<title>2026-07-03_CanwideSteel

FALL PROTECTION PLAN

OHS PROGRAM – WORK AT HEIGHTS

FORM #FPP-01 | REV. 01 | WorkSafeBC § 11.2

1 Project / Site Description

Name of Employer(s)*

Start Date for Work at Heights*

Site Address*

City

Site Description / Type of Structure

Work Area

Task Description*

First Aid Information

Name of First Aid Attendant

Contact for First Aid Attendant

Level of First Aid Attendant

Expiry Date for First Aid Certificate

2 Site-Specific Details for Work at Heights

Use the diagram / sketch (Section 3) to illustrate the following details on the worksite plan.

Maximum Heights

Maximum Height – Peak

m / ft

Maximum Height – Eaves

m / ft

Maximum Working Height*

m / ft

Roof Slopes

Toe-Holds (for slopes of 8:12 or more)

Toe-Holds Required? Yes No

Describe types of toe-holds used

Power Line Proximity

Proximity to High-Voltage Power Lines (if applicable)

Proximity to Low-Voltage Power Lines (if applicable)

Access Type and Location

Potential Hazards

3 Worksite Diagram / Sketch

Use this area to describe or attach a site sketch showing anchor locations, building elevations, access points, and hazards. Attach additional pages if needed.

Attach site sketch / diagram Click to browse or drag & drop · Image or PDF accepted

Additional Diagram Notes

4 Fall Protection System

Follow the fall protection hierarchy per Section 11.2 of the OHS Regulation. Complete one card per distinct work area.

Work Area 1

Area Description

Type of Fall Protection*

Guardrails Fall Restraint Fall Arrest Other Procedures

Explain other procedures

Reason for Selection

Manufacturer's Instructions Available On Site Manufacturer's Instructions Reviewed with Workers

Equipment Description & Procedures for Set-Up, Use, Maintenance, Inspection & Removal

5 Rescue Procedures

Rescue Procedure Description*

6 Record of Review

This plan has been reviewed with the following workers. Employers should retain this page.

#	Worker's Name	Signature (type to sign)	Company Name
1
2
3
4
5
6
7
8
9
10

Supervisor Sign-Off

Supervisor's Name*

Supervisor's Signature (type to sign)

Supervisor's Contact Number

Date

WorkSafeBC Reference: This form is based on the WorkSafeBC Fall Protection Plan template. Refer to Section 11.2 and 11.3(1)(b) of the OHS Regulation.