Rev. # / 0 / Rev. date: / 12/2/2010
Page: / 1 of 3

Safety Plan

For

Location[Insert Name of Vessel]

  1. Introduction

1.This Safety Plan is initiated for [insert task name and vessel], from [insert beginning and end dates of task] and applies to all [ ] employees and subcontractors.

a.The work will include:

[insert task items or summary of the statement of work].

b.Spaces affected:

[insert spaces].

2.References:

a.NAVSEA Instruction 5100.15A, NAVSEA OCCUPATIONAL SAFETY AND HEALTH (OSH) PROGRAM POLICY AND GUIDANCE

b.NAVSEA Standard Items

c.29 CFR 1915, OSH Standards for Shipyard Employment

d. Environmental, Health, & Safety Manual [insert additional local standards or other applicable references, or delete if NA]

  1. Purpose

1.This Safety Plan specifies the functions, responsibilities and actions which must take in support of the [insert task and vessel] in accordance with references (a) and (b).

2.This plan along with the set of all local safety requirements specifies the total set of requirements for this installation.

  1. Applicability

1.This Safety Plan is applicable to the [insert task name, vessel and beginning and end dates of the task].

  1. Description and Precautions [delete any items which do not apply]:

1.This is an industrial installation. Hazardous work is involved. Hazardous materials will be used and hazardous waste will be generated. Portable electrical, pneumatic, and hydraulic tools will be used and temporary services will be required.

2.Personnel shall follow the OSHA, Navy, , and local safety and health rules and regulations to maintain a safe work environment and to prevent mishaps from occurring. Técnico employees, subcontractors, Team Leads and EHS Officials shall inspect job sites frequently in order to identify unsafe conditions or work practices, and shall communicate them to supervision or management. Steps shall be taken in the task planning stage to prevent unsafe conditions and work practices, but if they are discovered during the task they shall be abated as soon as possible and, at the discretion of anyone on the work team, prior to continuation of work.

3.Potential hazards associated with the task shall be discussed with all employees and subcontractors associated with the task prior to the start of work, and routinely or as necessary thereafter. Aspects of emergency evacuation and muster policy, energy control (tagout), protection of deck openings and unguarded edges, and confined space entry shall be discussed at a minimum and as necessary.

4.Job Hazard Analyses shall also be discussed at task briefs with all employees and subcontractors associated with the task. These JHAs shall cover the common and/or most hazardous tasks, and shall be maintained in the work package for reference and shall be provided to the SUPERVISOR upon request. New JHAs shall be developed for tasks as necessary.

5.All personnel shall wear Personal Protective Equipment (PPE) in accordance with procedures including, but not limited to hard hat, safety glasses, face shields, steel or composite toed shoes, flash lights, hearing protection in spaces with elevated noise levels, and respirators (when required).

6.Fall protection [will/will not] be required for this task. Should a need arise for an employee to be positioned five feet or more above a solid surface, fall protection shall be implemented in accordance with procedures.

7.Confined Space Entry [will/will not] be required for this task. Should a need arise; Confined Space Entry shall be in accordance with procedures, NAVSEA Standard Items, and 29 CFR 1915. The [insert Ship’s name] shall be notified prior to entering any confined space. If required, Marine Chemist services will be arranged by Técnico’s. Gas analysis and assessment of other hazards shall be accomplished by a qualified Marine Chemist and/or an Qualified Shipyard Competent Person, as appropriate. The Marine Chemist certificate and/or Shipyard Competent Person Certificate shall be posted at the entrance of any confined space authorized for entry. Only workers who have completed the Técnico’sConfined Space Hazard Awareness training shall be permitted to enter and work in confined spaces.

8.Hotwork shall be accomplished in accordance with procedures, NAVSEA Standard Items, and 29 CFR 1915. Gas analysis and assessment of other hazards shall be accomplished by a qualified Marine Chemist and/or an Qualified Shipyard Competent Person, as appropriate. The Marine Chemist certificate and Shipyard Competent Person Certificate shall be posted in the space that is authorized for Hotwork. Técnico’s Hot Work Notice shall be approved by Ship’s Force and be posted in the space to authorize Hotwork. The Hotwork area shall be inspected prior to Hotwork to identify and control any fire safety hazards, to include the opposite sides of bulkheads, decks, and overheads, as appropriate. A qualified fire watch shall be assigned and shall maintain a fully charged and operable fire extinguisher of the appropriate classification. The fire watch must remain on-site for 30 minutes from the time Hotwork is concluded and the areas are cool to the touch.

9.Electrical Safety practices shall be followed in accordance with Electrical Safety Procedures. In addition, more stringent local requirements or vessel’s instruction for safe electrical practices shall be followed.

10.Tagout and Work Authorization shall be accomplished in accordance with local instructions [insert name of locality or vessel if necessary], the Tagout Users Manual, and Tagout and Work Authorization Procedures. Request for Tagout shall be made by submission of a Work Authorization Form (WAF) or Tagout request and Tracking Form. All tags shall be attached or removed by Ship’s Force only. After an energy source is tagged out by Ship’s Force, an electrician shall verify the Absence of Voltage daily, prior to use or more often as necessary.

11.All employees and subcontractors shall be familiar with the local [insert name of location or vessel] Fire Safety Plan and Fire Safety Plan. The plans shall be followed to minimize work site hazards, and to respond to emergencies.

12.In case of emergency or accident, all local and NAVSEA instructions shall be followed. The Government Representative/SUPERVISOR signee of this document will be the POC for the Alteration Installation Team (AIT) performing this work. Injuries/material property damages will be reported to the Government Representative/SUPERVISOR within 24 hours or as soon as possible.

13. shall conduct periodic site safety assessments of Técnico employees and subcontractors while working aboard [insert name of vessel or shipyard facility]. Safety assessments shall be documented and provided to the Government Representative/SUPERVISOR upon request.

14.The SUPERVISOR or Work Integration Leader for [insert name of task] will be contacted to coordinate any Temporary Power and Ventilation needs.

15.Materials and equipment shall be marked or tagged to display the company name, point of contact, phone number, item description and contents. Markings and/or tags shall stay attached and legible until the materials and equipment are removed.

16.The Government Representative/SUPERVISOR shall be provided a complete list of subcontractors (by name) hired by Técnicofor the [insert name of task and vessel] prior to the subcontractor(s) commencing work.

17. and its subcontractors shall ensure that Material Handling Equipment (MHE) and Aerial Work Platforms (AWP) are operated and maintained in accordance with OSHA standards and manufacturer’s specifications. Operators of MHE/AWP shall have met training and licensing requirements. Documentation of training/licensing shall be provided to the SUPERVISOR upon request. Operators shall conduct and document a daily operational check prior to operation of MHE/AWP. Such documentation shall be maintained for the duration of the period of performance of the prime contract and copies shall be provided to the SUPERVISOR upon request.

18.Scaffolding shall be built and maintained in accordance with OSHA standards and manufacturer’s specifications or under the direction of a Professional Engineer. Scaffold manufacturer’s specifications shall be provided to the SUPERVISOR upon request. Scaffolding must be tagged to display the stage of completion, the load capacity, and availability for use. Tags must remain attached and legible. Marine scaffolding must meet the guidance provided in OSHA’s Guidance Document: Safe Work Practices for Marine Hanging Staging, latest publication.

19.Points of Contact for Contractor Mishap Reporting:

Name / Title / Phone Number
[insert name] / [insert title of Gov’t Representative]
[insert name] / Project Manager
[insert name] / Team Lead
Local EHS Manager/Official
  1. Activity Signatures

1. personnel and contractors involved with the work addressed by this Safety Plan agree to the functions, responsibilities, and actions assigned above for the [insert name of task] being accomplished on/at [insert location or vessel].

(Print Name of Government Representative/Supervisor) / Title
(Signature) / Date
(Print Name of / Team Lead) / Title
(Signature) / Date