Site Specific Fall Protection Plan

List of chemicals/products used on site PRODUCT NAME: Wabo FlameGuard II Blanket Chemical Family: Refractory Fiber Link to MSDS:https://wbacorp.com/public/userfiles/WaboFlameGuardIIBlanket_MSDS.pdf

FALL PROTECTION PLAN SITE SPECIFIC

Product name: Sikaflex® ‐ 1A

Link to MSDS: https://usa.sarnafil.sika.com/downloads/repository/submittal/productdata/Sikaflex%C2%AE1A.pdf

Skanska/Balfour Beatty Project: Microsoft Parking Garage 07 95 00- Seismic Joint Covers

Microsoft Parking Garage - Fall Protection Plan & Checklist Project # MSCR 4218019

Spectrum Specialty Builders This is our fall protection plan specific for two locations of work that have potential fall hazards, all other work locations are at the floor or deck with less then 12" of floor gap.

There are two locations requiring fall protection: 1) Vertical seismic joints on P1 and P2 which will be accessed by scissor lift 2) West perimeter deck joint, where joint width is in excess of 12" wide Date

09/18/2020 Spectrum Foreman

Robin Pridemore Location

Level P2 perimeter joint Fall Protection Type

Scissor Lift-with harness/lanyard Scissor Lift Pre-Use Checklist Was scissor lift operated? if no, skip section

Yes Operating and emergency controls are in proper working condition Drive controls function properly and are accurately labeled All safety indicator lights are in proper working condition Oil level, Hydraulic oil level, Fuel level, Coolant level, Battery is charged All guard rails are in place, including basket chains Motion alarms are functioning Control panel is clean; all buttons and switches are clearly visible Both upper & lower controls are protected from inadvertent operation Lower operating controls successfully override the upper controls Functional upper drive control interlocks (foot pedal, spring lock, etc.)

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Microsoft Parking Garage - Fall Protection Plan & Checklist Project # MSCR 4218019

Full Body Harness

Inspect webbing and look for any wears or tears Inspect hardware and lanyard Inspect label

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Microsoft Parking Garage - Fall Protection Plan & Checklist Project # MSCR 4218019

Retractable Lanyard at Open Floor Joints Retractable lanyards are leading-edge rated and are only used at open floor joints in excess of 12" Retractable lanyard to be connected to a 5,000 point Tie-off Check functioning of retractable lanyard, including leading edge capability retractable lanyard is connected to a 5,000 point Tie-off Check that manufacturer's label is legible

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Microsoft Parking Garage - Fall Protection Plan & Checklist Project # MSCR 4218019

Man Lift Photo Photo of scissor lift with model number

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Microsoft Parking Garage - Fall Protection Plan & Checklist Project # MSCR 4218019

Demarcation of Open Floor Joints in Excess of 12" At open floor joints where temporary fall protection is removed, red warning tape is to be installed with signage indicating Spectrum Specialty Builders, foreman's name, and foreman's phone number.

At the level below the work location, red tape to be installed with signage indicating Spectrum Specialty Builders, foreman's name, and foreman's phone number.

Red tape is installed at work level to demarcate floor joint Red tape is installed at level below work area Signage is installed at red tape with foreman's name and phone number

Foreman Signature

Employee Signature

Employee Signature

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