Professional Documents
Culture Documents
Contractor Job Safety Plan: Project Name
Contractor Job Safety Plan: Project Name
Contractor Job Safety Plan: Project Name
Project Name:
TABLE OF CONTENTS
1.0
General Information..................................................................................................................................................................................................... 3
2.0
Project Tenets and Principles....................................................................................................................................................................................... 4
3.0
Job Scope Overview.................................................................................................................................................................................................... 5
4.0
Risk Assessment and Hazard Identification................................................................................................................................................................. 6
Revised: 11/13/2012
Page: 1 of 15
Table of contents can be updated by right clicking on it and choosing update field
1.0
General Information
Chevron Pipe Line
Company
Date
:
Location:
City:
Job ID:
Developed
for:
State
:
Job Description:
Name
Telephone
Cell Phone
CPL Contact
Contractor Foreman
Contractor Safety
Representative
Revised: 8/9/2012
Rev. 01
Page 2 of 15
2.0
(800) 284-3015
(877) 502-9466
Always:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
3.0
See instructions for an example of a typical project scope breakdown needed to accomplish an effective hazard analysis.
Revised: 8/9/2012
Rev. 01
Page 3 of 15
Location
Company
Revised: 8/9/2012
Rev. 01
Page 4 of 15
Major Equipment
4.0
See instructions for an example of a typical risk assessment of a Work Activity/Task Description.
Work Activity:
Revised: 8/9/2012
Rev. 01
Mitigations
Page 5 of 15
Temperature
Overhead work
Falling object
Excavation
Collapsing roof/equipment
Elevated/Uneven work surface
Open holes
Other:
Motion
Ignition source
Hot/Cold surfaces
Hot/Cold liquids
Hot/Cold gases
Hot/Cold weather conditions
Other:
Other:
Chemical
Vehicle/Equipment movement
Limited mobility (confined
space)
Material movement
Water/Wind movement
Body positioning/Ergonomics
Manual Lifting
Other:
Mechanical
Rotating equipment
Compressed springs
Drive belts and conveyors
Motors
Power/Hand tools
Other:
Electrical
Power lines (above/below)
Energized equipment
Static charges
Wiring
Batteries
Other:
Pressure
Hard hat
Safety shoes
Safety glasses
Face shield
Goggles
Cotton gloves
Leather gloves
Chemical gloves
Electrical rated gloves
Chemical suit
Work vest/Life vest
Full body harness
Hearing protection
Fire Resistant Clothing
Other:
Other:
Personal Monitors
Tag line
Safety cable
Safety Barricade
Caution tape
Area Monitors
Other:
Other:
Safety Equipment
Biological
Animals/Insects
Bacteria/Viruses
Blood Borne Pathogens
Contaminated food/water
Other:
Other:
Radiation
Lighting
Welding arc/flash
Sunlight
X-rays
NORM scale
Other:
Fire Extinguishers
Fire retardant tarps
Locks and tags
Gas detectors
Emergency/Contingency Plans
Spill Control
Spill Contingency Plans
Emergency Evacuation Plans
Environmental Equipment
Incident Reporting Procedure
Early Injury Management
Other:
Certification Requirements
Sound
Certified Welder
Qualified Crane Operator
Qualified Rigger
Qualified Signal Man
Competent Person
Scaffolding Inspector
Asbestos Abatement
Lead Abatement
Other:
Hazard
Rev. 01
Mitigation
Page 6 of 15
Absorbent pads
Containment pans
Other:
Licensing Requirements
Revised: 8/9/2012
Break Rotation
Temporary Lighting
Isolation of Hazardous Energy
Equipment Inspections
Other:
Other:
Other:
Explosive/Flammable vapors
Carcinogen Compound
Toxic Compounds
Corrosive Compound
Reactive Compounds
Pyro-phoric material
Other:
Equipment noise
Impact noise
Venting noise
Communication (SimOps)
Communication (Language)
Other:
Piping
Cylinders
Vessels/Tanks
Hoses
Other:
Other:
Work Permits
PPE Program
Warning signs
Pipeline markers
Spotters/Attendants
Barricades
Housekeeping
Work Activity:
Gravity
Overhead work
Falling object
Excavation
Collapsing roof/equipment
Elevated/Uneven work surface
Open holes
Other:
Motion
Ignition source
Hot/Cold surfaces
Hot/Cold liquids
Hot/Cold gases
Hot/Cold weather conditions
Other:
Other:
Chemical
Vehicle/Equipment movement
Limited mobility (confined
space)
Material movement
Water/Wind movement
Body positioning/Ergonomics
Manual Lifting
Other:
Mechanical
Rotating equipment
Compressed springs
Drive belts and conveyors
Motors
Power/Hand tools
Other:
Electrical
Power lines (above/below)
Energized equipment
Static charges
Wiring
Batteries
Other:
Pressure
Rev. 01
Work Permits
PPE Program
Warning signs
Pipeline markers
Spotters/Attendants
Barricades
Housekeeping
Break Rotation
Temporary Lighting
Isolation of Hazardous Energy
Equipment Inspections
Other:
Other:
Other:
Explosive/Flammable vapors
Carcinogen Compound
Toxic Compounds
Corrosive Compound
Reactive Compounds
Pyro-phoric material
Other:
Hard hat
Safety shoes
Safety glasses
Face shield
Goggles
Cotton gloves
Leather gloves
Chemical gloves
Electrical rated gloves
Chemical suit
Work vest/Life vest
Full body harness
Hearing protection
Fire Resistant Clothing
Other:
Other:
Personal Monitors
Tag line
Safety cable
Safety Barricade
Caution tape
Area Monitors
Other:
Other:
Safety Equipment
Biological
Animals/Insects
Bacteria/Viruses
Blood Borne Pathogens
Contaminated food/water
Other:
Other:
Radiation
Lighting
Welding arc/flash
Sunlight
X-rays
NORM scale
Other:
Fire Extinguishers
Fire retardant tarps
Locks and tags
Gas detectors
Emergency/Contingency Plans
Spill Control
Spill Contingency Plans
Emergency Evacuation Plans
Environmental Equipment
Incident Reporting Procedure
Early Injury Management
Other:
Certification Requirements
Certified Welder
Qualified Crane Operator
Qualified Rigger
Qualified Signal Man
Competent Person
Scaffolding Inspector
Sound
Equipment noise
Impact noise
Venting noise
Piping
Cylinders
Revised: 8/9/2012
Mitigations
Temperature
Page 7 of 15
Absorbent pads
Containment pans
Other:
Licensing Requirements
Asbestos Abatement
Lead Abatement
Other:
Communication (SimOps)
Communication (Language)
Other:
Safe Work
Bypassing Critical Protection
Confined Space
Diving
Mitigation
Work Activity:
Gravity
Overhead work
Falling object
Excavation
Collapsing roof/equipment
Elevated/Uneven work surface
Open holes
Other:
Motion
Ignition source
Hot/Cold surfaces
Hot/Cold liquids
Hot/Cold gases
Hot/Cold weather conditions
Other:
Other:
Chemical
Vehicle/Equipment movement
Limited mobility (confined
space)
Material movement
Water/Wind movement
Body positioning/Ergonomics
Manual Lifting
Other:
Mechanical
Rotating equipment
Compressed springs
Drive belts and conveyors
Motors
Power/Hand tools
Other:
Electrical
Power lines (above/below)
Revised: 8/9/2012
Mitigations
Temperature
Rev. 01
Work Permits
PPE Program
Warning signs
Pipeline markers
Spotters/Attendants
Barricades
Housekeeping
Break Rotation
Temporary Lighting
Isolation of Hazardous Energy
Equipment Inspections
Other:
Other:
Other:
Explosive/Flammable vapors
Carcinogen Compound
Toxic Compounds
Corrosive Compound
Reactive Compounds
Pyro-phoric material
Other:
Hard hat
Safety shoes
Safety glasses
Face shield
Goggles
Cotton gloves
Leather gloves
Chemical gloves
Electrical rated gloves
Chemical suit
Work vest/Life vest
Full body harness
Hearing protection
Fire Resistant Clothing
Other:
Other:
Personal Monitors
Tag line
Safety cable
Safety Barricade
Caution tape
Area Monitors
Other:
Other:
Safety Equipment
Biological
Animals/Insects
Bacteria/Viruses
Blood Borne Pathogens
Contaminated food/water
Other:
Other:
Radiation
Lighting
Welding arc/flash
Fire Extinguishers
Fire retardant tarps
Locks and tags
Gas detectors
Emergency/Contingency Plans
Spill Control
Spill Contingency Plans
Emergency Evacuation Plans
Certification Requirements
Page 8 of 15
Environmental Equipment
Incident Reporting Procedure
Early Injury Management
Other:
Absorbent pads
Containment pans
Other:
Licensing Requirements
Sunlight
X-rays
NORM scale
Other:
Certified Welder
Qualified Crane Operator
Qualified Rigger
Qualified Signal Man
Competent Person
Scaffolding Inspector
Sound
Pressure
Equipment noise
Impact noise
Venting noise
Communication (SimOps)
Communication (Language)
Other:
Piping
Cylinders
Vessels/Tanks
Hoses
Other:
Other:
Asbestos Abatement
Lead Abatement
Other:
Mitigation
5.0
Description
Description
Abrasive Blasting
Safety Observation/Audit
Scaffolding Safety
Hazmat Training
HAZWOPER Training
Water Survival
Welding/Cutting
Bloodborne Pathogens
Helicopter Safety
Other
Hot Taps
Other
Commercial Diving
Hot Work
Other
Revised: 8/9/2012
Rev. 01
Page 9 of 15
Electrical Safety
Lifeboat Safety
Offshore Diving
Fall Protection
Fire Safety
Radiation Control
Fire Watch
Respiratory Control
6.0
Hazard Communication
7.0
Revised: 8/9/2012
Rev. 01
Page 10 of 15
Hazard
Potential Source
Avenue of Exposure
Inhalation
Skin/Eye
Ingestion
Ammonia Nitrate
-Valve/Pump
Packing
Asbestos
-Gaskets
-Pipe
Coating
-Brakes
-Pipe
-Building
Materials
Operations and
Maintenance
-Insulation
-Sampling
-Crudes
-Spill Clean
up
-Products
Benzene
-Checking
Leaks
-Solvents
-Condensates
Bloodborne Pathogens
-Confined
Space
-Tank
Cleaning
-Tank
Inspections
-Waste
Handling
Rescue or Emergency
Activities
-Welding
-Hot Equipment
Burns
-Sunlight
-Vehicle Emissions
-Fire Combustion
Carbon Monoxide
Operations and
Maintenance
-Product
-Pipe Coating Material,
Herbicides, and Pesticides
Maintenance
-Weather
-Nitrogen Trucks
Cold
Operations, Maintenance,
Line Purging
-Refrigeration units
Epoxy Resins
Revised: 8/9/2012
-Abrasive
blasting
-Old
buildings
-Vaults
-Pipeline Coating
-Sealants
Rev. 01
Operations and
Maintenance
Operations and
Maintenance, Pipeline
Repairs
Page 11 of 15
Hazard
Potential Source
Avenue of Exposure
Inhalation
Skin/Eye
Ingestion
Other
-Scaffolding
Falling Object
-Construction zones
-Cranes
Fiberglass
Insulation
Operations and
Maintenance, Repairs
Grinding Dusts
Repairs,Grinding on
equipment, fabrication
Operations and
Maintenance, Pipeline
Repairs
H2S
Heat
-Offices
-Switch Gear
-Engines
-Hot Crude
Lines
Operations and
Maintenance, Pipeline
Repairs
Operations and
Maintenance, Pipeline
Repairs
Hydrocarbon Vapors
Operations and
Maintenance, Pipeline
Repairs
L.P.G.
Operations and
Maintenance, Pipeline
Repairs
Lube Oils
Operations and
Maintenance
Lyme Disease
Ticks
-Engines
-Pumps
-Compressors
Revised: 8/9/2012
Rev. 01
-Switches
Welding rods
ROW clearing
Metal Fumes
-Furnaces
Hydrocarbon Liquid
Mercury
Operations and
Maintenance
-Environmental
-Steam lines
-PRVs
Page 12 of 15
Hazard
Potential Source
Avenue of Exposure
Inhalation
Skin/Eye
Ingestion
-Hand Tools
Heavy
equipment
N.O.R.M.
Oxygen (lack of)
PCBs
Transformers
Pollen
Vegetation
Sewage
Operations and
Maintenance, pipeline
repairs and installs
Sharps
Operations and
Maintenance, pipeline
repairs and installs
Silica/sand
Operations and
Maintenance, pipeline
repairs and installs
Snake Bites
Snakes
Solvents
-Degreasers
-Paints
Water
-Gulf of Mexico
-Rivers, Stream
-Lab chemicals
Operations and
Maintenance, pipeline
repairs and installs
Operations and
Maintenance, pipeline
repairs and installs
Revised: 8/9/2012
Rev. 01
Page 13 of 15
8.0
Environmental
Wastes Generated:
Waste Management Procedure:
Environmental Permit Compliance:
Spill Prevention and Containment:
Sensitive Area Protection:
9.0
Managing Subcontractors
10.0
11.0
12.0
Security Measures
13.0
14.0
Communication
15.0
Revised: 8/9/2012
Rev. 01
Page 14 of 15
Phone
Phone
Phone
Phone
Contact
Phone
Phone
Phone
Phone
877-502-9466
Incident Response:
HAZWOPER Emergency Plan: (Refer to instructions for requirements. This section should be discussed in detail. Append additional documents as
appropriate.)
Revised: 8/9/2012
Rev. 01
Page 15 of 15