Form-0053R - Site Specific Fall Protection Plan

1 SITESPECIFICFALLPROTECTIONPLANFORM-0053R 1 of 6 Dominion Masonry THIS PLAN IS Specific TO:_____PROJECT & THIS PLAN IS Specific TO THE FOLLOWING AREA(S) ON SITE:Parkade level:Typical level:Other:_____Between G/ THIS PLAN IS APPLICABLE TO THE FOLLOWING height (S) ON SITE:Below 10 feetAbove 10 feet & below 25 feetAbove 25 feetAll PERSON COMPLETING THIS FALL Protection SAFETY NOTES:_____2 COMPANY SAFETY POLICY WILL: Adhere to the WorkSafeBC Regulation as well as any local Government health and safetyregulations. Provide the safest possible conditions for the above procedure. Ensure all employees are properly trained in regards to the Fall Protection Plan.

2 Ensure all employees abide by this Fall Protection Plan. Monitor the effectiveness of this Fall Protection Plan. Update and revise this Fall Protection Plan as deficiencies become apparent. Believe that safety is everyone s responsibility, and a team effort must be made to keepsafe work site SAFE WORK REQUIREMENTSP rior to exposing employees to heights above 25 feet ( ) or more a hazard assessment must becompleted by Supervisors for each work area where workers will be working above 25 feet. Each fallprotection plan must include the following information;1. The Specific fall hazard in the work area(s)2. The methods of Protection to be The method of assembly, maintenance, and inspection of The handling, storage, and security of tools and The types of overhead Protection to be used if completed a copy of this plan must be available for review by a WorksafeBC fall Protection hierarchy is defined as follows;1.

3 Guardrails are to be used as the first means of providing fall Protection to workers2. Fall restraint is to be used in the event that guardrails are not practicable3. Fall arrest is to be use if fall restraint is not practicable4. Written procedures and other fall Protection controls must be used providing they havereceived approval in writing from WorksafeBC for their list above is in order of priority. You may not substitute fall arrest in place of guardrails simplybecause the use of guardrails is time consuming. The hierarchy must be followed with each fall protectionmethod eliminated in order or priority through a systematic process of hazard of 6 Dominion Masonry PROCEDUREThe following points must be adhered to at all times by all workers who are exposed to a potential fall;1.

4 Protect all floor, roof and wall openings with adequate covers or guardrails as required by theWorkSafeBC Provide and enforce the use of fall arrest safety harnesses where workers are exposed to fallhazards of 25 feet or Solid hole covers shall be secured and labeled with a circle and an X .4. All guardrails must meet the requirement of the WorkSafeBC Enforce proper housekeeping practices, including the prompt clean up of oil, grease, orchemical spills, removals of debris, power cords, hoses and tools to eliminate slipping ortripping Control zone must be at least feet away from edge and must be physically marked withstanchions and rope with flagging.

5 The height of the flagging is to be approximately 36 A safety monitor is to ensure the work activity is performed in accordance with the FallProtection Plan and in a manner that minimizes the potential for a worker to fall. A safetymonitor must be trained and have visual contact at all times with the work activities and mustnot monitor more than eight workers at one When using lanyards limit the fall distance of the worker to 4 feet. If shock absorbinglanyards are being used fall distance should be increased to When anchoring to columns or rebar ensure that synthetic life lines are protected. Onemeans of Protection is sliding an appropriate length of gray plastic conduit along the length ofthe rope (from the end) until it reaches the top of the rope (where the snap ling is).

6 FALL Protection WORK IN THEWORKAREAD etermine what fall hazards exist in the work area. Check all that apply and then refer to the nextsection for the appropriate fall Protection system to edgesScaffoldsLeading edgeWork decksRoof edgeForming/pouring/strippingSlab/roof openingsExcavationsRolling stageElevator/stair shaftsFly TableBoom supported platformsCraneIt is important to check only those hazards that exist in the work area. If other work areas have differentfall hazards then an area Specific fall Protection plan will be aspects of fall hazards that must also be considered are:1. Swing factor Is there a potential for a swing hazard when a worker is anchored at one point andworking at another?

7 YesNo If Yes, are anchor points available at regular intervals ( every 10 feet) that workers canuse to anchor to as the move throughout the work area?YesNo If No, can anchor points be installed?YesNoIf No, then a horizontal lifeline must be of 6 Dominion Masonry Vertical ClearanceThis section is not applicable Is there sufficient clearance below workers to arrest a fall (min 12 feet measured verticallyfrom the work platform; may differ for horizontal life line systems)?YesNo If No, can the hazard be removed ( thrust out platform)?YesNoIf No, can vertical clearance be reduced (anchor point above, shorter lanyard)?YesNo If No, can the work be done from below?

8 YesNo If No, can a platform or net be installed below the work area?YesNoIf No, then a fall Protection plan Specific to that area is Other considerations Exposed rebar?YesNoIf Yes, all exposed rebar where workers will be above must be covered with woodentrough or reinforced rebar caps working near edges?YesNoIf Yes and workers will be above guardrails ( pouring outside columns or walls)workers must be on work platform with guardrails or must use fall Anchor points must be capable of holding 5,000 lbs per worker attached for fall arrest and800 lbs per worker for fall restraint. Anchor points accessible and adequate?YesNo If No, can more anchor points be installed ( drop through anchor slings)?

9 YesNo If No, can anchor points be installed on core walls or inside columns?YesNo If No, can life lines be placed around inside columns?YesNo If No, can a horizontal life line be installed?YesNoIf Yes horizontal life line must be engineered and installed as per manufacturersinstructionsa. If No, can netting be installed around outside of perimeter of work area?YesNoIf No then an alternate fall Protection plan must be developed and approved the hazards noted in the above section, follow the guidelines below for each hazard identified:1. Ladders: To be visually inspected before each use, safety feet in place, stepladders to eextended (no not lean against vertical surfaces), ladders for deck access will extend 36inches above the horizontal surface, installed at a 4 to 1 angle and be tied off.

10 Ladderssecured at top and bottom2. Scaffolds:Guardrails installed as required. All pins and braces in position. Stable back as required by manufacturer. Platforms in good condition and capable ofsupporting the weight applied. Cleats on either end of non-manufactured planks. Use fallarrest if work platform not available or when working below Work Decks:Guardrails installed as Vertical Forms:Work platform required. Guardrails installed. Access/egress via ladder mustbe point 1 above).5. Excavation:Temporary fence to prevent accidental/unauthorized access. Handrails will beinstalled at the top of the lagging where a fall hazard greater than 6 feet exists.