Subcontractor Safety Program Review

Please complete the form below and upload all required supporting documents.

Please be advised that additional information or submittals may be required following the review process. It is essential to provide all necessary documentation at least two weeks prior to the project's start date to ensure a smooth process. If the required materials cannot be submitted within this timeframe, we kindly ask that you contact us immediately to request an expedited review. Your prompt attention to these requirements will help avoid any potential delays.

Evaluations and/or recommendations are for general guidance only and should not be solely relied upon for legal compliance purposes. We do not make any warranty, expressed or implied, that your workplace is safe or healthful or that it complies with all laws, regulations or standards.

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General Contractor Requesting Review *

Subcontractor Company Name *

Subcontractor Contact Name *

First

Last

Subcontractor Contact Title *

Subcontractor Contact Email *

Subcontractor Contact Phone Number *

Trade/Subcontractor Type *

Average Number of Employees *

Required Safety Program Submittals

Injury & Illness Prevention Program / IIPP

Does your company have an IIPP? *

Instructions: Please upload your IIPP at the bottom of this form. Include the page number that each of the following required elements can be found below.

IIPP must include Cal/OSHA's required eight elements:

1. Responsibility (Page#)

2. Compliance (Page#)

3. Communication (Page #)

4. Hazard Assessment (Page #)

5. Accident/Exposure Investigation (Page #)

6. Hazard Correction (Page #)

7. Training and Instruction (Page #)

8. Record Keeping (Page #)

IIPP Information Link: https://www.dir.ca.gov/dosh/etools/09-031/what.htm

Hazard Communication Program

Does your company have a Hazard Communication Program? *

HazCom Information Link: https://www.dir.ca.gov/title8/5194.html

Trade Specific Safety Program(s)

Does your company have a Trade Specific Safety Program(s)?

Trade Specific Program Examples: Fall Protection, Respiratory Protection, Ladder Safety, etc..

CalOSHA Safety Regulation Topics: https://www.dir.ca.gov/samples/search/query.htm

Current EMR

Will you be working on ladders? *

Will you be working above 6'? *

Will you be working on scaffold? *

Will you be working with concrete or concrete products? *

Will you be preforming any Hot Work (Welding, Cutting, Grinding)? *

Will you be working in public areas? *

Will you be directing traffic or receiving deliveries from curb side? *