**CONSTRUCTION JOB HAZARDS ANALYSIS**

**SCAFFOLDING**

**Contractor Name: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date: \_\_\_\_\_\_\_\_\_\_\_\_\_**

+-------------+--------------------+-----------------------------------+
| **Scope of  | **Potential Safety | **Mitigation of Potential Risks** |
| Work**      | Risks/Issues**     |                                   |
+-------------+--------------------+-----------------------------------+
| General,    |                    | -   All work shall be in          |
| Site and    |                    |     accordance with the           |
| work area   |                    |     subcontractor's IIPP and in   |
| setup       |                    |     conformance with all LBNL     |
|             |                    |     policies, Federal OSHA &      |
|             |                    |     Cal-OSHA standards;           |
|             |                    |                                   |
|             |                    | -   All general safety orders     |
|             |                    |     shall be reviewed by          |
|             |                    |     subcontractors prior to       |
|             |                    |     starting work;                |
|             |                    |                                   |
|             |                    | -   All equipment shall be        |
|             |                    |     properly and completely       |
|             |                    |     inspected by its operator     |
|             |                    |     prior to use. Any equipment   |
|             |                    |     that is not fully operational |
|             |                    |     and function shall be removed |
|             |                    |     from service;                 |
|             |                    |                                   |
|             |                    | -   All extension cords are to be |
|             |                    |     in good working order, free   |
|             |                    |     from cuts and abrasions and   |
|             |                    |     properly grounded and of a    |
|             |                    |     gauge suitable for the        |
|             |                    |     amperage used;                |
|             |                    |                                   |
|             |                    | -   All power equipment shall be  |
|             |                    |     in good working order and     |
|             |                    |     only operated by trained      |
|             |                    |     employees;                    |
|             |                    |                                   |
|             |                    | -   In areas where the PEL's      |
|             |                    |     cannot be measured to ensure  |
|             |                    |     employees are not being       |
|             |                    |     exposed to OSHA permissive    |
|             |                    |     exposure limits, employees    |
|             |                    |     will wear OSHA and NOISH      |
|             |                    |     approved breathing            |
|             |                    |     apparatuses including         |
|             |                    |     particulate masks. If such    |
|             |                    |     apparatuses are use,          |
|             |                    |     employees shall be FIT tested |
|             |                    |     and their certification cards |
|             |                    |     shall be made available to an |
|             |                    |     LBNL representative upon      |
|             |                    |     request;                      |
|             |                    |                                   |
|             |                    | -   Power tools found not to be   |
|             |                    |     in good working order and     |
|             |                    |     unsafe to use shall be tagged |
|             |                    |     and removed from the work     |
|             |                    |     area; employees using tools   |
|             |                    |     are to be trained in their    |
|             |                    |     safe use and the safety rules |
|             |                    |     for them and                  |
|             |                    |                                   |
|             |                    | -   PPE required at all times     |
|             |                    |     including;                    |
|             |                    |                                   |
|             |                    | ```{=html}                        |
|             |                    | <!-- -->                          |
|             |                    | ```                               |
|             |                    | -   Hard Hats                     |
|             |                    |                                   |
|             |                    | -   Safety Glasses                |
|             |                    |                                   |
|             |                    | -   Respirators as necessary      |
|             |                    |                                   |
|             |                    | -   Masks                         |
|             |                    |                                   |
|             |                    | -   Proper Gloves as necessary    |
|             |                    |                                   |
|             |                    | -   Noise Protection              |
+-------------+--------------------+-----------------------------------+
| -   General |                    | Specific requirements pertaining  |
|     R       |                    | to the erection of scaffolding    |
| equirements |                    | will be found in 29 CFR 1926.451. |
|             |                    | A competent person is defined as, |
|             |                    | one who is knowledgeable through  |
|             |                    | training or experience as set     |
|             |                    | forth in the requirements of 29   |
|             |                    | CFR 1926.451. Prior to use on     |
|             |                    | each shift, a competent person as |
|             |                    | assigned by the Site Contractor   |
|             |                    | will perform inspections of all   |
|             |                    | scaffolds used and document the   |
|             |                    | inspection on the scaffold tag.   |
|             |                    |                                   |
|             |                    | -   The footing of scaffolds must |
|             |                    |     be sound and rigid, capable   |
|             |                    |     of supporting the weight of   |
|             |                    |     the scaffold and its intended |
|             |                    |     load                          |
|             |                    |                                   |
|             |                    | -   Only qualified persons shall  |
|             |                    |     erect, dismantle, move or     |
|             |                    |     alter scaffolds. All          |
|             |                    |     scaffolds shall have top      |
|             |                    |     rails, intermediate rails and |
|             |                    |     toe boards installed on all   |
|             |                    |     open sides                    |
|             |                    |                                   |
|             |                    | -   Guardrails shall have a       |
|             |                    |     toprail between 38 inches and |
|             |                    |     45 inches high above the      |
|             |                    |     platform surface and have     |
|             |                    |     supports not to exceed 8 feet |
|             |                    |     between vertical posts.       |
|             |                    |                                   |
|             |                    | -   Toe boards shall be 4 in.     |
|             |                    |     high                          |
|             |                    |                                   |
|             |                    | -   Scaffolds and components      |
|             |                    |     shall be able to support at   |
|             |                    |     least four times the intended |
|             |                    |     load                          |
|             |                    |                                   |
|             |                    | -   Any components of a scaffold  |
|             |                    |     damaged or weakened shall be  |
|             |                    |     repaired or replaced          |
|             |                    |     immediately. All planking for |
|             |                    |     platforms shall be overlapped |
|             |                    |     at least 12 inches and        |
|             |                    |     secured from movement         |
|             |                    |                                   |
|             |                    | -   Straight and/or extension     |
|             |                    |     ladders shall be provided for |
|             |                    |     safe access to all scaffolds  |
|             |                    |     and work platforms. The use   |
|             |                    |     of a scaffold system with     |
|             |                    |     built-in ladder is permitted. |
|             |                    |     The top of each ladder shall  |
|             |                    |     be secured with wire or rope. |
|             |                    |     Also, the ladder shall extend |
|             |                    |     at least 36 inches above the  |
|             |                    |     work platform. Climbing on    |
|             |                    |     cross braces is not permitted |
|             |                    |                                   |
|             |                    | -   Scaffold planks shall extend  |
|             |                    |     over their end supports at    |
|             |                    |     least 6 in, but not more than |
|             |                    |     12 inches and shall be wired  |
|             |                    |     down or otherwise secured     |
|             |                    |     from movement                 |
|             |                    |                                   |
|             |                    | -   Legs and uprights of scaffold |
|             |                    |     shall be plumb and rigidly    |
|             |                    |     braced to prevent swaying     |
|             |                    |                                   |
|             |                    | -   Overhead protection shall be  |
|             |                    |     provided for personnel on a   |
|             |                    |     scaffold exposed to overhead  |
|             |                    |     hazards. Overhead protection  |
|             |                    |     shall also be provided for    |
|             |                    |     employees passing by or under |
|             |                    |     scaffolds that pose overhead  |
|             |                    |     hazards                       |
|             |                    |                                   |
|             |                    | -   Wire or wire rope used for    |
|             |                    |     scaffold suspensions shall be |
|             |                    |     capable of supporting six     |
|             |                    |     times the intended load.      |
|             |                    |                                   |
|             |                    | -   Although it is required that  |
|             |                    |     each scaffold be inspected by |
|             |                    |     a competent person, it is the |
|             |                    |     responsibility of each user   |
|             |                    |     to check his/her scaffold     |
|             |                    |     prior to each use to ensure   |
|             |                    |     it is safe and properly       |
|             |                    |     tagged                        |
|             |                    |                                   |
|             |                    | -   A competent person shall      |
|             |                    |     place a white inspection tag  |
|             |                    |     on every scaffold for daily   |
|             |                    |     inspection.                   |
|             |                    |                                   |
|             |                    |     -   A green tag indicates     |
|             |                    |         that the scaffold is      |
|             |                    |         complete and safe to use  |
|             |                    |         with no additional        |
|             |                    |         precautions               |
|             |                    |                                   |
|             |                    |     -   A yellow tag indicates    |
|             |                    |         that the scaffold         |
|             |                    |         requires additional fall  |
|             |                    |         protection equipment as   |
|             |                    |         indicated on the back of  |
|             |                    |         the tag.                  |
|             |                    |                                   |
|             |                    |     -   A red tag indicates an    |
|             |                    |         unsafe scaffold and is    |
|             |                    |         not to be used. The only  |
|             |                    |         person who may enter a    |
|             |                    |         redtagged scaffold is a   |
|             |                    |         trained scaffold builder  |
|             |                    |         while completing or doing |
|             |                    |         repairs on the scaffold.  |
|             |                    |                                   |
|             |                    |     -   If a scaffold has no tag, |
|             |                    |         it is not to be used      |
|             |                    |         until inspected and       |
|             |                    |         properly tagged. If a     |
|             |                    |         scaffold is found to be   |
|             |                    |         deficient or unsafe and   |
|             |                    |         is tagged green or        |
|             |                    |         yellow, the tag should be |
|             |                    |         immediately removed and   |
|             |                    |         the Site Contractor       |
|             |                    |         notified.                 |
+-------------+--------------------+-----------------------------------+
| -           | -   Striking       | -   Be aware of surroundings      |
|    Climbing |     against other  |                                   |
|             |     objects        | -   Wear full body harness when   |
|             |                    |     working 6' above deck with    |
|             | -   Fall to a      |     lanyard or Arrestive Fall     |
|             |     different      |     Device (A.F.D.)               |
|             |     level          |                                   |
|             |                    | -   Maintain Proper footing       |
|             | -   Slip/trip      |                                   |
|             |                    | -   Maintain proper body          |
|             | -   Overexertion,  |     positioning at all times      |
|             |     strain, sprain |                                   |
+-------------+--------------------+-----------------------------------+
| -           | -   Striking       | -   Be aware of surroundings      |
|  Descending |     against other  |                                   |
|             |     objects        | -   Wear full body harness when   |
|             |                    |     working 6' above deck and     |
|             | -   Being struck   |     secured lanyard               |
|             |     by other       |                                   |
|             |     objects        | -   Maintain proper footing       |
|             |                    |                                   |
|             | ```{=html}         | -   Maintain proper body          |
|             | <!-- -->           |     positioning at all times      |
|             | ```                |                                   |
|             | -   Caught in      | -   Use Hand Rails                |
|             |     between        |                                   |
|             |     objects        |                                   |
|             |                    |                                   |
|             | -   Fall to a      |                                   |
|             |     different      |                                   |
|             |     level          |                                   |
|             |                    |                                   |
|             | -   Fall on the    |                                   |
|             |     same level     |                                   |
|             |                    |                                   |
|             | -   Slip/Trip      |                                   |
|             |                    |                                   |
|             | ```{=html}         |                                   |
|             | <!-- -->           |                                   |
|             | ```                |                                   |
|             | -   Overexertion,  |                                   |
|             |     strain, sprain |                                   |
+-------------+--------------------+-----------------------------------+

+-------------+--------------------+-----------------------------------+
| -           | -                  |                                   |
+-------------+--------------------+-----------------------------------+

+-------------+--------------------+-----------------------------------+
| -           | -                  |                                   |
+-------------+--------------------+-----------------------------------+

+-------------+--------------------+-----------------------------------+
| -           | -                  |                                   |
+-------------+--------------------+-----------------------------------+

General mitigating requirements are as follows:

1.  All employees shall be aware of General Safety Rules.

2.  All employees shall be aware and trained in the Illness & Prevention
    Program.

3.  All employees shall be aware and trained in the Chemical Hazards
    Communication Program.

4.  All MSDS for proposed and used chemicals shall be on file and
    approved with the General Contractor prior to the start of work.
    Provide training as required by the specific MSDS.

5.  All PPE shall be used in accordance with the applicable MSDS.

6.  All employees, where required shall be trained and certified when
    required by OSHA & Cal-OSHA.

7.  All PPE to be approved by ANSI or applicable approval agency.

8.  All MSDS sheets shall be submitted to the General Contractor prior
    to starting work.

9.  Fall protection measures shall be in place for ladder safety in
    heights of 6 feet and higher.

10. Any injury is to be reported to the Supervisor immediately

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Agreed To -- Date

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Approved -- Date

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Reviewed / Approved -- Lawrence Berkeley National Lab Date

**A signed copy of this JHA [must]{.underline} be posted while the
applicable subcontractor is working on-site and be available to any LBNL
employee upon request.**

Copy Distribution:

General Contractor Project Superintendent Subcontractor

LBNL Safety Officer LBNL Construction Manager

**Construction JHA Safety Sign-in Sheet**

**[Date: \_\_\_\_\_\_\_\_\_\_]{.underline}**

**[Print]{.underline} [Signature]{.underline}**

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