583-22-528 PCRA.pdf

Preconstruction Risk Assessment and Exposure Control Checklist

Project Name/Project No.: __________________________________________ Date: ______________

Scope of Work Overview:

Other Requirements for above project:

Preliminary Analysis – Project Engineer

Hazard Concern?

(Y/N) Remarks

Asbestos

Lead Base Paint

Confined Space

Dust

Fire & Smoke Walls

Moisture/Water Leaks/Mold

Vapors/Fumes

Noise

Vibration

Air Pressure Relationships

Upgrade Clean Rooms - Phase 4 - 583-22-528 7/8/2022

Richard L. Roudebush VA Medical Center (RLR VAMC) has a requirement to upgrade selected areas in preparation for a Weight-Based Inventory Management System.

The contractor shall install power outlets and data jacks, mount louver panels, and prepare and paint walls in selected areas. Work will be allowed to take place during normal business hours.

N area outside of room C-2065 - do not disturb flooring materials.

N N Y Drywall drilling/cutting N N N Y Moderate noise while drilling/cutting drywall

N Y Construction area will have negative air pressure

Electrical Modifications

Crane Operation

Traffic Flow

Open Outside Walls

Impact to Levels Above and Below

Proximity of Air Intakes

Pest Control Within Construction Area

Proximity of Immune Suppressed Patients

Security Issues/Concerns

ICRA Assessment

ILSM Assessment

Hot Work Permit

TB Risk Assessment

Radiation Safety

National Environmental Policy Act (NEPA) Evaluation – GEMS Coordinator, Jeff Abshire Note: All construction projects shall have a NEPA evaluation conducted per the requirements of Engineering Policy Memorandum 138-48.

NEPA Evaluation Evaluation Completed (Y/N)

Date NEPA Submitted Remarks

NEPA Evaluation submitted to the facility GEMS Manager?

Y

N

N N

N

N N

Y

N

Y

Y

N

N

N

Y 7/25/2022

See SOW

Potentially. Discuss with IP

Specific Control Measures

Asbestos – Industrial Hygiene (Laura Totten)

Yes/No Measure

Contractor to hire an asbestos abatement contractor for control and cleanup.

VA to hire independent Industrial Hygienist to inspect and clear area for re-occupancy based on monitoring and/or professional judgment.

Published asbestos protocol to be followed for work through ceilings.

Published asbestos protocol to be followed for work above ceilings.

Perimeter barrier to be constructed in the interstitial space to isolate the construction area with other areas in the interstitial.

Project area to be encased with spray-applied hard surface encasement material.

Provide mini containments under negative air in public areas.

Sealed gypsum board barrier to be constructed to isolate the construction area from the public.

Transit panels to be removed, which is considered Class B removal.

Comments:

Moisture/Water Leaks/Mold – IH (Laura Totten)

Yes/No Measure

Contain any water from core drilling activities.

Dike any floor penetrations to minimize risk of leaks from construction zone.

Request assessment for IAC ICRA from Safety. Follow VHA M3P.

N/A

N/A N/A

N/A N/A N/A N/A N/A

LMT - 7/25/2022

N/A N/A

LMT - 7/25/2022

Lead Base Paint – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

LBP reports available for testing results?

If none are available, hire environmental company for testing.

LBP is present, hire a lead remediation contractor to remove paint according to OSHA’s lead safe work.

Vapors/Fumes – Safety/IH (Dan Woody or Laura Totten)

Use of products with low Volatile Organic Compounds (VOCs).

Provide negative air in construction zone exhausted to outside, away from intakes.

Seal work area airtight barrier.

Cut all metal outside the building.

Seal any floor penetrations to minimize risk of fumes through construction zone.

Shut down air handler to minimize infiltration of fumes from outside.

Use carbon or activated charcoal filters on air scrubbers or negative air machines.

N

N/A

LMT - 7/25/2022

N/A N/A N/A N/A N/A N/A

Impact to Levels Above and Below – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

Coordinate with occupants in surrounding areas to explain the work occurring.

Follow asbestos protocol when doing under floor work.

Vacate areas when doing below floor work off of the catwalk.

Noise – Safety/IH (Dan Woody or Laura Totten)

Schedule demolition work after normal work hours.

Cut all metal outside the building.

Vibration – Safety/IH (Dan Woody or Laura Totten)

Schedule demolition work after normal work hours.

Coordinate with occupants in surrounding areas to explain the work occurring.

Y

N/A

LMT - 7/25/2022

N Y

LMT - 7/25/2022

N

Confined Space – Safety (Dan Woody)

Obtain an “Entry Permit” from Safety Services prior to entering the confined space.

The Entry Team must be trained as an Entry Supervisor, Attendant, or Entrant.

A specific confined space entry plan and rescue plan must be approved prior to entry into a permit-required confined space.

Safe entry conditions must be achieved before and during confined space entry.

Crane Operation – Safety (Dan Woody)

Contact Safety Services for review for any project crane operations.

Pest Control Within Construction Area – EMS Supervisor (Robert Franklin)

Provide barriers to any open outside walls.

Contact pest controller if any evidence of pests is found during the course of the work.

N/A

N/A

LMT - 7/25/2022

N

LMT - 7/25/2022

Proximity of Immune Suppressed Patients — IP (Diana Greathouse and or Jennifer Buchs)

Relocate patients away from construction zone for entire project.

Relocate patients away from construction zone during demolition operations.

Work will be done after hours to decrease risk

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Air Pressure Relationships — Infection Prevention and HVAC Supervisor (Diana Greathouse and then Nate Fair)

Yes/No Measure o Provide negative air during asbestos abatement.

l tis Provide negative air during construction.

Gs Seal off supply and exhaust Heating, Ventilation, and Air Conditioning (HVAC) registers.

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Dust — Infection Prevention (Diana Greathouse and or Jennifer Buchs)

Sealed gypsum board barrier to be constructed to isolate the construction area from the public.

Trash carts will be covered when transported through the building. I_ „ , ,,/ n VwA I f14 liu

PS

Provide negative air machine exhausted too outside.

T i /_

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Provide mini containments under negative air in public areas. i f e

`C h p

Gt b Provide negative air machine in space as air scrubber.

CS Provide walk off mats at entrances to work area.

l/ No

Perimeter barrier will be constructed in the interstitial space to isolate the construction area with other areas in the interstitial.

NO

Mist area to decrease dust (outside work)

No Provide anteroom under negative pressure at entrance to project zone.

Comments:

ICRA Assessment — Infection Prevention (Diana Greathouse and or Jennifer Buchs)

Meet with Infection Prevention to complete ICRA assessment.

ps Class Assigned — I, II, III, IV 1

Comments:

ICJk 7-O

TB Risk Assessment — IP (Diana Greathouse and or Jennifer Buchs) es/ o Measure

The contractor must provide written certification that all contract employees assigned to the work site have had a pre-placement tuberculin screening within 90 days prior to assignment of the worksite

~, f and been found to be negative TB screening reactions. (this can be CDC two-step skin testing or an

FDA approved blood test). If a positive screen identified, please defer to VHA directive 7715.

Contractors will be required to show documentation of negative TB screening reactions for any \J , additional workers who are added after the 90-day requirement before they will be allowed to work on the site.

(y

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Radiation Safety — Radiation Safety Officer (Jeff Mason or Mary Ann Spilker)

Yes/No I Measure

N Radiation shielding and testing will be required during this project.

Comments:

Proximity of Air Intakes — HVAC Shop Supervisor and Safety (Nate Fair and then Laura Totten)

Yes/No Measure

N Shut down air handlers to reduce infiltration of fumes from exterior activities such as painting, gasoline powered engines, roofing operations, equipment, etc.

Electrical Modifications – Electric Shop Supervisor (Steve Poynts)

Yes/No Measure

Additional circuits added.

Outlets or lighting moved.

Follow VA Project Electrical Inspection Checklist.

Traffic Control – Engineering Supervisor (James Wallace)

Access construction area via exterior door.

Schedule delivery of large quantities of material and demolition haul out after hours.

Open Outside Walls – Engineering Supervisor (James Wallace)

Construct temporary outside wall to limit the infiltration of wind, air, and temperature differences into the project site.

Hot Work Permit – Engineering Supervisor (James Wallace)

Yes/No Measure

A Hot Work Permit is required to be issued by the Project COR/Safety prior to completing any welding or brazing on site.

Fire & Smoke Walls – Engineering Supervisor and Safety (James Wallace and then Bryant Garibay)

Review latest LSC drawings to determine if existing fire and/or smoke walls will be affected.

Risk to be mitigated with ILSM.

2-hour gypsum barrier to be constructed.

ILSM Assessment – Engineering Supervisor and Safety (James Wallace and then Bryant Garibay)

Meet with VA resident LSC expert to complete ILSM assessment.

ILSM Required

Approval Signatures:

Project Engineer or COR:

Jose Javier Marquez Reina 3516632 oatea3W3ID.15b1116:38-04rMarquez

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Safety Officer: Laura M. Totten 7/25/2022

Infection Control: -D i Gu Ra- Grtct,~V~,ou, J̀ ie 63l~zz

Supervisory Engineer or Chief Engineer: