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Programmatic Safety Plan (PSP): Required for High Risk Routine & Repetitive Work
Contractor Name:
Our company is committed to Safety, Quality & Customer Service. More specifically, we are committed to perform work on behalf of PG&E in a manner which ensures Public & Worker safety at all times as well as to providing a quality work product which meets or exceeds PG&E's expectations. We will work in a manner which meets all of PG&E Standards and Procedures as well as all applicable regulations, ordinances & permit conditions. This programmatic safety plan outlines, but does not limit, the specific measures we will be utilizing on a daily basis to identify and mitigate hazards on PG&E work as well as ensuring worker and public safety. I am accountable on behalf of our organization for ensuring that all requirements below are met anytime work is performed on behalf of PG&E, either directly or through a contractor.
Signed: / Print name: / Date:
Title: / Responsible Person for implementing PSP/Title:
Item # / Action Description / Accountable Person
1 / No work is started on behalf of PG&E without having clearly defined & established scope of work through a CWA, contract or other written & signed PG&E contractual document. This scope of work is clearly communicated to our site supervision and is used in the process of preparing daily JHA. / Owner
2 / Our company and our personnel have reviewed, understand and will follow all applicable safety regulations, including but not limited to all PG&E, OSHA & all other applicable safety regulations. This specifically includes being familiar with PG&E hazards associated with the SOW, our facilities, assets and the Contractor Safety Standard (Utility Standard SAFE-3001S). / Owner
3 / Our company will provide competent and experienced supervision and oversight for all personnel 100% of the time while working on behalf of PG&E. In the case where we are performing work that requires additional qualifications (e.g. excavation work, fall protection, etc.) we will ensure that a competent or qualified person is present. / Owner
4 / Our company will ensure that only experienced, qualified and properly trained personnel are assigned to work on behalf of PG&E. We will maintain training records for all personnel as required by OSHA regulations. Training records shall be made available to PG&E upon request. / Owner
5 / Our company clearly understands and commits to subcontracting portions of our work only with the written permission of PG&E. In cases where PG&E agrees to subcontract work, only PG&E qualified subcontractors will be used. Approval includes the requirement of an A or B rating in ISN as well as a Gold Shovel Certification if the work involves excavation. / Owner
6 / Safety hazards are identified, communicated and mitigated. This involves all employees working on behalf of PG&E
(1) This includes specifically holding an initial contract pre-start meeting and requiring a daily JHA and tailboard, to review:
· The project scope of work
· All hazards associated with the work and mitigations
· Permit conditions
· Applicable PG&E safety policies
· The emergency response plan
· Applicable Company IIPP sections associated with the work
(2) Special emphasis includes communicating to all our employees:
· The right, obligation and responsibility to stop unsafe work
· Requirements for completing and documenting a JHA and holding safety tailboards with the entire job crew on a daily basis, at the start of a new shift, or more frequently whenever conditions or the scope of work changes
· The requirement to keep records of all safety tailboards, JHAs and safety plans and make them available to PG&E upon request
· An emergency response plan for each project, including providing closest medical facility and jobsite address. This notification may take the form of one or more white board placards posted where they are visible to all employees working at the site
· The obligation to immediately report to PG&E all safety incidents; including those involving the public / Owner & Job Foremen
7 / Every employee working on behalf of PG&E will have completed the appropriate personnel on-boarding, as prescribed by PG&E, prior to starting work. Our company will maintain records of this onboarding. No personnel will be assigned to work on behalf of PG&E without having completed the assigned onboarding. / Owner
8 / We will Conduct a JHA and safety tailboard with all construction personnel at a minimum once daily at the beginning of every shift and whenever new shifts start, new crews arrive, or conditions or scope of work changes. We will maintain JHA copies for a period of three years following the work. / Owner & Job Foremen
9 / SCOPE OF WORK: The standard scope of work performed on behalf of PG&E is ______(Add typical scope of work performed by company here). / Owner
10 / HAZARD IDENTIFICATION: The hazards encountered as part of this scope could include, but are not limited to: / Owner
GENERAL HAZARDS
  • Uneven Ground/ Slips/ Trips & Falls
  • Confined Spaces
  • Driving
  • Power Tool / Equipment Use
  • Ergonomics
  • Loading / Off-loading Equipment and Material
  • Unstable Ground Conditions
  • Safety-At-Heights / Scaffolding / Ladders
  • Cave-ins/ Excavating / Trenching / Shoring
  • Welding / Oxy Acetylene / Grinding
  • Fires/ Hot work
  • Aggressive Animals / Dogs / Etc.
  • High Crime Areas
HEALTH HAZARDS
  • Chemical Exposure / Burns
  • Noise Exposure
  • Pesticides / Fumigation
  • PCB / Lead / Mercury
  • Asbestos
  • Other Soil Contaminants
  • Hazardous Material Transportation
  • Hazardous Waste Transportation
  • Radioactive Exposure
ENVIRONMENT HAZARDS
  • Weather Conditions
  • Poison Oak
  • Bees, Wasps, Snakes, Spiders
  • Heat Illness
ELECTRICAL HAZARDS
  • Clearance Procedures / LOTO / Grounding
  • Underground / Overhead Utilities
  • Proximity to Energized Equipment
  • Induction
/ GAS HAZARDS
  • Oxygen Deficient Atmosphere
  • Explosive Atmosphere - Burns / Explosions
  • Clearance Procedures / LOTO
  • Dig-Ins / Line Strikes
  • Unmarked or Mismarked Utilities
PUBLIC SAFETY
  • Distracted, Impaired, Unsafe Motorists
  • Vehicular Traffic (Work Area Protection)
  • Pedestrian Traffic
  • Proximity to Railroads
EXCAVATION
  • Access / Proximity to Energized Equipment Proximity to Energized Circuits
  • OH/UG Energized Lines
  • Overhead Objects
  • Appropriate Tools & Equipment
  • Equipment Certifications
  • Blasting Safety / Certification
  • Confined Space
  • Driving
  • Environmental Issues
  • Open Excavation / Fall Restraint
  • Fire Protection
  • PPE
  • Proper Lifting / Ergonomics
  • Public Safety /Sidewalks / Roads
  • Soil Type / Conditions / Shoring / Sloping
  • Site Safety
  • Slopes / Terrain
  • Spoils Management
  • Traffic / Transport / Flagging
  • USAs
  • Work Site Protection
  • Weather
/ CRANE
  • Crane Capacity
  • Crane Size
  • Load Weight
  • Lift Plans
  • Traffic / Transport
  • Setup/Access
  • Stability / Terrain
  • Rigging
  • Cribbing
  • Dangerous Operations
  • Driving
  • Equipment Certification
  • Operational Certification
  • Electrical Hazards
  • Equipment Grounding
  • Clearances
  • Environmental issues
  • Experience
  • PPE
  • Suspended Loads
  • Weather Conditions
TRAFFIC CONTROL / FLAGGINIG
  • Environmental Conditions
  • Non-Compliant Drivers
  • Pedestrian Safety
  • Permits
  • Public Safety
  • Qualifications / Certifications
  • Site Specific Hazards
  • Traffic Control Plan
  • Low Light Conditions
  • Weather
  • Work Site Protection

11 / HAZARD MITIGATION: In addition to the safe work practices included in our Injury & Illness Prevention Program, the specific hazard mitigation measures used on PG&E work will typically include: Add task, hazard, mitigation and required training below for each major task performed on behalf of PG&E: / Owner
Task Description / Hazard Description / Hazard Mitigation / Required Training
Task 1
Task 2
Task Description / Hazard Description / Hazard Mitigation / Required Training
Task 3
Task 4
Task 5
Task 6
12 / We will regularly update this safety plan anytime our scope of work, hazards or mitigations change. We will ensure all of our employees are briefed on this plan and are adhering to it at all times. / Owner
13 / All of our employees working on behalf of PG&E will know and understand that they have the right, obligation and the responsibility to stop and report any unsafe work. / Owner
14 / All of our employees working on behalf of PG&E will have this safety plan readily accessible to them for their review. Additionally, the emergency plan will be at the job location. All employs shall understand and follow this safety plan and emergency plan. The emergency plan shall cover such items as emergency communication protocols, phone numbers, escape routes, emergency equipment, muster points, closest hospital and medical facilities. / Owner
15 / Note: This Programmatic Safety Plan is in addition to our existing IIPP.
16 / Any additional items add below: