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 Continental Building Systems agree to the joint implementation of a
partnership during construction of the 4 million dollar, Christ Temple
Project. The Project plans call for the construction of a new life and
health center consisting of a pre-engineered metal building and an attached
two-story traditional steel/concrete structure. The pre-engineered building
will house a gymnasium and a stage. The first floor of the other building
includes a welcome center, a full-service kitchen and a café. The second
floor has meeting rooms, a work-out facility, aerobic room and a sound room.
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, OSHA will provide timely responses to requests for information
and requests for clarification of OSHA standards as resources allow.
This agreement between Continental Building Systems and OSHA is expected to
result in decreased 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 Christ Temple
Life and Health Center Project Partnership and demonstrate implementation of
effective safety and health programs, for example, technical assistance from
OSHA and opportunities for 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 Continental Building Systems 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, Charleston Area Office (OSHA)
- Continental Building Systems (CBS)
III. Project Overview
Over the life of the project, approximately 15 different subcontractors will
be involved. At the busiest construction period, or at peak construction,
there will be approximately five subcontractors and 50 individual
tradespersons on site.
Work will include all facets of new construction, such as site construction,
excavation work, concrete, structural steel, sheet metal and miscellaneous
metal work, electrical, mechanical/plumbing, masonry, cranes and lifts,
drywall and interior finishes.
IV. Goals, Strategies, Measures
The partnership’s goal is to reduce injuries and illnesses and fatalities
through a cooperative relationship between Continental Building Systems and
OSHA. This goal will be accomplished by implementing and following the plan
outlined below and evaluating these actions as indicated:
- Continental Building Systems will 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.
Continental Building Systems agrees to complete a self-audit and an
evaluation of all subcontractors’ safety and health programs in accordance
with OSHA’s 1989 Safety and Health Management Guidelines or its equivalent.
OSHA will evaluate Continental Building Systems and subcontractors’ 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 2.7 for the year 2006. The
partnership goal is to further reduce this level of recordable injuries
annually by at least 5% for the duration of the partnership.
- Over the duration of the project, achieve a Days Away, Restricted or
Transferred Rates (DART) for each participant that is at least 10% below the
respective participant’s average rates for the two years prior to entering
the partnership.
Identify and correct primary causal factors in worker injuries and
illnesses.
Establish systems to identify and correct accidents and near misses.
OSHA will meet at least quarterly with Continental Building Systems 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 Continental’s Project
Superintendent, a Continental Safety and Health Manager and an OSHA
Compliance Specialist (CAS or CSHO).
- Help identify, through the review of OSHA 300 logs, accident or near miss
reports, primary causal factors in injuries and illnesses and recommend the
appropriate corrective actions.
- Provide information on training resources including available through 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 Compliance Specialist (CAS or CSHO) to serve as
a resource and liaison person for the partnership.
- Meet with Continental Building Systems 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.
Continental Building Systems agrees to:
- Serve as a safety resource in support of all of the project’s
subcontractors.
- Provide notice to all subcontractors that the Christ Temple Life and
Health Center Project has entered into 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 Charleston OSHA Area Office on a regular and recurring basis
of the names of subcontractors that have met the partnership criteria.
- Maintain a competent Site Safety and Health Coordinator with OSHA 30 hour
training to be available to assist 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
subcontractors, especially on the focused four construction hazards.
- Maintain a site injury and illness log of all injuries and illnesses
reported by all contractors and lower-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 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 lower-tier subcontractors
- fall protection plan and perimeter guards
- personal protective equipment, including equipment specified by NFPA 70
E, where applicable.
Continental Building Systems and its subcontractors agree to:
- Apply all relevant components of their respective comprehensive safety
and health programs to the Christ Temple Life and Health Center Project.
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 and enforce 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 subcontractors’ access to Continental Building Systems
management.
- Report all site injuries and illnesses to Continental Building Systems
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 take
appropriate interim protective measures for protection of all workers.
- Submit to Continental Building Systems the contractor’s OSHA history,
initial and updated records of their recordable injury and illness rates,
days away from work rates and restricted workdays.
- All 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 (competent person).
- All participating 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 Continental’s and
subcontractors’ implementation of policies and procedures to ensure that
safety rules and procedures are enforced at the site.
- Certify that policies 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 hours worked, lost work day injuries, accident records and OSHA
inspection results for review by OSHA. The purpose of such 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 Continental Building Systems, Appendix C,
indicating the 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.
- 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 policies 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
Continental Building Systems and made available for review.
- Provide periodic safety-related statistics (man hours worked, lost
workday injuries, accident records and OSHA inspection results). Continental
Building Systems 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
onsite
non-enforcement verification inspection will be conducted by OSHA after the
signing of this agreement and annually thereafter in accordance with OSHA‘s
Directive for the Strategic Partnership Program, OSHA Instruction CSP
03-02-002. The onsite non-enforcement verification will consist of a review
of written program elements and an inspection of the work site to assess the
implementation of the partnership agreement. If OSHA identifies serious
hazards that Continental Building Systems refuses to correct, OSHA will make
a referral for an enforcement inspection.
Verifications will be timed and conducted to adequately evaluate employee
exposure to hazards. At a minimum, verifications will be conducted annually
and/or at the conclusion of the partnership.
Employees and/or employee representatives will be provided the opportunity
to be involved in all onsite non-enforcement verification inspections. If
employee and/or employee representatives cannot actively participate in the
site verification inspection, then employee interviews conducted during the
non-enforcement verification audits will be utilized to determine the site’s
progress in meeting the goals and objectives stipulated within this
agreement.
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 Continental Building
Systems. 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 Continental Building Systems quarterly to
review partnership issues and to examine updated DART rates and the injury
and illness experience of Continental Building Systems and its contractors
at this site. OSHA shall provide feedback on any noted incident trends and
patterns.
- Benefits
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 work at the
site and filed with OSHA will be forwarded by fax or mail to the Christ
Temple Church Life and Health Center site office. In accordance with
applicable law, the identity of a complainant requesting confidentiality
will not be revealed. Continental Building Systems 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 programmed inspections and
investigations resulting from formal complaints, referrals, fatalities,
catastrophes, other accidents or significant events. OSHA will also
investigate contractors whose employees are exposed to or are creating plain
view hazards at the partnering worksite. 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 Continental
Building Systems 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 by the partners using
Appendix D at least annually and/or at the conclusion of the partnership.
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 two years from the date of the signing or upon
completion of the Christ Temple Church Life and Health Center. If either
OSHA or Continental Building Systems 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: Richard Jeffrey, Compliance Assistance Specialist, Charleston Area
Office, 304-347-5937
Continental
Building
Systems |
1. Meg DeWerth
Director of Safety
(614) 883-1315
(614) 206-8077 cell2. Matt Harbuck
Safety Assistant
(614) 883-1243
(614) 989-3669 cell |
3. Jerry Kahler
Site Superintendent
(304) 781-6721
(614) 206-8077 cell
4. Scott Flading
Site Project Manager
(614) 883-1093
(614) 625-3017 cell
|
Signature Page: Christ Temple Church Life and Health Center Project
Strategic Partnership Agreement between OSHA and Continental Building
Systems.
| All undersigned Parties mutually agree to the terms and
conditions of this document and commencement of this Partnership
Agreement on this day of |
Jeff Funke
Area Director
Charleston Area Office
USDOL/OSHA |
|
Meg DeWerth
Safety Director
Continental Building Systems |
|
Richard Jeffrey
Compliance Assistance Specialist
Charleston Area Office
USDOL/OSHA
|
|
Jerry Kahler
Project Superintendent
Continental Building Systems |
|
| |
|
Matt Harbuck
Safety Manager
Continental Building Systems |
|
|
|
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
Charleston, West Virginia Area Office (OSHA), and Continental Building Systems.
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 Christ
Temple Church Life and Health Center 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
technical assistance from OSHA and consideration for additional 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.
_______________________________
Jeff Funke
and/or Richard Jeffrey
Charleston Area Office
US/DOL/OSHA |
___________________________
Meg DeWerth
and/or Jerry Kahler
and/or Matt Harbuck
Continental Building Systems |
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 contractors’ safety and health
plans, hazard communication plans, and enforces a fall protection policy that is
consistent with this Agreement.
- Contractor has designated safety personnel at each site who conduct
documented safety inspections of all work on the contractor’s project, 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 subcontractors, and trains employees and subcontractors for hazard
recognition specific to the site.
- Contractor has evidence of employee involvement in safety and health such as,
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 (at peak):
We have read the requirements to participate in the Christ Church Temple Life
and Health Center/OSHA
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.
- Implementation of project safety requirements.
- 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 within one year of signing the
partnership agreement.
- 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 to CBS 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 technical assistance from OSHA and
consideration for additional penalty reductions.
Based upon the mutual interest to protect construction workers at the Christ
Temple Church Life and Health Center Project, we agree to the terms of the OSHA
Partnering Agreement.
| Signed this ________ day of _______________________________ by: |
| |
|
| ______________________________________________ |
_____________________________________________ |
| Printed Name/Title |
Signature |
|
Appendix D
OSHA STRATEGIC PARTNERSHIP PROGRAM
ANNUAL PARTNERSHIP EVALUATION REPORT
| Partnership Name |
Christ Temple Church Life and Health Center Project
|
| Purpose of Partnership |
The purpose of the partnership 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.
|
| Goals of Partnership |
| Goal |
Strategy |
Measure |
| 1. 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. |
1. Complete a self-audit and
audit of all subcontractors’ safety and health programs. |
1. Quarterly, OSHA will use
Appendix B to evaluate Continental’s and subcontractors’ safety and health
programs and ensure that appropriate management systems are effectively
implemented in the field. |
| 2. Achieve participant
recordable illness and injury rates below the national average for the
construction industry, with the partnership DART rate below 2.7 and a further
4% reduction of recordables annually. |
2. Identify and correct primary
causal factors in worker injuries and illnesses. Establish systems to identify
and correct accidents and near-misses. |
2. Quarterly, OSHA will evaluate
participants’ rates using OSHA 300 Logs and site-specific incident and near
miss forms, along with accident investigation reports.
|
| 3. Over the duration of the
project, achieve a Total Case Incident Rate (TCIR) for each participant that
is at least 10% below the respective participant’s average rates for the two
years prior to entering the partnership. |
3. Identify and correct primary
causal factors in worker injuries and illnesses and compare incidents from the
partnership to incidents in each participant’s previous two years. Establish
systems to identify and correct accidents and near-misses specific to the
partnership project. |
3. At the conclusion of the
partnership, OSHA will evaluate participants’ rates using OSHA 300 Logs and
site-specific reports. A comparison will be made between partnership
statistics and statistics from the participants’ previous two years.
|
| Strategic Management Plan Target
Areas (check one) |
| Construction |
X |
Amputations in Manufacturing |
|
| General Industry |
|
|
|
| Strategic
Management Plan Areas of Emphasis (check all applicable) |
| Amputations in Construction |
X |
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 |
X |
Ship/Boat Building and Repair |
|
| Ergo/Musculoskeletal |
|
Silica-Related Disease |
X |
| Landscaping/Horticultural Services |
|
|
|
|
2.
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 |
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
|
3.
Section 2 |
Activities Performed |
|
Note whether an activity was provided for 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
Inspection |
|
|
| 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) |
| 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) |
|
|
4.
Section 3 |
Illness and Injury Information* |
| Year |
Hours |
Total Cases |
TCIR |
# of Days Away from Work Restricted and
Transferred Activity Cases |
DART |
| 2008 |
|
|
|
|
|
| 2009 |
|
|
|
|
|
| 2010 |
|
|
|
|
|
| Total |
|
|
|
|
|
| Three-Year Rate (2008-2010) |
|
|
|
|
BLS National Average for 2006 |
|
|
2.7 |
| Baseline |
|
|
|
|
2.7 |
*Sample Chart – not required format
|
|
5.
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
(Check one) |
| Partnership Completed |
|
| Continue/Renew |
|
| Continue with the following provisions: |
|
|
| Terminate (provide explanation) |
|
|
|
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Printing Instructions
