CSRA 660-CSI-115 DEXA Site Prep.pdf

Attachment C - Construction Safety Risk Assessment Checklist

Construction Safety Risk Assessment Checklist, VA Salt Lake City Healthcare System

Hazard Likelihood: High: 76% - 100%

Medium: 51% - 75%

Low: 0% - 50%

Identify Hazards Evaluator

Is Hazard

Likely?

H-M-L

Severity H-M-L Mitigation Needed? Y/N Mitigation Strategies Mitigation Strategies Implemented? Comments

**Hazardous

Waste/Storage

JRK M M Y

• Empty chemical containers should be retained by contractor and disposed of at their facility.

• Pesticide is NOT to be stored on campus and may only be used by licensed applicators.

• Unused applications must be removed from the VA property daily.

• Any hazardous waste to be stored overnight must be stored in an enclosed and locked container and must have prior approval by the GEMS

Manager.

• All hazardous waste to be handled according to local, State and Federal regulations.

• All hazardous waste containers to be numbered and tracked.

• Notify GEMS x4533 before generating hazardous waste to ensure proper management methods.

• Provide waste generation information to

GEMS as instructed.

**Chemical Use/ PPE JRK L L N

Hazard

Communication

JRK M M Y

• Review Safety Data Sheets prior to starting work and whenever new products are introduced into the area.

• Maintain copies on site.

• Ensure all containers are properly labeled with approved GHS labels.

• Provide list of chemicals to Safety/GEMS and upload current SDSs via

3EProtect (formerly

3EOnline) ten days in advance for approval.

• Notify when uploaded.

Respiratory

Protection

JRK L L N

Personal Protective

Equipment

JRK M H Y

• Minimum requirement are hard hats safety glasses and safety boots.

• Other PPE shall be required based on the Job Hazard Analysis (JHA).

• Wear proper footwear and keep them clean to reduce the potential slipping hazards such as dirt, saw dust, oil, and grease.

• Proper ARC Flash rated

PPE to worn when conducting electrical work.

• All PPE to be inspected prior to commencing work.

Fire Protection JRK M H Y

• Establish fire extinguisher locations within job site for easy access.

• Review location with area walk through.

• Maintain housekeeping to prevent accumulation of combustible material.

• Maintain fire and smoke barriers.

Traffic Control & Site

Security

JRK M M Y

• All personnel shall wear VA badges.

• Control access to the worksite.

Wire Rope and

Rigging Equipment

JRK L L N

Demolition/

**Recycling

JRK M M Y

• Dust control during all interior demolition.

• Use PPE at all times.

• Stay clear of falling objects.

• Remove debris as generated.

• Document amount of materials recycled.

Any debris contaminated with asbestos must be disposed of as regulated waste and can NOT be recycled.

Hand and Power

Tools

JRK H M Y

• Inspect tools prior to use.

• Only double insulated or neutrally grounded tools can be used.

• Properly store tools when not in use.

• All guards to be in place and in good condition.

Project Manager: Joshua KeeneDate: 5/10/2023

Project Name: DEXA Site Prep

Project Number: 660-CSI-115

CSRA 660-CSI-115 DEXA Site Prep 1 of 4

Hazard Likelihood: High: 76% - 100%

Medium: 51% - 75%

Low: 0% - 50%

Identify Hazards Evaluator

Is Hazard

Likely?

H-M-L

Severity H-M-L Mitigation Needed? Y/N Mitigation Strategies Mitigation Strategies Implemented? Comments

Project Manager: Joshua KeeneDate: 5/10/2023

Project Name: DEXA Site Prep

Project Number: 660-CSI-115

Electrical JRK H H Y

• Develop, communicate, and follow a written plan before performing electrical work to maximize safety.

• Persons conducting electrical work shall have the knowledge, skills and abilities necessary to perform the task.

• Ensure all electrical circuits and circuit breakers are identified properly before troubleshooting or performing electrical work.

• Identify hazards and establish safety limits of approach.

• All work shall comply with NFPA 70 most recent edition.

• Verify code compliance prior to energizing.

• Inspect electrical cords before use.

• Do not use cords with damaged insulation or daisy chain them. Use

GFCI's.

• Wear properly rated and well maintained PPE.

• Adhere to all ARC Flash requirements and NO

ENGERGIZED work is authorized without approved permit.

Lockout / Tagout

Electrical

JRK H H Y

• Open circuit breaker that supplies power.

• Open visual disconnects.

• Lock-out and tag-out visual disconnect yourself and NEVER rely on someone to do this for you.

• VA first lock on/last lock off.

• Follow Engineering LO/TO SOP.

• Include Operations & Maintenance

Electricians in LO/TO plans.

Please refer to SLC VAMC

Engineering Services

SOP #91 for approved lockout tagout procedures

Lockout / Tagout Med

Gas or Oxygen

JRK M M Y

• VA first lock on/last lock off.

• Follow Engineering LO/TO SOP.

• Include Operations & Maintenance

Plumbers in LO/TO plans.

• Bleed lines and block inlets.

Please refer to SLC VAMC

Engineering Services

SOP #91 for approved lockout tagout procedures

Lockout / Tagout

Other Systems

(Specify)

JRK M M Y

• VA first lock on/last lock off.

• Follow Engineering LO/TO SOP.

• Include Operations & Maintenance in

LO/TO plans.

Please refer to SLC VAMC

Engineering Services

SOP #91 for approved lockout tagout procedures

Welding and Cutting JRK M H Y

• Hot Work Permits required daily for any work to include cutting, welding, brazing, soldering, thawing pipe, grinding, or other spark or flame producing operations.

• Any process that involves an open flames used temporarily for repair or temporary heating is considered a hot work operation.

Please refer to SLC VAMC

Engineering Services

SOP #90 for approved hot work procedures.

Confined Spaces JRK L L N

Tunnels and Shafts JRK L L N

Process Safety

Management

JRK N/A N/A N/A N/A N/A N/A

Cranes and Hoists JRK L L N

Steel Erection JRK L L N

Fall Protection JRK L L N

Scaffolds JRK L L N

CSRA 660-CSI-115 DEXA Site Prep 2 of 4

Hazard Likelihood: High: 76% - 100%

Medium: 51% - 75%

Low: 0% - 50%

Identify Hazards Evaluator

Is Hazard

Likely?

H-M-L

Severity H-M-L Mitigation Needed? Y/N Mitigation Strategies Mitigation Strategies Implemented? Comments

Project Manager: Joshua KeeneDate: 5/10/2023

Project Name: DEXA Site Prep

Project Number: 660-CSI-115

Ladders JRK M M Y

• Inspect before use.

• Do not use the top two steps on a ladder.

• Cracked frames, missing feet or bent rungs will not be allowed on any ladders.

• Use ladder only on stable and level surfaces.

• Keep ladders free of any slippery materials on the steps.

• Always face the ladder and maintain three points of contact when climbing or descending.

• Do not carry items or supplies when climbing or descending a ladder.

• Use a cord or rope to life or lower supplies or tools.

Trenching and

Excavation/

** SWPPP

JRK L L N

Motor Vehicles, Earthmoving, and

Mechanized Equip

JRK L L N

Concrete and

Masonry

JRK L L N

Lead, Asbestos, and

Silica

JRK M H Y

• A pre-construction survey for

Asbestos is required that tests all building materials that will be disturbed during project work.

• If Asbestos is identified appropriate work practices and plans are to be coordinated with the Asbestos

Program Coordinator in advance.

• Concrete dust to be kept to a minimum.

• Prevent dust from becoming airborne.

• Utilize wet methods and approved

HEPA vacuums as safely practical.

Contact Asbestos

Coordinator with any questions or concerns.

Utility Interruptions JRK M H Y

• Full coordination with COR and • Full coordination with COR and Operations

& Maintenance required.

• Notify and coordinate shutdown with all affected services to include VA

Police.

Dust JRK H M Y

• Maintain barriers to control dust.

• Use particulate filter masks when generating dust.

• Control dusts as needed for excavation work.

Moisture/Water Leaks JRK L L N

Vapors/Fumes/

**Air Emissions

JRK L L N

Noise JRK H M Y

• Notify tenants in the area before demolition or drilling.

• Hearing protection required when identified by job hazard analysis.

Vibration JRK H M Y Notify COR and tenants in the area before demolition or drilling.

Open Outside Walls JRK L L N

Impact to Levels

Above and Below

JRK H M Y

Coordinate all activities having an adverse impact on floors above or below project work with COR and affected occupants.

Proximity of Air

Intakes

JRK H H Y

• Cover air intakes or control outside air flow to prevent intrusion into the hospital when generating any type of fumes or vapors.

• Coordinate shutdown of air handlers with COR and building occupants.

• Notify all affected personnel prior to initiating work.

CSRA 660-CSI-115 DEXA Site Prep 3 of 4

Hazard Likelihood: High: 76% - 100%

Medium: 51% - 75%

Low: 0% - 50%

Identify Hazards Evaluator

Is Hazard

Likely?

H-M-L

Severity H-M-L Mitigation Needed? Y/N Mitigation Strategies Mitigation Strategies Implemented? Comments

Project Manager: Joshua KeeneDate: 5/10/2023

Project Name: DEXA Site Prep

Project Number: 660-CSI-115

Tuberculosis

Transmission

JRK L L N N/A

Until such time that the hospital is no longer low-risk for TB transmission per annual TB risk assessment, this will remain unchanged for all projects.

Pest Control within

Construction Area

JRK M M Y

• Keep area clear of any substances that could attract rodents or other animals.

• Remove debris at the end of each work shift.

No eating in work areas

Project Manager: Date:

Contractor: Date:

Safety Manager: Date:

Service / Section /

Program Director:

Date:

** These construction activities have been identified as significant based on potential environmental impacts.

Approval Signatures:

CSRA 660-CSI-115 DEXA Site Prep 4 of 4