1 - FP Template Reference Only.xlsx

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Fire Protection and Safety & Health Risk MGMT Surveys - 36 Leased Locations
Solicitation number
47PF0024Q0112
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About this file

This document appears to be a Risk Management Survey for a GSA leased building. It covers various safety and health risk assessments across different areas such as asbestos, drinking water, electrical, emergency planning, hazardous materials, indoor air quality, and others. The survey is formatted as a questionnaire with findings, observations, and recommended corrective actions for each area evaluated. However, the document does not appear to be directly related to a specific federal contract opportunity. It seems to be a template or reference document used for conducting these types of risk assessments on GSA leased facilities.

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Text version

RAC Summary

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Safety Health Survey

RAC Summary
12445EDITABLEN
Asbestos
Drinking Water
Electrical
Emergency Planning
Equipment Machine Guard
HazMat HazCom
Hazardous Energy Control
Indoor Air Quality
Lead
Non-ionizing Radiation
Confined Spaces
Powered Industrial Vehicles
Radon
Walking-Work Surfaces
High Risk Operations

Overall RAC

IRIS Building Profile

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Questions Response Findings/Observations

IRIS Building Profile
Region51708832737568821
GSA Building NumberIL2465ZZ1708832837568831
GSA Building NameRICKARD CENTER1708832937568841
Building Street Address1124 RICKARD RD1708833037568851
Building CitySPRINGFIELD1708833137568861
Date of Building Construction20001708833437568881
Building StateIL1708833237568871
Building Size (RSF)170883331
Building Size (GSF)32531708833537568891
Total Number of Floors Above Grade11708833737568901
Total Number of Floors Below Grade01708833837568911
12445N1708

Building Information

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Questions Response Findings/Observations

Building Profile
Date(s) of Onsite Survey171083391
Surveyor171083401
Type of Occupancies171083413
Building Point(s) of Contact for Survey171083421
Lease Number171083701
Lease Expiration Date171083711
Property Type171083453
What is the tenant breakdown?171083463
Primary Tenants171083471
Identify any Unique Space Type(s). If "other" is chosen, please describe the "other" unique space in the comments section.171083513
Identify any Unique Space Type #2.171083723
Identify any Unique Space Type #3.171083733
Identify any Unique Space Type #4.171083743
12445EDITABLEN1710

Asbestos

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Asbestos

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Asbestos
If required in the lease contract, has the lessor provided a written statement that no asbestos is present?Not PossibleNo ImpactNo175585664
If asbestos is present, is there a current asbestos management plan or O&M plan?Not PossibleNo ImpactNo175585674
Are visual inspections of the asbestos inventory conducted annually?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1755856837286684
Are asbestos notifications documented (e.g., annual, the start of a contract, and before an abatement project)?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1755856937286694
Is asbestos maintenance or renovation done in accordance with Federal, state and local regulations?Not PossibleNo ImpactNo175585704
Are pre-alteration assessments done before work that could disturb asbestos, as verified through the asbestos program manager? If in leased space, this would only apply to GSA-managed projects.Not PossibleNo ImpactNo175585714
Other Findings
Other Findings 1Not PossibleNo ImpactNo175485561
Other Findings 2Not PossibleNo ImpactNo175485571
Other Findings 3Not PossibleNo ImpactNo175485581
Other Findings 4Not PossibleNo ImpactNo175485591
Other Findings 5Not PossibleNo ImpactNo175485601
Other Findings 6Not PossibleNo ImpactNo175485611
Other Findings 7Not PossibleNo ImpactNo175485621
Other Findings 8Not PossibleNo ImpactNo175485631
Other Findings 9Not PossibleNo ImpactNo175485641
Other Findings 10Not PossibleNo ImpactNo175485651
Overall RAC
Overall RACNo175385535
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No175385546
Explanation of User Adjusted RACNo175385551
12445EDITABLEN1753
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Drinking Water

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Drinking Water

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Drinking Water
Is the water from a public or municipal provider?Not PossibleNo ImpactNo176786204
If the water is from a well source, is it tested regularly in accordance with State or local requirements?Not PossibleNo ImpactNo176786214
Have there been any unresolved drinking water complaints from GSA tenants since the last survey?Not PossibleNo ImpactNo176786224
Is chlorine testing and flushing conducted per PBS Guidance to Avoid Water Stagnation?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1767862337286704
If a GSA-managed child care center is present, has testing been performed for lead and copper per PBS Drinking Water Policy requirements?Not PossibleNo ImpactNo176786244
If a GSA-managed child care center is present, are all outlets flushed weekly?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1767862537286714
Are backflow prevention devices certified as prescribed by applicable Federal, state, and local laws, ordinances, and regulations? If no regulations exist, at least annually per the O&M contract requirements.N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1767869237286724
Other Findings
Other Findings 1Not PossibleNo ImpactNo176686101
Other Findings 2Not PossibleNo ImpactNo176686111
Other Findings 3Not PossibleNo ImpactNo176686121
Other Findings 4Not PossibleNo ImpactNo176686131
Other Findings 5Not PossibleNo ImpactNo176686141
Other Findings 6Not PossibleNo ImpactNo176686151
Other Findings 7Not PossibleNo ImpactNo176686161
Other Findings 8Not PossibleNo ImpactNo176686171
Other Findings 9Not PossibleNo ImpactNo176686181
Other Findings 10Not PossibleNo ImpactNo176686191
Overall RAC
Overall RACNo176586075
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No176586086
Explanation of User Adjusted RACNo176586091
12445EDITABLEN1765
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Electrical

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Electrical

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Electrical
Are there any visible electrical safety hazards in the GSA controlled space?Not PossibleNo ImpactNo175985864
Has an Arc Flash analysis for the building been conducted?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1759858537286734
Are proper Arc Flash warning labels posted on the appropriate electrical equipment?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1759858737286744
Have electrical spaces been limited to qualified personnel only per OSHA requirements?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1759858837286754
Is there a plan to replace electrical equipment that has reached the end of its life?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1759858937286764
Other Findings
Other Findings 1Not PossibleNo ImpactNo175885751
Other Findings 2Not PossibleNo ImpactNo175885761
Other Findings 3Not PossibleNo ImpactNo175885771
Other Findings 4Not PossibleNo ImpactNo175885781
Other Findings 5Not PossibleNo ImpactNo175885791
Other Findings 6Not PossibleNo ImpactNo175885801
Other Findings 7Not PossibleNo ImpactNo175885811
Other Findings 8Not PossibleNo ImpactNo175885821
Other Findings 9Not PossibleNo ImpactNo175885831
Other Findings 10Not PossibleNo ImpactNo175885841
Overall RAC
Overall RACNo175785725
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No175785736
Explanation of User Adjusted RACNo175785741
12445EDITABLEN1757
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Emergency Planning

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Emergency Planning

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Emergency Planning
Is there a current occupant emergency plan (OEP) in place?Not PossibleNo ImpactNo171984124
Are emergency drills performed (e.g., fire, tornado, etc)?Not PossibleNo ImpactNo171984134
Other Findings
Other Findings 1Not PossibleNo ImpactNo171884021
Other Findings 2Not PossibleNo ImpactNo171884031
Other Findings 3Not PossibleNo ImpactNo171884041
Other Findings 4Not PossibleNo ImpactNo171884051
Other Findings 5Not PossibleNo ImpactNo171884061
Other Findings 6Not PossibleNo ImpactNo171884071
Other Findings 7Not PossibleNo ImpactNo171884081
Other Findings 8Not PossibleNo ImpactNo171884091
Other Findings 9Not PossibleNo ImpactNo171884101
Other Findings 10Not PossibleNo ImpactNo171884111
Overall RAC
Overall RACNo171783995
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No171784006
Explanation of User Adjusted RACNo171784011
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Equipment Machine Guard

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Equipment Machine Guard

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Equipment Machine Guard
Is the facility machinery properly guarded and/or interlocked?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1775865837286774
Other Findings
Other Findings 1Not PossibleNo ImpactNo177486481
Other Findings 2Not PossibleNo ImpactNo177486491
Other Findings 3Not PossibleNo ImpactNo177486501
Other Findings 4Not PossibleNo ImpactNo177486511
Other Findings 5Not PossibleNo ImpactNo177486521
Other Findings 6Not PossibleNo ImpactNo177486531
Other Findings 7Not PossibleNo ImpactNo177486541
Other Findings 8Not PossibleNo ImpactNo177486551
Other Findings 9Not PossibleNo ImpactNo177486561
Other Findings 10Not PossibleNo ImpactNo177486571
Overall RAC
Overall RACNo177386455
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No177386466
Explanation of User Adjusted RACNo177386471
12445EDITABLEN1773
N

HazMat HazCom

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HazMat HazCom

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
HazMat HazCom
Does the O&M contractor have a written hazard communication program per 1910.1200(e)?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739849837286784
Does the O&M contractor maintain a chemical inventory, and SDSs for each chemical per 1910.1200(e)(1)(i)?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739849937286794
Does the O&M contractor properly label and store their chemicals?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739850037286804
Does the Custodial contractor have a written hazard communication program per 1910.1200(e)N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739850137286814
Does the Custodial contractor maintain a chemical inventory and SDSs for each chemical per 1910.1200(e)(1)(i)?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739850237286824
Does the Custodial contractor properly label and store their chemicals?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739869337286834
If emergency eyewash and shower equipment are used to treat chemical splashes or eye injuries in the workplace, is the equipment activated weekly and inspected per the ANSI/ISEA Z358.1 standard?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1739869437286844
If applicable, do the GSA tenants have a written hazard communication program per 1910.1200(e)?Not PossibleNo ImpactNo173986954
If applicable, do the GSA tenants maintain a chemical inventory, and SDSs for each chemical per 1910.1200(e)(1)(i)?Not PossibleNo ImpactNo173986964
If applicable, do the GSA tenants properly label and store their chemicals?Not PossibleNo ImpactNo173986974
Other Findings
Other Findings 1Not PossibleNo ImpactNo173884881
Other Findings 2Not PossibleNo ImpactNo173884891
Other Findings 3Not PossibleNo ImpactNo173884901
Other Findings 4Not PossibleNo ImpactNo173884911
Other Findings 5Not PossibleNo ImpactNo173884921
Other Findings 6Not PossibleNo ImpactNo173884931
Other Findings 7Not PossibleNo ImpactNo173884941
Other Findings 8Not PossibleNo ImpactNo173884951
Other Findings 9Not PossibleNo ImpactNo173884961
Other Findings 10Not PossibleNo ImpactNo173884971
Overall RAC
Overall RACNo173784855
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No173784866
Explanation of User Adjusted RACNo173784871
12445EDITABLEN1737
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Hazardous Energy Control

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Hazardous Energy Control

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Hazardous Energy Control
Does the O&M Contractor have a written hazardous energy control program?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1743851637286854
If observed, are proper lockout/tagout practices and procedures followed?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1743851737286864
Other Findings
Other Findings 1Not PossibleNo ImpactNo174285061
Other Findings 2Not PossibleNo ImpactNo174285071
Other Findings 3Not PossibleNo ImpactNo174285081
Other Findings 4Not PossibleNo ImpactNo174285091
Other Findings 5Not PossibleNo ImpactNo174285101
Other Findings 6Not PossibleNo ImpactNo174285111
Other Findings 7Not PossibleNo ImpactNo174285121
Other Findings 8Not PossibleNo ImpactNo174285131
Other Findings 9Not PossibleNo ImpactNo174285141
Other Findings 10Not PossibleNo ImpactNo174285151
Overall RAC
Overall RACNo174185035
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No174185046
Explanation of User Adjusted RACNo174185051
12445EDITABLEN1741
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Indoor Air Quality

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Indoor Air Quality

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Indoor Air Quality
Have there been any unresolved IAQ complaints from GSA tenants since the last survey?Not PossibleNo ImpactNo174785314
Does the building management office maintain a log of IAQ issues or complaints in NCMMS?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1747853337286874
Is the GSA Lease Administration Manager familiar with the IAQ portion of the contract?Not PossibleNo ImpactNo174785344
Are there visible signs of water damage or mold?Not PossibleNo ImpactNo174785354
If present, is the building dealing with water intrusion or visible mold growth per industry standards (e.g., ANSI / IICRC S500 & S520)?Not PossibleNo ImpactNo174785364
Other Findings
Other Findings 1Not PossibleNo ImpactNo174685211
Other Findings 2Not PossibleNo ImpactNo174685221
Other Findings 3Not PossibleNo ImpactNo174685231
Other Findings 4Not PossibleNo ImpactNo174685241
Other Findings 5Not PossibleNo ImpactNo174685251
Other Findings 6Not PossibleNo ImpactNo174685261
Other Findings 7Not PossibleNo ImpactNo174685271
Other Findings 8Not PossibleNo ImpactNo174685281
Other Findings 9Not PossibleNo ImpactNo174685291
Other Findings 10Not PossibleNo ImpactNo174685301
Overall RAC
Overall RACNo174585185
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No174585196
Explanation of User Adjusted RACNo174585201
12445EDITABLEN1745
N

Lead

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Lead

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Lead
Does the building contain damaged paint, similar surface coatings, or accumulated dust that contains lead?Not PossibleNo ImpactNo172384274
Are pre-alteration assessments done before work that disturb paint, similar surface coatings, or accumulated dust that could contain lead? If in leased space, this would only apply to GSA-managed projects.Not PossibleNo ImpactNo172384284
Other Findings
Other Findings 1Not PossibleNo ImpactNo172284171
Other Findings 2Not PossibleNo ImpactNo172284181
Other Findings 3Not PossibleNo ImpactNo172284191
Other Findings 4Not PossibleNo ImpactNo172284201
Other Findings 5Not PossibleNo ImpactNo172284211
Other Findings 6Not PossibleNo ImpactNo172284221
Other Findings 7Not PossibleNo ImpactNo172284231
Other Findings 8Not PossibleNo ImpactNo172284241
Other Findings 9Not PossibleNo ImpactNo172284251
Other Findings 10Not PossibleNo ImpactNo172284261
Overall RAC
Overall RACNo172184145
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No172184156
Explanation of User Adjusted RACNo172184161
12445EDITABLEN1721
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Non-ionizing Radiation

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Non-ionizing Radiation

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Non-ionizing Radiation
Are radio frequency (RF) transmitting devices on the facility's roof?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1731846037286884
Are safety zones established and proper danger signage posted?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1731846137286894
If applicable, is the FCC license and RF emissions analysis report from the device owner documented?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1731846237286904
Other Findings
Other Findings 1Not PossibleNo ImpactNo173084501
Other Findings 2Not PossibleNo ImpactNo173084511
Other Findings 3Not PossibleNo ImpactNo173084521
Other Findings 4Not PossibleNo ImpactNo173084531
Other Findings 5Not PossibleNo ImpactNo173084541
Other Findings 6Not PossibleNo ImpactNo173084551
Other Findings 7Not PossibleNo ImpactNo173084561
Other Findings 8Not PossibleNo ImpactNo173084571
Other Findings 9Not PossibleNo ImpactNo173084581
Other Findings 10Not PossibleNo ImpactNo173084591
Overall RAC
Overall RACNo172984475
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No172984486
Explanation of User Adjusted RACNo172984491
12445EDITABLEN1729
N

Confined Spaces

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Confined Spaces

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Confined Spaces
Are confined spaces in the building documented, including permit-required confined spaces (PRCS)?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1763860337286914
Are PRCS in the building properly labeled?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1763860437286924
Are GSA employees prohibited from entering PRCS?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1763860537286934
Does the O&M contractor have a written confined space entry program?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1763860637286944
Other Findings
Other Findings 1Not PossibleNo ImpactNo176285931
Other Findings 2Not PossibleNo ImpactNo176285941
Other Findings 3Not PossibleNo ImpactNo176285951
Other Findings 4Not PossibleNo ImpactNo176285961
Other Findings 5Not PossibleNo ImpactNo176285971
Other Findings 6Not PossibleNo ImpactNo176285981
Other Findings 7Not PossibleNo ImpactNo176285991
Other Findings 8Not PossibleNo ImpactNo176286001
Other Findings 9Not PossibleNo ImpactNo176286011
Other Findings 10Not PossibleNo ImpactNo176286021
Overall RAC
Overall RACNo176185905
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No176185916
Explanation of User Adjusted RACNo176185921
12445EDITABLEN1761
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Powered Industrial Vehicles

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Powered Industrial Vehicles

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Powered Industrial Vehicles
Do any occupants of the GSA controlled space use powered industrial vehicles (e.g., fork truck, tractor, platform lift truck, motorized hand truck, and other specialized industrial truck)?Not PossibleNo ImpactNo175185504
If yes, does that organization have a specific written powered industrial vehicle program applicable to the vehicles used?Not PossibleNo ImpactNo175185514
Is an evaluation of each powered industrial truck operator's performance within the last three years documented?Not PossibleNo ImpactNo175185524
Other Findings
Other Findings 1Not PossibleNo ImpactNo175085401
Other Findings 2Not PossibleNo ImpactNo175085411
Other Findings 3Not PossibleNo ImpactNo175085421
Other Findings 4Not PossibleNo ImpactNo175085431
Other Findings 5Not PossibleNo ImpactNo175085441
Other Findings 6Not PossibleNo ImpactNo175085451
Other Findings 7Not PossibleNo ImpactNo175085461
Other Findings 8Not PossibleNo ImpactNo175085471
Other Findings 9Not PossibleNo ImpactNo175085481
Other Findings 10Not PossibleNo ImpactNo175085491
Overall RAC
Overall RACNo174985375
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No174985386
Explanation of User Adjusted RACNo174985391
12445EDITABLEN1749
N

Radon

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Radon

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Radon
If required in the lease contract, is there a record of radon testing?Not PossibleNo ImpactNo172784424
If yes, are the radon levels within acceptable levels as identified in the contract?Not PossibleNo ImpactNo172784434
Has radon testing (initial baseline) been done for the building?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1727844437286954
If a childcare center is present, has testing been performed in the past 3 years, as applicable?
(note: some state licensing agencies require testing every 3 yrs)"Not PossibleNo ImpactNo172784454
Has the GSA-controlled space been retested for radon following any major construction work that affected the building foundation or involved penetrations from the building into the soil? If in leased space, this would only apply if included in the lease contract.Not PossibleNo ImpactNo172784464
Other Findings
Other Findings 1Not PossibleNo ImpactNo172684321
Other Findings 2Not PossibleNo ImpactNo172684331
Other Findings 3Not PossibleNo ImpactNo172684341
Other Findings 4Not PossibleNo ImpactNo172684351
Other Findings 5Not PossibleNo ImpactNo172684361
Other Findings 6Not PossibleNo ImpactNo172684371
Other Findings 7Not PossibleNo ImpactNo172684381
Other Findings 8Not PossibleNo ImpactNo172684391
Other Findings 9Not PossibleNo ImpactNo172684401
Other Findings 10Not PossibleNo ImpactNo172684411
Overall RAC
Overall RACNo172584295
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No172584306
Explanation of User Adjusted RACNo172584311
12445EDITABLEN1725
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Walking-Work Surfaces

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Walking-Work Surfaces

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
Walking-Work Surfaces
Are all observed open-sided floor or platforms at least 4 feet above the adjacent floor or ground level properly guarded by guardrail system or equivalent?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1735847637286964
Are there any tripping or fall hazards within the GSA controlled space, common areas, ramps, sidewalks, or entrance areas to the facility?Not PossibleNo ImpactNo173584774
Were there any areas in the GSA controlled space that raised concerns regarding the employer's obligation to ensure that each walking-working surface can adequately support the maximum intended load for that surface per 29 CFR 1910.22(b)?Not PossibleNo ImpactNo173584784
Is the roof properly guarded from falls through anchors, guardrails, fall protection plans?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1735847937286974
If present, have roof anchors used for rope descent systems been tested and certified per 29 CFR 1910.27?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1735848037286984
If present, have roof anchors used for personal fall arrest systems been confirmed capable of supporting at least 5,000 pounds (22.2 kN) for each employee attached per 29 CFR 1910.140(c)(13)(i)? Alternatively, have they been designed, installed, and used under the supervision of a qualified person as part of a complete personal fall protection system that maintains a safety factor of at least two per 29 CFR 1910.140(c)(13)(ii)?N/ANot applicable for Leased buildingNot PossibleNo ImpactNo1735869837286994
For buildings in high-risk seismic zones
Does the building exterior appear free of visible damage or deterioration?Not PossibleNo ImpactNo177686594
Are hanging objects (e.g. fixtures, decorations) in occupied areas secured to minimize swinging or falling?Not PossibleNo ImpactNo177686604
Are wall-mounted objects (e.g., shelves, cabinets, monitors, etc.) in occupied areas greater than 6 feet or otherwise noted in FEMA E-74 secured to the wall?Not PossibleNo ImpactNo177686614
Are free-standing objects (e.g., file cabinets, bookcases, machines, etc.) greater than 6 feet or otherwise noted in FEMA E-74 secured to the floor or wall?Not PossibleNo ImpactNo177686624
Other Findings
Other Findings 1Not PossibleNo ImpactNo173484661
Other Findings 2Not PossibleNo ImpactNo173484671
Other Findings 3Not PossibleNo ImpactNo173484681
Other Findings 4Not PossibleNo ImpactNo173484691
Other Findings 5Not PossibleNo ImpactNo173484701
Other Findings 6Not PossibleNo ImpactNo173484711
Other Findings 7Not PossibleNo ImpactNo173484721
Other Findings 8Not PossibleNo ImpactNo173484731
Other Findings 9Not PossibleNo ImpactNo173484741
Other Findings 10Not PossibleNo ImpactNo173484751
Overall RAC
Overall RACNo173384635
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No173384646
Explanation of User Adjusted RACNo173384651
12445EDITABLEN1733
N

High Risk Operations

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High Risk Operations

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACRepeat FindingsRepeat Condition IDLocalized or Building WideRecommendation
High Risk Laboratories
If a High Risk Laboratory Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B? (If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.)Not PossibleNo ImpactNo178887173
If a second (#2) High Risk Laboratory Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B?
(If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.)Not PossibleNo ImpactNo178887183
If a third (#3) High Risk Laboratory Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B?
(If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.)Not PossibleNo ImpactNo178887193
If a fourth (#4) High Risk Laboratory Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B?
(If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.)Not PossibleNo ImpactNo178887203
High Risk Firing Range or Shoot Houses
If a High Risk Firing Range or Shoot House Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B? (If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.)Not PossibleNo ImpactNo178987153
If a second (#2) High Risk Firing Range or Shoot House Space #2 exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B? (If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.)Not PossibleNo ImpactNo178987163
High Risk Explosives & Explosive Materials
If a High Risk Explosives or Explosive Materials Storage Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B? (If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.) NOTE: Storage of ammunition is not considered explosives or explosive materials storage.Not PossibleNo ImpactNo179087123
If a second (#2) High Risk Explosives or Explosive Materials Storage Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B? (If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.) NOTE: Storage of ammunition is not considered explosives or explosive materials storage.Not PossibleNo ImpactNo179087133
If a third (#3) High Risk Explosives or Explosive Materials Storage Space exists in GSA controlled space, does it create an incompatible grouping as defined in PBS 1000.4B? (If "Yes" or "No", Include in the "Finding / Observation" Column: Tenant Agency, Floor, Room Number, and Square Footage.) NOTE: Storage of ammunition is not considered explosives or explosive materials storage.Not PossibleNo ImpactNo179087143
Other Findings
Other Findings 1Not PossibleNo ImpactNo178787021
Other Findings 2Not PossibleNo ImpactNo178787031
Other Findings 3Not PossibleNo ImpactNo178787041
Other Findings 4Not PossibleNo ImpactNo178787051
Other Findings 5Not PossibleNo ImpactNo178787061
Other Findings 6Not PossibleNo ImpactNo178787071
Other Findings 7Not PossibleNo ImpactNo178787081
Other Findings 8Not PossibleNo ImpactNo178787091
Other Findings 9Not PossibleNo ImpactNo178787101
Other Findings 10Not PossibleNo ImpactNo178787111
Overall RAC
Overall RACNo178686995
User Adjusted RAC
: Once the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.No178687006
Explanation of User Adjusted RACNo178687011
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RAC Guidance Risk Management Survey Severity and Probability Assessment Guidance

SEVERITY ASSESSMENT GUIDANCE
SCOPE and APPLICABILITY
Environmental RiskFire Protection RiskSafety & Health Risk
Contamination of air, water soil, and biota or non-compliance with environmental regulationsEffects to occupants or facility as a result of a condition or potential event.Adverse health effects or injury to facility occupants, contractors or visitors in response to a condition or event
SEVERITY LEVEL DEFINITIONS
CATASTROPHICIrreversible long-term impacts.(1) Death, permanent disability or irreversible health effect to occupants or (2) a loss of an entire facility.Permanent disability, irreversible health effect or death.

SEVERE Reversible long-term damage (5+ years to remediate). (1) Severe injury, potential long-term health effect or (2) major loss or impact to a facility. Potential long-term health effect or severe injury.

SIGNIFICANT Reversible medium-term damage (1-5 years to remediate). (1) Minor injury or reversible health effect or (2) damage to a portion of a facility requiring an extended period of time to repair. Reversible health effect or minor injury.

MODERATE Reversible short-term impact (<1 year to remediate). (1) First aid, no lost time or (2) damage to a facility requiring a minimal amount of time to repair. First aid or no lost time.

MINOR De minimis regulatory violation. De minimis code violation. De minimis code violation.

NO IMPACTNo risk of impact.No risk of impact to the occupants or facility.No risk of impact.
PROBABILITY ASSESSMENT GUIDANCE
PROBABILITY LEVEL DEFINITIONS
LikelyImminent

or

1 in 10
ProbableProbable

or

1 in 100
PossiblePossible

or

1 in 1000
RemoteRemote

or

1 in 10,000
UnlikelyUnlikely

or

1 in 100,000
Not PossibleNon-existent

Help Text

RAC Summary
RAC Summary
IRIS Building Profile
IRIS Building Profile
Region
GSA Building Number
GSA Building Name
Building Street Address
Building City
Date of Building Construction
Building State
Building Size (RSF)
Building Size (GSF)
Total Number of Floors Above Grade
Total Number of Floors Below Grade
Building Information
Building Profile
Date(s) of Onsite Survey
Surveyor
Type of Occupancies
Building Point(s) of Contact for Survey
Lease Number
Lease Expiration Date
Property Type
What is the tenant breakdown?
Primary Tenants
Identify any Unique Space Type(s). If "other" is chosen, please describe the "other" unique space in the comments section.
Identify any Unique Space Type #2.
Identify any Unique Space Type #3.
Identify any Unique Space Type #4.
Asbestos
Asbestos
If required in the lease contract, has the lessor provided a written statement that no asbestos is present?
If asbestos is present, is there a current asbestos management plan or O&M plan?
Are visual inspections of the asbestos inventory conducted annually?
Are asbestos notifications documented (e.g., annual, the start of a contract, and before an abatement project)?
Is asbestos maintenance or renovation done in accordance with Federal, state and local regulations?
Are pre-alteration assessments done before work that could disturb asbestos, as verified through the asbestos program manager? If in leased space, this would only apply to GSA-managed projects.
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Drinking Water
Drinking Water
Is the water from a public or municipal provider?
If the water is from a well source, is it tested regularly in accordance with State or local requirements?
Have there been any unresolved drinking water complaints from GSA tenants since the last survey?
Is chlorine testing and flushing conducted per PBS Guidance to Avoid Water Stagnation?
If a GSA-managed child care center is present, has testing been performed for lead and copper per PBS Drinking Water Policy requirements?
If a GSA-managed child care center is present, are all outlets flushed weekly?
Are backflow prevention devices certified as prescribed by applicable Federal, state, and local laws, ordinances, and regulations? If no regulations exist, at least annually per the O&M contract requirements.
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Electrical
Electrical
Are there any visible electrical safety hazards in the GSA controlled space?
Has an Arc Flash analysis for the building been conducted?
Are proper Arc Flash warning labels posted on the appropriate electrical equipment?
Have electrical spaces been limited to qualified personnel only per OSHA requirements?
Is there a plan to replace electrical equipment that has reached the end of its life?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Emergency Planning
Emergency Planning
Is there a current occupant emergency plan (OEP) in place?
Are emergency drills performed (e.g., fire, tornado, etc)?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Equipment Machine Guard
Equipment Machine Guard
Is the facility machinery properly guarded and/or interlocked?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
HazMat HazCom
HazMat HazCom
Does the O&M contractor have a written hazard communication program per 1910.1200(e)?
Does the O&M contractor maintain a chemical inventory, and SDSs for each chemical per 1910.1200(e)(1)(i)?
Does the O&M contractor properly label and store their chemicals?
Does the Custodial contractor have a written hazard communication program per 1910.1200(e)
Does the Custodial contractor maintain a chemical inventory and SDSs for each chemical per 1910.1200(e)(1)(i)?
Does the Custodial contractor properly label and store their chemicals?
If emergency eyewash and shower equipment are used to treat chemical splashes or eye injuries in the workplace, is the equipment activated weekly and inspected per the ANSI/ISEA Z358.1 standard?
If applicable, do the GSA tenants have a written hazard communication program per 1910.1200(e)?
If applicable, do the GSA tenants maintain a chemical inventory, and SDSs for each chemical per 1910.1200(e)(1)(i)?
If applicable, do the GSA tenants properly label and store their chemicals?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Hazardous Energy Control
Hazardous Energy Control
Does the O&M Contractor have a written hazardous energy control program?
If observed, are proper lockout/tagout practices and procedures followed?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Indoor Air Quality
Indoor Air Quality
Have there been any unresolved IAQ complaints from GSA tenants since the last survey?
Does the building management office maintain a log of IAQ issues or complaints in NCMMS?
Is the GSA Lease Administration Manager familiar with the IAQ portion of the contract?
Are there visible signs of water damage or mold?
If present, is the building dealing with water intrusion or visible mold growth per industry standards (e.g., ANSI / IICRC S500 & S520)?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Lead
Lead
Does the building contain damaged paint, similar surface coatings, or accumulated dust that contains lead?
Are pre-alteration assessments done before work that disturb paint, similar surface coatings, or accumulated dust that could contain lead? If in leased space, this would only apply to GSA-managed projects.
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Non-ionizing Radiation
Non-ionizing Radiation
Are radio frequency (RF) transmitting devices on the facility's roof?
Are safety zones established and proper danger signage posted?
If applicable, is the FCC license and RF emissions analysis report from the device owner documented?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4
Other Findings 5
Other Findings 6
Other Findings 7
Other Findings 8
Other Findings 9
Other Findings 10
Overall RAC
Overall RAC
User Adjusted RACOnce the surveyor has reviewed the findings and Overall RAC provided above, if the RAC does not represent the risk associated with the findings as a whole, please provide an adjusted RAC and explanation below.
Explanation of User Adjusted RAC
Confined Spaces
Confined Spaces
Are confined spaces in the building documented, including permit-required confined spaces (PRCS)?
Are PRCS in the building properly labeled?
Are GSA employees prohibited from entering PRCS?
Does the O&M contractor have a written confined space entry program?
Other Findings
Other Findings 1
Other Findings 2
Other Findings 3
Other Findings 4

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