Fall Protection Plan Template Guide
Fall Protection Plan Template Guide
2 Why
Unprotected falls from elevation usually result in serious debilitating injury or death. Falls can be prevented
through the use of proper prevention and arrest systems.
4 When
The requirements of this chapter take effect 24 June 2022.
Chapter 45
Fall Protection
Product ID: 8 | Revision ID: 2454 | Date published: 24 June 2022 | Date effective: 24 June 2022
URL: [Link]
1 Purpose
The purpose of this program is to prevent unprotected falls through the use proper of prevention and arrest
systems. It covers working in unprotected elevated work areas (defined as any elevated work surface,
including roofs, not surrounded by a passive fixed barrier such as conforming guardrails or protective
parapet), use and design of fall protection systems, and designation of personnel. It applies to
workers/authorized persons, competent and qualified persons and qualified engineers, supervisors/line
management, the chief safety officer, the Department of Energy (DOE) site manager, and the fall protection
program manager.
The requirements of this program do not apply to scaffold erection, articulating boom type aerial lifts,
scissors lifts, excavations, motor vehicles, or personnel hoists, or work performed from ladders.
The roles may be performed by one or more individuals and one individual may play more than one role,
depending on the structure of the organizations involved. Responsibilities may be delegated.
4 Training
The minimum course requirement for workers who only access linac housing manway ladders or only use
ladders with an attached ladder climbing device is the following, which must be completed initially and
every 36 months:
ESH Course 203, LINAC Access Ladders and Ladder Climbing Devices (ESH Course 203) (every 36
months)
All other workers who must wear and use fall protection equipment or must access unprotected elevated
work surfaces as part of their jobs must complete the following course initially and every 36 months:
ESH Course 200, Fall Protection / Authorized Training (ESH Course 200) (every 36 months)
ESH Course 201, Fall Protection / Qualified Training (ESH Course 201)
Competent and qualified person or engineer training is offered through private firms that specialize in fall
protection engineering and applications. The program manager will assist in recommending training
courses.
5 Definitions
anchorage point. A secure point of attachment for lifelines, lanyards, or deceleration devices
controlled access zone (CAZ). An area in which certain work may take place without the use of guardrails,
personal fall arrest systems, or safety nets and access to the zone is controlled
elevated work surface. Roof surfaces within six feet of edge and work platforms more than six feet above a
lower level (for construction work) or four feet (for general industry work)
free fall. The portion of a fall before a personal fall arrest system begins to apply force to arrest the fall
frequent access, any other elevated work platforms or areas that are not roofs. More than 12 times per year
person, authorized. A person at SLAC who has completed required training and is authorized to wear and
use fall protection equipment and so work at unprotected elevations
person, competent. 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. 1 A designated SLAC fall protection
competent person has completed required training and has appropriate experience.
person, qualified. One who by reason of training, experience, or instruction has demonstrated the ability to
safely perform all assigned duties relating to work at or on elevated surfaces, unprotected or protected (see
engineer, qualified)
plan, elevated surface work. A document that examines and addresses fall hazards associated with a
particular job on an unprotected elevated work platform or area. Incorporates elements of a rescue plan if
fall arrest systems are in use.
plan, fall protection. A written document that describes the job task and procedures to eliminate or control
elevated fall hazards foreseeably encountered in the work when conventional fall protection measures
(guardrails, fall arrest equipment) are not feasible
plan, rescue. A strategy or procedure, planned in advance and practiced by designated rescue personnel, to
retrieve safely a person who has fallen from an elevated work surface and who remains suspended in a full
body harness, unable to perform self-rescue
protective parapet. A parapet surrounding the edge of a roof at least 24 inches high for roofing work, and at
least 42 inches for all other construction and general industry work
qualified engineer. A qualified person who is in addition licensed in accordance with federal, state, or local
laws and regulations (see also person, qualified)
roof. A walking or working surface whose primary function is to provide weather protection on a building,
C-train, modular trailer, rigid canopy, switch gear, transformer
two-person rule. Rule that people must work in teams of two or more in defined situations
system, fall arrest. A system used to arrest a person in a fall from a working level and that minimizes the
potential for compounding injury. It consists of an anchorage, connectors, and a body harness and may
include a lanyard, deceleration device, or lifeline.
system, fall restraint. An approved device and any necessary components that function together to restrain
an employee in such a manner as to prevent that employee from falling to a lower level
system, lifeline, horizontal. An engineered rail, rope, wire, or synthetic cable installed horizontally and used
for attachment of a worker’s lanyard or lifeline device while moving horizontally
transit from a ladder. The action of a person climbing off of or onto a ladder, usually at the edge of a roof
suspension trauma. The rapid onset of adverse physical symptoms to a person hanging in a full body
harness (after approximately 15 minutes) such as light-headedness, palpitations, tremulousness, fatigue,
nausea, dizziness, headache, sweating, weakness, loss of consciousness and even death, caused by venous
pooling and oxygen deprivation to the brain, kidneys, and other organs.
unprotected elevated work platform or area. Any elevated work surface, including roofs, not surrounded by
a passive fixed barrier such as conforming guardrails or protective parapet
work, construction. Any activity involving the construction, alteration, painting, repairing, construction
maintenance, renovation, removal, or wrecking of any fixed structure or its parts. This includes roofing
work.
work, general industry. Activities such as equipment maintenance, calibrations, inspections, plumbing
repair, running electrical cabling. Does not include construction activities.
work, on roofs (either construction or maintenance/general industry related). Any work done on a roof that
is unrelated to the roof surface itself, such as HVAC maintenance, equipment calibrations, new equipment
installation. Does not include roofing work.
work, roofing. Activities involving the application or removal of roofing materials such as asphalt or coal-
tar pitch, sheet metal, wood shakes, clay tile, concrete tile, slate or like materials. Roofing work includes
patching and repairing.
6 References
Other Documents
Title 29, Code of Federal Regulations, “Labor”, Subtitle B, “Regulations Relating to Labor”
(Continued), Chapter 17, “Occupational Safety and Health Administration, Department of Labor”
(Continued), Part 1926, “Safety and Health Regulations for Construction”, Subpart M, “Fall
Protection”, Appendix E, “Sample Fall Protection Plan - Non-Mandatory Guidelines for Complying
with 1926.502(k)” (29 CFR 1926 Subpart M Appendix E)
Title 8, California Code of Regulations, “Industrial Relations”, Division 1, “Department of Industrial
Relations”, Chapter 4, “Division of Industrial Safety”, Subchapter 4, “Construction Safety Orders”,
Article 2, “Definitions”, Section 1504, “Definitions” (8 CCR 1504)
1 Purpose
The purpose of these requirements is to prevent unprotected falls through the proper use of fall prevention
and arrest systems. It covers working in unprotected elevated work areas (defined as any elevated work
surface, including roofs, not surrounded by a passive fixed barrier such as conforming guardrails or
protective parapet), use and design of fall protection systems, and designation of personnel. It applies to
workers/authorized persons, competent and qualified persons and qualified engineers, supervisors/line
management, the chief safety officer, the Department of Energy (DOE) site manager, and the fall protection
program manager.
2 Requirements
For infrequent access to these locations or if guardrails are infeasible, fall protection equipment, such as
harnesses, lanyards, and anchorage points, may be used in conjunction with formal authorization as
described below.
Work in unprotected elevated work areas requires workers to be authorized persons, trained in fall
protection (see Section 2.4), and identification of hazards and controls, documented as follows:
1. If conventional fall protection measures (guardrails, fall restraint or arrest equipment, safety nets) are
feasible, an elevated surface work plan is used.
An elevated surface work plan must be developed by an authorized or competent person and approved
by a competent person. Plans for subcontractor construction work must in addition be accepted by a
SLAC competent person. The plan will address associated fall hazards and provide a rescue plan as
required. (See Fall Protection: Elevated Surface Work Plan Form.)
2. If conventional fall protection is impractical or creates a greater hazard, a control line can be set up and
workers can work behind that line in the designated area without fall protection. If a worker needs to
work beyond the control line, in the control access zone (CAZ), a fall protection plan must be
developed.
The fall protection plan must be written by a qualified person and approved in writing by the SLAC
chief safety officer and the Department of Energy (DOE) site manager or designee. (See Fall
Protection: Fall Protection Plan Requirements for required elements of such a plan.)
Authorization through an elevated surface work plan or fall protection plan must be noted in the worker’s
activity and training authorization documents, which must reflect any fall hazard, regardless of how the
work is authorized.
An example of unconventional means would be working in a designated area inside a properly set up
control line with an elevated surface work plan. Work beyond the designated area, in the controlled access
zone (CAZ), requires a fall protection plan. (See Figure 1.) (The first worker up can set up the control line
without using fall protection, “first man up rule”. Once the control line is set workers must stay behind the
control line.)
Until barriers or other effective methods of fall protection can be installed, transit to and from ladders at
roof edges will be permitted when all of the following conditions exist:
The roof being accessed is a low-slope roof.
There are no current adverse environmental conditions affecting ability to see or move safely over the
roof (such as high wind, extreme heat or sun glare, heavy rain).
Safe ladder usage
– A fixed ladder is used that has proper grab rails over the roof edge or parapet, conforms to
regulations, has been inspected and labeled by a competent person, and is deemed safe for
climbing, or
– A portable straight ladder is used that has been set up on a stable base, is properly secured to
prevent movement, and extends at least three feet above the roof landing surface.
Immediately upon reaching the roof, the person immediately walks away from the edge to the location
on the roof where the work is to be done.
To descend, the person approaches the ladder at an angle perpendicular to the roof edge to maximize
distance from the edge during access.
When performing elevated work an elevated surface work plan must be used. If an elevated surface
work plan is not feasible then a fall protection plan must be used.
Pre-engineered fall arrest equipment (such as an approved ladder climbing system or self-retracting lifeline)
must be used on fixed ladders over 20 feet in height that do not have required landing platforms and
compliant cages. Such fall arrest equipment must be installed under the supervision of a competent person.
When an elevated work surface cannot be accessed safely from a ladder or protected work platform or
when the installation of guardrails is infeasible, fall restraint or fall arrest systems may be used. A
competent person will make the appropriate equipment selection based on a complete evaluation of the
work site, conditions, and nature of work to be done, as documented in an elevated surface work plan.
Workers will use harnesses, self-retracting lifelines, lanyards, I-beam straps, and so on only as permitted by
the equipment manufacturer and in accordance with published instructions unless authorized by a
designated competent person.
Workers using fall restraint or fall arrest systems or control lines must work in teams of two or more (two-
person rule).
If work is being done in a location overhead where others may be working or walking below, access to that
lower area must be restricted if any items could be dropped or fall from the higher work level. This can be
accomplished through the use of barricade tape, signs, and rigid barriers. Signs and barricades will be
removed when work is completed.
Tools and materials being used over an occupied area must be secured (tethered) to the structure or person
if they might be dropped to the lower level. Toe boards must be provided on working platforms and
scaffolds over six feet in height.
Fall restraint systems consisting of the following minimum components may be used to prevent free fall:
Rated and approved anchorage point with a capacity at least four times the intended load or 800
pounds, whichever is greater
Lanyard (length must be limited to prevent access to edges where fall could occur)
Connecting hardware (double-locking snaphooks, carabineers, D-rings)
Full body harness
When using a fall arrest system, the fall distance calculation must account for the length of lanyard,
connecting hardware, deceleration distance, the height of the person wearing the equipment (or the height
of the D-ring attached to the back of the harness), one foot of stretch in the harness, the position of the
anchorage point, lanyard or rope elongation, and a safety factor.
A competent person must perform the fall distance calculation, or at a minimum verify that it was
performed properly if calculated by someone else.
Depending on the above variables, the minimum height required for a fall arrest system to be effective in
preventing contact with a lower level may be as much as 18 feet. Fall arrest systems should not be used at
heights with less than 18 feet clearance to a lower level unless it can be proven by a competent person that
the person will not contact the lower level in a fall. Where vertical clearance is inadequate, another way to
gain access to the elevated work location must be found (for example, scissors lift or ladder).
The area below and to the sides of the individual must be free of obstructions that could cause injury during
a fall. Fall arrest systems must be rigged so that a person cannot free fall for more than four feet or so that
the arresting forces on the body do not exceed 1,800 pounds.
Fall arrest systems should not be used to protect personnel working near vertical drop-offs such as roof
edges and hoist areas due to the potential for a swing impact injury, and the difficulty of rescue. Instead,
fall restraint systems should be used in these situations.
When fall arrest systems are in use, a competent person will develop an effective rescue plan specific to the
work location and job being performed before work starts. All SLAC fall protection rescue plans will be
documented in the elevated surface work plan. A written plan, prepared in advance, facilitates the training
of rescue personnel by increasing their familiarity with specific areas difficult to access.
Self-retracting lifelines (SRLs) must be installed directly above the user’s head, or at shoulder height
directly adjacent to the work area at a minimum. Extreme care must be taken to ensure the person will not
be exposed to a swing hazard, strike objects below, or exceed the maximum permissible free fall distance
or arresting forces on the body after a fall involving an SRL (such as may be the case if the SRL is mounted
below shoulder level). A designated competent person must inspect and approve of all SRL installations
before use.
Exceptions to installing an SRL at or above shoulder level near the work zone will be approved by a
competent person when no other fall protection option is feasible, and when the installation complies with
applicable regulations and manufacturers’ requirements addressing free-fall distance, arresting forces on
the body, and swing fall hazards.
Rated and approved anchorage points will be easily identified on the elevated surface work plan. Only
anchorage points that have been approved by a designated SLAC qualified engineer or that are known to
hold at least 5,000 pounds (such as structural I-beams or properly-installed pre-manufactured points) will
be used for fall protection purposes. Anchor points that are repeatedly used must be permanently marked or
identified and inspected twice annually by a competent person.
Under no circumstances will workers tie-off to piping, unistrut, racks, bracing, ventilation fan housings, or
any other non-approved locations. Permanent, fixed guardrails will not be used as anchorage points unless
specifically engineered and marked as approved anchorage points by a SLAC qualified engineer.
Only SLAC-designated qualified engineers may engineer and design fall protection systems such as
anchorage points, horizontal lifeline systems, or safety nets. If commercially available systems are pre-
engineered and certified to provide fall protection and comply with regulatory requirements, they may be
installed and used under the direction of a competent person and do not require a separate design by a
SLAC qualified engineer.
[Link] Inspections
Before each use, the user will inspect harnesses, lanyards, self-retracting lifelines, and connecting hardware
for wear, damage, contamination, and other deterioration according to manufacturer’s instructions and
checklists. Equipment not meeting inspection criteria will immediately be tagged DANGER – OUT OF
SERVICE and will not be used.
Twice annually, a competent person will inspect personal fall protection systems according to
manufacturers’ instructions and checklists. Such systems may include fixed, installed fall protection
systems such as self-retracting reels, anchorages, lifelines, or personal systems such as harnesses,
connectors, and lanyards. Ensuring the completion of inspections and required documentation is the
responsibility of line management.
Line management must designate a competent person as custodian of inspection records. The competent
person will retain documentation of the semi-annual inspection for three years. Documentation will include
the name of the inspector, the date equipment was inspected, and the results of the inspection. The
documentation will be made available upon request. The equipment itself will also be labeled with proof of
inspection.
Any equipment exposed to in-use loading or potential damage will be sent back be to the manufacturer for
complete inspection, rebuild if necessary, and recertification before being used again.
[Link] Marking
All fall protection system components will be labeled by the manufacturer according to
ANSI/ASSE Z359.1 or ANSI/ASSE A10.32. Only designated competent persons are authorized to mark
harnesses and lanyards with other information (such as name or department) to ensure proper ink is used to
prevent material deterioration
[Link] Storage
Fall protection system components will be stored away from direct sunlight and corrosive materials, oils
and solvents, moisture, heat, or any other substance that may cause damage. Harnesses, straps, and lanyards
will be hung by the D-ring or other connecting means to keep straps in a natural and untangled position
when not in use.
3 Forms
The following are forms required by these requirements:
Fall Protection: Elevated Surface Work Plan Form (SLAC-I-730-0A21J-047). Form for documenting
plan for working on unprotected elevated work platform or area
Competent and Qualified Persons and Engineers
4 Recordkeeping
The following recordkeeping requirements apply for these requirements:
Completed elevated surface work plans and fall protection plans must be kept with other work
authorization documents for the duration of the work
Competent persons maintain fall protection equipment inspection records, for three years
The fall protection program manager maintains fall protection designations in the Competent and
Qualified Persons and Engineers list
5 References
SLAC Environment, Safety, and Health Manual (SLAC-I-720-0A29Z-001)
Chapter 45, “Fall Protection”
– Fall Protection: Fall Protection Plan Requirements (SLAC-I-730-0A21S-054)
Other Documents
American National Standards Institute (ANSI)/American Society of Safety Engineers (ASSE) A10.32,
“Personal Fall Protection Used in Construction and Demolition Operations” (ANSI/ASSE A10.32)
American National Standards Institute (ANSI)/American Society of Safety Engineers (ASSE) Z359.1,
“The Fall Protection Code” (ANSI/ASSE Z359.1)
A generic version, for use by construction subcontractors who do not have their own equivalent form, is also available:
1. Adobe Acrobat (pdf)
2. Microsoft Word (docx)
General subcontractors must submit the completed, approved form to their SLAC field construction manager (FCM), who will acknowledge receipt
by signing and attaching a SLAC Receipt of Subcontractor Form. A SLAC Health and Safety Services representative must also sign the receipt.
Instructions
This form must be completed and approved before any worker, construction or general industry, accesses an unprotected elevated
work area. (An unprotected elevated work platform or area is any elevated work surface, including a roof less than six feet from the
edge, that is not surrounded by a fixed barrier such as conforming guardrails or protective parapet or where a portable guardrail system
cannot be used.) (See Fall Protection: Fall Protection Requirements [SLAC-I-730-0A21S-055]).
1. Describe the work to be done, fall protection to be used, and list the workers involved (Section 1).
2. Include a work plan drawing (Section 2).
3. If fall arrest is needed, complete a fall hazard analysis (Section 3) and rescue plan (Section 4).
4. Obtain approvals before work begins (Section 5).
The plan may be completed by a fall protection authorized person or fall protection competent person but must be approved by a
competent person. The completed plan must be kept with other work authorization documents for the duration of the work.
No elevated surface work plan is required if a ladder or mobile elevating work platform (MEWP) can be used to both access the work
area and complete the work safely. In such cases follow requirements in Chapter 15, “Ladder and Scaffold Safety” or Chapter 47,
“Mobile Elevating Work Platforms”, as applicable.
5. Approvals
ESWP author (print): Phone:
1 Purpose
The purpose of these requirements is to ensure the safety of workers in unprotected elevated work areas in
which conventional fall protection is impractical. They cover developing and approving fall protection
plans. They apply to workers, qualified persons, the SLAC chief safety officer, and the Department of
Energy (DOE) site manager.
2 Requirements
When the use of conventional fall protection (guardrails, fall restraint or fall arrest equipment, safety nets)
is impractical or creates a greater hazard, a fall protection plan must be used. 1 (For more on authorizing
work involving fall protection, see Fall Protection: Fall Protection Requirements). A fall protection plan
must
Be used for construction work only. A fall protection plan may be applied to general industry work,
but only on a case-by-case basis as determined by the local compliance officer (DOE site manager or
designee).
Demonstrate why conventional fall protection cannot or should not be used
Be prepared and changed only by a qualified person and developed specifically for the site where the
work is being performed
Name the qualified person who developed the plan
Be approved in writing by the SLAC chief safety officer and the Department of Energy (DOE) site
manager or designee
Be kept up to date as the project progresses or conditions change
Be kept at the job site
Be implemented under the supervision of a competent person in fall protection, who must be identified
in the plan
Include written discussion of other measures that will be taken to reduce or eliminate the fall hazard
for workers who cannot be provided with protection provided by conventional fall protection systems
1 Title 29, Code of Federal Regulations, “Labor”, Subtitle B, “Regulations Relating to Labor
(Continued)”, Chapter 17, “Occupational Safety and Health Administration, Department of Labor”,
Part 1926, “Safety and Health Regulations for Construction”, Subpart M, “Fall Protection”, Appendix
E, “Sample Fall Protection Plan - Non-Mandatory Guidelines for Complying with 1926.502(k)” (29
CFR 1926 Subpart M Appendix E)
Identify locations where conventional fall protection methods cannot be used and designate these
locations as controlled access zones (CAZs), cordon them off using a control line (see Figure 1), and
identify each worker allowed to work in the CAZ. Other workers may work within the control line, in
the designated area, under an elevated surface work plan (see Fall Protection: Fall Protection
Requirements)
Implement a safety monitoring system as needed when workers are in the CAZ, including making sure
workers work in teams of two or more
Designated Area
Elevated Surface Work Plan
Controlled Access
Zone
Fall Protection
Plan
3 Forms
The following are forms required by these requirements:
None
4 Recordkeeping
The following recordkeeping requirements apply for these requirements:
Completed fall protection plans must be kept with other work authorization documents for the duration
of the work
5 References
SLAC Environment, Safety, and Health Manual (SLAC-I-720-0A29Z-001)
Chapter 45, “Fall Protection”
– Fall Protection: Fall Protection Requirements (SLAC-I-730-0A21S-055)
Other Documents
Title 29, Code of Federal Regulations, “Labor”, Subtitle B, “Regulations Relating to Labor”
(Continued), Chapter 17, “Occupational Safety and Health Administration, Department of Labor”
(Continued), Part 1926, “Safety and Health Regulations for Construction”, Subpart M, “Fall
Protection”, Appendix E, “Sample Fall Protection Plan - Non-Mandatory Guidelines for Complying
with 1926.502(k)” (29 CFR 1926 Subpart M Appendix E)