.
Since crane operations at T Bailey projects involve some subcontracted or rental equipment,
the project manager and supervisor shall insure all crane operators working on T Bailey
projects are qualified to operate the specific crane in use.
17.1 Crane Operators
Crane operations on T Bailey projects may involve hiring a qualified subcontractor, or renting
a crane to be operated by T Bailey personnel. It is the responsibility of the project manager
and supervisor to verify that crane operations are conducted in accordance with applicable
standards, using qualified operators. (Note: Hawaii requires crane operator to be state
certified)
T Bailey Requirements
•All cranes operated on T Bailey-controlled sites shall meet applicable design standards
(i.e., ANSI, Power Crane and Shovel Association, etc.).
• Cranes shall have a copy of the most recent annual and periodic inspections on-board.
•All cranes shall be inspected by a qualified person, prior to operation (see Appendix A
Crane Inspection Checklist (Daily Checklist)), to verify proper working condition. If
this inspection is not conducted by a T Bailey operator, the T Bailey site supervisor
shall verify that it is done by initialing and dating the completed form.
•A copy of the manufacturer’s operating manual shall be carried on all cranes. The
manual shall include a load-rating chart that indicates safe loads in various
configurations, wire and cable minimums and maximums, and any special
considerations.
•Crane operators shall use the crane manufacturers operating manual for proper setup
and operation of the crane in use.
•The “Recognizing Unsafe Crane and Rigging Practices” (section 17.1.1), or equivalent,
and the “Hand Signals for Mobile Cranes” (section 17.1.2) are to be reviewed at the
Safety Meeting prior to crane operation.
• All cranes rented, leased, or purchased by T Bailey shall be equipped with a load
indicator.
•The daily inspection completed by the operator or a competent person before first
operational use of each shift. (Appendix A)
17.1.1 Recognizing Unsafe Crane and Rigging Practices
Be Alert For:
•Quick and sudden crane movements;
•Improper crane ground conditions;
•Improper crane support (mats, cribbing, etc.); - Mobile
•Horseplay with and around the crane;
•Unsecured crane swing radius; - Mobile
•Leaking hydraulic systems
•Unsecured crane load path;
•Loads being passed over the heads of personnel;
•Damaged wire rope on crane;
•Use of damaged rigging gear;
•Use of rigging gear without gloved hands;
•Improper use of Standard Hand Signs.
This list is not intended to be all-inclusive. The constant observance of crane and
rigging operations is a must to obtain the safest environment possible. Always be
on the lookout for acts that could lead to an accident.
•Overhead power lines;
17.1.2 HAND SIGNALS FOR MOBILE CRANES
EMERGENCY STOP. Arm
extended, palm down, move
hand rapidly right and left.
STOP. Arm extended, palm
down, hold position rigidly.
DOG EVERYTHING.
Clasp hands in front of body.
MOVE SLOWLY. Use one
hand to give any motion signal
and place other hand
motionless in front of hand
giving the motion signal. (Hoist
Slowly shown as example.)
RAISE BOOM. Arm extended,
fingers closed, thumb pointing
upward.
LOWER BOOM. Arm
extended, fingers closed,
thumb pointing downward.
USE MAIN HOIST. Tap fist
on head; then use regular
signals.
USE WHIP LINE. (Auxiliary
Hoist) Tap elbow with one
hand; then use regular signals.
SWING. Arm extended, point
with finger in direction of
swing of boom.
TRAVEL. Arm extended
forward, hand open and
slightly raised, make pushing
motion in direction of travel.
TRAVEL (One Track). Lock
the track on side indicated by
raised fist. Travel opposite
track in direction indicated by
circular motion of other fist
rotated vertically in front of
body. (For crawler cranes
only.)
TRAVEL (Both Tracks). Use
both fists, in front of body,
making a circular motion, about
each other, indicating direction
of travel, forward or backward.
(For crawler cranes only)
FOR HYDRAULIC MACHINES ONLY
HOIST. With forearm vertical,
forefinger pointing up, move
hand
in small horizontal circle,
LOWER. With arm
extended downward,
forefinger pointing down,
move hand in small horizontal
circles,
RAISE THE BOOM AND
LOWER THE LOAD. With
arm extended, thumb
pointing up, flex fingers in
and out as long as load
movement is desired.
LOWER THE BOOM AND
RAISE THE LOAD. With arm
extended, thumb pointing
down, flex fingers in and out
as long as load movement is
desired.
RETRACT BOOM (Telescoping
Boom). One Hand Signal. One
fist in front of chest, thumb
pointing outward and heel of fist
tapping chest.
EXTEND BOOM
(Telescoping Boom).
One Hand Signal. One fist in
front of chest with thumb
tapping chest.
EXTEND BOOM
(Telescoping Boom). Both
fists in front of body with
thumbs pointing outward.
RETRACT BOOM
(Telescoping Boom). Both
fists in front of body with
thumbs pointing toward each
other.
17.2 ERECTING AND STOWING THE SWING-AWAY BOOM EXTENSION
18 CRANE LIFTED WORK BASKET
18.1 Work Basket Operations
Crane operations on T Bailey projects may involve hiring a qualified
subcontractor, or renting a crane to be operated by T Bailey personnel. It is the
responsibility of the project manager to verify that crane operations are conducted
in accordance with applicable standards, using qualified personnel.
18.1.1 SAFE WORK PRACTICES
a.The use of workbaskets is a normal part of tank construction for work where
the use of scaffolding or man lifts is not possible because of structural design.
b. The use of the workbasket requires the completion of the Workbasket
Inspection Checklist prior to the hoisting of personnel. The supervisor and
each person that will be working with or in the basket shall sign the
Suspended Workbasket Authorization. In no case is a workbasket to be used
as an elevator.
c.The number of employees occupying the personnel platform shall not exceed
the number required for the work being performed.
d. Employees shall keep all parts of their bodies inside the workbasket during
raising, lowering and positioning.
e.Hoisting of employees shall be discontinued upon indications of any
dangerous weather conditions or other impending danger.
f.The work basket shall be hoisted just above the ground and inspected to
assure that it is secure and properly balanced before employees are allowed
to occupy the work basket.
g.Employees being hoisted shall be in continuous sight of and communication
with the crane operator or signal person. If at any time, the operator cannot
see hand signals or hear radio-relayed signals; he/she shall stop all operations
until he/she can receive signals.
h.Employees occupying the workbasket shall wear a full-body harness with a
lanyard appropriately attached to a structural member within the workbasket.
i.No lifts shall be made on another of the crane's load lines while personnel are
suspended on a platform.
j. Hoisting of employees while the crane is traveling is prohibited.
18.1.2 DESIGN GUIDELINES
a. A qualified engineer, who is competent in structural design, shall design
workbaskets. The basket will be designed and constructed for the specific
purpose of hoisting personnel by means of a crane.
b. Lifting bridles on the workbasket shall be designed to minimize tipping of
the basket due to the movement of employees occupying the basket. The
basket shall be at least four (4) feet square, head room should be provided,
which allows employees to stand upright in the platform and be of weld
construction with a safety factor of five (5).
c. A 42-inch high guardrail for perimeter protection of personnel within the
workbasket shall be maintained. It shall be either solid construction or
expanded metal having openings of no greater than 1/2 inch, with a gate that
swings inward only and equipped with a positive latch. The workbasket
weight, maximum number of employees, and the load capacity of the basket
must be posted permanently on the basket door. The workbasket shall be
easily identifiable by color or marking.
d. Personnel workbaskets are not to be used to hoist materials or tools without
employee.
e. A grab rail shall be provided inside the personnel basket. Overhead
protection shall also be provided when employees are exposed to falling
objects. A welder qualified for the weld grades, types and material specified
in the design shall perform all welding. All exposed rough edges shall be
ground smooth. Engineering must approve basket design.
18.1.3 RIGGING
a. Load block or ball hooks shall be a type that can be closed and locked,
thereby eliminating the throat opening. As an alternate, a shackle with a
screw pin, nut and retaining pin may be used.
b. When a wire rope lifting bridle is used to connect the workbasket to the load
line, the bridle legs shall be connected to a single ring or shackle. Lifting
bridles and associated hardware used for attaching the workbasket to the
hoist line shall not be used for any other service.
c. All eyes in wire rope slings shall be fabricated with thimbles. Wire rope,
shackles, rings and other rigging hardware shall have minimum safety factor
of five.
d. A safety wire rope sling shall be affixed from the uppermost part of the
lifting bridle to a point above the ball or the dead-end load line of the load
block or to the load block.
e. Tag lines shall be used where practical.
18.1.4 CRANE SETUP AND OPERATION
a.The crane shall be uniformly level within one percent of the level grade and
located on firm footing. Crane outriggers, if provided, shall be used
according to manufacturer's specifications when hoisting employees. Crane
travel is prohibited while the workbasket is suspended. The crane operator
shall remain at the controls at all times, with the engine running, when the
workbasket is suspended.
b. The total weight of the loaded workbasket and related rigging shall not
exceed 25 percent of the rated capacity for the radius and configuration of the
crane. The minimum load hoist wire rope safety factor shall be seven (7).
Except where rotation resistance ropes are used, the line should be capable of
supporting without failure at least ten times the maximum intended load.
Lifting and lowering speeds shall not exceed 100 feet (30m) per minute. The
load-line hoist drum shall have controlled (power) load-lowering capability;
free fall is prohibited. Only cranes with a fail-safe braking system will be
permitted.
c.Telescoping booms shall be marked or equipped with a device to clearly
indicate to the operator, at all times, the boom's extended length.
d. A positive acting device shall be used which prevents contact between the
load block or overhaul ball and the boom tip (anti-two-blocking device), or a
system shall be used which deactivates the hoisting action before damage
occurs in the event of a two-blocking situation (two block damage prevention
feature).
e.Load and boom hoist drum brakes, swing brakes and locking devices such as
dogs and pawls, as equipped, shall be engaged when the occupied work
basket is in a stationary working position. If the work is not landed, it shall
be secured to the structure before employees exit or enter the basket.
18.1.5 INSPECTIONS AND TESTING
a.The crane to be used and the work basket shall be inspected by a competent
person at the beginning of each shift and before hoisting employees in the
work basket after the crane has been used for any material handling operation
in which greater than 50 percent of the rated capacity was lifted.
b. A trial lift with the workbasket unoccupied shall be made for each new work
location and at the beginning of each shift to ensure that all systems, controls
and safety devices are functioning properly. A full-cycle operational test lift
at 200 percent of the intended load of the workbasket shall also be made at
each new setup location before hoisting employees for the first time.
c.A visual inspection of the crane, workbasket and base support shall be
conducted immediately after the test lift to determine whether the testing had
any adverse effect upon any component or structure. A copy of the Crane
Operator's Daily Checklist shall be avaialable.
d. Any defects found during such inspections, which may create a safety
hazard, shall be corrected before further use of the workbasket.
18.1.6 PRE-LIFT MEETING
a.A meeting attended by the operator, signal person(s) to be lifted, and the
person responsible for the task to be performed shall be held to review this
procedure and the work procedures to be followed.
This meeting shall be held before the beginning of personnel hoisting operations at each new
work location and thereafter for any employees newly assigned to the operation.
19 EMERGENCY RESPONSE CONTINGENCY PROCEDURES
19.1 On-Site Emergencies
An Emergency Information Contact Sheet containing emergency phone numbers and directions
to the closest hospital, is located in Appendix B. A copy of this sheet shall be posted in the
support area next to the telephone.
If an emergency occurs on site necessitating a response to an emergency, the emergency
coordinator on site shall be immediately alerted to the incident. This notification shall be an
audible alarm, by use of an air horn, radio or by telephone. Personnel should reassemble at a
pre-designated location to take a head count. The Emergency Coordinator shall direct personnel
to either evacuate, or make other assignments as necessary to mitigate the emergency.
19.1.1 Injury/Incident Reporting
TBI project employees are required to immediately report to their direct supervisor all
occupational injuries, illnesses, accidents, and near miss incidents having the potential for injury.
Refer to the Incident Reporting System Checklist, in Appendix B for detailed instructions
concerning notifying the safety office and health care provider in the event of an injury. In
addition all injury and mishap investigation reports must be sent to the client / owner of
the project within one week of the incident.
19.1.2 Emergency Procedures for First Aid Personnel
Whenever possible, personnel should wash before administering first aid:
*Skin Contact — Remove contaminated clothing, wash immediately with water, use
soap, if available.
*Inhalation — Remove victim from contaminated atmosphere. Remove any
respiratory protection equipment. Initiate artificial respiration, if necessary. Transport
to the hospital.
*Ingestion — Remove from contaminated atmosphere. Do not induce vomiting if
victim is unconscious. Also never induce vomiting when acids, alkalis, or petroleum
products are suspected. Transport to the hospital, if necessary.
If site personnel have unexplainably collapsed, all personnel must evacuate work area. Rescue
personnel must don supplied-air respiratory protection before evacuating victim from work area.
19.1.3 Emergency Equipment/First Aid
Basic first aid supplies (10 pack kit) will be located in the first aid box. The first aid box along
with first aid manuals and Medical Data Sheets, will be located in the trailer. Other on-site
emergency equipment includes an emergency alarm (i.e., air horn), emergency eyewash, DEET
spray solution, fire extinguisher, potable water and drinking cups, anti-bacterial soap, and
telephone.
19.1.4 Fire Reporting Procedures
In the event of fire immediately contact the Site Supervisor and the Fire Department 911. If the
fire cannot be controlled by trained personnel with the appropriate extinguishing equipment in
the inception stage all personnel shall evacuate the area. The fire department shall be notified of
ALL fires.
19.2 Chemical or Petroleum Product Spill Response Procedures
Despite the best effort of workers to prevent spills resulting in the release of chemicals or
petroleum products will occur. For this reason, it is essential that construction site personnel have
a spill response plan that includes appropriate procedures and materials to contain adequately
and cleanup a spill. The following procedures should be used as a guide to help personnel design
an effective spill control plan for their area of responsibility. Plan form is in Appendix ‘A’.
The person responsible for the activity, construction site, equipment or vehicle from which a
release of hazardous material occurs is responsible for the cleanup, removal and disposal of the
hazardous material. All cleanup and disposal will comply with state and federal regulations.
Additionally, the responsible company may be liable for the expenses incurred by the emergency
responders, including the cost of materials used by emergency responders in the containment,
treatment and/or disposal of the hazardous materials.
19.2.1 Spill Response - Major Spill
The person who discovers a spill that:
1) involves the release of a quantity over 3 gallons of chemical or petroleum
products or type that pose an immediate risk to health;
2) involves an uncontrolled fire or explosion; or
3)involves serious personal injury will immediately:
Notify the local Police & Fire at 911 of the location and nature of the spill, leak, or runoff of
hazardous material.
Notify State EPA. (See EPA contact information)
Notify T Bailey Safety Director
Evacuate the area and implement other measures as required to eliminate fire, explosion, and
health hazards.
Follow the instructions of the Site Emergency Coordinator or hazardous materials specialist
responding to the emergency call.
19.2.2 Spill Response - Minor Spill
In the event of a spill involving the release of a quantity under 3 gallons of chemical or
petroleum products or type which do not pose an immediate risk to health:
Notify the site supervisor and other personnel of the mishap / spill.
Notify T Bailey Safety Director within two hours. (If no answer leave a message with call
back number)
Isolate the area. Evacuate the immediate area if necessary.
Remove all ignition sources and establish exhaust ventilation. Vent vapors to outside of
building / tank only (open all entry points.)
Choose appropriate personal protective equipment (goggles, face shield, impervious gloves,
apron or coveralls, boots, respirator, etc.) All personnel must be properly fit tested before
using a respirator.
Confine and contain the spill. Cover with appropriate absorbent material. Sweep solid
material into a dustpan and place in a sealed plastic container. Decontaminate the area with
soap and water after cleanup and place residue in a plastic bag or another sealed plastic
container. Maintain the containers to Hazardous Waste in a safe place for pickup.
When the cleanup is complete, notify the Safety Director so arrangements can be made to
pick up the Hazardous Waste.
19.2.3 How To Report a Spill (Requires State Specific Information)
Spills of oil or hazardous substances must be reported .
Oregon State Spill Rules
State rules regarding spills or releases of oil and/or hazardous substances is found in OAR 340, Division
142 or go to the website at http://www.deq.state.or.us/lq/hw/rules.htm The rules state: In the event of a
spill or release or threatened spill or release of oil or hazardous material, the person owning or having
control over the oil or hazardous material shall take the following actions, as appropriate.
•Immediately implement the site’s Spill Prevention Control and Countermeasure (SPCC) or contingency
plan.
•If no plan exists, immediately take the following actions:
a. Activate alarms or warn persons in the immediate area.
b. Undertake every reasonable method to contain the oil or hazardous material.
•In the case of a medical emergency or public safety hazard, notify local emergency responders (fire
department, ambulance, etc.) using 911 where available.
•If the amount of oil or hazardous material exceeds the reportable quantity in any 24-hour period, report
the spill or release to the Oregon Emergency Response System (1-800-452-0311 in-state, and (503)
378-4124 out-of-state).
If the quantity of oil or hazardous material exceeds the quantity referenced in “d” below, report the spill
or release to the National Response Center, 1-800-424-8802.
Reportable Quantity
Reportable quantity as defined in OAR 340-142-0050:
(1) Spills and releases, or threatened spills or releases of oil or hazardous materials as defined by OAR
340-142-0005(9) in quantities equal to or greater than the following amounts must be reported a. Any
quantity of radioactive material or radioactive waste;
b. If spilled or discharged into waters of the state or in a location from which it is likely to escape into
waters of the state any quantity of oil that would produce a visible film, sheen, oily slick, oily solids,
or coat aquatic life, habitat or property with oil, but excluding normal discharges from properly
operating marine engines;
c. If spilled on the surface of the land, and not likely to escape into waters of the state, any quantity of
oil over one barrel (42 gallons);
d. An amount equal to or greater than the quantity listed in 40 CFR Part 302– Table 302.4 (List of
Hazardous Substances and Reportable Quantities) and amendments adopted prior to July 1, 2002;
e. Ten pounds or more of a hazardous material not otherwise listed as having a different reportable
quantity by the Department or the United States Environmental Protection Agency on the list of
hazardous substances in 40 CFR 302.4;
f. Any quantity of chemical agent (such as nerve agents GB or VX, blister agent HD, etc.;
g. Two hundred pounds (25 gallons) of pesticide residue;
h. Any quantity of a material regulated as a Chemical Agent under ORS 465.550;
i. Any quantity of a material used as a weapon of mass destruction, or biological weapon;
j. One pound (1 cup) or more of dry cleaning solvent, including perchloroethylene, spilled or released
outside the designed containment by a dry cleaning facility regulated under ORS 465.505(4).
NOTE: When in doubt about reporting the spill or
release — always report the incident to the Oregon
Emergency Response System (OERS). Let the OERS
determine if the release is important or not.
Cleanup
Anyone liable for the spill or release or threatened spill or release shall IMMEDIATELY
CLEAN UP THE SPILL OR RELEASE. Spills or releases must be cleaned up
completely as possible.
The Department’s Environmental Cleanup Program and/or the appropriate DEQ region
office should be contacted to assure that cleanup meets state requirements. The
Environmental Cleanup Program can be reached at (503) 229-5913.
Cleanup Report
The Department may require the responsible party to submit a written report to the
department describing all aspects of the incident and steps taken to prevent a recurrence.
NOTE: A hazardous waste determination will have
to be conducted on any cleanup debris, including
contaminated soil, water, or groundwater. If the generator
determines that the cleanup debris is hazardous
waste, it must be handled accordingly. Hazardous
waste cleanup debris may be managed in tanks and
containers without a facility permit following requirements
of 40 CFR 262.34
19.3 Site Evacuation
In the event of an emergency situation such as fire, explosion, significant release of toxic gases,
etc., an air horn or other appropriate device will be sounded indicating the initiation of
evacuation procedures. All personnel shall meet in the pre-designated site refuge location as
discussed during the initial site meeting.
20 TABLES
•Table 4-1 Properties of Potential Site Contaminants
•Table 5-1 Heat Index Guide
•Table 5-2 Heat Stress Rest Breaks
•Table 5-3 Heat Stress Outdoor Temperature Action Levels
•Table 5-4 Cold Stress Guidelines
•Table 5-5 Wind Chill Chart
•Table 7-1 Action Levels for Field Activities
Table 4-1 Properties of Potential Site Contaminants
Chemical Name Exposure Limits Route Of Entry Symptom/Health Effects Physical Properties
Carbon Monoxide TWA: 25 ppm
PEL: 35 ppm
STEL: 200 ppm
Inhalation Headache, Fatigue, Shortness of breath
Nausea, Dizziness, sometimes results in
unconsciousness then into death.
Colorless, odorless
Gas
Hydrogen Sulfide TLV: 10 ppm
PEL: 10 ppm
STEL: 15 ppm
Inhalation
Ingestion
Contact
ACUTE: Irritation of eyes, nose and throat.
CHRONIC: If high concentrations are inhaled,
hyperpnoea and respiratory paralysis may occur.
(FP) NA
(VP) 20 atm
(IP) 10.43eV
Methane TLV: NA
PEL: NA
STEL: NA
Inhalation ACUTE: Asphyxiation (FP) 140°
(VP) .55
(IP)
Lead PEL & TLV: 0.05 mg/m3 Inhalation
Ingestion
Contact
CHRONIC: Lassitude, insomnia, paleness, lack
of appetite, low weight, malnutrition,
constipation, abdominal pain, colic, vomiting,
tremors, paralysis of the wrists, and permanent
brain damage. Potential mutagen and teratogen.
Organic Solvents
(various)
Naphtha
PEL: 500 ppm
Inhalation
Ingestion
Contact
ACUTE: Mucous membrane irritant, cough,
chest tightness, headache, and dizziness.
CHRONIC: Memory problems, fatigue, vertigo
Various
Respirable Dust -
(PNOR) Particulates not
otherwise regulated
TLV: 10mg/m3 (inhal.)
TLV: 3 mg/m3 (resp.)
PEL: 15 mg/m3 (total)
PEL: 5 mg/m3 (resp.)
Inhalation ACUTE: Irritation of eyes, nose and throat.
Upper respiratory symptoms.
CHRONIC: Varies with the specific solid
involved.
Properties vary
depending upon the
specific solid
Table 5-1 Heat Index Guide
Heat Index (Apparent Temperature) Chart
The Heat Index (HI) is the temperature the body feels when heat and humidity are combined. The chart
below shows the HI that corresponds to the actual air temperature and relative humidity. (NOTE: This
chart is based upon shady, light wind conditions. Exposure to direct sunlight can increase the HI by up
to 15°F.) (Due to the nature of the heat index calculation, the values in the tables below have an error of
+/- 1.3F.)
Heat Index General Effect of Heat Index on People in Higher Risk Groups,
80 to 89o - Caution Fatigue possible with prolonged exposure and/or physical activity
90 to 104o -
Extreme Caution Sunstroke, heat cramps and heat exhaustion possible with prolonged exposure and/or physical activity
105 to 129o -
Danger
Sunstroke, heat cramps or heat exhaustion likely, and heatstroke possible with prolonged exposure
and/or physical activity.
130o or higher –
Extreme Danger Heat/sunstroke highly likely with continued exposure.
Relative Humidity (in percent)
Air
Temp
(in F)
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100
140 125
135 120 128
130 117 122 131
125 111 116 123 131 141
120 107 111 116 123 130 139 148
115 103 107 111 115 120 127 135 143 151
110 99 102 105 108 112 117 123 130 137 143 150
105 95 97 100 102 105 109 113 118 123 129 135 142 149
100 91 93 95 97 99 101 104 107 110 115 120 126 132 138 144
95 87 88 90 91 93 94 96 98 101 104 107 110 114 119 124 130 136
90 83 84 85 86 87 88 90 91 93 95 96 98 100 102 106 109 113 117 122
85 78 79 80 81 82 83 84 85 86 87 88 89 90 91 93 95 97 99 102 105 108
80 73 74 75 76 77 77 78 79 79 80 81 81 82 83 85 86 86 87 88 89 91
75 69 69 70 71 72 72 73 73 74 74 75 75 76 76 77 77 78 78 79 79 80
70 64 64 65 65 66 66 67 67 68 68 69 69 70 70 70 70 71 71 71 71 72
Dew Point (in F)
20.1.1.Air
Temp
(in F)
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
104 110 110 110 110 110 110 111 112 113 114 115 116 117 118 119 121 122 124 125 127 128 130 132 133 136 137
102 108 108 108 108 108 108 109 110 110 111 112 113 114 116 117 118 119 121 122 124 126 127 129 131 133 136
100 106 106 106 106 106 106 106 107 108 109 110 111 112 113 114 115 117 118 119 121 123 124 126 128 129 132
98 103 103 103 103 103 103 104 105 105 106 107 108 109 110 111 113 114 115 117 118 120 121 123 125 127 129
96 101 101 101 101 101 101 101 102 103 104 105 106 107 108 109 110 111 112 114 115 117 118 120 122 124 127
94 98 98 98 98 98 98 99 100 100 101 102 103 104 105 106 107 108 109 111 112 114 115 117 119 122 124
92 96 96 96 96 96 96 97 97 98 99 99 100 101 102 103 104 105 106 108 109 110 112 114 116 119 121
90 94 94 94 94 94 94 94 95 95 96 97 98 98 99 100 101 102 103 105 106 107 109 110 113 116 117
88 88 88 88 89 89 90 90 90 91 92 93 94 95 96 97 98 99 100 101 103 104 106 108 110 112 114
86 86 86 87 87 87 88 88 89 89 90 91 91 92 93 94 95 96 97 98 100 101 102 104 106 108 110
84 84 84 85 85 85 86 86 87 87 88 88 89 90 90 91 92 93 94 95 96 97 98 100 101 103 -
82 82 83 83 83 83 84 84 85 85 86 86 87 87 88 88 89 89 90 91 92 93 94 95 - - -
80 80 81 81 81 82 82 82 82 83 83 83 83 84 84 85 85 85 86 86 87 87 - - - - -
Table 5-2
Heat Stress Rest Breaks
Suggested Frequency of Physiological Monitoring for Fit and Acclimatized Workers a
Adjusted Temperature b Normal Work Clothing c Impermeable Clothing
90°F (32.2°C) or above After each 45 minutes of work After each 15 minutes of work
87.5°–90°F (30.8°–32.2°C) After each 60 minutes of work After each 30 minutes of work
82.5°–87.5°F (28.1°–30.8°C) After each 90 minutes of work After each 60 minutes of work
77.5°–82.5°F (25.3°–28.1°C) After each 120 minutes of
work
After each 90 minutes of work
72.5°–77.5°F (22.5°–25.3°C) After each 150 minutes of
work
After each 120 minutes of
work
a For work levels of 250 kilocalories/hour.
b Calculate the adjusted air temperature and humidity on the Heat Index Chart (attachment 2)
c A normal work clothing consists of cotton coveralls or other cotton clothing with long sleeves
and pants.
[Examples of Activities within Metabolic Rate Categories]
Table 5-3
Outdoor Temperature Action Levels
Categories Example Activities
Resting Sitting quietly
Sitting with moderate arm movements
Light
Sitting with moderate arm and leg movements
Standing with light work at machine or bench
while using mostly arms
Using 4 inch grinder for grinding or sanding
Standing with light or moderate work at machine
or bench and some walking about
Moderate
Hand sanding in a standing position
Walking about with moderate lifting or pushing,
outdoor forklift operation
Walking on level at 6 Km/hr- 3.73 Mi/hr while
carrying 3 Kg – 6.6 Lbs weight load
Heavy
Using a 9 inch grinder from waste to chest level
Shoveling dry sand
Heavy assembly work on a non-continuous basis
Intermittent heavy lifting with pushing or pulling
(e.g., pick-and-shovel work)
Very Heavy Shoveling wet sand, steel shot,
All other clothing 89o
Double-layer woven
clothes including
coveralls, jackets and
sweatshirts
77o
Non-breathing clothes
including vapor barrier
clothing or PPE such as
chemical resistant suits
52o
Table 5-4 Cold Stress Guidelines
The following table shows the recommended number of breaks that should be taken per hour based upon the air temperature and wind speeds
encountered. This table also lists the maximum sustained work period (in minutes) allowed when working under these conditions. (Ref. TBI H&S
policy HS401)
Work/Warming Regimen
Air Temperature -
Sunny Sky No Noticeable Wind 5 mph Wind 10 mph Wind 15 mph Wind 20 mph Wind
0C
(approx.)
0F
(approx.)
Max
Work
Period
# of
breaks
Max
Work
Period
# of
breaks
Max
Work
Period
# of
breaks
Max
Work
Period
# of
breaks
Max
Work
Period
# of
breaks
-26 to -28 -15 to -19 (Norm Breaks) 1 (Norm Breaks) 1 75 min. 2 55 min. 3 40 min. 4
-29 to -31 -20 to -24 (Norm Breaks) 1 75 min. 2 55 min. 3 40 min. 4 30 min. 5
-32 to -34 -25 to -29 75 min. 2 55 min. 3 40 min. 4 30 min. 5 non-emergency
work should cease
-35 to -37 -30 to -34 55 min. 3 40 min. 4 30 min. 5 non-emergency
work should cease
non-emergency
work should cease
-38 to -39 -35 to -39 40 min. 4 30 min. 5 non-emergency
work should cease
non-emergency
work should cease
non-emergency
work should cease
-40 to -42 -40 to -44 30 min. 5 non-emergency
work should cease
non-emergency
work should cease
non-emergency
work should cease
non-emergency
work should cease
-43 and
below
-45 and
below
non-emergency
work should cease
non-emergency
work should cease
non-emergency
work should cease
non-emergency
work should cease
non-emergency
work should cease
Table 5-5 Wind Chill Chart
Wind chill, or the cooling effect of moving air, is of critical importance when evaluating the cold exposure of site workers. The potential for frostbite
and hypothermia increases greatly with combined cold temperatures and high wind speeds. Workers should inform the site supervisor, or site safety
officer, if their hands, face, or feet feel numb, and workers should monitor each other for patches of pale or white skin on the face and ears.
The following table describes the cooling power of wind on exposed flesh. This information can be used as a guide for determining equivalent chill
temperatures when the wind is present in cold environments.
Cooling Power of Wind on Exposed Flesh Expressed as an Equivalent Temperature*
In using the table below, values of wind chill below -10° F are considered bitterly cold. Values of wind chill below -20° F are extremely cold - human flesh
will begin to freeze within one minute.
Wind Temperature (° F)
(mph) 35 30 25 20 15 10 5 0 -5 -10 -15 -20 -25
5 31 25 19 13 7 1 -5 -11 -16 -22 -28 -34 -40
10 27 21 15 9 3 -4 -10 -16 -22 -28 -35 -41 -47
15 25 19 13 6 0 -7 -13 -19 -26 -32 -39 -45 -51
20 24 17 11 4 -2 -9 -15 -22 -29 -35 -42 -48 -55
25 23 16 9 3 -4 -11 -17 -24 -31 -37 -44 -51 -58
30 22 15 8 1 -5 -12 -19 -26 -33 -39 -46 -53 -60
35 21 14 7 0 -7 -14 -21 -27 -34 -41 -48 -55 -62
40 20 13 6 -1 -8 -15 -22 -29 -36 -43 -50 -57 -64
Frostbite
Time
Thirty Ten Five
Minutes Minutes Minutes
Wind speeds above 40 mph have little additional chilling effect.
Wind Chill (0F) = 35.74 + 0.6215T - 35.75(V0.16) + 0.4275T(V0.16)
Where, T= Air Temperature (0F) V= Wind Speed (mph)
Table 7-1 Action Levels for Field Activities
Task
Monitoring
Instrument
Monitoring Frequency Action Levels 1 Required Action
These action levels apply to any
work that involves confined
space and excavation at the
project site.
Air monitoring of new tank
construction Non-Permit CS is
not required until the roof
installation is completed
O 2 /LEL/CO/
H 2 S Meter
Twice during a work shift:2
During excavation
Pond water management
LEL < 10%
O 2 > 19.5%
CO < 35 ppm
H 2 S < 10 ppm
Continue Work
NA LEL > 10% Evacuate Area3
INTRUSIVE ACTIVITIES
NA O 2 < 19.5% Evacuate area3
Excavation of any trench over
four feet deep.
NA CO > 35 ppm
H 2 S > 10 ppm Evacuate Area3
Hot work on Stainless Steel Air sample
for Cr6
Hexavalent
Chromium
At the start of hot work and continue until
sufficient samples show a maximum level
of contamination.
When the last sample was above the action
level continue air sampling every 90 days
or when work processes change or a
suspected increase in contamination.
2.5 ug / M3
Start OSHA required
protection.
CFR 1926.1126
1 If any LEL or CO is detected, investigate for cause of increase. If O2 drops below 20.1% or goes above 21.4% and CO above 5 ppm investigate for cause of deviation.
2 Frequency of monitoring may be changed when monitoring records support management consensus for changing monitoring intervals.
Note: LEL readings should be taken at the point of operation. O 2 readings should be taken in the worker’s BZ. 3 Contact Safety and investigate for cause of action level readings.
MEDICAL DATA SHEET
and
Emergency Contact Information
This brief Medical Data Sheet must be completed by all Personnel working on-site and will be kept in the
Project office during the site operations. This data sheet will accompany any personnel when medical
assistance is needed or if transport to the hospital facilities is required:
Site: ________________________________________________________________________________
Name: ___________________________________________ Home Telephone: ____________________
Address:______________________________________________________________________________
_____________________________________________________________________________________
Age: ______________ Height: ______________ Weight: ________________
Person to Contact in Case of Emergency:
1._______________________________________________________ Phone No. ___________________
2._______________________________________________________ Phone No. ___________________
Drug or other Allergies:_________________________________________________________________
Particular Sensitivities: __________________________________________________________________
Do You Wear Contacts? YES NO
Provide a Checklist of Previous Illnesses or Exposures to Hazardous Chemicals:
_____________________________________________________________________________________
What Medications are you presently using? __________________________________________________
_____________________________________________________________________________________
Do you have any Medical Restriction? ______________________________________________________
_____________________________________________________________________________________
Name, Address, and Phone Number of Personal Physician: (if known)
______________________________________________________________________________________
Please complete this acknowledgement form.
EMPLOYEE’S
SAFETY AND HEALTH MANUAL
ACKNOWLEDGE
I ACKNOWLEDGE MY RESPONSIBILITY TO READ AND
UNDERSTAND THE CONTENTS OF THE EMPLOYEE SAFETY
& HEALTH MANUAL (ESHM). I AGREE TO FOLLOW THE
PROCEDURES OUTLINED IN THE ESHM. FAILURE TO
FOLLOW THE PROCEDURES IN THE ESHM MAY RESULT IN
DISCIPLINARY ACTION OR TERMINATION. IF I HAVE
FUTURE QUESTIONS CONCERNING SAFETY & HEALTH
PROCEDURES OR POLICIES I WILL ASK MY SUPERVISOR
OR THE COMPANY SAFETY DIRECTOR
I ALSO UNDERSTAND THAT FAILURE TO IMMEDIATELY
REPORT A JOB SITE INJURY OR ILLNESS TO MY
SUPERVISOR MAY RESULT IN THE DENIAL OF WORKER
COMPENSATION BENEFITS.
EMPLOYEE NAME/DATE____________________________________
(PRINT) (DATE)
EMPLOYEE SIGNATURE ___________________________________
PROJECT/LOCATION______________________________________
Return the completed form to your supervisor.
HAZARD COMMUNICATION AND RIGHT-TO-KNOW
STANDARDS EMPLOYEE TRAINING RECORD
INITIAL:
1.I have been informed about the Hazard
Communication Program, GHS Program, Safety
Data Sheets (SDS), their use and location, and
the procedures to obtain copies.
2.I have been informed that some of my work
may involve exposure to toxic substances, the
hazards of which will be reviewed with me in
safety meetings or site-specific training.
3. I have been informed about the right of
employees to have access to relevant
exposure and medical records, and the
procedures for requesting access.
4. I understand that the company must act upon a
request in a reasonable amount of time so as
to avoid interruption of normal work operations.
5. I have been provided access to the applicable
regulations governing hazard communication,
and access to employee exposure and medical
records.
PRINT NAME:______________________________
SIGNATURE:_____________________________
By my signature I have received and understand the
company Haz Com Right to Know training.
DATE:________________
Q:What is the Global Harmonization System (GHS)?
A:
GHS is an international system used to
classify hazardous chemicals and standardize
hazard information on product labels and
safety data sheets, called SDSs.
Q:What is a Safety Data Sheet?
A:
A Safety Data Sheet (SDS) is replacing the
Material Safety Data Sheet (MSDS) as the
primary source for detailed hazard information
about chemical products. SDSs follow a
standardized format while MSDSs are permitted
to take on a variety of formats. The consistent
format of SDSs is expected to increase familiarity
so that employees can find information with
quicker success, especially in emergency
situations. To see what is included in one, visit the
OSHA website at www.OSHA.gov/Publications/
HazComm_QuickCard_SafetyData.html .
Q:Who is impacted by the GHS-based changes?
A:
All employers and chemical manufacturers,
importers, and distributors who are subject
to Chemical Hazard Communication rules in
Washington State will need to adapt to the
new GHS-based rules.
Q:When will the GHS changes affect me?
A:
Once the GHS-based changes are integrated
and adopted into Washington State’s Hazard
Communication rules, the new requirements
will be phased in and further information will
be provided by L&I. Here’s how you can stay
informed:
Sign up for L&I’s Division of Occupational
Safety and Health (DOSH) Listserv at
www.Lni.wa.gov/Main/Listservs/
SafetyStandards.asp .
See new rules activity at www.Lni.wa.gov/
Safety/Rules/WhatsNew .
Q:Will I need to change my Hazard
Communication Program?
A:
Yes. Once GHS-based requirements go into
effect in Washington State, your required
Hazard Communication Program will need
to be modified to include the new labels and
standardized SDS format. Your employees
will also need to be trained so they can
understand and use the new labels and SDSs.
The federal Occupational Safety
& Health Administration (OSHA)
has made changes to the Federal
Hazard Communication Standard based on the
International Global Harmonization System of
Classification and Labeling of Chemicals (GHS).
Washington State must adopt these changes, and
rulemaking is underway at the Department of
Labor & Industries (L&I) to do so.
These changes are intended to improve
comprehension of hazard information found on
product labels. Safety Data Sheets (SDSs) will
replace the current Material Safety Data Sheets
(MSDSs). The ultimate goal of these changes is to
more effectively prevent injuries and illnesses
and save lives.
www.Lni.wa.gov/Safety 1-800-423-7233
Division of Occupational Safety and Health
Questions and Answers:
Hazard Communication StandardQ&A
Background
OVER
Q:How do I know if I must follow the
manufacturer requirements of the rule?
A:
The definition for “chemical manufacturer”
will remain consistent with current rules.
You are considered a manufacturer when
you are an employer with a workplace
where chemicals are made, processed,
formulated, blended, extracted, generated,
emitted, or repackaged for use or distribution.
Manufacturers will need to follow changing
requirements for hazard classification,
labeling, and SDSs.
Q:What do I do about my old MSDSs? Do I need
to keep them?
A:
You need to keep them until you phase out
of your current stock of chemicals, and then
replace them with each chemical’s new SDS,
as they become available.
Q:How will labels change?
A:
The information on labels will become
more standardized to increase employee
comprehension of the potential hazards and
precautions. New labels will feature:
Hazard Pictograms (framed by a red border)
A Signal Word, such as DANGER
Hazard and Precautionary statements
A Product Identifier and a Supplier Identifier
For more information and sample labels and
pictograms, visit the OSHA website at:
www.OSHA.gov/dsg/hazcom/index.html .
For sample labels, see
www.OSHA.gov/Publications/HazComm_
QuickCard_Labels.html .
For pictograms, see
www.OSHA.gov/Publications/HazComm_
QuickCard_Pictogram.html .
Q:Will L&I have information online for me to use,
such as training and sample programs?
A:
L&I will provide training resources as soon as they
are developed. These resources will be located at
www.Lni.wa.gov/Safety/Topics/AtoZ under “H”
for Hazard Communication. You may also sign up
for listserv updates at www.Lni.wa.gov/Main/
Listservs/SafetyStandards.asp .
PUBLICATION F417-242-000 [12-2012]
December 2012
EMPLOYEE
AERIAL LIFT TRAINING RECORD
NAME LOCATION
SUPERVISOR
EMPLOYEE NUMBER INITIAL OR REFRESHER TRAINING (CIRCLE ONE)
AERIAL LIFT MAKE/MODEL(s)
•I have reviewed and agree to abide by the requirements established in the aerial lift
operation procedure.Initials
•I have reviewed, understand, and agree to abide by the aerial lift operational rules
described in Procedure HS818 or the Site HASP and the manufacturer's operating manual.
Initials
•I acknowledge that it is my responsibility to conduct a daily inspection of the aerial lift that I
will be expected to operate.
Initials
EMPLOYEE SIGNATURE DATE
•I have observed a demonstration of the aerial lift operational skills for the above employee
and feel that they understand the aerial lift's operational features, are familiar with safety
rules and operational requirements, and have demonstrated satisfactory operating skills.
INSTRUCTOR NAME
Print
INSTRUCTOR SIGNATURE DATE
Keep a copy of this training record in this book to be forwarded to the safety office at the
close of the project.
Notice:
If Aerial Lift will not be
used at this project site,
Training Not Required.
EMPLOYEE TRAINING RECORD:
LADDER TRAINING*
NAME EMPLOYEE NUMBER
LOCATION SUPERVISOR
1.I have reviewed, understand, and agree to abide by the ladder procedures described in Procedure
HS301 Fixed Ladders &/or HS302 Portable Ladders or the Site HASP. (circle the one(s) completed)
2.I acknowledge that it is my responsibility to inspect ladders prior to their use and after any event that
could result in ladder damage.
3.I shall ensure any ladder I climb on is on a stable surface and secured so the feet cannot slide out or
will not tip over.
SIGNATURE DATE
I have observed a demonstration of the ladder usage skills for the above employee
and feel that he or she understands how to correctly use a ladder; is familiar with
safety rules and regulatory requirements; and has demonstrated satisfactory ladder
skills.
INSTRUCTOR SIGNATURE DATE
Keep a copy of this training record in this book to be forwarded to the safety office
at the close of the project.
Notice:
If Ladders will not be
used at this project site,
Training Not Required.
EMPLOYEE
FORKLIFT TRAINING RECORD
NAME LOCATION
SUPERVISOR
EMPLOYEE NUMBER INITIAL OR REFRESHER TRAINING (CIRCLE ONE)
FORKLIFT MAKE/MODEL(s)
•I have received forklift training through my union within the past three years for the forklift I
will be operating. Initials
As supervisor I have verified the operator certification card. Initials
•I have reviewed and agree to abide by the requirements established in the forklift operation
procedure.
Initials
•I have reviewed, understand, and agree to abide by the forklift operational rules described in
Procedure HS820 and the manufacturer's operating manual.
Initials
•I acknowledge that it is my responsibility to conduct a daily inspection of the forklift that I will
be expected to operate.
Initials
EMPLOYEE SIGNATURE DATE
•I have observed a demonstration of the forklift operational skills for the above employee and
feel that they understand the forklift's operational features, are familiar with safety rules and
operational requirements, and have demonstrated satisfactory operating skills.
INSTRUCTOR/SUPERVISOR NAME
Print
INSTRUCTOR/SUPERVISOR SIGNATURE DATE
Keep a copy of this training record in this book to be forwarded to the safety office at the
close of the project.
Notice:
If Forklifts will not be
used at this project site,
Training Not Required.
DAILY WALK THROUGH AND SAFETY MEETING FORM
Project Name/Number: Date: Time:
Client:
Work Activities:
Safety Topics Presented
Physical Hazards: Slips, Trips, Falls, Cuts, Burns, Flash Burns, Loud Noises, Smashed Body Parts,
Dropped items, Heights
Chemical Hazards:
Specific Work Activity Personal Protective Equipment:
Activity: Cutting/Grinding/Welding PPE Hardhat/Face Shield, Boots, Gloves, Safety Glasses, Ear Protection
Activity: PPE Hardhat/Face Shield, Boots, Gloves, Safety Glasses, Ear Protection
Activity: PPE
New Equipment: 1 2
Other Safety Topic(s): 1 2
Topic Discussion: • Wear PPE at all times (Safety harness when required).
•Be aware of your surroundings/ look out for others.
•Permit required confined space Y/N (circle one)
•
•
DAILY SITE REVIEW CHECK LIST
Employee Safety PPE
Mobile Crane
Daily Checklist Completed
LOOK FOR OVERHEAD POWER
LINES
Crane Work Basket Day use check completed
Rigging Equipment Reviewed-Damage
Spreader Bar Reviewed-Damage
Sheet Clamps Reviewed-Damage
Gen Set
Grounded
Setting on earthen
Ground or with
Grounding rod
Welder Compressor Pack
Grounded-setting on earthen
ground or to Gen Set
Required Initials Notes
Equipment Fueling
Grounded to equipment during
fueling-
Spill and Fire Extinguisher Kits
available & spill protection under
fueling in process
Compressed Gas Bottles
Separate Storage locations for
Oxygen & Flammables Secure
from tipping -
Valve Cap on.
Fire Extinguishers At designated locations
Gen Set, Fuel Tank & Mobile equip
Scaffolding Inside edge of planks within 12
inches of tank Handrails
Overhead Protection Above all entryways
Fall Protection Available for all employees
working at heights & in Boom Lifts
Fall Protection –
Fixed ladders & Vert buggies
Use Self-retracting (YoYo’s) Life
lines Off set landings every 30 feet
are not a substitute
Welding Leads & Gas Hoses Protected through tank opening -Damage
Extension Cords Connected to GFCI when in-use -
Damage
Confined Space-
Non Permit
Air Monitoring -Door sheet out
Tank is exempt
Excavation Equipment Cordon off swing area and truck
loading area
Excavation/Trenching
Shoring, Benching or Slopping, Edge distance to vehicle traffic
Ingress/Egress – Air monitoring
O2, LEL, CO, H2s
Traffic Control
Traffic control plan for site &
vehicle Entry / Exit for public road
NAME PRINTED SIGNATURE
Required Initials Notes
Attendees
Meeting conducted by:
T Bailey, Inc.
CRANE OPERATOR'S DAILY CHECK LIST
CRANE NO. TYPE/CAPACITY LOCATION
CERTIFICATION EXPIRATION DATE SHIFT HOUR METER
1 2 3 START STOP
DATE OPERATOR'S NAME
LEGEND
S = SATISFACTORY U = UNSATISFACTORY NA = NOT APPLICABLE In Remarks: R(1,2,etc.) = REMARKS (see comments below)
1 WALK AROUND CHECK 2 MACHINERY HOUSE CHECK
a Safety Guards and Plates
S U NA Remarks
a Housekeeping
S U NA Remarks
b Carrier Frame and Rotate Base * b Diesel Engine and Generator *
c General Hardware c Leaks
d Wire Rope * d Lubrication
e Reeving * e Battery
f Block * f Lights
g Hook * g Glass
h Sheaves * h Clutches and Brakes *
i Boom and Jib * i Electric Motors *
j Gantry, Pendants and Boom Stops * j Auxiliary Engine and Compressor
k Walkways, Ladders and Handrails k Danger/Caution Tags
l Windlocks and Boom Stops I Fire Extinguishers
m Tires/Wheels and Tracks m Hoist drum pawl/rachet locks *
n Leaks
o Outriggers/Stabilizers and Locking Devices *
p Load Chain *
q Inspect Jib before/after each deployment *
r Inspect Jib before/after each deployment *
s Inspect Jib before/after each deployment *
3 OPERATOR CAB CHECK 4 OPERATING TEST
a Gauges
S U NA Remarks
a Check for Power Lines *
S U NA Remarks
b Indicator and Warning Lights b Area Safety *
c Visibility * c Crane Stability *
d Load Rating Charts * d Unusual Noises
e List/Trim Indicator (Floating Cranes) * e Operation *
f Boom Angle/Radius Indicator * f Control Action *
g Fire Extinguisher g Brakes *
h Level Indicator (Mobile Cranes) * h Boom Angle/Radius Indicator *
i Limit Switches *
j Emergency Stops *
k Other Operational Safety Devices *
l General Safety Devices
m Fleeting Sheaves
INSTRUCTIONS - Check all applicable items indicated, each shift. Suspend all operations immediately when observing an unsatisfactory condition of any
item indicated with an asterisk (*) unless the condition has been reviewed and the company maintenance manager and authorized continued operation in
writing. (Authorization letter shall be attached to this checklist) In addition, suspend operation when any unsafe condition is observed and immediately
notify supervisor. For any unsatisfactory item, identify the specific component and describe the deficient in the "Remarks" block.
REMARKS:
Use other side for more room.
OPERATOR'S SIGNATURE
DATE
SUPERVISOR'S SIGNATURE
DATE
DAILY AERIAL LIFT PRE-USE INSPECTION CHECKLIST
PROJECT/LOCATION NAME:______________________________________________________________ LOG #: ___________________
AERIAL LIFT MAKE/MODEL:_________________________________________________________________________________________
INSPECTION Week of:________________& COMPLETED BY: Mon. ___________________________ Tue.___________________________
(MM/DD/YYYY)
Wed.______________________________ Thu._________________________________ Fri._____________________________________
Sat. ______________________________________________ Sun. __________________________________________
ITEM ACCEPTABLE NOT ACCEPTABLE NOT
APPLICABLE DISCREPANCY
M T W T F S S M T W T F S S
Chassis (visual, cracks, dents, etc.)
Boom (visual, cracks, dents, etc.)
Platform
Controls (operation)
Gate
Hydraulics (visual)
Leaks
Loose Fittings
Fluid Levels
Tires (visual)
Excessive Wear
Splits
Missing Material
Loose/Missing Lug Nuts
Engine Compartment (visual)
Fluids Levels
Leaks
Fire Extinguisher (installed)
Emergency Controls (operate)
Gauges/Indicators (operate)
Steering
Lights
Horn
Travel Indicator
Brakes
Wiring Harness
Power Battery
Fuel System (Tank, Lines)
Safety Harness & Lanyard
If an unsafe condition is identified, a supervisor is to be immediately informed of the condition and the aerial lift not operated until
adequate repairs have been made.
COMMENTS:
DAILY FORKL IFT PRE-USE INSPE CTION CHE CKL IST
PROJECT/LOCATION NAME: LOG #:
FORKLIFT MAKE/MODEL:
INSPECTION Week of: & COMPLETED BY: Mon. ________________________ Tue.___________________
(MM/DD/YYYY)
Wed. _____________________________________Thu.________________________________Fri.____________________
Sat. Sun.
ITEM
ACCEPTABLE NOT
ACCEPTABLE NOT
APPLICABLE DISCREPANCY
M T W T F S S M T W T F S S
Fire Extinguisher
Mast
Roller
Forks
Hydraulics
Leaks
Loose Fittings
Fluid Levels
Tires
Excessive Wear
Splits
Missing Material
Separation From Rim
Loose/Missing Lug Nuts
Fork Carriage
Tilt Mechanism
Gauges/Indicators
Steering
Lights
Horn
Backup Indicator
Brakes
Other Fluids
Leaks
Levels
Power Source
Battery
Fuel System (Tank, Lines)
Seat Belt
If an unsafe condition is identified, a supervisor is to be immediately informed of the condition and the forklift not operated until
adequate repairs have been made.
COMMENTS:
Other fall hazards in the work area. Use extra sheets if necessary:
SITE SPECIFIC
FALL PROTECTION WORK PLAN
INSTRUCTIONS
A written fall protection work plan must be implemented by each employer on a job site where a fall
hazard of 10 feet or greater exists, in accordance with Department of Labor and Industries, WISHA
Regulations. The plan must be specific for each work site. The plan must be signed by all
T BAILEY Workers on the job site.
THIS WORK PLAN WILL BE AVAILABLE ON THE JOB SITE FOR INSPECTION
This fall protection work plan form must be filled out for each project where T BAILEY has
employees exposed to a fall hazard of 10 feet or greater prior to initiation of the work.
1.FILL OUT THE SPECIFIC JOB INFORMATION.
Project Name: Date
Job Task:
Job Foreman:
2.FALL HAZARDS IN THE WORK AREA
INCLUDE LOCATIONS AND DIMENSIONS FOR HAZARDS
Elevator shaft: Stairwell:
Leading edge: Window opening:
Outside static line: Roof eave height:
Perimeter edge: Roof perimeter dimensions:
Specific types of equipment on the job are:
3. METHOD OF FALL ARREST OR FALL RESTRAINT
(For fall protection equipment include details, such as manufacturer etc.)
Full body harness: Body belt (Restraint only):
Lan yard: Dropline:
Lifeline: Restraint line:
Horizontal lifeline: Rope grab:
Deceleration device: Shock absorbing lanyard:
Locking snap hooks: Safety nets:
Guard rails: Anchorage points:
Catch platform: Scaffolding platform:
Safety monitor: Name of monitor, if used:
Other:
4. ASSEMBLY, MAINTENANCE, INSPECTION, DISASSEMBLY PROCEDURE
Assembly and disassembly of all equipment will be done according to manufacturers’ recommended
procedures. (Include copies of manufacturer’s data for each specific type of equipment used.)
A visual inspection of all safety equipment will be done daily or before each use, as stated in the
Employee Training Packet. Any defective equipment will be tagged and removed from use
immediately. The manufacturer’s recommendations for maintenance and inspection will be
followed.
5. HANDLING, STORAGE & SECURING OF TOOLS AND MATERIAL
Toe boards will be installed on all scaffolding to prevent tools and equipment from falling from
scaffolding.
Other specific handling, storage and securing is as follows:
6. OVERHEAD PROTECTION
Hard hats are required on all job sites with the exception of those that have no exposure to overhead
hazards. Warning signs will be posted to existing hazards whenever they are present. In some cases,
debris nets may be used if a condition warrants additional protection.
Additional overhead protection will include:
Toe boards (at least 4 inches in height) will be installed along the edge of scaffolding and walking
surfaces for a distance sufficient to protect employees below, except when using tank scaffolding.
Where tools, equipment or materials are piled higher than the top of the toe board, paneling or
screening will be erected to protect employees below.
7. INJURED WORKER REMOVAL
Normal first aid procedures should be performed as the situation arises. If the area is safe for entry
and the employee has only suffered minor injuries then they should be removed from the area and
treated by Emergency Personnel. If the injury is thought to be serious or the employee is
unconscious the injured employee will not be moved unless their life is in imminent danger.
Emergency rescue personnel will be contacted for all other removals.
Initiate Emergency Services – Dial 911
Building location:
Room location:
Other:____________________________ Location:
Rescue considerations. When personal fall arrest systems are used, the employer must assure that
employees can be promptly rescued or can rescue themselves should a fall occur. The availability of
rescue personnel, ladders, or other rescue equipment should be evaluated. In some situations,
equipment that allows employees to rescue themselves after the fall has been arrested may be
desirable, such as devices that have descent capability.
8. SITE SECURITY
It is important to secure your site. No unauthorized people are allowed beneath your work area. Keep
people out through barriers and signage.
9. TRAINING AND INSTRUCTION PROGRAM
All new employees will be given instructions on the proper use of fall protection devices before they
begin work. They will sign a form stating they have been given this information. This form
becomes part of the employee’s personnel file.
The written fall protection work plan will be reviewed before work begins on the job site. Those
employees attending will sign below. The fall protection equipment use will be reviewed regularly
at the weekly safety meetings.
Date: ______________________________
Print Sign
Foreman:
Prior to permitting employees into areas where fall hazards exist, all employees must be trained
regarding fall protection work plan requirements. Inspection of fall protection devices/systems must
be made to ensure compliance with WAC 296-155-24510.
Project Name: Single Head Automatic Girth Welder Checklist Page
& Number: Setup Check List of
Completed
(Operator’s Initials) NOTES
Place addition
notes on the
reverse side with
reference #
Inside Date &
Course
Date &
Course
Date &
Course
Date &
Course
Date &
Course
Check Item
Removed from truck and assembled fragile
parts
1
Removed shipping supports 2
Adjusted height spacing 3
All vertical seams are Secure/Dogged 4
Set AGW on tank & adjusted wheel radius 5
Removed obstacles from path
(10” above to 20” below welding seam)
6
Position welding leads and hoses to allow
free movement
7
Outside
Before moving from inside to outside
insure adequate slack in leads and hoses
8
Set AGW on tank & adjusted wheel radius 9
Removed obstacles from path
(10” above to 20” below welding seam)
10
Position welding leads and hoses to allow
free movement
11
Remove AGW from tank before setting
next course!
12
Warning: 100% tie-off when climbing on AGW (Exception: see Procedure Inside line 8 & Outside line 5)
Only one signature per operator is required
Operator:
Print Name Signature Initials
Operator:
Print Name Signature Initials
Operator:
Print Name Signature Initials
Operator:
Print Name Signature
_
Initials
Operator:
Print Name Signature Initials
Operator Definition: An operator is any person that helps with the setup, moves or operates the AGW in any way.
Workbasket Inspection Checklist
Completed
Date/Time
1.Crane and workbasket inspection
2.Trial lift or full-cycle operational test lift completed before hoisting employees for the first time.
3.Visual inspection of the crane, workbasket and base support conducted after the test lift
4.A copy of the Daily and Monthly Safety Inspection checklist attached to this Suspended Personnel
Workbasket checklist and authorization form.
5.Any defects found during inspections were corrected.
PRE-LIFT MEETING
1.Meeting attended by the operator, signal person(s), and worker(s) to be lifted.
2.Review of the lift procedure and the work procedures completed.
3.Personnel hoisting operations orientation, new work location or newly assigned employee(s).
Print Name:
Signature:
Note: If Optional Basket Worker is not used place N/A in Print Name box.
Suspended Workbasket Authorization
We the undersigned of Project
at
Project Name / Number Location: City / State
Have verified all safety checklists are completed and approve the
workbasket operation for the work at
__________________________________________________________ Project Name
ON
________________________________ Date
Position/Title Print Name Signature Date
Site Supervisor
or
Forman
Required
Crane Operator Required
Basket Worker Required
Basket Worker Optional
Basket Worker Optional
Example (Sample) Permit and Non-Permit Designation Criteria (Sample)
CONFINED SPACE HAZARD EVALUATION
Project: Example Project # 12345 Eval. # 3 of 4
Location/Address Western States, USA Eval Date 6/05/06
Reason for Evaluation: Roof Installation
1.Past and current uses of space which may adversely affect the atmosphere of the space.
New Construction – No connection to water source – Open top natural ventilation
See atmosphere-testing log.
2.Physical characteristics, configuration and location of the space.
(Dimensions & Cubic Feet, number of entryways, etc. or attach drawing copy)
Tank: 85-foot diameter by 50 feet high. Three man ways, 39 inches in diameter and 26 inches
from bottom of man way to floor of tank.
3.Identify existing or potential hazards in the space such as (List and elaborate as necessary // What
work hazards will be created?):
A.Oxygen enrichment or deficiency: (welding, shielded welding, cutting, arc gouging, grinding etc.)
Work caused potential hazards:
Shielded gas welding, arc gouging, sub arc welding and grinding
B. Flammable / explosive gas, vapor, dust: (propane, acetylene, chemicals, etc.) None
C. Potential toxic air contaminants: (chemicals, paint, etc.) None
D. Biological: (organic material / sediment after water drained from used tank, rust, etc.) None
E. Mechanical: (moving parts) None
F. Other: None
4. Hazard Evaluation (Identify and elaborate as necessary):
A.Scope of exposure (consider size (cubic feet) of space) (PI x r2 x h) (PI=3.141593)
Welding inside seam of roof to tank, one person 4.3 hours, for two workers 2.0 hours.
(283,725.09 cubic feet)
B. Magnitude (serious injury or death) None
C. Likelihood of hazard occurrence: None
D. Consequences of hazard occurrence: Stop work activity
E. Potential for changing conditions Minimal if the man way covers are closed during
welding activity.
Example F. Strategies for controlling hazards (removing debris, ventilation, etc.) (283,725.09 cubic feet)
Natural convection airflow through man ways and roof vents. Man way covers
secured open.
Forced air ventilation 3500 cfm – one change of air every 1.35 hours
“ “ 1850 cfm – one change of air every 2.55 hours
Forced air ventilation used as a precaution only.
G. Impact on need for emergency response. None
5. Classification of confined space. (Circle one)
Non-Permit Space Alternate Entry Procedures Permit Required Confined Space
Comply with WAC and OSHA Codes Comply with TBI Confined Space Program
6.Next scheduled re-evaluation of space. (Installation of roof, doorplate, etc.)
Installation of doorplate
Evaluation performed by: Site Supervisor Date: 6/05/99
Evaluation reviewed by: Project Manager Date: 6/05/99
Note: If you have any questions on the confined space call the safety office, (360) 293-0682 ext 251
or cell phone (206) 790-0911. (Sample)
Page 1 of 2
Permit and Non-Permit Designation Criteria
CONFINED SPACE HAZARD EVALUATION
Project: Project # Eval. # of
Location/Address Eval Date
Reason for Evaluation:
1.Past and current uses of space which may adversely affect the atmosphere of the space.
New Construction | Used tank: Potable Water | Other: (paint cure time)
Work caused:| (circle one) Distilled Water |
| Waste Water |
| Chemicals |
2.Physical characteristics, configuration and location of the space.
(Dimensions & Cubic Feet, number of entryways, etc. or attach drawing copy)
3.Identify existing or potential hazards in the space such as (List and elaborate as necessary // What
work hazards will be created?):
A. Oxygen enrichment or deficiency: (welding, shielded welding, cutting, arc gouging, grinding etc.)
B. Flammable / explosive gas, vapor, dust: (propane, acetylene, chemicals, etc.)
C. Potential toxic air contaminants: (chemicals, paint, etc.)
D. Biological: (organic material / sediment after water drained from used tank, rust, etc.)
E. Mechanical: (moving parts)
F. Other:
4. Hazard Evaluation (Identify and elaborate as necessary):
A. Scope of exposure (consider size (cubic feet) of space)
B. Magnitude (serious injury or death)
Page 2 of 2
C. Likelihood of hazard occurrence
D. Consequences of hazard occurrence
E. Potential for changing conditions
F. Strategies for controlling hazards (removing debris, ventilation, etc.)
G. Impact on need for emergency response
5. Classification of confined space. (Circle one)
Non-Permit Space Alternate Entry Procedures Permit Required Confined Space
Comply with WAC and OSHA Codes Comply with TBI Confined Space Program
6.Next scheduled re-evaluation of space. (Installation of roof, doorplate, etc.)
Evaluation performed by:Date:
Evaluation reviewed by: Date:
Note: If you have any questions on the confined space call the safety office, (360) 293-0682 ext 251 or
cell phone (206) 790-0911.
Post this evaluation by the confined space entry or with the entry permit.
CONFINED SPACE ENTRY PERMIT
Location of Confined Space and description:
Permit Space to be entered:
Date /Time:
Purpose of entry:
Duration:
Entry Supervisor: Company:
Entry Supervisors signature of entry approval: Signature:
Expires on:
Date / Time of permit closure:Signature:
Communication procedures during entry: voice sight Radio-- Other
Authorized Entrant’s Name: Initial: Sign In-TIME/DATE Sign Out-TIME/DATE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Authorized Attendant’s Name: Initial: Sign In-Time/Dat e Sign Out-Time/Date
1.
2.
3.
4.
5.
6.
Type of Confined Space Being Entered: Select one:
l.1. This is a "PERMIT REQUIRED" Confined Space
2.This is an "ALTERNATE ENTRY PROCEDURE" Confined Space
3. This is a "NON-PERMIT REQUIRED" Confined Space- All hazards have been eliminated.
list of Potential Hazards of the Space:
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
Methods of Hazard Mitigation
MEASURES FOR ISOLATING
EQUIPMENT
YES NO NA YES NO
Continuous Air Monitoring Standby Rescue Personnel
kLockout/tag out Hearing protection- If needed
Self-contained breathing apparatus (SCBA) Head/Eye protection
line(s) broken- capped/blanked Air-line respirators w/ Emergency Escape Capabiliti es
Purge - flush & vent Air purifying respirat ors & cartridges
Ventilation Protecti ve clothing
Communication equipment lifelines
Secure area (post & flag) Hot work permit
Full body harness w/ D ring lighting (explosi on proof)
Tripod emergency escape unit Fire Extinguishers
Other: Other:
PRE ENTRY TEST
Atmospheric Monitoring
Test 1 PRE Entry Results Test 2 Test 3
Test(s) Accept able levels Required Date: Date: Date:
Ti me: Time: Time:
Oxygen 19.5-23.5% Yes/No
Combustible Gas Below 10% of LEL Yes/No
Carbon Monoxide 0 - 25 ppm Yes/No
Hydrogen Sulfide 0-10ppm Yes/No
Other: Yes/No
Individual performing initial entry test:
(Signature) Sign here:
Date: Time:
Continual Monitoring
Atmospheric Monitoring Sample Results (record actual readings)
Test 4 Test Test 6 Test 7
Test(s) Acceptable levels Required Date: Date: Date: Date:
Time: Time: Time: Time:
Oxygen 1 9.S-23.S%Yes/No
Combustible Gas Below 10% of LEL Yes/No
Carbon Monoxide o-25 ppm Yes/No
Hydrogen Sulfide 0 -10 ppm Yes/No
Other: Yes/No
Instruments Used
Model
Calibration Date
Individual Conducting Test (signature) J Sign Here: Date:
The Entry Supervisor must complete this section after the entry has been terminated.
Reason for Termination of Entry:
The work described in this permit was completed
A condition or situation in or near the confined space that required termination
End of Shift/ End of hour limitation
Return the completed Permit to the Supervisor
Entry Supervisor: Pri nt Name Signature Organizati on
Example Atmosphere Log
Project: Example Project # 12345 Log # 4 of 6
Location/Address Western States, USA Start Date 3/29/11
Reason for Log: Roof installation and start of forced air ventilation
Date /Time O2
19.5 – 22.5%
LEL
Max. 10%
CO
Max. 35 ppm
Toxin1 Cause of Deviation
& Correction
Floor BZ Floor BZ Floor BZ Floor BZ
6/05/99 - 0700 20.9 20.9 0 0 0 0 NA NA
6/05/99 - 0800 20.9 20.9 0 0 9 8 NA NA Generator exhaust blowing into fan
intake / Moved fan intake
6/05/99 - 0815 20.9 20.9 0 0 0 0 NA NA
6/05/99 - 0830 20.9 20.9 0 0 0 0 NA NA
6/05/99 - 0900 20.1 20.6 0 0 0 0 NA NA Leak in Argon gas hose / Replaced
hose
6/06/99 - 0930 20.9 20.9 0 0 0 0 NA NA
6/06/99 - 1030 20.9 20.9 0 0 0 0 NA NA
6/06/99 - 1200 20.9 20.9 0 0 0 0 NA NA
6/06/99 - 1400 20.9 20.9 0 0 0 0 NA NA
6/07/99 - 0700 20.9 20.9 0 0 0 0 NA NA
6/07/99 - 1200 20.9 20.9 0 0 0 0 NA NA
6/07/99 - 1600 20.9 20.9 0 0 0 0 NA NA
6/08/99 - 0700 20.9 20.9 0 0 0 0 NA NA
6/08/99 - 1200 20.9 20.9 0 0 0 0 NA NA
6/08/99 - 1600 20.9 20.9 0 0 0 0 NA NA
If any LEL or CO is detected, investigate for cause of increase.
If O2 drops below 20.1% or goes above 21.4% investigate for cause of deviation.
Readings at or beyond limits, evacuate the space. Find and eliminate cause of hazard,
complete new evaluation form before reentry.(Sample)
Atmosphere Test Log
Project: Project # Log # of
Location/Address Start Date
Reason for Log:
Date /Time O2
19.5 – 22.5%
LEL
Max. 10%
CO
Max. 35 ppm
Toxin1 Cause of Deviation
& Correction
Floor BZ Floor BZ Floor BZ Floor BZ
If any LEL or CO is detected, investigate for cause of increase.
If O2 drops below 20.1% or goes above 21.4% investigate for cause of deviation.
Readings at or beyond limits, evacuate the space. Find and eliminate cause of hazard,
complete new evaluation form before reentry.
Reference: Policy HS300 Confined Space
***Please retain this form for the project files on site***
12441 Bartholomew Road, Anacortes, WA 98221
A/D Name:
Project Number: Equipment #: Configuration:
Location: Model #: Date:
OK N/A Crane has been assembled and configured in accordance with the manufacture's criteria
OK N/A Ground conditions offer equipment proper support with little or no ground settling around outriggers
OK N/A Crane is in a level position within tolerances specified by the crane's manufacturer's recommendations
OK N/A Components being assembled have been pre-inspected prior to assembly
OK N/A Capacity Chart available OK N/A Appearance / House Keeping
OK N/A Operators Manual available OK N/A Tools / OPM supplies
OK N/A Fire Extinguisher charged and available OK N/A Ladder / Hand Holds
OK N/A Backup Alarms OK N/A Machinery Guards in place
OK N/A Boom Angle Indicator OK N/A Fuel Filler Location
OK N/A Load Moment Device OK N/A Instrument Check
OK N/A Telescoping Length Indicator OK N/A Glass / Visibility
OK N/A Load Indicator OK N/A Cab in neat orderly manner
OK N/A Controls Operational OK N/A Tires / Wheels (pressure / cuts)
OK N/A Hydraulic Leaks OK N/A Battery
OK N/A Drum rotation Indicator OK N/A Horn
OK N/A Turntable OK N/A Brakes, Clutches
OK N/A Swing Brakes OK N/A Power Boom Hoist
OK N/A Swing Mechanism / Circle OK N/A Boom Hoist Pawl
OK N/A Fluid levels (Hydraulic, oil, water)OK N/A Boom Hoist Kickout
OK N/A Check Valves OK N/A Power load Lowering
OK N/A Air Leaks OK N/A Brake Locks
OK N/A Pressure Settings OK N/A Revolving Frame
OK N/A Travel Mechanism OK N/A Gantry
OK N/A Hook and Block OK N/A Jib sections
OK N/A Headache Ball OK N/A Jib Stops
OK N/A Sheaves OK N/A Jib Pins / Keepers
OK N/A Sheave guards OK N/A Pendants
OK N/A Reeving correct OK N/A Weld Cracks or Corrosion
OK N/A Wedge OK N/A Counter Weight(s)
OK N/A Wire Ropes OK N/A Quick couplers securely fastened
OK N/A Sockets OK N/A Outrigger Pads
OK N/A Cable Clamps OK N/A Boom sections
OK N/A Auxiliary Head OK N/A Boom Stops
Exceptions Noted:
(If there are new components added, a new post assembly inspection report must be completed)
(Inspection report is required to stay on site for the duration of the job)
General
Machinery / Upper / Chassis (Crawler / Conventional Type Crane in Yellow)
Attachments (Crawler / Conventional Type Crane in Yellow)
Post Assembly Crane Inspection Report
ASSEMBLY / DISASSEMBLY SAFETY MEETING LOG
Date: Job#: Time: ( _)am / ( )pm Crane#:
Topic covered for assembly / disassemble crew instructions:
By signing below, I certify that I have the necessary qualifications to perform the duties that I have been assigned. I also understand my duties and
responsibilities and that the above list is not all encompassing.
A/D Director Signature Crew Member Signature
Crew Member Signature Crew Member Signature
Crew Member Signature Crew Member Signature
Yes N/A Assist Crane / Self Erecting (if applicable):
Locations identified
No critical lifts
LMI configured properly
Minimize radius / movement
Yes N/A Weight Of Components (if applicable):
Weight is marked or in trailer configuration book
Verify weights prior to lifting components
Yes N/A Center Of Gravity (COG) (if applicable):
Lift loads with hook / boom tip centered over center of
gravity
Yes N/A Working Under Boom / Jib (if applicable):
Avoid working under boom or jib during assembly /
disassembly
Safe use of hand tools
Pin removal process (see manufacturer assembly /
disassembly manual)
Ensure stability prior to pin removal
Yes N/A Blocking of Boom / Jib (if applicable):
Blocking must be placed to protect structural integrity of
equipment
Blocking must be placed to prevent dangerous movement
and collapse
Ensure blocking is in acceptable condition prior to use
Yes N/A Boom / Jib Pick Points (if applicable):
Ensure proper rigging/ slings are selected
Rigging / slings are in acceptable condition
Rigging / slings are attached to appropriate pick points
Rigging / slings are used properly
Yes N/A Boom Pendants (snagging) (if applicable):
Pendants must not be allowed to catch on boom or jib pins
/ keepers
Yes N/A Boom Hoist Brake (if applicable):
Test boom hoist brake in accordance with manufacturer
operations manual
Yes N/A Adverse Weather:
Communicate with lift director regarding weather
conditions
Determine effect of weather on crane and components
Follow crane manufacturer recommendations for responses
to weather
Yes N/A Each Crew Member Tasks / Hazards Associated:
Operator
Oiler (as applicable)
Rigger(s) (as applicable)
Signal Person (as applicable)
Yes N/A Area and Task Hazard Responses:
Personal Protective Equipment (PPE)
Location of first aid kit or station
Location of fire extinguisher
Location of emergency evacuation area
Yes N/A Hazardous Positions / Locations To Avoid:
Pinch points
Counterweight swing radius
Outrigger beams extending / retracting
Attaching components
Attaching rigging
Elevated positions
Avoid elevated positions
Use 3-point contact when climbing up / down
Safe use of ladders
Fall Protection Plan (See Safety Manual)
Yes N/A Crew Positioning:
Remain In view of operator
Notify operator prior to leaving operator view
Yes N/A Site/ Ground Conditions:
Communicate with lift director about underground
hazards
Communicate with lift director about ground conditions
Communicate with lift director about power line hazards
Review power line section of safety manual
Yes N/A Outrigger Mats: (blocking material)
Mats are in acceptable condition
Mats are sized in accordance with lift plan
Yes N/A Loss of Backward Stability:
Follow manufacturer manual for appropriate positioning
of superstructure and components.
Minimize superstructure rotation during assembly /
disassembly
Yes N/A Wind Speed:
Communicate with lift director regarding wind conditions
Determine effect of wind on crane and components
Follow crane manufacturer recommendations for
responses to wind
Field Safety Audit Checklist
(Share results of audit with Job Foreman. Send original to Safety Director).
Project: Job No.: Date:
Project Manager: Foreman:
Inspection Completed By: __________________________________________________________
Inspection Criteria Yes No NA Comments
A. General
1.Are warning signs posted on fence and tank?
2.First aid supplies readily available?
3.Eye wash equipment readily available??
4.Required posters and signs posted and readable?
5. Are documents in red binder signed by all workers?
6.Are Daily Toolbox talks being held and signed by all?
7.Fall Protection Work Plan filled out and signed by all?
8.Confined Space Entry Permit filled out and signed?
9. Hole watch in place and active as needed?
B. Personal Protective Equipment
1.Hard hats worn by all personnel in work areas?
2.Eye and face protection worn as required?
3.Hearing protection worn as required?
4.Respiratory protection worn as required?
5.Safety harnesses and lanyards worn for fall protection?
6.Proper hand protection worn for task being done?
7.Workers dressed properly for the job?
8.Personal protective equipment in good condition
C. Housekeeping
1.Walkways and stairs kept clear of material and debris?
2.Cords and hoses run to prevent trip and fall hazard?
3.Restrooms and eating areas clean?
4.Fabrication and work areas clean and orderly?
5.Site trailers and connex clean and orderly?
6.Gang boxes clean and orderly?
7.Trash, scrap, and debris picked up and disposed of?
Inspection Criteria Yes No NA Comments
D. Fire Protection
1. Firefighting equipment well marked and accessible?
2.Employees trained to use fire-fighting equipment?
3.Fire extinguishers inspected monthly?
4.Smoking prohibited where flammables are located?
5.Flammables stored and handled in approved containers?
6.Spill protection kit available near fueling station?
7.Temp. Heaters kept 20' away from combustible materials?
E. Material Handling and Storage
1.Materials stored neatly in stacks or piles?
2.Cylindrical materials racked or cribbed and blocked?
3.Loose materials containerized or palletized?
4.Aisle space maintained around stored materials?
5.Storage areas kept clear of scrap, debris, and trash?
6.Slings and chokers in good condition?
7.Chain falls and come-a-longs in good condition?
8.Workers move from under suspended loads?
9.Have all forklift operators been trained?
10.Are forklifts being inspected daily?
11.Are load capacity plates in place and legible?
12.Are seat belts being worn while operating forklifts?
F. Tools
1.Power tools have guards in place?
2.Power tools either grounded or double insulated?
3.Power tool cords and plugs in good condition?
4.ALL Grinders have handles attached while in use?
5.Broken tools tagged, and repaired or replaced as needed?
G. Welding and Cutting
1.Gas cylinders stored upright and secured?
2.Oxygen cylinders segregated from fuel gas cylinders?
3.Torch and hoses pulled out of tank when not in use?
4.Caps secured on all cylinders not in use?
5.Welding leads in good condition?
6.Welding screens erected in high flash areas?
Inspection Criteria Yes No NA Comments
7.Welding blankets used to protect materials/equipment?
8 Fire watches posted as needed?
9.Proper permits issued (as required)?
10.Fire extinguishers kept close to hot work areas?
H. Electrical
1.Ground Fault Circuit Interrupters in use?
2.Extension cords heavy duty, 3-wire type?
3.Temporary lights equipped with bulb guards?
4. Manway protected so it won’t cut cords and welder leads?
5.Sufficient lighting to work and move safely?
6.Lockouts used to de-energize operational systems?
7.Welders and stationary equipment properly grounded?
I. Ladders
1.Straight ladders secured at top landing?
2.Straight ladders extend 36" above top landing?
3.Straight ladders have feet or blocked at bottom?
4.Straight ladders set up with a 4 to 1 slope?
5.Top step of stepladders not used as a step?
6.Climbing the back of stepladders prohibited?
7.Workers use the proper height ladder for the job?
8.Portable ladders used only by company employees?
J. Scaffolds and Manlifts
1.Are scaffolds inspected and tagged prior to use?
2.All scaffold hardware and parts in good condition?
3.Scaffolds fully planked?
4.Overhead protection above all entryways to tank?
5.Scaffolds have tight guardrails and midrails?
6.Inside edge of planks within 12 inches of tank wall?
7.Wheels on rolling scaffolds locked during scaffold use?
8.Are all m anlifts inspected daily?
9.Only trained employees allowed to operate manlifts?
10.100% tie off required when exiting raised manlifts?
11.Workers only allowed to work from floor of basket?
12.Workers required to tie-off whenever inside basket??
Inspection Criteria Yes No NA Comments
K. Cranes
1.Are cranes restricted from operating within 20 feet of any
electrical power line?
2.Has the operator filled out his daily crane inspection form?
3.Are accessible areas within the swing radius barricaded?
4.Are tag lines being used to prevent spin and swing?
5.Does the fire extinguisher on the crane have a current
inspection tag?
6.Does the Rigger/Signalman have a current Rigger’s card?
7.Are all outriggers fully extended, and equipped with pads?
8. Are crane hand signals posted at job site?
9. Assembly/Disassembly forms filled out and signed as
needed for use of jib?
10. Crane workbasket form filled out and meeting held as
needed?
L. Excavation and Trenching
1. Excavations 4’ or deeper shored, sloped, or boxed?
2.Workers stay within shored area?
3.Excavated spoil stored at safe distance from work?
4.Barricades placed on all open sides at end of shift?
5.Lateral travel no more than 25’ for entry and egress?
6.Ladders secured and extended 3 feet above the trench?
7.Excavations de-watered as needed?
8. Backfill placed as soon as possible?
9. Daily Excavation forms being completed and signed by
Competent Person?
M. Employee Communications
1.Do foremen communicate with their crews on job methods?
2.Do foremen react to employee safety recommendations?
3.Do foremen address unsafe actions and conditions?
4.Are safety meetings held daily with all employees?
Comments:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
ATTACH ADDITIONAL COMMENTS TO BACK OF FORM
EXCAVATION INSPECTION
THIS INSPECTION IS TO BE COMPLETED BY THE COMPETENT PERSON EACH DAY THAT
EMPLOYEES WILL BE ENTERING AN EXCAVATION.
Project Name:
Date: _________________ Time: _____________________
Competent Person: ____________________________________________________
Soil Classification (see Soil Classification Worksheet):
Excavation Depth:______________________ Excavation Width:______________________________
Type of Protective System Used: ______________________________________________________
Τ
YES NO N/A
1. GENERAL:
Surface encumbrances removed or supported
Employees protected from loose rock or soil that could pose a hazard by falling or rolling into the
excavation.
Hard hats, steel-toed boots, and safety glasses worn by all employees.
Spoils, materials, and equipment set back at least 2 feet from the edge of the excavation.
Walkways over excavations 6 feet or more above lower levels are equipped with standard
guardrails.
Warning vest or other highly visible clothing provided and worn by all employees exposed to
public vehicular traffic.
Employees required to stand away from vehicles being loaded or unloaded.
Warning system established and utilized when mobile equipment is operating near excavation
edge.
Employees prohibited from going under suspended loads.
2. UTILITIES:
Utility companies contacted and/or utility locations delineated.
Underground installations protected, supported, or removed while excavation is open.
3. MEANS OF ACCESS AND EGRESS:
Lateral travel to means of egress no greater than 25 feet in trench excavations 4 feet or more in
depth.
Ladders used in excavations secured and extended 3 feet above the edge of the trench.
Structural ramps used by employees designed by a competent person.
Structural ramps used for equipment designed by a registered professional engineer.
Page 1 of 2
Page 2 of 2
EXCAVATION INSPECTION (continued)
YES NO N/A
4. WET CONDITIONS:
Precautions taken to protect from the accumulation of water.
Water removal equipment monitored by a competent person.
Surface water or runoff diverted or controlled to prevent accumulation in the excavation.
Inspections made after every rainstorm or other hazard-increasing occurrence.
5. HAZARDOUS ATMOSPHERE:
Atmosphere within the excavation tested where there is a reasonable possibility of an oxygen
deficient, combustible, or otherwise hazardous atmosphere.
Adequate precautions taken to protect employee from exposure to a hazardous atmosphere.
Testing conducted to ensure that the atmosphere remains safe.
Emergency equipment, such as breathing apparatus, safety harness and line, and basket stretcher
readily available where hazardous atmosphere does exist.
6. SUPPORT SYSTEMS:
Materials and/or equipment for support systems selected based on soil analysis, trench depth, and
expected loads.
Materials and equipment used for protective systems inspected and in good condition.
Damaged materials and equipment used for protective systems inspected by a Registered
Professional Engineer after repairs and before being placed back into service.
Protective systems installed without exposing employees to the hazards of cave-ins, collapses, or
from being struck by materials or equipment.
Members of support systems securely fastened to prevent failure.
Support systems provided to insure stability of adjacent structures, buildings, roadways,
sidewalks, walls, etc.
Excavations below the level of the base or footings approved by a registered professional
engineer.
Removal of support systems progresses from the bottom, and members are released slowly as to
note any indication of possible failure.
Excavation of material to a level of greater than 2 feet below the bottom of the support system
and only if the system is designed to support the loads calculated for the full depth.
Shield system placed to prevent lateral movement.
Employees are prohibited from remaining in shield system during vertical movement.
7. REMARKS:
SOILS CLASSIFICATION WORKSHEET
The following worksheet outlines the visual and manual tests that the competent person must perform at least
once, and each time soil conditions change. At least one visual and one manual test must be performed;
however, performing several tests is recommended so that the condition of the excavation is thoroughly
examined.
Project Name: Project Number:
Date: Time:
Where was the sample taken from? ------------------------------------
VISUAL TESTS: One or more visual tests are required for each classification and each time conditions change.
Estimate range of particle sizes: a. primarily fine-grained = cohesive material
b. primarily coarse-grained = granular material
Observe excavated soil: a.clumps = cohesive material
b. breaks up easily = granular material
Observe sides and adjacent surface area of
opened excavation:
a. crack like openings = fissured material
b. soil spalls off vertical sides = possible fissured material
Previous excavation activities: a. previously disturbed soil b. not previously disturbed soil
Observe opened side of excavation:
a. layered systems
c. estimate degree of slope of
layers:
b. layers sloped towards
excavation
___________________
Water condition: a. evidence of surface water
c. depth of water table :
b. water seeping from sides
___________________
Vibration present: a. area adjacent to excavation b. area within excavation
MANUAL TESTS- One or more manual tests are required for classification and each time soil conditions change.
Plastically- soil is cohesive if
following is true:
a. mold soil samples into a small ball
b. roll ball into thread c” diameter
c. pick up 2" length of c” thread by one end without breaking
Dry Soil Strength:
a. crumbles on its own or with moderate pressure = granular
b. falls into clumps which break into smaller clumps that are only broken with
difficulty = clay with gravel, sand, or silt.
c. breaks into clumps which do not break into smaller clumps and can only be
broken with difficulty with no visual indication of fissures = unfissured.
Thumb penetration test: (These
tests are to be run on a large clump
of material as soon as it is
excavated.)
a. can be easily indented by the thumb but penetrated by thumb only with great
effort =Type A
b. easily penetrated several inches by thumb and molded by light finger pressure =
Type C
Unconfined Compressive Strength:
(Saturated Soil Needed)
a. Pocket Penetrometer reading (take 10 readings and average) 0 - 0.5 = Type C,
0.5 - 1.5 =
Type B, 1.5 - 2.0 = Type A
b. Shear Vane reading X2: 0 - 0.5 = Type C, 0.5 - 1.5 = Type B,1.5 - 2.0 = Type A
Drying Test:
(A dry soil sample 1" thick X 6'
diameter is needed)
a. develops cracks = fissured material
b. dries without cracks and breaks by hand with considerable force significant
cohesive content = unfissured cohesive material.
c. sample breaks easily by hand = fissured cohesive or granular material
d. easily pulverize dry clumps by hand or by stepping on them = granular
e. don’t pulverize easily = fissured cohesive.
SOIL CLASSIFICATION: Type A Type B Type C Stable Rock Other
COMPETENT PERSON:
Print Name Signature
EMERGENCY CONTACT INFORMATION
Emergency Contacts Phone Number Hospital Directions
Fire/Rescue 911
Police 911
Ambulance 911 See attached route maps for directions to the Hospital
and Urgent Care
Urgent Care:
Project Personnel Phone Number
Project Manager,
Work
Cell Phone
FAX
Safety Director
Work
Cell Phone
Project Site Supervisor:
T Bailey, Inc.
INCIDENT REPORTING SYSTEM
In the event of an incident or injury
the Incident Reporting System must be
activated.
Refer to the Incident Reporting System
Checklist for detailed TBI Corporation
contact information.
Emergency Services Reporting
Information.
Main Office
Fax
MAP TO HOSPITAL & URGENT CARE PROVIDED ON THE FOLLOWING PAGES
Refer to the Incident Reporting System Checklist for detailed Reporting Instructions
Client Contact:
(360) 293-3893
HOSPITAL ROUTE MAP
Hospital
Hospital Directions
URGENT CARE
(Non-Life-Threatening Injuries)
Urgent Care Directions
Eye Care
Eye Care Directions
9628 S March's Point Rd
Anacortes, WA 98221
(360) 293-0682
Emergency Contingency Plan for Chemical Spills
Project No: Project:
Project Manager:
Date Last Revised:
FOR CHEMICAL SPILLS: (see ref. HASP Para. 19.2)
1.Remain calm.
2.Note what material / liquid spilled and the amount that spilled.
3.Notify all personnel in the area of the spill.
4.If necessary, evacuate the area and meet at:
5.If assistance is required, contact State EPA (see EPA spill contact) & Project Coordinator (PC). If
unable to contact EPA or PC, contact T Bailey Safety. Safety will then notify appropriate response
personnel.
EMERGENCY CONTACTS FOR THE PROJECT SITE:
Contractor Health and Safety
Police & Fire 911
Site Supervisor
EMERGENCY CONTACTS FOR THE PROJECT:
Name Company Address Office Phone Home/Cell Phone
T Bailey, Inc. 9628 S march's Point Rd
Anacortes, WA 98221
T Bailey, Inc. 9628 S March's Point
Rd Anacortes, WA
98221 EMERGENCY EQUIPMENT AND LOCATIONS FOR THE AREA:
Safety Data Sheets: In Site HASP
Safety Shower: N/A
Eyewash Station: Bottled Water Site- Conex / Office Trailer
Fire Extinguisher: Class: ABC Location: Site- Conex, fueling tank, Genset
Chemical Spill Kit: Type: Sorbent- pads & booms, plastic
bags & drum Location: Site- Conex
Updated 7/20/2020
Incident Reporting System Checklist
All work locations
IF AN EMPLOYEE IS HURT ON THE JOB:
Injury Notification:
Employee Immediately notify your supervisor.
If physically able, fill out Incident Report form. If unable, fill out once able to do so
Supervisor Immediately notify your Safety Manager Chad Kean (206) 790-0911
If the incident is a fatality or injured worker is hospitalized the supervisor must complete the
following AFTER notifying T Bailey Safety Manager.
•All work stops within and around the incident area, secure/cordon off the area. No work
can continue until released by the L&I investigator.
•Continue to call until you have spoken with the Safety Manager!
If medical treatment is necessary, beyond first aid, determine appropriate doctor’s office, walk-in clinic, or
emergency room to send the employee. When possible (First Aid), we want to send employee to an
Occupational Clinic. Refer to the on-site Health and Safety Plan (HASP), for the closest available medical
facility/Occupational Clinic. For a life threatening emergency call 911. Stay on the phone until released by
the emergency operator.
Contact the Safety Office at (360) 6 30 - 5837 Cell phone (206) 790-0911. Be prepared to provide the
name of the injured employee, name and phone number of the treating medical facility, as well as a brief
description of the incident.
AFTER EMPLOYEE HAS BEEN PROVIDED MEDICAL TREATMENT AND PRIOR
TO LEAVING THE MEDICAL FACILITY THE EMPLOYEE MUST:
Obtain a copy of all completed medical and workers comp forms. Return the completed forms to the
Safety office within 24 hours. Fax (360) 293-3893, email ckean@tbailey.com, or through text (206)
790-0911
The injured employee should contact T Bailey Safety Office to ensure work restrictions are clarified and are
consistent with medical recommendations.
AFTER EMPLOYEE HAS BEEN PROVIDED MEDICAL TREATMENT
SUPERVISORS/PROJECT MANAGERS MUST:
Complete the INCIDENT REPORT AND PRELIMINARY INVESTIGATION FORM Fax the completed
form to Chad Kean at (360) 293-3893, email ckean@tbailey.com or text (206) 790-0911 within one business
day.
Contact T Bailey Safety office at (360) 630-5837 or by cell phone at (206) 790-0911 to ensure that planned
light duty work activities are consistent with medical recommendations.
Procedure for Emergencies:
1. Call 9-1-1
Site Address
2. Stay with injured employee DO NOT CALL EMERGENCY CONTACTS
3. Call the Safety Manager –
Chad Kean 206-790-0911
4. Call Human Resources – have emergency ID card available
Leon Wroblewski- 360-630-5869
or
253-740-6179
HR will contact emergency contacts
Employee Medical Aid Checklist
Employee Name:Date/Time of Injury: Date RTW:
Supervisor’s Employee Injury Report started
On site First Aid / Supervisor’s Employee Injury Report completed
and turned in to the Safety Office. Date To (If First Aid only, Skip to
signature and date)
Medical treatment is necessary, beyond first aid
Refer to the medical aid maps for the appropriate medical facility
Release of Medical Information, Return to Work/Restrictions and Drug Test Chain of Custody Forms
Transport the injured worker to medical aid by company; Name of employee transporting IW:
Transported via ambulance Note: If worker is hospitalized DO NOT clean up mishap scene and discontinue
work in the area. Contact Safety immediately! 360-293-0682 ext 251, cell 206-790-0911 {See Note below}
(Treat and release from ER is not hospitalization.)
Contact the Safety Office (leave message if no answer) {If Fatality or Hospitalization continue calling until
you speak with a person.}
Drug Test Chain of Custody Employer copy returned to Personnel Office Date To
Return to work and work restrictions received by supervisor
Completed “Supervisor’s Employee Injury Report” turned into Safety Office Date To
Light Duty “Return to Work /Restrictions form” turned into Safety Office Date:To
Full Duty “Return to Work form” turned into Safety Office Date:To
Supervisor completing checklist: /
Print Name Signature
Date:
Note: WAC 296-800-32010
Make sure that any equipment involved in an accident is not moved
You must:
Not move equipment involved in a work or work related accident or incident if any of the following
results:
-A death
-A probable death
-An employee's hospitalization.
Not move the equipment until a representative of the Department of Labor and Industries
investigates the incident and releases the equipment unless:
-Moving the equipment is necessary to:
Remove any victims.
Prevent further incidents and injuries.
Report to L&I must be within 8 hours
Call T Bailey Safety (206) 790-0911 !
Property Damage Near Miss Medical Treatment Recordable
Employee Sent Home
Hospital
Actual Completion
Date
Accountable
Person
Department Date
Incident Report and
Preliminary Investigation
Position
First Aid
Corrective Action Required to Prevent
Recurrence
Expected Completion
Date
Return To Work Modified Duty
Outcome
Sent to Medical Clinic Family Doctor
Names of Witnesses:
Immediate Cause of the Incident
Basic (Root) Cause(s)
Summary of Events
Distribution
Date and Time of IncidentDepartment/LocationEmployee's Name (PLEASE PRINT NAME )
Date and Time of Investigation Occupation/Years of experience/Years at job Supervisor's Name
Investigation Team
Name
Key Learnings
Gene Tanaka, CEO/FOUNDER Justin Rawls, VP Safety Committee CO Wide Safety Topic
VEHICLE COLLISION REPORT Page 1 of 2 OTHER VEHICLE DRIVER________________________________________ DRIVERS LICENSE NO. ___________________ STATE _______
ADDRESS__________________________________________ CITY_____________________ STATE _____ ZIP _______
PHONE NO. ________________ S.S. NO. ______________________
OWNER'S NAME ( CHECK IF SAME AS DRIVER) _________________________________________________________________
ADDRESS ___________________________________________ CITY ____________________ STATE _____ ZIP _______
INSURANCE COMPANY ________________________________________ POLICY NO. ___________________________________
AGENT'S NAME _______________________________________________ PHONE NO. ______________________
ADDRESS __________________________________________ CITY ____________________ STATE _____ ZIP ________
VEHICLE YEAR _______ MAKE ___________ MODEL _____________ PLATE NO. _______________ STATE ___________
VEHICLE I.N. NO. ______________________________________________________________________________________________
VEHICLE DAMAGE _____________________________________________________________________________________________
PASSENGERS: NO YES INJURIES: NO YES (If Yes, list names and telephone numbers below)
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________ COMPANY VEHICLE DRIVER ______________________________________ DRIVERS LICENSE NO. _________________________ STATE _______
ADDRESS _________________________________________ CITY ___________________________ STATE _____ ZIP _________
WORK PHONE NO. ______________ S.S. NO. _______________ PROJECT NAME/NO ___________________/____________
VEHICLE NO ____________ YEAR _______ MAKE _____________MODEL ____________ LICENSE PLATE NO. _____________
STATE ______ VEHICLE OWNER: COMPANY LEASED/RENTED PRIVATE VEHICLE
VEHICLE TYPE: COMMERCIAL MOTOR VEHICLE NON-COMMERCIAL
IF NOT COMPANY-OWNED: OWNER ______________________________________________ PHONE NO__________________
ADDRESS _________________________________________ CITY ___________________________STATE _____ ZIP_______
VEHICLE DAMAGE___________________________________________________________________________________________
NO. OF VEHICLES TOWED FROM SCENE ________ NUMBER OF INJURIES __________ NUMBER OF FATALITIES _______
WERE HAZARDOUS MATERIALS RELEASED? NO YES IF YES DESCRIBE MATERIALS ___________________________
___________________________________________________________________________________________________________ COLLISION DESCRIPTION This report is to be initiated by the employee involved in the collision or his/her direct supervisor. Please answer all questions
completely. This report must be forwarded to the Safety Office within 24 HOURS of the collision.
COLLISION DATE _____________________________ TIME _________________________ A.M. or P.M.
LOCATION OF COLLISION (CITY, STATE) _________________________________________________________________________
DESCRIPTION OF COLLISION __________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
WITNESS __________________________________________ PHONE NO .________________________________________
ADDRESS __________________________________________ CITY ____________________________STATE _____ ZIP________
POLICE OFFICER'S NAME _____________________________ DEPARTMENT __________________________________________
VEHICLE COLLISION REPORT Page 2 of 2
Draw and name roadways showing
each vehicle. direction of travel,
and point of impact. Indicate travel
before the COLLISION with a solid
line, and post-collision movement
with a broken line.
SYMBOLS: Your Vehicle
Other Vehicle(s)
Pedestrian
Stop Sign
Yield
Railroad
ADDITIONAL
INFORMATION
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
All vehicle collisions involving third party individuals or property, must be reported to
Bush, Cotton & Scott by calling 1-425-489-4500 within 24 hours of the collision.
EMPLOYEE ______________________ _________________________________ ____________
(Print) (Signature) (Date)
SUPERVISOR _________________________ _________________________________ _________
(Print) (Signature) (Date)
SAFETY DIRECTOR _________________________ ____________________________ _________
(Print) (Signature) (Date)
REPORT MUST BE CALLED IN OR FAXED TO: T BAILEY SAFETY OFFICE (PHONE: 360-293-0682 EXT 251, FAX: 360-293-3893) WITHIN 24 HOURS, OR NOT LATER THAN NEXT BUSINESS DAY
WEATHER: Clear Cloudy Fog Rain Sleet Snow Other ________________________
PAVEMENT: Asphalt Steel Concrete Wood Gravel/Dirt
Brick/Stone Other _________________________________________________________________________________
CONDITION: Dry Wet Icy Pot Holes Other ___________________________________________
TRAFFIC CONTROL: Traffic Light Stop Sign Railroad No Intersection No Control
ROADWAY: Number of Lanes Each Direction: _____________ Residential Divided Highway Undivided Highway
__________________________________________________________________________________
GENERAL LIABILITY, PROPERTY DAMAGE, AND LOSS REPORT
REPORT MUST BE CALLED IN OR FAXED TO:
CORPORATE SAFETY DIRECTOR(PHONE: 360-293-0682 EXT 251, FAX: 360-293-3893)
WITHIN 24 HOURS, OR NOT LATER THAN NEXT BUSINESS DAY
This report is to be completed for all losses or damage to company property in excess of $1,000.00 and all third party damage, regardless of
value, resulting from company activities.
PROJECT/LOCATION ______________________________________________ PROJECT NO. __________ DATE __________________
ADDRESS ________________________________________________________________________________________________________
HOW DID DAMAGE OR LOSS OCCUR: __________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
DESCRIPTION AND VALUE ($) OF DAMAGED/LOST/STOLEN PROPERTY: _____________________________________________________
_________________________________________________________________________________________________________________
LOCATION OF DAMAGED/LOST/STOLEN PROPERTY (Before Loss): __________________________________________________________
_________________________________________________________________________________________________________________
DATE AND TIME OF DAMAGE, LOSS, OR THEFT: Date: ____________________ Time: ______________ a.m. / p.m.
OWNER OF DAMAGED/LOST/STOLEN PROPERTY:
Name ______________________________________________________________ Phone No. (____ )__________________________
Address ____________________________________________________________________ City _______________________________
Employer and Address ______________________________________________________________________________________________
INJURED PARTIES (Also complete a Supervisor's Employee Injury Report if a Company Employee):
Name _________________________________________________________________ Phone No. (____ )__________________________
Address _____________________________________________________________________ City _______________________________
Employer and Address ______________________________________________________________________________________________
Description of Injury _______________________________________________________________________________________________
_________________________________________________________________________________________________________________
WITNESSES:
1.Name _____________________________________________________________ Phone No. (____ )__________________________
Address ______________________________________________________________________ City _____________________________
Employer and Address ______________________________________________________________________________________________
2.Name _____________________________________________________________ Phone No. (____ )__________________________
Address ______________________________________________________________________ City ______________________________
Employer and Address ______________________________________________________________________________________________
WERE PICTURES TAKEN? YES NO
WERE POLICE NOTIFIED? YES NO DEPT. ____________________________ REPORT NO. ______________________
COMPLETED BY: _________________________________ _____________________________________________ _________________
(Print) (Signature) (Date)
PROJECT/LOCATION MANAGER: _______________________________ ____________________________________ _______________
(Print) (Signature) (Date)
MEDICAL FORMS
AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION
_______________________________, grant authorization to
(Print Full Name) (Treating Physician’s Name)
for the release of any information concerning my occupational injury/illness to:
For the purpose of disability follow-up and return to work authorization.
Please provide the following information:
EMPLOYEE INFORMATION:
Full Name:
Comp Claim #
Date of Birth:
Social Security #:
Home Address:
Work Phone:
MEDICAL INFORMATION:
Treating Physician’s Name:
Physician’s Address:
Phone Number:
Fax Number:
Employee Signature: Date: ____ / ____ / ____
These standard policies and procedures are applicable to T Bailey, Inc.
Washington State Claims
T Bailey, Inc.
9628 S March's Point Rd.
Anacortes, WA 98221
Phone:(360) 293-0682
x251 Fax (360) 293-3893
MEDICAL FORMS
RETURN-TO-WORK EXAMINATION FORM
Worker’s Compensation Claim #
Exam Date: / / Employee Name:
Birth Date: / / Social Security #: - -
Job Title: Sex: Male Female
Examining Provider: Please complete this form and fax to T Bailey. Inc. (360) 293-3893
Please contact T Bailey at (360)-293-0682 x251 to report status of employee post-treatment.
DIAGNOSIS:
TREATMENT PLAN:
MEDICATIONS:
PHYSICAL THERAPY:
OTHER:
May return to full duty work effective ___ / ___ / ___
May return to limited duty from ___ / ___ / ___ to ___ / ___ / ___
Unable to return to work from ___ / ___ / ___ to ___ / ___ / ___
WORK LIMITATIONS:
Restricted lifting/pushing/pulling: maximum weight in lbs: ______ (company limits all lifting 60 lbs).
Work only with right/left hand. Restricted repetitive motion right/left hand.
Sitting job only. Restricted operation of moving equipment.
Other:
FOLLOW-UP PLAN:
Release from care.
Schedule for follow-up appointment on ___ / ___ / ___
Time _________ AM/PM
Referral to ______________________
Appointment date ___ / ___ / ___ Time _________ AM/PM
Comments:
Examiner’s Name (print) Examiner’s Signature Date
These standard policies and procedures are applicable to T Bailey, Inc.
Washington State Claims
EXHIBIT G
PERMITTING STRATEGY PLAN
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The parties agree to the attached Permitting Strategy Plan
* The City of Pasco is responsible for all permitting. At time of this contract amendment both the
Special Use Permit and the Building Permit have been applied for and approved.
EXHIBIT H
QA/QC PLANS
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The Design-Builder shall comply with the attached QA/QC plan.
*Refer to Project Plans/Specifications for details on QA/QC plan.
EXHIBIT I
CONTRACT CLOSEOUT PLAN
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
The Design-Builder shall achieve the following milestones to close out the Project. Design-
Builder must provide the minimum amount of notice required below to Owner for each test and
1. The parties agree to the following definition of Ready for Water Milestone Completion:
The Reservoir Tank a) is available for storage of potable water with a connection to
Zone 3 of the City of Pasco water distribution system; b) the interior of the tank and
inlet/outlet piping is sufficiently complete in accordance with the Contract Documents so
that Owner can use the interior of the tank and the conveyance piping for their intended
purposes without compromising the basic operation of the increased storage capacity or
the Owner’s ability to reasonably use critical parts of the Project associated with basic
storage and distribution; and c) has passed the following Project Requirements:
Name of test Responsible
Party
Description of Passing
Test
Minimum
amount of
notice
required to
Owner
Documentation
Required
Health Sample
Tank and Piping
Contractor Satisfactory to BFHD 48 Hours Written Report
Leak Test Contractor No Detectable Loss 48 Hours Written Report
Soak Test Contractor IOC’s VOC’s and SOC’s
below MCL’s
48 Hours Written Report
Piping Pressure
Test
Contractor Hold 150 PSI for 1 hour
with no detectable loss
48 Hour Written Report
2. The parties agree to the following definition of Substantial Completion. The Reservoir
Tank a) is fully functional; b) is sufficiently complete in accordance with the Contract
Documents so that Owner can occupy and use the Project for its intended purposes
without compromising its operation (including materially increasing operating expenses)
or the Owner’s ability to reasonably use all parts of the Project; and c) has passed the
following Project Requirements:
Name of test
Responsible
Party
Description of Passing
Test
Minimum
amount of
notice
required to
Owner
Documentation
Required
Start-up Contractor Confirmation that all
electrical/mechanical
features operate as
intended
48 Hours Written Report
3. In addition to the definition of Final Completion in Section 1.2.13 of the General
Conditions, Design-Builder must achieve the following Project Requirements to achieve Final
Completion:
Name of
Benchmark
Responsible
Party
Description of Passing
Test
Minimum
amount of
notice
required to
Owner
Documentation
Required
Final Walk
Through
Contractor All Punch-List items
addressed
48 Hours Written Report
O&M Manuals Contractor O&M Manuals complying
with Project requirements
are delivered to City
N/A Written Report
As-Built/Record
Drawings
Contractor Provide As-Built/Record
Drawings in accordance
with project specifications
N/A Written Report
EXHIBIT J
DIFFERING SITE CONDITIONS REPORT
GMP/Lump Sum AMENDMENT
City of Pasco
Zone 3 Reservoir Storage Tank
1. The Contract Price is based on the Site Conditions contained in the following
documents:
List Geotech and other reports that form the basis of the Contract Price:
Name of Document Date
Engineering Geology Evaluation June 10, 2022
2. The Design-Builder has discovered the following Differing Site Conditions during Phase
1 of the Project and has taken such Differing Site Conditions into account in the Contract Price.
*The Design-Builder has not found any differing site conditions.