I. Scope/Background
To facilitate OSHA’s goal of reducing occupationally related fatalities by 3% each year, and
reducing the total Rate of Days Away from Work by 4% each year, Region III of the Occupational
Safety and Health Administration (OSHA) and Clark Construction Group, LLC have agreed to the joint
implementation of the partnership during construction of the 72 million dollar, 51 Louisiana Avenue
NW Project. The Project includes 440,000 square feet Class A office building and atrium two blocks
north of the Capitol Building at the corner of New Jersey Avenue and D Street in Washington DC. The
building, designed by HKS, is a ten-story core and shell office tower with six levels of below grade
parking. JBG owns the existing buildings and is the developer for the new building and atrium. Jones
Day signed a lease with JBG for six levels of the north building and has future rights to lease the
entire building. The parking garage is accessible via a vehicular entrance on 1st Street. There are
441 parking spaces including handicapped parking. The WMATA Red line borders the north side of the
project at D Street. The Tiber Creek combined sanitary and storm sewer borders the east side of the
project, along New Jersey Avenue.
The new building will consist of cast in place concrete with curtain wall exterior. The two existing
buildings on the site will be connected to the new building by a nine story glass enclosed atrium.
The atrium will integrate vertical, horizontal and sloped glass elements. The skylight is supported
by a boomerang shaped mass truss assembly, mast columns, roof purlins, and a cable wall system.
There are six elevated platforms, an observation elevator, and various bridge connections to the
1935 and 1953 buildings. The exterior of the atrium incorporates operable glass louvers, custom
aluminum louvers, and revolving glass doors.
Notice to proceed was given on April 11th, 2006. Tenant turnover is scheduled for September 4th,
2008 and substantial completion is December 23, 2008, resulting in a scheduled duration of
thirty-three months. The project team will seek LEED certification.
The goal of this program is to develop a contractor/government partnership that will encourage
construction contractors to improve their safety and health performance, assist them in doing that,
strive for the elimination of serious accidents in the construction industry, and recognize those
contractors with exemplary safety and health programs.
Under the partnership, the contractors expect that OSHA will acknowledge superior performance by
providing timely responses to requests for information and requests for clarification of OSHA
standards as resources allow.
This agreement between Clark Construction Group, LLC and OSHA is expected to result in decreased
serious injuries and illnesses and fatalities for the site and improve existing safety and health
programs. It provides incentives to construction contractors that voluntarily participate in the 51
Louisiana Avenue NW Project partnership and demonstrate implementation of effective safety and
health programs, for example, limited scope inspections and reductions in penalties. This agreement
will not in any way affect employees’ ability to exercise rights under the OSH Act and OSHA
regulations, including walk-around rights.
Therefore, OSHA and Clark Construction Group, LLC are entering into this partnership to foster a
safe and healthful workplace for employees by having joint cooperation as prescribed within the
terms and conditions set forth in this agreement.
II. Identification of Partners
The primary participants in this Partnership are:
- Occupational Safety and Health Administration, Baltimore/Washington Area Office (OSHA)
- Clark Construction Group, LLC
III. Project Overview
Over the life of the project (approximately 33 months) contractors will employ approximately 280
individual construction tradespersons at peak construction. The complete work will include: site
construction, concrete, excavation work, pile foundation installation, structural steel and
miscellaneous metal work, track work, electrical, masonry, mechanical/plumbing, rebar installation,
caissons, cranes and lifts use and installation and painting.
IV. Goals, Strategies, Measures
The partnership’s goal is to reduce injuries and illnesses and fatalities through a cooperative
relationship between Clark Construction Group, LLC and OSHA. This goal will be accomplished by
implementing and following the plan outlined below and evaluating these actions as indicated:
- Develop, implement and maintain effective and comprehensive safety and health programs in
accordance with OSHA’s 1989 Safety and Health Program Management Guidelines or its equivalent.
Clark Construction Group, LLC agrees to complete a self-audit and an evaluation of subcontractor’s
safety and health programs in accordance with OSHA’s 1989 Safety and Health Management Guidelines or
its equivalent.
OSHA will evaluate Clark Construction Group, LLC and subcontractor’s safety and health programs
prior to and during the OSHA verification inspection using Appendix B (or equivalent) and will
observe whether the safety and health management systems in place are adequately protecting
employees.
- Achieve participant recordable illness and injury rates below the national average for the
construction industry. A partnership goal is to keep the DART rate (cases with days away from work,
job-transfer, or restriction) below the national average for the most recent year published for
NAICS 236220 (SIC 1542), which was 2.6 for the year 2005. The partnership goal is to further reduce
this level of recordable injuries annually by at least 4% for the duration of the partnership.
Identify and correct primary causal factors in worker injuries and illnesses.
Establish systems to identify and correct accidents and nears misses.
OSHA will meet at least quarterly with Clark Construction Group, LLC to examine the injury and
illness experience of the partnership’s participants and to make corrections and adjustments as
needed.
DART rates and injury and illness experience will be evaluated through review of the OSHA 300 log
and any other relevant accident reports.
V. Statement of Agreement
OSHA agrees to:
- Help identify programmatic needs at this site by reviewing the documented safety and health
management system and providing practical guidance for implementation. The review will be performed
by the project Safety and Health Manager and a Compliance Safety and Health Officer (CSHO).
- Help identify, through the review of OSHA 300 logs, accident or near miss reports, primary causal
factors in injuries and illnesses, in particular the four top hazards at this site, and recommend
the appropriate corrective actions.
- Provide information on training resources including available OSHA Training Institute courses and
information on other available sources of training.
- Assist partners in assessing OSHA interpretations and clarifications as to the meaning and
application of OSHA standards and policy.
- Participate in training sessions and meetings as resources permit.
- Designate an experienced safety and health specialist to serve as a resource and liaison person
for the partnership.
- Meet with Clark Construction Group, LLC quarterly to review partnership issues and to examine
updated DART rates and the injury and illness experiences of its contractors at this site. OSHA
shall provide feedback on any noted incident trends and patterns.
Clark Construction Group, LLC agrees to:
- Serve as a safety resource in support of all of the project’s contractors and subcontractors.
- Provide notice to all contractors and subcontractors that the 51 Louisiana Avenue NW Project is
subject to this strategic partnership with OSHA. All employees will be informed of the partnership
and provided a fact sheet during orientation. (Appendix A).
- Administer the overall partnership program including, but not limited to, the initial contact and
evaluation of subcontractor applications to determine whether the subcontractor meets the criteria
specified within this partnership initiative under Section VI, Contractor Eligibility.
- Notify the Baltimore/Washington OSHA Area Office on a regular and recurring basis of the names of
subcontractors that have met the partnership criteria.
- Maintain a dedicated competent Site Safety and Health Coordinator available to assist contractors
and subcontractors with all safety and health issues.
- Act as liaison for contractors with OSHA.
- Offer on-going information on safety or health topics of importance for contractors, especially
on the focused four construction hazards.
- Maintain a site injury and illness log of all injuries and illnesses reported by all contractors
and tier subcontractors.
- Meet with OSHA quarterly to examine the injury and illness experience of the partnership’s
participants and to make corrections and adjustments as needed.
- Manage the following site safety or health issues common to all areas of the site and be
accessible to all contractors and subcontractors to reduce the potential for injury or illness in
accordance with this partnership agreement:
- emergency action plan
- hazard communication plan and inventory of site chemicals reported by contractors and tier subcontractors
- fall protection plan and perimeter guards
- personal protective equipment, including equipment specified by NFPA 70 E, where applicable
Clark Construction Group, LLC and its contractors and subcontractors agree to:
- Apply all relevant components of their respective comprehensive safety and health programs to the
51 Louisiana Avenue NW Project. These programs shall include:
- Analysis of all new and acquired work, materials, chemicals, and equipment before construction
activity begins to determine potential hazards and to plan for their prevention or control.
- Routine examination and analysis of hazards associated with individual jobs, processes, or phases
of construction.
- Routine self-inspections and hazard abatement.
- A system for project workers to notify management, without fear of retaliation, about conditions
that appear hazardous.
- A system for investigating accidents and near-misses, including procedures for guidance, reports
of findings, and the tracking of hazard correction to completion.
- A system to analyze trends through a review of site injury and illness data, and the hazards
identified through inspections so that patterns of common causes can be identified and eliminated.
- Comply with all current OSHA standards.
- Implement a 6 foot fall protection policy.
- Have supervisors provide visible leadership in implementing the safety and health program. This
includes:
- Supervisors establishing clear lines of communication with project workers.
- Supervisors setting an example of safe and healthful behavior.
- Creating an environment that allows project workers access to their top management and for
contractor management to have access to the prime contractor’s management, and;
- Report all site injuries and illnesses to Clark Construction Group, LLC immediately so that the
site injury and illness log may be accurately maintained.
- Report all program deficiencies or damage to protective equipment, specifically site fall
protection, immediately upon discovery and to take appropriate interim protective measures for
protection of their employees.
Additionally,
- Contractors and subcontractors will submit to OSHA, at least quarterly, records of their site
recordable injury and illness rates, days away from work rates, restricted workdays, and the
contractor’s OSHA history.
- All contractors and subcontractors must have a person on site that is responsible for, possesses
the authority over, and is capable of effectively implementing the overall site safety and health
program.
- All contractors and subcontractors must complete a successful assessment of their site safety and
health program. This assessment shall consider:
- the comprehensiveness of the program
- the degree to which it has been implemented
- the presence of competent persons as required by relevant standards
- the means by which the program is enforced
- Verify that a comprehensive written safety and health program exists or that it will be
implemented prior to starting work, which is at least equivalent to the criteria referenced herein,
including the contractor’s or subcontractor’s implementation of policies and procedures to ensure
that safety rules and procedures are enforced at the site.
- Certify that their policy and procedures hold supervisors and workers accountable for following
established safety and health rules and OSHA regulations.
- Ensure that employee training covers applicable site hazards and the means to correct them, as
well as pertinent standards and regulations. Provide appropriate safety information and training to
non-English speaking employees in their native language.
- Ensure that within one year after obtaining acceptance into this partnership program that a
designated safety representative or other person serving in the capacity as a competent person on
the project will have completed the OSHA 10-hour course for the construction industry (or its
equivalent).
- Provide safety related data or statistics, as requested, concerning such issues as man-hours
worked, lost work day injuries, accident records and OSHA inspection results will provide a summary
of and analysis of pertinent safety and health related information for review by OSHA. The purpose
of such summary information will assist in preparing an annual report necessary for evaluating the
merits of the program and making recommendations for continuous improvement.
VI. Contractor Eligibility
Subcontractors wishing to take advantage of this opportunity to partner with OSHA must:
- Sign a letter of agreement with Clark Construction Group, LLC indicating their intent to
participate in this partnership initiative and to take steps to adopt into their safety program all
of the provisions of the partnership agreement. Appendix C.
- Verify that a comprehensive written safety and health program exists or will be implemented
within 30 days of signing which is based on the OSHA 1989 Safety and Health Program Management
Guidelines (or their equivalent), and has site specific safety plans for all of the contractor’s
work sites.
- Certify that their policy and procedures hold supervisors and workers accountable for established
safety rules and OSHA regulations.
- Provide the level of training required by OSHA regulations to their workers either through their
own training personnel or other consultants or trainers.
- Ensure that as soon as possible, but not longer than one year after obtaining acceptance into
this partnership program, all supervisory personnel or other personnel serving in the capacity of
competent person will have completed the OSHA 10-hour course for the construction industry (or its
equivalent). Records of training certification will be provided to Clark Construction Group, LLC and
made available for review.
- Provide periodic safety-related statistics (man hours worked, lost workday injuries, accident
records and OSHA inspection results). Clark Construction Group, LLC is to provide a summary and
analysis for review by OSHA to track the progress of the partnership in meeting its goals to reduce
injury and illness rates and to prepare an annual report to evaluate the merits of the partnership.
VII. On-Site Verification Inspection and Benefits
- Verification
In order to assist in measuring the success of this partnership, an initial enforcement verification
inspection will be conducted after the signing of this agreement, and annually thereafter. The
onsite enforcement verification may be conducted as a focused inspection if the site meets the
criteria outlined in OSHA’s current enforcement guidelines (See OSHA Memorandum on the Focused
Inspection Initiative, September 20, 1995: http://intranet.osha.gov/doc/LAP/doc/handbook/ii_memo.html).
Annual verification inspections will be timed to adequately evaluate employee exposure to OSHA’s four
focus hazards.
The top causes of injuries and illnesses will be determined by all parties prior to and during the
initial OSHA verification inspection. Corrections will be identified by all parties and implemented
by Clark Construction Group, LLC. Injury and illness incidence in targeted areas will be evaluated
through the OSHA 300 log and any other relevant accident reports.
Additionally, OSHA will meet with Clark Construction Group, LLC quarterly to review partnership
issues and to examine updated DART rates and the injury and illness experience of Clark Construction
Group, LLC and its contractors at this site. OSHA shall provide feedback on any noted incident
trends and patterns.
- Benefits
Subcontractors, if participating in this partnership, will be granted a twelve-month inspection
deletion from programmed inspections, following a successful onsite verification inspection.
OSHA will not issue penalties to participating contractors for other-than-serious violations,
provided the violations are immediately abated. OSHA reserves the right to issue penalties for
regulatory violations for which mandatory penalties are established pursuant to the policy set forth
in the Field Inspection Reference Manual (FIRM).
When calculating initial penalty reductions, OSHA may provide an additional 10% penalty reduction
for good faith to participating contractors provided they have taken steps to adopt into their
safety program all of the provisions of the partnership agreement. This additional reduction will
not apply to high gravity serious, willful, failure to abate or repeat citations. In cases where a
contractor’s total penalty reduction is 100 percent or more, the minimum penalty provisions of
OSHA’s FIRM will apply.
VIII. OSHA Inspections
This partnership provides for the immediate response to each allegation of a safety or health hazard
brought to its attention by any person. Upon a finding that an allegation is valid, the employer
shall promptly abate the hazard.
- Non-formal Complaints:
OSHA agrees that a copy of each non-formal complaint related to the work at the site and filed with
OSHA will be forwarded by fax or mail to the 51 Louisiana Avenue NW Project site office. In
accordance with applicable law, the identity of a complainant requesting confidentiality will not be
revealed. Clark Construction Group, LLC agrees to investigate these complaints, regardless of the
employer involved and provide OSHA with a written response as follows:
- non-formal complaints/referrals alleging a hazard: 24 hours
Failure to meet this time frame, or providing a response determined by OSHA to be inadequate, will
place the complaint/referral outside the scope of this partnership and OSHA will respond as it would
to any complaint of a similar nature.
- Formal Complaints and Other Investigations:
OSHA personnel will continue to conduct investigations resulting from formal complaints, referrals,
local and national emphasis programs, fatalities, catastrophes, other accidents or significant
events. OSHA will also investigate contractors whose employees are exposed to or are creating plain
view hazards at partnering worksites. These investigations will be conducted outside of this
partnership agreement in accordance with established OSHA enforcement policy. Violations documented
during such investigations may result in the issuance of citations and penalties.
IX. Employee Rights
This Partnership does not preclude employees and/or employers from exercising any right provided
under the OSH Act (or, for federal employees, 29 CFR 1960), nor does it abrogate any responsibility
to comply with rules and regulations adopted pursuant to the OSH Act.
X. Leveraging
This partnership seeks to leverage the resources of both, Clark Construction Group, LLC and OSHA by
encouraging contractors to develop safety and health programs, implement them in an effective
manner, complete self inspections, and evaluate worksite conditions and near misses to prevent
accidents. By combining resources, OSHA expects to have a greater and more positive impact on safe
working conditions at this site than could be achieved otherwise.
XI. Evaluation
A joint evaluation of the partnership will be prepared annually by the partners using Appendix D.
The evaluation will review the success of the partnership, lessons learned, and changes that will be
made to meet the goals of the partnership.
XII. Termination
This agreement will terminate three years from the date of the signing or upon completion of the 51
Louisiana Avenue NW Project. If either OSHA or Clark Construction Group, LLC wishes to withdraw its
participation prior to the established termination date, the agreement will terminate upon receiving
a written notice of the intent to withdraw from either signatory.
OSHA will terminate the partnership if any employer on site is issued a citation related to
workplace hazards which resulted in a fatality.
XIII. Paperwork Reduction Act:
Paperwork Reduction Act Notice
Form Approved
OMB# 1218-0244 Expires 01-31-2009
Public reporting burden for the time needed to develop
the Partnership requirements, craft agreement language,
and conduct an internal review process is estimated to
be an average of 11 burden hours per respondent. |
XIV. Partnership Contacts:
OSHA: Leonard Moore, Area Director, Baltimore/Washington OSHA Office, 410-865-2055
Clark:
- Rick Bowers
Mid-Atlantic Regional Safety Manager
202-497-2330
- Jeff Ambrose
Washington DC Area Safety Manager
202-386-5019
- Monique Wall
Site Safety Manager
202-359-4245
Signature Page
Strategic Partnership Agreement between OSHA and Clark Construction Group, LLC.
| All undersigned Parties mutually agree to the terms and conditions of this
document and commencement of this Partnership Agreement. |
Leonard M. Moore, Jr.
Area Director
Baltimore/Washington Area Office
USDOL/OSHA |
Douglas F. Verdin
Vice President/Construction Executive
Clark Construction Group, LLC |
Date: _______________________________ |
Date: _______________________________ |
Rick Bowers
Regional Safety Director
Mid–Atlantic Region
Clark Construction Group, LLC |
Lee DeLong
Senior Project Executive
Clark Construction Group, LLC |
Date: _______________________________ |
Date: _______________________________ |
Geoff Piemme
Superintendent
Clark Construction Group, LLC |
|
Date: _______________________________ |
|
APPENDIX A
Partnership Fact Sheet |
A strategic partnership agreement has been developed jointly by the United
States Department of Labor, Occupational Safety and Health Administration Baltimore/Washington Area
Office (OSHA), and Clark Construction Group, LLC. The common objective and goal of the program is to
develop a contractor/government partnership that encourages all construction contractors to improve
their safety and health performance, assist them in doing that, strive for the elimination of
serious accidents in the construction industry, and to recognize those contractors with exemplary
safety and health programs. The specific impetus behind the agreement is to provide a safe and
healthful work environment for workers engaged in construction activities for the project.
Expected outcomes of this partnership include: developing criteria for a model multi-employer
worksite safety and health program which specifically identifies the responsibilities of each
subcontractor; making safety and health materials available to all subcontractors onsite; planning
for safety and health in all aspects of the project; providing visible safety and health leadership;
achieving participant recordable illness and injury rates below the national average for the
construction industry; and focusing OSHA enforcement activity on those contractors and
subcontractors who have little or no regard for the safety and health of their workers.
The agreement provides incentives to contractors and subcontractors who voluntarily improve their
safety and health performance. Incentives will include special recognition from OSHA and focused
enforcement efforts by OSHA and consideration for additional good faith penalty reductions.
This agreement is consistent with OSHA’s long-range effort to develop a contractor/government
partnership approach to safety management. It allows for better use of OSHA resources and for
innovation in safety management, and it encourages more participation in the safety process by each
stakeholder.
Leonard Moore
Area Director
Baltimore/Washington Area Office
USDOL/OSHA |
Douglas F. Verdin
Vice President/Construction Executive
Clark Construction Group, LLC |
Appendix B
Safety and Health Program Evaluation |
- Contractor has implemented a comprehensive written safety and health program based on ANSI
A10.38-1991 or the OSHA 1989 Safety and Health Program Management Guidelines, and has site
specific safety plans for all of the contractor’s work sites.
- Contractor maintains a copy of its specialty contractor’s safety and health plan, hazard
communication plan, and fall protection plan (where applicable) or contractor requires specialty
contractor to follow participant’s plan.
- Contractor has designated safety personnel at each site who conduct documented safety
inspections of all work on the contractor’s projects, and through training and experience, can
recognize hazards and have authority to take prompt corrective action. Training equivalent to the
OSHA 10-Hour Construction Outreach Course is satisfactory.
- Contractor has trained all field supervisory personnel and has provided additional training for
competent persons in such areas as scaffolding, excavation, fall protection, crane operations,
etc. (This additional training will be dictated by the type and scope of the work the contractor
routinely conducts).
- Contractor provides a safety and health program orientation for all new employees and trains
employees for hazard recognition specific to the contractor’s work sites.
- Contractor has evidence of employee involvement including, but not limited to, participation in
self-audits, site inspections, job hazard analyses, safety and health program reviews, safety
training and mishap investigations.
- Contractor conducts and documents weekly employee safety meetings.
- Contractor conducts and documents self-audits.
- Contractor uses a six-foot fall protection policy.
- Contractor has a written enforcement program.
Appendix C
LETTER OF INTENT TO PARTICIPATE
SAFETY PARTNERSHIP |
Name of Subcontractor: __________________________________________________________
Subcontractor Site Representative:____________________________________________________
Anticipated Number of Workers:___________________________________________________
We have read the requirements to participate in
Safety Partnership and agree with all aspects of the program, including the submission of the
required information. Specifically, we recognize the need to meet the following requirements:
- Establishment of a written safety and health program including the following elements:
management leadership, worker involvement, worksite analysis, hazard prevention and control, and
safety and health training.
- Compliance with all current OSHA standards.
- Provision of visible leadership by supervisors in implementing the safety and health program
including, but not limited to, having a representative complete the OSHA 10 hour construction
training program.
- Planning for safety and health as part of the overall management planning process, including
appropriate job hazard analyses.
- Establishment and communication of all safety and health program responsibilities to all
project workers.
- Evaluation of safety and health programs at least annually.
- Reporting all site injuries and illnesses so that a site log may be maintained.
- Reporting all deficiencies or damage to site wide programs or protective measures, specifically
site fall protection, immediately upon discovery and taking appropriate interim protective
measures for protection of their employees.
We understand the agreement provides incentives to participating
subcontractors who undertake these actions to voluntarily improve their safety and health
performance. Incentives will include special recognition from OSHA, focused enforcement efforts by
OSHA and consideration for additional good faith penalty reductions.
Based upon the mutual interest to protect construction workers in the , we agree to the terms of the OSHA Partnering Agreement.
Signed this ___ day of
_______________________________
Appendix D
OSHA Strategic Partnership Program
Annual Partnership Evaluation Report
Cover Sheet |
| Goals of Partnership |
| Goal |
Strategy |
Measure |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| Strategic Management Plan Target
Areas (check one) |
| |
Construction |
|
Manufacturing Amputations |
| |
Non-Construction |
|
|
| Strategic Management Plan Areas of
Emphasis (check all applicable) |
| |
Amputations in Construction |
|
Oil and Gas Field Services |
| |
Blast Furnaces and Basic Steel Products |
|
Preserve Fruits and Vegetables |
| |
Blood Lead Levels |
|
Public Warehousing and Storage |
| |
Concrete, Gypsum and Plaster Products |
|
Ship/Boat Building and Repair |
| |
Ergo/Musculoskeletal |
|
Silica-Related Disease |
| |
Landscaping/Horticultural Services |
|
|
|
Section 1 General Partnership Information |
| Date of Evaluation Report |
|
| Evaluation Period |
| Start Date |
|
End Date |
|
| Evaluation Contact Person |
|
| Originating Office |
|
| Partnership Coverage |
| # Active Employers |
|
# Active Employees |
|
| Industry Coverage (note range or
specific SIC and NAICS for each partner) |
| Partner |
SIC |
NAICS |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
|
Section 2 Activities Performed |
| Note whether an activity was
required by the OSP and whether it was performed |
| |
Required |
Performed |
| a. Training |
|
|
| b. Consultation Visits |
|
|
| c. Safety and Health Management Systems
Reviewed/Developed |
|
|
| d. Technical Assistance |
|
|
| e. VPP-Focused Activities |
|
|
| f. OSHA Enforcement Inspections |
|
|
| g. Offsite Verifications |
|
|
| h. Onsite Non-Enforcement Interactions |
|
|
| i. Participant Self-Inspections |
|
|
| j. Other Activities |
|
|
| 2a. Training (if performed,
provide the following totals) |
| Training sessions conducted by OSHA staff |
|
| Training sessions conducted by non-OSHA staff |
|
| Employees trained |
|
| Training hours provided to employees |
|
| Supervisors/managers trained |
|
| Training hours provided to supervisors/managers |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2b. Consultation Visits (if
performed, provide the following total) |
| Consultation visits to partner sites |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2c. Safety and Health Management
Systems (if performed, provide the following total) |
| Number of systems implemented or improved using the 1989
Guidelines as a model |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2d. Technical Assistance (if
performed, note type and by whom) |
| |
Provided by OSHA Staff |
Provided by Partners |
Provided by Other Party |
| Conference/Seminar Participation |
|
|
|
| Interpretation/Explanation of Standards or OSHA Policy |
|
|
|
| Abatement Assistance |
|
|
|
| Speeches |
|
|
|
| Other (please specify) |
|
|
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2e. VPP-Focused Activities (if
performed, provide the following totals) |
| Partners/participants actively seeking VPP participation |
|
| Applications submitted |
|
| VPP participants |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2f. OSHA Enforcement Activity (if
performed, provide the following totals for any programmed, unprogrammed, and verification-related
inspections) |
| OSHA enforcement inspections conducted |
|
| OSHA enforcement inspections in compliance |
|
| OSHA enforcement inspections with violations cited |
|
| Average number of citations classified as Serious, Repeat, and
Willful |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2g. Offsite Verification (if
performed provide the following total) |
| Offsite verifications performed |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2h. Onsite Non-Enforcement
Verification (if performed provide the following total) |
| Onsite non-enforcement verifications performed |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2i. Participant Self-Inspections
(if performed provide the following totals) |
| Self-inspections performed |
|
| Hazards and/or violations identified and corrected/abated |
|
| Comments/Explanations (briefly
describe activities, or explain if activity required but not performed) |
|
| 2j. Other Activities (briefly describe other
activities performed) |
|
|
Section 3 Illness and Injury Information* |
| Year |
Hours |
Total Cases |
TCIR |
# of Days Away from Work Restricted and
Transferred Activity Cases |
DART |
| 2007 |
|
|
|
|
|
| 2008 |
|
|
|
|
|
| 2009 |
|
|
|
|
|
| Total |
|
|
|
|
|
| Three-Year Rate (2007-2009) |
|
|
|
|
BLS National Average for 2005 |
|
|
2.6 |
| Baseline |
|
|
|
|
|
*Sample Chart – not required format
|
Section 4 Partnership Plans, Benefits, and Recommendations |
| Changes and Challenges
(check all applicable) |
| |
Changes |
Challenges |
| Management Structure |
|
|
| Participants |
|
|
| Data Collection |
|
|
| Employee Involvement |
|
|
| OSHA Enforcement Inspections |
|
|
| Partnership Outreach |
|
|
| Training |
|
|
| Other (specify) |
|
|
| Comments |
|
| Plans to Improve
(check all applicable) |
| |
Improvements |
N/A |
| Meet more often |
|
|
| Improve data collection |
|
|
| Conduct more training |
|
|
| Change goals |
|
|
| Comments |
|
| Partnership Benefits (check all
applicable) |
| Increased safety and health awareness |
|
| Improved relationship with OSHA |
|
| Improved relationship with employers |
|
| Improved relationship with employees or unions |
|
| Increased number of participants |
|
| Other (specify) |
|
| Comments |
|
| Status Recommendation |
| Partnership Completed |
|
| Continue/Renew |
|
| Continue with the following provisions: |
|
|
| Terminate (provide explanation) |
|
|
|
Printing
Instructions
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