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PARTNERSHIP AGREEMENT
Between the
NATIONAL ASSOCIATION OF TOWER ERECTORS
(NATE)
And
U.S. DEPARTMENT OF LABOR
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
(OSHA)

  1. PARTNERS

    The partners to this agreement are:

    • The National Association of Tower Erectors (NATE)
    • The Occupational Safety and Health Administration
    • Participating NATE members (shall be referred to as participants throughout the Partnership Agreement document)
    • Refer to Appendix A for participant eligibility criteria.
  2. PURPOSE, SCOPE, and BACKGROUND

    1. Purpose/Scope

      This partnering agreement was developed jointly by the National Association of Tower Erectors (NATE) and the Occupational Safety and Health Administration (OSHA). Realizing the importance of safety for their members, NATE agrees to increase its commitment and resources toward providing a safe and healthful working environment for its employees and contractors. For instance, this agreement provides for the placement of a competent person, responsible for employee safety and health efforts on all tower sites. Additionally, NATE has developed an organized system for partners to self-conduct safety and health audits for 10 percent of their work sites (or 24 total worksites, whichever is less), and report the results of such audits to NATE, who will then aggregate the results and forward to OSHA. In turn, OSHA anticipates the Partnership will increase OSHA's visibility among NATE's membership and further enhance the cooperative relationship between the two organizations.

      The partners will work to provide a safe and healthful work environment for employees and contractors involved in the telecommunications tower erection industry by preventing serious accidents and fatalities through increased training, implementation of best work practices, enhancement of safety and health management systems, and compliance with applicable OSHA standards and regulations.

      Partnership goals will be accomplished by focusing the efforts, skills, knowledge, and resources of NATE and OSHA to benefit tower erector industry employees. Increased communication and respect between partners are additional benefits expected to be realized through this Partnership.

    2. Background

      Advances in telecommunications and an increasing dependence on wireless communications and broadcast services have fueled the construction, service and maintenance of telecommunication and broadcast towers throughout the country. With this unprecedented growth, the telecommunications and broadcast tower erection industry and the safety and health community have expressed concerns about work practices and the health and safety of tower workers. As a result, NATE and OSHA have worked jointly for several years to improve the safety and health of tower workers.

      One such successful endeavor was the OSHA Strategic Partnership between NATE and OSHA's Region V, established December of 2001. Additionally, in 1996, OSHA established the Tower Task Force to address the concerns of this industry. OSHA and NATE have jointly conducted telecommunications and broadcast tower safety and health training for both industry representatives and OSHA personnel in order to provide education on best work practices with regard to the erection of telecommunications towers.

      NATE is an association that represents the employers of employees who erect, service and maintain telecommunication and broadcast towers. This trade association was formed in 1995, and more than 500 companies are members. The companies range in size from five to 300 employees, with 99% having fewer than 200 employees and 85% having 15 or fewer employees.

  3. GOALS, STRATEGIES, AND MEASURES

    These tables are best viewed on tablets, notebooks, or desktop computer screens.

    GOALS STRATEGIES MEASURES
    1) Reduce the percentage of injuries, illnesses and fatalities of participating telecommunication and broadcast tower erection employers, and their subcontractors, to an aggregate rate that is below the BLS average, based on most recently published data.
    1. Analyze participant data to identify causal factors and corrective actions. Share corrective actions.
    2. Establish a baseline year to provide for the analysis of results.
    3. Participants to use tools such as the NATE Site Safety Audit Checklist. See Appendix E.
    4. Create/disseminate safety and health materials to NATE participants.
    5. OSHA to provide 10 Hour training up to two times a year as resources allow. All supervisory personnel to receive OSHA 30 hour training.
    6. Develop, implement, and share best practices with participants. Establish a website or tool to communicate best practices among participating NATE members. For example, produce/disseminate guidelines for the use of gin poles and tower maintenance activities.
    7. Participants to provide 100% fall protection.
    8. Review annually and provide feedback on participants' safety and health management systems as needed.
    1. OSHA 300 Logs
    2. Percent of participant employees and contractors receiving requisite OSHA 10 or 30 hour training
    3. Percent of participants using each tool
    4. Number of best practices developed and the percentage of implementation among NATE participants
    5. Number of injuries/fatalities related to falls (compared to baseline)
    6. Number of casual factors identified and abated by participants
    7. Percentage of participants Safety and Health Management Systems reviewed by NATE as part of the application agreement process.
    8. Percent or number of fatalities reduced from baseline
    9. Results of NATE audits
    2) Recognize participants that successfully achieve reductions in illnesses, injuries, and fatalities.
    1. Develop a recognition system to recognize participants for reductions in injuries, illnesses and fatalities in the telecommunications and broadcast tower erection industry.
    1. Number and percentage of participants recognized
    3) Improve awareness of OSHA Compliance Safety and Health Officers (CSHO's) on the hazards/issues associated with the tower erecting industry.
    1. Increase the number of employees that attend the OSHA 3150 Tower Safety course.
    1. Number of CSHO's completing the course from the time of the established baseline.
  4. ANNUAL EVALUATION

    The Partnership will be evaluated on an annual basis using the Strategic Partnership Annual Evaluation Form as specified in Appendix C of CSP 03-02-002, OSHA Strategic Partnership Program for Worker Safety and Health Directive. It will be the responsibility of NATE to gather required participant data to evaluate and track the overall results and success of the Partnership. This data will be shared with OSHA through the Partnership Management Team (PMT) (see Section VIII). It will be the responsibility of OSHA to finalize the evaluation, with input from its partners.

  5. OSHA VERIFICATION

    OSHA shall verify participant compliance with the Partnership agreement through offsite verification. OSHA will review Partnership data provided with the application forms (See Appendix C) and reports submitted annually by NATE. Documentation is reviewed to determine whether partners are implementing the provisions of the Partnership agreement. The documentation selected for review will relate to the goals, objectives and stated measures of the Partnership agreement. Examples include illness and injury data, training course agendas and rosters, and the annual report on the results of the self-audit. Verification shall be accomplished on an annual basis and will coincide with the annual evaluation. Verification will consist of CEO signatures attesting to meeting partnership requirements, and the site safety and health audits submitted to NATE.

    Partnering employers remain subject to OSHA programmed inspections, referrals, and investigations for formal complaints, fatality/catastrophes and imminent danger situations in accordance with agency policies and procedures. Employees remain assured of their statutory rights with regard to inspection participation. OSHA will use the Telecommunication and Broadcast Tower Inspection Checklist (See Appendix D) when conducting programmed inspection activity at participant sites. OSHA will not expand beyond the normal scope of focused inspections for construction, nor will they address issues beyond the checklist unless those items are not properly addressed. OSHA reserves the right to expand the inspection scope if the items are not properly addressed. Citations will be issued and penalties assessed for violations of statutes, regulations or the general duty clause consistent with OSHA policies and procedures and this Partnership. See Section VIII, Employee/Employer Rights and Responsibilities.

  6. BENEFITS

    The following benefits are available to qualifying participants:

    Focused Inspections

    Programmed inspections of participants will be limited to the aforementioned inspection checklist as outlined above (See Appendix D) and any observable hazards. If necessary, those checklist items and/or observed hazards should then be properly addressed. OSHA reserves the right to expand the inspection scope if the checklist items or observed hazards are not properly addressed, or if the site falls outside of the criteria required for conducting focused inspections in construction.

    Unprogrammed Inspection Activity

    Complaints, Referrals, or Fatality inspections shall be conducted per the FIRM.

    Citation Issuance

    When calculating the initial penalty reduction, OSHA will provide an additional 10% reduction for good faith beyond the reductions provided in the FIRM where the employer, in implementing the OSP, has taken specific significant steps beyond those provided in the FIRM to implement the Act and achieve a high level of employee protection (see FIRM, Chapter IV.C.2.i.5[b]). This additional reduction will not apply to high gravity serious, willful, failure to abate or repeat citations. In cases where a partner's total penalty reduction is 100 percent or more, the minimum penalty provisions of the FIRM will apply (see FIRM, Chapter IV.C.2.b).

    In the event that a citation with penalty is issued to an OSP partner, the Regional Administrator (RA) has the authority to negotiate the amount of penalty reduction as part of the informal conference settlement agreement.

    No citations will be issued for other-than-serious violations when the violations are immediately abated.

    Priority Consideration

    As resources allow, participants will receive priority consideration for compliance assistance and offsite technical assistance (phone calls/faxes) by OSHA . Where appropriate, OSHA-funded State Consultation Projects will be encouraged to participate in this Partnership and/or offer assistance to participating members.

    Recognition

    Recognition such as certificates and press releases issued by OSHA, recognition on OSHA's web page, worksite banners, letters and plaques will be available to Partnership participants.

  7. PARTNERSHIP MANAGEMENT AND OPERATION

    Representatives from NATE and OSHA will jointly manage the Partnership. The Partnership Management Team (PMT) will consist of the following representatives:

    • OSHA's Directorate of Cooperative and State Programs (1)
    • OSHA's Directorate of Construction (1)
    • OSHA's Directorate of Enforcement Programs (1)
    • OSHA Field Representation (2)
    • NATE Executive Committee (3)
    • NATE Executive Director (1)
    • NATE OSHA Relations Committee Member (1)
    • NATE Legislative and Regulatory Committee Member (1)
    • OSHA State Plan States are encouraged to adopt this Partnership, and if appropriate, a state plan representative may be selected for participation on PMT.

    In addition to their responsibilities as part of the PMT, the partners commit to the following individual roles:

    NATE will:

    Administer the application and certification protocol (including review of participant safety and health audits) of participating companies (see Appendices A and B);

    Ensure compliance with partnership requirements, including adherence to OSHA's Partnership Directive;

    Supply OSHA with an initial list of eligible participants for review and inclusion in this Partnership agreement. Submit a new list annually thereafter for review by OSHA. This process will assist in the overall tracking of the industry performance;

    Continue to increase its commitment and resources to safety and health efforts;

    Participate in the PMT;

    Continue to share and mentor prospective Partnership candidates in broadcast and telecommunications tower best practices; and

    Track and report data for participant companies to OSHA (see Section III);

    Help identify programmatic needs of this Partnership by reviewing the documented safety and health management systems of participating members

    Help identify (through the review of OSHA 300 logs) accidents, near misses, and primary causal factors in injuries and illnesses and strategies to improve.

    Identify best practices to be shared among NATE members and OSHA.

    OSHA will:

    Support NATE in providing assistance to participants to improve their safety and health management systems;

    Assist with a trend analysis of the identified accidents, near misses, primary causal factors of injuries and illnesses, and in coordination with NATE, recommend strategies to improve;

    Provide information on training resources, including available OSHA Training Institute (OTI) and OSHA Education Centers Courses;

    Assist partners in accessing interpretations and clarifications as to the meaning and application of OSHA standards and policy;

    Participate in training sessions and meetings, as resources, law and OSHA policy permit;

    Designate a safety and health specialist(s) experienced in working with the tower industry to serve as a resource and liaison for partnership participants as resources allow. The designated specialist is expected to participate on the PMT;

    In coordination with NATE, develop a limited access web page for participant's use.

    Participate in and coordinate the Partnership Management Team.

  8. EMPLOYEE/EMPLOYER RIGHTS AND RESPONSIBILITIES

    This partnership does not preclude employees and/or employers from exercising any right provided under the OSH Act, nor does it abrogate any responsibility to comply with rules and regulations adopted pursuant to the Act.

  9. TERMINATION

    This agreement will terminate on ________, which is three years from the date of the signing. If either OSHA or NATE wishes to withdraw their participation prior to the established termination date, the agreement will terminate upon receiving a written notice of the intent to withdraw from either signatory.

    For non-signatory participants of the strategic partnership, OSHA or NATE may terminate the participant's involvement at any time with written notice. Additionally, the participant may withdraw their participation from the strategic Partnership at any time with a written notice of the intent to withdraw to OSHA and NATE.

  10. SIGNATURES

     

     


    • Don Doty
    • Chairman
    • National Association of Tower Erectors

    • Edwin G. Foulke, Jr.
    • Assistant Secretary
    • Occupational Safety and Health Administration

    • Patrick M. Howey
    • Executive Director
    • National Association of Tower Erectors

 

 

Appendix A
Eligibility Criteria for Additional Participants

Eligible tower owners, general contractors, and carriers are invited to join this Partnership. Although such companies may or may not perform construction work on their towers using their own employees, they shall assure that contractors performing work on their towers have implemented effective safety and health management systems that address telecommunications tower hazards, including 100 percent fall protection above 6'.

All participants will conduct safety and health audits for 10 percent of their work sites (or 24 total worksites, whichever is less), per year, and report the results of such audits to NATE, who will then aggregate the data and submit to OSHA.

Owners and Carriers must meet the following criteria before becoming eligible to participate in this Partnership:

  1. Implement a safety and health management system that meets the minimum requirements set by NATE, modeled after OSHA's 1989 Safety and Health Guidelines;
  2. Maintain towers in accordance with the Telecommunications Industries Association (TIA) tower standard, TIA 222;
  3. Meet, at a minimum, the practices set forth in the NATE Tower Owner Safety Checklist (See Appendix D);
  4. Ensure the presence of a competent person, responsible for safety and health activities, at each tower covered under this Partnership. A competent person is defined as follows, taken from OSHA standard 1926.450:

    "'Competent person' means one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them."

    A competent person must be present at all times on every site;

  5. Have no willful violations, or serious violations directly related to a fatal accident within the last three years from the date of this agreement (based on national inspection history);
  6. Submit OSHA 300 logs for the previous three years to NATE; and
  7. Submit a letter of commitment, signed by management, ensuring all eligibility criteria has been met.

Contractors must meet the following criteria before becoming eligible to participate in this Partnership:

  1. Implement a safety and health management system that meets the minimum requirements set by NATE, modeled after OSHA's 1989 Safety and Health Guidelines;
  2. Meet, at a minimum, the practices set forth in the NATE Qualified Contractor Evaluation Checklist
  3. Ensure the presence of a competent person at each tower covered under this Partnership. A competent person, responsible for safety and health activities, is defined as follows, taken from OSHA standard 1926.450:

    "'Competent person' means one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them."

    A competent person must be present at all times on every site

  4. Have no willful violations, or serious violations directly related to a fatal accident within the last three years from the date of this agreement (based on national inspection history);
  5. Submit OSHA 300 logs for the previous three years to NATE;
  6. Submit a letter of commitment, signed by management, ensuring all eligibility criteria has been met; and
  7. Provide 100 percent fall protection over 6'.

 

 

Appendix B
Application Process

Tower Erectors Application Process

Tower erection, service and maintenance companies can apply for participation in the NATE/OSHA Partnership by submitting the attached application/agreement form, including the signature of the company CEO and including necessary documents as listed, to the NATE office. Participation is contingent upon NATE and OSHA approval. See attached Document B.

Owners, Carriers, and Contractors

Tower Owners, Carriers and General Contractors can participate in this partnership by filing appropriate application form to be developed, contingent upon NATE and OSHA approval.

 

 

Appendix C
Participant Application
Tower Erection and Maintenance Industry Partnership Application/Agreement Form

Submit to the National Association of Tower Erectors (NATE) by October 1, 2006

Contractor

_________________________________________

Address

_________________________________________

City, State, Zip

_________________________________________

Telephone

_________________________________________

Fax

_________________________________________

Email

_________________________________________


SIC Code: (Tower Erectors 1799 - Other codes may be used if applicable.)

________ (Classification)

  1. Supply injury and illness data for the last three years from your OSHA 300 logs.
    (include OSHA 300 logs with application/agreement and designate the number of hours)

    These tables are best viewed on tablets, notebooks, or desktop computer screens.

      2003 2004 2005
    a. Number of fatality cases      
    b. Total hours worked, or approximate number of employees      
    c. Lost workday incidents
    (also includes injury cases with restricted work)
         
    d. Incidents
    (recordable injuries or illnesses without lost days)

    SIC Code: _____________
         
    e. Experience Modification Rate
    (from your insurance carrier)

    SIC Code: _____________
         

    *In a situation where a company may be new or a company with less than ten employees that may not have an OSHA 300 log, provide the injury and illness data you have, accompanied by a letter explaining why you are not submitting OSHA logs.

  2. Do you use the reference material NATE recommends for safety and health?
    Yes No
  3. Do you regularly attend NATE sponsored safety seminars?
    Yes No
  4. Do you hold weekly safety meetings?
    Yes No
  5. Does your company have a written safety and health program that meets or exceeds the NATE program?
    Yes No
  6. Do you supply your employees with your company's safety and health program?
    Yes No
  7. Do you have on-site safety inspections?
    Yes No
    1. If yes, who conducts these inspection? ____________________________
    2. Frequency of inspections? ____________________________
    3. Written record maintained? ____________________________
  8. Has your company had a willful violation or a serious violation from OSHA, nationwide, directly related to a fatality within the past three (3) years?
    Yes No
  9. Does your company policy require your supervisors and employees to be held accountable for following your safety and health programs that meets or exceeds the OSHA rules and regulations?
    Yes No
  10. Will you provide all supervisory personnel or "competent persons" engaged in construction activities the OSHA 30-hour course that relates to the tower communication industry or its equivalent within one year of signing this agreement?
    Yes No
  11. Will you provide all non-supervisory personnel engaged in construction activities the OSHA 10-hour course or its equivalent within one year of signing this agreement?
    Yes No
  12. Will you permit site verification audits to assure OSHA Partners are adhering to the agreement? (Approximately 10% of participation NATE members will be audited on an annual basis.)
    Yes No
  13. Do you agree to have a competent person from your company conduct safety audits on your jobsites and forward audits for 10% of your projects to the NATE office via the NATE website on a quarterly basis?
    Yes No

President or CEO (please print): ____________________________

Signature: ____________________________

Person Completing Application (please print): ____________________________

Title: ____________________________

Signature: ____________________________ Date: ____________________________

Each participating NATE member will be provided with partnership identification cards for on site crew supervisory personnel. Please indicate how man I.D. cards your company will require: ________

Note: In order for this document to be valid, the original copy of the application/agreement must be mailed along with a copy of you OSHA 300 logs. Faxed copies will not be accepted. Failure to meet any of the requirements of this agreement will result in your company being removed from the Partnership.

Please mail to: National Association of Tower Erectors
8 Second Street • Watertown, South Dakota 57201-3624

 

 

Appendix D
OSHA Inspection Checklist
TELECOMMUNICATION TOWER INSPECTION CHECKLIST

An effective safety and health program has been implemented on the job site

A competent person, responsible for safety and health activities, has been designated for onsite activities

100% Fall protection over 6' training has been completed for all exposed employees and written certification maintained:

  • Each individual having received training has been personally identified
  • The completion date for the training has been documented on each training record
  • All employees' training records are readily accessible for inspection purposes

Inspections of the following equipment are performed every time put into use:

  • All personal protective equipment
  • Fall protection systems including fall restraint, arrest and positioning device systems
  • All hand tools and electrical equipment
  • Rigging equipment
  • Tag lines

    NOTE: It is recommended that a written validation of inspection be maintained at the job site and that a tagging system be implemented for equipment taken out-of-service.

Location(s) where high-voltage lines and other electrical hazards have been identified and marked

  • Electrical service provider has been notified prior to the start of work (if needed)
  • Site specific briefing notifying employees of identified hazards and means of control/elimination has been performed

Emergency procedures have been determined and implemented prior to the start of work

  • Personnel trained in first-aid and CPR have been identified
  • Site specific emergency rescue procedures have been developed and documented
  • All applicable warning and danger signs have been posted and maintained on the job site

SAFETY REQUIREMENTS TO BE IMPLEMENTED WHEN RIDING THE LINE

All hoist operators have been trained

  • Written certification of training is maintained at the job site

Daily hoist inspections are performed and documented

Hoists shall be approved for personnel lifting

Inspection records are maintained at the job site or are readily accessible

Load capacity charts and operating manuals are maintained on the job site

Load capacity charts for gin poles are maintained on the job site

Gin Poles shall be inspected before use by a competent person to determine they are free from defects

A pre-lift meeting shall be held prior to the trial lift at each location

  • Documentation with signatures of attendees
  • Meetings documentation contains a list of all points covered and hazards identified
  • Meetings documentation is maintained on the job site

Daily inspections of radio communication devices are performed, if in use

Anti-two blocking device or system is operational and functioning properly

A trial lift is performed prior to placing personnel on the line or in man baskets and repeated if the configuration changes that may cause a hazard

  • Trial lifts are documented and the documentation is maintained on the job site
  • All hoist system controls and safety devices are activated and functioning properly
  • No interference with the lift exists

All identifying tags on personnel platforms are posted and maintained

The hour meter is operational and functioning properly

All exposed gears, belts, pulleys, projected screws, set screws, chains, chain sprockets, and reciprocating and rotating parts are properly guarded

Hoist controls are clearly identified

  • Each control is legibly marked
  • All controls are within easy reach of the operator's station
  • Where applicable, over-speed prevention devices are used

All hoists are secured and properly anchored to ensure hoisting safety

 

 

Appendix E
OSHA Inspection Checklist
NATE/OSHA Partnership
Site Safety Audit Form

Company

_________________________________________

Site Location:

_________________________________________

Name of Competent Person on Site:

_________________________________________

Name of Person Conducting Audit:

_________________________________________

Customer:

_________________________________________

Type of Structure:

Monopole  SST  Guyed  Rooftop  Water  Tank  Other _______________________

Scope of Work:

_________________________________________

PART 1: JOB SITE DOCUMENTATION
A. Was a Job Hazard Analysis conducted, form filled out and on site? Yes No N/A
B. Are the applicable safety signs posted? Yes No N/A
C. Is there a competent person on site? Yes No N/A
D. Is someone on site certified in First Aid / CPR / BBP? Yes No N/A
E Has the emergency data for been filled out and posted? Yes No N/A
F. Has a site-specific emergency rescue plan been developed and documented? Yes No N/A
G. Is there a documented procedure for any overhead electrical hazards? Yes No N/A
H. Are MSDS's available for the material being used on site? Yes No N/A
PART 2: JOB SITE CONDITIONS (INCLUDE ENVIRONMENTALS)
A. Is the work site clean of trash? Yes No N/A
B. Are materials stored properly and orderly? Yes No N/A
C. Are measures taken to prevent access by unauthorized personnel to the site? Yes No N/A
D. Are areas barricaded as required? Yes No N/A
E. Is drinking water available? Yes No N/A
F. Are chemical, flammable and combustible liquids stored properly? (i.e. No plastic gas cans) Yes No N/A
G. Are fire extinguisher of the appropriate size and type available, and with current inspection tags? Yes No N/A
H. Are plant and animal hazards addressed and documented? Yes No N/A
PART 3: PPE
A. Are employees wearing hard hats? Yes No N/A
B. Are employees wearing proper work boots? Yes No N/A
C. are safety glasses being used? (if applicable) Yes No N/A
D. Are employees wearing gloves? (if applicable) Yes No N/A
E. Are employees dressed in appropriate work clothing? Yes No N/A
F. Is hearing protection being used? (if applicable) Yes No N/A
PART 4: FALL PROTECTION EQUIPMENT
A. Do employees that are exposed to falls have documented training? Yes No N/A
B. Is fall protection equipment being inspected daily and documented? Yes No N/A
C. Are all Fall Protection equipment tags legible? Yes No N/A
D. If the work being performed requires fall protection, is it being used 100%? Yes No N/A
E. Is the proper equipment on the site to complete the task? Yes No N/A
PART 5: RF
A. Have RF hazards been considered (if applicable)? Yes No N/A
B. Is there a procedure in place to reduce the RF exposure within statutory limits?
(if applicable)
Yes No N/A
PART 6: HOISTS
A. Are daily inspections being completed with documentation on site? Yes No N/A
B. Is hoist operator qualified? (Certified through training or qualified through experience) Yes No N/A
C. Are load charts posted and readily available to hoist operator? Yes No N/A
D. Is there an operator's manual for the unit on site? Yes No N/A
E. Are headache ball markings legible? Yes No N/A
F. Is end connection properly secured? Yes No N/A
G. Are all hoists secured and properly anchored for the load intended? Yes No N/A
H. Are hoist controls clearly identified? Yes No N/A
I. Are hoist controls easily accessible to the operator? Yes No N/A
J. Is the hour meter operational and functioning properly? Yes No N/A
K. Are to-way radios being tested daily, if being used? Yes No N/A
L. Are all exposed moving parts properly guarded? Yes No N/A
M. Is a hand signal chart posted and visible to all personnel on site? Yes No N/A
PART 7: PERSONNEL LIFTING
A. Is the hoist approved for lifting personnel? Yes No N/A
B. Has a pre-lift meeting been held, documented and made available on the site? Yes No N/A
C. In the pre-lift plan, was the trial lift completed and documented? Yes No N/A
D. If a personnel platform is on site, does it have an identification plate with the proper data in place? (Proper data includes: weight of the platform, maximum intended load, and employee capacity) Yes No N/A
E. If a gin pole is being used, does it have a load chart? Yes No N/A
PART 8: RIGGING & BLOCKS
A. Are proper rigging practices being utilized? Yes No N/A
B. Is rigging equipment in good condition? Yes No N/A
C. Are the tags on synthetic slings legible? Yes No N/A
D. Is rigging equipment being inspected daily and the inspection documented? Yes No N/A
E. Are tag lines in good condition? Yes No N/A
PART 9: GIN POLES
A. Is gin pole rigging in good condition? (If visible) Yes No N/A
B. Des the gin pole have an identification tag? (If visible) Yes No N/A
C. Is the gin pole pre-job inspection form filled out and site or readily available? Yes No N/A
D. Does the sheave in the Rooster Head match the wire rope? (If visible) Yes No N/A
PART 10: LADDERS
A. Are units well maintained and in good working order? Yes No N/A
B. Are ladders at the proper slope? (4:1 ratio) Yes No N/A
C. Does the ladder extend 36 inches past the landing? Yes No N/A
D. Is the ladder stable, on good ground? Yes No N/A
E. Is the ladder set up correctly? Yes No N/A
PART 11: COMMENTS















PART 12: OVERALL IMPRESSION OF VISIT
OUTSTANDING
ABOVE AVERAGE
AVERAGE
BELOW AVERAGE
Amount of time spent on this visit: ___________ HOURS ____________ DAYS
Necessary to follow up with written documentation? Yes No
If any deficiencies, were they corrected immediately? Yes No N/A
Comments:














This report was reviewed with: Supervisor Crew
Crewmembers
 
 
 
 
 
 
 
 
 
 

Supervisor Signature


Date

DIRECTOR DEFICIENCY COMPLIANCE REPORT
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
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Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
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ITEM #   Compliance Completed By:   Date:  
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ITEM #   Compliance Completed By:   Date:  
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Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 
ITEM #   Compliance Completed By:   Date:  
Noted Deficiency:  
Course of Action:  
 

By submitting this form to the NATE office the auditing official affirms that all deficiencies have been brought into compliance.

 


Auditing Official's Signature:


Date

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