Inspection or Certification – New Construction/(ACT+10) Page 1 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
Marathon Petroleum Company LP
Transportation & Logistics (T&L)
Pre-Job Environmental & Safety Checklist
Project Location/Organizational Component: Contractor(s): Brief Description of Work Scope: Project AFE # (if applicable): MPC Project Manager: Onsite MPC Representative: MPC HES Rep: Date: General T&L Expectation & Requirements of Contractors
Contractor safety is of the utmost importance at all T&L facilities. Contractor OSHA recordable
performance is a key indicator in MPC’s Annual Safety metrics.
Contractors must abide by all applicable laws and regulations.
Contractors MUST have a training certificate card from a Reciprocal Safety Council (ARSC); or from
another pre-approved certified safety training organization. At a minimum, refresher training is required
every 36 months from the certification date. Contractors must remain current if the certified training
requires a more frequent refresher, successfully watch MPC’s safety orientation video once per year
and place a hard hat decal on hard hat.
Contractor shall obtain all applicable Marathon standards from the Project Leader which apply to the
project and review such standards prior to work beginning. Marathon standards take precedence over any
contractor standard.
Contractors must maintain a written Contractor Site Specific Emergency Contact plan on-site. The safety
plan needs to cover at a minimum the information on the "Contractor Site Specific Emergency Contact
Plan" attached to this document. All contractor employees, subcontractors and Inspectors/Site Facilitators
must be familiar with this plan. Plus, the Contractor shall provide a comprehensive case management
care plan that includes their intentions to provide upfront documentation for management care prior to the
start of the job, and their Corporate and local management involvement and direction. (The information
should include the name of managed care facility and the names of local and corporate contractor
personnel who will oversee managed care in the event of a job site injury).
Contractors are responsible for the safety and control of their employees and must ensure they comply
with all site safety rules and safe work practices while working at a Marathon Petroleum Company LLC
(“MPC”) facility.
Contractors are responsible for ensuring that all of their employees working on this project have received
regulatory and job specific training for the tasks which will be performed. T&L reserves the right to audit
all training records. Contractors need to provide training records when working at PSM regulated
facilities. (Contract employee name, date of training and means to verify understanding) Contractors are responsible for ensuring that all of their employees performing covered tasks have been
qualified under the Operator Qualification requirement of CFR 195.
Contractors are responsible for providing their employees with all necessary protective & safety
equipment (as well as equipment and tools.)
Contractors must immediately report ALL injuries, accidents/spills and near misses occurring on MPC
facilities to the Onsite MPC Representative and MPC Project Manager and provide copies of all accident,
accident investigation and medical treatment reports to MPC representative.
Contractors shall not alter any equipment/system, unless defined in the scope of work, without the
approval of the appropriate MPC Operations Organization representative (i.e. turning a valve), or alter the
physical design of the project as outlined in the project documents, without approval of the Engineer of
Record (EOR).
Contractors must conduct frequent inspections of the job site and equipment (to be made by competent
contractor personnel).
Contract Supervision will be provided with a copy of the MPC Contractor Safety and Environmental
Handbook.
Contract Supervision Signature of Receipt: _____________________________________________
Inspection or Certification – New Construction/(ACT+10) Page 2 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
Emergency Procedures
Emergency Alarms
Explicitly cover each specific
Emergency Alarm
Primary & Alternate Evacuation
Routes
-Muster points (meeting locations)
-Posting locations
Emergency Numbers
-Posting location at the worksite
First Aid (Contractor Responsibility) –
kit locations
-Identify the contractor personnel
trained in First Aid /CPR (required for
bigger projects)
All Contractors MUST sign-in and
sign-out of all T&L facilities and/or
covered areas and permitted areas
Emergency Equipment Location
Fire Monitors – operated by MPC
-Discuss responsibilities
-Locations
Fire Extinguishers
-Types onsite
-Locations
Safety Showers and Eyewash Stations
-Locations
Miscellaneous
Drug & Alcohol – possession, use, or
sale of any alcohol, drugs or drug
paraphernalia is strictly prohibited
-Any person, vehicle or device on
MPC’s property or job site is subject to
an unannounced search.
Smoking Policy
-Designated areas
Site Security
-Report all unauthorized people and
suspicious behavior
-No firearms
-Prior approvals for any explosives
Sanitation Facilities
-No drinking, swimming or other use
of surface water
-Contractor is responsible to supply
water and sanitary facilities
-Housekeeping of sanitary facilities
(i.e. break areas and port-a-pots)
Driving Safety
-All drivers must have a valid driver’s
license for the vehicle they operate
Inspection or Certification – New Construction/(ACT+10) Page 3 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
-Identify acceptable paths/parking for
vehicles
-Speed Limit on MPC property - 10
MPH unless otherwise stated
-Maximum speed on ROW - 20 MPH
-Identify all driving hazards
- ATV’s (3 wheelers or 4 wheelers) are
not approved for use at T&L location
unless given an exemption.
- UTV’s are acceptable for use at T&L
locations under the following
conditions:
1. Individuals ride “in” the UTV
and not “on” the UTV
2. Individuals must wear
seatbelts at all times
UTV must have seatbelts and certified
roll bars from the manufacturer
Retail Projects require a Certificate of
Occupancy (CO) for buildings prior to
turn over.
Personal Protective Equipment
Hard Hats – must be worn on all MPC
facilities.
Exceptions: - Vehicle cabs and offices
- Activities requiring welding
hood
- Parking lots, break areas and
picnic areas
- Testing rooms and cut-shacks
Helmet – while riding in UTVs
Requirements:
All T&L employees and contractors
operating or riding in an UTV will be
required to wear an:
o attached face shield for a street
class helmet
o or anti-fogging goggles with a
foam seal around the eyes for a
dirt class helmet
o A DOT or Snell approved helmet is
required unless a Job Safety
analysis has been performed and
an exemption has been granted
Safety Glasses – with side shields are
required in all work areas
Exceptions:
- Vehicle cabs and offices
- Parking lots, break areas and
picnic areas
Goggles – required where splashing or
misting make take place
Face Shields – must be worn in
conjunction with impact goggles or
safety glasses with side shields
Inspection or Certification – New Construction/(ACT+10) Page 4 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
Required for the following activities:
- Grinding
- Chipping
- Wire brushing
- Other activities where flying
particles may strike the eyes
or face.
Burning Goggles – must have proper
filter lenses for work being preformed
Protective footwear – must be worn at
all work locations
Exceptions: - vehicle cabs and offices
- All footwear must meet ASTM
F2413, 2005 (old ANSI Z41.1-1991)
Contractor’s operating a jackhammer
on MPL sites must wear some form of
metatarsal guard
Rubber Boots with safety toes should
be worn while working in standing
water
Protective Gloves
-Identify the proper glove type for
chemicals being used – consult MSDS
sheets
Cloth/Leather Gloves
-All contractors (including electricians)
must wear protective gloves while
performing work
Respirators
-Only trained, fit tested and medically
approved employees can wear
respirators
Contractors will supply:
- Respirators and cartridges
- Training
- Atmospheric monitoring
equipment
Hearing Protection
-Identify type of protection and all
locations
Fire Resistant Clothing Protection
Requirements
-Must be worn as outer layer (except
when wearing Tyvek suits and rain
gear)
-Must cover entire trunk and limbs
Exceptions:
- Vehicle cabs and offices
Asphalt facilities
Add under Exceptions:
- For MPL, the Permit Writer may
allow personnel working outside
fenced facilities (example: pipeline
rights-of-way) to roll up the sleeves of
FR Clothing and/or unzip/unbutton FR
Inspection or Certification – New Construction/(ACT+10) Page 5 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
Clothing to mid-chest level providing
the following conditions are met:
a) personnel must not be within 35’ of
exposed piping or appurtenances,
and
b) there must be no other fire hazards
present (example: refueling
internal combustion engine tools
such as a weed eater or chain saw),
and
c) an undershirt is being worn under
the FR Clothing, and
d) The exemption must be identified
on the Work Permit by the MPL
Permit Writer.
e) If an undershirt is not being worn,
then the FR Clothing should
remain zipped/buttoned to near
The neckline.
-Refer to the Contractor Safety &
Environmental Handbook for examples
Tyvek Suit
-Must be worn as outer garment during
lead abatement and during other
activities where chemical exposure is
possible
-Discuss proper disposal
Rain Gear
-Can be worn as outer garment over
FR clothing.
Personal Floatation Device (PFD)
-Identify locations and activities on the
project which will require a PFD
-Must meet US Coast Guard
requirements
Reflective Vest
-Shall be used on remote or rural ROW
during hunting seasons
-Where exposed to vehicular traffic
Personal H2S monitors – Required at
all facilities with crude and/or other
affected products. Refer to
TNLHES008 for facility listings.
Physical Hazards
Discuss what unique hazards will be
present due to contractors work or
processes. Plus contractor is to inform
local operations of any unique hazards
new discovered while performing their
work.
Discuss the various stages of the
project and the changes in work types
that will occur. For each stage/work
type identified, discuss the hazard
recognition and mitigation tools (e.g.
Inspection or Certification – New Construction/(ACT+10) Page 6 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
JSAs, walk-thrus, work permits, etc.)
that will be utilized before beginning
the next stage or work type, and
identify the attendees and participants
who need to be involved.
Ensure that any of these discussions
that cannot be completed at the time of
the pre-job, are completed in the field
upon reaching the previously identified
milestones.
Heat Stress/Cold Stress
-Contractor responsible for monitoring
the weather conditions and make
available appropriate supplies and
breaks for their employees
First Opening of Equipment
-Ensure proper bonding & grounding
-Atmospheric monitoring
-Discuss emergency containment
Housekeeping
-Stack and store materials to prevent
sliding or collapsing
-Proper storage of flammables and
combustibles in non-smoking areas
-Organize material in such a way they
will not be damaged by heavy
equipment or expose employees to any
hazards
-Follow proper tool safety and storage
MPL has an expectation that all work
Trailers are kept clean and in an
orderly fashion.
Slips, Trips & Falls
-Identify potential hazards
Do not use previously modified or cut
Timber Mats. Consider filling all gaps
in Timber Mats with sand or gravel.
When using Timber Mats, the lifting
cables need to be sprayed painted a
bright color and tied down.
When working at night, consider
multiple sources of light to minimize
shadows. Employees and contractors
may need to carry Flashlights.
In muddy conditions, provide means to
de-mud boots prior to using stairs and
platforms.
Struck By, Pinch Points
-Identify potential hazards
Radiation Safety / Ohmart
Gravitometers
-Contractors may not transport,
commission, or decommission Ohmart
gravitometers
-Coordination must be made with MPC
Inspection or Certification – New Construction/(ACT+10) Page 7 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
personnel if Contractor will be
working in close proximity of Ohmart
-In the event of an emergency near or
involving an Ohmart Gravitometer,
contact the Radiation Safety Officer
Natural Hazards (snakes, bees, etc.)
-Heavy boots and clothing covering the
trunk, arms, and legs are required for
activities along MPC ROW
-Insect stings or animal bites must be
reported and treated like another safety
incident
Poisonous plants - If poisonous plants
are prevalent in the area, some
determination should be made if
anybody is highly allergic to any
poisonous plant and if they should
continue with the job function
Life Critical Activities
Disregard for Life Critical safety
policies and procedures may result in
disciplinary action
Confined Space Entry
-Contractor must obtain a Work Permit
from local operations before
beginning work.
-All OSHA requirements must be
followed
-Contractor is responsible to verify all
employees have been trained
(Attendant & Entrants)
Rescue Provisions:
– Establish plan
– Ensure and verify rescue
service is available
– Rescue must be on-site in
IDLH conditions
-Ensure atmospheric monitoring
instruments are/will be calibrated
-Establish when/where continuous
monitoring will be necessary
Hot Work
-Contractor hot work program must be
approved by MPC
- Contractor must obtain a Work
Permit from local operations before
beginning work.
-Equipment properly grounded and
guarded
-Sealed pipes drilled & tested for
vapors
The Permit Writer must ensure that the
work area is tested for combustible
gases using the properly calibrated
combustible gas analyzer. The lower
explosive limit (LEL) must be less
than 0%. Any concentration greater
Inspection or Certification – New Construction/(ACT+10) Page 8 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
than 0% LEL will prohibit Hot
Work except in areas with oxygen
readings less than 10% (i.e. nitrogen
purged equipment). Any other areas
with LEL greater than 0% will
require consultation with the HES
Department prior to any Hot Work
-Oxygen and fuel cylinders stored a
minimum of 20 feet apart or have a 5
ft. barrier between them with at least a
30 minute fire rating.
-Only trained employees
-Drain down as much as possible
-Establish trained Fire Watch, make
sure they are only watching one permit
area
-Discuss spark containment
WELDING
-Obtain Hot Work Permit
-Remove combustibles
-Discuss spark containment
-Ensure proper grounding
-Identify proper fire extinguishers
-Ensure sewer/trenches are covered
-Locate welding rigs and
oxygen/acetylene tanks outside the
confined space area
Ensure a Fire Watch is in place for 30
minutes after welding activities.
Fall Protection
-Comply with CFR 29 1910 OSHA
Subpart D and CFR 29 1926 OSHA
Subpart M. Note: 4’ requirement
applies at Marathon locations
-PFAS use requires rescue plan
-Certified tie-off/restraint points
Safety Harness/Lanyard
-Must meet OSHA standard
-Identify tasks requiring protection
-Only trained employees
-Inspect fall protection equipment prior
to use
Scaffolds
-All scaffolding must meet OSHA
specifications
- Fall Protection is required on all
working surfaces above 4’ that are
NOT certified scaffolding by a
Competent person OR if the Permit
Writer requires additional Personal Fall
Protection
-Perimeter guarding
Inspection or Certification – New Construction/(ACT+10) Page 9 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
-Competent Person inspections
-Maintain >10’ clearance between
scaffold and power lines
Ladders
-Inspect prior to each use – must meet
OSHA requirements
-Do not use ladders which have been
repaired or painted
-Ladders shall extend at least 3 feet
above an upper access landing
-Ladders need to be tied-off
- Three points of contact are required
with the ladder while climbing or
descending from a ladder
- While working on a ladder, a
person’s belt buckle MUST remain in-
between the ladder rails. Depending
on the hazards, a Permit Writer may
require additional Personal Fall
Protection.
-Do not stand above the
manufacturer’s recommended level
-Do not leave ladders in
doorways/walkways
Lockout / Tagout Program
-Contractor responsible to ensure all
employees have been properly trained
in Lockout/Tagout
-Identify all potential energy sources
while walking the process during a
Joint Site Visit
Make provisions for Thermal relief
-Contractors MUST supply own
Locks/Tags
Permits & Specific Programs
Asbestos Exposure / Abatement
-Cover plan with Project Leader and
Industrial Hygienist before beginning
work.
-Review applicable section of Terminal
Asbestos Survey with contractor
Y – asbestos listed
N – asbestos not listed and testing
completed prior to contractor
beginning work
-Will work impact asbestos?
Y – Contractor must be approved for
asbestos abatement
N – Contractor will not disturb
asbestos.
Asbestos location (if applicable)
All OSHA requirements must be
followed
Lead Exposure/Abatement Program
-Cover plan with Project Leader and
Inspection or Certification – New Construction/(ACT+10) Page 10 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
Industrial Hygienist before beginning
work
-Contractor must test paint for lead
prior to work or check records for
previous testing.
-All OSHA requirements must be
followed
Decommissioning/Recommissioning
Plans
-Cover with each employee working
on project
Construction Activities
Excavations
-Follow OSHA 1926.650, Subpart P –
Excavations requirements
Notify State One Call number within
pre-defined time allowance as per the
respective state requirements
(Typically 48 or 72 hours, but could be
greater).
o Excavator is responsible for
making State One Call
notifications.
o Comply with wait time
o DO NOT DIG if incomplete
positive response for
unmarked hazardous or high
impact utilities – contact
Local operations or Project
Leader
MPL – Utilize the Excavation Damage
Prevention Review List
(MPLMNT139)
MPL – Be aware of potential for
uncovering archeological items and be
aware of the “Accidental
Archeological Discovery Plan” in the
event of a finding (MPLHES006).
Tolerance Zone: Do not power dig in
the Tolerance Zone (a measured buffer
of protection defined by each state).
MPL Tolerance Zone – Powered
excavation not allowed within the
Zone before physically locating and
confirming the MPL-operated asset. If
a foreign utility, no powered
excavation in the Zone at any time.
-Competent Person must inspect
excavations daily
-Protection from cave-ins (shoring,
benching, etc.)
Monitoring w/ calibrated instruments
-When hazardous materials are
present
-Deeper than 4 feet
-Barricades
-Ladders every 25’ lateral travel if
Inspection or Certification – New Construction/(ACT+10) Page 11 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
excavation is 4’ deep or deeper
-Soil must be placed >2’ from all
excavations
Work Along Public Roads
-Proper notification made to local
officials
-Orange cones, barricades, flagmen
Floating Roofs: Prior to working on
any Floating roof, the seals need to be
inspected and there needs to be a
discussion on proper Cribbing.
Demolition Plan
Steel Erection Plan
Blasting Plan (MPC Pre-Approval)
Lifting / Materials Handling / Heavy
Equipment
Cranes/Ariel Lifts/Fork Lifts
-Inspect equipment prior to each use
-Trained/Qualified Operators only –
certificates must be made available
upon MPC request
-Discuss reach & rate capacity of
equipment
-Seat belts/body harnesses
-Perform rigging inspections
-Tag lines to control the loads
Identify personnel who will be the
spotter. Spotter needs to be a
competent person.
-Written plan & tag lines for critical
lifts
-Barricade area below load
-Discuss overhead power lines –
minimum of 10 feet
-Discuss pipelines/tree branches/gate
clearances
-Weather conditions
-Location of stacked materials
-Discuss excavations/trenches
-Discuss location of slopes, sharp
inclines, holes in road and surfaces
-Identify vehicle traffic nearby
-Identify location of electrical
equipment
-Discuss water/muddy areas to ensure
solid footing for people and equipment
-Verify working backup alarms
Electrical
Identify Cathodic Protection
- Discuss responsibilities
Ground Fault Circuit Interrupters
(GFCI) shall be used to protect
Inspection or Certification – New Construction/(ACT+10) Page 12 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
workers
Electrical Devices (i.e. phones, pagers)
-Potential hazards
-Locations where these items are
permitted/prohibited
Electrical Cords
-Condition of cords
-Properly sized for load
-Trip hazards
Identify overhead utility lines
-Minimum of 10’ from Lines
-Location of lines on property
-Temporary utility locations
Static Electricity (Bonding &
Grounding)
-Required for use of vac trucks
-Required when separating flanges/
removing valves, spool pieces, line
sections, etc. from the pipeline.
Classified Areas
Class I, division 1: - Ignitable concentrations of
flammable gases or vapors are
expected to exist under
normal operating conditions
or in faulty operation of
equipment or processes.
Class I, division 2:
Flammable gases or vapors may
be present, but normally are
confined within closed systems
and are prevented from
accumulating by adequate
ventilation.
- Follow MPLCON005, TT&M
Terminal Specifications, API RP 500,
and NEC NFPA 70 when determining
Class I, Division 1 or 2 areas.
Hazard Communication
Hazard Communication Program
-Every contractor must have a Hazard
Communication
Program
-Contractors need to supply local
Operations with a copy of the MSDSs
for all chemicals they bring on site.
-Discuss the location of MPC Hazard
Communication Plan and MSDS
Identify Chemical Hazards
-Benzene, Gasoline, Kerosene, etc.
-H2S, Nitrogen, etc.
-Lead Based Coatings
Inspection or Certification – New Construction/(ACT+10) Page 13 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
REQD/APPL N/A PROGRAM COMMENTS
-Determine atmospheric monitoring
requirements
Container Labeling System
-Original manufacturer’s label or an
approved warning label system (i.e.
NFPA 704) must remain in good,
readable condition on each container
Waste Management & Minimization
Contractor must coordinate
environmental plan with MPC HES
-Contractor must ensure environmental
plans and permit conditions are
communicated, understood, and strictly
followed
-Maintain materials in properly
covered containers – no rain water
-Prevent contact with soil and water
-Develop secondary containment plan
-Contractor is responsible for disposal
of partially full containers at the end of
each job
-Do not mix liquid with solid waste
streams or hazardous with non-
hazardous waste streams
-All containers must be labeled and
marked immediately. Unknown
materials are to be treated as hazardous
until proven to be non-hazardous
-Liquids are not to be placed in roll-off
boxes.
Manifests must be signed by an
Operations Representative or a MPC
Environmental Professional
Hydrostatic Testing (Discharge Permit)
Hydro Excavation Run-off
Containment / Permit)
Inspection or Certification – New Construction/(ACT+10) Page 14 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
Inspection or Certification – New Construction/(ACT+10) Page 15 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
Contractor Pre-Job Meeting Attendance Sheet
By signing this attendance sheet, the below listed individuals confirm attendance at the Pre-Job Safety Meeting and
knowledge of the discussed Environmental, Safety & Regulatory issues in relation to the above listed work to be
performed for MPC Transportation & Logistics.
Employee Name Company
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Inspection or Certification – New Construction/(ACT+10) Page 16 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
CCoonnttrraaccttoorr SSiittee SSppeecciiffiicc PPrroojjeecctt
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The Plan must be reviewed and agreed to by Marathon prior to starting job. The following apply to the content and utilization of the Plan:
It is intended to be written so as to be understood by workers in the field.
It must be reviewed each day with all contractor and subcontractor employees before they start work at the site.
As a project moves to a different phase, the plan elements pertaining to that phase must be reviewed with all contractor and subcontractor employees.
Each day, and whenever site conditions change or new hazards are identified, ALL workers at the site will participate in a work site “walk through” to assist/verify identification of hazard potentials.
Subcontractor Requirements:
Must submit their own Contractor Site Specific Emergency Contact Plan which must be reviewed and approved by the Primary Contractor and submitted to MPC for review.
Note: The information should include the name of managed care facility and the names of local and corporate contractor personnel who will oversee managed care in the event of a job site injury.
Inspection or Certification – New Construction/(ACT+10) Page 17 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
Contractor Site Specific Emergency Contact Plan At least one form MUST be filled out for each Contractor Company on-site
Add Maps and driving directions to nearest Emergency and Urgent Care medical treatment facility:
( Enter Company Name )
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Location: City: State:
Job ID:
Job Description:
MPC Facility Contact: Phone: Cell:
Project Manager: Phone: Cell:
Contractor Foreman: Phone: Cell:
Contractor Safety Representative: Phone: Cell:
Contractor Site Safety Representative: (if different from above)
Phone: Cell:
Injury and Illness Management
Respond to the injured employee. Injury reporting is second to responding to the injured employee.
Employee immediately reports incident to Foreman
Foreman immediately reports incident to Local operations, Inspector, and Project Leader
Decision will be made to call “Managed Care” provider (Contractor’s or Axiom)
Per Managed Care providers advice, properly treat the employee
DOT POST- ACCIDENT TESTING
“Accident” is a term defined by regulation and may not include all incidents. Project Leader to contact Local
Operations for determination
For DOT-regulated assets, Marathon has the federal regulatory duty and authority to require post-accident testing of
contractors and subcontractors who MUST remain available for post-accident testing.
All employees involved in the accident MUST remain at the scene or in a safe location adjacent to the scene while the
determination if DOT Post – Accident testing is required.
If Marathon determines the need for post-accident testing, the Project Leader/Local Operations or HR will notify the
employee’s Foreman and Safety Representative of requirements.
Contractor’s Managed Care Provider:
Contact Person: Phone:
If Contractor does not have a Managed Care Provider, Axiom MUST be used Phone:
Axiom is contacted through MAPLINE Phone: 1-877-627-5463
Emergency Medical Facility:
Emergency Transportation Provider: (Attach driving route to this plan) Local Ambulance provider
Phone:
Urgent Care Medical Facility: (if different then Emergency Medical Facility)
Phone:
Incident Reporting & Investigation Process:
Incidents that require medical treatment will be handled as follows:
Inspection or Certification – New Construction/(ACT+10) Page 18 Form TNLCSC6 TNL-SFT-00072-SPE Custodian: Original in Project file in MOC T&C, Copy: Contract/Subcontract Supervision (on-site during job) Attention: Printed copies should be used with caution. The user of this document must ensure the current approved version of the document is being used. This copy was printed on 10/21/2011 3:43:08 PM
MPC Transportation & Logistics Standards and Practices
Controlled Microsoft Word Document
Document Number Document Title
TLSP0015 Pre-Job Environmental & Safety Checklist
Revision Number Effective Date Revision Date Records Retention
14 10/20/2011 10/20/2011 Project File, Engineering and Construction – Final
(ACT+10)
Review Cycle Next Review Date Custodial Organization
3 10/20/2014 MPC T&L ES&S
Document Author Document Approver
Brian Hyde Steve Willis
Revision History
Revision
Number
Revision
Date Description of Change
0 Initial Publication
1
2
3
4 4/8/09
5 6/11/09 Update Record Retention
6 12/1/09 Format changes
7 4/28/2010 Revised the Site Specific Safety Plan template attached to the Pre-Job Checklist
8 5/18/10 Added “DOT Post Accident Testing” to Contractor Site Specific Emergency Contact Plan. Revised the Scaffolding and Ladder section. FR requirements on MPL ROW. Revised the requirements for UTV’s. Marathon standards take precedence over Contractor standards.
9 6/24/10 Revised document Owner
10 10/7/2010 Add Life Critical items
11 11/11/2010 Added a section under “Miscellaneous” about New Employees; and added a section under “Physical Hazards” about changing work types.
12 12/21/2010 Added a comment under “Construction Activities” about MPL and uncovering archeological items. Added a comment under “Physical Hazards” about discussing hazards at different
stages of projects.
13 4/13/2011 Added a section under “Physical Hazards” – “Housekeeping”, housekeeping in work trailers. Added verbiage under “Personal Protective Equipment” – “Helmets”, about exemptions. Added OSHA Training Criteria
14 10/20/2011 Updated MOC to MPC – Brian Hyde T&L ES&S, Added new Policy, changed verbiage in box #3 under General T&L Expectation & Requirements of Contractors, Updated Approver