03.Activity Hazard Analysis-Blank Work Sheet.docx

This is an Activity Hazard Analysis (AHA) blank worksheet template designed to document safety risk assessments for construction work tasks and activities. The form requires contractors to identify specific hazards, implement safety controls, and assign Risk Assessment Codes (RAC) based on a severity and probability matrix. The RAC matrix uses four risk levels: Extremely High Risk (E), High Risk (H), Moderate Risk (M), and Low Risk (L), determined by crossing severity categories (Catastrophic, Critical, Marginal, Negligible) against probability factors (Frequent, Likely, Occasional, Seldom, Unlikely). The worksheet includes sections for documenting the activity or work task, project location, contract number, date prepared, and personnel responsible for preparation and review.

The form requires contractors to complete two primary steps: first, reviewing each identified hazard with its corresponding safety controls to determine the appropriate RAC rating, and second, annotating the overall highest RAC at the top of the completed AHA. The worksheet provides columns for detailing job steps, specific hazards, implemented controls, RAC assignments, equipment to be used, training requirements or qualifications of assigned personnel, and required inspection procedures. This template is directly applicable to the DCMR Ramp Improvement Project at the U.S. Embassy in Bangui, which involves concrete repair, ramp extension, and erosion mitigation work requiring comprehensive hazard identification and safety control documentation.