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HBI - Fall Protection Work Plan

HBI

Fall Protection Work Plan

Employees must review the requirements of this
fall protection work plan prior to starting work

MM slash DD slash YYYY

Hazards

Identify all hazards 4’ or greater on a walking working surface and 6’ or greater in all other cases

Fall Protection Equipment

Method of fall protection to be provided

Procedure for Assembly, Maintenance, Inspection & Disassembly of Personal Fall Restraint / Arrest Equipment.

Assembly & Disassembly of all equipment will be done in accordance with the manufacturer’s recommended procedures.

A visual inspection of all Personal Fall Restraint / Arrest equipment will be performed daily or before each use. Any defective equipment will be tagged and removed from use immediately. The manufacturer’s recommendations for maintenance and inspection will be followed.

Handling, Storage and Securing of Tools and Materials

Method(s) of Overhead Protection

Describe the method of providing overhead protection for workers or others who may be in, pass through or near the area below the work site.

Adequacy of Attachment Points

Describe the method used to determine the adequacy of attachment points.

Injured Worker Rescue Plan

In the event of a fall from height, the supervisor will immediately alert the jobsite contact and the rescue and first aid teams. If the rescue team cannot perform a rescue within 5 minutes Emergency Services are to be called at once.

Rescue Equipment

What equipment is needed to ensure rescue within 5 minutes, to minimize suspension trauma?

Communication or Method of Contact

What communication methods will be used between the suspended worker and supervisor / rescue team?

Rescue Procedures

Special Cosideration & Coordination

Employee Acknowledgment of Fall Protection Training

Name:
Name:
Name:

All employees are to adhere to the Fall Protection procedures that are set forth in the HBIC Safety & Risk Management Plan. All employees shall have been trained by a qualified competent person; the training shall consist of a review of the fall protection plan and the proper use of fall protection equipment before work is to begin. Copies of this form are to be turned into the HBIC Safety Department and maintained at the jobsite.

Approvals

Fall Protection Work Plan Completed By:
Submitted To:
MM slash DD slash YYYY
Approved By:
MM slash DD slash YYYY

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