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Fall Protection Work Plan

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rapha
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11 views

Fall Protection Work Plan

Uploaded by

rapha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Fall Protection Work Plan

Worksite _______________________ Job Location_______________________________

Supervisor______________________ Start Date_____________ End Date___________

1. Description of Fall Hazards:

2. Fall Protection System to be employed:

Fall Arrest Travel Restraint Procedures


Guardrails Work Platform Aerial Platform
Scaffold Control Zone Safety Net

3. Procedure for assembly of system:

Manufacturer’s instructions (see attached)


Other (describe below)

4. Procedure for inspection of system and components:

Manufacturer’s instructions Daily inspection using checklist below

5. Procedure for maintenance of system:

Manufacturer’s instructions Other (list below)


6. Method used to determine attachment point(s):

Engineer evaluation Blueprints


Manufacturer’s data Judgement of Competent Personnel

7. Procedure for handling, securing and storage of tools:

No tools allowed in elevated area No tools or materials within 2m of edge


Tools and materials secured (describe below)

8. Procedure for protection of workers below:

Barricades/warning signs Toe boards/coverings Other (list below)

9. Procedure for rescue of fallen or injured worker(s):

Tools and equipment needed (list below)

Emergency communication signal -


Number of personnel required -
External emergency services number -
Contact to be made by -
Procedure:
10. Identification of safety watch personnel:

11. Inspection Checklist:

All tags are legible Stitching is secure


Manufacturer’s assembly instruction No holes or burns in web material
Horizontal lifeline tension correct No cuts or frays in web material
Anchor points are adequate All components are clean
Protection for workers below employed No signs of heat damage
Guardrails are sound and secure No signs of chemical damage
Hole covers secure and adequate No signs of ultraviolet damage
Tools and equipment are secure Buckles and D-rings are free from damage
Self Retracting Lifelines are free from Snap hooks/carabiners are free from
damage and have swivel damage
Fall indicators have not been deployed Snap hooks/carabiners are self closing and
locking
All workers are trained All workers understand this plan
Other

Fall Protection Plan completed by:____________________________________________

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