36C26118B0604-0002009.docx

Reno, NV

INTERIM LIFE SAFETY MEASURES (ILSM) CHECKLIST

Project Name B3 Lobby Remodel Project Number 654-18-825

Project Start/End Date 09/01/2018 – 02/28/2019 COTR Jon Emis, (775) 722-9396

1.

Will any exits/means of egress be obstructed during construction such that alternate exits will have to be established?

If YES, then ensure that staff is notified/trained on alternate routes of exit and that proper signage is installed. Ensure that escape routes for construction workers are maintained at all times, and the means of exiting construction areas are inspected daily.

If NO, ensure that existing exit routes are free and unobstructed thru daily construction safety check.

2.

Will access to emergency entrance be obstructed or will access by emergency forces (fire, police) be impaired?

If YES, ensure that alternate means of access or proper direction for emergency service personnel are provided.

3.

Will any fire alarm, detection or suppression system be impaired during this project?

If YES, provide temporary but equivalent system. Inspect temporary systems monthly.

If NO, ensure that they are in good working order.

4.

Will temporary construction partitions be installed?

If YES, ensure that temporary construction partitions are smoke tight and built of noncombustible or limited combustible materials that will not contribute to the development or spread of fire. Ensure integrity of partitions during daily construction safety check.

Construction barriers will be installed on an as-needed basis.

5.

Is additional fire-fighting equipment necessary?

If YES, ensure that they are provided and that staff are trained on their use.

Contractor to provide fire extinguishers when heat and spark generating work taking place on door frames.

6.

Ensure that construction personnel are briefed on Medical Center’s “no smoking” policy and that “no smoking” signs are installed in and near the construction area.

7.

Ensure that practices that reduce the building’s flammable and combustible fire load to the lowest feasible level are maintained and enforced (daily removal of debris, good housekeeping, and minimum storage of construction materials). This will be confirmed through daily construction checks and Medical Center staff’s hazard surveillance.

8.

If implementation of ILSMs is required, are 2 fire drills per shift per quarter required to be conducted?

If YES, ensure that fire drill(s) are properly conducted and recorded/documented.

9.

If implementation of ILSMs is required, then ensure that hazard surveillance of buildings, grounds, and equipment, with special attention to excavations, construction areas, construction storage, and field offices, are conducted.

10.

Are structural or compartmentalization features of fire safety impaired?

If YES, ensure that impacted staff are trained to compensate for impaired structural or compartmentalization features of fire safety.

11.

Ensure that life safety building deficiencies, construction hazards, and ILSM for construction areas are announced in appropriate hospital communication channels..

General - Provide hospital wide safety education programs to promote awareness of life safety building deficiencies, construction hazards, and ILSM through the annual mandatory training.

COMMENTS:

Majority of work to be conducted Monday-Friday (0730-1600)_________________________ Work Location: Building 12 3rd floor lobby area and one room on 4th floor______________

Jon Emis COTR Printed Name & Signature / Date Contractor Printed Name & Signature / Date

Mechelle Arenque N/A Safety Officer Printed Name & Signature / Date Fire Alarm Printed Name & Signature / Date

Version 27 Aug 08 Page 1 of 2