Activity Hazard Analysis-Blank Work Sheet.docx
DOCX document 37 KB Posted
- Solicitation number
- 19KE5025Q0012
- Issued by
-
Department of State
About this file
This is an Activity Hazard Analysis (AHA) blank worksheet template used to assess and document safety risks for work activities. The template includes a Risk Assessment Code (RAC) matrix that evaluates hazard severity (Catastrophic, Critical, Marginal, Negligible) against probability of occurrence (Frequent, Likely, Occasional, Seldom, Unlikely) to determine overall risk levels ranging from Extremely High (E) to Low (L). The worksheet provides blank sections for documenting job steps, associated hazards, control measures, required equipment, training requirements, and inspection requirements.
This template appears to be related to a Department of State contract opportunity (19KE5025Q0012) for demolition and construction of a new boundary wall at LOCHAB residence Phase Two in Nairobi. While the AHA template itself does not contain project-specific details, it would likely need to be completed by contractors as part of their safety documentation for the construction project, which has a mandatory pre-proposal conference on January 17, 2025, questions due by January 21, 2025, and proposals due by January 29, 2025.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Activity Hazard Analysis (AHA)
| Activity/Work Task: |
| Overall Risk Assessment Code (RAC) (Use highest code) |
| Project Location: |
| Risk Assessment Code (RAC) Matrix |
| Contract Number: |
| Severity |
| Probability |
Date Prepared:
| Frequent |
| Likely |
| Occasional |
| Seldom |
| Unlikely |
| Prepared by (Name/Title): |
| Catastrophic |
| E |
| E |
| H |
| H |
| M |
| Critical |
| E |
| H |
| H |
| M |
| L |
| Reviewed by (Name/Title): |
| Marginal |
| H |
| M |
| M |
| L |
| L |
| Negligible |
| M |
| L |
| L |
| L |
| L |
| Notes: (Field Notes, Review Comments, etc.) |
| Step 1: Review each “Hazard” with identified safety “Controls” and determine RAC (See above) |
| “Probability” is the likelihood to cause an incident, near miss, or accident and identified as: Frequent, Likely, Occasional, Seldom or Unlikely. |
| RAC Chart |
| “Severity” is the outcome/degree if an incident, near miss, or accident did occur and identified as: Catastrophic, Critical, Marginal, or Negligible |
| E = Extremely High Risk |
H = High Risk
| Step 2: Identify the RAC (Probability/Severity) as E, H, M, or L for each “Hazard” on AHA. Annotate the overall highest RAC at the top of AHA. |
| M = Moderate Risk |
L = Low Risk
| Job Steps |
| Hazards |
| Controls |
| RAC |
| Equipment to be Used |
| Training Requirements/Competent or Qualified Personnel name(s) |
| Inspection Requirements |
File details come from the government source that posted it. Updated .