About this file

This document contains a risk management survey template and related federal contract opportunity. The template includes questions and responses regarding safety and health risks at a GSA Region 5 leased facility, including assessments of asbestos, drinking water, electrical systems, emergency planning, equipment guarding, hazardous materials, energy control, high risk operations, indoor air quality, lead, non-ionizing radiation, confined spaces, powered vehicles, radon, and walking surfaces. The corresponding federal contract opportunity is for leased fire protection facility assessment reports, risk management surveys, and safety and health risk management surveys at multiple GSA Region 5 locations. The solicitation number provided is 47PF0023Q0191 and it is being issued by the General Services Administration Public Buildings Service Region 5.

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Text version

RAC Summary

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Safety Health Survey

RAC Summary
8604EDITABLEN
Asbestos
Drinking Water
Electrical
Emergency Planning
Equipment Machine Guard
HazMat HazCom
Hazardous Energy Control
High Risk Operations
Indoor Air Quality
Lead
Non-ionizing Radiation
Confined Spaces
Powered Industrial Vehicles
Radon
Walking-Work Surfaces

Overall RAC

IRIS Building Profile

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Questions Response Findings/Observations

IRIS Building Profile
Region51451709327554061
GSA Building NumberIL2514ZZ1451709427554071
GSA Building NameORLAND OFFICE CENTER II1451709527554081
Building Street Address15321 S 94th Ave1451709627554091
Building CityORLAND PARK1451709727554101
Date of Building Construction1451710027554121
Building StateIL1451709827554111
Building Size (RSF)145170991
Building Size (GSF)153001451710127554131
Total Number of Floors Above Grade01451710327554141
Total Number of Floors Below Grade01451710427554151
8604N1451

Building Information

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Questions Response Findings/Observations

Building Profile
Date(s) of Onsite Survey145371051
Surveyor145371061
Type of Occupancies145371073
Building Point(s) of Contact for Survey145371081
Lease Number145371361
Lease Expiration Date145371371
Property Type145371113
What is the tenant breakdown?145371123
Primary Tenants145371131
Identify any Unique Space Type(s). If "other" is chosen, please describe the "other" unique space in the comments section.145371173
Identify any Unique Space Type #2.145374243
Identify any Unique Space Type #3.145374253
Identify any Unique Space Type #4.145374263
8604EDITABLEN1453

Asbestos

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Asbestos

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Asbestos
Has the lessor provided a written statement that no asbestos is present in accordance with the lease contract requirements?Not PossibleNo Impact149873254
If asbestos is present, is there a current asbestos management plan or O&M plan?Not PossibleNo Impact149873264
Are visual inspections of the asbestos inventory conducted annually?N/ANot applicable for Leased buildingNot PossibleNo Impact1498732726434974
Are asbestos notifications documented (e.g., annual, the start of a contract, and before an abatement project)?N/ANot applicable for Leased buildingNot PossibleNo Impact1498732826435004
Is asbestos maintenance or renovation done in accordance with Federal, state and local regulations?Not PossibleNo Impact149873294
Are pre-alteration assessments done in advance of work that could disturb asbestos as verified through the asbestos program manager?N/ANot applicable for Leased buildingNot PossibleNo Impact1498742726435024
Other Findings
Other Findings 1Not PossibleNo Impact149773151
Other Findings 2Not PossibleNo Impact149773161
Other Findings 3Not PossibleNo Impact149773171
Other Findings 4Not PossibleNo Impact149773181
Other Findings 5Not PossibleNo Impact149773191
Other Findings 6Not PossibleNo Impact149773201
Other Findings 7Not PossibleNo Impact149773211
Other Findings 8Not PossibleNo Impact149773221
Other Findings 9Not PossibleNo Impact149773231
Other Findings 10Not PossibleNo Impact149773241
Overall RAC
Overall RAC149673125
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.149673136
Explanation of User Adjusted RAC149673141
8604EDITABLEN1496
N

Drinking Water

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Drinking Water

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Drinking Water
Is the water from a public or municipal provider?Not PossibleNo Impact151073774
If the water is from a well source, is it tested regularly in accordance with State or local requirements?Not PossibleNo Impact151073784
Have there been complaints about the drinking water within the past year?Not PossibleNo Impact151073794
If there have been complaints, have they been resolved?Not PossibleNo Impact151073804
Is there a water management plan in place for microbial control?N/ANot applicable for Leased buildingNot PossibleNo Impact1510738126435254
If a childcare center is present, has testing been performed for lead and copper within the past three years or more recently if required by the state license or NAEYC accreditation?Not PossibleNo Impact151073824
Other Findings
Other Findings 1Not PossibleNo Impact150973671
Other Findings 2Not PossibleNo Impact150973681
Other Findings 3Not PossibleNo Impact150973691
Other Findings 4Not PossibleNo Impact150973701
Other Findings 5Not PossibleNo Impact150973711
Other Findings 6Not PossibleNo Impact150973721
Other Findings 7Not PossibleNo Impact150973731
Other Findings 8Not PossibleNo Impact150973741
Other Findings 9Not PossibleNo Impact150973751
Other Findings 10Not PossibleNo Impact150973761
Overall RAC
Overall RAC150873645
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.150873656
Explanation of User Adjusted RAC150873661
8604EDITABLEN1508
N

Electrical

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Electrical

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Electrical
Are there any visible electrical safety hazards?Not PossibleNo Impact150273444
Has an Arc Flash analysis for the building been conducted?N/ANot applicable for Leased buildingNot PossibleNo Impact1502734326435034
Are proper Arc Flash warning labels posted on the appropriate electrical equipment?N/ANot applicable for Leased buildingNot PossibleNo Impact1502734526435044
Have electrical spaces been limited to qualified personnel only per OSHA requirements?N/ANot applicable for Leased buildingNot PossibleNo Impact1502734626435054
Is there a plan to replace electrical equipment that has reached the end of its life?N/ANot applicable for Leased buildingNot PossibleNo Impact1502734726435264
Other Findings
Other Findings 1Not PossibleNo Impact150173331
Other Findings 2Not PossibleNo Impact150173341
Other Findings 3Not PossibleNo Impact150173351
Other Findings 4Not PossibleNo Impact150173361
Other Findings 5Not PossibleNo Impact150173371
Other Findings 6Not PossibleNo Impact150173381
Other Findings 7Not PossibleNo Impact150173391
Other Findings 8Not PossibleNo Impact150173401
Other Findings 9Not PossibleNo Impact150173411
Other Findings 10Not PossibleNo Impact150173421
Overall RAC
Overall RAC150073305
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.150073316
Explanation of User Adjusted RAC150073321
8604EDITABLEN1500
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Emergency Planning

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Emergency Planning

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Emergency Planning
Is there a current occupant emergency plan (OEP) in place?N/ANot applicable for Leased buildingNot PossibleNo Impact1462717526435064
Are emergency drills performed (e.g., fire, tornado, etc)?N/ANot applicable for Leased buildingNot PossibleNo Impact1462717626435074
Other Findings
Other Findings 1Not PossibleNo Impact146171651
Other Findings 2Not PossibleNo Impact146171661
Other Findings 3Not PossibleNo Impact146171671
Other Findings 4Not PossibleNo Impact146171681
Other Findings 5Not PossibleNo Impact146171691
Other Findings 6Not PossibleNo Impact146171701
Other Findings 7Not PossibleNo Impact146171711
Other Findings 8Not PossibleNo Impact146171721
Other Findings 9Not PossibleNo Impact146171731
Other Findings 10Not PossibleNo Impact146171741
Overall RAC
Overall RAC146071625
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.146071636
Explanation of User Adjusted RAC146071641
8604EDITABLEN1460
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Equipment Machine Guard

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Equipment Machine Guard

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Equipment Machine Guard
Is the facility machinery properly guarded and/or interlocked?N/ANot applicable for Leased buildingNot PossibleNo Impact1518741526435084
Other Findings
Other Findings 1Not PossibleNo Impact151774051
Other Findings 2Not PossibleNo Impact151774061
Other Findings 3Not PossibleNo Impact151774071
Other Findings 4Not PossibleNo Impact151774081
Other Findings 5Not PossibleNo Impact151774091
Other Findings 6Not PossibleNo Impact151774101
Other Findings 7Not PossibleNo Impact151774111
Other Findings 8Not PossibleNo Impact151774121
Other Findings 9Not PossibleNo Impact151774131
Other Findings 10Not PossibleNo Impact151774141
Overall RAC
Overall RAC151674025
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.151674036
Explanation of User Adjusted RAC151674041
8604EDITABLEN1516
N

HazMat HazCom

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HazMat HazCom

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
HazMat HazCom
Are chemicals properly labeled and stored in the facility?Not PossibleNo Impact148272604
Does O&M and Custodial have a Hazcom Program?N/ANot applicable for Leased buildingNot PossibleNo Impact1482726126435274
Is there a chemical inventory, and are SDS available for each chemical on the inventoryNot PossibleNo Impact148272624
If applicable, is an emergency eye wash/shower available for caustic chemical splashes?N/ANot applicable for Leased buildingNot PossibleNo Impact1482726326435284
If applicable, are emergency eye wash/showers routinely inspected?N/ANot applicable for Leased buildingNot PossibleNo Impact1482742826435094
Other Findings
Other Findings 1Not PossibleNo Impact148172501
Other Findings 2Not PossibleNo Impact148172511
Other Findings 3Not PossibleNo Impact148172521
Other Findings 4Not PossibleNo Impact148172531
Other Findings 5Not PossibleNo Impact148172541
Other Findings 6Not PossibleNo Impact148172551
Other Findings 7Not PossibleNo Impact148172561
Other Findings 8Not PossibleNo Impact148172571
Other Findings 9Not PossibleNo Impact148172581
Other Findings 10Not PossibleNo Impact148172591
Overall RAC
Overall RAC148072475
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.148072486
Explanation of User Adjusted RAC148072491
8604EDITABLEN1480
N

Hazardous Energy Control

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Hazardous Energy Control

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Hazardous Energy Control
Does the Operations and Maintenance Contractor have a written hazardous energy control program?N/ANot applicable for Leased buildingNot PossibleNo Impact1486727726435104
If observed, are proper lockout/tagout practices and procedures followed?N/ANot applicable for Leased buildingNot PossibleNo Impact1486742926435114
Other Findings
Other Findings 1Not PossibleNo Impact148572671
Other Findings 2Not PossibleNo Impact148572681
Other Findings 3Not PossibleNo Impact148572691
Other Findings 4Not PossibleNo Impact148572701
Other Findings 5Not PossibleNo Impact148572711
Other Findings 6Not PossibleNo Impact148572721
Other Findings 7Not PossibleNo Impact148572731
Other Findings 8Not PossibleNo Impact148572741
Other Findings 9Not PossibleNo Impact148572751
Other Findings 10Not PossibleNo Impact148572761
Overall RAC
Overall RAC148472645
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.148472656
Explanation of User Adjusted RAC148472661
8604EDITABLEN1484
N

High Risk Operations

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High Risk Operations

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
High Risk Operations
Does the building contain high risk operations (e.g., high risk laboratory, firing range, shoot house, or explosive materials storage) as defined in PBS 1000.4A?Not PossibleNo Impact151473964
If Laboratory is present, is it compatible with other occupancies? (ref. 29 CFR 1960.34(a))Not PossibleNo Impact151473974
If Firing Range or Shoot House is present, is it compatible with other occupancies?Not PossibleNo Impact151473984
If Explosive materials storage is present, is it compatible with other occupancies?Not PossibleNo Impact151473994
Other Findings
Other Findings 1Not PossibleNo Impact151373861
Other Findings 2Not PossibleNo Impact151373871
Other Findings 3Not PossibleNo Impact151373881
Other Findings 4Not PossibleNo Impact151373891
Other Findings 5Not PossibleNo Impact151373901
Other Findings 6Not PossibleNo Impact151373911
Other Findings 7Not PossibleNo Impact151373921
Other Findings 8Not PossibleNo Impact151373931
Other Findings 9Not PossibleNo Impact151373941
Other Findings 10Not PossibleNo Impact151373951
Overall RAC
Overall RAC151273835
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.151273846
Explanation of User Adjusted RAC151273851
8604EDITABLEN1512
N

Indoor Air Quality

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Indoor Air Quality

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Indoor Air Quality
Have there been IAQ complaints since the last survey?Not PossibleNo Impact149072914
If yes, have the complaints been resolved?Not PossibleNo Impact149072924
Does the building management office maintain a log of IAQ issues or complaints in NCMMS?N/ANot applicable for Leased buildingNot PossibleNo Impact1490729326435124
Is the GSA Lease Administration Manager familiar with the IAQ portion of the contract?Not PossibleNo Impact149072944
Are there visible signs of water damage or mold?Not PossibleNo Impact149072954
If present, is the building dealing with water intrusion or visible mold growth per industry standards (e.g., ANSI / IICRC S500 & S520)?Not PossibleNo Impact149072964
Other Findings
Other Findings 1Not PossibleNo Impact148972811
Other Findings 2Not PossibleNo Impact148972821
Other Findings 3Not PossibleNo Impact148972831
Other Findings 4Not PossibleNo Impact148972841
Other Findings 5Not PossibleNo Impact148972851
Other Findings 6Not PossibleNo Impact148972861
Other Findings 7Not PossibleNo Impact148972871
Other Findings 8Not PossibleNo Impact148972881
Other Findings 9Not PossibleNo Impact148972891
Other Findings 10Not PossibleNo Impact148972901
Overall RAC
Overall RAC148872785
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.148872796
Explanation of User Adjusted RAC148872801
8604EDITABLEN1488
N

Lead

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Lead

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Lead
Does the building contain paint, similar surface coatings, or accumulated dust that contains lead?Not PossibleNo Impact146671904
Are pre-alteration assessments done in advance of work that disturb paint, similar surface coatings, or accumulated dust that could contain lead?Not PossibleNo Impact146674304
Other Findings
Other Findings 1Not PossibleNo Impact146571801
Other Findings 2Not PossibleNo Impact146571811
Other Findings 3Not PossibleNo Impact146571821
Other Findings 4Not PossibleNo Impact146571831
Other Findings 5Not PossibleNo Impact146571841
Other Findings 6Not PossibleNo Impact146571851
Other Findings 7Not PossibleNo Impact146571861
Other Findings 8Not PossibleNo Impact146571871
Other Findings 9Not PossibleNo Impact146571881
Other Findings 10Not PossibleNo Impact146571891
Overall RAC
Overall RAC146471775
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.146471786
Explanation of User Adjusted RAC146471791
8604EDITABLEN1464
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Non-ionizing Radiation

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Non-ionizing Radiation

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Non-ionizing Radiation
Are radio frequency (RF) transmitting devices on the building roof?N/ANot applicable for Leased buildingNot PossibleNo Impact1474722226435134
Are safety zones established and proper danger signage posted?N/ANot applicable for Leased buildingNot PossibleNo Impact1474722326435144
If applicable, is the FCC license and RF emissions analysis report from the device owner documented?N/ANot applicable for Leased buildingNot PossibleNo Impact1474722426435154
Other Findings
Other Findings 1Not PossibleNo Impact147372121
Other Findings 2Not PossibleNo Impact147372131
Other Findings 3Not PossibleNo Impact147372141
Other Findings 4Not PossibleNo Impact147372151
Other Findings 5Not PossibleNo Impact147372161
Other Findings 6Not PossibleNo Impact147372171
Other Findings 7Not PossibleNo Impact147372181
Other Findings 8Not PossibleNo Impact147372191
Other Findings 9Not PossibleNo Impact147372201
Other Findings 10Not PossibleNo Impact147372211
Overall RAC
Overall RAC147272095
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.147272106
Explanation of User Adjusted RAC147272111
8604EDITABLEN1472
N

Confined Spaces

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Confined Spaces

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized 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 Impact1506736126435164
Are PRCS in the building properly labeled?N/ANot applicable for Leased buildingNot PossibleNo Impact1506736226435174
Are GSA employees prohibited from entering PRCS?N/ANot applicable for Leased buildingNot PossibleNo Impact1506736326435184
Does operations and maintenance contractor have a written confined space entry program?N/ANot applicable for Leased buildingNot PossibleNo Impact1506743126435194
Other Findings
Other Findings 1Not PossibleNo Impact150573511
Other Findings 2Not PossibleNo Impact150573521
Other Findings 3Not PossibleNo Impact150573531
Other Findings 4Not PossibleNo Impact150573541
Other Findings 5Not PossibleNo Impact150573551
Other Findings 6Not PossibleNo Impact150573561
Other Findings 7Not PossibleNo Impact150573571
Other Findings 8Not PossibleNo Impact150573581
Other Findings 9Not PossibleNo Impact150573591
Other Findings 10Not PossibleNo Impact150573601
Overall RAC
Overall RAC150473485
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.150473496
Explanation of User Adjusted RAC150473501
8604EDITABLEN1504
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Powered Industrial Vehicles

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Powered Industrial Vehicles

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Powered Industrial Vehicles
Are powered industrial trucks (e.g., fork trucks, tractors, platform lift trucks, motorized hand trucks, and other specialized industrial trucks) used on-site?N/ANot applicable for Leased buildingNot PossibleNo Impact1494731026435204
Does the facility have a facility specific written Powered Industrial Vehicle program, applicable to the vehicles used?N/ANot applicable for Leased buildingNot PossibleNo Impact1494731126435214
Is an evaluation of each powered industrial truck operator's performance within the last three years documented?N/ANot applicable for Leased buildingNot PossibleNo Impact1494743226435224
Other Findings
Other Findings 1Not PossibleNo Impact149373001
Other Findings 2Not PossibleNo Impact149373011
Other Findings 3Not PossibleNo Impact149373021
Other Findings 4Not PossibleNo Impact149373031
Other Findings 5Not PossibleNo Impact149373041
Other Findings 6Not PossibleNo Impact149373051
Other Findings 7Not PossibleNo Impact149373061
Other Findings 8Not PossibleNo Impact149373071
Other Findings 9Not PossibleNo Impact149373081
Other Findings 10Not PossibleNo Impact149373091
Overall RAC
Overall RAC149272975
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.149272986
Explanation of User Adjusted RAC149272991
8604EDITABLEN1492
N

Radon

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Radon

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized or Building WideRecommendation
Radon
Is there a record of radon testing per lease contract requirements?Not PossibleNo Impact147072044
If yes, are the radon levels within acceptable levels as identified in the contract?Not PossibleNo Impact147072054
Has radon testing (initial baseline) been done for the building?N/ANot applicable for Leased buildingNot PossibleNo Impact1470720626435234
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)"N/ANot applicable for Leased buildingNot PossibleNo Impact1470720726435244
Has the building been retested for radon following any major construction work that affected the building foundation or involved penetrations from the building into the soil?Not PossibleNo Impact147072084
Other Findings
Other Findings 1Not PossibleNo Impact146971941
Other Findings 2Not PossibleNo Impact146971951
Other Findings 3Not PossibleNo Impact146971961
Other Findings 4Not PossibleNo Impact146971971
Other Findings 5Not PossibleNo Impact146971981
Other Findings 6Not PossibleNo Impact146971991
Other Findings 7Not PossibleNo Impact146972001
Other Findings 8Not PossibleNo Impact146972011
Other Findings 9Not PossibleNo Impact146972021
Other Findings 10Not PossibleNo Impact146972031
Overall RAC
Overall RAC146871915
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.146871926
Explanation of User Adjusted RAC146871931
8604EDITABLEN1468
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Walking-Work Surfaces

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Walking-Work Surfaces

Risk Assessment Code (RAC)Recommended Corrective Actions
QuestionsResponseFindings/ObservationsRegulatory CitationProbabilitySeverityRACIs there a recommended corrective action associated with this item?Responsible OfficeLocalized 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 Impact1478723826435294
Are there any tripping or fall hazards within the occupied space, common areas, ramps, sidewalks, or entrance areas to the building?Not PossibleNo Impact147872394
Are floor loads known and available? (example: mezzanines)N/ANot applicable for Leased buildingNot PossibleNo Impact1478724026434984
Is the roof properly guarded from falls through anchors, guardrails, fall protection plans?N/ANot applicable for Leased buildingNot PossibleNo Impact1478724126434994
If present, have roof anchors been tested and certified?N/ANot applicable for Leased buildingNot PossibleNo Impact1478724226435011
For buildings in high-risk seismic zones
Does the building exterior appear free of visible damage or deterioration?Not PossibleNo Impact151974164
Are hanging objects (e.g. fixtures, decorations) in occupied areas secured to minimize swinging or falling?Not PossibleNo Impact151974174
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 Impact151974184
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 Impact151974194
Other Findings
Other Findings 1Not PossibleNo Impact147772281
Other Findings 2Not PossibleNo Impact147772291
Other Findings 3Not PossibleNo Impact147772301
Other Findings 4Not PossibleNo Impact147772311
Other Findings 5Not PossibleNo Impact147772321
Other Findings 6Not PossibleNo Impact147772331
Other Findings 7Not PossibleNo Impact147772341
Other Findings 8Not PossibleNo Impact147772351
Other Findings 9Not PossibleNo Impact147772361
Other Findings 10Not PossibleNo Impact147772371
Overall RAC
Overall RAC147672255
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.147672266
Explanation of User Adjusted RAC147672271
8604EDITABLEN1476
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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
Has the lessor provided a written statement that no asbestos is present in accordance with the lease contract requirements?
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 in advance of work that could disturb asbestos as verified through the asbestos program manager?
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 complaints about the drinking water within the past year?
If there have been complaints, have they been resolved?
Is there a water management plan in place for microbial control?
If a childcare center is present, has testing been performed for lead and copper within the past three years or more recently if required by the state license or NAEYC accreditation?
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?
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
Are chemicals properly labeled and stored in the facility?
Does O&M and Custodial have a Hazcom Program?
Is there a chemical inventory, and are SDS available for each chemical on the inventory
If applicable, is an emergency eye wash/shower available for caustic chemical splashes?
If applicable, are emergency eye wash/showers routinely inspected?
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 Operations and Maintenance 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
High Risk Operations
High Risk Operations
Does the building contain high risk operations (e.g., high risk laboratory, firing range, shoot house, or explosive materials storage) as defined in PBS 1000.4A?
If Laboratory is present, is it compatible with other occupancies? (ref. 29 CFR 1960.34(a))
If Firing Range or Shoot House is present, is it compatible with other occupancies?
If Explosive materials storage is present, is it compatible with other occupancies?
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 IAQ complaints since the last survey?
If yes, have the complaints been resolved?
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 paint, similar surface coatings, or accumulated dust that contains lead?
Are pre-alteration assessments done in advance of work that disturb paint, similar surface coatings, or accumulated dust that could contain lead?
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 building 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 operations and maintenance contractor have a written confined space entry program?
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
Powered Industrial Vehicles
Powered Industrial Vehicles
Are powered industrial trucks (e.g., fork trucks, tractors, platform lift trucks, motorized hand trucks, and other specialized industrial trucks) used on-site?
Does the facility have a facility specific written Powered Industrial Vehicle program, applicable to the vehicles used?
Is an evaluation of each powered industrial truck operator's performance within the last three years 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
Radon
Radon
Is there a record of radon testing per lease contract requirements?
If yes, are the radon levels within acceptable levels as identified in the contract?
Has radon testing (initial baseline) been done for the building?
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)"

Has the building been retested for radon following any major construction work that affected the building foundation or involved penetrations from the building into the soil?
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
Walking-Work Surfaces
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?
Are there any tripping or fall hazards within the occupied space, common areas, ramps, sidewalks, or entrance areas to the building?
Are floor loads known and available? (example: mezzanines)
Is the roof properly guarded from falls through anchors, guardrails, fall protection plans?
If present, have roof anchors been tested and certified?
For buildings in high-risk seismic zones
Does the building exterior appear free of visible damage or deterioration?
Are hanging objects (e.g. fixtures, decorations) in occupied areas secured to minimize swinging or falling?
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?
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?
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

RAC_VALUE_HELPER

PossibleMinor4
ProbableCatastrophic1
ImminentModerate3
Not PossibleSignificant6
UnlikelyModerate5
RemoteModerate4
PossibleNo Impact6
PossibleSevere3
ImminentMinor3
Not PossibleModerate6
Not PossibleNo Impact6
RemoteCatastrophic3
ProbableSevere2
ProbableModerate3
ImminentNo Impact6
PossibleCatastrophic2
RemoteNo Impact6
RemoteSevere3
UnlikelySignificant4
Not PossibleSevere6
ImminentSignificant2
PossibleModerate4
UnlikelyCatastrophic3
UnlikelySevere4
ImminentCatastrophic1
ProbableNo Impact6
RemoteSignificant4
Not PossibleMinor6
UnlikelyMinor5
RemoteMinor5
ImminentSevere1
ProbableSignificant3
ProbableMinor4
Not PossibleCatastrophic6
UnlikelyNo Impact6
PossibleSignificant3

Microsoft_Excel_Worksheet.xlsx

GSA National Consolidated Risk Management Survey Environmental Survey

RAC Summary

448 EDITABLE N

Documentation 1

Air Programs 1

Fuel Storage Tanks 1

Hazardous Materials 1

Hazardous Waste 1

PCBs 1

Solid Waste 1

Water Pollution 1

Overall RAC 1

GSA National Consolidated Risk Management Survey

Questions Response Finding & Observation

IRIS Building Profile

Region 11 63 342 834236 1

GSA Building Number DC0010ZZ 63 343 834237 1

GSA Building Name LYNDON B. JOHNSON FEDERAL BLDG 63 344 834238 1

Building Street Address 400 MARYLAND AVE SW 63 345 834239 1

Building City WASHINGTON 63 346 834240 1

Building State DC 63 347…

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