1e SOW_MAINT FACILITIES_MAR_2021.pdf

STATEMENT OF WORK

Environmental Health and Safety Industrial Hygiene Services for

Maryland Army National Guard (MDARNG) Maintenance Facilities

March 2021

1 General.

1.1 Objective.

1.1.1 The purpose of this contract is to anticipate, recognize, and evaluate potential health hazards according to appropriate requirements (attachment 1) associated with processes performed at MDARNG Maintenance facilities and to provide sound recommendations for hazard control. The surveys will serve to establish a baseline of workplace conditions or update a previous baseline so that a worker’s history of exposures is provided for civilian and military employees.

1.1.2 Background: In accordance with (IAW) The Occupational Safety and Health (OSH) Act of 1970, Title 29 of the Code of Federal Regulation, Section 25, Part 1960, Title 29 CFR, paragraph (c) states that “all areas and operations of each workplace, including office operations, shall be inspected at least annually. More frequent inspections shall be conducted in all workplaces where there is an increased risk of accident, injury, or illness due to the nature of the work performed.” In addition, DODI 6055.1, paragraph E3.5.3.1, and AR 385–10 also require annual workplace inspections conducted by qualified safety and occupational health personnel. The industrial hygienist is included in the definition of “qualified safety and health personnel” from all three references cited.

1.1.3 The period of performance is 15 May 2021 through 14 May 2022.

1.1.4 The Contractor shall provide the necessary personnel, equipment, and materials required to conduct baseline, annual, and special environmental health and safety industrial hygiene surveys and to prepare a comprehensive report for the specified facilities.

1.2 Description of Facilities. A list of typical processes that occur in ARNG maintenance facilities is included as attachment 2. This list is not all inclusive.

Using professional judgment list all potentially hazardous processes whether planned in the near future, currently operational, or previously occurred. Do not limit evaluation to the operations on this attached list.

ARNG-CSG-P

Statement of Work, Maintenance Facilities

1.2.1 Army Aviation Support Facility (AASF). The AASF performs backup Aviation Unit Maintenance I (AVUMI) and limited Aviation Intermediate Maintenance (AVIM), which includes direct support maintenance.

1.2.2 Combined Support Maintenance Shop (CSMS). The CSMS provides field and sustainment level maintenance of all vehicles and equipment, except those that receive this level of maintenance at a Maneuver and Training Equipment Sites (MATES) with a sustainment maintenance mission or at another CSMS authorized to the State.

1.2.3 Field Maintenance Shop (FMS). The FMS performs field level maintenance on all vehicles and equipment required for the supported units.

1.3 Quotes and Contract Award.

1.3.1 Price will be for survey planning and coordination; field work; and report writing. Contractor will provide equipment (see 1.4). Air sampling will not be required (see 2.1.2).

1.3.2 Evaluation factors will be price, past performance and technical capability.

Determination for award is based on “best value” lowest price while technically acceptable, which includes the following factors in order of importance:

1.3.3 Experience. (Technically accurate, comprehensive, consistent) and past performance.

1.3.4 Price will include travel costs incorporating a plan to spend TWO FULL DAYS at each maintenance facility.

1.4 Equipment. The ARNG Region Northeast Industrial Hygiene (IH) Office will NOT provide industrial hygiene equipment. Contractor is required to have on every survey the equipment listed in attachment 3. The equipment must have a current, valid calibration.

1.5 Scheduling and Coordination.

1.5.1 The contractor shall contact the ARNG Region Northeast IH Office to obtain the MDARNG Safety and Occupational Health (SOH) point of contact (POC) information. The contractor must contact the SOH POC prior to scheduling with the facility to make sure it is all right to do so, to determine if they will be going on the survey, and whether they want an in- and out-brief.

1.5.2 The contractor shall coordinate survey dates with the facilities’ POCs. The contractor shall provide survey dates to the SOH POC, the Region Northeast Industrial Hygienists, point of contact will be provided upon award of contract.

Contact the Region Northeast IH Office immediately if a facility was closed or combined with another one after the contract was awarded. In most cases, an alternate facility may be determined to replace the facility that was closed.

1.6 Payment.

1.6.1 The contract will be paid as final reports have been completed and accepted.

1.6.2 Final payment will not be made unless all reports are completed and accepted.

1.7 Media and Laboratory Analyses. Air and surface wipe sampling will not be performed during these IH surveys.

1.8 Personnel Qualifications. Field work and report writing must be performed by an American Board of Industrial Hygiene (ABIH) Certified Industrial Hygienist. They must be proficient in the anticipation, recognition, evaluation, and control of environmental factors or stresses from the workplace, which may cause sickness, impaired health and well-being, or significant discomfort among workers. The NGB Region Northeast IH Office reserves the right to request a change in industrial hygienist if there is a conflict with facility personnel, improper/unethical actions on site, or due to a lack of experience.

2 Descriptions of Tasks and Specifications

2.1 Evaluation of Processes. Each process evaluation must include a description, local exhaust ventilation system evaluation (if present), noise dosimetry, lighting, indoor air quality, any additional information, interpretation of results, and recommendations for corrective action. Contractor must provide this information whether or not the process is performed during the survey.

2.1.1 Process Description.

2.1.1.1 Describe the process, the basic tasks, and the area in which it’s located.

2.1.1.2 Describe the hazards associated with the process.

2.1.1.3 Report the number of personnel performing each process (on survey date and the total who perform the work), the process duration, and frequency (i.e. times per week/month/year).

2.1.1.4 List and evaluate any engineering controls associated with the process (described further in para 2.1.3). Describe administrative controls if in place.

2.1.1.5 Describe the appropriate personal protective equipment (PPE) required for the process (if possible). List PPE used and/or available at the facility.

2.1.2 Sampling. Air and surface wipe sampling will not be performed during these IH surveys.

2.1.3 Ventilation system evaluation.

2.1.3.1 Evaluate the effectiveness of all general and local exhaust ventilation systems, i.e. welding hoods, paint booth, vehicle tailpipe exhaust systems, etc. Evaluate even if ventilation system is not being used during the survey. Note damaged or inoperable systems.

2.1.3.2 Use smoke candles or smoke tubes to evaluate airflow in paint and abrasive blasting booths and describe pattern of flow in report.

2.1.3.3 Identify any potential for contamination of clean air sources by contaminated air.

2.1.4 Noise dosimetry.

2.1.4.1 Conduct personal noise dosimetry on employees most likely to be exposed to noise at facilities that have noise producing processes. Dosimeters must be worn and collecting data for a minimum of 75% of the workday. .

2.1.4.2 Perform dosimetry on at least ten maintenance employees.

2.1.4.3 Set dosimeters to Army/ACGIH standards (3 dB exchange rate and 85 dBA TWA8) IAW DA PAM 40-501.

2.1.4.4 Present results for individuals as the TWA8. If there are six or more dosimetry results for a similar exposure group (SEG) calculate the occupational exposure group (OEG) upper threshold level (UTL). See attachment 6 for determination of noise risk assessment codes (RACs).

Personal noise dosimetry results will be placed onto a DA form 4700 following the example in attachment 7.

2.1.5 Lighting. Measure lighting several areas of the facility. Report measurements in footcandles (fc). If task lighting is available such as the work lights used in vehicle maintenance areas, measure illumination in fc and note on report. For example, overall lighting in the aircraft hangar may be insufficient but once task lighting is used, it is now acceptable.

2.1.6 Additional information. Include any other information pertinent to the process.

2.1.7 Interpretation of Results and Further Recommendations. Interpret results of measurements, sampling, and observations. Include an explanation if a process evaluation could not be performed. Recommend repeat or additional evaluation if applicable. Include a recommendation for every finding noted. Risk assessment codes shall be applied to each recommendation (attachment 5).

2.2 Physical Condition of Facility and Personnel Concerns.

2.2.1 Note condition and location of damaged paint. Example Finding: Peeling and chipping red paint was noted on all four walls of the drill hall. Example Recommendation: Alert the facilities management office (FMO) of the peeling and damaged paint so that if they have not already done so, they may make arrangements to have the paint tested for lead content and perform remediation if necessary.

2.2.2 Perform a visual inspection for suspected asbestos containing material (ACM). Note the condition, location, and quantity of any ACM and/or suspect ACM. Example Finding: Broken and crumbling 9” X 9” floor tiles encompassing approximately 450 square feet, that are presumed to contain asbestos were noted in the break room and office 101. Example Recommendation: Alert the FMO of the damaged asbestos containing floor tiles so that they may make necessary arrangements for cleaning and remediation of potentially released asbestos fibers.

2.2.3 Note the location and extent of water damage and/or visible mold. Discuss potential source of water incursion.

2.2.4 Determine if there are any indoor air quality concerns through employee interviews. Measure carbon dioxide, carbon monoxide, temperature, and relative humidity and note outdoor levels.

2.2.5 Provide an initial ergonomic assessment and note any work practices that require repetitive motions, heavy lifting, standing in place for long periods, and awkward work positions. Recommend adjustments to work stations, the use of appropriate equipment such as carts/dollies and anti-fatigue mats, and other ergonomic improvements if appropriate.

2.2.6 Evaluate housekeeping and hygiene practices pertaining to material storage, handling, and cross contamination into clean administrative areas.

2.3 Safety Data Sheet Review. Review all safety data sheets (SDSs) available at the facility and create an inventory of product, chemical/hazard (those with published occupational exposure limits [OELs], and process used for.

2.4 Photographs. Provide photographs, clearly labeled, of damaged or inoperable engineering controls and other deficiencies noted in the report.

2.5 State Employees and Contractors. Noise dosimetry SHALL NOT be performed on State Employees or Contractor Employees.

3 Reporting Requirements.

3.1 Coordinate with the State POC to arrange for facility survey visits and once a final schedule is created, send a copy to the ARNG Region North IH Office.

3.2 If there is an urgent situation during the survey (such as suspected overexposures, damaged and/or friable suspected asbestos materials, improper PPE during high hazard operations, etc.) that will be classified as a RAC 1 or 2, alert an onsite safety representative or facility supervisor immediately. Call or email the NGB Region North IH Office and SOH POC as soon as possible. Additionally, within one week provide a summary of the situation with findings, recommendations, and any corrective actions already taken (if any).

3.3 An electronic draft report, field notes, and DA 4700s for each facility is due to the Region Northeast Industrial Hygienists Cynthia Harrison at cynthia.s.harrison2.civ@mail.mil and Jayson Allan at jayson.r.allan.civ@mail.mil., four weeks after the survey date. Do not wait until all surveys are completed before sending reports. Final reports are due two weeks after receipt of comments from the ARNG Region Northeast IH Office. All comments that were made on the draft report must be implemented. If there are any issues or questions regarding the comments, contact the ARNG Region Northeast IH Office. The following should be included for the final report:

3.3.1

3.3.1.1 The date of the survey, address, and the POC of the facility.

3.3.1.2 Do not collect or include social security numbers or birth dates on any documents or reports. The full name of the employee, facility name, and job title is sufficient to identify the employees and their exposure records will be updated with additional information by the occupational health nurse.

mailto:cynthia.s.harrison2.civ@mail.mil mailto:jayson.r.allan.civ@mail.mil

3.3.1.3 A table of contents for the report.

3.3.1.4 The survey specifications outlined in paragraph 2 of this SOW.

3.3.1.5 A conclusion. Maximum of 1-2 paragraphs.

3.3.2 The following information shall be included in the appendices along with the information identified in paragraph 2. When applicable, appendices shall be referenced in the report. For example, “refer to Appendix A for noise dosimetry results.”

3.3.2.1 Noise dosimetry printouts for each record.

3.3.2.2 References. The list provided is only an example. Only the references used in writing the report should be included in the reference section.

Since publication dates may change, verify that the last published reference date is used.

3.3.2.3 Recommendations for engineering controls, administrative controls, and/or PPE, to include risk assessment codes (RACs) for health hazards, noise, safety, and ergonomics and specific referenced citations. Every finding must have a corresponding recommendation.

3.3.3 The following information shall be provided as separate documentation from the report. At a minimum, it shall include:

3.3.3.1 (Removed)

3.3.3.2 Copy of field notes so that the reviewer can compare notes to the report.

3.3.3.3 One copy of the DA 4700 noise exposure forms for each employee who wore a noise dosimeter. Calculate the UTL if there are at least six dosimetry results for an OEG. (See attach 6 and 7 for an example of the form and to calculate the noise RAC. The information on the form must be adapted depending on the results.)

3.3.3.4 (Removed)

3.3.3.5 The entire report and supporting documents in electronic format as PDF files. Send draft/final reports and supporting documents to Cynthia.s.harrison2.civ@mail.mil and Jayson.r.allan.civ@mail.mil. Please name report files as state_facility_city_mm_yyyy (i.e. NJ_CSMS A_Trenton_10_2017).

mailto:Cynthia.s.harrison2.civ@mail.mil mailto:Jayson.r.allan.civ@mail.mil

4. General Information.

4.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS.

The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO) acceptance in writing of any proposed changes to its

QCP.

4.2 Quality Assurance (QA): The Government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level.

4.3. Recognized Holidays: The following are recognized US holidays and the organizations observed days off. The holidays that fall on a Monday are observed on the Friday prior to the actual holiday. The contractor shall treat these days as a holiday in compliance with section 1.4.4 of this PWS.

4.3.1. New Year’s Day: January 1st

4.3.2.. Martin Luther King, Jr.’s Birthday

4.3.3. President’s Day

4.3.4. Memorial Day

4.3.5. Independence Day: July 4th

4.3.6. Labor Day

4.3.7. Columbus Day

4.3.8. Veteran’s Day: November 11th

4.3.9. Thanksgiving Day

4.3.10. Christmas Day

4.4 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Contractors are required to follow the guidelines of each installation visited. Violation of post guidelines may result in termination of access to and driving privileges on the installation. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Moving violations of any contractor motor vehicle may also result in the termination of the contractor employee’s installation driving privileges.

4.5 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance.

4.6 COMSEC/IT Security. All communications with DOD organizations are subject to communications security (COMSEC) review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DOD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DOD organizations. Therefore, the contractor is advised that any time contractor place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of this information to all employees dealing with DOD information. The contractor is not authorized use of the Government's computer network.

4.7 Protection of Personally Identifiable Information (PII). As applicable, the contractor shall protect all Personally Identifiable Information (PII) encountered in the performance of services in accordance with DFARS 224.103, DoDD 5400.11 and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor is responsible for all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

4.8 CAC Requirements: The Common Access Card (CAC) is the

DOD Federal Personal Identity Verification (PIV) credential. The contractor is not authorized or required to have a CAC card in the performance of services.

4.9 AT Level 1 Awareness Training (AT): All contractor employees requiring access to Army Installations, facilities, and controlled access areas shall complete Level 1 AT prior to gaining access to any MDARNG facility. The contractor shall submit certificates of completion for the contractor and/or subcontractor conducting the training, to the COR, within 15 calendar days of the scheduled on-site training. Level 1 AT is available at http://jko.jten.mil.Administration

4.10 Identification of Contractor Employees: All contractors working in a situation where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on email) and dealings with Government or non- Government entities/Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from their employees who depart employment for any reason. All identification media (i.e., badges and vehicles passes) shall be returned to the KO within 14 days of an employee’s departure.

4.11 Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in any form of trafficking in persons in performance of the contract. This includes but is not limited to procuring commercial sex acts and the use of forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy. The necessary actions will be taken against contractor for violation of this policy. Such actions may include, but are not limited to, removal from the contract, revocation of contract, and termination of employment. The Contractor shall take the appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

4.12 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel will not be performing services under this contract that may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5.

5. Definition and Acronyms:

http://jko.jten.mil.administration/

Statement of Work, Maintenance Facilities

5.1 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

5.2 CONTRACTING OFFICER (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

5.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government designated by the KO to monitor contractor performance.

Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

5.4 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

5.5 DELIVERABLE. Anything that can be physically delivered and includes survey notes or reports.

5.6 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the SOW. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

5.7 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property. Complete OPSEC Awareness for Military Members, DoD Employees and Contractors "https://securityawareness.usalearning.gov/opsec/ index.htm. Also complete Protection of Personally Identifiable Information (PII) https://securityawareness.usalearning.gov/piiv2/index.htm.

5.8 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

5.9 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized

written document specifying the surveillance methodology to be used for surveillance of contractor performance.

5.10 QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

5.11 SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

5.12 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

5.13 WORK WEEK. Tuesday through Friday, unless specified otherwise.

5.2 ACRONYMS:

AEI

AFARS Army Federal Acquisition Regulation Supplement AR Army Regulation AT/OPSEC Antiterrorism/Operational Security CFR Code of Federal Regulations CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf DA Department of the Army DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Classification Specification DFARS Defense Federal Acquisition Regulation Supplement DOD Department of Defense FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services IA Information Assurance IS Information System(s) KO Contracting Officer OCI Organizational Conflict of Interest ODC Other Direct Costs PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program SOW Statement of Work TE Technical Exhibit

6. Contractor Requirements

6.1 The contractor shall arrive on time to prepare and conduct the IH survey.

6.2 Personal appearance. The contractor and staff shall present a professional appearance wearing appropriate clothing for maintenance work locations and conduct themselves in a professional manner at all times. Shorts, skirts, and sleeveless garments do not protect skin adequately.

6.3 Contractor and staff will present with good personal hygiene and ensure clothing is clean and neat on their person.

6.4 Clothing will not be derogatory or offensive in nature or suggestive of sexual behavior or conduct unbecoming in the presence of employees.

6.5 The contractor shall abide by applicable laws and regulations governing the safety and health programs.

6.6 Complete disclosure. Complete disclosure of any past incidents involving the professional duties of staff which might have an impact on professional standing, such as charges (unless acquitted) involving either felonies or misdemeanors (other than minor traffic violations) is a necessary part of the competency process. This disclosure must also specifically include reports of any actions, claims, charges of malpractice ever brought against any of the staff or subcontractors (either individually or as a part of a group), as well as the outcome (or current status) of any such case. The ARNG IH representative will evaluate any such incident and determine whether it should be disqualifying.

6.7 If at any time during the contract period it is discovered that an employee is currently pending charges, or has previously been convicted of any of the aforementioned incidents, the contract may be terminated pending further investigation. Upon discovery the COR will consult with the contractor and will handle situations on a case by case basis.

6.8 Unacceptable skills. The ARNG IH Office reserves the right to assess the services provided and the staff providing the service at any time during the contract. Should there be a question on the skill or employee is found to be unsatisfactory or unfit for duty, they will be asked to cease performance of such services.

6.9 Misconduct/Disruption of Services. At any time during the performance of this contract, the COR may immediately request the removal of contractor staff whose actions or impaired state, results in the clear disruption to the work force.

6.10 Litigation. In the event of litigation/investigation of a claim of liability or malpractice the contractor shall cooperate fully with government authorities and designated officials in the investigation of the claim or preparation of litigation.

The contractor shall immediately notify the KO and COR of any claims and promptly furnish copies of all pertinent papers received; cooperate with the government in the processing, review, settlement, or defense of the suit, action or claim; and authorize government representatives to settle or defend the claims and to represent the healthcare provider in, or take charge of, any litigation involved in such action.

6.11 Confidentiality. The contractor shall abide by the agency requirements concerning the nature of limited privileged communication of information gathered to entities outside of the ARNG. The contractor shall not release any information regarding ARNG worksites, facilities or shops without first receiving written approval from the COR.

7. Conflict of Interest

7.1 The contractor shall not introduce any new services without prior approval of the COR. In disagreements or deviations from established protocols, COR will be the deciding authority.

7.2 The contractor shall not use services rendered pursuant to this agreement as part of a study, research grant, or publication without the prior written consent of the KO.

7.3 The contractor shall not bill the worksite or anyone else for services rendered. The only compensation the contractor is entitled to for performance of the contract is payment as specified by this contract. .

7.4 The contractor and staff shall not be an employee of the United States government if the employment would create a conflict of interest

7.5 Vehicle registration. The contractor shall comply with the local installation requirements for vehicle registration and operation on the military facility. Any vehicle operated by the contractor in performance of this service must have the minimum liability coverage required by the state in which the installation is located.

7.6 The agency has a strict policy against sexual harassment, sexual assault and discrimination of any kind. Contractor and employees must not engage in these acts will treat everyone with respect and without discrimination based on gender, race, sexual orientation, or religious beliefs.

8 Points of contact. Contact the NGB Region Northeast IH Office for further information. Technical POCs are Cynthia Harrison (Cynthia.s.harrison2.civ@mail.mil) and Jayson Allan (jayson.r.allan.civ@mail.mil)

Attachments

1. Regulations and Standards

2. Typical Operations at ARNG Maintenance Facilities

3. Required Industrial Hygiene Equipment and Supplies

4. Example of Operation Description Format for Report

5. Risk Assessment Codes for Health and Safety

6. Risk Assessment Codes for Noise

7. DA 4700, Medical Record for Noise Exposure

Attachment 1 Regulations and Standards

1. Title 29, Code of Federal Regulations (CFR), Part 1910, Occupational Safety and Health Administration, current Ed. http://www.osha.gov/comp-links.html http://www.osha.gov/comp-links.html

2. Department of Defense Instruction (DODI) 6055.01, Department of Defense Occupational Safety and Health (OSH) Program, 14 October, 2014.

http://www.dtic.mil/whs/directives/corres/pdf/605501p.pdf

3. Army Regulation (AR) 11-34, The Army Respiratory Protection Program, 25 July 2013. http://armypubs.army.mil/epubs/pdf/r11_34.pdf

4. AR 40-5, Medical Services, Preventive Medicine, 25 May 2007.

http://armypubs.army.mil/epubs/pdf/R40_5.pdf

5. AR 385-10, The Army Safety Program, 27 November 2013.

http://armypubs.army.mil/epubs/pdf/r385_10.pdf

6. Department of the Army Pamphlet (DA PAM) 40-501, Medical Services, Army Hearing Program, 8 January 2015.

http://armypubs.army.mil/epubs/pdf/P40_501.pdf

7. DA PAM 40-11, Preventive Medicine, 22 July 2005, RAR issue date: 19 October 2009. http://armypubs.army.mil/epubs/pdf/p40_11.pdf

8. DA PAM 40-503, Medical Services, The Army Industrial Hygiene Program, 2 April 2013. http://armypubs.army.mil/epubs/pdf/P40_503.PDF

9. UFC 3-410-01FA, Heating, Ventilating, and Air Conditioning Systems, 1 July 2013, change 1, October 2014.

http://www.wbdg.org/ccb/DOD/UFC/ufc_3_410_01.pdf

10. Threshold Limit Values (TLVs) and Biological Exposure Indices (BEIs), American Conference of Governmental Industrial Hygienists (ACGIH), current Ed.

11. Industrial Ventilation – A Manual of Recommended Practice for Design, ACGIH, current Ed.

12. American National Standards Institute (ANSI)/International Safety Equipment Association (ISEA) Z358.1-2009, Emergency Eyewash and Shower Equipment.

13. ANSI/American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (ASHRAE) 55-2013, Thermal Environmental Conditions for Human Occupancy.

14. ANSI/ASHRAE 62.1-2016, Ventilation for Acceptable Indoor Air Quality.

15. The Lighting Handbook, IESNA, current Ed.

http://www.dtic.mil/whs/directives/corres/pdf/605501p.pdf http://www.dtic.mil/whs/directives/corres/pdf/605501p.pdf http://armypubs.army.mil/epubs/pdf/r11_34.pdf http://armypubs.army.mil/epubs/pdf/r385_10.pdf http://armypubs.army.mil/epubs/pdf/P40_501.pdf http://armypubs.army.mil/epubs/pdf/p40_11.pdf http://armypubs.army.mil/epubs/pdf/P40_503.PDF http://www.wbdg.org/ccb/DOD/UFC/ufc_3_410_01.pdf

16. OSHA Instruction Letter 02-02-058, Lead Exposure in Construction, Office of Health Compliance Assistance, 13 December 1993.

17. OSHA Standard Interpretation, Clarification of “as free as practicable” and lead contamination under 29 CFR 1926.62, dated January 13, 2003.

Notes:

1. Corps of Engineer standards should not be used.

2. Contact the Regional Industrial Hygiene Office for a copy of references if none is available.

Attachment 2 Typical Processes that occur at ARNG Facilities

This list is not all inclusive. Using professional judgment list all potentially hazardous processes whether planned in the near future, currently operational, or previously occurred.

Do not limit evaluation to the operations on this list.

CSMS

FMS

Vehicle and Equipment Maintenance, Inspection, and Repair Battery Charging and Maintenance Brake Pad Replacement Solvent Use and Parts Washing Vehicle Idling Welding, Grinding, and Cutting Metals Machining Spray Painting (Aerosol Can and/or Compressed Air Application) Canvas and Vinyl Repair Woodworking and Crate Construction Flammable and Combustible Materials Storage Warehousing and Storage Electronics Repair and Soldering Weapons Storage, Repair, and Test Firing Night Vision Device (NVD) Repair and Nitrogen Purging

AASF

Rotary Aircraft Maintenance, Inspection, and Repair Confined Space Entry – Fuel Cells, Tail Boom Battery Charging and Maintenance Solvent Use and Parts Washing Welding, Grinding, and Cutting Metals Machining Spray Painting (Aerosol Can and/or Compressed Air Application) Aviation Life Support Equipment (ALSE) Canvas and Vinyl Repair Flammable and Combustible Materials Storage Warehousing and Storage Electronics Repair and Soldering Aircraft Blade Repairs (solvents, epoxy, isocyantes) Engine Test

Attachment 3 Required Industrial Hygiene Equipment and Supplies

All Equipment on this list must be provided by the contractor for the survey and be under current calibration (if applicable).

Equipment Capability Purpose Quantity Air velocity Meter Air velocity in feet per minute Test Ventilation -

Assess air velocity and volume for paint booths, welding hoods, slot hoods, vehicle tailpipe exhaust systems, etc.

1 per survey location

Indoor Air Quality Meter

Carbon Monoxide, Carbon Dioxide, Percent Relative

Humidity, Temperature

Measure indoor air quality parameters.

1 per survey location

Light Meter Footcandles Measure illumination

1 per survey location

Noise Dosimeters Data log for both OSHA and

Army/ACGIH criteria

Conduct 8 hour time weighted average sampling on maintenance personnel

10 per survey location

Noise Dosimeter Tone Generator

Acceptable for use with dosimeter make/model

For calibration of dosimeters

1 per survey location

Smoke Candles (cool burning)

Flameless, spark free product that emits smoke.

Study airflow patterns in paint booths and media blast booths

1 per booth

Tape Measure Standard U.S.

measurement

Measure diameter of hoods, dimensions of booths, etc

1 per survey location

Attachment 4

Sample Process Description

CSMS Spray Painting Operation. The Paint Shop contained a large downdraft booth and was located adjacent to the vehicle maintenance bays in the “E” Wing of the CSMS. The dimensions of the booth were approximately

17.5 feet wide (17.5’ W), 40 feet long (40’ L), and 12.5 foot height (12.5’ H).

Vehicle sized swing hinge doors were installed at each end of the booth and four human entry/exit doors were approximately 3’W X 7’H. Two full time painters were assigned and reported that at the current workload they were required to paint for a duration of approximately four hours 2 to 3 days per week.

(1) Exhaust Ventilation. The average cross sectional air velocity in large paint booths is recommended by OSHA 29 CFR 1910.94 Table G-10 to be between 75 and 125 feet per minute (fpm) (reference X). The paint booth at the CSMS had an average cross sectional velocity of 64 fpm which did not meet the standard and one side of the booth performed much better than the other.

Smoke testing demonstrated that the ventilation system what somewhat effective from removing air from the booth. The system should be serviced and balanced.

Regular servicing and lubrication of belts, moving parts, and filtering systems will extend the life of the equipment and ensure effective performance (reference X).

(2) Booth Pressure. The booth relative to the adjacent work space was under the desired slight negative pressure. The ACGIH Ventilation Manual, Paragraph 13.75, explains that maintaining the paint booth under slight negative pressure will reduce the potential of toxic paint vapors escaping the booth into adjacent work areas (reference X).

(3) Pressure Gauge (Manometer). Manometers were installed on the booth supply and exhaust filter banks to show the pressure drop as required by the OSHA 29 CFR 1910.94(c)(7)(iii)[b] (reference X). The manometers needed fluid, to be zeroed, and to be marked correctly.

(4) Sound Pressure Levels. A sound level meter was used to measure the pressure levels in the booth during spray painting and all levels were found below the Army criterion threshold level of 85 dBA (reference X) and are presented in Appendix X.

(5) Personal Protective Equipment (PPE). Personnel donned disposable coveralls (Tyvek), gloves, and supplied airline respirators.

(6) Emergency Equipment. An emergency eyewash and shower unit was provided next to the paint mixing area. The unit was documented as inspected weekly and provided tepid flushing fluid as recommended by ANSI/ISEA Z358.1- 2009, Emergency Eyewash and Shower Equipment (reference X).

Statement of Work, Maintenance Shops

B-1

Attachment 5

DERIVING RISK ASSESSMENT CODES (RACs) FOR CHRONIC HAZARDS Department of Defense Instruction 6055.01, Appendix to Enclosure 3

Department of Defense Occupational Safety and Health Program, 14 October 2014

1. DETERMINE THE HEALTH HAZARD SEVERITY CODE (HHSC). Use the following procedures to assess exposure and medical effects points and determine the health hazard severity category (HHSC). The HHSC reflects the magnitude of exposure to a single physical, chemical, or biological agent and the effects of chronic exposure.

a. Determine Exposure Points.

AER Possible?

Exposure Condition

95th percentile <10% of OEL

95th percentile between 10% of OEL and 50% of OEL

95th percentile between 50% of OEL and

OEL

95th percentile

>OEL

No 0 3 5 7 Yes 1 – 2 4 6 9

AER = Alternate exposure route, such as skin absorption, ingestion.

OEL = Occupational Exposure Limit, such as OSHA PEL or ACGIH® TLV®.

b. Determine Medical Effects Points.

Condition Points No medical effect, such as nuisance noise and nuisance odor 0 Temporary reversible illness requiring supportive treatment, such as eye irritation and sore throat 1 - 2

Temporary reversible illness with a variable but limited period of disability, such as metal fume fever 3 - 4

Permanent, non-severe illness or loss of capacity, such as permanent hearing loss 5 - 6

Permanent, severe, disabling, irreversible illness, such as asbestosis, lung cancer, or death 7 - 8

c. Determine the HHSC by totaling the points assessed.

Total Points (sum of Exposure Points [1a] and Medical Effects Points [1b]) HHSC

13 – 17 I

9 – 12 II

5 – 8 III

0 – 4 IV

B-2

APPENDIX B (CONTINUED)

2. DETERMINE THE EFFECT PROBABILITY CATEGORY (EPC). Use the following procedures to assess exposure frequency and duration to determine the effect probability category (EPC). The EPC is a function of the duration and frequency of exposure and the number of exposed personnel.

a. Determine Duration and Frequency of Exposure Points. Add exposure duration points and exposure frequency points, divide total by 2, then round UP.

Points

Exposure Duration >8 hours/day 6-8 hours/day 4-6 hours/day 2-4 hours/day 1-2 hours/day

30-60 minutes/ day

15-30 minutes/ day

0-15 minutes/ day 8 8 6 5 4 3 2 1

Points

Exposure Frequency

Daily 2-3 times/week Weekly 2-3 times/ month Monthly Quarterly or 2-3 times/year

Annual Less than

Annual 8 7 6 5 4 3 2 1

b. Determine Number of Exposed Personnel Points.

Number of Exposed Workers Points < 5 1 - 2

5 - 9 3 - 4 10 - 49 5 - 6

> 49 7 - 8

c. Determine the EPC by totaling the points assessed.

Total Points (sum of Exposure Duration and Frequency Points [2a] and Exposed

Personnel Points [2b])

EPC

13 – 17 A 9 – 12 B 5 – 8 C 0 – 4 D

B-3

APPENDIX B (CONTINUED)

3. Determine the RAC for Chronic Hazards.

HHSC EPC

A B C D

I 1 1 2 3

II 1 2 3 4

III 2 3 4 5

IV 3 4 5 5

4. RAC Descriptor.

RAC Descriptor 1 Critical 2 Serious 3 Moderate 4 Minor 5 Negligible

DERIVING RACs FOR SAFETY HAZARDS

1. Use the matrix and descriptive definitions below as a model to determine the RAC for safety hazards:

a. Determine Accident Probability.

b. Determine Hazard Severity.

Code Description A Likely to occur immediately B Probably will occur in time C Possible to occur in time D Unlikely to occur

Code Description I Death, permanent total disability or loss of facility or asset

II Permanent partial disability, temporary total disability in excess of 3 months or major property damage

III Lost-workday injury or compensable injury or minor property damage

IV

Minimal threat to personnel or property, first-aid, minor supportive medical treatment, but still a violation of a standard

2. Determine the RAC for health hazards by using the following matrix to measure safety severity and mishap probability factors.

HAZARD

SEVERITY

CODE

ACCIDENT PROBABILITY CODE

A B C D

I 1 1 2 3

II 1 2 3 4

III 2 3 4 5

IV 3 4 5 5

From Table 3 of Department of Defense Instruction 6055.1, Department of Defense Occupational Safety and Health Program, 19 August 1998 (reference 1).

3. RAC DESCRIPTOR

RAC DESCRIPTOR

1 CRITICAL

2 SERIOUS

3 MODERATE

4 MINOR

5 NEGLIGIBLE

Attachment 6 Determining the Noise Risk Assessment Code (RAC)

To determine the Noise Risk Assessment Code (RAC) for inclusion on the DA Form 4700.

1. Determine the number of personnel in a similar exposure group (SEG)/occupational exposure group (OEG).

Example: 20 personnel at the aviation facility (AASF) wear noise dosimeters. 10 are aircraft mechanics, 5 are ground support personnel, and 5 are machinists.

There are three SEGs/OEGs, they are ‘aircraft mechanics’, ‘ground support’, and ‘machinists’.

2. Calculate the Upper Tolerance Limit (UTL) for groups of 6 or more in a

SEG/OEG.

Example: The 10 aircraft mechanic results are used to calculate a UTL of 91 dBA. The ground support and machinist personnel have individual noise TWA8s because there are not at least 6 in their SEG/OEG.

3. Compare each to the simplified noise RAC table.

Results for individual or group UTL # of people in SEG/OEL

< 10 10 or more < 82 dBA 4 3 82 dBA and over 3 2

Example: The aircraft mechanics UTL of 91 dBA results in a noise RAC 2 (10 or more people + 82 dBA or greater). Two sample results for the machinists were 78 TWA8 dBA and 83 TWA8 dBA. The 78 TWA8 dBA results in a noise RAC 4 and the 83 TWA8 dBA results in a noise RAC 3 using the simplified noise RAC table.

Attachment 7

Noise Exposure DA 4700 Medical Record

The information on this form must be adapted as necessary depending on the results.

Two examples are provided.

Statement of Work, All Facilities

1. DA Regulation requires employees to be notified of their exposure results from Industrial Hygiene Surveys.

Employee Occupational Exposure Group

(OEG)

Noise Exposure (in dBA) RAC

TWA OEG UTL

J. Doe Test Pilot 89.1 N/A 2 Notes: TWA – Time Weighted Average over 8 hours

UTL – Upper Tolerance Level

2. Statistical calculations of this employee’s occupational exposure group could not be calculated because the sample size (one) was too small therefore the personal measurement (TWA8) must be used.

3. This employee’s TWA for noise exposure was above the 85 dBA Army standard for single hearing protection. Therefore, this employee must be enrolled or maintained in the NYARNG Hearing Conservation Program.

4. According to the noise survey performed, you are required by the DA’s Hearing Conservation Policy, DA Pam 40-501, to:

a. Be enrolled in the NYARNG Hearing Conservation program.

b. Wear either earplugs or noise muffs whenever noise levels are greater than or equal to 85 dBA and wear both earplugs and noise muffs whenever noise levels are greater than 103 dBA.

c. Obey warning signs throughout the installation in noise hazardous areas and on equipment, which require personnel to wear hearing protection.

5. For additional information see the report regarding this survey.

6. If you have any questions regarding this matter contact the NYARNG Safety and Occupational Health Manager, Alicia Howard at (518) 786-6097 or alicia.l.howard.mil@mail.mil.

PREPARED BY (Signature & Title)

Jayson Allan Jayson Allan Regional Industrial Hygienist

DEPARTMENT/SERVICE/CLINIC

NGB-IH

DATE

1 October 2019

PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C., Section 301; 10 U.S.C., Section 3013 PURPOSE: This form is used to store patient information in an automated computer system; retrieval of information is by the patient's SSN and is required to properly record Occupational Worksite Hazard Exposure Sampling Data.

DISCLOSURE: Personal information on this form is given on a voluntary basis. Failure to provide this information, however, may result in failure to obtain proper medical surveillance healthcare.

DA FORM 4700

HSXR-APG-Z OP 32 1 Jan 90

MEDICAL RECORD – SUPPLEMENTAL MEDICAL DATA

For use of this form, see AR 40-66; the proponent agency is the Office of The Surgeon General.

REPORT TITLE

WORKERS' OCCUPATIONAL NOISE DOSIMETRY DATA RECORD

OTSG APPROVED (Date)

PATIENT'S IDENTIFICATION (For typed or written entries give: Name --last, first, mi)

NAME: Doe, J.

SSN: XXXXXXXXX

FACILITY: AASF 2 Rochester, NY JOB DESCRIPTION/SERIES: Avionics SAMPLING DATE: 28 November 2018

Statement of Work, All Facilities

MEDICAL RECORD – SUPPLEMENTAL MEDICAL DATA

For use of this form, see AR 40-66; the proponent agency is the Office of The Surgeon General.

REPORT TITLE

WORKERS' OCCUPATIONAL NOISE DOSIMETRY DATA RECORD

OTSG APPROVED (Date)

PATIENT'S IDENTIFICATION (For typed or written entries give: Name --last, first, mi)

NAME: Smith, J.

SSN: XXXXXXXXX

FACILITY: AASF 2 Rochester, NY JOB DESCRIPTION/SERIES: Avionics SAMPLING DATE: 28 November 2018

1. DA Regulation requires employees to be notified of their exposure results from Industrial Hygiene Surveys.

Employee Occupational Exposure Group

(OEG)

Noise Exposure (in dBA) RAC

TWA OEG UTL

J. Smith Avionics 68.9 N/A 3 Notes: TWA – Time Weighted Average over 8 hours

UTL – Upper Tolerance Level

2. Statistical calculations of this employee’s occupational exposure group could not be calculated because the sample size (two) was too small therefore the personal measurement (TWA8) must be used.

3. This employee’s TWA8 for noise was below the 85 dBA Army standard for inclusion in the Army Hearing Program (AHP), however, historical data demonstrates that personnel working in AASF facilities are routinely exposed to noise levels above 85 dBA and therefore should be enrolled or maintained in the NYARNG Hearing Conservation Program.

4. According to the noise survey performed, you are required by the DA’s Hearing Conservation Policy, DA Pam 40-501, to:

a. Be enrolled in the NYARNG Hearing Conservation program.

b. Wear either earplugs or noise muffs whenever noise levels are greater than or equal to 85 dBA and wear both earplugs and noise muffs whenever noise levels are greater than 103 dBA.

c. Obey warning signs throughout the installation in noise hazardous areas and on equipment, which require personnel to wear hearing protection.

5. For additional information see the report regarding this survey.

6. If you have any questions regarding this matter contact the NYARNG Safety and Occupational Health Manager, Alicia Howard at (518) 786-6097 or alicia.l.howard.mil@mail.mil.

PREPARED BY (Signature & Title)

Jayson Allan Jayson Allan Regional Industrial Hygienist

DEPARTMENT/SERVICE/CLINIC

NGB-IH

DATE

1 October 2019

PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C., Section 301; 10 U.S.C., Section 3013 PURPOSE: This form is used to store patient information in an automated computer system; retrieval of information is by the patient's SSN and is required to properly record Occupational Worksite Hazard Exposure Sampling Data.

DISCLOSURE: Personal information on this form is given on a voluntary basis. Failure to provide this information, however, may result in failure to obtain proper medical surveillance healthcare.

DA FORM 4700

1 MAY 78

HSXR-APG-Z OP 32 1 Jan 90