Attachment 3 - Work Risk Analysis.xlsx
XLSX spreadsheet 40 KB Posted
- Attached to
- Residential Elevator with Installation Federal contract opportunity
- Solicitation number
- 19MX5325Q0021
- Issued by
- Department of State US Embassy Mexico
About this file
This is a Job Hazard Analysis (JHA) template provided in both English and Spanish formats. The template is designed to document workplace safety assessments and includes sections for documenting job steps, identified hazards, risk assessment codes (RAC), and control measures. The template contains a risk assessment matrix that evaluates the severity of potential incidents (from minor to catastrophic) against the likelihood of occurrence (from improbable to very probable).
The template is specifically provided as part of a solicitation for the replacement and installation of a residential elevator at a U.S. Embassy apartment building in Mexico City, with an estimated value between $100,000 and $250,000. This form would be used to assess and document safety risks associated with the elevator installation project. The matrix provides a standardized way to classify risks from "Very Low" to "High" based on the intersection of severity and probability ratings.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 002 19MX5325Q0021 Residential Elevator.pdf | ||
| RFQ 19MX5325Q0021-Amendment 0002.pdf | ||
| Amendment 001 19MX5325Q0021 Residential Elevator.docx | DOCX document | |
| RFQ 19MX5325Q0021-Amendment 0001.docx | DOCX document | |
| Letter to Offerors-19MX5325Q0021.pdf | ||
| Vendor Portal 4.pdf | ||
| Attachment 1 - Certification.docx | DOCX document | |
| RFQ 19MX5325Q0021.pdf | ||
| Vendor Portal 3.pdf | ||
| Attachment 4 - Work at heights.xlsx | XLSX spreadsheet | |
| Vendor Portal 1.pdf | ||
| SF-18 19MX5325Q0021 Elevator Replacement.pdf | ||
| Attachment 2 - Safety Management Plan.docx | DOCX document | |
| Vendor Portal 2.pdf |
Show all 14
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Text version
Format in English JOB HAZARD ANALYSIS RAC table
DATE:
LOCATION:
TASK:
INVOLVED PERSONNEL:
REQUIRED SAFETY PROTECTIVE EQUIPMENT:
| JOB STEPS (TASKS) | IDENTIFIED HAZARDS | RAC RATE | CONTROLS (SAFE PROCEDURES AND PROTECTIVE MEASURES) | CLASS AFTER CONTROLS | |
| 1 |
sPECIAL SAFETY PROTECTIVE EQUIPMENT (IN CASE REQUIRED):
| SUPERVISOR APPROVAL/APPROVED BY : | |
| Page 1 of ____ |
Formato en español
ANALISIS DE RIESGO DEL TRABAJO CALIFICACION DE RIEGO
FECHA:
UBICACION:
TAREA:
PARTICIPANTES DE LA TAREA:
EQUIPO DE PROTECCION PERSONAL REQUERIDO:
| PASOS DE LA TAREA | RIESGOS IDENTIFICADOS | CALIFICACION | CONTROLES A APLICAR | RECALIFICACION | |
| 1 |
EQUIPO DE PROTECCION ESPECIAL ESPECIFICO (EN CASO DE REQUERIRSE):
| AUTORIZACION DEL SUPERVISOR/APROBADO POR: | |
| Hoja 1 de ____ |
RAC - tabla de riesgo
| SEVERIDAD | ||||||
| 1 | 2 | 3 | 4 | |||
| PROBABILIDAD DE QUE OCURRA O DE EXPOSICION | ||||||
| PARA UNA UNIDAD DE TIEMPO DETERMINADA | CATASTOFRICO |
Muerte o incapacidad permanente
CRITICO
Incapacidad de hasta 3 meses
MODERADO
Lesión menor, días de incapacidad
MENOR
Primeros auxilios, Tratamiento Médico menor
| 1 | FRECUENTE | |||
| Es probable que ocurra repetidamente | 1 =ALTO | 1= ALTO | 2 =SERIO | 3= MEDIANO |
| 2 | PROBABLE | |||
| Es probable que ocurra muchas veces | 1= ALTO | 2= SERIO | 3= MEDIANO | 4 = BAJO |
| 3 | OCASIONALMENTE | |||
| Es probable que ocurra en alguna ocasión | 2= SERIO | 3= MEDIANO | 4 = BAJO | 5= MUY BAJO |
| 4 | REMOTA | |||
| No es probable que ocurra | 3= MEDIANO | 4 = BAJO | 5= MUY BAJO | 5= MUY BAJO |
| 5 | IMPROBABLE |
Casi imposible, podemos asumir que no va a ocurrir
| SEVERITY | ||||
| 1 | 2 | 3 | 4 | |
| LIKEHOOD OF OCCURRENCE OR EXPOSURE | CATASTROPHIC |
DEATH OR PERMANENT INJURY/ILLNESS
CRITIC
UPON 3 MONTHS AWAY FROM JOB
MODERATED
MINOR INJURY, DAYS AWAY FORM JOB
MINOR
FIRST AID, MINOR MEDICAL TREATMENT
| 1 | VERY PROBABLE | |||
| VERY SURE TO HAPPEN OR BE EXPOSED | 1 =HIGH | 1 =HIGH | 2 =SERIOUS | 3= MID |
| 2 | PROBABLE | |||
| MAY HAPPEN | 1 =HIGH | 2 =SERIOUS | 3= MID | 4 = LOW |
| 3 | OCASSIONAL | |||
| MAY HAPPEN IN SPECIAL SITUATION | 2 =SERIOUS | 3= MID | 4 = LOW | 5= VERY LOW |
| 4 | REMOTE | |||
| NOT PROBABLE TO HAPPEN | 3= MID | 4 = LOW | 5= VERY LOW | 5= VERY LOW |
| 5 | IMPROBABLE |
ALMOST IMPOSIBLE TO HAPPEN
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