STATUS:
APPROVED
319A1 - Indian River State College
General Information
Subcontractor:
Richmond Electric Inc
Subcontractor Project Manager:
Ronald Perkins
Phone #:
772-461-1951
Email:
SECTION #1: Job-Site Specific Accident Prevention Plan
Please download the documents you wish to review.
Key personnel
Emergency List
OSHA 300
Appointment Letter
Basic Safety AHA:
7.-
Do you plan to perform work at heights greater than 6 feet at any time using ladders, scaffolds, or any aerial work platform (AWP)?
YES
8.-
Do you plan to perform any excavation work at any point during your project?
NO
9.-
10.-
Do you anticipate performing any electrical or demolition work at any stage of your project?
YES
Attach a copy of your Certificate of Insurance (COI):?
SECTION #3: Equipment Certification (If Applicable)
Do you plan to use any of the following equipment during your activities on the project?
Scissor Lift Use? | Boomlift? | Forklift? | Welder? | Heavy Equipment? |
|---|---|---|---|---|
NO | NO | NO | NO | NO |
If you answered “Yes” to any of the previous questions, please attach the certificate(s) of the operator(s) below.
Person Responsible for Submitting the Information:
Name:
Ronald Perkins
Position:
Project Manager / Estimator
Email:
Signature:
⚠️ For LEGO CO Safety Department Use ONLY
Observations:
1.- The plan must be reviewed and improved. It is important that the Safety Plan include information such as the Fall Protection Plan, Hazard Communication, PPE Plan, and Fire Prevention Plan. It should also include documentation and procedures for incident reporting, corrective actions, and company policies. The document you submitted contains valuable information, but it does not constitute a Safety Plan.
2.- You must complete and sign page 14 of the BASIC SAFETY AHA.
3.- The LO/TO plan you attached is dated September 1983. In addition, the plan is not project-specific and is too broad, covering multiple industries. Please update the plan and replace it with one that is adequate for construction.
4.- You must attach the OSHA 30 certificate of the supervisor who will be present on the project, or alternatively indicate the timeframe required to submit this information by letter.
5.- You must attach the OSHA 10 certificates of the workers who will be present on the project, or alternatively indicate the timeframe required to submit this information by letter.
08/28/2025 10:21 AM
Observations:
1.- The plan must be reviewed and improved. It is important that the Safety Plan include information such as the Fall Protection Plan, Hazard Communication, PPE Plan, and Fire Prevention Plan. It should also include documentation and procedures for incident reporting, corrective actions, and company policies. The document you submitted contains valuable information, but it does not constitute a Safety Plan. NOT CORRECTED
2.- You must complete and sign page 14 of the BASIC SAFETY AHA. Please send the copmplete AHA not just Page 14 NOT CORRECTED
3.- CORRECTED
4.- NOTED
5.- YNOTED
09/05/2025 1:05 PM
Observations:
1.- CORRECTED
2.- You must complete and sign page 14 of the BASIC SAFETY AHA. Please send the copmplete AHA not just Page 14 NOT CORRECTED
3.- CORRECTED
4.- NOTED
5.- YNOTED
09/05/2025 1:56 PM
Observations:
1.- CORRECTED
2.-CORRECTED
3.- CORRECTED
4.- NOTED
5.- NOTED
09/08/2025 12:49 PM