1 Site Specific EH&S Plan (Template) INSTALL NEW DIELECTRIC STORAGE UNIT FOUNDATION, TANK AND ENCLOSURE Location Contracting Company EHS Representative Revision # 2 - 9/30/2010 2 Contractor Information Contracting Company Address Project Manager (owner) Office phone# Cell phone # E-mail address Emergency Contact Office phone# Cell phone # Job Site Supervisor Office phone# Cell phone # Site EHS (Safety Officer) Representative Office phone# Cell phone # Con Edison Site Representative Office phone# Cell phone # Site Location Description Hospital Phone # Fire Dept Phone # 3 Environmental Health and Safety Plan 1) Job Description: Describe or attach job work scope presented in work package. Include the different phases of the job (i.e. mobilization, excavation, laying conduit, etc). Include plates, prints layouts, drawings or photos. Are permits and/or licenses needed for this work? Yes No If yes, state the licenses/permits 2) Emergency Procedures Provide emergency evacuation procedures for job location including all emergency contacts (Fire Dept., Police Dept. Nearest hospital etc.). Provide nearest hospital and route map. List all applicable emergency equipment. 3) Site Control Describe site control measures to be taken on the project (access points, security, barricades, fencing etc.) 4 4) Job Hazard Analysis and Control: Hazard Identification: Identify all the EH&S hazards present during the course of performing this job activity. Below are general hazard classifications that you are required to select. Additional hazards should be presented below. A description of how each hazard will be controlled MUST be attached to this plan. 1.0 Introduction 2.0 Air Resources 3.0 Asbestos Awareness 4.0 BBP/First Aid/CPR 5.0 Chemical Safety/HazCom 6.0 Close Call Program 7.0 Confined Space Program (Permit-Required) 8.0 Drug and Alcohol Program 9.0 Electrical Enclosed Spaces 10.0 Electrical Safety 11.0 Excavating and Trenching 12.0 Fire Protection and Prevention 13.0 Fish, Wildlife and Wetlands 14.0 Gas Enclosed Spaces 15.0 Hearing Conservation 16.0 Heat Stress/Cold Stress 17.0 Insulation Materials (Non-Asbestos) 18.0 Job Briefings 19.0 Lead Management Program 20.0 Management of Change 21.0 Materials Handling 22.0 Mechanical Equipment 23.0 Mercury Management Program 24.0 Noise 25.0 Oil and Dielectric Fluid 26.0 Operator Qualifications 27.0 PCB Management 28.0 Personal Protective Equipment 29.0 Pesticides 30.0 Respiratory Protection Program 31.0 Sampling 32.0 Time Out Program 33.0 Vehicle Management 34.0 Waste Management 35.0 Water Resources 36.0 Welding and Burning 37.0 Work Area Protection 38.0 Working at Elevations 39.0 Rules We Live By Applicable to Project? YES YES YES YES YES YES YES YES YES Note: All hazards already answered “yes” are required to be addressed. Provide a description of other Hazards present: 5 5) Hazard Evaluation: Hazard evaluation involves the process of identifying the hazards associated with the job, instituting control measures (engineering or administrative) to reduce or remove the hazard, then identifying the personal protective equipment (PPE) necessary to protect the worker. See attachment 1 for typical hazards that may be encountered on the job. Describe each hazard individually using the following set of criteria below: Hazard Explain extent of Hazard Administrative/Engineering Controls PPE determined If Respiratory protection is required explain? Employee Training General precautions Note: All chemicals/products brought to a Con Edison facility and will be used on Con Edison equipment or systems will be approved by Con Edison’s IH section prior to use. (MSDS sheets not older than 5 yrs shall be submitted to Con Edison for acceptance.) List all MSDS sheets submitted for this project and attach them to this plan. 6) Housekeeping: Identify housekeeping procedures that will be utilized throughout the project durations. Identify techniques to be used for normal operations or when hazardous materials are involved: 7) Training and Hazard Communication: Are all your personnel (including sub-contractors) trained to conduct their job responsibilities in this plan? Yes No Are your employees Haz-Com trained in the hazards they will be confronting for this project? Yes No Job Briefings will be conducted with employees at the start of the shift? Yes No How often are documented safety talks conducted? Daily shift weekly Will all visitors be briefed on evacuation/fire/emergency procedures? Yes No Will all Sub-Contractors be covered under this site-specific HASP? Yes No 6 If Respirators are used, will all employees be medically qualified, clean-shaven and fit-tested in the respirator? Yes No Comments (explain all negative responses and discuss with site representative.) 8) Environmental Management: Check off or include any environmental issue that your job presents. Air Resources Fish, Wildlife and wetlands PCB Management Hazardous Waste Management Waste Management Spill Management Water Resources Asbestos Management Other: Explain in detail all items identified above and control methods to manage or avoid the concern: 9) Waste Disposal Method Explain how all waste will be managed, packaged, transported and disposed of for all waste streams generated: 10) Contractor Employee Acknowledgement Contractor site supervision is responsible for assuring the contents of this eHASP are known by all contractor employees and are implemented on site during job performance. Signature of authorized person: _____________________________________ Name of authorized person: ________________________________________ Title of authorized person: _________________________________________ Date: ___________________________________________________________ 7 Attachment 1 -- Typical Hazards of Concern Physical Heat Noise Radiation Cold Confined Space Excavation Trenching Welding Burning Electrical Fire Protection Road Work Rotating Equipment Cranes Work in Elevations Scaffolding Rigging Material Handling Grinding Ladders Hand Tools Steel Erection Demolition Concrete Power Tools Mechanical Equipment Slippery Surfaces Chemical Lead Mercury Asbestos Oil PCBs Lubricants Cement Dielectric fluid Solvents Gasoline Diesel Other Fuels Silica Carbon Monoxide Pesticides Dust-Particulates Hydrogen Sulfide Isocyanates Acids Caustics Glues Adhesives Epoxies Detergents Bleach Ammonia Heavy Metals Benzene VOCs Lacquers Solders Asphalt
