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6131 Appendix T4: Fall Protection Permit
Instructions |
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1.0
Purpose
A work control document is required to govern the use of active fall protection systems (fall arrest or fall restraint). Unless work is performed in accordance with an Operational Safety Procedure (OSP) or Temporary Operational Safety Procedure (TOSP), a Fall Protection Permit must be completed and approved to satisfy the work control document requirement.
This appendix provides instruction for completing a Fall Protection Permit to authorize use of active fall protection systems.
2.0
Scope
Jefferson Lab
requires fall protection if personnel may fall 4 ft. or more to a lower level,
or come into contact with dangerous equipment regardless of fall distance. The
Fall Protection Permit may be used, if work is not covered by an OSP or TOSP, as
a temporary work control document for application of active fall protection
systems.
Fall Protection
Permits are applicable only to JLab staff, and are valid for a maximum of 30 calendar
days beyond their issue date.
This appendix is
written in coordination with ES&H Manual
Chapter 6131 Fall Protection Systems.
3.0
Responsibilities
Note: Management
authority may be delegated to a task-qualified TJNAF employee at the discretion
of the responsible manager.
3.1
Employees
Using Fall
Protection Systems
·
Maintain
current training, applicable to use of active fall protection systems.
·
Collect
active fall protection system components from the Material Handling Manager (MHM).
·
Conduct
a pre-use inspection of active fall protection system equipment.
·
Wear
the appropriate active fall protection equipment for the job.
·
Do
not use equipment that fails a pre-use inspection or is past due for a formal
inspection. Remove from service and notify supervision.
·
Transfer
active fall protection system component that fails a pre-use inspection, is
past due for a formal inspection, or has
arrested a fall to the MHM.
·
Review, sign, and abide by hazard mitigation methods
outlined in Fall
Protection Permit.
3.2
Supervision
·
Complete
Fall Protection Permits and obtain necessary approvals prior to start of work.
·
Ensure
walking/working surfaces can support maximum loads.
·
Ensure
anchorages for active fall protection systems have been evaluated and approved
by a qualified person.
·
Ensure
that proper fall protection is being employed by workers.
·
Ensure
all active fall protection system components are available for formal
inspection by the MHM.
·
Ensure
active fall protection equipment is stored appropriately to prevent damage from
operations, the environment, or other work activity.
3.3
Material Handling Manager (MHM)
·
Conduct
formal inspections of all active fall protection system components annually or
in accordance with manufacturer’s recommendations, whichever is more frequent.
·
Purchase
and issue active fall protection system equipment.
·
Maintain
inspection records of active fall protection system components.
·
Dispose
of defective or otherwise unusable active fall protection system components.
·
Conduct
harness fitting for affected personnel and certify individuals have demonstrated
proper donning/doffing of active fall protection system gear.
·
Approve
use of crane hooks as anchor points.
3.4
ESH Fall Protection Subject Matter Expert
(SME)
·
Establish
and maintain training programs for active fall protection systems.
·
Conduct
pre-work walk-downs of jobsite prior to approval of work control documents.
·
Provide
oversight on the implementation of fall protection systems.
·
Approve
use of crane hooks as anchor points.
3.5
Anyone at
Jefferson Lab
· If the
integrity or load-bearing capacity of a walking/working surface is questioned, suspend
work activity, secure the area, and notify supervision.
· If the
integrity of fall protection systems is questioned, or observed to be deficient,
suspend work activity, secure the area, and notify supervision.
4.0
Fall Protection Permit Preparation
4.1 General Requirements
· The Fall Protection Permit form may be accessed at:
· The permit form is to be completed by the supervisor of those performing work using active fall protection (work supervisor).
· Fall protection permits are valid for a maximum of 30 calendar days beyond the issue date.
· The completed permit form is to be posted in the immediate vicinity of the jobsite.
· All person(s) using active fall protection must be current in the following training courses:
o SAF 202 – Personal Fall Protection
o SAF 202A – Harness Fitting
o SAF 202B – Fall Protection (Site Specific)
4.2
Specific Requirements
Note:
Complete all other sections of the permit form, including authorization
signatures, prior to entering Issue and Expiration Dates. |
· Issue Date: Date the permit form has been satisfactorily
completed, and all signatures obtained.
This is the date of the first day which active fall protection may be
used in accordance with the permit.
· Expiration Date: The date of the last day in which the permit
is valid, not to exceed 30 calendar days beyond the issue date. If the duration of work exceeds 30 days, a
new permit shall be completed, approved, and posted at the jobsite.
· Building: Indicate the building at which work will be
performed (indoors or outdoors), or the building closest to the work. Use either the building description (e.g.,
Test Lab) or building number (e.g., Bldg. 58) or both.
· Area: Identify the specific location, within or
outside the building, at which work will be performed.
· Work Supervisor: Record the full name of the supervisor of the
individual(s) using active fall protection, as well as the cell phone number at
which they can be reached. If multiple
work groups are involved, a single individual must be identified/designated as
the Work Supervisor (point-of-contact), or as an alternative, post a separate permit for each
work group.
· Fall Exposure(s): Identify
all locations representing a hazard to personnel of falling 4 ft. or more to a
lower level, or contacting dangerous equipment.
· Fall Arrest vs. Restraint: Check appropriate box by the type of active fall protection being used, either fall arrest (which limits fall distances) or fall restraint (which prevents workers from being exposed to fall hazards).
·
Working Surface: Briefly
identify/describe the following:
o
What means will be
used (such as, a portable ladder, roof hatch, etc.) to access the work site;
o
The walking/working
surface(s) which will be used by personnel;
o
The maximum intended
load(s) on the working surface;
The person evaluating
the working surface(s) must record their name, sign and date the permit.
·
Anchorages
o
Identify what is being
used for fall protection anchorage;
o
Check appropriate box
to answer the following two questions:
Note:
At least one of the two responses must be marked ‘Yes’ as being
applicable. |
§ Are anchorages capable of supporting at least 5,000 lbs. per
person attached? If this is marked
‘Yes’, a qualified
person must record their name, sign and date the permit. Otherwise, mark ‘N/A’.
§ Are anchorages designed, installed, & used under the supervision
of a qualified person, with a minimum safety factor of 2? If this is marked ‘Yes’, a qualified person
for each phase (design, installation, and use) must record their name, sign and
date the permit. Note: horizontal
lifelines must have a safety factor of at least 2, and require a qualified
person to supervise their design, installation, and use. Otherwise, mark ‘N/A’.
A qualified
person is one who, by possession of a recognized
degree, certificate, or professional standing, or who by extensive knowledge,
training, and experience, has successfully demonstrated the ability to solve
or resolve problems relating to the subject matter, the work, or the project. A list of lab staff may be located at Qualified
Persons for Fall Protection. |
· Cranes: Check the appropriate box to indicate if a
crane hook is being used for anchorage of the active fall protection system. If ‘Yes’, the Material Handling Manager (MHM)
must record their name, sign and date the permit. If ‘No’, mark ‘N/A’.
·
Fall Protection Components:
Record the manufacturer, model no., and/or a brief description of the
following active fall protection system components, making note of any specific
features necessary for its successful use, and its latest annual inspection
date (marked on the equipment):
o
Anchorage Connector;
o
Lanyard;
o
Full Body Harness.
· Authorizations:
The Work Supervisor and ESH Fall Protection SME (or assigned designee)
must record their name, sign and date the permit.
· Person(s)
Using Fall Protection: Personnel performing work using
active fall protection systems must review identified requirements, then record
their name, sign and date the permit.
4.3 Additional
Requirements
· Upon conclusion of work covered by the Fall Protection Permit, the form shall be removed from the jobsite and forwarded by the Work Supervisor to the ESH Division, Fall Protection SME.
· In the event a worker has experienced a fall and requires assistance, dial 9-1-1 immediately and request response from the Newport News Fire Department. If a cell phone is used to dial 9-1-1, contact Jefferson Lab security at 757-269-5822 so that they may direct the first responders to the jobsite (security is automatically notified if 9-1-1 is dialed via a Jefferson Lab land-line phone).
5.0
Revision Summary
Revision 0.1 –
11.08.2023 – Changed TPOC from GPerry to CBailey; extended review date due
to staffing and transition of duties; updated header and footer hyperlinks
Revision 0.0
– 04-28-2020 – Initial content to
support associated chapter and appendices changes
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ISSUING AUTHORITY |
TECHNICAL POINT-OF-CONTACT |
APPROVAL DATE |
NEXT REVIEW DATE |
REVIEW CYCLE |
rev |
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ES&H Division |
04.28.2020 |
04.28.2024 |
3 years |
0.1 |
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