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<br />Total Employee-Hours Worked* <br />' Previous 2 YRS 3 YRS <br />Year-to-Date VPar Previous Previous <br />a) IIR <br />b) # of Fatalities ** ** ** ** <br />c) SR <br />--SEE NERT PAGE FOR MORE INFORMATION-- <br />APPENDIX A <br />CONTRACTOR SAFETY QUESTIONNAIRE (con't.) <br />' * Use 173.3 hours per employee per month if employee hours are <br /> unknown. <br /> ** Attach description of event <br /> <br /> 6. Does your firm have written safety and health policies <br /> and procedures and safety <br />operations? manuals appropriate for your <br /> Yes No <br /> If Yes, Available Upon Reque st? Yes No <br /> 7. Are accidents investigated and reports circulated to your <br /> firm's management staff? <br /> Yes No <br />B. Do you hold site safety and health meetings for all employees? <br />Yes No <br />How often? a) weekly b) Bi-weekly c) Monthly _ <br />d) Quarterly _ e) Less often, as needed _ <br />' 9. Do you conduct field safety and health inspections? <br />Yes No If yes, who conducts the inspection? <br />(Title) <br />And how often? <br />' 10. During foreman/supervisor performance reviews, do you use <br />safety and health as a criteria for rating them? <br />' Yes No <br />11. Does your Company conduct new employee safety orientation <br />' training? <br />Yes No ,_ <br />If yes, does it include the following (if applicable): <br />A-2 <br />