ISLM Refurbish AHUs.pdf

Department of Veterans Affairs ATTACHMENT A Memorandum 626-01-EC5-01

INTERIM LIFE SAFETY MEASURES

(ILSM) CHECK SHEET

PROJECT NO. COTR

The COTR for each and every project will complete this ILSM Check Sheet prior to the start of the project. When project work makes it necessary to implement ILSM, the Safety Officer will be informed. The Safety Officer will assist in initiating those ILSM necessary to maintain life safety before the project starts. The COTR is responsible for assuring that the project does not start before ILSM are in place. The COTR is responsible for conducting daily inspections of the work site.

1. Will any exits be obstructed during construction such that alternative exits will have to be established? If yes, then the Safety Officer must provide training to all concerned staff on alternative exiting arrangements. Yes No

Training completed:

Date By

2. Will access to emergency services be obstructed so that emergency forces cannot gain access?

If yes, then alternate means of access or proper direction for emergency service personnel must be provided. Yes No

Corrections completed:

Date By

3. Will any fire alarm, detection, or suppression system be impaired during this project? If yes, then a temporary but equivalent system must be provided. The temporary system must be inspected every day. Yes No

Temporary in place:

Date By

4. Will temporary construction partitions be necessary? If yes, then the temporary partitions must be smoke tight and built of non-combustible or limited-combustible materials that will not contribute to the development or spread of fire.

Yes No

5. Will additional fire fighting equipment be necessary? If yes, then the COTR will assure that the contractor provides construction employees with adequate fire extinguishers and assure that these employees are properly trained in the use of the fire fighting equipment.

Yes No

6. Will the level of fire safety that is required by the Life Safety Code be reduced because of exiting deficiencies or other activities due to the construction? If yes then the Safety Officer will initiate a program of conducting two fire drills per shift per quarter in the areas affected by the construction for the duration of the project.

Yes No

7. Will structural or compartmentation features of fire safety be compromised? If yes, then the Safety Officer will provide training on alternate fire safety procedures to the personnel of all smoke zones that will be affected. Yes No

Training completed:

Date By

8. Will any of the above ILSM need to be implemented? If yes, then In addition to the training and education initiatives, the Safety Officer will initiate a memorandum for the Director’s signature addressed to all employees that clarifies the ILSM taken to address any Life Safety Code deficiencies and/or construction hazards that will exist during this project. Yes No

Memorandum initiated:

Date By

Remarks:

AHU Refurbish Fan Room 15/6/12 Clint Roberts

4/29/2026 All work will be performed in the fan room inside the actual air handling unit.