Attachment F - Activity Hazard Analysis.pdf
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- Solicitation number
- 478778
- Issued by
-
Department of Energy
About this file
This is a template for a UT-Battelle Subcontractor Activity Hazard Analysis (AHA) Form used to document safety and environmental health (ES&H) planning for subcontract work at Oak Ridge National Laboratory. The form is designed to ensure subcontractors identify, evaluate, and control hazards before commencing work activities.
The AHA form requires subcontractors to complete four key sections: project identification (title, subcontract number, subcontractor name), a description of planned activities and tasks for the entire project scope, identification of applicable ES&H clauses amended to the subcontract from a comprehensive checkbox list, and a detailed activity-task analysis table. The ES&H clause options include over 30 hazard categories ranging from accessible electrical hazards and asbestos to welding/cutting/hot work and water/boating activities. The core of the form is a multi-page table where subcontractors must break down work into specific activity/task steps, identify associated hazards for each step, and define three categories of controls: engineering controls (local exhaust ventilation, HEPA filtration), administrative controls (work methods, procedures, training), and personal protective equipment (safety glasses, hearing protection). The form requires approval signatures from both the UT-Battelle Technical Project Officer (TPO) and an ES&H/Qualified Health and Safety Professional (QHSP) Representative prior to work commencement. Subcontractors must also consider potential troubleshooting activities and ensure all requirements from applicable ES&H clauses are addressed in the appropriate task steps. The form is revision 2, dated April 15, 2025, and is four pages in total length.
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Text version
Activity Hazard Analysis (AHA) Form Page 1 of 4 Rev. 2 – April 15, 2025
Project Title Subcontract Number Subcontractor Name
Description of Planned Activities/Task for the Scope-of-Work for the Entire Project
ES&H Clauses Amended to Subcontract ☐ Accessible - Exposed Electrical Hazards ☐ Lead ☐ Asbestos ☐ Lockout/Tagout ☐ Beryllium ☐ Noise ☐ Biohazards ☐ NRC Exemption ☐ Bloodborne Pathogens ☐ Outages of Emergency Evacuation-Notification Systems ☐ Confined Space ☐ Outages of Fire Protection Systems ☐ Cooling Towers ☐ Penetration through Fire Barrier ☐ Cryogenics ☐ Peroxide Forming Chemicals ☐ Dosimetry ☐ Powder Actuated Tools & Equipment ☐ Electrical – Post Receipt Field Evaluation ☐ Respirable Crystalline Silica ☐ Explosives – Blasting ☐ Respiratory Protection ☐ Firearms ☐ Unbound Engineered Nanoparticles ☐ Hoisting & Rigging Cranes ☐ Water/Boating Activities ☐ Lasers ☐ Welding, Cutting, & Hot Work ☐ Other Hands-on Work – No ES&H Clauses, No Purchase Rec, etc.
Directions
1. Break planned work scope into activity/task steps in the table below
2. Evaluate possible troubleshooting activities/tasks which may be needed
3. For each task step identify the applicable hazards and define the controls which will be used
4. Ensure requirements from ES&H Clauses identified in the subcontract are addressed in the appropriate task step
5. Additional guidance can be found here (link)
6. Submit completed AHA to UT-Battelle Technical Project Officer (TPO) for review and approval prior to commencement of work
AHA Author Date Completed
UT-Battelle TPO signature indicates approval of activity-specific hazard controls identified in the subcontractor AHA
Name: Signature: Date:
UT-Battelle ES&H/QHSP Representative Concurrence https://contracts.ornl.gov/activity-hazard-analysis-aha/
Activity Hazard Analysis (AHA) Form Page 2 of 4
Name: Signature: Date:
Activity/Task Step Hazard(s) Control(s) Engineering Controls (Local Exhaust Ventilation, HEPA Filtration, etc.)
Administrative Controls (Work Methods, Operation Procedures, Training, etc.)
Personal Protective Equipment (Safety Glasses, Hearing Protection Devices, etc.)
Activity Hazard Analysis (AHA) Form Page 3 of 4
Activity Hazard Analysis (AHA) Form Page 4 of 4
File details come from the government source that posted it. Updated .