Site-Specific Safety Plan Template - Date March 2014 - Soil Excavation Safety

Sep 11, 2026

Uploaded by Xiajie

Site-Specific Safety Plan Template provides general safety-planning information for projects involving soil excavation at the Del Oeste Veterinary Clinic property and along the adjacent Prairie Road. The template includes contact details, nearest locations for emergencies, planned site activities, and site status. It identifies hazard categories and describes potential hazards from aged gasoline and diesel in soils and groundwater. It also lists safety considerations, monitoring equipment, PPE guidance, training requirements, and procedures for site entry, protection changes, and regulated materials disposal.

LanguageEnglish

CategoryForms

FormatPDF

Pages9

Reading Time3 min

AccessFree to download

Table 1: Contacts

Table 2: Locations of Nearest (locate on map)

Table 3: Site Activities Planned

Table 4: Site Status

Table 5: Hazard Assessment

Describe Potential Site Hazards

Table 6: Safety Considerations

Table 7: Activity Considerations

Table 8: Personal Protective Equipment (PPE) to be Used

Table 9: Work Party

Table 10: Signatures for Site-Specific Safety Plan

SITE-SPECIFIC SAFETY PLAN TEMPLATE Date: March 2014 This Site-Specific Safety Plan Template contains general information that is typically part of a complete Site-Specific Safety Plan that may be required under applicable Federal and State regulations when conducting soil excavation at the Del Oeste Veterinary Clinic property or along the adjacent Prairie Road. All information contained in this Template should be verified for correctness before inclusion into a complete Site-Specific Safety Plan. | Table 1. Contacts | | | | --- | --- | --- | | Project Manager | | | | Project Number | | | | Site/Project Name | Del Oeste Veterinary Clinic | | | Site Address/Location | 90238 Prairie Road, Eugene, Oregon | | | Site Contact | | | | Name | Richard Mosier | | | Phone | 541-689-0205 | | | Emergency Contacts | | | | Contact | Name | Phone Number | | Local Police | Eugene Police Department | 911 | | Local Ambulance | | 911 | | Local Fire Department | Eugene Fire Department | 911 | | Local Hospital | Peace Health Sacred Heart Medical Center | (541) 686-7300 | | Local Hospital Address | RiverBend Campus
3333 RiverBend Drive
Springfield, OR 97477 | | | Poison Control Center | Oregon Poison Center | 1-800-222-1222 | | Local Contractor’s Office | | | | Table 2. Locations of Nearest . . . (locate on map) | | | --- | --- | | Telephone | Cell phone | | Running Water Source | Del Oeste office | | Public Road | Prairie Road | | Rest Room | | | | | | | | | | | | Table 3. Site Activities Planned | | | | --- | --- | --- | | Activity | Location | Date | | | | | | | | | | | | | | | | | | | | | | | | | Table 4. Site Status | Active | X | | --- | --- | | Inactive | | | Abandoned | | | Unknown | | | Table 5. Hazard Assessment | | | --- | --- | | Hazard of Concern | | | Heat Stress | | | Cold Stress | | | Explosive/Flammable | | | Oxygen Deficient | | | Excessive Noise | | | Inorganic Chemicals | | | Organic Chemicals | Petroleum products | | Other | | | Chemical State | | | Liquid | | | Solid | | | Gas | | | Other | | | Unknown | | | Chemical Characteristics | | | Corrosive | | | Flammable | X | | Toxic | X | | Volatile | X | | Inert | | | Other | | Describe Potential Site Hazards. Soils and groundwater containing aged gasoline and diesel fuels may be encountered when excavating soil at the property and along Prairie Road adjacent to the property. | Table 6. Safety Considerations | | | --- | --- | | Monitoring Equipment | | | Organic Vapor Meter | | | O2 Meter | | | Explosimeter | | | H2S Meter | | | Other | | | Actions to Take if Hazards Listed in Table 5 (Hazard Assessment) Occur | | | A project specific safety plan should be prepared to address specific risks associated with work that includes soil excavating at the property and along Prairie Road adjacent to the property. | | | Table 7. Activity Considerations | | | --- | --- | | Will Site Representative be Present? | | | Yes | | | No | | | Exact location of Chemicals | | | Known | X | | Assumed | X | | Unknown | X | | Characterize Nearest Offsite Population | | | Residential | X | | Industrial | X | | Rural | | | Urban | | | Table 8. Personal Protective Equipment (PPE) to be Used | | | | | --- | --- | --- | --- | | Foot | Petroleum resistant, as needed | | | | Hand | Petroleum resistant, as needed | | | | Eye/Face | | | | | Head | | | | | Ear | | | | | Clothing | Long sleeve shirt and pants | | | | Respiratory | | | | | Additional Gear | | | | | Other | Project specific PPE should be addressed in a project specific safety plan | | | | | | | | | First Aid Kit | | | | | Yes | | | | | No | | | | | | | | | | Training Requirements | | | | | Type of Certificate | | Yes | No | | • HAZWOPER 40-Hour | | X | | | • HAZWOPER 8-Hour Refresher | | X | | | • First Aid/CPR/AED | | As required by employer | | | | | | | | | | | | | Table 9.

FAQs

What is the purpose of the Site-Specific Safety Plan Template?

It provides general information typically required to develop a complete site-specific safety plan for soil excavation at the Del Oeste Veterinary Clinic property and nearby Prairie Road. All details should be verified before inclusion in the final plan.

What potential site hazards are highlighted for this soil excavation project?

The template notes that soils and groundwater containing aged gasoline and diesel fuels may be encountered. It also includes hazard assessment categories such as chemical hazards and stress-related hazards.

Which monitoring equipment and PPE elements are referenced in the template?

Safety considerations include monitoring equipment such as an organic vapor meter, O2 meter, explosimeter, and H2S meter. PPE guidance calls for petroleum-resistant foot and hand protection, long sleeve shirt and pants, and project-specific PPE to be addressed in the site-specific plan.

Sep 11, 2026

Uploaded by Xiajie