JHA#: Reviewed By:

Job Hazard Analysis Date:

Contract: SCRM 8356921 Phase: Horizontal slab on deck formwork

Contractor: Formwork Location: La Jolla, CA Completed By:

Unsafe Condition, Action, or Preventative or Corrective Action That Will be Taken

Activity Operation Other Hazard (Applicable Site & Specific MSDS should be listed.)

All Equipment flown into work area should have appropriate

number of tag lines. Tower Crane shall signal when load is
arriving overhead. Ensure you are clear of loading zones
Installing Shoring Tower Struck By Material Hoisting
when equipment is being flown onto deck/slab. All rigging
should have appropriate tags identifying lifting capacities.
Rigging shall be inspect for damage prior to picking any loads.
All equipment should be stacked and organized with routes of
travel left clear & open. Stacked material should be secure
Struck By Material Storage
from falling or tipping hazards. When landing material ensure
your body is not in between load and solid structure.
Ensure forklift back up alarm is working. Make eye contact
with lift operator when working in proximity. Area where forklift
is working should be cautioned off to ensure only deck crew is
Struck By Forklift working in area. All personnel in area are required to have
safety vests. Ensure forks are down when moving forklift and
parking brake is on if operator leaves the lift. Lift operator must
wear seat belt during lift operation.
Ensure you are following manufacturer guidelines when using
scissor lift for shoring tower erection. All scissor lift operators
must have received proper aerial lift training. Ensure
Falling Scissor Lift extending portion of lift is locked into place and access chain
is in place prior to beginning work. Area of deck/slab should
be surveyed for any openings prior to work. All openings must
be clearly marked prior to working on scissor lift to ensure lift
The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 1 of 8 Form C4.1

JHA#: Reviewed By:

does not tilt/fall over.

When working above 6' for shoring tower installation setup

working platform three scaffold planks wide with no gaps. Use
only OSHA grade scaffold planks. Climb scaffold tower as a
ladder using three points of contact at all times. Once safely
on the scaffold use lanyard to tie off to shoring tower. Ensure
all frames have been securely attached and fully braced.
Falling Shoring Tower Utilize cleats on the bottom of all scaffold planking to ensure
the planking stays in the desired location. Remain aware of all
special planking conditions which may cause cantilever
unsupported planked sections. Only members of the deck
crew are allowed to access shoring towers. Ensure all other
personnel stay out of decking zones. Utilize caution tape as
necessary to secure all work zones.
Ensure all towers and posts are installed 100% prior to leaving
area. Install all required tower bracing as shown on formwork
Struck by Shoring Towers drawings. If any towers seem unstable contact Forman prior to
leaving area. Ensure all pins are locked in place and all safety
devices have been correctly installed.
Work as a team to spread decking towers. Use proper lifting
Strains
techniques.
100% fall protection required when working above 6'. Ensure
fall protection system has appropriate 5000# anchorage point.
Setting Stringers and Beams Falling Ensure all SRL's which are being utilized for decking operation
have pull cords to allow access to device from safe working
area.
Ensure area below installation has been cautioned off. Ensure
all hand tools are securely located in tool bags. If unaware
workers come into decking area notify them that they are in a
controlled zone and that they must leave area until decking
Struck by deck material
operation is complete. Carefully land all material loads to
ensure they will not fall over. Keep in mind wind gusts when
landing materials and ensure materials are placed in a manner
that they cannot be blown off building.
Work as a team to spread large deck beams. Use proper
Strains
lifting techniques.
The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 2 of 8 Form C4.1

JHA#: Reviewed By:

Ensure leading edge area is established. Employees on

leading edge must be tied off to leading edge horizontal
lifeline or SRL. SRL on all leading edge must be shock pack
model if SRL cable is subjected to greater than 90 degree
bend. If SRL is installed onto deck it must be held upright
using armadillo holder to keep it in place. All SRL's must be
attached to appropriate 5000# anchorage point. Area of work
Installing Deck Material Falling should be 100% passive fall protection prior to allowing
personnel to access deck. Access zone shall to leading edge
shall remain clearly marked with barricade and or caution tape
placed greater than 6' back from edge. Only decking crew will
be allowed passed leading edge zone delineation. Decking
crew working out passed the zone and with in 6' of a fall
hazard must have appropriate fall protection system in place
prior to coming within 6' proximity of leading edge.
All deck material should be cut utilizing cutting tables allowing
for correct use of Skil saw. Gloves shall be worn when using
Cutting Injuries
cutting devices. All power tools should be inspected prior to
use to ensure all guards are working properly.
All power tools should have all appropriate grounds attached
or be double insulated. Inline GFCI shall be used when using
generator as power source. If you are using a spider box
Electrocution
check box to ensure it has had its monthly inspection. If Spider
box has not had a inspection within prior month report
immediately to Forman or Superintendent.
Utilize gloves to protect hands when using hammers and all
Struck By Hand Tools similar hand tools. Inspect personal hand tools on a daily
basis to ensure tools are in good working condition.
All deck openings should be protected with secured covers
capable of supporting working load or guard rail capable of
supporting 200 lb. lateral load. Guard rail material shall be
Falling A Deck Openings select lumber free of knots and splits #2 or better. Openings
are never to be left unattended. Carpenters installing or
removing opening protection shall have area marked off with
danger tape and must be 100% tied off.
All access ladders shall extend 36" above deck to which they
Falling A Ladders
are accessing and secured top and bottom. Guardrail shall be
The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 3 of 8 Form C4.1

JHA#: Reviewed By:

in place providing safe passage to deck work area. Ladders

shall be climbed using three points of contact and signage
indicating this shall be in place at top and bottom of ladder. All
ladders shall have visible signage indication load limits.
Ladders with bent or damaged rungs and without proper load
markings shall not be used.
Deck area shall be kept tidy and organized. Construction trash
should be picked up and dumped on a daily basis or as
Tripping & Slipping
needed. Materials shall remained neatly stacked and paths of
travel shall remain free from obstructions.
Provide all craft safe access to working deck. Review access
areas to working deck with Superintendent and Forman prior
Falling A Access to putting up. Ensure access has been appropriately tagged
with date (green tag for approved access red tag for closed
access point).
Follow decking drawings to ensure all supports are installed
as necessary. Review deck with Atlas and HP Superintendent
prior to placement. Review cantilever sections which require
specific loading requirements. Review necessary deck
placement pattern with placement crew prior to pour. Monitor
decking and placement crew to ensure deck is loaded evenly
Placing Deck Collapsing deck material during concrete placement and formwork maintains its
intended shape. Utilize preAestablished grade check points to
see how deck is reacting under load. Ensure adequate lighting
is available to utilize tools and equipment necessary for
operations. Have additional shoring available as necessary for
added support prior to pour. Forman documentation of deck
review process is mandatory.
Inspect fall protection on a daily basis and or before use.
Ensure all nylon webbing is free from frays and all connectors
require two actions to open. Ensure all metal rings are free
from visible signs of cracking and visible deformation. Check
General Falling all SRL's to ensure they are retracting and locking prior to
hooking up. Report any deficiencies with harness or other fall
protection components to Forman or Superintendent
IMMEDIATELY. HPCC has a Zero tolerance policy for fall
protection violations. The first fall protection violation will result
The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 4 of 8 Form C4.1

JHA#: Reviewed By:

in being sent home for the day. The second fall protection
violation will result in termination.
Ensure you are following manufacturer guidelines when using
scissor lift for shoring tower erection. Inspect scissor lift daily
to ensure all components are function properly. All scissor lift
operators must have received proper aerial lift training. Ensure
extending portion of lift is locked into place and access chain
is in place prior to beginning work. Ensure you understand the
lift's capacity in its various configurations and that the machine
Falling Scissor Lift
is not being over loaded. Ensure alarm is working when
lowering lift. Be cognizant of your position and the positions of
your coworkers, double check your surroundings before
moving the lift. Area of deck/slab should be surveyed for any
openings prior to work. All openings must be clearly marked
prior to working on scissor lift to ensure lift does not tilt/fall
over.
Check horizontal life line for abrasion prior to installation.
Insure unprotected parts of the line are not allowed to come in
contact with reinforcing causing damage to life line. Ensure
that all SRL's are attached to the rings supplied in the HLL kit.
Horizontal Life Line
Ensure the SRL you are attached to is near your work area
and you are not exposing your self to a swing fall hazard. As
you are shifting your work area you must be shifting your SRL
attachment point.
Ensure all air tools are inspected prior to use. Ensure all
Air Tools Safety retaining pins are in place and whip checks are installed on all
air hose connection points.
All power tools shall be checked prior to use. Ensure all
guards are fully functional and that all cords have proper
Power Tools
grounds. All power cords must be checked for
nicks/cuts/exposed wiring prior to use.

The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 5 of 8 Form C4.1

JHA#: Reviewed By:

Equipment To Be Used Inspection Requirements Training Requirements

Tower Crane Prior to each shift; annual; quadrennial NCCCO

Scissor Lift Prior to each shift Operator Card

Forklift Prior to each shift Operator Card

The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 6 of 8 Form C4.1

JHA#: Reviewed By:

Designated Competent Person Activity

Peter Shruggs Fall Protection

The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 7 of 8 Form C4.1

JHA#: Reviewed By:

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The JHA has been reviewed by HPCC for general compliance with the jobsite safety requirements. HPCC review, however, does not relieve Subcontractor of the responsibility for compliance with all
applicable safety laws, regulations, ordinances, and contractual requirements. Subcontractor is responsible for reviewing this JHA with all personnel involved with the Definable Feature of Work
(DFOW) on a regular basis and must notify HPCC and adjust the JHA as necessary whenever the plan for performing the DFOW is modified.

Modified: 04.2011 Page 8 of 8 Form C4.1