Attachment 4 668-24-108 PCRA.pdf
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- Solicitation number
- 36C26027R0021
About this file
This is a Pre-Construction Risk Assessment form (Rev 6) for a federal construction project. The document evaluates potential risks and compliance requirements across nine categories to ensure safe and compliant project execution.
The project is identified as 668-24-108 REPAIR Sanitary Waste Piping Bldg 1, located in Building 1 (all floors, central corridor), with a planned start date of 08/28/2025 and estimated duration of 209 days. The assessment indicates several identified risks requiring mitigation: fire and smoke compartments will not remain intact and unchanged (answered "No" to question 1c), construction area will not be separated by solid non-combustible smoke-tight partitions (question 1f), contract clauses for risk enforcement are required (question 4a), nuisance noise levels are anticipated for adjacent areas (question 5b), asbestos-containing material (ACM) disturbance is anticipated (question 7a), and an Infection Control Risk Assessment (ICRA) is required prior to construction start (question 8a). All other assessed areas—including egress routes, exit stairs, fire alarm/detection systems, fire suppression systems, emergency access, confined space work, physical security impacts, utility shutdowns, vibration effects, trenching, radiographic examination, traffic control, biological area work, environmental permits, hazardous chemicals, patient safety monitoring, patient access, and patient relocation—were answered in the negative, indicating no additional mitigation measures are needed in those areas.
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Text version
R e v 6 P a g e 1 | 3
Pre-Construction Risk Assessment Project Number and Name: Planned Project Start Date:
Location of Construction: Estimated Duration:
Safety/Life Safety Risk Assessment-Safety officer should be involved in the design/planning of all projects
Y N 1. FIRE AND LIFE SAFETY IMPACTS
a. Will egress routes and exit signage from occupied areas remain unchanged? If no, ILSM is needed.
b. Will exit stairs remain unobstructed with appropriate fire protection? If no, ILSM is needed.
c. Will fire & smoke compartments remain intact & unchanged? If no, ILSM is needed.
d. Will fire alarm and detection systems remain functional & unimpaired; outages
<4 hours? If no, ILSM is needed.
e. Will fire suppression systems remain functional & unimpaired; outages <10 hours? If no, ILSM is needed.
f. Will construction area be separated by solid non-combustible smoke tight partitions? If no, ILSM is needed.
g. Will emergency access by Fire Department remain unobstructed? If no, ILSM is needed.
h. Will hot work be performed? If yes, submit hot work permit to Safety
2. SAFETY
a. Will a confined space work permit be required? If yes, submit permit
b. Will the project introduce other significant hazards? If yes, describe below
Additional Requirements and Description of Mitigation:
Construction Safety Specialist / Safety Specialist Signature: Date:
Y N 3. PHYSICAL SECURITY IMPACTS
a. Will the construction compromise security? If yes, describe necessary mitigation below
b. Will construction affect traffic control or cause road closures?
c. Do badging requirements exceed non-PIV level?
Additional Requirements and Description of Mitigation:
VA Police Signature: Date:
R e v 6 P a g e 2 | 3
Y N 4. CONTRACT COMPLIANCE
a. Will contract clauses be included for enforcement of identified risks? If no, describe necessary mitigation below
Y N 5. CONSTRUCTION ACTIVITY
a. Will there be any anticipated utility shutdowns? (Communications, electrical, heating/cooling, HVAC, medical gases, vacuum, water, sewer) If yes, describe necessary mitigation below and consider impact memo
b. Will there be nuisance noise levels for adjacent areas? If yes, describe necessary mitigation below
c. Will vibration levels affect operations of sensitive medical equipment? If yes, describe necessary mitigation below
d. Will construction require trenching?
e. Will radiographic examination be required of piping or structural steel? If yes, contact RPO
f. Will construction affect traffic control or cause road closures?
g. Will this contract complete work with a biological area such as a lab? If yes, Facility Specific Training required.
Additional Requirements and Description of Mitigation:
Project Manager Signature: Date:
Y N 6. ENVIRONMENTAL
a. Will the project require a NEPA assessment above a CATEX? Contact GEMS for a determination. CATEX #: If yes, submit draft NEPA to GEMS
b. Will the project require a permit from the Air Quality District? Contact GEMS for a determination. If yes, submit draft to GEMS
c. Will this project require a storm water permit? Contact GEMS for a determination. If yes, submit draft to GEMS
Y N 7. HAZARDOUS MATERIALS
a. Will this contract disturb known asbestos containing material (ACM)? Contact
Safety for a determination. If yes, describe necessary intervention:
b. Will contract require the use of hazardous chemicals? If yes, review by facility IH is required
GEMS Signature: Date:
R e v 6 P a g e 3 | 3
Y N 8. INFECTION CONTROL
a. Will this contract require an Infection Control Risk Assessment? If yes, ICRA shall be completed prior to construction start.
Additional Requirements and Description of Mitigation:
Infection Control Representative Signature: Date:
Y N 9. PATIENT SAFETY
a. Will project require additional monitoring for patient safety?
b. Will construction affect patient access?
c. Will patients need relocation during construction?
Patient Safety Signature: Date:
| Project Number and Name: 668-24-108 REPAIR Sanitary Waste Piping Bldg 1 |
| Planned Project Start Date: 08/28/2025 |
| Estimated Duration: 209 Days |
| Date: |
| Date_2: |
| Date_3: |
| Date_4: |
| Date_5: |
| Date_6: |
| Location of Construction: Building 1, All floors, central corridor |
| 2b: N |
| 2a: N |
| 1h: Y |
| 1g: Y |
| 1e: Y |
| 1d: Y |
| 1c: N |
| 1b: Y |
| 1f: N |
| 1a: Y |
| 3a: N |
| 3b: N |
| 3c: N |
| 4a: Y |
| 5a: N |
| 5b: Y |
| 5c: N |
| 5d: N |
| 5e: N |
| 5f: N |
| 5g: N |
| 6a: N |
| 6b: N |
| 6c: N |
| 7a: Y |
| 7b: N |
| 8a: Y |
| 9a: N |
| 9b: N |
| 9c: N |
| Additional Requirements and Description of Mitigation_Fire Life Safety: |
| Additional Requirements and Description of Mitigation_Physical Security Impacts: |
| Additional Requirements and Description of Mitigation_Contract Compliance & Construction Activity: |
| Additional Requirements and Description of Mitigation_Environmental & Hazardous Materials: |
| Additional Requirements and Description of Mitigation_Infection Control: |
| Additional Requirements and Description of Mitigation_Patient Safety: |
| CATEX #: |
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