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Fall Protection Plan and Appt

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lloyd.cooper5
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14 views

Fall Protection Plan and Appt

Uploaded by

lloyd.cooper5
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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FALL PROTECTION PLAN

Contractor Name:
Event Name:
Event Date:

The following documents must be supplied with this fall protection plan for all employees
performing work at heights, above 1.5 meters:
• Work at height and fall protection training certificates
• Medical certificates of fitness valid for the period of the event (Note: medical
certificates must be renewed annually)
• Inspection checklists for access equipment and fall protection equipment

1. List of activities taking place at height (above 1.5m from the ground):

2. List of equipment used to access work at height (e.g. ladder, scaffold, cherry picker etc):

3. List of fall protection equipment to be used (e.g. harness, life line etc):

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4. Who will be appointed from the company to ensure adherence to the fall protection plan:

5. List of staff who will be working at heights. Medical certificates of fitness must be
available for each of these employees:

6. Who will be inspecting and maintaining the fall protection equipment and how often will
they inspect it?

7. Rescue Plan - How will employees who fall and are suspended by their harness lanyard
be rescued?

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FALL PROTECTION PLAN COORDINATOR APPOINTMENT

CONSTRUCTION REGULATION 8

A contractor shall cause⎯

(a) the designation of a competent person, responsible for the preparation


of a fall protection plan;

(b) the fall protection plan contemplated in (a) to be implemented, amended


where and when necessary and maintained as required;

(a) steps to be taken in order to ensure the continued adherence to the fall
protection plan.

I, (Employer Name)

representing (Company Name)

do hereby appoint (Name of Appointee)

as the Fall Protection Plan Coordinator in terms of Construction Regulation 8(1),

at (Event Name)

Signature of Employer Date

ACCEPTANCE OF APPOINTMENT

I, do hereby accept this appointment

and understand the scope of my responsibilities as the Fall Protection Plan Coordinator in
terms of Construction Regulation 8(1).

Signature of the appointee Date

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