Rev. 07/04

2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42



Safety Policy and Safety Rules revised 1/22/2009 Superintendents’ Responsibilities revised 10/2/2009 Required Postings revised 8/28/2009 Safety Incentive/Recognition Program revised 8/17/2009 Drug and Alcohol Substance Abuse Policy Disciplinary Policy Safety Training revised 1/20/2010 Accident/Incident Procedures revised 2/18/2010, report revised 1/22/2009 Early Return to Work Program revised 2/18/2010 Emergency Response Plan revised 2/18/2010 Media Guidelines for Jobsite Accidents revised 11/02/2004 Safety Committee Policy Safety Consultations revised 1/20/2010 Job Hazard Analysis/ Pre-Task Planning revised 1/20/2010 Personal Protective Equipment (PPE) Program revised 1/20/2010 Fall Protection revised 10/19/2009 Excavation and Trenching Protection Plan revised 3/24/2010 Steel Erection Responsibility Checklist revised 3/24/2010 Ladder and Stairway Safety revised 7/17/2009 Scaffold and Aerial Lifts revised 9/10/2009 Cranes, Rigging, Material and Personnel Hoists revised 10/26/2009 Hoisting of Personnel in Baskets revised 10/26/2009 Forklift Program revised 7/23/2009 Housekeeping Policy GFCI Temporary Power Respiratory Protection Program revised 1/22/2009 Hearing Conservation Program Asbestos Containing Materials Safety Lead Based Paint Safety Policy Bloodborne Pathogen Safety Policy Hazard Communication Program revised 7/17/2009 Chemical Management Procedures Lockout/Tagout Program Confined Space Entry Program Fire Prevention Plan Welding, Cutting and Brazing Fire/Exposure Control Tilt-Up Safety revised 12/17/2009 Concrete Safety Requirements for Masonry Construction Safety Meetings revised 4/29/2005 Hand, Power and Powder Actuated Tools revised 7/7/2009 Forms A. Weekly Jobsite Inspection Checklist revised 10/2/2009 B. Equipment Trained Personnel revised 8/4/2009 C. Subcontractor Orientation Checklist D. Employee Jobsite Orientation Checklist E. Equipment User Rental Agreement / Indemnification and Release F. Visitor Hold Harmless Agreement G. Employee Safety Walk Through Report Form created 8/17/2009 Stretch and Flex


Management Policy Statement on Safety

You are now a critical member of the Pence/Kelly Safety Team. Pence/Kelly has an exceptional safety record and is pleased to return workers safely to their families each day. Your continued employment is contingent upon you working safely at all times. Before you begin working on the site you must review the General Safety Practices and have your superintendent or foreman train you on the specific site hazards and safety requirements. Utilizing the employee jobsite orientation checklist as a member of Pence/Kelly’s Safety Team you will be asked to participate in specific job hazard analysis/pre task planning. Take this opportunity to make your job safer. New employees are at the greatest risk of being injured on a construction site. Remember, other workers and their families are counting on you working safely. The Pence/Kelly management team is committed to the safety and health of all employees.

Thank you for your commitment to safety,

Dave Hays Vice President of Operation


revised 1/22/2009

The following general safety rules apply to all Pence/Kelly Concrete, LLC projects. Additional rules may be added based on Project Specific Hazards or Protocols. It is important to remember that rules cannot be created to cover all conditions on the construction site. The most important element in prevention of injuries is a positive safety attitude. 1. 2. 3. 4. 5. 6. Follow all Pence/Kelly Concrete, LLC project safety rules. Fall protection required over 6 ft. Never violate any warning signs or barricades. Report any unsafe conditions to your supervisor immediately. Attend weekly safety meetings. Report any injury to your supervisor immediately. This includes: If you are taking any medication that could cause physical or mental impairment. Or if you have a domestic or other problem that may reduce your ability to concentrate on work. Compliance with Alcohol and Drug Policy is mandatory on all jobsites. No fighting, horseplay, stealing, running, drug or alcohol use. Wear appropriate work clothing and Personnel Protective Equipment (PPE). Safety glasses or prescription glasses with safety lenses to be worn at all times. If you are not sure how to perform your assigned task safely stop and contact your immediate supervisor. Help promote good housekeeping, This includes proper disposal of lunch bags, or other personal items brought to the job. Indiscriminate throwing of materials from elevations is prohibited. Operate only the equipment that you have been trained and authorized to use. Do not walk or stand under suspended loads. Think before you lift… I. Plan the lift II. Mover close to the Load III. Keep your back straight IV. Bend your knees & lift with your legs V. Do not lift and twist in the same motion VI. If the load is too heavy get help Always use equipment in accordance with the manufacturers’ specifications. Appropriate work boots shall be worn at all times. Do not enter a ditch or trench that is not in compliance with OSHA code, (over 4 feet in depth), unless properly shored or sloped at the correct angle of repose. Only trained personnel may access and/or erect scaffold. Smoking is only permitted in designated areas. All employees must be familiar with emergency procedures and locations of fire extinguishers and first aid supplies. MSDS (Material Safety Data Sheets) are available in the job shack or from the supervisor. All hazardous chemicals or solvents shall be stored in properly labeled containers. Only those trained in the proper usage shall handle such materials. WORKING SAFELY IS A CONDITION OF EMPLOYMENT ON A PENCE/KELLY CONCRETE, LLC PROJECT. Failure to abide by the safety rules and procedures will be subject for disciplinary action up to and including immediate termination, and/or removal/debarment from the jobsite, whichever is applicable. These rules must be posted on the project bulletin board.

7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

17. 18. 19. 20. 21. 22. 23. 24.



revised 1/22/2009

• Maintain a current First Aid/CPR card. Superintendents will be responsible and accountable for a superior level of safety performance. Refer to local codes for work outside of Oregon. More stringent codes may apply. 2. • Train employees in site specific hazard communication program. • Report all accidents/incidents/near misses etc. • Develop a site specific Fall Protection Plan for jobsite and train employees. • Ensure employees have proper training to operate equipment and tools.2. • Hold and document weekly “Tool Box” safety meetings with crew and subcontractors. The following are some general responsibilities: • Institute work practices. o The Superintendent shall ensure that the weekly safety inspection is performed by a Competent Person or perform the inspection himself. • Facilitate a team approach to job hazard analysis/pre-task planning. • Weekly Jobsite Safety Inspections. Leadership Team.1 Revised 10/2/2009 . and General Superintendent will provide support to ensure jobsite safety. This safety manual is based on the Oregon Occupational Safety and Heath code. o The Competent Person shall be agreed to by the Superintendent and Safety Manager. Contact the General Superintendent or your project manager to make your forms and orientation site specific. most efficient methods available for accomplishing the required tasks. • Maintain fully stocked First Aid Kits. • Provide site specific safety orientation with all subcontractors prior to them working on the jobsite. • Attend quarterly safety training.2 SUPERINTENDENT’S RESPONSIBILITIES SAFETY – PEOPLE ARE OUR MOST IMPORTANT ASSET. All safety forms and documents are available on a CD. The Safety Committee. • Ensure tools on site function properly and safely. • Abide with and enforce LCG Pence Safety Policies. o The Competent Person must have at an OSHA 10 Hr card or similar training. • Post all mandatory poster forms at jobsite. o The Superintendent must sign the weekly safety inspection form. which reflect the safest. The project superintendent is fully responsible for overall safety on the job. • Provide site specific safety orientation for all LCG Pence employees prior to them working on site.                     2.

Postings are available from the Salem Office.16) Sexual Harassment Policy EEO Policy Military Family Leave Safety Document Matrix OREGON • • • • • • • • • • • • • Federal Minimum Wage Federal EEO is the Law Federal Family & Medical Leave Employee Polygraph Protection Act State of Oregon Construction Contractors Board License Worker’s Comp Notice of Compliance OROSHA “It’s the Law” Oregon Family Leave Act Oregon Minimum Wage OSHA 300 Log (February 1st to April 30th) BOLI Prevailing wage rates and benefits (On Prevailing wage jobs) USERRA Poster Oregon’s Smoke-free Workplace Law WASHINGTON • • • • • • • • • • Maternity Leave L&I Rights as Non-Agriculture Worker L&I Rights as Agriculture Worker Washington Minimum Wage Unemployment Benefits Job Safety & Health Protection L&I Notice to Employees Certificate of Coverage OSHA 300 Log (February 1st to April 30th) BOLI Prevailing wage rates and benefits (On Prevailing wage jobs) 2.41) Description of Assured Equipment Grounding Program Fall Protection Plan (2.6) Listing of People Trained in the use of Hazardous Chemicals (2.5) Listing of Ladder Trained personnel (2.03 REQUIRED POSTINGS The following are required to be posted at all jobsites.2.31.2) Visitor’s Hold Harmless Agreement Emergency Response Plan (2.5) Listing of Equipment Trained personnel ( Emergency Action Principles Drug Free Workplace Hazard Communication Notice Listing of Hazardous Chemical on Site (2. ALL SITES • • • • • • • • • • • • • • • • General Safety Practices (2.10.1 revised 8/28/2009 .31.

• Making safety suggestions. If you are interested in being involved with the safety committee. • Reporting workplace hazards. detecting and correcting hazards before they result in injuries.1 revised 8/17/2009 . • Involvement with the safety committee and other activities. please contact one of these people. • Holding subcontractors accountable for safe work practices Safety awards are given at the end of each quarter. Superintendents and Foreman are recognized by the General Superintendent for the following: • Providing safe work and a safe workplace. In addition to the behaviors above.04. Roland Mack. Chairman. Each situation will be reviewed by the safety committee. • Leading their crew in job hazard analysis/pre task planning. Regularly inspecting work being done. 2. • Providing effective safety oversight. John Moore. or failure to report an injury on the job may result in some loss or total loss of accumulated hours. we want to reinforce safe work habits. Gary “Whitey” White. failure to follow safety rules. • Developing safe work habits.2. Angie Schornstein.04 SAFETY INCENTIVE/ RECOGNITION PROGRAM Pence/Kelly believes that employees with safe working habits should be rewarded for their efforts. Mick Haggerty and Eric Ross. We don’t want to reward the lucky or those who don’t report injuries. Pence/Kelly wants to recognize the following safe behaviors for employees: • Complying with company safety rules. • Providing effective safety training. Any unsafe act. Any employee laid-off for three months or less will not lose his or her accumulated hours. • Reporting workplace injuries immediately. Dave Hays. Members of the Safety Committee as of July 2009: Tim Fasching.

000 milestone will be $500 cash. Superintendents are in a separate program based on quarterly safety reviews. THINK SAFETY! 2. 20.SAFE HOURS 200 500 1000 1500 2000 3000 4000 5000 6000 1ST AWARD 2ND AWARD 3RD AWARD 4TH AWARD 5TH AWARD 6TH AWARD 7TH AWARD 8TH AWARD 9TH AWARD AWARD HAT POCKET KNIFE $20 CASH $35 CASH $50 CASH $75 CASH $100 CASH $150 CASH $200 CASH Each additional 1000 hours will be a $200 cash award.000.04.2 revised 8/17/2009 . The 10.

awards banquets or social holiday parties) when beer or wine will be served. will be subject to discharge. consumption or being under the influence of any intoxicating liquor while on. RIGHT TO TEST AND SEARCH Where evidence indicates to us that an employee may have violated either of the above rules.                                                    DRUG AND ALCOHOL 2. The conduct prohibited includes consumption of any intoxicating liquor prior to reporting to work or breaks or lunch period. or in other circumstances we believe might affect our operation or safety. company property. and consumption will be strictly monitored and controlled. or in route to. The possession. or in route to.1 . consumption or being under the influence of any illegal drug while on. When reasonable grounds exist to believe an employee has consumed or is under the influences of alcohol or any substance in violation of this policy. sale. an employee will be required to sign and follow as condition of continuing employment. including clothes. etc.02 BrAC/BAC or greater will be deemed “under the influence” for purposes of this rule.05. company time. sale. Alcohol will only be served with prior approval from management in these situations. employee may be required to submit to search of his/her possessions and to submit to chemical testing. will be deemed “under the influence” for purpose of this rule. Company function: There may be some company function (for example. An employee who tests “positive” for any such substance by screening and confirmation tests. the Company may search the employee’s possessions located on Company property or job site. company time. tool box. or in other circumstances we believe will adversely affect our operations or safety. in such circumstances. desk. DRUGS The possession. car. may result in immediate termination. An employee who tests positive for alcohol to any degree 0. may also require the employee to submit to appropriate tests for alcohol or prohibited 2. The Company.5 SUBSTANCE ABUSE POLICY ALCOHOL Disciplinary action may be imposed when there is a positive test for the presence of a controlled substance in violation of this policy. a “Last Chance” Agreement. The conduct prohibited by this rule includes consumption of any such substance prior to reporting for work or during breaks or lunch period. locker. If eligible for continued employment. lunch box. company property.

This will be completed before any job offers are finalized. Employees subject to discharge under Section 4 may be offered the opportunity to participate in a chemical dependency rehabilitation program as an alternative to discharge.05. follow-up drug/alcohol testing and other associated costs incurred from a rehabilitation program will be the sole responsibility of the employee. no compensation is given for time loss. Reasonable suspicion also exists when the employee has been arrested during non-working hours for drug or alcohol use. TESTING PROCEDURES PRE-EMPLOYMENT TESTING Employees applying for positions may be required to pass a chemical screen test as a condition of employment. If the test is positive. blood and breath test. REASONABLE SUSPICION All employees will be tested for drugs and/or alcohol when there is reasonable suspicion to believe that the employee has violated the Company drug and alcohol policy. The Company will enforce this policy rationally based on each individual factual circumstance and at its discretion. decide not to search or test an employee despite the fact that is could do so under this policy. the job applicant shall be warned that a second dilute test will result in the job offer being withdrawn. The decision to offer a “Last Chance Agreement” will be made on a case-by-case basis depending upon the circumstances. they will not be allowed to operate a motor vehicle or return to work until the test results are confirmed. In some cases it may. 2. based on all factual circumstances. Failure to promptly permit such searches and tests will be grounds for immediate discharge.2 . If a pre-employment chemical screen is diluted. including urinalysis. Whether reasonable suspicion exists depends on the indicators used to determine that an employee may use or be under the influence of drugs or alcohol. All treatment. It is the responsibility of the employee to notify employer of arrests made for alcohol or drug offenses. This option will only apply to a first time violation of the drug-free policy. Such individual situations of Company discretion shall not affect the company’s right to enforce the policy in other situations. If the test results are negative the employee will be compensated for the normal amount of hours that they would have worked while waiting for the results. Employees who are instructed to submit to testing under reasonable suspicion will be escorted to the collection facility. not all employees will be offered this option. These are examples of situations in which the Company may ask an employee to submit to a chemical test or search. provided the employee voluntarily agrees to the terms of a “Last Chance” agreement.drugs or substances in his/her system.

in most cases. If a “Last Chance” follow-up drug or alcohol test is positive during the term of the contract the employee will. Positive test results will be considered with medical and other evidence to determine what action. Refusal or failing to show up for the test within 2 hours of a request will result in a presumption that the employee was incapable of passing the test and that the test results would have indicated an unacceptable level of prohibited substances. repeated disregard of safety rules or procedures. Each employee will have an equal chance of being selected. then the employee will submit to all unannounced requests for drug or alcohol screening during the term of the “Last Chance” agreement. RANDOM TESTING Random selections will be facilitated by computer-generated random number selection or by other valid method. if any.Among the situations where the Company may exercise its “reasonable cause” right to test and search include the following: • An observable symptom of an employee being under the influence of drugs or alcohol.g. and the fact that a test was performed. • Unexplained significant changes in behavior (e. • Failure to sign a “Last Chance” or work performance contract after treatment has started. positive or negative. 2.3 .” TEST RESULTS The employee’s test results. whether the employee is responsible for the accident in whole or in part when another person is operating the equipment or motor vehicle.. FOLLOW UP TESTING If the “Last Change” contract requires chemical or alcohol monitoring. • Employee admissions regarding drug or alcohol use. will be kept as confidential as possible under all the factual circumstances.) • Failure to complete or comply with a treatment program already started.05. Testing may also be requested in a “near-miss” situation where injury or property damage could have occurred. Post-accident testing may be required in the event of an injury requiring medical care. Refusal or failing to show up for the test within 2 hours of a request will result in a presumption that the employee was incapable of passing the test and the test results would have indicated an unacceptable level of prohibited substances. Failing to report to the test site within the 2-hour time frame will be defined as a “Refusal to test. • On the job accidents involving medical treatment or property damage. abusive behavior. etc. be terminated. is to be taken. damage to property or in a near miss situation that could have resulted injury or damage. POST-ACCIDENT Post-accident testing may be required when an employee is involved in an accident. insubordination.

a positive test results related to such medication will not be cause for discharge or discipline unless the employee failed to notify the company prior to the test of the use of a medication that could impair the employee’s ability to work safely. the employee must report the use of such medication to her or his supervisor before reporting to work. SHY-BLADDER Employees unable to provide acceptable urine sample in a three-(3) hour time period after arrival at the testing location will be deemed as “refusing to test. the company will reverse the “refusal” and consider the test as a negative test 2. in most cases. employees are responsible for knowing the effects of any such medications. if an employee is taking marijuana upon the advice of a State-licensed medical provider and the employee can provide conclusive evidence of recommended use by submitting a formal recommendation document signed by the licensed provider and a current state issued permit. such as medications that cause drowsiness. and that the results would have indicated an adverse level of prohibited substances. However. If a chemical or alcohol specimen screen is determined to be invalid or unreliable by the clinic or certified lab due to circumstances unrelated to the conduct of the employee. If a chemical screen or breath specimen is determined to be invalid or unreliable by the clinic or the certified lab because of circumstances related to the conduct of the employee.If an employee is currently using legal prescription or nonprescription medications. subjecting the employee to termination as prescribed by the company policy.” If the employee is able to demonstrate that the “shy-bladder” situation is due to a qualified medical condition. However. If an employee is taking any medication that may interfere with her or his ability to perform the job. refusal to offer an adequate specimen. REFUSALS TO TEST Refusal to test includes failure to cooperate with the testing process in a manner which does not allow the test to be conducted. a presumption will arise that the employee was incapable of passing the test. failure to immediately report to the collection location when requested. If the medication was properly authorized and appropriately used.05. the employee may be asked to identify any such medications on the consent form prior to testing. the employee will be notified of the circumstances that require a re-test and will have the option of immediately collecting a new specimen. result in termination from employment. substituting or tampering with a specimen or other behavior that interferes with the testing. adulterating. The company prohibits employees from having any detectable level of marijuana in their system while working for this company. it will be taken into consideration. MEDICINAL USE OF MARIJUANA The company considers marijuana an illicit substance as defined by the federal government as a Class I controlled substance. Consequences of refusal to test will.4 .

but does not include unsupported assertions of “situational anxiety” or dehydration.05. SITUATIONS NOT COVERED BY POLICY We recognize that situations may arise which are not specifically covered by these guidelines. 2. the potential impact on safety. The employee claiming a medical condition will automatically be placed on unpaid administrative leave for up to five-(5) working days after the shy-bladder situation to obtain a written report prepared by a physician who has medical expertise in the condition the employee claims is the reason for the shy-bladder.5 . For the purpose of this paragraph. production and customer service. the employee will be terminated from employment.g. a urinary system dysfunction) or a medically documented pre-existing psychological disorder. etc. We deal with them on a “case by case” basis taking into account such things as the nature of the situation or problem. If the employee has not presented a physician report that is acceptable to the company medical review officer at the end of the five-(5) day period.result. a medical condition includes an ascertainable physiological condition (e. the employee overall employment record and job assignment.

1 . Employees found to be in non-compliance with the Safety Policies and Procedures of Pence/Kelly Concrete LLC. Third Offense o Will result in termination. o If an employee is found working in an unsafe manner. are subject to this policy. To this end. Second Offense o Will receive a written warning. POLICY • First Offense o Will receive a documented verbal warning. subcontractor employee. that employee will again be counseled concerning their unsafe work habit. including subcontractor and sub tiered contractor employees.2. To effectively and consistently achieve this goal. sub tiered contractor employee. Documentation will also be as stated above. Blatant Violation o Will result in immediate termination. a safe working environment to practice their trades. be immediately terminated from and escorted off of the project. the employee will be counseled in his/her work habits and how working in an unsafe manner is inconsistent with our goals. a written warning will be given to the employee that will state what unsafe action was noted and that they are in jeopardy of being terminated for further noncompliance with the safety policies & procedures. or any employee of contractors under the management of Pence/Kelly Concrete. In addition. • • • 2. any Pence/Kelly Concrete LLC employee. The counseling session will be documented as to who was present. Project Supervision demonstrating a lack of Safety commitment will be subject to the terms of this policy. o If the employee is found a second time working in an unsafe manner. what was discussed and why. our Clients and General or Prime Contractors will be counseled or disciplined up to including termination from the applicable project. o The third time an employee is found working in an unsafe manner. that employee will.06. all or in part. compliance to the Safety Policies & Procedures are a mandatory requirement and is considered a condition of employment. and will serve as a verbal warning to the employee.06 PURPOSE & INTENT • DISCIPLINARY POLICY • • Pence/Kelly Concrete LLC made a firm commitment to providing all employees. for their own safety and the safety of others.

TERMINATION • It would be the hope of Pence/Kelly Concrete LLC that we would never have to resort to termination of any employee on one of our projects. we retain the right and responsibility to terminate the employment. or cause the removal from the project. of any individual who has demonstrated a habitual unwillingness to work in the safest possible manner. for the safety of all employees on the project. 2. or any individual that blatantly places themselves or others in extreme or excessive danger.2 . But.06.

The employee was counseled in his/her work habits and how working in an unsafe manner is inconsistent with our goals. Third or Blatant Offense: Employee was found working in an unsafe manner or has blatantly placed themselves or others in extreme or excessive danger and is to be immediately terminated. The employee is in jeopardy of being terminated for further non-compliance with safety policy and procedures.06. EMPLOYEE SIGNATURE: ____________________________________ SUPERVISOR SIGNATURE: __________________________________ WITNESS SIGNATURE: ______________________________________ 2.EMPLOYEE SAFETY VIOLATION NOTICE Employee: ______________________ Supervisor: _____________________ Date: _________________ Job Site: ______________ Stated Policy Violation: ________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ First Offense: Employee was found working in an unsafe manner. The employee was counseled in his/her work habits and how working in an unsafe manner is inconsistent with our goals.3 . Second Offense: Employee was again found working in an unsafe manner.

SAFETY VIOLATION JOBSITE: __________________________________________________ SUBCONTRACTOR: _________________________________________ DATE: _______________________ TIME: _______________________ PENCE/KELLY RESPONSIBILITY IS TO PROVIDE A SAFE WORKING ENVIRONMENT TO OUR EMPLOYEES.7. and a copy will be faxed to Pence/Kelly’s main office. the Pence/Kelly Concrete LLC Supervisor will fill out the compliance date and time and return the yellow copy to the subcontractor.06. AND VENDORS. ________________________________ Pence/Kelly Superintendent Compliance Date: _______________ ________________________________ Subcontractor Time: ____________ A copy of this notice will be faxed to the Subcontractor’s main office. SUBCONTRACTORS. WE FIND YOUR COMPANY HAS THE FOLLOWING CONDITION: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ PLEASE TAKE CARE OF THIS PROBLEM IMMEDIATELY! PENCE/KELLY CONCRETE LLC CONTRACT. Subcontractor – Original White and Yellow Copy Pence/Kelly Supervisor – Pink Copy 2. When violation has been corrected. SECTION 8. STATES “If the Subcontractor fails to immediately commence compliance with such safety duties or commence clean-up duties within 24 hours after receipt from the Contractor of written notice of non-compliance. the Contractor may implement such safety or cleanup measures and deduct cost thereof from amounts due to the Subcontractor”.4 .

the term also refers to a person assigned by an employer to perform a specific task or to be in a specific location at a jobsite. DEFINITIONS: OR-OSHA has general training requirements intended to make workers aware of the overall safety and health aspects of their jobs and specific training requirements that apply to workers who perform special jobs or tasks. For example. OR-OSHA’s safety and health rules allow only trained audiologists. See the appropriate section of the Safety Manual for training requirements. authorized.2. For example.1 revised 1/20/2010 . • A qualified person is someone who. The Salem Office maintains the attached Field Employee Training Report. designated. competent person. otolaryngologists. • Designated generally refers to a person who has received extensive training in a particular task and is assigned by the employer to perform the task. • A competent person is someone who has broad knowledge of worksite safety and health issues. Only a competent person can supervise erecting.07. who is capable of identifying existing and predictable worksite hazards. for example. This report shows when employees received formal safety training on the listed subjects. moving. an individual may be qualified to perform electrical circuit tests but not qualified to perform hydraulic pressure tests. 2. The table on page 2 shows required training which must be documented. • Authorized refers to a person permitted by an employer to be in a regulated area. OR-OSHA’s safety and health requirements frequently use the words certified. or technicians who have been certified by the Council of Accreditation in Occupational Hearing Conservation to perform audiometric tests. and qualified person to identify workers who must meet specific training requirements. or dismantling scaffolds at a worksite. has demonstrated the ability to resolve problems relating to a specific task or process. Superintendents are responsible for the Site Specific portion of training. through training and professional experience.07 PURPOSE AND INTENT SAFETY TRAINING  Pence/Kelly provides “Train the Trainer” safety training for Superintendents which enables them to train their crew. and who has management approval to control the hazards. • Certified indicates that a worker has successfully completed specialized training and that the training has been certified in writing by a professional organization.

20 2.31 & 2.36 2.SAFETY TRAINING Type Forklift First Aid/CPR Respirator Powder Actuated Tools Welding/Cutting Excavation Confined Space Fall Protection Ladders Aerial Lifts Scaffold Erector Scaffold User Hazmat Lead Awareness Asbestos Awareness PPE Rigging Card Required X X X X X X X X X X X X X X X X 2.20 2.20 2.23 2.28 2.29 2.2 revised 1/20/2010 .32 2.19 2.26 Expires 3 Years 2 Years 1 Year 1 Year 1 Year 2.17 2.07.21 Site Specific X Safety Notebook Reference 2.15 2.34 2.23 2.

All accidents/incidents/near misses shall be reported. 2.2. • Have employee and any others involved with accident/incident transported for drug/alcohol testing. Superintendent to fill out Employer section of 801form. • Take photos of the accident scene and the surrounding area immediately. Safety Manager and Claims Manager within 2 hours of the incident.1 revised 2/18/2010 . and the project.08. and then investigated to determine the root cause and corrective actions implemented to prevent recurrence. In case of fatality or catastrophic contact the crisis manager (Bob Hill 503-932-4455). • Contact the General Superintendent and Safety Manager immediately. • Secure the accident scene. SUPERINTENDENTS RESPONSIBILITIES • Ensure the safety and security of the individuals who were injured or involved. other people on site. you must then document in some way the date the pictures were taken. o A digital camera can be used for this purpose. Safety Manager and Claims Manager within 48 hours of the incident. • Complete the Incident Investigation Form at the end of this section and submit to the General Superintendent. o If the camera does not document the day and time the pictures were taken.08 POLICY STATEMENT ACCIDENT/ INCIDENT PROCEDURES The intent of this section to ensure all injuries and incidents are reported. o Use the date stamp function if the camera has it. Any injury which requires offsite medical attention is considered reportable. • Have employee fill out Worker portion of 801form in attached Instructions for Injured Employees who Require Medical Attention packet and return form to the office within 24 hours. • Complete Incident Report • Report all accidents/incidents/near misses SAFETY MANAGERS RESPONSIBILITIES • Send out or cause to have sent. • Have employee read and complete remainder of packet • Have employee and any others involved with the accident/incident or are in the area of the accident. the public. Disturb only as necessary for rescue of injured workers or preventing further injury or damage. • Conduct an accident/incident investigation. complete a witness statement. • Complete the Incident Report Form at the end of this section and submit to the General Superintendent. an initial incident report notification to all upper management personnel.

any subcontractors involved. processes. procedures and practices (inadequate implementation) exist. 2. the Safety Manager will notify OR-OSHA within 8 hours after occurrence or employer knowledge.Put up a barrier • Implement the solution • Share or cause to share the findings with all projects teams. o Determine implementation flaws to determine the underlying design weaknesses.08. project team.2 revised 2/18/2010 . In case of a fatality or catastrophe. the involved party and the VP of Operation in attendance. In Washington.• • • • • • • • • • Ensure the accident scene is secured and unmodified until the investigations are complete. Collect the facts about what happened Develop the sequence of events In case of a fatality or catastrophe the Safety Manager will lead the investigation. In case the VP of Operations is unavailable any one of the upper management group can fill in.Remove or reduce the hazard o Management Controls. plan.Remove or reduce the exposure o Personal Protective Equipment. the Safety Manager will notify OR-OSHA within 24 hours after occurrence or employer knowledge. the Safety Manager will notify the nearest office of the Department of Labor and Industries in person or by phone within 8 hours of the work related incident or accident as listed below: o In case of a fatality o In case of a probable fatality o In case of 2 or more employees are admitted to the hospital See WAC296-800-32005 for further requirements. programs. Conduct or cause to have conducted an incident review meeting with the General Superintendent. • Recommend corrective actions and improvements o Engineering Controls. or three or more employees are admitted to a hospital or an equivalent medical facility. Assist the project team in the accident/incident investigation. In case of a overnight hospitalization of an injured employee. • Determine possible disciplinary actions. SAFETY COMMITTEE RESPONSIBILITIES • Evaluate all accidents to determine the causes o Analyze the injury event to identify and describe the direct cause of injury o Analyze events occurring just prior to the injury event to identify those conditions and behaviors that caused the injury (primary surface causes) for the accident o Analyze the conditions and behaviors to determine other specific conditions and behaviors (contributing surface causes) that contributed to the accident o Analyze each contributing condition and behavior to determine if weaknesses in carrying out safety policies. o A catastrophe is defined as an accident in which two or more employees are fatally injured.

• Follow up to verify solution is working 2.08.3 revised 2/18/2010 .

08.INCIDENT REPORT Injured Employee’s Name _______________________________________________ Jobsite Location _____________________________________________________ Date of Injury ___________________ 20______ Hour _____________ A. Name ____________________________________________________________ Employee ____________________________________________________________ Doctor ______________________________________________________________ Date _____________ 20__________ ________________________________ Supervisor’s Signature 2.M.M. work habit etc _____________________________ _____________________________________________________________________ Was incident caused by faulty equipment? If so. explain : ____ ______________________________________________________________________ ____________________________________________________________________ Describe action taken to prevent similar occurrence in the future______________ ______________________________________________________________________ ____________________________________________________________________ Medical Authorization __________________________________________________ Co. was operator trained on this equipment?________ If incident involved a person not employed by Pence/Kelly. P. ie: rule violation. Type of Injury ________________________________________________________ Treatment Required ________ First Aid _________ Doctor ___________ Hospital Names of Witnesses ___________________________________________________ Area Injury Occurred __________________________________________________ Describe incident _____________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ___________________________________________________________________ Describe Any Injury ____________________________________________________ ______________________________________________________________________ ____________________________________________________________________ Identify Cause.3 revised 4/27/2005 . identify _____________________ ______________________________________________________________________ ____________________________________________________________________ If incident involved equipment. give name and address: Name _______________________________________________________________ Address _____________________________________________________________ If previous injury/condition of employees was a contributing factor.







com .Company name: PENCE/KELLY CONCRETE. Bill BIO-MED for the collection ** Employer to donor ** You are to report as soon as possible to provide a urine sample for drug testing and/or participate in a breath alcohol test. LLC Donor name (employee or prospective employee) __________________________________ Department & Contact Person:_________________________________________________ REPORT with this letter and photo identification (driver’s license or other card with your picture and identification on it) to: BIO-MED approved collection site: Not for commercial drivers – nonDOT testing only PURPOSE ( one) Random Follow-up Post Accident Other:_________ Pre-employment Reasonable Cause Check here if nonDOT Breath Alcohol Test also ordered ⇐ nonDOT PANEL 2 ** Collection Site Use Legacy single specimen collection/ BIO-MED acct # 02063. You must provide the sample within _______ hours of receiving this letter or the test will not be considered valid. Donor received this letter on _____________________________ at approximately ____________________________ (DATE) (TIME) Employer Initial ____________________ Employee/Perspective Employee Initial __________________ 1952 McGilchrist Street SE Salem. OR 97302-1561 ► Tel: (503) 585-6654 ►Toll Free: (800) 434-6654 ► Fax: (503) 315-8995 e-mail: info@bio-medtesting.

’s Office Hospitalization Injured Part of Body: DAMAGED PROPERTY Property. Equipment or Material Damaged Object or Substance Inflicting Damage: Visible Damage DESCRIPTION OF WHAT HAPPENED (Attach photographs or diagrams if necessary) ROOT CAUSE ANALYSIS (Check all that apply) Unsafe Acts Improper work technique Safety rule violation Improper PPE or PPE not used Operating without authority Failure to warn or secure Operating at improper speeds By-passing safety devices Guards not used Improper loading or placement Improper lifting Servicing machinery in motion Horseplay Drug or alcohol use Unnecessary haste Unsafe act of others Other Unsafe Conditions Poor workstation design or layout Congested work area Hazardous substances Fire or explosion hazard Inadequate ventilation Improper material storage Improper tool or equipment Insufficient knoledge of job Slippery conditions Poor housekeeping Excessive noise Inadequate guarding of hazards Defective tools/equipment Insufficient lighting Inadequate fall protection Other: Page 1 of 2 Management Deficiencies Lack of written procedures or policies Safety rules not enforced Hazards not identified PPE unavailable Inusfficient worker training Insufficient supervisor training Improper maintenance Inadequate supervision Inadequate job planning Inadequate hiring practices Inadequate workplace inspection Inadequate equipment Unsafe design or construction Unrealistic scheduling Poor process design Other: Revised 9/30/2008 .THIS FORM MUST BE SUBMITTED WITHIN 48 HOURS OF INCIDENT COMPANY INCIDENT INFORMATION Date of Accident Time INCIDENT INVESTIGATION FORM Days of Week S M T W Shift 1 2 Department 3 T F S INJURED PERSON Name: Address: Age: Phone: Supervisor Name: Job Title: Length of Employment at Company: Length of Employment at Job: Employee Classification: Full Time Part Time: Contract Temporary Nature of Injury Bruising Dislocation Other (specify) Scratch/Abrasion Internal Strain/Sprain Amputation Foreign Body Remarks: Fracture Chemical Reaction Laceration/Cut Burn/Scald Name and Address of Treating Physician or Facility Treatment First Aid Emergency Room Dr.

explain the cause(s) of the incident in as much detail as possible INCIDENT ANALYSIS How bad could the accident have been? Very Serious Serious Minor Describe actions that will be taken to prevent recurrence What is the chance of the accident happening again? Frequent Occasional Rare Deadline By Whom Complete PREVENTATIVE ACTIONS WITNESS(ES) Print Name Signature Supervisor’s Initials Safety Manager Safety Committee Review Revised 9/30/2008 Page 2 of 2 .COMPANY Using the root cause analysis list on the previous page.


Light duty jobs will be identified after obtaining and examining the injured worker’s physical limitations of restrictions. On-the-job injuries and occupational diseases will be handled by a team consisting of the injured worker. if offered. or the next scheduled business day. or a job that is specifically designed around the worker’s restrictions. a different regular job currently existing at the workplace. You and your supervisor must complete forms as soon after the injury as possible. the supervisor. temporarily. EMPLOYEE’S RESPONSIBILITIES • • Report all injuries to you supervisor immediately. modified by removing heavier tasks and reassigning these to other workers. his or her supervisor. Wage rate will not necessarily be the same as that of the regular job. the safety manager. If medical treatment is necessary. and the safety manager are outlined in the following pages.09. discuss the possibilities with you supervisor and/or the safety manager. The team approach is the most effective method for achieving a return to productive work at the earliest opportunity. you must report for work at the time designated by the company. • • • 2. If you are not released for regular work. the company owners. Pence/Kelly Concrete.2 revised 2/18/2010 . and the injured workers physician. but are released for light duty. o Tell the doctor the company may be able to place you in a temporary modified job if you cannot return to regular work. A light duty job offer will be made only when the work is available and of benefit to the company.2. the insurance company. Take the Physical Status Update form with you to the first and all subsequent medical visits. The light duty job.09 PURPOSE AND INTENT • EARLY RETURN TO WORK PROGRAM • • • In order to minimize serious disability due to on-the-job injuries and to reduce workers’ compensation costs. Light duty and modified work may not be implemented in every injury or illness. will end with the date the worker received a regular release. “Light duty” might be the worker’s regular job. you should go to nearest available immediate care facility or if necessary emergency facility. Each case will be assessed individually based on need. If an appropriate light duty job is developed. o Return form completed by the doctor to you supervisor or to the office the same day. and may be ended at any time if there is no longer a need for the light duty work. If medical treatment was required. LLC has developed procedures to deal with injuries/illnesses in which the worker can be offered light duty or modified work. you will complete an 801 form. whether it is a modified version of your regular job or another light duty job. Responsibilities of the injured worker.

Work with the safety manager and employee to determine what light duty jobs are available that will meet the restrictions specified by the treating physician. Verify that the employee does not go beyond either the duties of the job or the physician’s restrictions. If you see a Doctor or Emergency facility after hours or on a weekend for a work related injury. SUPERINTENDENT/FOREMAN RESPONSIBILITIES • • • Assure the employee understands and follows his/her responsibilities as listed above. you must make sure that you do not go beyond either the duties of the job or you physician’s restrictions. 2.• • • • If you are taken off work completely.2 revised 2/18/2010 . o If your restrictions change at any time.09. SAFETY MANAGER’S RESPONSIBILITIES • Assist the superintendent/foreman in determining available light duty work that will meet the restrictions set by the treating physician. or if light duty is unavailable. If you return to a light duty job. Also furnish the office with you current mailing address and telephone number. you must report your medical condition and you progress to the safety manager at least once a week. you must notify your supervisor at once and give your supervisor a copy of the new medical release at which time the light/modified duties may be changed to be consistent with your current restrictions. Report in person if possible. Employee must understand that refusal of a light duty job offer may impact the workers worker compensation benefits. you must notify your Supervisor of this fact and the nature of the injury and any restrictions on the next scheduled business day.

: FIRST AID TRAINED: FIRST AID SUPPLIES: EMERGENCY RESPONSE ____________________ _______________ _____________________________________ ___ ______________________________ _______________ RALLY POINT FOR HEAD COUNT: __________________________________ IN THE EVENT OF A SERIOUS ACCIDENT OR INJURY DIAL 911 Directions: Tell dispatch we will meet them at: to direct them to the injured person. Have someone contact the Pence/Kelly supervisor immediately.1 Oregon revised 2/18/2010 . Supervisor: ___________________ Home phone: ________________ Cell phone: _______________ Alternate Contact: ______________ Home phone: ________________ Cell phone: _________________ Emergency Medical Facility: ____________________ Address:_____________________________________ Phone Number: ________________________________ THIS PLAN MUST BE POSTED AT ALL PHONES AT THE PENCE/KELLY JOBSITE! SUBCONTRACTORS: PLEASE POST BY PHONE IN YOUR JOB TRAILER 2.2.10 PLAN PROJECT: ADDRESS: PHONE NO.10.

1Washington revised 2/18/2010 . Supervisor: ___________________ Home phone: ________________ Cell phone: _______________ Alternate Contact: ______________ Home phone: ________________ Cell phone: _________________ Emergency Medical Facility: ____________________ Address:_____________________________________ Phone Number: ________________________________ THIS PLAN MUST BE POSTED AT ALL PHONES AT THE PENCE/KELLY JOBSITE! SUBCONTRACTORS: PLEASE POST BY PHONE IN YOUR JOB TRAILER 2. Have someone contact the Pence/Kelly supervisor immediately.2.: FIRST AID TRAINED: FIRST AID SUPPLIES: EMERGENCY RESPONSE ____________________ _______________ _____________________________________ ___ ______________________________ _______________ RALLY POINT FOR HEAD COUNT: __________________________________ IN THE EVENT OF A SERIOUS ACCIDENT OR INJURY DIAL 911 Directions: Tell dispatch we will meet them at: to direct them to the injured person.10.10 PLAN PROJECT: ADDRESS: PHONE NO.

This plan must be developed for each project regardless who would be taking the lead with the media. The project teams should develop the Crisis Management Plan prior to starting the project. the general contractor on a stand alone site or the general contractor on a large site where the owner has requested that all media relations be handled by their spokesperson the information within this plan will help who ever is dealing with the media. Our customers. industry peers and others. without causing a major disruption of normal activities. Because emergencies do not pause to allow us to think through the problem. Our plan is organized for immediate use in the event of an emergency.11 CRISIS MANAGEMENT PLAN AND MEDIA GUIDELINES FOR JOBSITE ACCIDENTS CRISIS MANAGEMENT PLAN AND MEDIA GUIDELINES The overall reason for planning for an emergency is to provide a systematic approach to managing the crisis in an organized fashion. should all feel we were well organized and handled the emergency in a professional manner.2. financial supporters. we need to be prepared for every emergency most apt to happen. A crisis management plan is designed to maintain the Company's credibility and positive image with all of its identified audiences in the face of adversity. management. The Crisis Management Plan template and the instructions for developing the Crisis Mangement Plan can be located at J:\SAFETY\PENCE KELLY SAFETY MANUAL\CRISIS MANAGEMENT PLAN . employees. Copies of the plan should be printed out and kept onhand by all senior staff of the project. Whether we are a subcontractor.

There will be an equal number of field and office employees. unless agreed upon otherwise. LLC. Evaluate all accidents for cause and possible disciplinary action.12 PURPOSE SAFETY COMMITTEE POLICY To propagate a safe working environment throughout Pence/Kelly Concrete. Improve the spirit of cooperation between employer and employee. Meetings will be held the fourth Tuesday of each month. 2. and to all office and shop personnel. Promote and publicize safety.1 . PROCEDURE • • • • The committee will consist of at least four volunteer members of the workforce and management. Monitor the safety program effectiveness. Copies of the minutes will be distributed to all superintendents to be posted on their bulletin board. Our safety committee consists of representations from employees and management.12. Provide a channel for communication between employees and management to address safety questions or concerns. To assist in the detection and elimination of unsafe conditions and work procedures. Minutes will be maintained in the file for a period of three years. OBJECTIVE • • • • • • To establish procedures to ensure a safe and hazard free work areas for our employees.2.

2.1 revised 1/20/2010 . Industrial hygienists. Contact the Safety Manager to arrange a WISHA Consultation. and Accident investigation. OR-OSHA CONSULTATIVE SERVICES • Pence/Kelly Concrete. Occupational safety and health programs.13 PRE-JOB SAFETY CONSULTATIONS • SAFETY CONSULTATIONS Pre-job Safety consultations will be scheduled with project superintendent. Consultants can be utilized for pre-job and pre-task planning. Occupational safety and health programs. Occupational safety and health programs. LLC encourages the use of WISHA consultative services to help employers and employees identify and correct occupation safety and health hazards. LLC encourages the use of AGC consultative services to help employers and employees identify and correct occupation safety and health hazards.13. Consultants can be utilized for pre-job and pre-task planning. • AGC SAFETY CONSULTANTS • Pence/Kelly Concrete. Ergonomic evaluations. Services include: Hazard assessments. Contact the Safety Manager to arrange a AGC Consultation. Industrial hygienists. Contact the Safety Manager to arrange an OR-OSHA Consultation. project manager and Safety Committee. Industrial hygienists. Ergonomic evaluations. Consultants can be utilized for pre-job and pre-task planning. and Accident investigation. Services include: Hazard assessments. LLC encourages the use of OR-OSHA consultative services to help employers and employees identify and correct occupation safety and health hazards. Services include: Hazard assessments. Topics are on attached checklist. Ergonomic evaluations. • WISHA CONSULTATIONS • Pence/Kelly Concrete. and Accident investigation. • 2.

Lead.Pence/Kelly Concrete. LLC Pre-Job Safety Consultation Job: _________________________________________________ Date: ________________________________________________ • • • • • • • • • • • • • • • • • • • • • • Chemicals: MSDS Concrete Work: Pre-cast. Tilt-up. Partial Demolition. General Demolition Emergency Response Plan Excavation & Trenching Fall Protection Plan Fire Prevention Hoisting/Rigging Activities: Cranes. Vertical.13. Concrete Pump Confined Space Demolition Activities: Asbestos. Form Work. Forklifts Housekeeping & Sanitation Jobsite Orientation: Employee & Subcontractor Job Hazard Analysis/ Pre Task Planning Masonry Non-Routine Activities Owners Requirements Public Exposure: Phased Occupancy.2 revised 1/20/2010 . Traffic Control Scaffolding Site Constraints Staging Areas Steel Erection: General Contractor and Steel Erectors Responsibilities Subcontractors Safety Record Temporary Power (GFCI) 2.

2. o Refer to and identify all applicable emergency equipment. re-communicate any additional changes. work crew coordination and communication needs and implement practices which ensure all tasks are performed incident free. To effectively plan the task being performed. etc. the crew or individual must physically walk down the area before the work is to be performed to identify all potential hazards. make necessary modifications. ensure the proper training is completed prior to start of work. this includes all subcontractors onsite. o Supervisor. project engineer. Ensure the location of each is known by all crewmembers. o The completed worksheet is posted in the foreman’s trailer.. NOTE: If performance of the task requires deviation from the posted plan. the crew is to immediately cease work and notify supervision.1 revised 1/20/2010 . superintendent.14 PURPOSE • JOB HAZARD ANALYSIS/ PRE-TASK PLANNING • To eliminate incidents/accidents and business interruptions by utilizing and standardizing best know methods. may help to identify potential hazards and effects on systems. 2. Once the potential hazards are identified the crew or individual shall: o Refer to and identify all Personal Protective Equipment (PPE) applicable to the work to be performed. initial the worksheet and post the modified plan before resuming work. safety coordinator. and remains posted for the duration of the task. Supervisor and crew shall re-assess the plan.14. The crew or individual assigned to perform the task must prepare the pre-task planning worksheet. If an item is checked. To recognize existing and potential hazards. safety committee.

2 revised 1/20/2010 . WORK MUST STOP AND PRETASK UPDATED FOR CHANGING CONDITIONS 2.14.Pre-Task Plan Check List Start Date End Date Crew Size Project name: ___________________ Crew Supervisor Review: _________ P/K Superintendent Review: _______ Be sure to ask the following during evaluation of your work: Will your work impact existing buildings/occupants? Does this task require disassembly or equipment? Should the safety comm. Crew Leader’s Signature: ____________________________ Crew Signature: Foreman’s Signature: ___________________________ 1 2 3 4 5 6 7 8 9 10 IF WORK CONDITIONS CHANGE. be involved in this planning? Are Toxic or Hazardous chemicals in use? Are the shop drawings on hand? Have the Material Safety Data Sheets been reviewed? Will weather conditions affect the safe completion of this work? Has a complete hazard analysis been done? Date of analysis:_____________ Are enough personnel assigned to this task to complete it safely? Was pre-task planning at work location? Does this task require any special permits/procedures? Do other subs need to be involved? Does this task require special training? If a ladder is required for this task has it been inspected? If rigging is required for this task has it been inspected? Check if any of the following required: Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Open Flame Barricades/Signs Fall Protection PPE Hearing PPE Reviewed w/all crew members Dust Control Eye/Face PPE Hand/Arm PPE Respirator Full Body PPE Hazard Communications Other The tasks for today have been reviewed in the work area they will be performed and the workers on this crew have been through the required training.

3 revised 1/20/2010 . Company Name: Author: Prepared Task Plan Data: Pence/Kelly Const System/Area of Work: Task to be accomplished: Page of SEQUENCE OF CONSTRUCTION ACTIVITIES HAZARD ANALYSIS METHOD TO ELIMINATE HAZARDS IF WORK CONDITIONS CHANGE WORK MUST STOP AND PRETASK UPDATED FOR CHANGING CONDITIONS 2.Pre-Task Plan Work Sheet Task Plan No.14.

15. the area and requirements can be reassessed. should conditions change. Appropriate training on the use and maintenance of PPE will be provided by. Therefore.2.) the requirements for PPE are 100% coverage all the time for all people onsite.1 revised 1/20/2010 .. 2. PPE is designed to protect the worker from injury or harm. it is not designed to prevent the occurrence of an incident which might cause harm or injury. After achieving T. Prior to achieving Temporary Certificate of Occupancy (T. or arranged for by.15 PURPOSE PERSONAL PROTECTIVE EQUIPMENT (PPE) PROGRAM Pence/Kelly Concrete. by the project superintendent.C. This policy reviews basic requirements for personal protective equipment including: • Appropriate Clothing • Head protection • Hearing – ear protection • Eye and Face protection • Hand protection • Foot protection PROCEDURES Workplace hazards will be assessed by the project superintendent. Workers shall be retrained if necessary. However. we must ensure that working conditions are safe and PPE is used as a back-up for additional protection. The PPE provided shall be used as outlined by specific job procedures and maintained in a sanitary and reliable condition. or supervisors. The selection of PPE shall be made by our management staff and designed to match the hazard to allow employees to safely conduct their job tasks. Employees are required to wear proper personal protective equipment.C. unless inspected and approved by job site supervision. LLC has adopted this Personal Protective Equipment (PPE) policy and procedure to ensure that when hazards cannot be fully controlled with engineering or process controls that employees use appropriate personal protection.O. This policy does not include Fall or Respiratory Protection – see separate programs for those policies. Employees shall not provide any of their own personal protective equipment. It is also to assist in ensuring compliance with OSHA standards.O.

Clothing that may get caught in tools or equipment. torn or ragged clothing shall not be allowed on the jobsite.Selected PPE shall be fitted to each affected employee.15. Areas requiring hearing protection shall be posted. HEARING PROTECTION • Earmuffs and earplugs are used to protect against hazardous noise levels when they cannot be adequately lessened by various engineering controls. APPROPRIATE CLOTHING • • • Long pants are required at all times. The sites’ noise levels will vary a great deal. protruding objects. and electrical shock. Eye protection is required to meet the following criteria based on Safety Regulations: o Provide adequate protection against the particular hazards for which they are designed. tank top or similar shirts are allowed on the jobsite. Hard hats shall be used by all employees at construction sites or when overhead hazards are present. Shirts with sleeves that cover the shoulder are required. or inside a confined space below ground level.2 revised 1/20/2010 . As a result. mesh. 2. impact. temple bars of glasses will interfere with the seal of the ear piece. hearing protection should be worn whenever there are loud sounds from power equipment or processes. If earmuffs are worn. • • EYE AND FACE PROTECTION • • Safety glasses or prescription glasses with safety lenses and side shields to be worn at all times. dresses and sweat pants are not allowed on the jobsite. Shorts. such as loose fitting. This includes when working under floor openings or walkways. Shirts with the hem on the sleeve cut off are not allowed on the jobsite. Hard hats shall be worn whenever ‘hard hat’ signs are posted regardless of whether an overhead hazard exists. Defective or damaged PPE shall not be used. ear plugs should be worn by those required to wear safety glasses or glasses with corrective lenses. If not. Hard hats used at our work operations will meet ANSI standards for the job task. No muscle. Hearing protective devices are supplied to all employees. HEAD PROTECTION • • • Hard hats are to be used to protect the head from flying objects.

Chemical protective gloves are selected based on the type of rubber/plastic material which affords proper protection against specific chemicals used. heat. o Be kept clean and in good repair. o Be capable of being cleaned easily. HAND PROTECTION • • • Hand protection is worn to protect the hands from a mechanical injury due to friction.15.• o Provide reasonable comfort and shall not unduly interfere with the movements of the wearer. • • FOOT PROTECTION • Appropriate work boots are required to be worn. The selection will be made by the supervisor.3 revised 1/20/2010 . o Arc welding requires the use of a welding helmet with a dark lens covering. shearing/cutting actions. The specific type of eye and face protection needed depends on the type of hazard. o Particle hazards for grinding/chipping require safety glasses with side shields in tandem with a full face shield. Kevlar gloves will be worn when erecting tilt panels. o Liquid splash hazards require chemical splash goggles or safety glasses with a face shield. 2. o Be durable. and for protection against chemicals. o Face protection is worn when liquid splashes or significant particle matter could impact the face and cause injury. Chemical protective gloves will be worn when there is skin contact with the following chemicals: o Solvents o Any corrosives o Spill clean-up o Concrete Kevlar gloves will be worn when using hand held grinders. o Gas welding requires welding goggles.



Fall Protection is a broad concept that includes training, procedures, rules, systems and methods, intended to protect workers from fall hazards. Pence/Kelly requires fall protection for work activities that expose workers to fall hazards of 6 feet or more or over dangerous equipment. All employees must comply with the site fall protection policy. Failure to adhere to the site fall protection policy is grounds for immediate termination of offending employee This section is in reference to Division 3, Subdivision M – Fall Protection. Scaffold and Elevated Work Platforms are covered in Section 2.20. Ladders and Stairways are covered in Section 2.19. Steel Erection is covered in Section 2.18. PRE-TASK PLANNING A site specific Fall Protection Plan is required to be submitted and approved prior to performing activities that expose workers to fall hazards. You should try to engineer out the need for a fall arrest system during your pre-task planning. Examples would be prefabricating on the ground, using a man-lift, or installing standard guardrails. A company safety representative will approve Fall Protection Plans. Fall Protection equipment will not be issued from the shop without an approved plan. Fall Protection equipment is for exclusive use of Pence/Kelly employees and will not be loaned to others. Fall Protection Plan shall include the following: • Type of Work • Procedures • Assembly, Inspection and Disassembly • Rescue Plan • Training Program and list of trained employees • Date plan Prepared and Approved • Fall protection Equipment Required See attached sample Fall Protection Plan and Fall Protection Plan Outline FALL-PROTECTION SYSTEMS A fall-protection system refers to equipment designed to control fall hazards. All fallprotection systems either prevent a fall from occurring or safely arrest a fall. Types of fall-protection systems include the following: • Guardrail Systems o Top edge height of guardrail systems shall be 42”, plus or minus 3”. Guardrails shall have a midrail and toe board.


revised 10/19/2009

o Guardrail systems shall be capable of with standing a 200-pound force in any outward or downward direction. o Wood top rails and posts shall be at least 2”x4” and posts shall be spaced not more than 8’ on center. o Wire rope used for a top rail must be at least ¼” diameter and be flagged at not more than 6’ intervals with high-visibility material. o When guardrail systems are used at hoisting areas, a chain, gate or removable guardrail section shall be placed across the access opening when hoisting operations are not taking place. • Warning Lines O Warning lines may be used for roofing work. Roofing work does not include construction of the roof deck or leading edge work. O A warning line system shall not be used as fall protection on roof slopes greater than 2 in 12. O Warning lines shall be erected not less than 6’ from roof edge. O Warning lines shall be flagged with high-visibility material at not more than 6’ intervals. O Height of warning line shall be 34” to 39”, and capable of withstanding a 16 pound force when applied horizontally at the stanchion. Safety Monitoring System O Safety monitoring systems shall only be used for roofing work. Roofing work does not include construction of the roof deck or leading edge work. O At no time shall the Safety Monitoring Systems be used as a means for fall protection without prior approval of the Safety Manager. Warning Lines Used for Other Than Roofing Work O Warning lines may be used to mitigate the fall hazards by eliminating exposure. O When a safe work distance is designated, which may also include some sort of warning line or other barricade, it must be one that eliminates the potential for the worker to stumble and fall over the unprotected edge but at a minimum 10 feet. O There should also be a margin of error included in the distance since there is not a positive means of stopping the worker’s forward momentum toward the unprotected edge. o Factors that might enter into such an evaluation could include weather conditions, lighting, the slope and condition of the walking surface, the kind of work being performed, materials being handled, the height of the worker above the work surface (such as working from a ladder), housekeeping, training, experience, how much time the job takes, or the distance that the worker stays away from any open sides or edges. o The guiding principle to follow when evaluating warning or barricade lines is that the distance from the unguarded edge of the work surface must be great enough to remove the worker from exposure to a fall hazard.


revised 10/19/2009

o Factors to evaluate in determining the allowable use and correct location of barrier lines include such things as the kind of fall hazard present, the work being done and the exposure to the hazard, the pitch of the work surface, whether the deck is secure or not, the degree of slickness of the walking surface, weather conditions and environmental conditions (ice, moss, rain, wind, lighting, sun glare, etc.), what equipment is being used, access and egress protection, training, and supervision. o It’s quite simple, if there’s no exposure, then there’s no hazard, and thus, no violation. o Warning lines should be constructed the same as for roofing work. • Safety Net Systems O Safety Net systems consist of mesh nets, including panels, connectors, and other impact absorbing components. O If safety nets are needed, the designated competent person will oversee the installation and performance requirements of the system. Personal Fall Arrest Systems o Personal Fall Arrest Systems have four basic components. o Pence/Kelly exclusively uses DBI/SALA brand for the full body harness. (a limited number of Miller Harnesses remain to be replaced) The designed working load for DBI/SALA, combined weight (clothing, tools, etc.) is no more than 420 lbs., unless labeled otherwise. DO NOT EXCEED THIS WEIGHT. Body Support (Full body harness) • The only form of body wear acceptable for fall arrest is the full body harness. The Lanyard connecting device (Connecting components) • Lanyards shall be constructed of synthetic material (nylon rope, nylon webbing) and have a locking snaphook. • Lanyards will not be “tied-back” unless they are designed for that purpose (IE: Miller BackBiter). Carabiners shall be locking. • Lanyards, connectors and carabiners shall have a minimum breaking strength of 5,000 pounds. Deceleration devices (rope grabs, shock absorbing lanyards, self-retracting lanyards) • You need to verify if the retractable lanyard you are using may be operated flat, some need to be in the overhead position. Anchorage points ( includes: lifelines; horizontal and vertical) • Anchorage points need to be capable of supporting 5,000 pounds for each employee attached to it. • Anchorage points and lifelines are not required to be DBI/SALA brand.


revised 10/19/2009

• • •

If there are no permanent tie –off anchors installed on building, the Superintendent should work with the owner and architect to have them installed. Vertical lifelines are designed to be used by only one person with a rope grab for vertical mobility, only for up and down movement. Horizontal lifelines can only be used when designed, installed and used under the supervision of a qualified person. o Horizontal lifelines and their anchors are subject to much greater load than vertical lifelines. o Although two workers can tie off to the same horizontal lifeline, if one falls, the line movement could cause the other worker to fall, too, subjecting the line and anchors to even greater forces. o For these reasons, horizontal lifelines must be designed, engineered, and installed under the supervision of a qualified person. o Locations of anchor points need to be planned, considering free-fall distances and swing fall risks.

Covers o Floor and roof openings shall be protected by a standard guardrail system or covered. The cover shall be clearly marked “hole” or “cover” and be secured to prevent accidental displacement. Covers shall be capable of supporting at least twice the weight of employees, equipment or material that may be imposed on them at any one time.

PROCEDURES All components of PFAS shall be inspected before usage for damage and serviceability. Refer to manufactures instructions for inspection procedures. Lanyards, Harnesses, Lifelines and Retractable Lanyards shall be checked quarterly by job foreman or superintendent and marked with colored tape according to the Assured Grounding Program. RESCUE PLAN Workers who use personal fall arrest systems must be able to rescue themselves if they are suspended after a fall or they must be promptly rescued. Workers may be trained in self-rescue or aided-rescue. See “Fall Protection for the Construction Industry” pamphlet from OROSHA. Superintendent should consult with local fire department for rescue procedures and access to site. Only rescue trained personnel should assist with rescue.


revised 10/19/2009

TRAINING PROGRAM The employer shall provide a training program for each employee who might be exposed to fall hazards. The program shall enable each employee to recognize the hazards of falling and shall train each employee in the procedures to be followed in order to minimize these hazards. Fall protection training shall be site specific. The employer shall assure that each employee has been trained in the following areas: • The nature of fall hazards in the work area; • The correct procedures for erecting, maintaining, disassembling, and inspecting the fall protection systems to be used. • The use and operation of guardrail systems, personal fall arrest systems, safety net systems, warning line systems, safety monitoring systems, personal fall restraint systems, slide guard systems, positioning devices, and other protection to be used; • The limitations on the use of mechanical equipment during the performance of roofing work; • The correct procedures for the handling and storage of equipment and materials and the erection of overhead protection; and • The role of employees in the fall protection plan CERTIFICATION OF TRAINING Training shall be documented on the site specific Fall Protection Plan. The written certification record shall contain the name of the employee trained, the date(s) of the training, and the signature of the person who conducted the training. RETRAINING When the employer has reason to believe that any affected employee who has already been trained does not have the understanding and skill required, the employer shall retrain each such employee. Circumstances where retraining is required include, but are not limited to, situations where: • Changes in the workplace render previous training obsolete; or • Changes in the types of fall protection systems or equipment to be used render previous training obsolete; or • Inadequacies in an affected employee's knowledge or use of fall protection systems or equipment indicate that the employee has not retained the requisite understanding or skill.


revised 10/19/2009

TIE OFF TO COLUMNS” 2. covers and warning lines. TYPE OF WORK Includes installing SOMD concrete. Top cable shall be flagged at 6’ intervals with high-visibility material and be marked “FALL PROTECTION REQUIRED BEYOND THIS POINT. guardrail systems. 2.4 All sides of floor deck shall have a guardrail erected. life lines. double locking lanyards. 2. Perimeter guardrail shall consist of a top 3/8” cable at 42” AFF. rope grabs. a middle cable at 21” AFF and a 4” high toe board. PROCEDURES 2. Cover shall be secured to prevent accidental displacement and be marked “ FLOOR OPENING Do not remove cover” 2.5 Materials will be landed on 2nd floor at designated hoist areas ONLY. 2. roof sheathing at wood and metal deck.2 Fall protection shall be accomplished through the use of full body harness. At hoisting areas a chain or removable guardrail section shall be placed Page 1 of 6 . clerestory wall framing. nailable roof insulation. Cable will be anchored at steel columns with a washer and a post at mid-column.3 All openings in floor or roof deck shall be protected with a guard rail or cover. DO NOT TIE OFF TO THIS LINE.1 Fall protection shall be required for all employees who are working from unprotected work surfaces 6 ft or greater in height. and integral gutter backing. OREGON 97302 (503) 399-7223 OR (503) 224-8681 (503) 585-7477 FAX FALL PROTECTION PLAN FOR JOB # 01-025 OREGON DEPARTMENT OF FORESTRY Public Services Building 1. T&G roof decking. LLC 2747 PENCE LOOP SE SALEM.PENCE/KELLY CONCRETE. retractable lanyards.

Employees will be required to use a full body harness and a double locking lanyard that is secured to designated tie off points in manlifts or forklift basket. Employees will be trained in the proper use and maintenance of equipment.7 Elevating Work Platforms (Scissor Lift. rope and rope grab will be installed at hoist area in west corner of 2nd floor by grid C-8 in Room B211 2. An anchor point.000# per worker).6. Lifeline or retractable lanyard will be attached to CrossArm strap with locking carabiner. Warning lines shall be flagged at not more than 6’ intervals with a high visibility material. Each employee in a hoist area shall be protected from falling to lower levels by a guardrail system or personal fall arrest system. Lifeline or retractable lanyard will be attached to Qual-Craft Roof Edge Anchor with locking carabiner. 2. Manlift.strap will be wrapped around beam or column.9 All sides of the flat roof deck will have a warning line erected 10’ from the edge. Anytime a employee doesn’t have at least one foot on the scissor lift deck. 2.4 Permanent Fall Protection Anchor Points. 2. See foreman for locations of anchor points. If guardrail must be removed to facilitate hoisting.3 Miller RoofStrider.8 Roof brackets and 2x6 slide guards will be installed at edge of 3:12 roof at locations directed by foreman.6 Anchor points are designed for one worker only (5. The warning line will shall be supported so the Page 2 of 6 . See attached installation instructions. 100% fall protection is required.RoofStrider and retractable lanyard will be installed per attached instructions.6. Lifelines or retractable lanyards shall be secured to anchor points as follows: 2. and Forklift basket) may be used for some tasks.6.6. 2.across the access opening when hoisting operations are not taking place. 2.2 Qual-Craft Roof Edge Anchor. employee shall be protected from fall hazards by a personal fall arrest system.Lifelines or retractable lanyards may be secured to permanent anchor points at clerestory windows. 2.1 Miller Cross-Arm Strap. Brackets will be spaced no more than 8’ on center.Roof edge anchor will be fastened to 3x8 T&G decking or 3x nailer with 2” #10 wood screws. Anchor points must be placed high enough for a worker to avoid contact with a lower level.

Foreman. 3. torn.2.4 Lifelines and retractable lanyards shall be inspected before usage to insure they are properly secured to anchor point. and mark with colored tape according to Assured Grounding Program. investigation. or assessment of workplace conditions prior to the actual start of construction work or after all construction work has been completed. or frayed in any way 3. wear. corrosion. 3.1 Employee will inspect anchor points daily and prior to use. or malfunctioning components. cracks. Inspect for physical damages. and mark with colored tape according to Assured Grounding Program. or frayed in any way.2 Lifelines & Retractable Lanyards 3. 3.1 Lifelines shall be inspected before usage to see that they are not cut.10 The provisions of this fall protection plan do not apply when employees authorized by jobsite superintendent are making an inspection.3. 3.3 Check quarterly with Eric Devenport. 2.1 Each employee issued a harness and lanyard shall inspect the safety equipment before usage to see that they are not cut.1 Harness & Lanyard 3.1.1. Lanyards will not be “tied-back” 3. Foreman.2.2 Retractable lifelines shall be inspected before usage per manufacturer instructions. Any equipment found defective will be returned to foreman. ASSEMBLY.lowest point is no less than 34” above the deck and the highest point is no more than 39” above the deck.3 Anchorage points 3. torn. 3. 3. Page 3 of 6 .3 Check quarterly with Eric Devenport. INSPECTION AND DISASSEMBLY 3.

First responders should clear a path to the victim.4.3 Only trained personnel may attempt a technical rescue. (See following page). 4. Eric Devenport Page 4 of 6 . forklift and ladders may also be utilized for rescue.2 Pence/Kelly will assist fire department in rescue and retrieval if required. RESCUE PLAN 4. DATE PLAN PREPARED: October 10.1 Call 9-1-1 if an emergency occurs and ensure foreman/superintendent is notified. 5. 4. TRAINING PROGRAM 5. 2002 Plan prepared by: Roland Mack Plan Approved by: Dave Hays Plan Supervised by: Roland Mack.1 Employees will sign form stating they have been given this training. Others should meet emergency personnel at gate and direct to scene. Aerial lifts. 6.

Date Employee Name Employee Signature Trainer ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ __________________________________________________________ ___________________________________________________________ ___________________________________________________________ Page 5 of 6 . Failure to adhere to the site fall protection policy is grounds for immediate termination of offending employee.EMPLOYEES TRAINED IN FALL PROTECTION OREGON DEPARTMENT OF FORESTRY PUBLIC SERVICES BUILDING All employees must comply with the site fall protection policy. Please make sure that you read and understand your project fall protection policy before you begin work.

JOB # 01-025

___ Body Harness- Small ___ Body Harness- Medium ___ Body Harness- Large ___ Body Harness- Extra Large ___ Rope lanyard ___ Shock-absorbing lanyard ___ Positioning Assembly ___ Rope Grab ___ Locking Carabiner ___ 25’ Self-Retracting Lifeline ___ 30’ Mighty-Lite Self-Retracting Lifeline ___ 50’ Mighty-Lite Self-Retracting Lifeline ___ Lifeline ____’ ___ Lifeline ____’ ___ Cross-Arm Strap (wrap around beam or column) ___ Roof Strider for _________ deck ___ DBI Sala D-Ring anchorage connector ___ Qual-Craft #5100 Roof Edge Anchor ___ Qual-Craft # 5200 Roof Peak Anchor ___ P/K Anchor plates for CMU/Concrete ___ Roof Bracket (toe kick) ___ Warning Line ____’ ___ Warning Line Posts ___ Guardrail Posts ___ Guardrail Cable ___ U-bolt cable clips ___ “Hole” signs or stencil

Page 6 of 6

2747 PENCE LOOP SE SALEM, OREGON 97302 (503) 399-7223 OR (503) 224-8681 (503) 585-7477 FAX


1. TYPE OF WORK Type of work being performed Examples- Concrete formwork, Precast erection, Roof framing, Top plate installation.


Identify different tasks and activities that require fall protection. Describe method of fall protection for each activity.

Page 1 of 6

Identify anchor points and how lifelines, lanyards will be secured. Anchors must be capable of supporting a minimum load of 5,000 pounds per worker. Attach sheets with anchor installation details.

Describe access to work area for workers and material.

Describe protection at openings, slab and roof edges, etc.

See attached examples of fall protection plans. You should also read OROSHA Division 3, Subdivision M

Page 2 of 6

3. ASSEMBLY, INSPECTION AND DISASSEMBLY 3.1 Harness & Lanyard Describe inspection procedures for harness and lanyard

3.2 Lifelines & Retractable Lanyards Describe inspection procedures for lifelines, rope grabs, retractable lanyards, etc. if required.

3.3 Anchorage points Describe inspection procedures for anchorage points.

Page 3 of 6

Employees will be retrained if there are changes in the type of fall protection systems or equipment used. 5. litter basket. 6. forklift. etc._________________________________________ Plan Approved by_________________________________________ Plan Supervised by:________________________________________. or if use of the equipment indicate the employee has not retained the requisite understanding or skill.1 Employees will sign form stating they have been given this training with date and signature of trainer (See following page). Page 4 of 6 . crane.1 Emergency Procedures Describe rescue procedures.4. DATE PLAN PREPARED: Month xx. xxxx Plan prepared by . Call the fire department and have them look at your site. You may need to assist in rescue with a manlift. Workers in 9-1-1 service areas can use ambulance service for rescue if the local fire department has the capabilities for rescue. TRAINING PROGRAM 5. RESCUE PLAN 4.

Failure to adhere to the site fall protection policy is grounds for immediate termination of offending employee. Date Employee Name Employee Signature Trainer _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Page 5 of 6 .EMPLOYEES TRAINED IN FALL PROTECTION Job Name All employees must comply with the site fall protection policy. Please make sure that you read and understand your project fall protection policy before you begin work.

FALL PROTECTION EQUIPMENT REQUIRED JOB # ________ ___ Body Harness.Small ___ Body Harness.Extra Large ___ Rope lanyard ___ Shock-absorbing lanyard ___ Positioning Assembly ___ Rope Grab ___ Locking Carabiner ___ 25’ Self-Retracting Lifeline ___ 30’ Mighty-Lite Self-Retracting Lifeline ___ 50’ Mighty-Lite Self-Retracting Lifeline ___ Lifeline ____’ ___ Lifeline ____’ ___ Cross-Arm Strap (wrap around beam or column) ___ Roof Strider for _________ deck ___ DBI Sala D-Ring anchorage connector ___ Qual-Craft #5100 Roof Edge Anchor ___ Qual-Craft # 5200 Roof Peak Anchor ___ P/K Anchor plates for CMU/Concrete ___ Roof Bracket (toe kick) ___ Warning Line ____’ ___ Warning Line Posts ___ Guardrail Posts ___ Guardrail Cable ___ U-bolt cable clips ___ “Hole” signs or stencil Page 6 of 6 .Large ___ Body Harness.Medium ___ Body Harness.

Project Superintendent’s responsibilities as a “competent person” must satisfy the definition of “competent person” as stated in Code of federal Regulations 29. o The availability of rescue equipment and services to include emergency medical response. o Ensuring that only those employees who have received appropriate training enter the trench or excavation. o Supervising the installation of shoring/shielding systems. o Removing or supporting underground installations that would threaten the safety of employees. o Maintaining emergency rescue equipment on site.2. o Determining the scope of all work performed in the trench or excavation.17. 2. threatening employee safety. o Correcting unsafe conditions within the excavation or trench. o Conferring with registered professional engineer for the design of shoring systems or shielding systems. o Removing employees from the excavation or trench when conditions deteriorate. The Project Superintendent or “competent person” will also be responsible for the following: o Performing daily inspections of excavations and recording the results of these inspections on the attached inspection form. PURPOSE AND SCOPE The purpose of this program is to define procedures for the protection of Company personnel anytime they are required to work in a trench or excavation. o Testing for and controlling hazardous atmospheres. o Locating all underground utility installations. On our varied projects the opportunity for employee exposure to the hazards associated with trenching and excavation are numerous.1 revised 3/24/10 .17 INTRODUCTION EXCAVATION AND TRENCHING PROTECTION PLAN The primary objective of this trenching and excavating plan is to prevent injury or death to Company personnel when excavations or trenches are opened on our job sites. o Maintaining a log of daily inspections and their results on attached form. RESPONSIBILITIES • • • The Project Superintendent will be responsible for ensuring the presence of a “competent person” when employees are working in any excavation. therefore no work will commence until all aspects of this program are addressed. Part 1926 Labor and applicable sate standards.

will not be placed on the edge of any excavation as to present a hazard to workers in the excavation. steadying equipment etc. While the excavation is open underground installations will be removed or supported as necessary to safeguard employees (utilizing local utility companies as required). fuel. are not to disturb the actual top of slope. No employee will enter the bucket or scoop of any excavation equipment for the purposes of being lifted or lowered.SURFACE ENCUMBRANCES • • • • All surface encumbrances such as rail road tracks. etc.17. the exact location of these installations shall be determined by requesting a “locate” from the client or their representative. and water lines are to be determined before opening any excavation. workers. Large rocks. footings. 2. ramps or other safe means of egress shall be located in trenches and exactions greater than four (4) feet in depth. ACCESS AND EGRESS • Ladders. stairways. scrap pipe etc. electric. as necessary to safeguard employees.2 revised 3/24/10 . if the operator does not have a clear view of the edge of the excavation. etc. will be removed or supported. WARNING SYSTEMS FOR MOBILE EQUIPMENT • When mobile equipment is operated adjacent to an excavation or when equipment must approach an excavation. A minimum 10 foot setback for workers is advised. a ground guide will be used to guide the operator in conjunction with appropriate back up alarms on bi-directional equipment. Equipment. so as to require no more than twenty-five (25) feet of lateral travel for employee. Employees will stand away from any vehicle being loaded or unloaded to avoid being struck by any spillage or falling materials. EXPOSURE TO FALLING LOADS • • • • • • No employee will be permitted under loads handled by lifting or excavation equipment. UNDERGROUND INSTALLATIONS • • • The estimated location of all underground installations such as telephone. When excavation operations approach the estimated location of underground installations. Spoil piles will be located at least two (2) feet from the edge of the excavation. Pipe staged along a trench will be placed at least two (2) feet from the edge of the trench to prevent it from being dislodged and rolling into the trench. Equipment and materials will be evaluated individually.

to prevent exposure of employees to harmful levels of atmospheric contaminants and to assure acceptable atmospheric conditions the following requirements will apply: o Where oxygen deficiency (atmospheres containing less tan 19. or where water is accumulating.C.) have been taken to protect employees from the hazards associated with water accumulation (trench wall soaking up water and sloughing in etc. o Adequate precautions will be taken (providing respiratory protection. will be readily accessible where hazardous atmospheric conditions exist or may be expected to develop during work in excavations.e. (2). or ventilation) to prevent employee exposure to atmospheres containing less than 19. Excavations subject to run off from heavy rains or excessive ground water will be inspected by the Project Superintendent or other “competent person” in accordance with 29 CFR 1926. safety harness and lifeline.5 percent oxygen.501926.5 percent oxygen) or a hazardous atmosphere exists or could reasonably be expected to exist.B.3 revised 3/24/10 .A. etc. EMERGENCY RESCUE EQUIPMENT • Emergency rescue equipment i. o When controls are used that are intended to reduce the level of atmospheric contaminants to acceptable levels. o Adequate precaution (ventilation etc. such as in excavations in landfill areas or excavations in areas where hazardous substances are stored nearby. 2.17. the atmospheres in the excavation shall be tested before employees enter excavations greater than 4 feet (1. • Adequate protection shall be provided to protect employees from loss rock or soil that could pose a hazard by falling or rolling from an excavation face.) will be taken to prevent exposure of employees to atmospheres containing more than twenty (20) percent of the lower explosive limit of flammable gas. S. unless adequate precautions (pumping. PROTECTION FROM HAZARDS ASSOCIATED WITH WATER ACCUMULATION • No Company employee will work in any excavation where there is water accumulation. testing shall be conducted as often as necessary to ensure that the atmosphere remains safe..22 m) in depth.107. installing wells. or basket stretcher.HAZARDOUS ATMOSPHERES • In addition to the requirements set forth in subparts D and E of 29 CFR 1926.) The Project Superintendent will be responsible for dewatering excavations.651 (k). • • PROTECTION OF EMPLOYEES FROM LOOSE ROCK OR SOIL. (1).

has been taken. or by the use of retaining devices that are sufficient to prevent material or equipment from falling rolling into excavations. o Results of the inspection (hazards found etc. employees will be removed or prevented from entering the excavation/trench until corrective action. Employees shall be protected from excavated or other materials or equipment that could pose a hazard by falling or rolling into excavations.8m) or more in depth shall be protected from falling by guardrail systems. The inspections will focus on situations that could result in possible cave-ins.• • • Such protections shall consist of scaling to remove loose material. adjacent areas. INSPECTIONS • • • Daily inspection of excavations. including flagging off the area with danger tape to ensure their safety. fences. hazardous atmospheres or other hazardous conditions. fences. The attached form may be used for this purpose. barricades. shaft. installation of protective barricades at intervals as necessary on the face to stop and contain falling material. Guardrails which comply with 1926.4 revised 3/24/10 . or by a combination of both if necessary. Each employee at the edge of an excavation six (6) feet (1. and protective systems will be made by the Project Superintendent or other “competent person”.61m) from the edge of excavations. indications of failure of protective systems. or covers. or barricades when the excavations are not readily seen because of plant growth or other visual barrier. o The date and time of the inspection.17. • • FALL PROTECTION • • • Walkways shall be provided where employees or equipment are required or permitted to cross over excavations. Each employee at the edge of a well. • 2. pit.8 m) or more above lower levels. A log of these inspections will be kept to include: o The name of the excavation inspected. Protection shall be provided by placing and keeping such materials or equipment at least 2 feet (. or other means that provide equivalent protection.) o Name of “competent person” making the inspection.502(b) shall be provided where walkways are six (6) feet (1. and similar excavation six (6) feet (1. When the “competent person” finds a hazardous condition to exist.8 m) or more in depth shall be protected from falling by guardrail systems.

Walkways and bridges over excavations 6' (4' for WA) or more in depth are equipped with standard guardrails and toeboards. Inspections made after every rainstorm or other hazard increasing occurrence. adjacent areas. Employees prohibited from working on the faces of sloped or henched excavations above other employees. Project: Competent Person: Excavation Depth/Width: Protective System: General Site Conditions Description Date: Time: Soil Type: Yes No N/A Excavation. This is an initial review of required procedures. Surface wear or runoff diverted or controlled to prevent accumulation in the excavation. Structural ramps used for equipment designed by a registered professional engineer. Barriers provided at all remotely located excavations. Ladders used in excavations secured and extended 3' above the edge of the trench. Warning vests or other highly visible clothing provided and worn by all employees exposed to vehicular traffic. Yes No N/A Wet Conditions Description Precautions taken to protect employees from the accumulation of water. shafts. Surface encumbrances removed or supported. Employees are prohibited from going under suspended loads.Excavation & Trenching Checklist To be completed prior to any excavation or trenching work. Competent person has the authority to remove employees from the excavation immediately and stop work.17. supported or removed when excavation is open. and equipment set back at least 2' from the edge of the excavation. Spoils. Exact locations of utilities marked Underground installations protected. Employees protected from cave-ins when entering or exiting excavations. Ramps constructed of materials of uniform thickness. Structural ramps used by employees designed by a competent person. Yes No N/A 2. cleated together on the bottom and equipped with a no-slip surface. and protective systems inspected by a designated competent person daily prior to start of work or hazards warrant. Utilities Description Utility company contacted and/or utilities located. Employees protected from loose rock/soil that could pose a hazard by falling or rolling into the excavation. etc. materials.5 revised 3/24/10 . Employees required to stand away from vehicles/equipment being loaded or unloaded. Yes No N/A Means of Access & Egress Description Unobstructed lateral travel to means of egress no greater than 25' in excavations 4' or more in depth. Water removal equipment monitored by a competent person. wells. pits.

Damaged materials and equipment used for protective systems inspected by a registered professional engineer after repairs and beore being placed back into service. Ventilation provided to prevent employee exposure to an atmosphere containing flammable gas in excess of 10% of the lower explosive limit of the gas. Members of support system securely fastened to prevent failure. roadways. walls.6 revised 3/24/10 . Support systems provided to insure stability of adjacent structures. Removal of support systems progresses from the bottom and members are released slowly as to not and indication of possible failure. Employee trained to use PPE and rescue equipment Safety harness and lifeline used and induvidually attended when entering bell bottom or other deep confined excavations. Emergency equipment. Yes No N/A Support Systems Description Materials and/or equipment for support systmes selected based on soil analysis.17. etc. combustible. Shield system placed to prevent lateral movement. Testing conducted often to ensure that the atmosphere remains safe.Hazardous Atmospheres Description Atmosphere within the excavation tested where there is a reasonable possibility of an oxygen deficiency. Yes No N/A Comments ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 2. or other harmful contaminant posing a hazard. etc. buildings. buildings. depth. width and wxpected loads. Materials and equipment not in good condition have been tagged and removed from service.5% or more than 23. sidewalks. Adequate precautions taken to protect employees from exposure to an atmosphere containing less than 19.5% oxygen and/or other hazardous atmosphere. Protective systems provided to insure stability of adjacent structures. Backfilling progresses with removal of the support system. Excavation material to a level no greater than 2' below the bottom of the support system and only if the system is designed to support the loads caculated for the full depth. Materials and equipment used for protective systems inspected and in good condition. safety harness and lifelines and/or basket stretcher readily available where hazardous atmospheres could or do exist. walls. Employees are prohibited from remaining in shield system during vertical movement. roadways. sidewalks. such as breathing apparatus. Excavations below the level of the base or footing supported and approved by a registered professional engineer.

etc. have measures been taken to protect against exhaust fumes and are reflective vests.17.7 revised 3/24/10 . what type: ____________ ___________________ ___________________ ___________________ Surface encumbrances: Yes No Water conditions: Dry Wet Submerged Hazardous atmosphere exists: Yes Action Plan: _____________ ________________________ ________________________ ________________________ No No Yes No Action Plan: _____________________ ________________________________ ________________________________ ________________________________ Is a ladder within 25’ of all worker? Yes No Is excavated material stored 2’ or more from the edge of the excavation/trench? Yes No Are other utilities protected? Yes No Are sewer or natural gas lines exposed? Yes No Did all employees receive training in excavation & trenching? Yes No Other ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Is excavation/trenching exposed to public vehicular traffic? Yes No If yes.Daily Excavation & Trenching Log Project: Competent Person: Excavation Depth/Width: Protective System: Date: Time: Soil Type: Weather: Protective system: Trench Shield (Box) Sloping Shoring Other_______________ ___________________ ___________________ Purpose of excavation: Drainage Water Sewer Electrical Other_______________ ___________________ ___________________ Were visual soil tests made: Yes If so. in place? 2. signage. barricades.

FALLING OBLECTS. This checklist needs to be completed prior to steel erection. replacements. but are not limited to. APPROVAL TO BEGIN. either 75 percent of the intended minimum compressive design strength or sufficient strength to support the loads imposed during steel erection. SITE LAYOUT. general contractor. the controlling contractor shall ensure that the steel erector is provided with the following written notifications: o The concrete in the footings.18 STEEL ERECTION RESPONSIBILITY CHECKLIST Job Name______________________________________________ Job #__________________________________________________ Steel Erector____________________________________________ Date___________________________________________________ The following is an excerpt from Subdivision R-Steel Erection.18. construction manager or any other legal entity which has the overall responsibility for the construction of the project-its planning.759(b). AND SITE-SPECIFIC ERECTION PLAN APPROVAL TO BEGIN STEEL ERECTION • Before authorizing the commencement of steel erection. SITE LAYOUT • The controlling contractor shall ensure that the following is provided and maintained: 2. Controlling contractor’s duties/responsibilities are listed. and 1926. 1926. DEFINITIONS Controlling contractor means a prime contractor. and modifications to the anchor bolts were conducted in accordance with 1926. quality and completion. the duties specified in 926. Refer to Subdivision R (2 pages attached) for more information.760(e). and walls and the mortar in the masonry piers and walls have attained. piers. o Any repairs. on the basis of an appropriate ASTM standard test method of field cured samples.1 revised 3/24/10 . FALL PROTECTION. SUBDIVISION R-STEEL ERECTION SCOPE The duties of controlling contractors under this subpart include.752(a) and (c).755(b).2.755(b)(2). 1926.

752 and 437-003-0752.2 revised 3/24/10 . special arrangements to be made in your site specific erection plan. SITE SPECIFIC ERECTION PLAN • Steel Erection Contractor must develop and implement a written site-specific erection plan per 1926. and the material to be erected and means and methods for pedestrian and vehicular control. • Protection from falling objects other than materials being hoisted. FALL PROTECTION • Custody of fall protection: o Fall protection provided by the steel erector shall remain in the area where steel erection activity has been completed.o Adequate access roads into and through the site for the safe delivery and movement of derricks. Exception: this requirement does not apply to roads outside of the construction site. drained area. shall be secured against accidental displacement. which are not in use while aloft. trucks. only if the controlling contractor or its authorized representative: Has directed the steel erector to leave the fall protection in place. to be used by other trades. o A firm. • The controlling contractor shall bar other construction processes below steel erection unless overhead protection for the employees below is provided. readily accessible to the work with adequate space for the safe storage of materials and the safe operation of the erector’s equipment. FALLING OBJECT PROTECTION • Securing loose items aloft. • Also see attached Appendix A to Subpart R-Guidelines for Establishing the Components of a Site-Specific Erection Plan: Non-Mandatory Guidelines for Complying with 1926. Has inspected and accepted control and responsibility of the fall protection prior to authorizing persons other than steel erectors to work in the area. other necessary equipment.752. and tools. 2. All materials. properly graded. equipment.18. cranes. o At tight sites.



grease. or. cause the ladder to slip off its support.2. Type 1 Heavy Duty. Stairways having four or more risers or rising more than 30 inches (76 cm). Ladders shall be maintained free of oil. Type 1AA Special Duty. When portable ladders are used for access to an upper landing surface. In no case shall the extension be such that ladder deflection under a load would. c. by itself. or personnel hoist is provided. 2. Load capacity: 300lbs. industrial use. b. Type 1A Extra Heavy Duty.19 A. when such an extension is not possible because of the ladder's length. sloped embankment. building construction. such as a grabrail. etc. whichever is less. and no ramp. the ladder side rails shall extend at least 3 feet above the upper landing surface to which the ladder is used to gain access.19. shall be provided to assist employees in mounting and dismounting the ladder. roofing and general contracting. There are three sub-classifications to this group. and other slipping hazards. LADDER & STAIRWAY SAFETY A stairway or ladder shall be provided at all personnel points of access where there is a break in elevation of 19 inches (48 cm) or more. except as otherwise indicated: a. and a grasping device. and one stairrail system along each unprotected side or edge. The following requirements apply to the use of all ladders. Do not use a ladder that is rated less than a Type 1. There are three classifications assigned to commercially manufactured ladders and a label must be affixed on the ladder showing the classification. Ladders shall not be loaded beyond the maximum intended load for which they were built. shall be equipped with at least one handrail. utilities contractors. industrial contractors and other heavyduty applications. professional use. Potential uses: Industrial construction. Load capacity: 250lbs.1 . Potential uses: Heavy-duty industrial construction. professional use. Load capacity: 350lbs. runway. They are: • Type I: INDUSTRIAL Type I ladders are for heavy-duty use such as that which is experienced by utilities. then the ladder shall be secured at its top to a rigid support that will not deflect. nor beyond their manufacturer's rated capacity. including jobmade ladders.

maintenance work and drywalling. lashing. When used to access another level. Cross-bracing on the rear section of stepladders shall not be used for climbing unless the ladders are designed and provided with steps for climbing on both front and rear sections.2 . Type III: HOUSEHOLD DO NOT USE Type III ladders constructed for light duty or household uses. This means if you are using a 12’ ladder. They have a load limit capacity of 200 lbs. level footing. Ladders shall not be used on slippery surfaces unless secured or provided with slip-resistant feet to prevent accidental displacement. These ladders have a load capacity of 225lbs. Extension ladder A non-self-supporting portable ladder that is adjustable in length. B. 2. Common use is to access a trench or excavation. ladder must extend 3’ above level and be secured. the base should be 3’ from the structure. Do not stand on or above the top two treads on a step ladder. When using extension ladders use the 1:4 rule. or holding a ladder that is used upon slippery surfaces including. Ladders shall be used only on stable and level surfaces unless secured to prevent accidental displacement. • Ladders shall be used only for the purpose for which they were designed.• • Potential uses: General contracting.19. Type II: COMMERCIAL DO NOT USE Type II ladders are for medium duty use. Stepladders should only be used on surfaces that offer firm. Stepladder A self-supporting portable ladder. It consists of two or more sections in guides or brackets that permit length adjustment. such as activities required by painters. Length is measured along the front edge of a side rail. nonadjustable in length that has flat steps and a hinged back. d. offices or other light industrial or commercial users. Slip-resistant feet shall not be used as a substitute for care in placing. • • A. Ladder is not designed to lean against a wall. Type III ladders are not authorized for use. nonadjustable in length. but not limited to. Straight ladder A single section non-self-supporting portable ladder.

shall either be immediately marked in a manner that readily identifies them as defective. Portable ladders with structural defects. C. An employee shall not carry any object or load that could cause the employee to lose balance and fall. F.flat metal or concrete surfaces that are constructed so they cannot be prevented from becoming slippery. K. When ascending or descending a ladder. or other faulty or defective components.19. The top of a non-self-supporting ladder shall be placed with the two rails supported equally unless it is equipped with a single support attachment. cleats. and shall be withdrawn from service until repaired. such as. M. E. or driveways shall be secured to prevent accidental displacement. Ladders placed in any location where they can be displaced by workplace activities or traffic. or a barricade shall be used to keep the activities or traffic away from the ladder. the user shall face the ladder. J. or steps. L. 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. or be tagged with "Do Not Use" or similar language. you’re in an unsafe position. or extended while occupied. doorways. Ladders shall not be moved. I. Raise and lower heavy. corroded components. broken or split rails. broken or missing rungs. shifted. such as in passageways. H. Ladders shall have nonconductive side rails if they are used where the employee or the ladder could contact exposed energized electrical equipment. 2.3 . but not limited to. awkward loads with a hand line or hoist. Move the ladder or use other equipment such as scaffolding. Each employee shall use at least one hand to grasp the ladder when progressing up and/or down the ladder. D. The area around the top and bottom of ladders shall be kept clear. If your work position requires that your shoulders be outside the side rails. G.

E. placement. as necessary. as applicable: The nature of fall hazards in the work area. The proper construction. The maximum intended load-carrying capacities of ladders used. F. maintaining. The correct procedures for erecting. The employer shall provide a training program for each employee using ladders and stairways.19. and shall train each employee in the procedures to be followed to minimize these hazards. Site specific training shall be recorded and posted on Safety Bulletin board The employer shall ensure that each employee has been trained by a competent person in the following areas. D. B.TRAINING A. use. Retraining shall be provided for each employee as necessary so that the employee maintains the understanding and knowledge acquired through compliance with this section. The program shall enable each employee to recognize hazards related to ladders and stairways.4 . and care in handling of all stairways and ladders. C. G. and disassembling the fall protection systems to be used. 2.

EMPLOYEES TRAINED IN LADDER SAFETY Job Name I have been trained in the use ladders and understand the necessary safety precautions. Date Employee Name Employee Signature Trainer ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ .

subcontractors or suppliers shall use the Pence/Kelly Concrete. If a subcontractor or any of its agents. • Approved by the Vice President of Operations. its agents. LLC employee operating such equipment. LLC. All working levels must be fully planked. its own weight and at least 4 to 6 times the maximum intended load applied or transmitted to it. o Planking Only scaffold grade planking shall be used. subcontractors or suppliers shall use Pence/Kelly Concrete. employees. employees. except where such loss or damage shall be found to have been due solely to the negligence of Pence/Kelly Concrete. suppliers or lower tier subcontractors utilize any machinery. without failure. Each scaffold and scaffold component shall be capable of supporting. Construction Industry Regulations. the Subcontractor shall be liable to the Pence/Kelly Concrete. tools. Each subcontractor working on a Pence/Kelly Concrete. The specific load requirement is specified in OR-OSHA Subdivision L. LLC owned or rented scaffolding without the express written permission of the Pence/Kelly Concrete. its agents. • Provide proof of user training for every worker using the scaffolding. o Erection Scaffolds must be erected under the supervision of a competent person. or under the control of Pence/Kelly Concrete. equipment. Subdivision L – Scaffolds.20 SCAFFOLDS SCAFFOLDS AND AERIAL LIFTS No subcontractor. LLC Scaffolding equipment. No subcontractor. LLC owned or rented scaffolding without: • First reading and signing the Equipment Indemnification form. LLC project will comply with 29 CFR 1926.1 Revised 9/10/09 . leased. lifts or similar items owned. The name and qualifications of this person must be submitted to Pence/Kelly prior to the start of work. This form must be read and signed by every person using the Pence/Kelly Concrete. LLC for any loss or damage (including personal injury or death) which may arise from such use. employees.2. scaffolding. 2. LLC designated representative.20. in addition to the following: PROCEDURES • General Requirements o Capacity Scaffolds shall be designed by a qualified person and shall be constructed and loaded in accordance with that design. hoists.

water or similar material may not be used. frames and uprights must be placed on compatible wheel assemblies or steel base plates.o Supported Scaffolds Scaffold poles. proper ladders must be installed. Scaffolding inspection checklist is included at the end of this section. Counterweights must be secured to the outrigger beams by mechanical means to prevent accidental displacement. • The tiebacks must be attached to a structural member of the building. Steel plates must be secured to the mudsills. they must be restrained from tipping. legs.2 Revised 9/10/09 . posts.20. • Standpipes. or other safe means of access. o Scaffold Use A competent person must inspect each scaffold before every shift and after any occurrence that may affect its structural integrity. Cross bracing must never be used as a means of access. When free standing scaffold exceed four times their minimum base dimension vertically. • Scaffolding shall be tagged as “out of service” by a positive means. Outrigger beams that are not bolted to the structure must be secured by tiebacks. Any damaged or defective component discovered during the inspection will require: • Scaffolding immediately taken out of service until the component is repaired or replaced. gravel. o Fall Prevention A Personal Fall Arrest System (PFAS) or guardrail system must be in place on all scaffolds at 6 feet or higher. then mudsills or other adequate firm foundations. stair tower or similar. Stair rail and handrail systems must be smooth surfaced so as to prevent lacerations or puncture wounds. Sand. A competent person must evaluate and decide whether a ladder. 2. • The competent person will “tag” the scaffold “in service” or “out of service” prior to employee use. is feasible during the erection and dismantling of scaffolds. If the tag system is used the: • Tag shall be present on all scaffolding. conduit and other piping systems are not adequate structural members. o Scaffold Access When scaffold platforms are more than 2’ above or below a point of access. o Suspension Scaffolds Counterweights must be made of non-flowable material. A tagging program can be used to verify daily inspection of the scaffolding. vents.

Frame scaffolds. Caster and wheel stems must be pinned to the scaffold legs or adjustment screws. The use of fall prevention devices are required during the erection or dismantling of a scaffold. o Pump Jack Scaffolds Brackets. the competent person must demonstrate to the Pence/Kelly Superintendent that all components of the cross bracing meets the OR-OSHA Standards for use as midrail. On suspension scaffolds the personal lifelines must be independent of the scaffold support lines. Requirements for Specific Scaffold Types o Tube and Coupler Scaffolds Tube and coupler scaffolds. braces and accessories must be fabricated from metal. 2. if more then one section is used on this type of scaffold. At no time will a worker “self propel” a mobile scaffolding. o Fabricated Frame Scaffolds Frames and panels must be braced by cross. must be designed by an RPE. outriggers must be used.3 Revised 9/10/09 . o Mobile Scaffolds Mobile scaffolds must be braced by cross.20. Scaffolds that are less then 45” in width (Baker Type). horizontal or diagonal braces. a guardrail is required when working height is greater then 6 feet above the floor. Scaffold sections must be pinned to prevent displacement. All wheels must be locked when in use. Frames and panels must be joined together vertically by stacking pins or equivalent couplings. Each pump jack bracket must have two positive gripping mechanisms to prevent failure. Do not attempt to move mobile scaffolding without sufficient help to watch for obstructions on the floor and overhead. in excess of 125’. o Falling Object Protection The area below a working scaffold must be barricaded to protect employees from a falling object hazard. The height to base width ratio on a mobile scaffold cannot exceed 2:1 unless it is braced with outrigger frames. in excess of 125”. Toeboards or other means of falling object protection is required at all times.• If cross bracing is used as the midrail. If the competent person does not feel this is feasible the Pence/Kelly Safety Manager must be consulted prior to erection or dismantling. horizontal or diagonal braces based on manufacturer’s requirements to prevent racking during movement. In addition. must be designed by a registered professional engineer (RPE).

repairing. o Training for Pence/Kelly employees must be documented using the sign in sheet at the end of this section. dismantling. maximum intended load carrying capacity and intend use of the scaffold. • • • • All scissor lift and articulating boom platforms must be inspected pre-shift to assure there are no mechanical defects. disassembling. The proper use of scaffold. The correct procedures for erecting.• Scaffold Training Requirements o Each employee that works on a scaffold must be trained by a qualified person in the recognition and avoidance of hazards associated with the type of scaffold they will be required to work from. or suppliers may then place it “on rent” with the rental yard. The correct procedures for dealing with electrical hazards and for erecting. Until both actions have taken place the lift is not to be used by non-Pence Kelly Concrete. Pence/Kelly Concrete. Field modifications are not allowed on aerial lifts. subcontractors. operating. moving. Any other pertinent requirements of OSHA regulations. Daily inspections shall be documented by the subcontractors and are subject to verification by Pence/Kelly. The maximum intended load and the load carrying capacities of the scaffolds used. subcontractor. and disassembling the fall protection systems and falling object protection systems being used. o The training shall include the following topics as applicable: The nature of scaffold hazards.20. and maintaining the type of scaffold in question. employees. o Each employee involved in the erection. Subcontractor. operating. its agents. LLC. maintaining or inspecting of a scaffold must be trained by a qualified person in the recognition and avoidance of hazards associated with these operations. If it is a rented lift the superintendent may take it “off rent” with the rental yard and the inspector. or suppliers use an aerial boom lift or a scissor lift that is owned or rented by Pence/Kelly Concrete. owner’s representative. subcontractors. Pence/Kelly employees shall use the Scissor/Boom Lift Inspection checklist is included at the end of this section. owner’s representative. moving. inspecting. o The training shall include the following areas. its agents. LLC allow an inspector. employees. Only authorized and trained individuals may operate aerial lifts. LLC owned equipment shall never be used by non-contractor personnel. as applicable: The natures of any electrical hazards and falling object hazards in the work area. AERIAL LIFTS At no time shall Pence/Kelly Concrete. and the proper handling of materials on the scaffold. 2. The design criteria. repairing.4 Revised 9/10/09 . maintaining. LLC personnel.

20. provided they can safely be in stalled. When working from a scissor lift. Wheel chocks must be used before using an aerial lift on an incline. The brakes should be locked on when outriggers are used. A spotter may be needed when there is a potential for operator or pedestrian injury due to physical contact with facility systems or structures or in congested areas.5 Revised 9/10/09 . 100% fall protection is required. the use of fall prevention devices depends upon several factors. Slight movements can be made in the raised position to fine tune your placement. o Prior approval of the Pence/Kelly Safety Manager. Employees must use personal fall arrest systems (PFAS) when working from articulating boom platforms.42 of the Pence/Kelly Safety Manual. They should be positioned on pads or a solid surface. including. Aerial Lift Training Requirements o Each employee that works on an aerial lift must be trained by a qualified person in the recognition and avoidance of hazards associated with the type of aerial lift they will be required to work from.• • • • • • • • • • Boom and basket load limits specified by the manufacture should not be exceeded. An aerial lifts must be in the lowered position to travel. o Training for Pence/Kelly employees must be documented on the Equipment Trained Personnel sign in sheet located in the Forms Section 2. 2. but not limited to the following: o Client / contract requirements o Manufacturer’s recommendations o Pence/Kelly site specific requirements Anytime a worker doesn’t have at least one foot on the scissors lift deck. Man baskets such as those utilized from fork truck type vehicles are not allowed on Pence/Kelly projects unless: o The man basket was built by the manufacturer of the forklift. Spotters may also be needed when there is a potential for damage to sensitive facility systems or structures.

(list details on back) Are safety harnesses available for use when needed? Have all employees working on scaffold been informed of and trained in safe working practices while working on the scaffold? Are out riggers properly installed at 90 degree angles perpendicular to the bldg. Are Sills properly placed and adequately sized? Have screw jacks been used to level and plumb scaffold instead of unsafe objects such as concrete blocks? Are base plates and/or screw jacks in firm contact with sills and frames? Are all scaffold legs braced with braces properly attached? Is guard railing in place on all open sides and ends above the 10’ level? Have ladders been provided as a means of access to the scaffold? Have free standing towers been guyed or tied so as not to exceed the 4 to 1 base height ratio IAW Subpart “L” of the OSHA standards 29 CFR 1926. 15. 22. 16. or some other type of fall protection? Have employees been properly instructed in the safety procedures for using rolling tower. 4.20. 10. 9. 6. 5. 18. 20. 12. 8. 2.? Have scaffold components been properly inspected for damage and compatibility? Are outriggers (if required) properly installed on both sides of rolling towers? Are platforms fully planked with no gaps greater than 1 inch? Are wheel brakes operable. 7. Baker or Perry Scaffolds? Have caster or wheel stems been pinned or otherwise secured to prevent them from coming separated from the scaffold legs? Company Foreman: Time of Inspection YES NO Rolling Towers/Baker/Perry Scaffolds 2. 21. 3.45 (c) (1) (ii).Daily Scaffold Safety Checklist Project Erecting Supervisor/ Competent Person Date of Inspection Item 1. and have employees been instructed to set brakes while in use? Are safety rails installed at the 10 foot level. 14. 11. Are working level platforms fully planked between guard rails with no split planking used? Does planking have minimum 12” overlap extended beyond supports and cleated at ends? Are toe-boards installed properly? Has a tie off analysis been performed. 19. . 13. 17.

All Safety Indicator lights work. chemical lines. 17 Braking devices are operating properly. 13 Work platform & extension slides are clean. & clear of debris. etc. spring lock. Housekeeping: debris. including basket chains. adjacent structures. Hazardous Energy: Electrical power cables or panels. 12 All guardrails are sound and in place. Upper drive control interlock mechanism is functional (i. 10 Motion alarms are functional. ceiling grids. with adequate air pressure if pneumatic. 18 The manufacturer’s operations manual is stored on unit. left. uneven surfaces. etc. 4 Both upper and lower controls are adequately protected from 5 inadvertent operation. down. hydraulic leaks. drain lines. etc.) All switch & mechanical guards are in good condition and properly 7 installed. back).20. 14 Work platform extension slides in and out freely with safety locking pins in place to lock setting on models with extension platforms. sloped floors.. Y/N P/F Y/N P/F Y/N P/F Y/N P/F Y/N P/F Y/N P/F Y/N P/F Workplace Assessment Survey work area for potential hazardous operating conditions prior to use of lift. damaged control cables or wire harness. 16 Tires and wheels are in good condition. or two hand controls). etc. 3 Lower operating controls successfully over-ride the upper controls.e. 9 right. dry. construction material/ supplies. pipe racks. utilities. etc. gas lines. foot 2 pedal.EMO button or Emergency Stop Device.Scissor Lift/Boom Lift Inspection Company Name Type of Lift DATE Initials of person performing inspection Has the operator been instructed in the safe operation of this type of lift? Contact Number Model or Equip Number Inspection Item & Description Pass Fail Status Operating and emergency controls are in proper working condition 1 . fuel leaks. Emergency lowering function operates properly. 15 Inspect for defects such as cracked welds. 11 Safety decals are in place and readable. etc. forward. Overhead obstructions: tight working conditions. holes. cords. 8 Drive controls function properly & accurately labeled (up. Are Conditions Present ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο ο 2. . Ensure all the hazards identified are addressed in pre task planning with sufficient strategies to mitigate the hazards and or risks. Control panel is clean & all buttons/switches are clearly visible (no 6 fire proofing. floor obstructions. Floor conditions: Drop offs. paint over spray.

Date Employee Name Employee Signature Trainer ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ .EMPLOYEES TRAINED IN SCAFFOLDING USE Job Name I have been trained in the use of scaffold and understand the necessary safety precautions.

including cell • • • • • • • • • • • • • • 2. The annual inspection must be performed by a certified person. MATERIAL AND PERSONNEL HOISTS The intent of Crane and Rigging Safety Procedures is to insure all crane operations are performed in a safe manner. RIGGING. An anti two-block or warning device is required on all cranes except those engaged in driving piles.21 POLICY CRANES. LLC project until an annual inspection and supplemental reports are submitted to Pence/Kelly indicating that the crane or hoist meets the manufacturer’s inspection criteria. rigging and loads are not permitted within 10 feet of power lines. Use of a dedicated bellman should be considered. Construction Industry Regulations. Inspection logs for daily/weekly/monthly inspections and the crane’s operator manual including the load chart must be in the cab of the crane. and shall comply with the American Society of Mechanical Engineers B30. The swing radius of cranes must be properly barricaded at all times while working on site. Subdivision N – Cranes. All outriggers are to be fully extended and on stable ground. Each contractor working on a Pence/Kelly Concrete.21. No computer systems or limit switches are to be in a non-functioning or override position. Elevators and Conveyors. LLC project will comply with 29 CFR 1926. Mobile crane movement on site must be in accordance with manufacturer’s recommendations. Hoists. Crane operator must complete a daily inspection of the crane and must give a copy of the daily inspections to the Pence/Kelly Superintendent weekly. The crane operator must have a current crane operator’s certification for the size of crane he/she is operating.2. Crane Operators are not allowed to use Handheld Electronic Devices of any type while they are in the operating position of the crane unless they are being used as part of the lift. Handheld Electronic Devices are handheld devices. Cranes. All rigging gear must be rated for safe capacity and inspected for defects by a qualified rigger prior to each shift. The weight of the load and distance from center pin must be known. Derricks.1 revised 10/26/2009 .5-2007 Safety Codes for Mobile and Locomotive Cranes in addition to the following: GENERAL REQUIREMENTS • No crane or hoist shall be placed in service on a Pence/Kelly Concrete.

Hand signals to crane operators shall be those prescribed by the applicable ANSI Standard for the type of crane in use. The use of a crane to hoist employees in a personnel platform is prohibited except as allowed in section 2. o Direct the load so that it minimizes passing over anyone. MP3 players (or equivalent).21. PDA’s. If the lift is to be conducted over several days (example steel erection) then only one lift plan needs to be submitted.22 of the Pence/Kelly Concrete. An illustration of the signals shall be posted at the jobsite. Palm Pilots. o Use hand signals only when conditions are such that his signals are clearly visible to the operator.• • • phones. (See sample at the end of this section) Written Lift Plans must be submitted to Pence/Kelly five (5) days prior to the lift. o Contractor responsible for the lift o Company supplying the crane o Crane information including weight capacity and boom length o Information of the load(s) specifically the weight o Angle of the boom at furthest point o Company responsible for rigging o Competent person performing the inspection of the rigging o Any overhead or underground hazards o Weather conditions at the time of the lift o Diagram of the lift area including buildings. obstructions and crane location A written steel erection plan that covers all the above will be considered a lift plan. Pre-Planning must be documented in the form of a written Lift Plan. date.2 revised 10/26/2009 . Lift Plans must contain at a minimum but not limited to: o Lift information including location. faxes and other communication devices. The signalman/bellman must: o Be fully qualified by experience with the operation. LIFT PLANS • • • • • ALL lifts must be preplanned. • 2. o Inspect the load to see that it is rigged safely. Blackberries. LLC Safety Manual. o Be responsible for keeping the public and all unauthorized personnel outside of the crane’s operating radius. pagers. etc.

21. location.CRITICAL LIFT PLANS • • • • A Critical Lift Plan must be developed for any lift that exceeds 75% rated capacity. Critical Lift Plans must contain at a minimum but not limited to: o Lift information including project. If the Critical Lift will be conducted over several days then only one Pre-Planning Meeting is required unless conditions change that would warrant an addition meeting.3 revised 10/26/2009 . o Contractor responsible for the lift o Company supplying the crane o Why the lift is considered critical o Crane information including weight capacity and boom length o Information of the load(s) specifically the weight (Verified) o Angle of the boom(s) at the furthest point o Radius of the boom(s) at the furthest point o Company responsible for rigging o Competent person performing the inspection of the rigging o Description of the rigging including the weight o Any overhead or underground hazards o Weather conditions at the time of the lift o Diagram of the lift area including buildings. A Critical Lift Plans must be submitted to Pence/Kelly five (5) days prior to the lift. is specified by the project team as a Critical Lift or requires two cranes to pick one piece of equipment or material. (See sample at the end of this section) The Pence/Kelly Safety Manager must be involved with any Critical Lift. date. Pre-Planning Meeting must discuss at a minimum but not limited to: o Review of the Critical Lift Plan draft (Critical Lift Plan can not be finalized until Pre-Planning Meeting has been conducted) o Calculation of gross weight of the load and all rigging components o Load chart calculations o Angle of boom anticipated during the lift o Distance of the landing area from the center of the crane o Radius measurements anticipated during the lift o Weather and soil conditions o Overhead high voltage power line clearances 2. etc. obstructions and crane location o Means of communication between the signalman/bellman and the operator(s) o Time and date specified for the Pre-Lift Meeting PRE-PLANNING MEETING • • • A Pre-Planning Meeting to discuss the Critical Lift will be held at the jobsite with all parties involved in the lift prior to the day of the lift.

o The meeting will be conducted by the Pence/Kelly Superintendent with all members of the crew involved with the Critical Lift. If the lift is to be conducted over several days (example steel erection) then only one Pre-Lift Meeting need be conducted.4 revised 10/26/2009 . Etc. (Superintendent. Bellman.• o Rigging responsibilities o Define who is the lift supervisor o Define who can shut the lift down. (Except for Critical Lifts) Items to be discussed or accomplished at the Pre-Lift Meeting are at a minimum but not limited to: o Review Lift Plan or Critical Lift plan. The meeting will be conducted by the Pence/Kelly Superintendent with all members of the crew involved with the lift. Safety Manager. Lift Supervisor.21. Crane Operator. Verify crane is the one specified in the plan Verify annual inspection of the crane Verify operators certification for the crane used Verify overhead and underground hazards o Review responsibilities of all parties involved in the lift o Discuss weather conditions at the time of the lift o Rigging inspection of all components o Determine who has the authority to call off the lift DOCUMENTATION The following documentation should be in the superintendent’s possession prior to the lift. • Written Lift Plan • Annual Inspection of the Crane • Operators Certification • Verification of rigging competent person • Documentation of rigging inspection (at pre-lift meeting) • Documentation of daily inspections (to be submitted weekly) • Documentation of Pre-Planning Meeting (Critical Lift Only) • Documentation of Pre-Lift Meeting MATERIAL AND PERSONNEL HOISTS • Material Hoists 2.) A Pre-Lift meeting. PRE-LIFT MEETINGS • • • • A Pre-Lift meeting will be required for All lifts. o If the Critical Lift is to be conducted over more than one day then a PreLift meeting must be conducted daily.

pear-shaped links.5 revised 10/26/2009 . o All hoists shall have a “No Smoking” sign posted in the car and a fully charged fire extinguisher available for use. o All entrances to hoists must be protected by substantial gates or bars. when not in use. Special custom design grabs. RIGGING Knowledge of the equipment and materials with which we work is one of the most important factors in accident prevention. supervisors.• o Operating rules must be posted at the operator’s station along with the notice “No Riders Allowed”. rings. • 2. Each piece of equipment and material has been designed and developed to serve a specific purpose. Recognizing its capabilities and limitations not only improves efficiency but also eliminates hazards. Personnel Hoists o Hoistway doors or gates shall be at least 6’6” high and shall have a mechanical lock. grade. Defective rigging equipment shall be removed from service. o All hoists shall be inspected and tested at not more than three-month intervals. shall be marked to indicate the safe working loads and shall be proof-tested prior to use to 125 percent of their rated load. Hoists shall also be inspected after exposure to winds exceeding 35 mph. prefabricated structures and similar materials. operators. rated capacity. Alloy Steel Chains o Welded alloy steel chain slings shall have permanently affixed durable identification stating size. oblong links. shall have a rated capacity at least equal to that of the chain. Rigging equipment shall not be loaded in excess of its recommended safe working load. or other attachments. which guard the full width of the landing entrance. riggers and employees who are concerned with or responsible for safety in construction. It should be used as a guide in conjunction with the applicable safety regulations by contractors. welded or mechanical coupling links. and sling manufacturer. shall be removed from the immediate work area so as not to present a hazard to employees. for such units as modular panels.21. o Hoists shall be inspected on a weekly basis. Rigging equipment. o Hooks. hooks. when used with alloy steel chains. clamps. GENERAL REQUIREMENTS • • • • • Rigging and all rigging equipment shall be inspected prior to use on each shift and as necessary during its use to ensure that it is safe. or other lifting accessories. which cannot be operated from the landing side.

The weight of the load shall be within the rated capacity of the sling. sharp edges. or makeshift fasteners. (see load chart) Slings with fittings which are used as a choker hitch shall be of sufficient length to assure that the choking action is on the webbing and never on a fitting. Slings shall always be protected from being cut by sharp corners. o Use spreader bars when needed. Use the correct type for your job. or cracked. o Check load rating stamped on each choker to determine its correct capacity. formed from bolts. etc.. distorted fitting or any distortion of the sling If you see our Red Core warning yarns. Select sling having suitable characteristics for the type of load. o Rated capacity (working load limit) for alloy steel chain slings shall conform to the values shown in OR-OSHA 1926. cuts or snags or embedded particles Broken or worn stitching in load bearing splices Excessive abrasive wear Knots in any part of the sling Excessive pitting or corrosion. 2. Anytime a sling is loaded beyond its rated capacity or reason o Operating Practices Determine weight of the load. o When increasing the spread or angle of chokers you decrease the capacity. protrusions or abrasive surfaces. Slings used in a basket hitch shall have the load balanced to prevent slippage.6 revised 10/26/2009 . Holes. Slings shall not be dragged on the floor or over an abrasive surface. Synthetic Web and Round Slings o Removal From Service The sling has an identification tag is missing or in any way unreadable Acid or caustic burns Melting or charring of any part of the sling.• • o Job or shop hooks and links. shall not be used. or other such attachments. The opening in fittings shall be the proper shape and size to insure that the fitting will seat properly in the hook or other attachments.251 Rigging Equipment for Material Handling Table H-1 Wire Rope Chokers o There are several different types of wire rope chokers. rods. hitch and environment. Consideration shall be given to the sling to load angle which affects rated capacity. Slings shall not be loaded in excess of the rated capacity.21. tears.

21. or joined by knotting. Twisting and kinking the legs (branches) shall be avoided. Slings that appear to be damaged shall not be used unless inspected and accepted. shall be kept from between the sling and the load. Periodic Inspection • This inspection shall be conducted by designated personnel. Load applied to the hook shall be centered in the base (bowl) of hook to prevent point loading on the hook. (see load chart) Place blocks under load prior to setting down the load.7 revised 10/26/2009 . as well as to determine that the sling meets the requirements of this specification and has not been damaged in shipment. Personnel shall not ride the sling. Frequency of inspection should be based on: o Frequency of sling use 2. Store slings in a cool. Frequent Inspection • This inspection shall be made by a qualified person handling the sling each time the sling is used. Do not drop slings equipped with metal fittings. it shall be inspected by a designated person to ensure that the correct sling is being used. During lifting. with or without the load. Exposure to sunlight or ultra-violet light degrades the strength of slings. personnel shall be alert for possible snagging. Personnel. The sling shall be hitched in a manner providing control of the load. Nylon and Polyester slings shall not be used at temperatures above of 194 degrees F (90 degrees C). to allow removal of the web sling. o Inspections Initial Inspection • Before any new or repaired sling is placed in service. Personnel shall stand clear of the suspended load. The web slings' legs (branches)shall contain or support the load from the sides above the center of gravity when using a basket hitch. Shock loading shall be avoided. Slings shall not be pulled from under loads if the load is resting on the sling.Slings shall not be twisted or tied into knots. Slings shall be long enough so that the rated capacity of the sling is adequate when the angle of the legs (branches) is taken into consideration. if applicable. including portions of the human body. and from between the sling and the crane hook or hoist hook. dry and dark place when not in use.

As illustrated. the load on each leg increases. o Hooks All hooks must have a safety latch. when this angle decreases. pelican hooks) are to be used. This data is only for equally loaded sling legs. When doing cycle work (concrete work and spreaders) check the pins frequently or use anchor shackles.L. in a basket hitch or for multi-legged bridle slings. 2.21. No open throat hooks (sorting hooks. Choker must never rest on the pin. turn shackles upright. This principle applies whether one sling is used to pull at an angle. • Shackles – Hooks o Shackles All shackles should have a U. then back it off ¼ turn. This angle is very important and can have a dramatic effect on the rated capacity of the sling. Screw shackle have a pin which must be in all the way. load rating stamped on the side to indicate its capacity. Anchor shackles have a bolt with nut a cotter pin. hooks must have a latch.o Severity of service conditions o Experience gained on the service life of slings used in similar applications o Periodic inspections should be conducted at least monthly o Sling Angle and Sling Load Chart SLING ANGLE is the angle measured between a horizontal line and the sling leg or body. Never pull at an angle. Sling angles of less than 30 degrees are not recommended.8 revised 10/26/2009 .

• Tag . certified by the manufacturer or a qualified rigger. Overhead Loads • 2. instead let the operator set the load on the ground to stop the spin. o Pick heavy pallets by the strong side. o Controlled load lowering shall be used whenever the load is over the workers setting the components • LOADS • Flying Loads o Choke all possible loads. wear. Multiple Lift Procedures (Non Steel Erection) o A multiple lift shall only be performed if the following criteria are met: A multiple lift rigging assembly is used A maximum of five members are hoisted per lift All employees engaged in the multiple lift have been trained in these procedures No crane is permitted to be used for a multiple lift where such use is contrary to the manufacturer’s specifications and limitations.Lines o All loads must have at least one tag line. o Do not fly barrels by holes cut in the top. shall be based on the manufacturer’s specifications with a 5 to 1 safety factor for all components. o Never attempt to stop a load that is spinning uncontrollable. o Never wrap tag line around wrist or waist. deformation. o The multiple lift rigging assembly shall be rigged with members: Attached at their center of gravity and maintained reasonably level Rigged from top down o The members on the multiple lift rigging assembly shall be set from the bottom up. o Long loads should have an appropriate length tag line for greater control. o Do not fly rebar by the bundle wire. o Components of the multiple lift rigging assembly shall be specifically designed and assembled with a maximum capacity for total assembly and for each individual attachment point. o No knots or eyes on end of line.21. if there is more than 10% wear in the crown or pin hook or shackle must be thrown away. o This capacity.9 revised 10/26/2009 .Check for cracks. o Each leg of the assembly must be independently supported so that if one leg fails no other load will fall o The total load shall not exceed: The rated capacity of the hoisting equipment specified in the hoisting equipment load charts The rigging capacity specified in the rigging rating chart.

21. • IN CONCLUSION: .TAKE YOUR TIME – DO IT RIGHT THE FIRST TIME! . and state the command without the adverb. state clearly the command example “load up” will begin the load moving upward. o Do not push or pull the load when it is in the air.NEVER SACRIFICE SAFETY FOR PRODUCTIVITY! . swing right. o When changing channels make sure the channel is clear before breaking in. if you are unsure. Let the machine do the work. indicate where the load is to go in advance so the operator can get the load to its destination quickly. o The operator may sound his horn when load is coming overhead stay alert to this sound. ask. o Warn other personnel if a load is coming overhead so they have time to prepare. Signaling – Using Hand o Make sure the operator can see you clearly. 2. swing left. trolley in. load down. Example: “load” o Keep the mike keyed in when signaling in the blind (when the operator can not see you and you can not see the operator) This will ensure that the operator will hear ever command. SIGNALING • Signaling – Using the Radio o Use standard crane and derrick signals (find attached) o Use one word commands whenever possible. o To stop the movement. trolley out. when load is near its destination you can fine tune location for placement. o Never stack anything higher than it is wide.IF ANYONE HAS A SUGGESTION ON A BETTER WAY TO DO SOMETHING LET YOUR SUPERVISOR KNOW.10 revised 10/26/2009 . o Use proper signals. o To begin the movement key in the mike. o When signaling the crane.OUR GOAL IS TO HAVE EVERYONE FEEL SAFE 100% OF THE TIME! . key in the mike. let the operator move the load that is what he or she is there for. load up.• o Stay out from under overhead loads at all times. Landing Loads o Avoid pinch points (stay out of the bite) o Keep fingers and toes out from under the load o Use proper dunnage (cribbing) Do not use 2x4’s on edge always lay them flat.

2.11 revised 10/26/2009 .21.

21.12 revised 10/26/2009 .2.

13 revised 10/26/2009 .2.21.

2.14 revised 10/26/2009 .21.

15 revised 10/26/2009 .2.21.

21.2.16 revised 10/26/2009 .

2.17 revised 10/26/2009 .21.

18 revised 10/26/2009 .21.2.

21.2.19 revised 10/26/2009 .

EMPLOYEES TRAINED IN RIGGING AND SIGNALING Job Name I have been trained in the rigging and signaling and understand the necessary safety precautions. Date Employee Name Employee Signature Trainer ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ .

LLC Lift Information: Project Name: Project Address: Superintendent: Project Number: Contractor in charge of the lift: Company supplying the cranes: Company supplying rigging: CRITICAL LIFT PLAN Date: This plan is to be followed if any of the following apply (check where applicable): Load capacity is equal to.21B.PENCE/KELLY CONCRETE. Length of Boom) Load Description: Load Weight: Specify how the weight was determined and by whom: Description and Weight of Rigging and Attachments: Weight: Description: Weight determined by whom and how: 2. Model. or exceeds 75% of load chart rating Load of any capacity that could endanger existing facilities 2 or more cranes will be used during lift Any unusual circumstances Specify: Description of the Cranes: (Make.1 Revised 10/23/2009 .

21B.Total Weight of Load/Rigging/Attachments/Load Chart Deductions: Equipment: Maximum operating radius: Planned operating radius: Allowable load from crane load chart: Ratio of lift to allowable load (actual total load including rigging and attachments divided by allowable load from chart: Clearance: Clearance between boom and lift: Clearance to surrounding objects: Clearance for load movement sufficient: Stability of Ground: Is the ground compact & stable: Are steel mats required: Outriggers in place and blocking used: Lift Drawing: Is required for this lift.2 Revised 10/23/2009 . Is it attached? Communication: What type of communication will be used between the operators and the bellman? Weather: What are the weather conditions? What is the maximum wind speed for this lift? Who determined the maximum wind speed? Other Considerations: Are there other trades in the area? Is the general public in the area? Are other considerations not mentioned? 2.

21B.Comments: Lift Approval: Signatures: Crane Operator #1: Crane Operator #2: Rigging Supervisor: Lift Supervisor: Bellman: Project Superintendent: Safety Manager: Other (Specify) Date: 2.3 Revised 10/23/2009 .

LLC 1 2 3 4 5 6 7 8 9 Pre-Lift Information Contractor controlling the lift Contact Name Crane Company Operator Name Date of lift Location of lift Type of lift Annual Crane Certification Load Cut sheet Yes / No Yes / No Yes / No Yes / No Normal Yes / No Yes / No Critical Sticker on crane See attached Phone# Cell: Phone# Lic# Time CRANE LIFT PLAN Yes / No Yes / No Yes / No 10 Weight verified 11 Description 12 Engineered pick points 13 Approved pick points Lift Information 14 Load weight [lb] 15 Rigging weight [lb] 16 Block [lb] 17 Total [lb] 18 Total weight [lb] 19 Radius [ft] 20 Boom Angle [degree] Operator Verification: 21 Within 75% of chart Rigging 22 Inspected each part Part -1 .1 revised 10/23/2009 .21C.4 .PENCE/KELLY CONCRETE.2 .6 Chart= Total Weight Radius Boom Angle Signature: Yes / No Yes / No Signature: Nylon Sling Yes / No Yes / No Yes / No No knots Long enough Yes / No Yes / No Over 3/8 in diameter Yes / No Length needed Yes / No Basket Load rating Load rating Other: Wire rope Straight Crane chart indicates % Rigging Competent Person Verification 23 Rigging Type 24 Rigging configuration 25 Rigging load rating 26 Shackle 27 Spreader bar 28 Tag line all loads over head 29 Proper tag line 30 Are two tag lines needed 2.

Roads See Attached Yes / No 2. Spotters.Crane Set Up 31 Over head obstructions If yes describe 32 Power lines If yes describe clearances 33 Underground utilities If yes describe clearances 34 Ground conditions Yes / No Yes / No Yes / No Soft Sloped Yes / No Overcast 6-10 mph Locate: Wet Concrete Yes / No Loose Level Hard Paved 35 Trench or slope within 10ft of a outrigger 36 Weather conditions Wind 37 Outriggers fully extended 38 Crane level 39 Two block used/tested 40 Swing Zone protected 41 Fire Extinguisher in crane 42 Daily inspection of crane 43 Verify radius from crane to load 44 Verify radius from crane to set 45 Dedicated signalman/bellman 46 Communication Clear 0 .2 revised 10/23/2009 . Swing Zone. Load. Buildings Underground. Barricading. Delivery Truck.5mph Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Radio Drizzle Rain 11-15mph Over 15 Outrigger pads Fog Yes / No Sun Barricade Yes / No Spotters Yes / No Yes / No Corrections needed Hand Phone In the blind Diagram of Lift 47 Draw a diagram of the lift area to include but not limited to.21C. Overhead. Location. Trees. Radius.

Pre Lift Safety Meeting 48 Pre-Task Plan completed See Attached 49 Reviewed by PK prior to lift Yes / No Yes / No Yes / No If NO Stop and Complete before pick Name [print]: Signature: Date: 50 Pre pick Safety Meeting Attendees: Name: Date: Company: Time: PK 51 Superintendent: Date: 2.21C.3 revised 10/23/2009 .

would be more hazardous. This is to insure that the headache ball is not run up tight to the boom or jib. Must have load lines capable of lifting seven times the maximum intended load. or is not possible because of structural design or worksite conditions. except when the erection. Be within one percent of level and on firm footing. elevating work. Below is a brief on the key points of this new ruling. ladder. but is not limited to.22. the following: • Crane configuration requirements • Additional crane instrumentation and/or components • Specific platform design.1 revised 10/26/2009 .550(g) (4). must be followed if it is determined that a suspended personnel platform will be used.2. listed in 29 CFR 1926. The use of a crane or derrick to hoist employees on a personnel platform is prohibited. Must be capable of supporting its’ own weight plus 5 times its’ maximum intended lifting capability.22 POLICY HOISTING OF PERSONNEL IN BASKETS The use of a crane suspended personnel platform is prohibited on Pence/Kelly Concrete. and dismantling of conventional means of reaching the worksite. Criteria includes. aerial lift. The Pence/Kelly Safety Manager shall be notified of each request. LLC projects unless the employer can demonstrate that conventional methods to do the work are more hazardous. such as a personnel hoist. PERSONNEL PLATFORMS • • • Shall be designed by a qualified engineer or a qualified person competent in structural design. use. platform or scaffold. CRANES & BOOM TRUCKS • • • • • Must be equipped with anti-two blocking device. 2. Specific crane operational criteria. Subpart N. Must have (controlled load lowering) – no down free fall capabilities. This does not apply to steel erection RE: Division 1926. Telescoping boom rigs must have a device that indicates to the operator the extended length of boom. stairway. construction and loading requirements • Specific rigging and trial lift guidelines Oregon has adopted OSHA’s new ruling on hoisting employees in baskets of any type. Must be enclosed at least from the toe board to mid rail with solid material or expanded metal with maximum ½ inch opening.

After the trial lift and before lifting personnel. Top rail does not qualify as a grab rail. This meeting and all tests shall be documented per attached log and left with the crane operator.2 revised 10/26/2009 . Shall be attached to hook via a four way bridal of equal length legs and attached to the platform via shackles rated equal to 5 times the intended load of the platform. A safety wire rope choker minimum of 5/8 inch. the basket must be lifted a few inches and inspected for defect/damage. A trial lift (unoccupied) shall be made with the crane/boom truck with the anticipated live weight at any time the crane or boom truck is set up. • • 2. Access gates shall not swing outward during hoisting and shall have a restraining device to prevent accidental opening. Employees occupying the personnel platform are to use a full body harness/lanyard system with the lanyard firmly attached to the lower load block or overhaul ball or to a structural member of the platform capable of withstanding fall impact.• • • • Must be equipped with a grab rail inside the entire perimeter. This meeting shall also be held at any time different employees are assigned to operation. moved. grab rail.22. or maximum load is increased.e. i. connecting the bridle O ring to a shackle on the load line above the overhaul “headache” ball. their tools and sufficient material to do the job. They are not to be used to transport bulk materials. shall be installed. HOISTING PROCEDURES • • • • Hoisting of personnel in a basket is to be done ONLY if there is no other safe access available. Suspended personnel platforms shall only be used for personnel. A pre-lift meeting will be held prior to the trial lift at each new work location. Must be permanently posted with weight of platform rated load capacity and/or maximum intended load.

grab rail. 6. 2. Other safe access to hoist area Written fall protection work plan review Personal Protective Equipment: Overhead protection Tools and equipment needed 4. 5. safety choker Results of equipment inspection and weight test Specific job hazard(s) _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ YES YES NO NO YES YES NO NO TIME: WORKERS PRESENT SIGNATURE PRINT 2.3 . 3.Man Lift Basket Pre-Lift Meeting Log DATE: Specific lift location: Supervisor/Lift Coordinator (PRINT) (SIGNATURE) TOPIC DISCUSSED 1.22. Man basket safety features.

etc.( ) p. ( ) EQUIPMENT INSPECTION 1 2 3 4 5 1 2 3 4 Qualified/Certified Crane/Boom Truck Operator Crane/Boom Truck current certification Anti two blocking device equipped and checked Free fall function locked out Set up properly--out riggers.m.MANLIFT INSPECTION & WEIGHT TEST DATE: Specific lift location: any other SAFE access available: Operator performing lift test: Supervisor or lift operations: TIME: a.physical inspection of: Basket Bridle Hook and Headache Safety Choker 4 Test weight removed _____ _____ _____ _____ _____ _____ _____ _____ YES NO YES YES NO NO 2.22.4 . out level.m. YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO BASKET INSPECTION Designed by qualified engineer Posted with basket weight and load capacity Four (4) way bridle attached all four (4) corners via shackles Minimum of 5/8 safety choker attached to bridle top ring to above headache (overhead) ball PRE-LIFT TEST 1 2 3 Test weight attached equal to maximum intended load Basket and test weight hoisted to all locations personnel are expected or anticipated to be hoisted to Hoisted and suspended 4 to 12 inches -.

TRAINING PROGRAM IMPLIMANTATION A. Steering and maneuvering. Upon completion of the training program the operator must be evaluated by the trainer before being allowed to operate a forklift on an actual jobsite. and how they work. what they do. Vehicle capacity and how to use the load chart. Forklift Topics a.1 b. f. warnings. a. . and precautions for the types of forklift the operator will be authorized to operate. d. Operating instructions. c. Operator training and evaluations must be conducted by persons who possess the knowledge. e. 2. training. and experience to train forklift operators and evaluate their competence. g. where they are located. c. Differences between the forklift and the automobile.23 FORKLIFT PROGRAM Per OR OSHA regulation Division 2 1910. training and experience to train operators and evaluate their competence and Where such operation does not endanger the trainee or other employees. b.23. and use limitations. Pence /Kelly Concrete. Fork and attachment adaptation. Under the direct supervision of persons who have the knowledge. TRAINING PROGRAM CONTENT – FORKLIFT OPERATORS SHALL RECEIVE INITIAL TRAINING ON THE FOLLOWING TOPICS: A. Engine or motor operation. Trainees may operate a forklift only. Visibility (including restrictions due to loading). h. LLC requires that any employee that operates a powered industrial truck (forklift) of any size must first complete a training program.178(1)(1)(i). operation. Forklift controls and instrumentation.2.

and experience to evaluate operators in their competence. Workplace Topics – Site Specific a. Changing surface conditions where the vehicle will be operated. Ramps and sloped surfaces that could affect the vehicles stability. j. e. m. c. l. Load manipulation. Operator evaluations shall be conducted at least every three years by persons who possess the knowledge. Any vehicle inspection and maintenance the operator will be required to perform. Hazardous locations where the vehicle will be operated. Pedestrian traffic. warnings. d. Composition of loads to be carried and load stability. Closed environments and other areas where insufficient ventilations could cause the build up of carbon monoxide or diesel exhaust.i.2 . Vehicle stability. b. Any other operating instruction. training. B.23. and un-stacking. stacking. Other unique or potentially hazardous environmental conditions in the workplace that could affect safe operation. Narrow and restricted areas where the forklift will be operated. or precautions listed in the operator’s manual for the type of vehicle the operator is being trained to operate. Refresher training may be required if: 2. Refresher Training a. g. Operating limitations. i. f. C. Refueling and/or charging of batteries. k. h.

and They first sign a release of indemnification form and. An operator is assigned to operate a different type or size of forklift or A condition in the workplace changes which could affect the safe operation of the forklift.• • • • An operator has been observed operating a forklift in an unsafe manner. • • • • The name of the operator being trained. D. • • • Approved by Vice President of Operations. Operation of forklifts by others than those employed by Pence/Kelly Concrete. The name and signature of the trainer. LLC are not allowed to operate Pence/Kelly equipment or equipment rented by Pence/Kelly unless. Persons other than those employed by Pence/Kelly Concrete.23. a. Provide proof of training for the size and type of forklift they are requesting to operate. 2.3 . The date the training was conducted. LLC. An operator is involved in an accident or near miss incident. E. The date the operator was evaluated. Pence/Kelly will issue trained operators a forklift license which includes the following. Documentation a. It is required by OR OSHA that any operator that is trained and or evaluated in forklift operation be “certified” by documentation of such.

Leaks. etc.PENCE/KELLY CONCRETE FORKLIFT OPERATOR’S DAILY CHECKLIST Before Starting Engine Check the Following Walk Around Items (Visual) Decals. Forks. Boom Wheels. Lug Nuts.) Status OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK Comments NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO ADD ADD ADD ADD ADD ADD After Starting Engine Check the Following Start-Up Items Engine (Does it sound normal) Instruments (Check for normal readings) Exhaust Sys (Check leaks and smoke) Lights (All Lights) Horn and Backup Alarms (Working) All Controls (Working normal) Transmission (Working normal) Brakes (Both parking and service) Steering (Working normal) Status OK NO OK NO OK NO OK NO OK NO OK NO OK NO OK NO OK NO OK NO NOTE ANYTHING ABNORMAL OR IN NEED OF REPAIR Comments Operator: Vehicle: Superintendent: Date: . Tires. Mast. Air Pressure Engine (Check oil level and leaks) Transmission (Check oil level and leaks) Engine Belts (Adjustment and wear) Air Cleaner Fuel Filter Radiator (Check level and leaks) Hydraulic Tank (Check level and leaks) Fuel Tank (Check level and leaks) Lubricate Chassis (As required) ROPS (Check for damage and steps etc. Carriage. Front End. Signs.

Site management shall see that lunch trailers and office trailers are routinely cleaned and disinfected if appropriate. shall be kept cleared from work areas. or hazardous wastes. debris. etc.24. It is the position of the company that every worker strives to provide a work environment free of unnecessary clutter. . c. b. and refuse of any kind. and other refuse. trailers etc. rags. Clean up of the work area shall be ongoing. alteration. form and scrap lumber with protruding nails. as possible and accessible to the site workers. An ample supply of refuse containers shall be located to facilitate refuse removal. Store only that material that will be utilized in the near future whenever possible. or repairs. and stairs. Welding rod ends. such as caustics.1 B. flammable. paper. and all other debris. Containers shall be provided for the collection and separation of waste. passageways. Combustible scrap and debris shall be removed at regular intervals during the course of construction. scrap materials. acids. During the course of construction. An appropriate number of refuse containers shall be located as near the work stations. in and around buildings or other structures. It is the policy of the company that all direct hire. and weekly composite etc. Safe means shall be provided to facilitate such removal. sub-contractor and sub tiered contractor work areas. shall not be allowed to accumulate. d. Work areas shall not be overly stocked with materials as to create/cause undue congestion. Each employee is responsible for keeping his/her immediate work area clean.2. a. Also ensure that appropriate containers are available and labeled for hazardous waste items. Ensure containers are dumped as needed. Garbage and other waste shall be disposed of at frequent and regular intervals. trash. 2. or cramped conditions. shall be equipped with covers. oily and used rags. harmful dusts.24 POLICY STATEMENT HOUSEKEEPING POLICY A. material storage areas and parking areas will be kept in a clean and orderly manner at all times. lunch & office trailers. Containers used for garbage and other oily. lay down areas.

24.000. g. Periodic audits of these facilities shall be performed to verify that the cleaning schedule is adequate. Materials and supplies that are not compatible shall be stored separate form one another.00 or more. Tool rooms/trailers are to be maintained in a neat and orderly fashion at all times.000. Adjust schedule as needed. f. 2.2 . Consult the Material Safety Data Sheet for compatibility information. materials and supplies in tool rooms/trailers. A routine cleaning schedule shall be developed to ensure continued sanitary conditions. Special attention shall be given to the storage of tools. Toilet facilities/water closets shall be available on site in adequate numbers. Clean hands unit shall be provided on projects in Oregon with an estimated cost of $1.e.

E. 15-20 and 30. that are for temporary power and are available for use by employees. and June)………………… Quarter 3 (July. Quarter 2 (April. On or before October 1. and March)………. 2. and September)……….Ampere receptacles on construction sites. In addition each jobsite will test continuity of power cords quarterly and mark female cord end with the appropriate colored tape which are as follows: Quarter 1 (January. November. Once repairs are made to any tool or power cord it will be tested and marked with the appropriate colored tape before being placed back in service.25 GFCI TEMPORARY POWER The project superintendent is responsible for ensuring this program is properly implemented.25. May. Quarter 4 (October. C. At least quarterly all GFCI receptacles will be tested to ensure proper functioning... 2003 all 125 volt. A. must have approved ground fault circuit interrupters. February.. All electrical power equipment in field and shop operations will be inspected before each shifts use. single phase. GFI protection must be at the outlet end of the circuit. If any power cord. end. In accordance with OAR 437-003-0404 as of October 1. Defective………………………………………… D. December)……..2. or receptacle is found to be defective or in need of any repair it will be marked with BROWN tape and taken out of service for repairs. 110 volt extension cords will also be inspected immediately if subjected to possible damage by vehicle or equipment traffic. 2003 all company branch circuits will use GFCI (ground fault circuit interrupters).1 . Extension cords or other devices with listed ground-fault circuit interrupter protection for personnel identified for portable are acceptable. WHITE GREEN RED ORANGE BROWN B. August.

tool body and guards. for external defects. D. If tool. E. Competent person designated to implement this program are superintendents. Before each shifts use. Extension cords. A. Test all equipment grounding conductors for continuity. Any damaged or defective cord device or tool will be taken out of service tagged and sent to shop for repairs. 30-ampere will be subject to the assured equipment grounding program as follows. visually inspect each extension cord. and tools more than 125 volt. cords. and for signs of possible internal damage.2 . 2. C. Should a visual inspection indicate a need for repairs. B. the tool shall be tagged "out of service" and sent to the shop for repairs. Please indicate on the tag what is wrong with the tool. • Before first use after repair.All power tools will be inspected before each shifts use. cord. and plug are defect-free the appropriate colored tape must be in place before the tool is used. All 220 volt temporary power cords will be protected from damage by vehicle and equipment traffic. including power cord. F. • Before use after any incident that reasonably could cause damage. devices and receptacles not exposed to damage are exempt from this inspection. B. The employer must designate one or more competent person to implement this program. • At least every 3 months. plug.25. single phase. Test each receptacle or plug to assure the equipment grounding conductor is connected to its proper terminal. Receptacles. G. and any equipment connected by cord and plug. A. such as deformed or missing pins or insulation damage. Do all required tests: • Before first use. or other device. Record all tests required in this paragraph by means of colored cord tape as described above.

Employees participating in the respiratory protection program do so at no cost to them. and/or the presence of wood dust. This program applies to all employees who may come into contact with the hazards.26. the necessity and procedures for protecting themselves from such hazards.2. and maintenance provisions of this program. Any employees required to wear respirators must be enrolled in the company’s respiratory protection program. and training in different types of respirators. C. Program Administrator: Duties of the program administrator include: a. maintenance. and storage of respirators. and other particulates and vapors (the hazards). or tasks that require workers to wear respirators. To be enrolled requires a medical evaluation. Employees who voluntarily wear filtering face pieces (dust masks) are not subject to the medical evaluation. b. training in cleaning. our employees may at times be exposed to respiratory hazards during the course of their work. 2. SCOPE AND APPLICATION A. LLC has determined that. The expense associated with training.1 revised 1/22/2009 . These hazards may include lack of sufficient breathable oxygen.26 PURPOSE A. cleaning. RESPIRATORY PROTECTION PROGRAM Pence/Kelly Concrete. RESPONSIBILITIES A. and of remedial health measures to take if they are exposed to such hazards. and respiratory protection equipment will be borne by the company. due to the nature of the construction industry. storage. Selection of respiratory protection options. Identifying work areas. medical evaluations. and evaluating hazards. B. The purpose of this program is to ensure that all Pence/Kelly employees are aware of such hazards.

and annual medical evaluation. Being aware of tasks requiring the use of respiratory protection.c. d. h. and store them in a clean sanitary location. i. Updating written program. as needed. e. required to wear a respirator. b. Ensuring employees under their supervision. Care for and maintain their respirators as instructed. Enforcing that respirators are properly cleaned. e. maintained. Evaluating the program. Administering the medical surveillance program. f. c. d. C. Employees: Duties of the employee: a. Arranging for and/or conducting training. g. Ensuring the availability of appropriate respirators and accessories.26. Maintaining records required by the program. Monitoring respirator use by employees in accordance with their certifications. 2. are enrolled in the company’s respiratory program and have received appropriate training. Conducting qualitative fit testing. j. Continually monitoring work areas and operations to identify respiratory hazards.2 revised 1/22/2009 . and stored according to the respiratory protection plan. Coordinating with the Program Administrator on how to address respiratory hazards or other concerns regarding the program. B. g. f. Ensuring proper storage and maintenance of respiratory protection equipment. Ensuring that respirators fit well and do not cause discomfort. fit testing. Supervisors: Duties of the Jobsite Superintendent include: a.

3 revised 1/22/2009 b. Review work processes to determine where potential exposure to these hazardous substances may occur. The Program Administrator will provide a copy of the Pence/Kelly Respiratory Protection Program. Updating the Hazard Assessment: The Program Administrator must revise and update the hazard assessment as needed. The Program Administrator will evaluate the potential hazard and communicate the result to all employees. Inform their supervisor or the Program Administrator of any respiratory hazard that they feel is not adequately addressed in the workplace and any other concerns they have regarding the program. Monitoring may be contracted out. Exposure monitoring to quantify air contaminants. The Program Administrator will conduct a hazard evaluation for each operation. c. MEDICAL EVALUATION A. and request a new one that fits properly. c. a copy of the list of hazardous 2. based on the hazards to which workers may be exposed and in accordance with all OR OSHA standards. If an employee believes respiratory protection is necessary. PROGRAM ELEMENTS A. or work area where airborne contaminants may be present in excess. The Occupational Medicine Department at the Urgency Care Center on Bellevue St. The hazard evaluation will include: a.26. The medical evaluation procedure is as follows: a. . The Program Administrator will provide the questionnaire (see following copy) for the employee to fill out and give to the Occupational Medicine Dept. b. Employees who are required to wear respirators must pass a medical exam before using a respirator on the job. in Salem or a Cascade Occupational Medicine Clinic in Portland. B. Selection Procedures: The Program Administrator will select respirators to be used on site. will conduct the exams. Identification and development of a list of hazardous substances used in the workplace. he/she is to contact the supervisor or the Program Administrator.b. Inform their supervisor if the respirator no longer fits well.

Disassemble respirator. After an employee has received clearance and begun to wear his/her respirator. Wash the face piece and associated parts in a mild detergent with warm water. When air particles are greater than tolerance levels. Prior to being allowed to wear any respirator with a tightly fitting face piece. etc.4 revised 1/22/2009 b. c. All examinations and questionnaires are to remain confidential between the employee and the physician. or cartridges. or facial scarring. When employee requests. Employees who are required to wear half-face piece APR’s will be fit tested as follows: a. d. RESPIRATOR USE A. b. CLEANING MAINTENANCE CHANGE SCHEDULES AND STORAGE A. chest pains. FIT TESTING A. additional medical evaluations will be provided if the employee reports shortness of breath. Rinse completely in clean warm water. When required by MSDS. and a list of employees enrolled in the Respiratory Program to the Occupational Medicine Dept. 2. Annually When there are changes in the employee’s physical condition such as loss/gain of weight. beards. dizziness. c. . Do not use organic solvents. c. c. Respirators are to be regularly cleaned ad disinfected as follows: a. or wheezing. canisters. removing any filters.substances used in the company.26. b. Respiratory protection is required in the following situations: a.

or prior to supervising 2. STORAGE A. Each employee will clean and inspect their respirator in accordance with this program. and cracked or loose lenses/face shield. f. Supervisors will also be trained prior to using a respirator in the workplace. and in accordance with the manufacturer’s recommendations.d. Filters/Cartridges – Approval designation. and cracks or tears in valve material. d. Head straps – Breaks or tears. Respirators must be stored in a clean. dry plastic bag or other air tight container. dry area. The following checklist will be used when inspecting respirators: a. and loss of elasticity. Reassemble the respirator and replace any defective parts. Air dry in a clean area. e. CHANGE SCHEDULES A. or holes. Place in a clean. MAINTENANCE A. such as a coffee can. c. g. gaskets. tears. or at the end of each work week to ensure the continued effectiveness of the respirators. TRAINING A. and proper cartridge for hazard.26. Workers will be trained prior to using a respirator in the workplace. cracks or dents in housing. b. Wipe the respirator with disinfectant wipes to kill germs. Face piece – Cracks. broken buckles. The Program Administrator will provide training to respirator users and their supervisors on the contents of the Pence/Kelly Respiratory Protection Program and their responsibilities under it.5 revised 1/22/2009 . Valves – Residue or dirt. facemask distortion. Employees shall change the cartridges on their respirators when they first begin to experience difficulty breathing while wearing their masks.

h. as existing employees receive refresher training. The Pence/Kelly Respiratory Protection Program Respiratory hazards encountered by Pence/Kelly Proper use of respirators Limitations of respirators Fit checks Emergency use procedures Maintenance and storage Medical signs/symptoms limiting the effective use of respirators Employees will be retrained annually or as needed.employees that must wear respirators. Respirator training will be documented by the Program Administrator and the documentation will include the type. Employees must demonstrate their understanding of the topics covered in the training through hands-on exercises and written test. The training course will cover the following topics: a. e. and is available to all employees who wish to review it. 2. g. The company will only retain the physician’s written recommendation regarding each employee’s ability to wear a respirator. DOCUMENTATION AND RECORD KEEPING A. B. The completed medical questionnaire and the physicians documented findings are confidential and will remain at the Occupational Medicine Dept. A written copy of this program and the OR OSHA standard is kept with the Program Administrator.26. b. The Program Administrator will also maintain copies of when and what employees have had medical evaluations. and size of respirator for which each employee has been trained and fit tested. Also maintained by the Program Administrator are copies of training and fit test records. and as new fit tests are conducted. c. d. f. C. These records will be updated as new employees are trained.6 revised 1/22/2009 . model.

L L C 2747 Pence Loop SE. OR 97301 Fax: 503-561-2807 Cascade Occupational Medicine 3449 N. Salem.7223 Portland Phone 503.PENCE/KELLY CONCRETE.8681 Memorandum For: Pence/Kelly employees Subject: Respirator Medical Evaluation Instructions 1. and questions 1-9 in Part A Section 2 of attached questionnaire.224. 500 Portland. Anchor St. Write your name on the outside of the envelope. OR 97302 Salem Phone 503. LLC Attn: Lenny Martin 2747 Pence Loop SE Salem. You will be notified of your test results and training date. Ste. Notice to Physician Send results to Pence/Kelly Concrete.7 revised 1/22/2009 . OR 97217 503-285-6627 Fax: 503-978-0989 3. Notice to Employee: Fill out Part A Section 1.26. Notice to Program Administrator: Mail questionnaire to Salem Hospital Occupation Medicine Attn: Grace Tran 503-561-5352 1002 Bellevue SE Salem. Insert questionnaire in attached envelope and return to Lenny Martin at the P/K office.. OR 97302-1153 Fax: 503-585-7477 “Creating Landmarks of Excellence” 2. 2.399.

26.“Creating Landmarks of Excellence” 2.7 revised 1/22/2009 .

no. Check the type of respirator you will use (you can check more than one category): a. selfcontained breathing apparatus). 7. Section 1. The best time to phone you at this number: 10. Your age (to nearest year): 4. and your employer must tell you how to deliver or send this questionnaire to the health care professional who will review it. Your weight: lbs. Claustrophobia (fear of closed-in places): Yes / No e. and to question 9 in Section 2 of Part A. Diabetes (sugar disease): Yes / No c. Have you ever had any of the following conditions? a. Sex (circle one): Male / Female 5. b. Trouble smelling odors : Yes / No 3. Today’s date: 2. 1.26. 1. supplied-air.or full-facepiece type. or have you smoked tobacco in the last month: Yes / No 2. 6. N. what type(s): Part A. Your height: ft. Do you currently smoke tobacco.yes.OSHA RESPIRATOR MEDICAL EVALUATION QUESTIONNAIRE To the employer: Answers to questions in Section 1. A phone number where you can be reached by the health care professional who reviews this questionnaire (include the Area Code): 9. or P disposable respirator (filter-mask. in. Has your employer told you how to contact the health care professional who will review this questionnaire (circle one): Yes / No 11. Section 2.8 . To the employee: Your employer must allow you to answer this questionnaire during normal working hours. Asbestosis: Yes / No b. (Mandatory) The following information must be provided by every employee who has been selected to use any type of respirator (please print). 12. or .’). Seizures (fits): Yes / No b. To maintain your confidentiality. Allergic reactions that interfere with your breathing : Yes / No d. half. Other type (for example. non-cartridge type only). R.. powered-air purifying. (Mandatory) Questions 1 through 9 below must be answered by every employee who has been selected to use any type of respirator (please circle . or at a time and place that is convenient to you. Asthma: Yes / No c. Your job title: 8. Have you worn a respirator (circle one): Yes / No If . Your name: 3. Have you ever had any of the following pulmonary or lung problems? a. Chronic bronchitis: Yes / No d. your employer or supervisor must not look at or review your answers.yes. do not require a medical examination. Part A. Emphysema: Yes / No Revised 8/30/05 2.

Heart arrhythmia (heart beating irregularly): Yes / No g. Any other symptoms that you think may be related to heart or circulation problems: Yes / No 7. Coughing that wakes you early in the morning: Yes / No i. Heart trouble: Yes / No c. Silicosis: Yes / No h. Swelling in your legs or feet (not caused by walking): Yes / No f. Wheezing that interferes with your job: Yes / No m. Any other lung problem that you’ve been told about: Yes / No 4. have you noticed your heart skipping or missing a beat: Yes / No e. Any other symptoms that you think may be related to lung problems: Yes / No 5. Coughing that produces phlegm (thick sputum): Yes / No h. Tuberculosis: Yes / No g. Have to stop for breath when walking at your own pace on level ground: Yes / No e. Shortness of breath when walking fast on level ground or walking up a slight hill or incline: Yes / No c. Heart attack: Yes / No b. Shortness of breath: Yes / No b. Any chest injuries or surgeries: Yes / No l. Do you currently take medication for any of the following problems? a. Do you currently have any of the following symptoms of pulmonary or lung illness? a.26. Heartburn or indigestion that is not related to eating: Yes / No f. Pneumonia: Yes / No f. Lung cancer: Yes / No j. Shortness of breath when walking with other people at an ordinary pace on level ground: Yes / No d. Have you ever had any of the following cardiovascular or heart problems? a. Coughing up blood in the last month: Yes / No k. Frequent pain or tightness in your chest: Yes / No b. Blood pressure: Yes / No d. Have you ever had any of the following cardiovascular or heart symptoms? a. Angina: Yes / No d.9 . Any other heart problem that you’ve been told about: Yes / No 6. Wheezing: Yes / No l. Stroke: Yes / No c. Shortness of breath when washing or dressing yourself: Yes / No f. Pain or tightness in your chest that interferes with your job: Yes / No d. Pneumothorax (collapsed lung): Yes / No i. Heart failure: Yes / No e. Shortness of breath that interferes with your job: Yes / No g. Seizures (fits): Yes / No Revised 8/30/05 2. Chest pain when you breathe deeply: Yes / No n. Broken ribs: Yes / No k. High blood pressure: Yes / No h. In the past two years. Breathing or lung problems: Yes / No b. Pain or tightness in your chest during physical activity: Yes / No c.e. Coughing that occurs mostly when you are lying down: Yes / No j.

Have you ever had an injury to your ears. answering these questions is voluntary. check the following space and go to question 9:) a. Wear a hearing aid: Yes / No c. or feet: Yes / No b. Have you ever had a back injury: Yes / No 15.10 . Anxiety: Yes / No d. Do you currently have any of the following vision problems? a. Skin allergies or rashes: Yes / No c. including a broken ear drum: Yes / No 13. Do you currently have any of the following musculoskeletal problems? a. General weakness or fatigue: Yes / No e. Color blind: Yes / No d. Back pain: Yes / No Revised 8/30/05 2. Wear contact lenses: Yes / No b.8. Would you like to talk to the health care professional who will review this questionnaire about your answers to this questionnaire: Yes / No Questions 10 to 15 below must be answered by every employee who has been selected to use either a fullfacepiece respirator or a self-contained breathing apparatus (SCBA). Any other problem that interferes with your use of a respirator: Yes / No 9.26. Wear glasses: Yes / No c. hands. legs. If you’ve used a respirator. Do you currently have any of the following hearing problems? a. Any other eye or vision problem: Yes / No 12. Weakness in any of your arms. have you ever had any of the following problems? (If you’ve never used a respirator. Have you ever lost vision in either eye (temporarily or permanently): Yes / No 11. 10. Eye irritation: Yes / No b. Any other hearing or ear problem: Yes / No 14. Difficulty hearing: Yes / No b. For employees who have been selected to use other types of respirators.

251978. and impulse sound levels in the range of eighty (80) dBA to 130 dBA will be integrated into the exposure monitoring.4-1971. HEARING CONSERVATION PROGRAM The purpose of this program is to protect Pence/Kelly employees from noise induced hearing loss and to comply with all applicable state and federal regulations regarding hearing conservation at all job sites. All continuous. Administrative control involves rotating workers out of noisy areas and is of limited use if all work areas are noisy.1. If the employees are highly mobile or if there are significant variations in sound level or impulse noises. Dosimeters must meet the Class 2A-90/80-5 American National Standard Specification (ANSI) S. When employee noise exposure may equal or exceed an 8 hour TWA of 85 dBA. For example. Employees who are exposed at or above eighty-five 85 dBA will be notified of the monitoring results. Employees included in the hearing conservation program or their representative will be given an opportunity to observe the monitoring. B. Whenever employee noise exposures equal or exceed an 8 hour TWA of 90 dBA. After the initial noise exposure assessment. process.1 . Sound level meters will be used for determining the daily exposure of employees only when noise levels and exposures are continuous. If engineering or 2. and sound level meters must meet the Type 2 requirements of ANSI S.1. intermittent. MONITORING A. Altering the work process is a simple and effective engineering control. and sound level meters will be used for personal or area sampling. NOISE CONTROL A. A hearing conservation program is required by state and federal regulations whenever employee noise exposures equal or exceed an 8 hour time weighted average (TWA) sound level of 85 dBA.2. administrative or engineering controls must be used. welding machines can be moved further from the work site or a soft material can be placed in the jaws of pipe stands to absorb or deaden the noise. Dosimeters will be used to measure personal employee exposure. equipment or controls increases the sound level.27 INTRODUCTION A. dosimeters will be used instead of sound level meters.27. individual or representative monitoring will be conducted to determine actual employee exposure. monitoring will be repeated annually or whenever a change in production. Monitors will be calibrated before and after sampling.

and they operate by averaging the sound level throughout the day and calculating a noise dose.administrative controls are not feasible or do not lower the exposure level below 90 dBA. Effects Of Noise On Hearing a.27. the middle ear. The ear drum is a thin membrane which stretches across the ear canal ad separates the outer ear from the middle ear. TRAINING A. if a pair of ear plugs had an attenuation factor of 32 dB and the exposure level without earplugs was ninety-five (95) dB. then hearing protective devices must be used. The outer ear. Hearing protectors must be assessed for each noise environment and must attenuate employee exposure to at least an 8 hour TWA of 90 dBA. The middle ear is an air filled chamber that contains three small bones which 2. the actual noise attenuation would be 25 dB (32 dB – 7 dB) and the exposure level with those earplugs in would be 70 dB (95 dB – 21 dB). Hearing protectors will be made available to all employees at no cost to the employee. The training program will encompass three major areas. The OSHA allowable noise dose is 100% which corresponds to 90 dB averaged over an 8 hour day. B. and participation will be ensured by a quiz covering the material. Dosimeters are worn by employees during the work shift. . According to OSHA.2 b. The sound level of a normal conversation is approximately 65 dB. Employee exposure is measured with either a sound level meter or a dosimeter. B. A training program will be initiated for those employees exposed to noise at or above an eight 8 hours TWA of 85 dBA. and the pain threshold level or level at which pain begins is about 120 to 125 dB. and the inner ear. collects sound waves and channels them to the ear drum. For example. The human ear has three arts: the outer ear. The OSHA permissible exposure level for noise is 90 dB averaged throughout a work shift. Sound level intensity is measured in units called decibels (dB). the manufacturer’s attenuation factor should be reduced by 7 dB to determine the actual attenuation. Employees will be given a choice between at least two different types of suitable hearing protectors. Sound level meters are real time monitors that constantly display the current noise level. These hearing protectors must be worn by employees. Training will be repeated annually and include updated information on protective equipment and work processes. Supervisors will ensure that employees wear their hearing protection when it is needed. which includes the auricle and the ear canal.

Sound and specifically speech will still seem muffled and fuzzy no matter how high the volume. but the service life is limited ranging from a single use to several months.transmit sound vibrations from the ear drum to the inner ear. The cochlea is lined with tiny cells which turn vibration into electrical nerve signals that are perceived by the brain as sound. and care. Sensorineural hearing loss is a result of damaged hair cells in the cochlea and is often due to repeated and excessive exposure to noise. This hearing loss is permanent. use. For example. fitting. It is important to remember that attenuation factors cannot be added together when two hearing protectors are worn. c. d.27. the advantages. Hearing aids are not very effective for noise induced hearing loss because they function by amplifying sound. C. There are three categories of aural inserts: formable. if a worker is using a pair of earplugs with an attenuation factor of 30 dB. and attenuation of various types. and the hair cells sensitive to the higher frequency range around 4. The hair cells in the cochlea correspond to the audible frequency range which is 20 Hz to 20. Aging also causes some sensorineural hearing loss but noise induced hearing loss occurs more quickly and is more extreme. There are two types of hearing loss: conductive and sensorineural. Aural inserts-Aural inserts or earplugs are inserted into the outer ear canal. Hearing Protectors Hearing protector training will include the purpose of hearing protectors. Earplugs are usually inexpensive. Hearing protectors reduce noise exposure to a level which is designed to prevent hearing loss. Only 5 to 10 additional decibels of sound attenuation can be obtained from the added ear muffs. a.3 . Prolonged and excessive noise exposure will damage more and more hair cells causing permanent hearing loss over a wider frequency range. less sensitive to sound waves. and pre-molded. 2. and instructions on selection. custom-molded. disadvantages. and they are made with soft pliable materials to prevent any injury to the ear canal lining. Exposure to loud noises for an extended period of time causes the hair cells to become worn down and thus.000 Hz are usually the first to be damaged.000 Hz for a normal young ear. Conductive hearing loss is due to impairment of sound transmission before it reaches the inner ear and is usually not a result of prolonged and excessive noise exposure. adding a pair of ear muffs with a noise reduction rating of 20 dB does not result in a total attenuation factor of 50 dB.

Their attenuation factor ranges from 26 dB to 32 dB. 2. Pre-molded earplugs are either made in various sizes or designed to fit all ear canals like canal caps.• Formable earplugs are inserted by reaching over the head and grasping the top of the ear and placing an earplug that has been rolled between the fingers into the ear canal. Earmuffs are expensive but they last for a long time and they are comfortable to wear for extended periods of time.27. they may shrink and become hard if they come in contact with ear wax which extracts the plasticizer from some plug materials. Regular cleaning of these protectors with mild soap and water prolongs their useful life. but they last longer and are more comfortable. Custom-molded devices are made for the individual user and fit the ear canal precisely. but they have several disadvantages. The attenuation factor for pre-molded earplugs varies from 20 dB for canal caps to 26 dB for some universal fit earplugs. Noise attenuation varies with the type of earplug. • • • b. the attenuation factor decreases when glasses are worn because a proper seal cannot be maintained. Finally. the noise reduction rating for ear muffs is approximately 20 dB which is less attenuation than most earplugs. They are either attached directly to hard hats or on a spring-loaded headband. they have to fit snugly. In addition. and this may be uncomfortable for some. Circumaural Protectors -Circumaural protectors or earmuffs consist of two dome shaped devices that fit over the entire external ear and seal against the side of the head. Formable and custom-molded earplugs have the highest noise reduction rating because they fit the ear canal more precisely. These earplugs last longer because they do not need to be compressed with dirty fingers. the seals need to be replaced periodically because perspiration tends to extract the plasticizer from the seal material which causes stiffening. In addition. To be effective.4 . However. Custom-molded earplugs should be washed with warm water and mild soap periodically. These earplugs get dirty easily and should be thrown away when they become soiled. They are more expensive.

Monitoring records will be retained for two years. A copy of this standard will be available to all affected employees or their representatives and will be posted at all job sites. RECORD KEEPING A. • • • • • • • • • • Name Social security number Job classification Date Name of tester Location Test time Serial numbers of equipment used Calibration dates Exposure level B.5 .27.D. and employee representatives. All monitoring records will be provided upon request to employees. Noise exposure monitoring records will include the following for each employee represented by the sample. former employees. Right to Access To Records a. 2.

LLC is not a licensed abatement contractor. LLC are not permitted to abate asbestos. a. workers may encounter materials which contain asbestos fibers. or disturb asbestos containing materials.2. c. Exposure to asbestos fibers has been linked to cancer and asbestosis. B. Pence/Kelly Concrete. Only the areas of the building that are being renovated or demolished need to be surveyed. it must be abated by a licensed abatement contractor. If materials are discovered that could be asbestos containing. C. and cannot abate asbestos. If the asbestos containing material is in an area where it will not be disturbed. Buildings built after 1986 are assumed to be free from asbestos. In the course of renovation and demolition.28 ASBESTOS CONTAINING MATERIALS SAFETY The project superintendent will coordinate with the project manager to ensure that this policy is properly implemented. b. Do not work in or around areas where abatement is taking place. and not required a survey. bring this occurrence to the immediate attention of the project superintendent or the 2. the following policy prevents exposure to asbestos fibers. A. b.1 . unless special dispensation has been give in writing by the Pence/Kelly Concrete. Prior to the renovation or demolition of any building. LLC leadership team. regardless of whether they are properly licensed. d. The following exceptions apply: a. Employees should never attempt to remove dispose of. In order to mitigate these problems. an asbestos survey from a certified asbestos technician must be provided. it does not need to be abated. The result of this survey must be kept on the jobsite for the duration of the renovation or demolition. Subcontractors of Pence/Kelly Concrete. Do no disturb asbestos containing materials.28. If asbestos is discovered by the certified asbestos technician.

Floor Base and Mastic (Commonly 9” x 9”) Roofing Material Plaster Ceiling Tile and Mastic Pipe Lagging HVAC Duct Tape/Lagging Insulation b. a. Do not allow subcontractors to remove. A copy of this policy shall be made available to all employees and concerned parties. 2. and they appear to be other than the materials described in the building survey. If you discover these items.2 .28. disturb. The following items are commonly asbestos containing. notify your project superintendent or project manager and do not disturb them: • • • • • • • VCT Flooring. or dispose of materials that are suspected of being asbestos containing. Do not remove or disturb them until they have been proven to be non-asbestos containing.project manager.

e. 2. a. Prior to the renovation or demolition of any building.1 . Buildings built after 1980 are assumed to be free from lead based paint. a.29 LEAD BASED PAINT SAFETY POLICY The project superintendent will coordinate with the project manager to ensure that this policy is properly implemented. B. Develop a lead compliance plan: • A sample plan is attached • Plan must be project specific • Plan must be kept on site Have an on-site lead competent person: • Person will be the jobsite superintendent • Person must have received lead competence training Employees working on tasks that disturb the lead must be lead and respirator trained. workers may encounter lead based paint. A. a lead based paint survey from a certified technician must be provided. and do not require a survey. The results of this survey must be kept on the jobsite for the duration of the renovation or demolition. the following policy has been developed. Only the areas of the building that are being renovated or demolished need to be surveyed. In the course of renovation and demolition. • Contact your project manager to arrange training d. If lead based paint is discovered by the certified technician. the following procedures must be followed. Lead is a poison. c. b. c.2. Provide a hepa-filtered vacuum at the jobsite Provide hand washing facilities at the jobsite b. and exposure to lead based paint could be hazardous to your health. In order to mitigate these problems.29.

b. wear the “bunny suits” and respirators After the air monitoring has proven that the task is below the permissible exposure level.2 . b.f. modify task and retest Never work on a task that is above the permissible exposure level h. • • • i. “bunny suits” and respirators are optional If above the permissible exposure level. j. It is intended that the written lead compliance program shall be used by subcontractors as well. Sign the project as required in the lead compliance program Provide “bunny suits” for all employees working on tasks that disturb lead based paint Provide air monitoring for each different task that disturbs the lead based paint • Until the tests prove that the exposure for that task is below the permissible exposure level. Record the tasks and results in the written lead compliance plan Dispose of debris that contains lead based paint only in state regulated disposal sites C. Consider utilizing temporary barriers to protect adjacent people and spaces Consider utilizing air moving equipment to exhaust air from the contaminated area E. g. 2. a. Work to minimize the exposure of adjacent facilities to debris that contains lead based paint. Subcontractors will follow the written lead compliance program Air monitoring will be required for each of their tasks that disturb the lead based paint.29. Free-Air (whole building) demolitions done entirely from the exterior with a back-hoe or similar equipment will not require the items in paragraph B A copy of this policy shall be made available to all employees and concerned parties. D. a.

3 .29.2.

2.4 .29.



LLC. It should be noted that the guidelines included in this plan are subject to change as new information becomes available through further testing and project evaluation. LCG Pence and our subcontractors are committed to taking necessary steps to ensure that all work done on the project is performed in a manner which reduces potential employee exposure and is within regulatory requirements. This plan includes work practices to perform renovation activities.INTRODUCTION Lead-containing paint was identified at the Lent Elementary Fire Restoration project in Portland.1 LCG PENCE. Paul Schulz (Project Manager) Tom Morley (Superintendent) Mobile Phone (503) 209-3593 (503) 399-7223 Office: - Oversee and administer compliance plan Disseminate testing information to subcontractors Perform necessary demolition and renovation activities to complete project Ensure employees are adequately trained in relation to lead-based paint tasks Provide adequate personal protective equipment to employees Ensure subcontractor(s) comply with applicable OSHA regulations and this plan LENT ELEMENTARY FIRE RESTORATION. The purpose of this plan is to establish standards and protocol for: • • • • Inspection Testing Lead-based paint exposure controls Disposal of lead-based paint The following information outlines the individual roles and responsibilities of the project as they relate to impact of lead-based paint. The building will be undergoing renovation that will impact lead-based paint (LBP). • General Contractor: Contacts: LCG Pence. LCG Pence has self-prepared this Lead-Based Paint Compliance Plan. OR. LLC REGULATORY OVERVIEW . PORTLAND. OR PAGE 1.

Lead-based paint abatement projects can product potentially large quantities of solid or hazardous waste such as building components. Reference TAB 8 DEQ Hazardous waste reduction policy and follow all requirements under the Oregon DEQ. practices. and after disposal. their standards may be utilized for work procedures. PORTLAND.. and procedures on testing. Management of Building Demolition Waste. The HUD guidelines apply to Public and Indian Housing Authorities and are not requirements for any other agencies. HUD has determined 5. cleanup and disposal of lead-based paint.0 milligrams per square centimeter (mg/cm2) using the XRF spectrum analyzer. TCLP testing) if demolition debris is disposed of at a solid wasted landfill that is permitted by DEQ and which meets the current design standards for municipal solid waste disposal facilities of 40 CFR Part 258. The HUD definition of LBP hazard includes exterior as well as interior intact and flaking painted surfaces. number 97-002 for proper disposal of lead –based painted demolition waste. If dust sampling is performed HUD and EPA protocols will be utilized to determine lead contamination. during. abatement worker protection. thus it is important to properly determine what is hazardous waste.6) provided the metals meet the definition of scrap metal. Although the HUD guidelines may not apply to this project. It provides information on required procedures to be followed before.000 ppm of lead as the definition for LBP requiring abatement using atomic absorption and 1. Metal components which will be recycled are exempt from RCRA regulations (40 CFR Part 261.e. waste water from cleanup. OREGON DEQ Disposal of building demolition waste coated with lead-based paint will generally not require a hazardous waste determinations (i. etc. LENT ELEMENTARY FIRE RESTORATION.. The guidelines do.1 100 mg/SF 500 mg/SF 800 mg/SF LCG PENCE. identification of LBP and dust sampling. sludges from paint stripping. OR PAGE 2.REGULATORY OVERVIEW EPA/HUD The Environmental Protection Agency (EPA) and the Department of Housing and Urban Development (HUD) has the primary responsibility to regulate LBP in federally owned or assisted housing. represent the first national compilation of technical protocols. Lead is considered a hazardous material and therefore falls under RCRA. RCRA governs federal hazardous waste and defines hazardous waste and hazardous waste generators. lead paint chips and dust. The following criteria will be utilized when determining lead dust levels: Floors: Window Sills: Window Wells: RCRA The basic federal law governing wasted disposal is the Resource Conservation and Recovery Act (RCRA) of 1976. however. A Toxicity Characteristic Leachate Procedure (TCLP) sample is necessary if there is likelihood that lead or other materials will be classified as hazardous and be disposed of as such. The surface areas selected will be wiped using nonalcoholic-containing wipes in a one square foot area. LLC OSHA REGULATORY OVERVIEW .

8 for details concerning blood monitoring and medical surveillance. disposal. Transportation. The PEL is the uppermost limit at which an employee can be exposed to over an 8-hour period. The OR-OSHA standards outline worker exposure limits. See discussion. Oregon OSHA adopted this federal standard (29 CFR 1926. and employer responsibility for exposure assessment. OR LCG PENCE. storage or containment of lead or lead-containing materials on the site or a location at which construction activities are performed. New construction. page 4. LLC PAGE 2. or renovation of structures or materials containing lead. OSHA has set the level of 50 micrograms/cubic meter (mg/m3) over an 8-hour period as the Permissible Exposure Limit (PEL) for lead exposure. alteration.62) in November of 1993. Oregon OSHA has adopted the standard under OAR 437 Division 3-001.2 REGULATORY OVERVIEW . training. All work related to construction. repair. housekeeping and recordkeeping. This includes but is not limited to the following: • • • • • • • Demolition of structures where lead-containing materials are present. or repair. Reference: the EPA Lead Exposure Associated with Renovation and Remodeling Activities Summary report in TAB 8 for additional information on the likelihood of lead exposure above the PEL during a renovation activities. Installation of materials or products containing lead. PORTLAND. and Maintenance operations associated with construction activities. The AL for lead in the construction standard is an airborne concentration of 30 mg/m3 calculated as an 8-hour time weighted average (TWA). personal protection requirements. Employees with exposure for more than 30 days per year and who have a blood lead level over 40 mg/dl will require full medical surveillance. MEDICAL SURVEILLANCE (Blood Lead Level) Employers associated with this project will make available initial blood monitoring for employees who are occupationally exposed to lead at or above the action level for more than 1 day per year. Removal or encapsulation of materials containing lead. alteration. OSHA’s lead standard applies to all construction work where employees may be exposed to lead. LENT ELEMENTARY FIRE RESTORATION.Although the Occupational Safety and Health Administration (OSHA) regulations for lead exposure have been in effect for 23 years. OSHA EXPOSURE LIMITS The Action Level (AL) is the level at which an employer must begin certain compliance activities outlined in the OSHA standard. OSHA has only recently (May 1993) revised the regulation to provide better protection for general industry and the construction industry. Lead contamination cleanup activities.

PORTLAND.58 Office of Health Compliance Assistance Applicable Paragraphs of 1926. OR PAGE 2. LLC BUILDING CHARACTERIZATION . Change Areas Handwashing Facilities Biological Monitoring Hazcom Training (and/or Safety Temporary Training and Removal Due to Education) Elevated Blood Lead Information and Training Safety Training and Education LENT ELEMENTARY FIRE RESTORATION.OSHA Instruction CPL 2-2.3 LCG PENCE.62 The following table summarizes actions triggered when AL or PEL are exceeded. For Specific Air Lead Levels ______________________________________________________________________________________ Regardless >AL (30 mg/m3) >PEL During Of Level 1-30 Days >30 Days (50 mg/m3) >4 x PEL Assessment of Trigger Tasks Exposure Assessment and Interim Protection Housekeeping Handwashing Facilities Monitoring Representative of Exposure for Each Exposed Employee Initial Medical Surveillance Follow-up Blood Sampling Medical Surveillance Program Medical Exams and Consultation (if required) Engineering and Work Practice Controls Respiratory Protection Protective Clothing and Equipment Hygiene Facilities and Practices Signs Hazcom Training Respirator Training Clean Protective Clothing Daily Appropriate Respiratory Protection Protective Clothing and Equip.

All samples were analyzed using AAS (Atomic Absorption Spectroscopy). A chip of paint was removed with a sharp tool and placed in a clean. Laboratory reports are included under Tab 2. you must test or presume the painted surface contains lead. down to the underlying substrate. This section summarizes the results of this testing.1 LENT ELEMENTARY FIRE RESTORATION. Sampling equipment was wet-wiped between each sample to avoid cross-contamination of samples. FOR THIS PROJECT If work is being performed that will disturb a painted surface that is not identified in this report. Laboratory results indicate that lead is present in virtually all tested paint. (See: laboratory report in Tab 2) This report should not be considered an exhaustive inspection of all painted components.BUILDING AND SITE CHARACTERIZATION SAMPLE COLLECTION Paint chip sample collection and lead paint identification have been performed on selected building components. all layers present were sampled. PORTLAND. however. Where various paint layers were encountered. Analysis was performed by an agency under contract with Portland Public Schools. individually numbered container. PAGE 3. it is intended to convey sample results of significant building components being impacted by the renovation. with results reported in parts per million (ppm) of total lead. OR PROJECT ACTIVITIES IMPACTING LCG PENCE. LLC LEAD-BASED PAINT .

A completed task specific activity log must be completely filled out by the contractor or subcontractors whom are working under this compliance plan. engineering controls. and work practices. ceilings. “COMPETENT PERSON” A competent person means one who is capable of identifying existing and predictable lead hazards in the surroundings or work conditions and who has the authority to take prompt corrective measures to eliminate them. • • • Demolition of interior walls. Ensure that all employees wear required protective work clothing and personal protective equipment and are trained in and use appropriate exposure control methods. Demarcate lead work areas. The competent person shall also make inspections of equipment. Ensure the adequacy of any employee monitoring data and exposure assessments. Additional sampling performed following the development of this Compliance Plan may alter this listing. doors.PROJECT ACTIVITIES IMPACTING LEAD-BASED PAINT KNOWN LBP AREAS TO BE IMPACTED The following activities within the Lent Project that are likely to impact known LBP. 4. CONTRACTOR/TASK SPECIFIC ACTIVITY LOG The purpose is to gather specific information on tasks that impact lead-based paint. 3. 5. etc. log such inspections and take corrective measures if needed. mechanical and electrical anchorage ADMINISTRATIVE CONTROLS: Employee job rotation is not expected to be necessary to reduce employee exposure on this project. The competent person’s duties shall include: 1. Take effective measures to reduce lead hazards.1 LCG PENCE. LENT ELEMENTARY FIRE RESTORATION. operated and maintained properly. structural. whether lead is present in the workplace. Penetrations Architectural. 2. Completed activity log must be submitted and approved by the general contractor prior to commencement of any work. 6. OR PAGE 4. Copies will be inserted into TAB 6 as that become available. Ensure that engineering controls are designed. PORTLAND. Determination prior to the performance of the job. LLC PROJECT ACTIVITIES IMPACTING LEAD-BASED PAINT .

The Clean Change Area will be kept free of lead dust. OR LCG PENCE. must be provided in accordance with 29 CFR 1926. Hand washing facilities. and cosmetics may not be applied in areas where employees are exposed to lead above the PEL. WORK PRACTICES Normal demolition and renovation practices will be employed which include but are not limited to: manual and mechanical means (saws-alls. Where exposures exceed the PEL (50 mg/m3.ENGINEERING CONTROLS Water will be utilized during procedures that impact lead-based paint whenever possible to accomplish dust suppression. LLC PAGE 4. if feasible. sanders). Workers will be required to use the wash facilities to cleanse hands and face at breaks and before leaving the site at the end of the work shift. Negative air exhaust machines equipped with HEPA filtration or local exhaust ventilation fans will be utilized in the immediate work areas to move and filter air. The following activities are prohibited work practices unless it has been determined that lead is not present: A. Waste material will be collected and disposed of as soon as it is practical. used. At a minimum waste will be containerized at the end of each work day. 3. jackhammers. beverages. use of tools. HYGIENE The employer will provide the following when workers are exposed to lead above the PEL or are doing any of the “lead-related tasks”: 1.. which are required at any exposure level. contaminated materials and other lead-related hazards.8 hr TWA) showers will be provided. HEPA vacuums will be on site and available to all trained personnel to collect lead dust and/or paint chips as needed. The hygiene facility will be equipped with a hand/face washing station. and tobacco products may not be present. fume. 4. Open flame (torch) burning of lead-based paint B. conveyors and other equipment to gather waste material. Silica sandblasting of lead-based paint LBP component removal and waste collection will be handled in ways that minimize worker contact with the LBP (i. 2. establishment of separate locations in the work area for disposal of waste). Food. drills. Clean break and eating areas.e. LENT ELEMENTARY FIRE RESTORATION. or consumed. Showers.51 (f). PORTLAND. .2 PROJECT ACTIVITIES IMPACTING LEAD-BASED PAINT . A clean change area will be designated separate from the work area.

4. discarding. LLC PAGE 4.HOUSEKEEPING The following housekeeping procedures will be followed on this work site: 1. LENT ELEMENTARY FIRE RESTORATION. at a minimum: 1. Procedures for ensuring adequate air quality for supplied air respirators. disinfecting. or other methods that minimize the likelihood of lead becoming airborne. Maintain surfaces as free of lead and lead-contaminated dust as is practical. Whenever an employee requests a respirator. RESPIRATORY PROTECTION Respirators are required for employees in the following situations: 1. and cleaning. Training in proper use and maintenance of respirators. Compressed air must not be used to remove lead from any surface unless it is used in conjunction with a ventilation system that captures the airborne dust created by the compressed air. As an interim protection for employees performing one of the “lead-related task. When an employee’s exposure exceeds the PEL. Clean surfaces with a vacuum equipped with HEPA filters. and maintaining respirators. dry or wet sweeping. Procedures for ensuring that workers who voluntarily wear respirators (excluding filter facepieces) comply with the medical evaluation. 8. Medical evaluation of employees required to wear respirators. 5. Shoveling. OR LCG PENCE. The written program will be available at each worksite. 2. A designated program administrator who is qualified to administer the program. storing. storing and maintenance requirements of the standard. 2. 12. 6. Fit test procedures Routine procedures and emergency respirator use procedures. inspecting. 9. Training in respiratory hazards. 3. 4. 2. Program evaluation procedures.” Respiratory Protection Program Employers must have a written respiratory protection program in accordance with 29 CFR 1910. 3. 3. Procedures for evaluating and updating the program as necessary to account for changes in the workplace affecting respirator use. Procedures for selecting respirators. 7. PORTLAND. A respiratory protection program includes.134.3 PROJECT ACTIVITIES IMPACTING LEAD-BASED PAINT . 10. Procedures and schedules for cleaning. and brushing can be used only where vacuuming or other equally effective methods have been tried and found not to be effective. 11.

Fit-testing Fit-testing of all negative pressure respirators will be conducted in accordance with 29 CFR 1910. prior to their first use by employees and every six months thereafter. Work clothing will be removed and kept or disposed of before leaving the project site and before breaks (lunch. disposable clothing and other protective equipment will be provided to the workers. air-purifying respirator with HEPA filters in place of a half-face respirator whenever it will provide adequate protection to the employee. At a minimum half-face negative pressure respirators with HEPA cartridges will be provided to the workers to wear within the work area. Half-face APR will be tested using qualitative methods. training. When an employee’s exposure exceeds the PEL. and shoes or disposable shoe coverlets. 3. vented goggles and hearing protection. vented goggles. (f).). Face shields. Workers will be required to wear respirators until an initial determination has been made that activities are not creating exposures above the action level. All equipment. An employer shall provide a powered.134. Gloves. PROTECTIVE CLOTHING/EQUIPMENT Employers must provide protective clothing to employees: 1. OR PAGE 4. etc. 2.” Any air-purifying respirator used for lead work must be equipped with high efficiency particulate air (HEPA) filter cartridges. 3. LENT ELEMENTARY FIRE RESTORATION. such as if it may increase work efficiency. for example: 1. hard hats. LCG Pence will review the adequacy of the respirators provided after initial air sample results are obtained.4 LCG PENCE. A full-face (full-facepiece) respirator with HEPA filters is required if the airborne lead particles cause eye or skin irritation at the concentrations occurring during the work.Respirators The lead standard includes a table specifying which respirators should be used when exposures are above the PEL or when performing one of the “lead-related tasks. PORTLAND. Coveralls or full body work clothes. and medical evaluations must be provided at no cost to employees. When employees are exposed to lead or other compounds that may irritate the skin and eyes. hats. Washable coveralls. When an employee is performing any of the “lead-related tasks. A half-face (half-mask) respirator with HEPA filters is the minimum respirator required for leadcontaminated dust exposures above the PEL. and may be used whenever a half-face respirator is allowed for lead work. 2. LLC PROJECT ACTIVITIES IMPACTING LEAD-BASED PAINT .” Protective clothing must be appropriate for the work.

hand washing facilities. At least one sample for each job classification in each work area must be obtained. The “lead related tasks” are listed below in three groups with their assumed lead levels. The following limits are set by the standard: • • AL = 30 micrograms (mg) of lead per cubic meter (m3) (30 mg/m3) of air PEL = 50 micrograms of lead per cubic meter (50 mg/m3) of air* *For shifts greater than 8 hours in any work day use: PEL = 400 divided by number of hours worked in a day. LLC LEAD-BASED PAINT Lead-Related Tasks . OSHA has identified a group of “lead related tasks” that are presumed to generate lead levels in excess of the PELs. AIR MONITORING OSHA’S lead standard sets limits for the amount of lead in the air and in the blood of exposed workers. some work tasks generate high levels of lead.Waterproof disposable clothing will be provided whenever tasks are being done where exposure to contaminated water is anticipated (i. The results should be compared to the PEL and AL. The Permissible Exposure Limit (PEL) is the highest amount of lead in air to which employees may be exposed. The samples should represent the worker’s regular. protective clothing. change areas. biological monitoring and training required for an assumed level for these tasks. Exposure assessment Employers must determine if any of their employees are exposed to lead at or above the Action Level. wet cleanup). daily exposure to lead. When lead is present. employers must provide workers with respirators. When the actual level of exposure for the job has been measured. One method is to collect air samples from the worker’s breathing zone and have them analyzed by a laboratory. OR PROJECT ACTIVITIES IMPACTING LCG PENCE. that employee must be protected as required for exposures above the PEL until monitoring is performed. if an employer has reason to believe a worker’s exposure in a job not listed by OSHA may be above the PEL. In addition.e. Certain actions must be taken in work areas where these limits have been exceeded. The samples should be taken for the full work shift. PORTLAND. the requirements for the level of exposure can be used. The Action Level (AL) is an amount of lead in air at or above which employers must perform certain actions in addition to those they perform for any work involving occupational exposure of employees to lead. equipment. Until then. water blasting. PAGE 4. and that require interim protection until air monitoring determines the actual lead exposures. The workers’ exposure is the exposure that would occur if they were not wearing respirators.5 LENT ELEMENTARY FIRE RESTORATION.

further air monitoring is not required unless there is a change in equipment.” If the initial air monitoring shows that employee exposure is below the Action Level. or a new task is added that may result in new or additional exposures to lead. If the initial air monitoring shows that employee exposure is at or above the AL. are below the AL. The work that was monitored must closely resemble the processes. taken at least 7 days apart. The existing results must be personal air samples that are less than 12 months old. Air monitoring results meeting these requirements are known as “historical data. This report must be given within 5 working days after completion of the exposure assessment.6 LCG PENCE. OR PAGE 4. The sampling and analytical methods used must meet the standards’ technical accuracy requirements. If the initial air monitoring shows that employee exposure is above the PEL. drywall) Dry manual scraping Dry manual sanding Using a heat gun Power tool cleaning with dust collection systems Spray painting with lead-based paint Employers must assume exposure over 500 and up to 2500 mg/m3 for the following tasks: • • • • • • Using lead containing mortar Burning lead Rivet busting on lead paint Power tool cleaning without dust collection systems Clean up activities where dry expendable abrasives are used Abrasive blasting enclosure movement and removal Employers must assume exposure over 2. control methods. PORTLAND. Employees must also be told in .Employers must assume an exposure over 50 and up to 500 mg/m3 for the following tasks: • • • • • • Manual demolition of structures (e. The air monitoring must continue until two consecutive measurements. The air monitoring can then be stopped.. material types. but at or below the PEL. taken at least 7 days apart. LLC PROJECT ACTIVITIES IMPACTING LEAD-BASED PAINT Employees must be notified in writing of the results of their air monitoring.g.500 mg/m3 for the following tasks: • • • • Abrasive blasting Cutting Welding Torch burning In certain cases. processes. and environmental conditions of the current operation. instead of taking new air samples. If the results are at or above the AL then air monitoring must continue every 6 months. to make the initial determination of whether the worker’s exposure exceeds the PEL or AL. LENT ELEMENTARY FIRE RESTORATION. controls or personnel. then no further air monitoring is required unless changes occur that may result in new or additional exposures to lead. The air monitoring must continue until two consecutive measurements. the employer must repeat the air monitoring quarterly. work practices. are at or below the PEL. If the results are below the AL. the employer may use existing air monitoring results. the employer must perform additional air monitoring every 6 months.

LLC LEAD-BASED PAINT MEDICAL SURVEILLANCE . For employees exposed below the Action Level. air monitoring will be conducted it there is a possibility of exposure. TRAINING Employers must provide hazard communication training for all employees exposed to lead at any level before they start their job assignment. processes or personnel are used on a project. Samples will be taken and analyzed using NIOSH 7082 method. and limitations of respirators The purpose and description of the medical surveillance program and medical removal program The engineering and work practice controls associated with an employee’s job assignment(s) The contents of the employer’s written compliance program Instructions to employees prohibiting use of chelating agents except under medical supervision and removal from lead exposure The right of employees to access their exposure and medical records For employees performing work in any of OSHA’s “lead related tasks.” as described above.writing when their exposure is at or above the PEL. fitting. fitting. the employer shall train the employees in: • • • The basic training topics listed above The purpose. proper selection. use. A qualified testing firm will perform initial air monitoring to determine representative exposures for each task that may result in exposures exceeding the PEL. When new equipment. Air monitoring results will be made available to the workers within 5 working days of the sample time. a broader training program must be provided initially and at least annually afterward. OR PROJECT ACTIVITIES IMPACTING LCG PENCE. labels. PORTLAND. and material safety data sheets (MSDSs) The requirements of the OSHA lead in construction standard For employees exposed to lead at or above the Action Level on any day. The training program for these employees must include: • • • • • • • • • The basic training topics listed above The contents of the lead in construction standard and its appendices The nature of tasks that could lead to exposures at or above the Action Level The purpose. The same training must also be provided initially to any employees subject to exposure to lead compounds that could irritate the skin or eyes. Employees also have the right to observe the air monitoring. and until the employer performs an exposure assessment that documents that employee exposure is below the PEL. basic training is required .8 LENT ELEMENTARY FIRE RESTORATION. proper selection. and limitations of respirators Safety issues related to the work PAGE 4. including instruction in: • • • The hazards of lead Warning signs. use. or where an employer has reason to believe that the exposure is above the PEL. All air monitoring results will be inserted under TAB 5 as they become available. Measured exposures that exceed the OSHA Action Level (30 mg/cubic meter TWA) or the Permissible Exposure Level (50 mg/cubic meter TWA) shall trigger a review and possible changes to this compliance plan and work procedures. This notice must include what actions are being taken to reduce lead exposures below the PEL.

Testing should continue at this rate until 2 consecutive blood sample results are below 40 mg/dl At least monthly during a period when an employee has been removed from work because of high blood lead levels If an employee’s blood sample results exceed the criterion level for removal. Blood sampling and analysis for lead and zinc protoporphyrin must be made available: • • At least every 2 months for the first 6 months and every 6 months thereafter. OREGON . SALEM. Employers must also provide biological monitoring for all employees performing lead-related tasks presumed to create employee exposures above the PEL. PORTLAND. OR LEAD COMPLIANCE PLAN ACTIVITY LOG LCG PENCE. This program will include biological monitoring and medical examinations and consultations.A medical surveillance program must be provided for employees exposed at or above the action level for more than 30 days in any consecutive 12 months. another blood sampling test should be provided within 2 weeks • • Medical exams and consultations must be made available on the following schedule: • • At least annually for an employee whose blood lead level was 40 mg/dl or greater in the last 12 months As soon as possible for any employee who has developed signs and symptoms commonly associated with lead poisoning or who desires medical advice concerning the effects of current or past exposure to lead on the ability to have a healthy child As soon as possible upon learning an employee is pregnant As soon as possible after an employee has shown difficulty in breathing during a respirator fit test or use As medically appropriate for each employee removed from lead exposure due to a risk of sustaining material impairment to health • • • BLOOD MONITORING Employers shall make initial blood monitoring available to any employee exposed at or above the action level on any day. PAGE 4. LLC TASK SPECIFIC ACTIVITY LOG LENT ELEMENTARY. and for employees exposed above the AL. This initial surveillance must include sampling for blood lead and zinc protoporphyrin levels.8 LENT ELEMENTARY FIRE RESTORATION. for employees exposed at or above the Action Level (AL) for more than 30 days in any consecutive 12 months At least every 2 months when blood lead level is at or above 40 mg/dl.

This activity log complies wit the OSHA Construction Lead Standard. Competent Person: The contractor shall comply with all the provisions of the “Competent Person” outlined in tab 1. page 4. and includes all of the information required in section (e) (2) (i-v). Crew: What specific tasks will each of them be performing: Name:_______________________ SS#.1 of the lead compliance plan. PORTLAND. Copies of the completed activity logs shall be submitted for review by General Contractors Superintendent. Completed activity logs must be inserted in Tab 6 of the Lead Compliance Plan prior to commencement of work. Date: ____________________ Contractor Name: _______________________________________________________________________ Address:_______________________________________________________________________________ Phone:_________________________________________Fax:____________________________________ Site Supervisor:______________________Phone:_____________________Pager:___________________ Activity Start Date:________________________Activity Completion Date:_________________________ 1.62. OR Page 1 LEAD COMPLIANCE PLAN ACTIVITY LOG LCG PENCE. 29 CFR 1926.______________________Task:_______________________ Name:_______________________ SS#:______________________ Task:_______________________ Name: _______________________ SS#:_____________________ Task: _______________________ Name: _______________________ SS#:_____________________ Task: _______________________ Name: _______________________ SS#: ____________________ Task: _______________________ LENT ELEMENTARY FIRE RESTORATION. Who is the “competent person” for this activity: Name:____________________________________________________________________________ What specific duties will this person perform: __________________________________________________________________________________ __________________________________________________________________________________ 1. Location of the project: . LLC 2.

power tools. Equipment and materials: List equipment being used like wrecking bars.2 of the lead compliance plan. plastic sheeting. When applicable. Control Measures: The contractor shall comply with all the provisions of the “engineering controls” outlined in tab 1. page 4. describe work practices/control methods. saws. etc. Merely mentioning wet method will be employed is not enough (Be Specific): Wet methods: LENT ELEMENTARY FIRE RESTORATION. For example. anchorage. sledge hammers. pumps. paint preparation. drilling. etc. Known areas of lead hazards: Has the Building and site characterization testing & inspection data been reviewed by the “competent person” prior to beginning of work? Yes _____ No_____ Has this information been communicated to the crew? Yes ____ No ____ 4. cutting. personal protective equipment etc: 6. Description of the work tasks which will impact lead paint: Selective demolition. how are wet methods to be used in controlling lead dust. cutting equipment. drills. List materials including. PORTLAND. component removal. rubber gloves. LLC LEAD COMPLIANCE PLAN ACTIVITY LOG Local exhaust ventilation fans: . List good work practices that apply to this job. OR Page 2 LCG PENCE. 5. cleaning detergents. Be specific to the tasks being performed.Where is the work taking place? Interior? Exterior? First floor? Second floor? Room #? (Be specific) 3.

Location of hand washing facilities: Location of clean changing area: Is hot water. Hygiene facilities and practices to be used on the project: The contractor shall comply with all the provisions of the “Hygiene” as outlined in tab 1. Respiratory protection program: The contractor shall comply with all the provisions of the “respiratory protection” outlined in tab 1.Enclosures or barriers: HEPA vacuums: Disposal Methods: Other: 7. submit your respiratory protection program to LCG Pence for inclusion into the lead compliance plan under tab 3. page 4.3 of the lead compliance plan.3 of the lead compliance plan. Describe housekeeping procedures to be followed on site: 9. Prior to beginning work. soap and towels to be provided? Yes _____ No _____ Are hygiene facilities being cleaned up at the end of each shift? Yes _____ No _____ Location of clean eating area: 8. Have you submitted your respiratory protection program? Yes _____ No _____ Page 3 LENT ELEMENTARY FIRE RESTORATION. OR LEAD COMPLIANCE PLAN ACTIVITY LOG LCG PENCE.2 of the lead compliance plan. Housekeeping: The contractor shall comply with all the provisions of “Housekeeping” as outlined in tab 1. page 4. PORTLAND. LLC Include a description of the respirators (type & manufacturer) and filters . page 4.

Attach historic air monitoring data to this activity log for inclusion into the lead compliance plan. Will Initial exposure assessment monitoring be performed in conjunction with this activity or task? Yes: ______ No: ______ If YES. Training: The Contractor shall comply with all the provisions of the “Training” as outlined in tab 1. As results become available. Have you submitted your training records? Yes _____ No _____ Page 4 LENT ELEMENTARY FIRE RESTORATION.4 of the lead compliance plan. OR LEAD COMPLIANCE PLAN ACTIVITY LOG LCG PENCE. Air monitoring: The contractor shall comply with all provisions of “Air Monitoring” as outlined in tab 1. submit all training records for all personnel working on the specific task or activity outlined above for inclusion into the lead compliance plan under tab 4.What parts of the job will require respirators? (link the respiratory protection to specific tasks) 10.7 of the lead compliance plan. submit for inclusion into tab 5. Protective clothing: The Contractor shall comply with all provisions of “protective clothing” as outlined in tab 1. 12. Remember to link the exposure to task. Disposable clothing __________ Launderable clothing __________ Other __________ 11. PORTLAND. page 4. page 4.7 of the lead compliance plan. . Who is responsible for this task? Name and address of consultant. and name of field technician who will conduct monitoring: Name and address of laboratory that will perform analysis: IF NO.5 of the lead compliance plan. Prior to beginning work. page 4. page 4. Medical Surveillance Program: The Contractor shall comply with all the provisions of the “Medical Surveillance” as outlined in tab 1. Do you have historic data from work which is similar. LLC 13.

PORTLAND. Multi-contractor work sites: Have you communicated with other contractors in or in adjacent to the work area about the potential for lead exposure: Yes _____ No _____ Describe any arrangements made with these contractors to reduce secondary exposure: I understand that I will adhere to the requirements of the Contract Specification with regards to the Lead Handling Procedures and the Lead in Construction Industry Standards OAR 437. If applicable. I have read and will comply with the provisions of the LCG Pence Lead Compliance Plan for the Lent Elementary Fire Restoration Project. 3. Have you submitted your Medical Surveillance Program? Yes _____ No _____ N/A _____ Have you submitted blood monitoring results? Yes _____ No _____ N/A _____ 14..Prior to beginning work. I will provide all required submittals for this plan and will comply all applicable OR-OSHA regulations.62. 1926. submit your medical surveillance program to LCG Pence for inclusion into the lead compliance plan under tab 7. Div. Signature: Title: Date: LENT ELEMENTARY FIRE RESTORATION. OR Page 5 .

bagged. If there is any possibility of body fluids coming into contact with the face. b. Dispose of used gloves in sealed. Gloves will be readily available on every jobsite. • These devices will be readily available on every jobsite. regardless of whether or not blood is visible. • Used gloves should be disposed of properly. with the following exception. Always wear rubber or latex gloves when administering first aid.30 BLOODBORNE PATHOGEN SAFETY POLICY The Project Superintendent will coordinate with the Project Manager to ensure that this policy is properly implemented. a. Needles brought to or used at the project site. Ensure you take the following steps when administering first aid. B. but are not limited to. These include. Contact with human blood at the workplace will likely be limited to the application of first-aid. • Eye and mouth protection will be readily available on every jobsite. must be safely stored. If mouth to mouth resuscitation is required.1 . The purpose of this policy is to prevent the spread of these diseases in the workplace. and disposed of offsite. Needles may be used in conjunction with the treatment of doctor approved medical conditions such as type II diabetes. a. A. “eye and mouth” protection must be used. c. e.30. 2. Do not clean-up areas contaminated by human blood • Contact your jobsite Superintendent or Project Manager to coordinate clean-up of blood contaminated areas • Immediately barricade off the contaminated areas f. garbage containers. Various microorganisms may be present in human blood and bodily fluid that can cause disease. d. The use of needles at the workplace is prohibited.2. Hepatitis and HIV. use a proper dam or mouthpiece. Always wash your hands and then your face with antibacterial soap immediately after the administration of first-aid.

D.C. contact your Superintendent or Project Manager immediately. A copy of this policy shall be made available to all employees and concerned parties. If you come in contact with human blood. If you discover blood waste or used needles. Do not touch blood waste or hypodermic needles. 2.30.2 . notify your Superintendent or Project Manager immediately. Medical treatment may be available to reduce the risk of infection.

C. If there is any question as to the safe handling of any material covered by this program. Note the appropriate hazard warnings. The foreman will ensure that all secondary containers meet this standard. OAR 437. Division 155. the following written Hazard Communication Program has been established for us. The Employee is responsible to know how to identify the hazards of a material from the label and to ensure it is handled in a safe manner. Therefore. It is company policy that no incoming container will be released for use until the above data is verified. or the company’s Shop Foreman for help labeling.1 Revised 7/17/2009 . Ensure the name. CONTAINER LABELING All containers of hazardous chemicals will be labeled to ensure that employees have a means to identify the hazards involved. address. D.31.2. 2. do not handle until the safe handling procedures have been reviewed. The person receiving the hazardous chemical must first receive and verify the MSDS Sheet for that chemical before it is transferred to their possession. Please contact your foreman. Hazard Communication. required an employer to provide information to its employees as to the hazardous chemicals/agents that they may be exposed to in the work place. the Washington Administrative Code 296-62-50409. Clearly label all secondary containers with the identity of the hazardous chemical and the appropriate hazard warnings. and emergency phone numbers of the manufacturer are legible. The foreman will verify that all chemical containers received will: A. Be clearly labeled as to the contents and to hazard involved. Do not deface original labels on incoming containers.31 HAZARD COMMUNICATION PROGRAM WRITTEN HAZARD COMMUNICATION PROGRAM The Oregon Health and Safety Code. the Project Superintendent. B.

All MSDS’s will be readily available during non-emergency situations and immediately available emergency situations. Where employees must travel between work places during a work shift. A list of all hazardous materials will be posted on safety bulletin board. EMPLOYEE TRAINING AND INFORMATION Every new employee will receive an overview of the requirements contained in OAR division 155. Physical and health effects of the hazardous chemicals.e.: machine guarding). D. Copies of the MSDS’s for the hazardous chemicals to which company employees or subcontractors or other’s employees may be exposed will be kept at the appropriate work site with the written Hazard Communication Program. If the MSDS’s are not available or new chemicals in use do not have MSDS’s immediately contact the or the Project Superintendent. the MSDS’s can be located at the Corporate Office. Chemical present in the work place operations.31. E. and WAC 296-62-054 Hazard Communication during new employee orientation. Employee Right to Know: A. F. MSDS’s will be available to all employees in their work area for review during each work shift. Site specific training will include.MATERIAL SAFETY DATA SHEETS (MSDS) The manufacturer provides Material Safety Data Sheets to identify chemicals in a product presenting physical or chemical hazards. Please call company Safety Department in any emergency pertaining to hazardous chemicals. How to read container labels and review MSDS’s to obtain appropriate hazard information. Hazard Communication Rules. and work practices. Location of the written Hazard Communication Program. 2. Steps the company has taken to prevent or reduce exposure to these chemicals. personal protective equipment. Prevention or reduction of exposure to these hazardous chemicals through physical controls (i. B. C.2 Revised 7/17/2009 .

the list for the project will be accessible on site only.31. Methods and observation techniques used to determine the presence or release of hazardous chemicals in the work area. 2. Prior to a new and different chemical being introduced into the work site. each employee will be required to sign a form to verify that they have attended the training.3 Revised 7/17/2009 . C. and other emergency procedures. HAZARDOUS NON-ROUTINE TASKS Periodically. including: ventilation. Measures the Company has taken to lesson the hazards. First Aid and Safety emergency procedures to follow if employees are exposed to these chemicals. received the written material.G. As each project will have a different list of hazardous chemicals. hygiene practices. and affected employee will be given specific instruction as to the hazards involved by his/her supervisor. B. This information will include: A. each employee involved in the use of the material will be given the information outlined above. and understand the Company’s policies on Hazard Communications. Before starting work on such a project. Protective / safety measures employees are to take. personal protective equipment. LIST OF HAZARDOUS CHEMICALS A list of hazardous chemicals used by the company will be kept current and on file at the project Location at all times. or their designee. H. The specific chemical hazards involved. After attending the training class. employees may perform hazardous non-routine tasks.

CHEMCIAL IN PIPES Work activities are often performed by employees in areas where chemicals are transferred through pipes. The chemical in the pipes. C. the employee shall contact the foreman for information regarding: A. or the insulation material on the pipe. B. The safety precautions which should be taken. 2. The potential chemical hazards.4 Revised 7/17/2009 . Prior to starting work in these areas.31.

EMPLOYEES TRAINED IN HAZ-COM Job Name I know or have been trained in the use of hazardous chemicals on the jobsite. Date Employee Name Employee Signature Trainer ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ . I also am aware of the protection equipment required.

) 2.PENCE/KELLY CONCRETE.) 8.) 3.) 18.) 11.) 20.) 12.) 9.6 . Job: ________________________________________________ Superintendent: ______________________________________ 1.) 10.) 17.) 5. LLC Listing of hazardous chemicals/materials on this jobsite.31.) 6.) 15.) 16.) 14.) 2.) 13.) 4.) 7.) 19.

Have spill control materials available ie: kitty litter.2. withdrawing. stream. Use the chemical up. on the ground. Thinners. etc. • Reusable containers should be returned to the supplier. Secure chemical container lids and caps at all times except when adding.1 . • Containers in poor condition are to be emptied. brooms. storm drain. crushed and placed in a dumpster. C. (1 copy for client) All hazardous chemicals delivered to site must have label from manufacture on container. or into any scrap or waste dumpster. pond. B. SPECIAL PROCEDURES A. B. sanitary sewer.32 CHEMICAL MANAGEMENT PROCEDURES MATERIAL SAFETY DATA SHEET (MSDS) AND CONTAINER LABELING A. All hazardous chemicals brought onto the job site must have and MSDS on file at the job site. Paints. Do not dump or drain any chemicals (this includes oils) into a process sewer. All hazardous chemicals that are put into a secondary container must be totally used up within workshift or be properly labeled with NFPA labels or per client mandate. C. or using chemical. B. Empty Chemical Containers • Never dump or drain chemicals to empty containers. and Solvents 3. CHEMICAL HANDLING PROCEDURE A. absorbent pads. Chemical containers shall be stored so as to prevent rainwater from entering container either by covering container or tipping container to allow water to run off.32. • All non-reusable containers are to be completely emptied before disposal. sump. drain covers. sawdust. D.

Many clients require that alternative materials be used whenever possible. Open paint. • Any spill with potential to affect human health or the environment (except when occurring in secondary containment) must be 3. purchase one 55 Gallon Drum and the remainder in 5 Gallon cans etc. PURCHASING HAZARDOUS MATERIALS A. Other Special Chemicals • If project requires work with other special chemicals. purchase only 5 Gallon cans. Contact Safety. CONTAINMENT AND CLEAN-UP OF A SUDDEN OR ACCIDENTAL RELEASE A. Do not date the container! All chlorinated solvents must be approved for use by the Safety Committee.• • • • C. D. Notification • If anyone is injured. Check with the project manager prior to purchasing hazardous materials. • Inform foreman immediately of any spill or release. B. Substitutions can often be made with materials that do not create hazardous waste. unless chemical is not listed and does not meet any Hazardous Waste characteristics. seek medical help. If less than 55 Gallons of product is needed. and also per client mandate. Purchasing. As soon as possible notify the project safety representative or project superintendent. Dispose of per client contact or Safety Committee. Purchase only the amount of material necessary to complete the project at hand. Many clients require advanced MSDS review/approval prior to delivery of hazardous materials to the project.2 . management as stated above. or solvent cans only as needed.32. check with the Safety Committee for special handling requirements. Use proper secondary label and also label as “Hazardous Waste”. thinner. C. If less than 110 Gallons of product is needed. Leave ample time for client review.

• Place contaminated materials inside an approved container. D. Liquid Spills • Immediately confine liquid spills to the smallest possible area using dams. Gaseous Release • Evacuate area in case of a gaseous release. and/or absorbent. Disposal • Consult warning labels on container and/or MSDS’s for procedures and precautions necessary for safe and proper disposal of the hazardous waste. 3. Protection • Get personal protective equipment as required by HMIS label or MSDS.32. Contact foreman and project safety representative immediately. • Dispose of small quantities of oil soaked absorbent material as solid waste. • In case of a large liquid spill. Use Personal Protective Equipment (PPE) as required.3 . Contain spill as above where possible. State and Local Regulations. B. Also contact client site safety representative. contact client site safety representative for instructions for disposal. C.reported to local authorities in accordance with the local emergency plan. dispose of in accordance with all Federal. E. dikes.

gases. gravity or toxic substances. compressed air (pneumatic systems). all energized electrical work will require an Electrical “Hot Work” Permit to be completed fully prior to work commencing (see attached).33 PURPOSE AND SCOPE A. Cord and plug connected equipment should be exempt. before employees perform any service. This program has been put in place to ensure that machines. All subcontractors must provide a Lock Out/Tag Out Program prior to performing working on equipment with potentially hazardous energy sources. Furthermore.33. flammable. 2. LOCK OUT/ TAGOUT  The Lock Out/Tag Out program has been developed to establish the procedures for the control of potentially hazardous energy sources. equipment or fixtures are isolated from all potentially hazardous energy sources. The Lockout/Tagout protocol should apply to all permanently wired machines and equipment. maintenance. demolition or installation activities on them. “Energy source” is defined to include electricity.2. Energized electrical work will not be allowed unless work is infeasible to perform de-energized. corrosive. fluid systems.1 . steam. B. provided that the cord is unplugged and under the direct control of the employee performing the service or maintenance.

Electrical Hot Work Permit #1 Project Information Date: Facility Name: Address: Subcontractor Name: Project: #2 “Hot Work” Classification What “Hot Work” classification does this work fall under? .2 .33.Supports Life Sustaining Equipment . etc.Severe Economic Impact (example: shutting down major operational systems. is it close enough to work being performed that it can be turned off in case of an emergency? YES If NO. or if the disconnect is not close. why? YES NO Does this equipment have a disconnect? YES NO NO If YES. what steps will be taken to remove an employee from energized circuits? #3 Personal Protective Equipment Personal protective equipment required: 2.Emergency Event Can the equipment be shut down? If NO. disrupting R&D prototypes.) .

and any special protocols for electrical hot work attached to this permit? YES NO #6 Names of Qualified Persons who will perform this work: Contractor Name : Print Name Signature : Print Name Signature : Print Name Signature : Print Name Signature : Print Name Signature #7 Owner/Customer Agreement: Has the Owner/Customer been notified and is in agreement with the need for this Hot Work? YES NO Print Name Signature Owner Representative: #8 Signatures: Pence/ Kelly Pence/ Kelly Superintendent: Print Name Signature Subcontractor Foreman: Print Name Signature Safety Officer: Print Name Signature 2.33. step-by-step pre-task plan – completed by Foreman and crew -.#4 Emergency Procedures Names of individuals who have a valid first-aid and CPR card and are present while working is being performed: Emergency contact numbers: #5 Site Specific Safety Planning Is the detailed.3 .

Non-Permit Confined Space – means a confined space that does not contain or. DEFINITIONS A. By following this procedure. • contains a material that has the potential for engulfing an entrant. vaults and pits). contact the Entry Supervisor or the safety person on site for specific answers to your questions before proceeding with the confined space operation. you will help to insure a safe entry. and OR OSHA. tanks vessels. storage bins. The risks are too high to proceed with any unanswered questions. • limited or restricted means of entry or exit (for example. stay and exit of confined spaces by reducing the likelihood of any injuries or accidents associated with confined space work. The majority of these occurrences could have been eliminated with proper training and procedure compliance. . INTENDED TO REPLACE THESE STANDARDS. B. CONFINED SPACE ENTRY PROGRAM Confined spaces kill over 300 workers each year throughout the industry. silos. If any questions arise prior to or during confined space operations. with respect to atmospheric hazards. • has an internal configuration such that an entrant could be trapped or asphyxiated by inwardly converging walls or by a 2. c.34. THIS POLICY IS.34 PURPOSE A. The intent of this procedure is to comply with the complex rules and regulations of OSHA. Confined Space – A space that is/has: • large enough and so configured that a worker can bodily enter and perform assigned work. have the potential to contain any hazard capable of causing death or serious physical harm. hopper.1 b. BY NO MEANS. Confined Space a. • not designed for continuous worker occupancy. WISHA.2. Sixty percent of these fatalities were would-be rescuers. Permit-Required Confined Space (Permit Space) – means a confined space that has one or more of the following characteristics: • contains or has potential to contain a hazardous atmosphere.

incapacitation. or above 23. vapor or mist in excess of 10% of the lower explosive limit. The person (supervisor or foreman) responsible for determining if conditions are acceptable at the permit space where an entry is planned. D. G.34. C. Entry Permit a. oversee the entry operation and terminate the entry and permit as required by this procedure. Hole Watch (Attendant) a. Written document that is required to enter a “permit required” confined space that is to control entry into a confined space and contains all pertinent information about that space and the immediate area outside the confined space. B. The individual stationed outside the confined space who monitors the authorized entrants while there is work in process. Hazardous Atmosphere a. Authorized Entrant a. IDLH (Immediately Dangerous to Life and Health) a. and completes the duties assigned as dictated in this confined space program. Flammable gas. The person that is authorized to enter the confined space and has received the required training to do so. They shall authorize the entry permit. Entry Supervisor a.5%. or any atmospheric condition that is immediately dangerous to life or health.2 . Any condition that poses an immediate hazard or delayed threat to ones life or that would cause irreversible adverse health effects or 2.5%. An atmosphere that may expose workers to the risk of death. airborne combustible dust at a concentration that meets or exceeds its lower explosive limit. oxygen concentrations below 19. E. F. contains any other recognized serious safety or health hazard. impair their ability for self rescue.• floor that slopes downward and tapers to a smaller cross section. or may cause acute illness from one or more of the following.

This will include information as to signs.34. They shall terminate the permit at the completion of the job. Entry Supervisors a. The HOLE WATCH shall know the hazards faced during the initial entry. Attendants shall not perform any duties that interfere with their primary job of monitoring and protecting the entrants inside the confined space. Communication shall be maintained at all times with the authorized entrant. This is also true if any condition arises that may pose a threat to the workers inside. They shall verify that the confined space permit is filled out in full and all tests have been completed as required. an evacuation shall be implemented and the confined space permit shall be reevaluated by the entry supervisor and new procedures implemented to correct the problem. Authorized Entrants 2. and maintain a record of all authorized entrants. B. C. or when conditions not covered on the permit arise. and all equipment specified on the permit is in place and operable before allowing entry into the confined space. This will include information as to signs. They shall verify that rescue services are available and that the means of contacting them is operable. and consequences relating to any exposure to substances that may be found inside the confined space. symptoms. and consequences relating to any exposure to substances that may be found inside the confined space. Any unauthorized entrants must be immediately removed from the area and reported to the entry supervisor. They shall cause the removal of any unauthorized personnel from the confined space or immediate area outside. Attendant (Hole Watch) a.that would interfere with ones ability to escape from a confined space without the aid of rescue personnel. symptoms. while entries are in progress. They shall be aware of possible behavioral effects these substances may cause to the entrants. If for some reason communication fails.3 . Entry supervisors shall know the hazards faced during the initial entry. and throughout the work process. SPECIFIC DUTIES A. They must remain outside the entrance to the confined space while work inside is in progress. and throughout the work process.

keep all cords and hoses out of harms way.4 . The Safety Training Department will assist as needed in training. Know the area you are going to enter and any of the hazards that you may encounter during your course of work. Pre-Evaluations a.a. They are not runners for the people inside the confined space.34. Stay in communication with the HOLE WATCH the entire time you are in the confined space. This will give you an idea as to the type of environment you are likely to encounter. All persons posted as a Hole Watch shall remain at the entry to the confined space as long as there are workers inside the space. or when directed to exit by the HOLE WATCH and/or ENTRY SUPERVISOR. See attached flow chart. sign or change in behavior to yourself or co-workers. and abide by all aspects of this procedure while conducting any confined space work. Inform the HOLE WATCH of these symptoms or conditions when exiting. though they may assist in ferrying tools and materials staged at or near the confined space entrance. The first and foremost requirement prior to opening a confined space is to first find out what the confined space was used for. and the exit of the confined space. The Site Superintendent (or designee) is required to review the confined space entry permit after the initial air quality testing is completed prior to entering the confined space. All Confined Spaces shall have a qualified “Hole Watch” posted prior to entry. A Hole Watch must be trained in his duties as well as being physically fit and able to complete his duties as required. and will determine if any flushing of the system may be needed prior to opening for testing. Utilize all personal protective equipment required by the entry permit. MINIMUM REQUIREMENTS A. The job specific Entry Supervisor in charge shall be responsible for the permit approval. or on designated preset intervals. The duties of the Hole Watch are only those associated with their specific task. safe entry. as well as obtaining proper safety equipment needed to ensure a safe entry. Exit the confined space at the first sign of any symptom. work to take place. The authorized entrants are required to abide by the following rules. Eliminating Potential Hazards 2. B. CONFINED SPACE ENTRY PROCEDURES A.

Electrical . extension cords. opening and locking of circuit breakers or switches.5 . maim or kill. and used in conjunction with a GFCI. battery operated converted. This can be accomplished by the removal and tagging of belts. Prior to Opening a Confined Space 2. Any electrical component that may present even the slightest hazard must be eliminated prior to entering and working in a confined space. Atmospheric Testing a. etc. or any other device that moves must be made inoperable. mechanical. This can be accomplished by locking out and tagging out the system. electrical circuits. the removal of fuses or disconnecting of wiring and tagging the location. ventilation equipment. gases or dusts must conform to current NEC codes. power tools. lighting. Confined spaces that contain devices that could injure. All lighting and power cords must also be protected from damage by power cords must also be protected from damage by keeping them out of confined space entries. All lighting and tools used in an area that contains flammable vapors. Mechanical . or electrical hazard shall be eliminated prior to entering the confined space. Any system that has the possibility of creating a physical. is not permitted. All other confined space lighting must be protected by the use of a ground fault circuit interrupter (GFCI) located outside the confined space. • • B. This may entail system walk downs as well. All portable tools shall be grounded or double insulated. and working spaces.34. such as agitators.Mechanical hazards must also be eliminated.A physical hazard example could be an un-shored excavation over four feet in depth where the soil type is a class B or C. walkways. industrial quality. All lighting in wet or damp areas must be low voltage.a. Great care must be taken when working around electrical components. These will include but are not limited to.Electrical hazards come in many forms. This means that the excavation must be shored and inspected by a competent person prior to entering the exaction. • Physical . They must also be heavy duty. The tagging of controls alone. fans. Lock-out/tag-out procedures must be completed prior to the opening of confined spaces.

If at all possible, PRELIMINARY air quality testing should be done prior to opening the system. There are many ways to accomplish this. One simple way to test the air quality at the bottom of a tank, is to insert the test probe into the drain of the confined space. This will tell you if there are any heavy gases laying at the bottom of the unit, as well as letting you know that the unit is indeed empty. The next step is to check the top of the unit by using the top vent if possible. This will tell you if there are any light gases near the top of the unit. By doing an initial air quality check in this manner, you will be greatly reducing the risk of a potential accident.


After a Confined Space is Open • After the confined space has been opened, the PRIMARY testing of the air quality can be done. The first thing that needs to be done is to check the air directly inside the opening. The first thing that needs to be done is to check the air directly inside the opening. The next, is to check the air directly inside the opening. The next, is to check the air at the bottom of the space followed by checking the air at the top of the space. This needs to be done because of condition known “stratification” takes place when air sits dormant for a length of time causing a layering affect to take place. The heavy components migrate to the bottom, and the light components move to the top, leaving the components with the near same molecular weight of the air we breathe in the middle. If only the middle of the space is checked, there is a chance that as workers move about inside the confined space, a toxic environment could develop and endanger the workers simply by moving and mixing different layers.


Ventilation a. Prior to entry, there must be at least 5 air exchanges completed by ventilating the confined space. If the atmosphere is toxic, flammable or both, you will need to have a minimum of 10 air exchanges. To do this, you must know the approximate size of the confined space.


The confined space is 20’W X 10’H. This would give you an area of 4,000 cubic feet. If you ventilate the space with an 8” red box fan rated at 1,500 CUBIC FEET PER MINUTE, it would take just over 2 ½ minutes to make one air exchange. To make 5 air 2.34.6

exchanges, it would take 12 ½ minutes. This would be the earliest time that anyone could enter the space. c. For toxic or flammable atmospheres, the 10 air exchanges needed prior to entering would increase the time to properly ventilate to 25 minutes. Continuous ventilation must be maintained while workers are in the confined space, if there is any possibility that a hazardous atmosphere could develop, including by the work process, i.e. welding, grinding, etc., being performed in that space. If for some reason the ventilation stops, the workers must be removed the space until it can be reestablished and the minimum per-entry air exchanges completed. All fans and other equipment used to remove flammable gases or vapors shall conform to NFPA requirements and not create an ignition hazard.



General Requirements a. Once the air quality and ventilation have been established, a few other areas of concern must be dealt with. The first is the permit system we use. This is to be used and maintained by the hole watch the entire time that the confined space is occupied. The permit contains all of the vital information found and near the confined space. As long as the hole watch is at the hole, they are in charge of the immediate vicinity outside the confined space, as well as all persons entering and exiting the area. If they say that everyone is to exit the space, they must do so. Should the hole watch be in a position to monitor more than one confined space, the following procedure must be followed: • •



Maintain constant contact with all entrants. Should an emergency situation develop in any of the spaces, all entrants are to evacuate so the attendant can focus on summoning rescue and emergency services.


Should other contractors need to perform work in the same confined space, they must comply with the requirements listed on the permit. Should any incident or contractor’s work change the condition of the space, or place others at risk, a new permit with specific requirements to protect other will be issued prior to allowing re-entry. 2.34.7


The written confined space program will be reviewed at least annually, and revised should additional hazards be present. Canceled entry permits must be kept on file for one year. Only designated competent persons may take the air samples needed for the initial entry, but the trained hole watch may preside over continuous air monitoring and take actions accordingly. The designated competent person must remain on site while any confined space work is taking place and confirm and document the air quality on a maximum time frame of 2 hour intervals. Communication shall be maintained between the hole watch and the people inside the confined space at all times. This can be accomplished by sight, voice, or radio communications. The hole watch must also have in their possession a signaling device that is capable of producing an alarm sound of 110db such as a police whistle or an air horn in case of an emergency. They also must have either a radio or be in close proximity to a phone with emergency numbers listed to summon help in the event of an emergency. Should situations arise such as employee complaints, unauthorized entry, or additional hazards, the program shall be reviewed and changes implemented as necessary.

f. g.



Hot Work a. Any hot work inside a confined space requires the use of an approved “HOT WORK PERMIT” prior to entry (See section 2.36). All combustible materials shall be protected from ignition at all times, and all flammable atmospheres shall be controlled. If the hot work produces any toxic gases, fumes or vapors, ventilation shall be required to extract these contaminates, and/or the use of the proper respiratory protection shall be implemented. Testing of the atmosphere inside the confined space shall be continuous as long as these conditions exist.


Compressed gas cylinders are not allowed inside any confined space. They are to be located outside and monitored while in use so that they can be shut down if an emergency arises. Any time an oxy-acetylene cutting or brazing outfit is not in use, it is to be removed from the confined space and shut down to prevent any accidental release of gases inside the confined space. Also, any arc welding power must be shut down if an emergency develops. 2.34.8


Retrieval Systems/Rescue a. Retrieval Systems are to e used anytime there is the possibility of an IDLH atmosphere, and or, the entrant is to enter a confined space over 5 feet in depth from the top. For the types of retrieval systems to use for your particular application, contact the Safety Department. Rescue personnel are to be notified prior to any entries into these types of confined spaces. This notification is to include the number of persons entering, the type of hazards involved, and the exact area of the confined space. They are also to be contacted at the end of the confined space work. Rescue and emergency services will be summoned by radio or telephone. Under no circumstances will anyone other than members of the designated rescue team (client provided, or the local fire department) attempt rescue. They will also provide needed medical service. Should an emergency situation develop, it is the attendant’s responsibility to summon the response team and to keep all unauthorized personnel from entering the space.




Barricades/Postings a. During the initial set-up of the confined space, caution barrier are to be set-up around the entry of the confined space and barrier tags are to be filled out describing the work taking place. This area is to be maintained by the Hole Watch while any confined space work is in process. This area should encompass an area large enough to prohibit the entry of any fuel burning equipment than could introduce “bad air” into the confined space through the ventilation system in use, or possibly block any exit or rescue of the confined space.

EXITING CONFINED SPACES A. After work in the confined space is complete, the confined space shall be secured by posting or closing the access. The permit to enter is to be closed out by the Entry Supervisor and is to remain in file as a permanent job record. All barriers are to be removed, and emergency services are to be contacted and informed of the job completion if, applicable. 2.34.9

Employees who are required to work in a confined space. and the consequences of the exposure. c d e. Emergency entry and exit procedures. Training will be documented by the trainers and employees signature along with the date of training. and all other aspects of the entry program. Safety equipment use. Recognition of the signs and symptoms of exposure to a hazard. ensuring that the permit calls for adequate safeguards. Before the employee is first assigned duties involving confined space. b How the communications will be maintained between the attendant and the workers in the confined space. g.10 . C. Work practices required under the permit. Lockout and isolation procedures. Understand the hazards associated with confined spaces. D. 2. or in support of those working in a confined space.EMPLOYEE TRAINING PROGRAM A. B. Training frequency: a. i.34. Use of respirators and other protective equipment. This individual needs to know how to use the testing and monitoring equipment. f. • • General hazards and the specific hazards for each confined space that will be entered. h. Permit system. shall have the following training: a. Supervisor Training: The individual in charge of authorizing the entry shall have additional training on how to evaluate the confined space. Rescue procedures.

34. or your site safety representative. Any questions regarding to “Permit Confined Spaces” or “Non-Permit Confined Spaces” should be directed to the Safety Committee.11 .b. Whenever there is a change in permit space operations that presents a hazard about which an employee has not previously been trained. Whenever there are deficiencies in the program and/or employee performance relating to the safety of the confined space entry. 2. c.

2.12 .34.

13 .34.2.

Exits are to be clearly marked with signs designating them as such. an annual inspection tag or log must be kept. LLC and client personnel. E. LLC shall be conspicuously located. PORTABLE FIRE EXTINGUISHERS A. FIRE PREVENTION PLAN The plan is intended to establish guidelines to reduce the number and severity of construction/maintenance related fires. Each workplace building must be equipped with at least one portable fire extinguisher rated at not less than 2ABC for each 3000 square feet of the protected building area. or 100’ of travel. Access to all available fire fighting equipment shall be maintained at all times. This plan will encompass all temporary offices.35 PURPOSE A. and all demolition work on client property. structures during construction/alteration.2. D. Defective equipment should be replaced immediately. All fire fighting equipment provided by Pence/Kelly Concrete. C. storage sheds. In multistory buildings. SCOPE A. in addition. One or more fire extinguishers rated at not less than 2ABC shall be provided on each floor. FIRE EXITS A. Fire extinguishers must be visually inspected and monthly documented on job site inspection check list. Exits must remain clear and free of obstructions and no doors are to be locked while the building is occupied. at least on fire extinguisher shall be located adjacent to the stairway. 2. trailers.35. prevent injury to Pence/Kelly Concrete. B. LLC and client property and equipment. B.1 . and eliminate losses associated with fire to Pence/Kelly Concrete.

and at least annually thereafter. H.35.2 . Refuse containers shall be emptied on a regular basis. 2. EMPLOYEE TRAINING A. B. Training is required before performing assigned job duties.F. The following elements can serve as a basis for successful fire prevention on the average construction site. Fire extinguishers with capacity of 5 gallons or more are to be placed at or within 25 ft. A fire extinguisher rated not less than 10B. Proper operation of fire extinguishers. The key to a successful fire protection program is prevention. empty food containers. Only those fire extinguishers listed or approved by a nationally recognized testing laboratory (Underwriters Laboratories) may be used. a. and wrappers. Containers shall be placed in lunch trailers for scraps. rubbish and trash shall not be allowed to accumulate throughout the site. Procedures to alert others. shall be provided within 50 feet of wherever more than five gallons of flammable or combustible liquids or 5 pounds of flammable gas are being used on the job site. d. Hazards of fighting fires in the incipient stage. Employees expected to use fire extinguishers must be trained in the following: a. Evacuation routes and procedures. Appropriate receptacles shall be provided for the collection of rubbish and debris. G. Housekeeping • Construction debris. b. c. FIRE PREVENTION A. of any fuel using equipment.

STORAGE OF LPG INDOORS IS PROHIBITED. Dispensing of Flammable and Combustible Liquids • Approved safety cans or Department of Transportation approved containers shall be used for the handling and use of flammable liquids in quantities of 5 gallons or less.b.35. Flammable liquids may be used only where there are no open flames or other sources of ignition within 50 feet of the operation. falling. Flammable gases shall be stored separately and secured in an upright position out of doors. identifying the contents and the appropriate hazard warnings.152. In certain circumstances (refineries. unless conditions warrant greater clearance. Storage • Materials and supplies shall be stored in on orderly manner.(a)(1) through (5). Material stored in tiers shall be stacked and blocked to prevent sliding. • • • • 2.3 . Aisles and passageways shall be kept clear to provide free to fire fighting equipment and personnel. or collapse. Transfer of flammable liquids from one container to another shall be done only when containers are electrically (bonded). Flammable/combustible materials shall be stored separate from materials that would accelerate combustion or add to the fire load. chemical plats) client mandate will dictate procedures used. Welding/Burning • As a minimum the attached guidelines shall be followed when any welding or burning operations take place. d. Flammable liquids shall be kept in closed containers when not actually in use. under cover out of direct sunlight. No more than 25 gallons of flammable or combustible liquids shall be stored in a room or storage “shed” unless the materials are stored in an approved cabinet meeting the requirements of 29 CFR 1926. All containers of flammable and combustible liquids shall be labeled. • c.

gasoline. fuel oil etc. may be used to extinguish class “A”.150 through 1926. Class “C” – electrical equipment Class “D” – flammable metals. 4. 3. b. b. etc. 2. LLC Project Managers and Superintendents to develop a “site specific” fire protection plan. (common combustibles) Class “B” – flammable liquids. a. Subpart F. Water – recommended for class “A” fires and is used conjunction with foam to control class “B” fires. The extinguishing media for each type of fire include: 1. 2. Dry Powder is specifically formulated for use on burning metals. The plan should be developed and implemented as soon as practical after mobilization. 1926. magnesium.159 Fire Protection and Prevention. Fires are identified as one of four classes and various extinguishing methods are appropriate for each. B. CLASSES OF FIRES A. and “C” fires. Dry Powder – used for class “D” fires and is usually supplied in a bucket with a scoop. Class “A” – wood.35. paper.4 . “B”.• At least one portable fire extinguisher having a rating of not less than 20 shall be provided on all vehicles used for transportation and/or dispensing flammable and combustible liquids. Carbon Dioxide – recommended for class “C” fires and is preferred over Halon 111 or 112. This plan is not all inclusive but is intended to be a guide for Pence/Kelly Concrete. Dry Chemical extinguishers must not be substituted for Dry Powder. Dry Chemical – depending on the chemical. c. sodium etc. For complete information on fire prevention and protection requirements refer to Code of Federal Regulations 29 Part 1926.

.36. prior to operation. Cutting. All other welding terms: used in OSHA standard are in accordance with American Welding Society – Terms & Definitions As-0. Supervisors: Supervisors are responsible to see that only trained employees are authorized to weld.36 PURPOSE A. POLICY A. Authorized Operators: Employees who are trained and authorized to perform welding & cutting operations must follow all safety procedures as outlined in this chapter. The following precautions are required to be taken by our employees who perform welding and brazing operations. Employees are required to inspect their equipment daily. WELDING. Management is required to see that adequate maintenance services are provided and used to ensure safe operating conditions and that all Energy Control Procedures are followed as they relate to maintenance welding on equipment. Approved: means listed or approved by nationally recognized testing laboratory. CUTTING. GENERAL RESPONSIBILITIES A. Welding and welding operator: means any operator of electric or gas welding and cutting equipment. DEFINITIONS A.969. C.1 B. B. Welding is a hazardous operation which must be performed in accordance with safety standards and by qualified trained employees. Fire watch personnel will be trained in their duties by the supervisors. This chapter is to ensure work place safety and compliance with Oregon OSHA and Washington WISHA standards.2. to ensure that all safeguards are on the 2. and Brazing Safety Chapter to ensure that employees are aware of the hazards associated with welding and ensure proper fire protection. by OSHA rules and manufacturer’s recommendations. AND BRAZING FIRE AND EXPOSURE CONTROL The Company has adopted its Welding.

Electric shock and burns: must be guarded against when using welding equipment. ELECTRIC SHOCK AND BURNS FIRE COMPRESSED GAS HAZARDS RADIANT ENERGY INHALATION EXPOSURE TO GASES. Hot metal that is being welded or cut can cause fires if allowed to contact flammable or combustible material such as drip pans. or combustible materials. The degree of risk depends on the type of welding process. Compressed oxygen gas used in welding is a fire hazard because it supports and intensifies the rate of combustion of other materials. B. Fire Hazards: a. Any defect or safety hazards shall be reported and the equipment taken out of service until repairs can be made by qualified personnel. c. b. It is the responsibility of the employee’s supervisor to ensure that all welders and fire watch personnel understand these hazards. only a tiny spark is needed to set off a fire or explosion. Welding is associated with five principle hazards. The torch flame used by the welder is another source of ignition and must be handled carefully. All accidents will be reported immediately to the supervisor. vapors. Fire Watches: Employees who are trained in the use of fire extinguishing equipment and familiar with the procedures for sounding and responding to an alarm WELDING HAZARDS A. Flying pieces of molten metal can fall through cracks and openings as small as nail holes and ignite combustibles that are beyond the welder’s visual range. 2. d. and dusts are present.36. oily rags. FUMES AND MISTS A. Flying sparks are the source of many industrial In areas where flammable gases. Basic Hazard Awareness: Safety in the many processes of welding and cutting requires certain precautions and standardized operating procedures.2 . C.

welding exposures include iron oxides. a Hot Work Permit will need to be issued by the Supervisor. the fire protection equipment should be staffed while welding operations are being conducted. D. or heat. Radiant Energy Hazards in welding include: ultraviolet light. infrared light and visible light. If this cannot be done.C. Infrared rays act upon the eyes simply as heat and can cause a burn or irritation of the tissue affected. In critical areas. type of rods and fluxes used. and nickel. Welding produces airborne exposures to a variety of potentially harmful gases and fumes. sparks. WELDING SAFEGUARDS – SAFE WORK PROCEDURES A. eye fatigue. a. and loss of visual efficiency. Inhalation of Welding Fumes: a. slag. a. d. Protective eyewear must be worn during welding to prevent harm to the eyes from light energy. the fire protection equipment should be staffed while welding operations are being conducted. spatters. Fire protection equipment should be kept immediately at hand and ready for use. Proper ventilation is required.36. c. The hazard level from metal fumes depends on the type of metal. chromium. The permit will describe the welding zone controls such as enclosing in fireproof blankets or other protective shields when materials in nearby areas can be affected by welding arcs. 2. In steel. The glare of excessive visible radiation can cause headaches. flames. Fire protection equipment should be kept immediately at hand and ready for use. Fire Protection Requirements: Welding operations need to be performed away from flammable materials or special precautions are necessary. c. The gases also vary with the type of shield gases used in arc welding. Exposure to the welding arc (ultraviolet rays) may result in very painful irritation of the eyes and skin. b. In critical areas. b. manganese. Fumes are generated from both the base metal and the wire or rod used in the process.3 .

or hollow structure. • e. • • d. such as during the lunch period. cutting. be before welding. additional personnel shall be assigned to guard against fire while the actual welding. the gas supply to the torch shall be positively shut off at some point outside the enclosed space whenever the torch is not to be used or whenever the torch is left unattended for a substantial period of time. Before heat is applied to a drum. or hollow structures which have contained toxic flammable substances shall. and ceilings.4 . container. or similar work should be undertaken on tanks. No welding.• When the welding. No welding. Flammable and other potentially hazardous materials should be cleaned from surfaces before welding is started. the same precautions shall be taken on the opposite side as are taken on the side on which the welding is being performed. cutting. either be filled with water or thoroughly cleaned of such substances and ventilated and tested. floors. Such personnel shall be instructed as to the specific anticipated fire hazards ad how the fire fighting equipment provided is to be used. barrels. or heating operations is such that normal fire prevention precautions are not sufficient. When welding. or heating shall be done where the application of 2. since direct penetration of sparks or heat transfer may introduce fire hazard to an adjacent area. or heating is performed on walls. cutting. Open end fuel gas and oxygen hoses shall be immediately removed from enclosed spaces when they are disconnected from the torch or other gas-consuming device. For the elimination of possible fire in enclosed spaces as a result of gas escaping through leaking or improperly closed torch valves. or heating operation is being performed. or heating is undertaken on them. and for one half hour after completion of the work to ensure that no possibility of fire exists. Overnight and at the change of shifts. (See Hot Work Permit) • Drums containers. drums or other containers which have been contaminated with flammable materials unless the contamination is first removed so that there is no possibility of fire or emission of toxic vapors. a vent or opening shall be provided for the release of any built-up pressure during the application of heat. cutting. the torch and hose shall be removed from the confined space. cutting. cutting.36.

Flameproof. or hot metal. Transporting. c. Cylinders shall be moved by tilting and tolling them on their bottom edges. • • Valve protection caps shall be in place and secured. They shall not be intentionally dropped. body and hands should be covered to prevent burns from splatter. Respiratory equipment may be necessary if ventilation is not sufficient. moving. f. struck. When cylinders are hoisted. they shall be secured on a cradle. B. b.36. Other personnel in the vicinity of welding operations should be protected from reflections by suitable shields and barriers. The face. or sling board. The eyes and skin should be protected against the flare and radiation from a welding arc or flame. Bars shall not be 2. Gas Cutting/Welding Safeguards a.5 • • • . C.flammable paints or the presence of other flammable compounds. • • Helpers and attendants should also be provided with eye protection. they shall be secured in a vertical position. heat-insulating gloves should be worn during welding operations. slag. Should the elimination of fire hazards not be possible the area will be restricted and no welding or cutting shall be performed until it is safe to do so. or permitted to strike each other violently. Personal Protective Equipment a. Wet or excessively worn gloves should not be used. sparks. Valve protection caps shall not be used for lifting cylinders from one vertical position to another. or heavy concentrations creates a hazard. When cylinders are transported by powered vehicles. Specific operation requirements should be made by your supervisor. and sorting compressed gas cylinders. They shall not be hoisted or transported by means of magnets or choker slings.

No damaged or defective cylinder shall be used. for short periods of time while cylinders are actually being hoisted or carried. Oxygen cylinders should be separated from fuel-gas cylinders or other combustible materials by at least 20 feet or by fire-resistant barrier at least feet high. regulators shall be removed and valve protection caps put in place before cylinders are moved. • Unless cylinders are firmly secured on a special carrier intended for this purpose. whether full or empty. Treatment of welding gas cylinders. not boiling.36. and never used to lubricate oxygen cylinder valves or regulators. Grease and oil should be kept away from. • Oxygen from supply cylinders should be checked to make certain they are not leaking. shall not be used as rollers or supports. when cylinders are empty. if necessary. chain. water shall be used to thaw cylinders loose. • 2. When work is finished.6 . • • • b. the cylinder valve shall be closed. Acetylene cylinders must always be maintained in an upright position. • • • • Cylinders. A suitable cylinder truck. where it can cause ignition of materials that are not normally highly flammable. or other steadying device shall be used to keep cylinders from being knocked over while in use. or when cylinders are moved at any time. Warm. Compressed gas cylinders shall be secured in an upright position at all times except. especially in enclosed spaces.used under valves or valve protection caps to pry cylinders loose when frozen.

then close and attach an oxygen regulator to the valve. fire resistant shields shall be provided. Do not tamper with cylinder valves or try to repair them. first open the valve slightly for an instant.7 . or flame will not reach them. hot slag. if valves will no open by hand. Placing Cylinders • Cylinders shall be kept far enough away from the actual welding or cutting operation so that sparks.• • Do no handle oxygen cylinders with oily hands or gloves Before connecting an oxygen bottle. except when the cylinder is in use or being connected or disconnected. including the cylinder serial number. Valve protection caps should always be in place on those cylinders designed for caps. Never strike an arc against a gas cylinder. c. Do not use a hammer or wrench to open cylinder valves. Always stand to one side when opening the valve. and follow the supplier’s instructions.36. Empty gas cylinders should be marked and have their valves closed tightly. 2. Always open the cylinder valve slowly. • • • • Backflow or flashback presenters shall be installed on all oxygen/flammable gas welding and cutting units between the torch or blowpipe and the hoses. Send the supplier a prompt report of the trouble. Gas cylinders should be stored out of the direct rays of the sun and away from other sources of heat. When this is impractical. Gauges shall be maintained in good condition. notify the supplier. Cracked or missing glass shall be replaced prior to use.

For quick closing. Fuel gas cylinders shall be placed with valve end up whenever they are in use. Cylinders containing oxygen or acetylene or other fuel gas shall not be taken into confined spaces. They shall not be placed in a location where they would be subject to open flame.8 . valves on fuel gas cylinder shall not be opened more than 1 ½ turns. or other sources of artificial heat. the valve shall be opened slightly and closed immediately. flame.• Cylinders shall be placed where they cannot become part of an electrical circuit. The cylinder valve shall always be opened slowly to prevent damage to the regulator. Use of fuel gas. When a special wrench is required. which may damage the safety device or interfere with the quick closing of the valve.36. hot metal. or other possible sources of ignition. In the case of manifold or coupled cylinders. not in front of it. The employer shall thoroughly instruct employees in the safe use of fuel gas. To prevent regulator burnout regulators will be “backed out” whenever torch is turned off. Fuel gas shall not be used from cylinders through torches or other devices which are equipped with shot off valves without reducing the pressure through a suitable regulator attached to the cylinder valve manifold. • • • 2.) The person cracking the valve shall stand to one side of the outlet. at least one such wrench shall always be available for immediate use. it shall be left in position on the stem of the valve while the cylinder is in use so that the fuel gas flow can be shut off quickly in case of an emergency. as follows: • Before a regulator to a cylinder valve is connected. • • d. sparks. (This action is generally termed “cracking” and is intended to clear the valve of dust or dirt that might otherwise enter the regulator. Electrodes shall not be struck against a cylinder to strike an arc. The valve of a fuel gas cylinder shall not be cracked where the gas would reach welding work.

Oxygen and fuel gas hoses shall not be interchangeable. carrying acetylene. there is found to be a leak around the valve stem. and it shall be properly tagged and removed from the work area.36. rather than from the valve stem and the gas cannot be shut off. or any gas substance which may ignite or enter into combustion. or hose in doubtful condition. • • e. not more than 4 inches out of 12 inches shall be covered by tape. • • • • f.• Before a regulator is removed from a cylinder valve. In the event that fuel gas should leak from the cylinder valve. The contrast may be made by different colors or by surface characteristics readily distinguishable by the sense of touch. Defective hose. the cylinder shall be properly tagged ad removed from the work area. Torches 2. Defective hose shall be removed from service. Hoses • Fuel gas hose and oxygen hose shall be easily distinguishable from each other. the cylinder shall be removed from the work area. natural or manufactured fuel gas. oxygen. If a leak should develop at a fuse plug or other safety device. If. or be in anyway harmful to employees. Hoses. shall be inspected at the beginning of each working shift. shall not be used. the valve shall be closed and the gland nut tightened. ladders and stairs.9 . If a regulator attached to a cylinder valve will effectively stop a leak through the valve seat. the cylinder valve shall always be closed and the gas released from the regulator. When parallel sections of oxygen and fuel gas hose are taped together. cables and other equipment shall be kept clear of passageways. All hoses in use. A single hose having more than one gas passage shall not be used. the cylinder need not be removed from the work area. the use of the cylinder shall be discontinued. If this action does not stop the leak. when the valve on a fuel gas cylinder is opened.

Any current-carrying parts passing through the portion of the holder which the arc welding or cutter grips in has hand. and up connections. drills. the electrodes shall be removed and the holders shall be so placed or protected that they cannot make electrical contact with employees or conducting objects. to do so may expose the arc welder or cutter to electric shock. regulators. couplings. and are of a capacity capable of safely handling the maximum rated current required by the electrodes. Torches in use shall be inspected at the beginning of each working shift for leaking shutoff valves. Manual electrode holders • Only manual electrode holders which are specifically designed for arc welding and cutting. • D. Arc welding and cutting a. Hot electrode holders shall not be dipped in water.36. shall be fully insulated against the maximum voltage encountered to ground. • • • 2.10 . greasy clothes. Defective torches shall not be used. hose. Oxygen shall not be directed at oily surfaces. Oil and grease hazards • • Oxygen cylinders and fittings shall be kept away from oil and grease. cylinder caps and valves. and not by matches or from hot work. and apparatus shall be kept free from oil or greasy substances ad shall not be handled with oily hands or gloves. • g. or other devices designed for such purposes. Torches shall be lighted by friction lighters or other approved devices. Cylinders. shall be used. or within a fuel oil or other storage tank or vessel. and the outer surfaces of the jaws of the holder.• • Clean clogged torch tip openings with suitable wires. hose couplings. When electrode holders are to be left unattended.

Welding cables and connectors • All arc welding and cutting cables shall be of the completely insulated. flexible type. 2. Only cable free from repair or splices for a minimum distance of 10 feet from the cable to which the electrode holder is connected shall be used. taking into account the duty cycle under which the arc welder or cutter is working. shall be checked to ensure that the circuit between the ground and the grounded power conductor has resistance low enough to permit sufficient current to flow to cause the fuse or circuit breaker to interrupt the current. Grounding circuits. or when the arc welding or cutting machine is to be moved. Shielding .Whenever practicable. all arc welding and cutting operations shall be shielded by noncombustible or flameproof screens which will protect employees and other persons working in the vicinity from the direct rays of the arc. the power supply switch to the equipment shall be opened.11 • • . Ground returns and machine grounding • A ground return cable shall have a safe current carrying capacity equal to or exceeding the specified maximum output capacity of the arc welding or cutting unit which is services. All ground connections shall be inspected to ensure that they are mechanically strong and electrically adequate for the required current. capable of handling the maximum current requirements of the work in progress. • c. b. other than be means of the structure.36. except that cables with standard insulated connectors or with splices whose insulating quality is equal to that of the cable are permitted.• When the arc welder or cutter has occasion to leave his work or to stop work for any appreciable length of time. The frames of all arc welding and cutting machines shall be grounded either through a third wire in the cable containing the circuit conductor or through a separate wire which is grounded at the source of the current.

or for cleaning the work area. and heating a. blowing dust from clothing. Welding. Welding. b. f. e. Oxygen shall not be used for ventilation purposes. Ventilation and protection in welding. This system shall be of sufficient capacity and be arranged as to remove fumes and smoke at the source and keep the concentration of them I the breathing zone within safe limits.36. or heating of metals of toxic significance • • • • Zinc-bearing base or filler metals or metals coated with zinc-bearing materials. Contaminated air exhausted from a working space shall be discharged into the open air or otherwise clear the source of intake air. c. and heating in the way of prescriptive coating h.12 . Lead base metals (See Lead Compliance Plan). Local exhaust ventilation shall consist of freely movable hoods intended to be placed by the welder or burner as close as practicable to the work. 2. General mechanical ventilation shall be of sufficient capacity and so arranged as to produce the number of air changes necessary to maintain welding fumes and smoke within safe limits. g. cutting.E. All air replacing that withdrawn shall be clean and respirable. cutting. Cadmium-bearing filler materials. Chromium-bearing metals or metals coated with chromium-bearing materials. Other employees exposed to the same atmosphere as the welders or burners shall be protected in the same manner as the welder or burner. d. comfort cooling. cutting. Employees performing such operations in the open air without exhaust ventilation shall be protected by filter-typed respirators. i.

Artificial cooling of the metals surrounding the heating area maybe used to limit the size of the area required to be cleaned. a test shall be made by a competent person to determine its flammability. and heating in confined spaces. cutting.13 . The preservative coatings shall be removed to sufficient distance from the area to be heated to ensure that the temperature of the unstirred metal will not be appreciably raised. they shall be chipped from the area to be heated to prevent ignition. Protection against toxic preservative coatings shall be through ventilation and/or respiratory protection. Procedures need to meet confined space entry requirements.• Before welding. cutting. k. Preservative coatings shall be considered to be highly flammable when scrapings burn with extreme rapidity. 2. First-Aid Equipment shall be available at all times. Precautions shall be taken to prevent ignition of highly flammable hardened preservative coatings. When coatings are determined to be highly flammable. Welding. • • • j.36. All injures shall be reported as soon as possible for medical attention. or heating is commenced on any surface covered by a preservative coating whose flammability is known.

covered with damp sand or fire-resistive sheets. but is not limited to: Brazing. C. All wall and floor openings covered. the precautions checked on the Required Precautions Checklist have been taken to prevent fire. including any coffee or lunch breaks. Otherwise protect with fire-resistive tarpaulins or metal shields. HOT WORK BEING DONE BY: EMPLOYEE CONTRACTOR ________________________________ Available sprinklers. hose streams. charged small hose.HOT WORK PERMIT BEFORE INITIATING HOT WORK. Work on enclosed equipment Enclosed equipment cleaned of all combustibles.36. Issue PART 2 to person doing job. Combustible on other side of walls moved away. above and below. Soldering. Fire watch may be required for adjoining areas. Other Precautions Taken DATE PROJECT LOCATION/BUILDING & FLOOR NATURE OF JOB NAME OF PERSON DOING HOT WORK I verify the above location has been examined.14 . Work on walls or ceilings Construction is noncombustible and without combustible covering or insulation. Fire watch/Hot Work area monitoring Fire watch will be provided during and for 60 minutes after work. SIGNED: (FIRE SAFETY SUPERVISOR) PERMIT EXPIRES: DATE & TIME AM PM NOTE EMERGENCY NOTIFICATION ON BACK OF FORM. This includes. CAN THIS JOB BE AVOIDED? IS THERE A SAFER WAY? This Hot Work Permit is required for any temporary operation involving open flames or producing heat and/or sparks. Superintendent A. Fire watch is trained in use of this equipment and in sounding alarm. Complete and retain PART 1. and permission is authorized for this work. Grinding. B. 1. Explosive atmosphere in area eliminated. Floors swept clean. lint and oily deposits removed. Cutting. PART 1 INSTRUCTIONS Required Precautions Checklist MUST BE RETAINED AS RECORD OF HOT WORK ACTIVITY. dust. Fire watch is supplied with suitable extinguishers. Containers purged of flammable liquids/vapors. USE AS APPROPRIATE FOR YOUR FACILITY. Requirements within 35 ft (10m) of work Flammable liquids. Fire-resistive tarpaulins suspended beneath work. Torch Applied Roofing and Welding. Remove other combustibles where possible. Thawing Pipe. _________________________________________ _________________________________________ _________________________________________ 2. Verify precautions listed at right (or do not proceed with the work). Combustible floors wet down. and extinguishers are in service/operable. Hot Work equipment in good repair.

indicate time completed and leave permit posted for Fire Watch. Monitor: After 4 hours. 2. Required Precautions Checklist MAY BE RETAINED AS RECORD OF HOT WORK ACTIVITY. Containers purged of flammable liquids/vapors. including any coffee or lunch breaks. charged small hose. Signed:________________________________ Other Precautions Taken ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ _____ 2. and permission is authorized for this work. Fire-resistive tarpaulins suspended beneath work. Combustible floors wet down. Floors swept clean. Remove other combustibles where possible. HOT WORK BEING DONE BY: EMPLOYEE CONTRACTOR ________________________________ ⎮ PROJECT ⎮ LOCATION/BUILDING & FLOOR DATE NATURE OF JOB NAME OF PERSON DOING HOT WORK I verify the above location has been examined. Hot Work equipment in good repair. and extinguishers are in service/operable. leave permit posted and notify Fire Safety Supervisor. FIRE WATCH SIGN OFF Work area and all adjacent areas to which sparks and heat might have spread were inspected during the fire watch period and were found fire safe. After Hot work. do final inspection. Fire watch is supplied with suitable extinguishers. Fire watch/Hot Work area monitoring SIGNED: (FIRE SAFETY SUPERVISOR) TIME STARTED AM PM DATE & TIME FINISHED AM PM TIME AM PM PERMIT EXPIRES: Fire watch will be provided during and for 60 minutes after work. Work on enclosed equipment Enclosed equipment cleaned of all combustibles. hose streams. sign.15 . Signed:________________________________ FINAL CHECKUP Work area was monitored for 1 hour following Hot Work and found fire safe. Work on walls or ceilings Construction is noncombustible and without combustible covering or insulation. dust. Fire watch may be required for adjoining areas. sign and return to Fire Safety Supervisor. lint and oily deposits removed. Available sprinklers. All wall and floor openings covered.WARNING! HOT WORK IN PROGRESS WATCH FOR FIRES! PART 2 INSTRUCTIONS 1. Combustible on other side of walls moved away. covered with damp sand or fire-resistive sheets. Requirements within 35 ft (10m) of work Flammable liquids. Fire watch: Prior to leaving area. do final inspection. 3. Person doing Hot Work: indicate time started and post permit at Hot Work location. Fire watch is trained in use of this equipment and in sounding alarm. above and below.36. Otherwise protect with fire-resistive tarpaulins or metal shields. the precautions checked on the Required Precautions Checklist have been taken to prevent fire. Explosive atmosphere in area eliminated.

leading to bondbreaker absorption and poor parting characteristics. Also. and parking and truck areas. It is critical for the engineers and contractors to plan and review this process completely and thoroughly.2. Bondbreaker can be tested by dropping a small amount of water on the casting bed. o Check the slab and bondbreaker before pouring any concrete. The application of the curing compound on the floor slab is the most critical step in the preparation process.37. soapy feeling. steel trowel surface. For best results. A cure coat applied too late may render the slab highly permeable. Slab as a Work Platform o Initial grading of the site should include completion of all sub-grade work for the building floor. check job site restriction on tonnage or limitations on access to the site. Slab thickness and compressive strength must meet bracing designs. The erection of the wall panels is the most important phase of tilt-up construction. Effort must be directed to ensure that the tilting phase of the job is done safely and efficiently. the floor slab should have a hard. You may have to pour a thickened slab at brace locations Bondbreaker and Curing Compounds o Bondbreakers and curing compounds are among the most critical materials used on a tilt-up project. These products should have their performance criteria carefully evaluated. dense. This provides additional space for casting panels. Site Access and Job Conditions o It is advisable to investigate regulations on daily start up times. The tilt-up panels are normally cast on the floor slab of the building and any imperfection in the floor slab will be mirrored in the panel. o Plans should be made for stubbing all electrical and plumbing items below the finished floor level. the slab will only be as good as its sub-base. The slab should have a slightly tacky.37 PREPLANNING •  TILT-UP SAFETY • • • General Requirements o The nature of tilt-up construction dictates the need for thorough preplanning. Regardless of how much effort goes into producing a good slab. A roadbed and an accessibility ramp to the sub-grade should also be completed at this time. and provides an obstacle free area for crane movement. well compacted sub-grade. Emphasis must be placed on having a strong.1 revised 12/17/2009 . noise and dust control and job site perimeter fencing. The economy and success of tilt-up construction is realized by efficient on-site production operation and careful planning with each step of the construction sequence building on the previous step. o The quality of the floor slab in a tilt-up constructed building is extremely important. The application should begin immediately after the hard steel troweling and the dissipation of the excess bleed water. from two feet above 2.

37. Locate and prepare all pertinent embedded devices that are accessible. o Tilt-up panels should be cast as near as possible to their final location in the structure. For a smooth construction sequence. ERECTION • Preparation for Lifting o Clean the panel and the surrounding floor slab area. Mark locations and heights of all shims in case they are displaced. Place the identifying mark in a position that will not be exposed when the structure is completed. always apply more. drills. The structure footing should also be marked with the corresponding identifying numbers to give the erection crew clear indication where each panel goes. cleaned out and tested with a hardware unit several days prior to erection day. try to keep the distance as short as possible. if possible. two important criteria must be met: The panels must be located for efficient casting. Rotary hammers. Crane Certification o Cranes selected for tilt-up projects should be properly certified. The contractor should also 2. Attach all pipe braces and strong backs as required. o Each panel should be numbered and clearly identified according to the panel layout/erection sequence plan. If a panel must be "walked" to its final position. For larger panels. If the water does not bead. re-spray all of the suspected areas of the casting slab. Have additional cylinders cast on your last tilt panel pour. o All lifting inserts should be uncovered. level and plumb bob and a full set of hand tools should be available at the job site. A final note: whenever there is doubt about sufficient bondbreaker on the casting slab. "Walking" the panels should be avoided. Most states have standards with which erection subcontractors must comply. Contractors should make certain that they have documentation available at the job site attesting to the crane's certification. The footing should be appropriately marked to show the proper position of each panel on the footing. leveling shims. The panels must be located for safe and efficient erection. steel wedges. If the bondbreaker is applied correctly. pry bars. Do any dressing or patching that can be accomplished on the ground. cutting torch. An effort should be made to place as many side by side as possible. the water will bead into small droplets as it would on a freshly waxed automobile.2 revised 12/17/2009 • . Panel Casting Layout o The panel contractor should consult with the erection contractor in the development of a good casting layout. Have back up tools onsite. you may need a port-a-power for alignment. It is the cheapest insurance available for a successful tilt-up job.• to allow it to splatter. o Verify concrete compressive strength (f'c) at time of initial lift is at least the strength listed in the insert selection chart for the insert being used.

See attached safety check list and have all crew members go over it and sign it at the end of the safety meeting. this is the crane contractor's responsibility. These details are an integral part of the erection stress calculations and should be strictly adhered to. Braces are \usually attached to the panels prior to lifting. where all pertinent safety details are discussed and all questions answered. Inspect all rigging and hardware for alignment and be sure that the rigging is free of snags. All members of the erection crew will wear safety vests. Safety is everyone's responsibility and each crew member's safety depends on each other's safety practices. be sure that the braces will not be trapped by the rigging during the lift. The rigging foreman will wear high visibility gloves. they invariably tend to twist and rotate the hardware.• • • • obtain a letter of certification of liability insurance from the erection subcontractor. The rigging crew needs to be alert for this condition and halt the lift to realign the hardware. and how to use any necessary tools or equipment. Inspect all panels for projections (such as rebar) that may interfere with the process. make certain the sheaves are properly aligned. The erection details supplied by Tilt-up Technical Services Department will specify all rigging configurations and cable lengths required for the project. the rigger foreman should demonstrate the proper use of the lifting hardware and bracing hardware.37. o During the safety meeting.3 revised 12/17/2009 . If non swivel sheaves are being used. It is the rigger foreman's responsibility to be alert to any obstacles in the path of the panel and crew. This individual will be the one the crane operator looks to for all signals during the lifting process. Make sure the area is clear of spectators. Reinforce the need for all concerned to be alert during lifting. Be alert for panels sticking to the casting bed. o The rigger foreman should be identified at the safety meeting. Prior to Lifting o Check wind conditions prior to lifting a panel. If the crane is to use rolling outriggers. The rigger foreman must be experienced with handling panels and be familiar with the precise set of hand and arm signals to communicate with the crane operator. During the Lift o As the cables are being tensioned. Equipment and Crew o The panel contractor and erection contractor must itemize the rigging and equipment required for a proper and safe lift. Twisting the hardware can cause side loading. Only members of the erection crew will be allowed in area. Carefully positioned pry bars and/or wedges at the insert lines can often help the crane successfully release the panel from the casting bed. a warning to stay clear is in order. The erection details do not specify the diameter or safe working load of the rigging cables. 2. Day of Erection Safety Meeting o A full crew safety meeting should be held each day prior to lifting.

Coil bolts must have a minimum coil penetration through the insert coil. and attachment bolts bear fully on the hardware. no more than one panel behind the erection crew. If the panel being plumbed is a closure panel. depending on the building design. This should be accomplished as soon as possible.4 revised 12/17/2009 . unintended loading. Bracing anchors must be installed per manufacturers instructions. and end or cross bracing. 2. This excavated area can be up to five or six feet deep. take exact measurements prior to lifting to be sure the panel will fit. the lateral and end bracing can be completed. but are not bearing on concrete at the bottom of the void. When the bracing design specifies a subsequent system of knee. AFTER THE LIFT • When constructing the floor slab. putting the panel and workers in a dangerous position. Attempts to adjust a panel after subsequent bracing is in place would necessitate loosening or removing the bracing. Bracing Panels o All bracing should be in place and complete before relaxing the crane load. lateral. Bolted hardware must have full bearing on the concrete surface. generally three to five feet wide is often open to facilitate the footing excavation. Keep the area surrounding the panel clear of workers until the panel is firmly braced. Once the crane has cleared the area. do not use wedge anchors for braces. tightness of bolts must be checked. o Tilt-up panels should be as plumb as possible prior to attaching the bracing to the floor slab. Fine tuning of the panel plumb can be accomplished with the pipe braces. The perimeter strip must be backfilled and compacted very carefully to avoid movement or bending of the panel. o There are instances when the crane's position will prevent the lateral bracing to be completed. The supporting panels need to be accurately placed in their exact position to prevent the need of adjusting them after placement of the spandrel or lintel panel. Temporary out-of-plumb should not exceed 4" at the top of the panel. Bracing on erected panels must be completed at the end of the work day. the bracing does not appear adequate. and won't be backfilled until after the wall panels have been erected. After winds of more than 35 mph or more have been experienced.37. The crane load should be released slowly.• • Plumbing the Panels o Make certain that the panel being plumbed does not strike a previously erected panel or panel bracing. Caution must be taken so that the hardware is not subjected to a side loading that will cause an additional. a perimeter strip. o There are two common conditions that require a panel to be plumb before releasing the crane: When the panel is going to support an adjacent spandrel or lintel panel. Do not release the crane load if for any reason.

• • Wall braces should never be removed until all structural connections are complete.5 revised 12/17/2009 . If the building's structural drawings do not indicate when the braces can be removed. 2. the engineer of record should be consulted.37. Note that the perimeter strip between the floor slab and the wall panels is considered a structural connection.

Daily Tilt-Up Erection Safety Meeting Job Name____________________________ Date________________ Verify concrete meets minimum compressive strength required for erection Only erection crew allowed in area. (Use tri-square or other tool to reposition shims). Review location of crane access road and outrigger placement. Watch panel inserts during lift. Never allow heads. crew is often required to support braces. Verify correct bolts and torque required. Review panel erection sequence Review location for lifts and equipment If wedges are used to break the bond. watch out for pinch points. Designate who is authorized to tell rigging foreman to release panel. Area is flagged off to prevent unauthorized entry. Recheck if winds are in excess of 35mph Install panel clamps before end of shift. Kevlar work gloves) The rigging foreman will be the ONLY one the crane operator looks to for all signals. The rigging foreman will wear high visibility colored gloves.37. Place experienced crew member with inexperienced member. If cracks appear set panel down and consult with Engineering. Bracing on erected panels must be completed before end of shift. Review proper use of rigging and brace hardware. Check all bolts/braces daily. Designate clean up crew. More than one person may be required to support heavy braces. Special precautions must be taken during adverse weather conditions. Braces must never be held by the foot because a sudden movement of the panel will push the brace into the body. Review Emergency Response Plan and Rally Point location You cannot stop a moving panel 2. Use wood to guide panel in. Do not use a burke bar until panel is set down.6 revised 12/17/2009 . Tilt-up panels should be as plumb as possible prior to attaching the bracing to floor slab. Verify maximum wind speed for safe tilt erection. Crew and the crane may slip on wet or icy slabs. If the crane is to use rolling outriggers. and slab block outs and any other danger locations. Fingers must never be placed between footing and a panel being places. Brace should be passed under an arm to allow freedom of movement. Review each member of tilt crew’s role. Review locations of power lines. a warning to stay clear is in order. Temporary out-of-plumb should not exceed 4” at the top of the panel. Have proper back up equipment and tools available. During placement crew should never get behind a panel (on the underside of tilt). safety glasses. Stay alert at all times. When panel is traveling. worker using hammers should stand on the ground and not on the panel. hands or feet on the underside of a panel for any reason. hardhats. overhead obstructions. Ensure area is kept clean. Erection crew is wearing proper PPE ( safety vests.

All protruding reinforcing steel. eye protection and rubber boots shall be worn to protect employee from cement burns. No employee (except those essential to the post-tensioning operations) shall be permitted to be behind the jack during tensioning operations. or clothing that comes in contact with concrete.38 GENERAL REQUIREMENTS A.1 . that the structure or portion of the structure is capable of supporting the loads. No employee shall be permitted to ride concrete buckets. based on information received from a person who is qualified in structural design. E. Employees with a cement burn should immediately seek medical treatment. D. CONCRETE SAFETY Construction Loads No construction loads shall be placed on a concrete structure or portion of a concrete structure unless the employer determines. b. the damage has been done. Immediately rinse with clean water eyes. skin. 2. Riding Concrete Buckets. To the extent practical. elevated concrete buckets shall be routed so that no employee. Post-Tensioning Operations. Personal Protective Equipment Rubber gloves. onto and into which employees could fall. By the time an employee becomes aware of a cement burn. Working Under Loads a. a. shall be guarded to eliminate the hazard of impalement. F. concrete safety and barriers shall be erected to limit employee access to the post-tensioning area during tensioning operations. and the burn can continue to get worse even after the cement has been rinsed off.2.38. C. Reinforcing Steel. b. or the fewest number of employees are exposed to the hazards associated with falling concrete buckets. Signs. B. No employee shall be permitted to work under concrete buckets while buckets are being elevated or lowered into position.

d. g. fabricated. e. d. Never kink the hose Watch out for pinch points Never straddle or sit on a pressurized pipeline Only one person should signal the pump operator. erected. Do not look into the end of a plugged hose or pipe Stay away from the point of discharge when starting or restarting.CONCRETE PUMPING A. c. B. If necessary. Do not walk backwards. the hose man. c.38. f. b. Have the pump operator test soil bearing capacity by slowly moving empty boom over each outrigger. Lateral concrete pressure on forms is affected by the following: a.2 . h. stay out of the path of the boom. Never hold the hose with your shoulder. supported. b. or when there’s air in the pipe. CAST IN-PLACE CONCRETE A. Position the pump so a minimum safety distance of 17 feet is maintained in all the boom positions needed to do the job. the operator and the spotter should agree on hand signals. Concrete Pump Setup a. Safety Rules for the Placing Crew a. Never open a pressurized pipeline Do not hug the boom hose. f. Check soil conditions before jacking the outriggers. Avoid hazardous proximity or contact with electric lines. Before the pour begins. hold it with both hands to allow the hose to move freely. and maintained so that it will be capable of supporting without failure all vertical and lateral loads that might be applied to the formwork. Concrete pour rates for wall forms must not be exceeded. Height of pour Pour rate Unit weight of concrete 2. braced. b. Consider the safe approach and departure of the ready-mix trucks. i. e. use cribbing or suitable pads to increase the area of soil contact. General Requirements For Formwork Formwork must be designed. c. Never hang more than one pipe or hose from the boom Maintain a safe distance between the concrete and the edge of a cliff or excavation.

f. Measures must be taken to prevent unrolled wire mesh from recoiling. b. and similar vertical structures must be adequately supported to prevent overturning and collapse. C. but are not limited to. piers. and such conditions have been followed. during. The plans and specifications stipulate conditions for removal of forms and shores. columns. Shoring equipment that is found to be damaged or weakened after erection must be immediately reinforced. B. c.38. Temperature Type of cement Vibration Concrete slump Chemical Additives Shoring And Re-shoring All shoring equipment must be inspected prior to erection to determine that the equipment meets requirements specified in the formwork drawings. or The concrete has been properly tested with an appropriate ASTM standard test method designed to indicate the concrete compressive strength. and immediately after concrete placement. e. 2. h. Re-shoring shall not be removed until the concrete being supported has attained adequate strength to support its weight and all loads in place upon it. Such measures may include.3 . Erected shoring equipment must be inspected immediately prior to. Reinforcing Steel Reinforcing steel for walls. Damaged shoring equipment must not be used for shoring. and the test results indicate that the concrete has gained sufficient strength to support its weight and superimposed loads. Removal Of Formwork Forms and shores (except those used for slabs on grade and slip forms) must not be removed until it is determined that the concrete has gained sufficient strength to support its weight and superimposed loads. securing each end of the roll or turning over the roll.d. Such determination shall be based on compliance with one of the following: a. D. g.

The limited access zone for a masonry wall that is not reinforced and braced in accordance with requirements must run the entire length of the wall.39   A. B. Reinforced Masonry Walls. the limited access zone shall remain in place until the bracing requirements have been met. A limited access zone must be established when constructing a reinforced wall. No other employees are allowed to enter the zone without permission from a competent person.1 b. in which case. b. • A limited access zone must be located on the side of the wall not scaffolded. c. The limited access zone shall be restricted to entry by employees actively engaged in constructing the wall. and extend away from the wall a distance equal to the height of the grout pour plus four feet. . The limited access zone shall remain in place until the wall is adequately supported to prevent overturning and to prevent collapse unless the height of wall is over eight feet. 2. The limited access zone shall be established on the side of the wall which will be un-scaffolded. No other employees shall be permitted to enter the zone. A limited access zone must be established before construction of the wall begins. Non-reinforced Masonry Walls. • Entry into the limited access zone is limited to employees actively engaged in construction of the wall.39.2. and extend away from the wall a distance equal to the height of the wall plus four feet. A limited access zone must run the entire length of the wall.       REQUIREMENTS FOR MASONRY CONSTRUCTION                  LIMITED ACCESS ZONE A limited access zone shall be established whenever a masonry wall is being constructed. C. • All activity within the limited access zone is under the direction and control of a competent person. a. The limited access zone shall be established prior to the start of construction of the wall. a.

A qualified person demonstrates that modifications per (B. or follow the following requirements. The bracing system must be designed by a registered professional engineer. Design bracing systems according to (d) and (e) below install them under the direction of a competent person. Bracing must remain in place until permanent supporting elements of the structure are in place. A registered professional engineer must design bracing when there is one or more of the following: • • • • The wall is more than 24 feet in height. . If any of these conditions exist.)(c. b. The wall is eight feet or less in height.) listed below are adequate when addressing these or other inherently more stable conditions: • • • • • • B. The minimum requirements of this section are not met.2 b. Permanent supporting elements of the structure are in place a. During construction of a masonry wall. Masonry pilasters. When wind speeds reach 35mph. intersecting walls. or Corner returns. When speeds reach 25mph all braces must be examined and the site made secure. BRACING FOR MASONRY WALLS All masonry walls over eight feet in height must be adequately braced to prevent overturning and collapse unless the wall is adequately supported. Change in wall thickness. Infills in existing walls.• • • A competent person is responsible for monitoring wind speed. Construction in protected areas. Stack bond Or high wind areas. The limited access zone must remain in place until any wall over eight feet in height is adequately braced or supported to prevent overturning and to prevent collapse. Shafts. the bracing is not needed: a. all employees in the limited access zone and in proximity to the wall under construction must move to a safe location. 2. A.39. adequate bracing must be in place to prevent the wall from overturning or collapse.

A structural masonry wall bracing system must be designed by a qualified person. 2000psi grout required at reinforced areas. pullout force. The brace angle must not be greater than 60 degrees from the horizontal. Option 1 – Low Lift Grout Walls-Bracing structural masonry walls when grout pours are limited to 5’-4” or less in height. for use in Options 1 or 2: Note: This information may be included in the blueprints. The base connection of brace must consist of a minimum ¾” anchor attached to either a 4” minimum thick slab or deadman.#4 horizontally and 1 .) Metal concrete tilt braces.39. concrete block laid in running bond pattern Type S mortar. The horizontal bracing distance from an end of wall or control joint must not exceed 10’.#5 vertically at 48” on center. placed around a structural rebar located at an un-grouted bond beam. d. The design and installation of the bracing system must comply with the following requirements: • Minimum design requirements. A qualified person must determine if walls less than 20’ in length require two braces. 2. The slab or deadman connection must resist a minimum 3400lbs.250 lb.3 . The connection of the brace to the masonry wall must consist of a minimum ¾”straight coil loop insert.c. Wall height not to exceed 24’. F’m 1500psi. with minimum placement of 2 . 60ksi rebar. including minimum requirements per chapter 26 of the Uniform Building Code. At least one structural rebar must be located between the attached bar and face shell that receives brace (see figure 1). • Minimum field requirements for use in Options 1 or 2: The horizontal spacing distance between two or more braces must not exceed 20’. Straight coil loop insert with coil bolts (safe working load = 2.

4” of additional wall may be laid with reinforcement located to receive straight coil loop inserts at a bond beam location.4 . 2. A maximum 5’-4” of additional wall may be laid with reinforcement located to receive straight coil loop inserts at the bond beam location. Low Lift is similar. e. See attached diagram of High Lift Grout sequence of construction. The first brace must be connected to the wall insert and attached to slab or deadman at base of wall. A maximum 5’. No more than 4’ of un-grouted wall above the brace point is permitted. • • • • • • • • A maximum 8’ of the initial wall height may be laid with minimum reinforcement and then grouted.• • • • • • A maximum of 8’ of initial wall height may be laid with minimum reinforcement and then grouted. Option 2 – High Lift Grout Walls-Bracing structural masonry walls with grout pours up to 8’ in height. The reinforced section must be grouted. Braces must be connected to coil loop inserts in the wall and attached at the base to either a slab or deadman. The wall may be laid and reinforced up to the grout pour. Additional wall may be construction following the steps above. Grouting may be done after each section of wall is adequately braced. A maximum of 8’ of additional wall height may be constructed and braced following steps above.39. See attached diagram for sequence of construction.

2.39.Figure 1. Straight coil loop insert attached to rebar with perpendicular rebar between it and face shell to receive brace.5 .

39.2.6 .

JOBSITE WEEKLY SAFETY MEETINGS When working as the General Contractor.40. SUBCONTRACTOR SAFETY MEETINGS When working as the General Contractor. LLC WEEKLY SAFETY MEETINGS Superintendents will hold weekly Tool Box Safety Meetings and require all Pence/Kelly jobsite employees to attend. The meeting shall be documented and a copy returned to the Salem Office. You should discuss site specific concerns. www. You may use the topics from “Weekly Safety Meetings for the Construction Industry”.toolboxtalk. See attached form for documentation of revised 4/29/05 . superintendents will hold weekly jobsite safety meetings with all workers on site.40 SAFETY MEETINGS PENCE/KELLY CONCRETE. At a minimum the following topic should be discussed: • Required PPE • Job Specific Safety Requirements • Upcoming tasks and conditions onsite • Employee Orientation • Equipment training requirements • Safety concerns and questions • Any Accidents/Incidents/Near Misses 2. You may use the same resources above. superintendents will hold weekly safety meetings with subcontractors at the foreman’s meeting. Any hazards noted at Safety Meeting must be investigated immediately and corrective action must be taken to preclude potential hazards.2. or other topics which are site specific.

40.2 revised 4/29/05 .WEEKLY JOB SITE SAFETY MEETING Job Name: Date: Topic: (Staple to Back) Special Topics for Your Project: Employee Safety Recommendations: Reviewed MSDS # Meeting Attended By: Name and Company Subject: Supervisor’s Signature: (Continue on back if required) 2.

Meeting Attended By (continued): 2.3 revised 4/29/05 .40.

bench mount or floor mount grind wheels on metal surfaces are required to wear leather gloves. All workers using hand held. General Requirements a. and hearing protection must be worn during operation. respirator or hearing protection. so handle them with the same respect and safety precautions. Before use. and that the barrel is free of obstructions. chaps. Construction Industry Regulations. Backpack Type Gas Powered Leaf Blowers and Similar Tools a. POWER AND POWDER-ACTUATED TOOLS All Pence/Kelly Concrete.41. the tool should be checked to see that it is clean. competent and authorized personnel to use powder actuated tools. D. SAFETY RULES FOR OPERATION A. B. The RPM rating on all grinding machine motors must not exceed the speed rating of the grinding wheel attachment. such as a face shield. POWDER-ACTUATED TOOLS Permit only trained. Operators must have a operators card supplied by the manufacture. All workers using hot saw or chop saw type tools on metal surfaces are required to wear goggles or a face shield/safety glass combination. Abrasive Wheels and Tools a. B. All workers are required to place both arms through the shoulder straps when operating this tool. Subdivision I – Tools – Hand and Power. metatarsal protection. All workers are required to wear 18 inch flame retardant protective sleeves on both arms when operating this tool. in addition to the following: HAND AND POWER TOOLS A. C. b. 2. C. These tools should not be used in an explosive or flammable environment. goggles or a face shield/safety glass combination. The tool should NEVER be pointed at anyone. LLC Employees and Subcontractors working on a Pence/Kelly project must comply with OR-OSHA regulation 29 CFR 1926. b. Additional personal protective equipment (PPE). that all moving parts operate freely. c. These tools operate like loaded guns.1 Revised 7/7/09 . E.41 HAND. leather gloves.2. Safety shield or glasses. All body parts should be kept clear of the barrel end. may be required while operating a tool.

you should hold the tool in the fixed position for at least 30 seconds and then unload with extreme caution. K. G. Fasteners must not be driven into very hard or brittle materials that might. Misfired loads should be placed in water. Load powder-actuated tools just before use. The muzzle end of the tool must have a protective shield or guard centered perpendicularly on the barrel to confine any flying fragments or particles the tool might create when it is fired. Store tools and cartridges in a locked container. Do not carry cartridges loose or in a pocket. Do not leave powder-actuated tools unattended. B. If the tool develops a defect. Use only fasteners recommended by the manufacturer. H.41. chip. Warning signs must be posted stating “POWDER-ACTUATED TOOLS IN USE” Clean and maintain tools according to manufactures recommendations. G. FASTENERS A. it should be tagged and removed from use immediately. or make the fastener ricochet. In steel. Do not carry loaded tools job to job. Use the tool at a right angle to the work surface. H. Fasteners must not be driven into material that would let them pass through the other side. C.F.2 Revised 7/7/09 . 2. the fastener must not come any closer than ½” from a corner or edge. J. D. Provide adequate ventilation in confined spaces where powder-actuated tools may be used. Do not attempt to force a cartridge in a tool. If the tool should misfire. F. The fastener must not be driven into materials like brick or concrete close to an edge or corner. splatter. I. Make sure to use the correct loads for the job. E.

___ Emergency Action Principles ___ Hazard Communication Notice ___ Listing of Hazardous Chemicals ___ Trained Employees in use of Hazardous Chemicals ___ Trained Employees in Ladder Use ___ Forklift/Equipment Trained Employees ___ Fall Protection Plan ___ Color Code for Equipment Grounding ___ Assured Equipment Grounding Prog. __________ __________ __________ __________ State of Oregon “Commonly Required Postings in Oregon” ___ First Aid Emergency Medical Serve. __________ __________ __________ __________ __________ Revised 10/2/2009 2.A Page 1 of 3 . ___ Fire extinguishers at or within 25’ of fuel using equipment ___ No Smoking signs posted in refueling areas ___ Fire extinguishers are placed at or within 25 feet of contact of any fuel using equipment. __________ Fire Extinguishers inspection dates are current. as required.42. ___ Sexual Harassment Policy ___ EEO Policy ___ Workers Compensation “Notice of Compliance” ___ Address of Jobsite ____ Provisions for firefighting equipment and plan in case of fire. __________ __________ Fire extinguishers every 3000 sf of protected building area or 100’ of travel ___ Fire extinguisher on each floor of multi-story structure.WEEKLY JOBSITE SAFETY INSPECTION CHECKLIST Job Name: _____________________________________ Inspection performed by: Date: _____________ __________________________________________________ Superintendent’s Signature: ___________________________________________________ ITEM FIRST AID Approved first aid kit is on Site and well stocked. All employees are wearing safety glasses and hard hats. MSDS sheets from subs are in job shack. All necessary safety sign are posted. Band-Aids ___ Tweezers ___ 8”x10” Gauze Pads ___ Blanket ___ Moist Towelettes ___ Eye Wash ___ 3”x3” Gauze Pads ___ Triangle Bandage ___ Scissors ___ Blood Pathogen Kit ___ IN COMPLIANCE NOT ACCEPTABLE __________ __________ Any First Aid trained personnel on site Safety equipment box is on site and well stocked. Safety Glasses ___ Clear Lens ___ Ear Plugs ___ Hard Hats ___ Grey Lens ___ Gloves ___ Goggles ___ __________ __________ __________ __________ MSDS book is in jobshack.

ELECTRICAL IN COMPLIANCE and inspected. SCAFFOLDING/FALL PROTECTION Ladders and scaffolds are in safe working condition. dismantling. Scaffolds erected correctly ___ Mobil scaffolds are secure ___ Scaffold bracing secure ___ Sound. diesel. outlets. junction boxes. Ground fault circuit interrupters (GFCI’s) __________ __________ __________ __________ __________ __________ Protection/grounding for temporary lamps ___ Controlled access to installations operating at over 600 volts ___ Equipment used in manner prescribed ___ No splicing and tapping electrical cords___ No polarity of conductors OK ___ Unused opening in boxes must be closed and conductors entering boxes must be protected from abrasion. Secondary Containers are properly labeled. rigid.A Page 2 of 3 . and load capable footings and anchorages ___ Scaffolds tightly planked ___ Ladder/stair affixed for access/egress ___ Stair rail and/or handrail in place ___ Competent person supervision during erection. oxygen and acetylene are labeled and stored properly. ___ GFCI or Assured grounded program___ FUELS Fuels. etc. ___ Covering provided for pull boxes. Proper ventilation is provided and utilized in confined spaces. Torch cutting equipment has back flash arresters and is labeled "Use no Oil". gas. ___ Locked/pinned legs to prevent uplift ___ Lifeline support on suspension scaffolds ___ __________ ___________ __________ ___________ __________ ___________ __________ __________ __________ __________ Ladder in place for elevations over 19” ___ Ladders extended 3’ above landing ___ Portable ladders secured ___ Stair rails required at 30” elevation change or 4 risers ___ Watch swing radius for doors/gates at stairway ____ Open sided floors or platforms are protected properly. and etc. __________ NOT ACCEPTABLE Electrical cords are property coded Jan-Mar: white Apr-Jun: green ___ ___ __________ Jul-Sep: red ___ Oct-Dec: orange ___ Temporary power cords are protected from vehicle traffic. Power tools have guards in place around moving parts. __________ __________ Revised 10/2/2009 2. such as propane.42.

A Page 3 of 3 . Floor openings are protected and property labeled.42. __________ __________ __________ __________ __________ __________ Daily inspection of physical components of trench and protection systems ___ Spoil pile protection ___ Access/Egress from trench/excavation ___ High visibility garments are required when exposed to vehicular traffic. EXCAVATIONS Excavations are properly shored and/or protected. tag and date. Rebar protection is in place where required. date and sign Employee close calls or Incidents Explain: __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ __________ ____________________________________________________________________________________ Please add any other important safety items not listed above. Backup alarms on moving equipment are in working order. Grease and oil spills are promptly cleaned up to prevent slipping. _______________________________ _______________________________ Tool Box safety sheet read. ____ EQUIPMENT Forklift baskets are in good condition and are attached to forklift. HOUSEKEEPING Work areas are clean and free of debris. and lanyards are used when required and inspected for tears or frays. Revised 10/2/2009 2.IN COMPLIANCE Safety harnesses. NOT ACCEPTABLE __________ ___________ Proper slings or chokers are used while lifting or pulling loads. belts.

PENCE/KELLY CONCRETE. EQUIPMENT TRAINED PERSONNEL PROJECT: SUPERINTENDENT: EQUIPMENT: The following people have been trained in the use of the equipment specified: Print Name Signature Forklift Scissor Boom Other Date: 2.B .42. LLC.

D.S. As-built updates. P/K Supervision required onsite Weekly Foreman’s Meetings.PENCE/KELLY CONCRETE. Salem OR 97302 (503) 399-7223 Portland (503) 224-8681 Fax (503) 585-7477 Your Job Name Job Address Subcontractor Orientation Checklist Subcontractor__________________________ Date________ M. If it looks wrong. LLC 2747 Pence Loop SE.C . on file Subcontract signed and returned Insurance Certifications submitted to Salem Office Weekly Safety Meetings required Site Specific Safety Plan Assured Grounding Program Scaffold Training Fall Protection Equipment Training Rally Point ____________ Hard Hats and PPE required Appropriate behavior and clothing Jobsite Working Hours. write a RFI.____________ Daily Reports (Due at 0800 next day) Staging Areas Prevailing Wage Job ____ Yes _____No Check in with Superintendent when onsite Parking Area Jobsite Information Box in Trailer Do not deviate from plans/specs without approval.Before cover and must be updated monthly Extra Stock requirements Inspection requirements Composite Cleanup Crew on Friday’s at 0800 Radio’s allowed ____No _____Yes 2.S.____________.42.

42.Union rules Parking Jobsite Phone # ____________ 2. DO NOT ENTER Yellow Caution Ribbon.Caution.D.PENCE/KELLY CONCRETE.D .Break and Lunch time Tool Storage. Enter with care and only when necessary Appropriate behavior and clothing First Aid Kit Locations Fire Extinguisher Locations Assured Grounding Program Scaffold Training M.S. Salem OR 97302 (503) 399-7223 Portland (503) 224-8681 Fax (503) 585-7477 Your Job Name Employee Jobsite Orientation Checklist Name______________________ Date_______ Fall Protection Plan Report ALL Accidents/Incidents Emergency Response Plan Rally Point ______________ Hard Hats Required Eye Protection Required Glove Policy Red Danger Ribbon.S. LLC 2747 Pence Loop SE. Equipment Training Site Specific Forklift Training Ladder Training Respirator Program Jobsite Working Hours.Extreme danger.

Pence/Kelly makes no promises. agents and employees) from and against any and all loss. maintenance of. Pence/Kelly shall have no duty to Equipment User to inspect. Further. about the quality of.7477 www. nor on any representations of Pence/Kelly regarding the Equipment’s general condition or its fitness for this use. However. OR DOWN CCB #146525 503.EQUIPMENT USER RENTAL AGREEMENT. LLC (“Pence/Kelly”) is using Equipment on this project. REPRESENTATIONS AND WARRANTIES ARE HEREBY EXPRESSLY DISCLAIMED. INDEMNIFICATION AND RELEASE Job #: Project: Equipment Type (“Equipment”): Company Using/Operating Equipment Person Using/Operating Equipment Use of Equipment. employees. INCIDENTAL. it did not rely on Pence/Kelly’s expertise. Safety Instruction. or operation of the Equipment. the undersigned Equipment User hereby agrees to the foregoing. Pence/Kelly Concrete. UNDER NO CIRCUMSTANCES SHALL PENCE/KELLY BE LIABLE TO EQUIPMENT USER FOR ANY SPECIAL. Release of Rights. Duty to Indemnify and Defend. ALL OF WHICH PROMISES.224. 503. cost. but with consideration in the form of Equipment User’s promises herein. LOSS OF USE. employees and any others who Equipment User allows to use the Equipment with his express or implied approval) has been trained by a person qualified in the subject matter to recognize the hazards associated with the type of equipment being used and to understand the procedures to control or minimize those hazards per the rules and regulations of the state in which the Equipment is being used or operated. cost. Equipment User agrees that it is renting the Equipment on a non-exclusive basis. and without any right to priority with regard to the time(s) it may use the Equipment. and (d) Equipment user agrees that scheduling for use of the Equipment shall be at the sole discression of the Pence/Kelly Project Superintendent. and those for whose conduct Equipment User is legally responsible). INCLUDING WITHOUT LIMITATION THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. Equipment User shall defend and indemnify Pence/Kelly (including without limitation all its officers. representations or warranties. and hold Pence/Kelly harmless from all loss. Pence/Kelly will allow such non-exclusive rental usage of the Equipment only if any such person or entity using the Equipment (the “Equipment User” or “Lessee”) agrees by signing this document (a) that Pence/Kelly shall have no liability to the Equipment User relating to such use.399. Disclaimer of Warranty. safe use of.pencekelly. OR CONSEQUENTIAL DAMAGES. damage or expense (including without limitation attorneys’ and expert witness fees) arising out of or relating to such use by Equipment User (including without limitation use by Equipment User’s agents. Lessee acknowledges that in deciding to use the Equipment. No Representations or Warranties by Pence/Kelly. and Indemnity by the Equipment User. Equipment User Bears the Risk of Use.O. Equipment User further agrees that this Rental Agreement is not intended by the parties to be a construction agreement within the meaning of any rules and statutes of the state in which the Equipment is being used or operated. indemnify. WHERE IS. 503.7223 Fx. EXPRESS OR IMPLIED. and on the basis that the Equipment is being so rented to Equipment User AS IS.8681 Portland . maintain or safely operate the Equipment. Pence/Kelly is willing to rent the non-exclusive use of the Equipment to certain others at the above referenced project site without monetary consideration to Pence/Kelly.585. (c) that Equipment User shall to the fullest extent permitted by law defend. OR 97302-8109 Ph. claim. Waiver of Rights. (b) that the Equipment User expressly waives and releases all rights against Pence/Kelly (as more fully set forth below) arising out of or in any way relating to such use. damage penalty or liability of any Owner: Prime Contractor: Scaffold Forklift P. Pence/Kelly MAKES NO WARRANTIES. but instead is a personal property rental agreement for the use of the Equipment without monetary consideration. By signing this Rental Agreement. express or implied. INCLUDING BUT NOT LIMITED TO DAMAGES FOR DELAY. The Equipment User acknowledges that he (or his agents. inspection of. DISRUPTION. Box 4109 2747 Pence Loop SE Page 1 of 1 Salem.

terms. damages or corrective measures. and whether or not contributed to by any wrongful or negligent act or omission. employees. resulting from the failure to comply therewith. and each party will be responsible for its proportionate share of any damages awarded. The Equipment User shall be liable to Pence/Kelly Construction for all loss. Box 4109 2747 Pence Loop SE Page 2 of 2 Salem. 503. any fines. The Equipment User agrees to be bound by. In the event any provision or portion thereof of this Rental Agreement becomes less than fully operative. then this provision shall nevertheless be enforceable to the greatest extent permitted.585. and all others for whose acts or omissions Equipment User is legally responsible). The indemnification shall not be limited in any way by any limitation on the amount or type of damages.O. or any violation of law. If this obligation is limited in part. Nothing in this Rental Agreement shall be construed to negate. state and local laws. and at its own cost. ordinances and regulations applicable to safety. Pence/Kelly will promptly reimburse Equipment User for the attorneys fees and costs incurred by the Equipment User in defending Pence/Kelly to said tender of defense multiplied by the Percentage of Own Fault. at which time such duty will cease to the extent that a party being defended is found to have been negligent. Once a court of competent jurisdiction has determined that Pence/Kelly was negligent in whole (100%) or in part (less than 100%) (the “Percentage of Own Fault”). penalties. the parties expressly agree that the court or arbiter shall construe such provision to the fullest extent it can be enforced under applicable law. If any provision of this Rental Agreement or any portion of a provision shall at any time be held to be invalid in whole or in part under any applicable federal or state law. Final Agreement. agents and employees). disability benefit acts or other employee benefit acts. assure that its conduct and that of its agents or employees (a) complies at all times with all federal. conditions or obligations other than those contained herein. No Oral Modification. or otherwise reduce any other right or obligation of indemnity that would otherwise exist as to any party or person. then such provision shall remain in effect and enforceable to the fullest extent it can be validly construed under applicable law. LLC By: ____________________________ Title:_____________ Date: ________ P.pencekelly. or contamination of or adverse affects on the environment and any clean-up costs in connection therewith. agree to the above. ruling or regulation. There are no promises. but not limited to. including without limitation injury to or death sustained by any person (including without limitation Equipment User’s employees) or damage to property of any kind (including loss of use). cost and expense attributable to any acts of commission or omission by the Equipment User. procedures and rules applicable to this CCB #146525 503. (c) complies at all times with the Safety Procedures. any others who Equipment User allows to use the Equipment with his express or implied approval. (b) complies at all times with all Pence/Kelly Construction safety standards. the Equipment User.8681 Portland . governmental regulation. including. and the remaining provisions hereof shall remain in full force and effect. I. OR 97302-8109 Ph. COMPLIANCE WITH LAWS and STANDARDS. and (d) at all times is safe while using the Equipment.kind.399. actual or alleged. whether active or passive. rules or orders. of Pence/Kelly (including without limitation all its officers. This obligation to defend and indemnify shall be enforced to the fullest extent allowed under applicable law. or be unenforceable in whole or in part for any reason. This Rental Agreement is the final and entire agreement of the parties and supersedes all prior and contemporaneous oral or written communications or agreements between the parties relating to the Equipment.7223 Fx. arising out of or relating in any way to use of the Equipment by Equipment User (including without limitation its agents. ____________________Date: _______ Equipment User Signature Print name: ____________________________ Pence/Kelly Construction. as well as for 100% of its further attorneys fees or costs incurred thereafter in defending the claim. including without limitation attorney fees. Equipment User’s duty to provide defense will continue until there is a determination by a court of competent jurisdiction that Pence/Kelly was negligent in whole or in part. 503. compensation or benefits payable by or for the Equipment User under worker's or workmen's compensation acts. This Rental Agreement shall not be supplemented or modified in any way except in a writing signed by the party against whom the modification is asserted and stating that it modifies or amends this Rental Agreement.7477 www. Successors. or abridge. Savings Clause.

The undersigned. from and against. In the event any clause. injuries and any and all other claims of any type whatsoever for personal injury (including death) and other loss or damage of any nature whatsoever for the injury to myself and/or damage to my personal property. including any underground areas. Each of the undersigned acknowledges the risk(s) and voluntarily assumes such risk(s). and assume the risk. it shall in no manner effect the other clauses. representatives and assigns Date Company Name Visitor's Name Signature . for any and all damages. and indemnify Pence/Kelly Concrete. is and are dangerous and that risk of serious accident or injury is inherent. as if the clause. LLC . terms and provisions hereof. her or their respective heirs. losses.Visitor’s Hold Harmless Agreement In consideration of being permitted for my own purposes and interest to enter upon the premises or construction site of Pence/Kelly Concrete. acknowledges that the Project sites. the project Owner. and its consultants. hold harmless. term or provision of this agreement shall be declared or adjudicated void or invalid. and subcontractors. sustained or caused while on such premises or site. which shall remain in full force and effect. and each of us. This release and hold harmless agreement is binding upon the undersigned and each of his. term or provision so declared or adjudicated invalid were not originally a part hereof. LLC. I hereby release.

INITIAL BY AND DATE     SAFETY ISSUE/HAZARD SPECIFIC LOCATION RECOMMENDED CORRECTIVE ACTION RESPONSIBLE CONTRACTOR * Return Completed Form(s) to Superintendent. Updated 6/8/09 . *** If not completed by stated date the work will be completed for you and charged accordingly. Page of .Date: Company: LCG Pence and Pence/Kelly Field Employee Safety Walk Through Report Conducted By: Submitted To: ITEM COMPLETED CONTRACTOR PLEASE COMPLETE SUPT. ** Please respond immediately if you feel one or more of these issues is not yours to correct.

a 5-10 minute program designed to prepare personnel for work and conditioning. B. This shall be done at least at the start of every shift for all Pence/Kelly Employees. Performing this program as a group helps create a team atmosphere and helps build employee morale. Over time. The company has an outstanding safety record and believes that all accidents are preventable. • Bend your knees and lift with your legs. the safety of our workforce is our number one priority. as a result. strength and range of motion-all of which enhances a person’s capacity to do physical work without injury. This means pre-planning and scheduling large equipment such as cranes and forklifts.43 . the exercises have been shown to raise workers’ energy levels and to improve flexibility. get help. D. Back strains and other related injuries account for more than half of all work related incidents. C. Use material handling equipment as much as possible to do the heavy lifting. Employees taking part in Stretch and Flex should recognize improvements in their flexibility and energy levels and. E. The basic rules for safe lifting: ( see attached safe lifting techniques) • Plan the lift. • If the load is too heavy.2. • Move close to the load. 2. Some of these activities can be physically demanding on an employee so it is important for employees to maintain physical health and condition in order to provide their best work effort. Unfortunately. many workers only learn how to lift safely after already hurting their back. At Pence/Kelly. Stretch and Flex. may stretch more regularly on their own. Stretch and flex also helps employees prepare themselves mentally for the tasks they are about to performanother important factor in reducing the potential for a work-related injury. • Do not lift and twist in the same motion. • Keep your back straight. Employees at Pence/Kelly Concrete perform physical activities while at work.43 PURPOSE AND SCOPE Stretch and Flex Program   A.( see attached stretching examples) F. G.