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This document is a checklist for department supervisors to identify potential fall hazards and hazardous materials at work sites, along with suggested engineering and administrative controls.
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How to fill out USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A

01
Begin by obtaining the USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A form.
02
Read the instructions carefully to understand the requirements.
03
Fill in the header section with your name, department, and date.
04
Identify the work location and type of fall protection needed.
05
Assess the specific hazards present in the work area.
06
List the fall protection equipment that will be used (e.g., harnesses, lanyards).
07
Specify the training records for each employee who will be using fall protection equipment.
08
Include any rescue plan specifics if applicable.
09
Review the document for completeness and accuracy.
10
Submit the form to your supervisor for approval.

Who needs USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A?

01
Employees who work at heights or in environments with potential fall hazards.
02
Supervisors responsible for overseeing work at height.
03
Safety personnel involved in workplace safety assessments.
04
Contractors and subcontractors performing work requiring fall protection.
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USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A is a document that outlines the requirements and protocols for implementing fall protection measures to ensure the safety of workers at heights within USC's jurisdiction.
Individuals or departments engaged in activities that involve working at heights and require fall protection measures are required to file USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A.
To fill out USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A, individuals must provide details about the work being performed, the potential fall hazards, the fall protection measures to be implemented, and any training or certification related to fall protection.
The purpose of USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A is to ensure that all fall hazards are properly assessed and addressed to minimize the risk of fall-related injuries and fatalities among employees.
The information that must be reported on USC Environmental Health and Safety – Fall Protection/Fall Arrest – Appendix A includes the specific location of the work, description of tasks, identification of fall hazards, type of fall protection equipment to be used, and the names of personnel involved.
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