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Federal Aviation Administration

Memorandum Date: See date of signature

To: Manager, Cleveland District

From: Manager, CSA Terminal/Surveillance/Weather Engineering Group AJW-2C11

Prepared by: Ronald M. Hubrich, Project Manager, Tel. 847-294-7729

Subject: ACTION: Review Project Transmittal CAK_MFD_TRACON_Refurb_Transmittal_1701251_1701252_23Sep15 to Refurbish TRACONs at Akron Canton Airport (CAK) North Canton, OH and Mansfield Lahm Regional Airport (MFD) Mansfield, OH.

SCOPE: Attached is the project transmittal to Refurbish TRACONs at Akron Canton Airport (CAK) North Canton, OH and Mansfield Lahm Regional Airport (MFD) Mansfield, OH.

While developing this Engineering Transmittal we have coordinated with the SSC through site survey(s), design review meetings and or discussions; but please review and prepare any comments within 30 days.

A Project Review Telecon will be coordinated with your SSC office to discuss the final details identified in the Project Engineering Transmittal.

If there are any questions regarding the proposed work, please contact Ronald M. Hubrich at 847-294-7729.

cc:

w/ drawings Manager, Canton System Support Center (2 Sets) Manager, Cleveland Technical Support Center (1 set) Manager, Air Traffic, Akron-Canton ATCT (CAK) (digital copy) Manager, Air Traffic, Mansfield ATCT (MFD) (digital copy) Manager, District Facilities, Pittsburgh Group (digital copy) for

2023-09-14T12:44:57-0500

DOUGLAS E WEAVER

Federal Aviation Administration

Memorandum Date: See date of signature

To: Terminal/Surveillance/Weather Construction Center, Chicago

From: Manager, Terminal Engineering Group, Chicago AJW-2C11A

Prepared by: Ronald M. Hubrich, Project Manager, Tel. 847-294-7729

Subject: ACTION: Review Project Transmittal CAK_MFD_TRACON_Refurb_Transmittal_1701251_1701252_23Sep15 to Refurbish TRACONs at Akron Canton Airport (CAK) North Canton, OH and Mansfield Lahm Regional Airport (MFD) Mansfield, OH.

SCOPE: Attached is the project transmittal to Refurbish TRACONs at Akron Canton Airport (CAK) North Canton, OH and Mansfield Lahm Regional Airport (MFD) Mansfield, OH. See Part I - Section C, Description/Specifications.

EOSH IMPACTS: SEE ATTACHMENTS

TARGET DATE: Work is scheduled to begin in winter of 2023/2024. Performance time for this contract is estimated at 150 calendar days.

FUNDS: DPN: 1218SW1104/1218SW1103/1218SW0525

Job Control Numbers: 1701251/1701252/1701388

MATERIALS: All materials under this are contractor furnished.

DISTRICT REVIEW: As required for facility.

INSURANCE: Contractor to provide bonding and any additional standard facility requirements.

SPECIAL INSTRUCTIONS:

LEASE: Not Applicable.

ATTACHMENTS: - Part I - Section C, Description/Specifications

- Part III - Section J attachment list

- List of Specifications

- List of Drawings

- EOSH Impact Statements

- CSA EOSH Project Review Checklists

- Design Risk Analysis EOSH Checklists 3900-17

- Pre-Construction EOSH Checklists 3900-18

- Lockout/Tagout (LOTO) Procedure & Guidelines

- SOP Hazardous Energy

- SOP Lead Base Paint Activities

- Specifications

- Drawings

Submitted by:

Ronald M. Hubrich, Project Manager CSA Terminal Engineering Center – Chicago

Approved by:

Douglas E. Weaver Manager, CSA Terminal Engineering Center - Chicago

PART I - SECTION C

DESCRIPTION / SPECIFICATIONS

SCOPE: Furnish all labor, equipment, materials, supplies, permits, and transportation required to perform the work in accordance with drawings and specifications. Contractor shall provide activities plan and coordinate all activities, especially in any Air Traffic work areas affected, with the Contracting Officer’s Representative (COR), to minimize impact to air traffic.

Summary Work:

Akron-Canton Airport

The work is limited to the TRACON, Kitchen, and Locker Room areas located on the facility’s sixth floor. Parsons is responsible for, but is not limited to:

a. Contacting local FAA SSC to discuss scope of work, schedule, and local requirements such as mobilization, badging, escorts, known site issues.

b. Demolition work will consist of the removing:

i. Obsolete furniture, equipment, cabinets, counters, ceiling tiles, and flooring

ii. Water dispenser, hot water heating radiator system, kitchen sink, plumbing utilities, supply air diffusers, return air grilles, flexible ductwork, and sprinkler heads.

iii. Light fixtures, light switches, and receptacles

c. New construction work will consist of:

i. Ceiling tiles, patching walls, lockers, cabinets, counters, carpeting, and flooring

ii. Kitchen sink, plumbing utilities, supply air diffusers, return air grilles, flexible ductwork, sheet metal ductwork, redistributing airflow, and sprinkler heads

iii. Light fixtures, light switches, receptacles, data cabling, and data outlets

d. Site Acceptance:

i. Review completed work with SSC representative.

ii. Obtain SSC signature on FAA form 6010-5 (CAI)

e. Site Closeout

i. Provide close out package to FAA.

1. Before and after pictures

2. Redlined Drawings

Mansfield Lahm Airport

The work is limited to the TRACON Room located on the facility’s first floor. Parsons is responsible for, but is not limited to:

a. Contacting local FAA SSC to discuss scope of work, schedule, and local requirements such as mobilization, badging, escorts, known site issues.

b. Demolition work will consist of the removing:

i. Obsolete furniture, equipment, cabinets, lockers, ceiling tiles, wall coverings, and flooring

ii. Supply air diffusers, return air grilles, flexible ductwork, humidifier, and controls.

iii. Light fixtures, light switches, and receptacles

c. New construction work will consist of:

i. Ceiling tiles, stud wall, wall repairs, and carpeting

ii. Supply air diffusers, return air grilles, flexible ductwork, sheet metal ductwork, and redistributing airflow.

iii. Light fixtures, light switches, receptacles, data cabling, and data outlets

d. Site Acceptance:

i. Review completed work with SSC representative.

ii. Obtain SSC signature on FAA form 6010-5 (CAI)

e. Site Closeout

i. Provide close out package to FAA.

1. Before and after pictures

2. Redlined Drawings

PART III - SECTION J:

ATTACHMENT LIST

The following attachments should be listed in Part III - Section J of the Contract Documents:

NUMBER DATE TITLE PAGES

- 9/15/2023 List of Specifications 1

- 9/15/2023 List of Drawings 2

9/15/2023

LIST OF SPECIFICATIONS

NUMBER DATE TITLE PAGES

WORK

RELEASE:

AGL-3064

9/15/2022 Technical Specifications, CAK ATCT Vacated TRACON Area Conversion, Akron-Canton Regional Airport Canton, Ohio

LIST OF DRAWINGS

LIST OF AKRON-CANTON AIRPORT DRAWINGS

DRAWING DATE Total TITLE

CAK-1701251-G006 9/15/2022 1 Cover Sheet and Vicinity Map

CAK-1701251-G007 9/15/2022 1 Index of Drawings, Legend and Abbreviations

CAK-1701251-G008 9/15/2022 1 General Notes

CAK-1701251-D001 9/15/2022 1 Demolition Floor Plan

CAK-1701251-D002 9/15/2022 1 Electrical Demolition Plan

CAK-1701251-A010 9/15/2022 1 New Construction and RCP Plan

CAK-1701251-A011 9/15/2022 1 Kitchen Room Elevations and Details

CAK-1701251-M002 9/15/2022 1 Mechanical Cover Sheet

CAK-1701251-M003 9/15/2022 1 Mechanical Partial Sixth Floor Plan – Demo & New Construction

CAK-1701251-P001 9/15/2022 1 Plumbing and Fire Protection Cover Sheet

CAK-1701251-P002 9/15/2022 1 Plumbing Partial Fifth Floor Plan Demo & New Construction

CAK-1701251-P003 9/15/2022 1 Plumbing and Fire Protection Partial Sixth Floor Demo & New Construction

CAK-1701251-E006 9/15/2022 1 Electrical Notes, Legend and Abbreviations

CAK-1701251-E007 9/15/2022 1 Proposed 6th Floor Power and Lighting Plan

CAK-1701251-E008 9/15/2022 1 Proposed 6th Floor Local Area Network Data Plan

CAK-1701251-E009 9/15/2022 1 Facility Panel Schedules

CAK-1701251-E010 9/15/2022 1 Conference Room Luminaire Schedule Mounting Detail & Device Flow Chart

LIST OF MANSFIELD-LAHM AIRPORT DRAWINGS

MFD-1701252-G012 7/15/2022 1 Cover Sheet, Vicinity Map, and Index of Drawings

MFD-1701252-G013 7/15/2022 1 Legend and Abbreviations

MFD-1701252-G014 7/15/2022 1 General Notes

MFD-1701252-D001 7/15/2022 1 Existing Ground Floor Plan

MFD-1701252-D002 7/15/2022 1 Electrical Demolition Plan

MFD-1701252-A017 7/15/2022 1 Ground Floor Plan and RCP Plan

MFD-1701252-M001 7/15/2022 1 Mechanical Coversheet

MFD-1701252-M002 7/15/2022 1 Mechanical Partial Ground Floor Plan – Demo and New Construction

MFD-1701252-E011 7/15/2022 1 Electrical Notes, Legend and Abbreviations

MFD-1701252-E012 7/15/2022 1 Proposed Ground Floor Power, Lighting and Local Area Network Plan

MFD-1701252-E013 7/15/2022 1 MFD Facility Panel Schedules

MFD-1701252-E014 7/15/2022 1 Conference Room Luminaire Schedule & Lighting Fixture Detail

LIST OF AKRON-CANTON AIRPORT DRAWINGS

TITLE

Total

DATE

LIST OF MANSFIELD-LAHM AIRPORT DRAWINGS

2023-09-14T10:15:28-0500

RONALD M HUBRICH

2023-09-14T12:46:14-0500

DOUGLAS E WEAVER

2023-09-14T12:46:41-0500

DOUGLAS E WEAVER

ATTACHMENT

EOSH IMPACTS

Project:

TRACON Restoration at Akron – Canton Regional Airport in Akron, Ohio

Engineer / Routing Code: Ron Hubrich/AJW-2C11A Manager / Routing Code: Doug Weaver /AJW-2C11A SECM: Garry Gavin/AJW-C21B SECM: Musa Abuzir/AJW-C21B ES EOSH Coordinator: Steven Myers/AJW-2C16E

EOSH IMPACTS

1. Asbestos:

The CAK ATCT has been surveyed for asbestos containing materials. According to the most recent asbestos re-inspection report for the CAK ATCT that ES has on file, the following asbestos containing materials are located on the 6th floor area:

- Radiator Feed Filler in the TRACON and Ready Room/Break Room

- 12” x 12” Gray Floor tile and mastic in the Hallway and Men’s Bathroom

- Mudded fittings in the Hallway, Equipment Room, and Men’s Bathroom

- Carpet/Floor Tile Mastic in the Ready Room/Break Room

Based on the submitted drawings, these materials may be impacted by the restoration activities.

Additionally, the 6th floor previously contained 9”x9” green floor tile and mastic in the TRACON and green speckled asbestos vinyl sheet flooring in the kitchen and break room. The floor tile and vinyl sheet flooring were abated in 2007, but remnants may remain underneath equipment cabinets, kitchen counters and lockers.

All asbestos containing materials must be removed by asbestos workers currently licensed in the State of Ohio. Abatement activities should be designed in accordance with the FAA Model Asbestos Abatement Specification. Air monitoring shall occur while abatement activities occur.

Clearance samples will be required at the end each abatement activity. A 10 Day notification must be filed with the State of Ohio before starting any asbestos abatement activities.

An approved FAA Asbestos work permit shall be posted at the facility during abatement activities.

Asbestos work permits may be applied for on the FAA Work Review Request website.

2. Lead Based Paint:

The CAK ATCT has not been tested for lead based paint. All painted surfaces should be assumed to contain LBP unless determined otherwise through appropriate testing. As currently scoped, the project will impact potential lead bearing surfaces. Work activities impacting painted surfaces shall follow the SOP for lead based paint (see attached). All demolition debris assumed or known to have LBP should be disposed of appropriately. Provide documentation for the disposal of all demolition debris.

3. Employee Health (First Aid / Blood Borne Pathogen):

When first aid situations arise, local emergency response systems shall be the primary source of emergency first aid. Ensure a viable and reliable source to contact first responders is present and functional within the worksite and ensure employees or contractors be properly instructed in how to access the system, e.g., by dialing 911. If working in rural areas where there is no coverage by a local emergency medical response system, make provisions for acceptable emergency transportation. Ensure that job sites or vehicles have a properly stocked and approved first aid kit.

To ensure compliance with FAA Blood Borne Pathogen rules and regulations make sure of the following;

• Appropriate engineering and work practice controls are in place.

• Ensure that appropriate personal protective equipment is available at the project site.

• Ensure the worksite is maintained in a clean and sanitary condition.

• Any spills of blood or other potentially infectious material on work surfaces are cleaned with an appropriate disinfectant.

All incidents resulting in first aid treatment should be reported in the same manner as any other occupational injury or illness as described in FAA Order 3900.19C, Chapter 3.

4. Fire Life Safety:

An emergency action plan should be established to identify exit routes and means of egress in case of an emergency. Good housekeeping practices are required to ensure a safe means of egress and to eliminate a possible fuel source for fires. For additional reference regarding fire life safety, refer to OSHA CFR 1910 Subpart L.

5. Hazard Communication:

• Familiarize yourself with the applicable FAA and OSHA standards regarding hazard communication.

• Obtain from SSC or create a list of the hazardous chemicals in the workplace.

• Obtain material safety data sheets for all chemical substances in the workplace.

• Ensure that all containers are labeled.

• Request and review the District SSC Written Hazard Communication Programs.

Guidance on Hazard Communication include, FAA Order 3900.19C, FAA Order 6000.54, Airway Facilities Hazard Communication Program, PASS CBA, Article 52, Section 10, and OSHA - 29 CFR 1910.1200 - Hazard Communication. If you need further assistance regarding hazard communication, contact the District Safety and Environmental Compliance Manager (SECM) or EOSH contract support staff at the pertinent Technical Support Center (TSC).

6. Hazardous Energy (Construction):

Based on the parameters of the project, lockout/tag out is required. The contractor/employee is responsible for creating equipment specific lockout/tag out procedures for this project. Refer to the Engineering Services Standard Operating Procedures (SOP) Hazardous Energy for work requirements regarding lockout / tag out. For reference regarding hazardous energy lockout / tag out, refer to OSHA (29 CFR 1910.147 and 1960) and by FAA Order 3900.19C.

7. Post Construction LOTO Plan:

The designer/contractor shall develop a site specific lockout / tag out plan for the new installations as required. This plan will be based on manufacturers recommended procedures and site specific switch locations and conditions. The plan will follow the standard FAA LOTO format.

8. Personal Protective Equipment (PPE):

Following review of the project scope of work, the EOSH Coordinator has determined that PPE is required for this project. PPE should consist of gloves, hard hats, safety glasses, respirators, https://employees.faa.gov/employee_services/safety/occ_safety/order3900/media/ch19.pdf http://www.faa.gov/documentLibrary/media/Order/6000_54.pdf http://www.faa.gov/documentLibrary/media/Order/6000_54.pdf https://employees.faa.gov/org/staffoffices/ahr/emp_labor_management_relations/labor_relations/agreements/media/07-02-00%20PASS-AF%20-%20Bus%200067.pdf http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10099 and safety boots / shoes. OSHA 1926 Subpart E and FAA Order 3900.19C provides guidance and instructions on the selection, use, and maintenance of PPE.

9. General:

Safety Data Sheets (SDS) for hazardous materials already present in the workplace shall be provided by the Canton SSC. Contractors shall identify and provide SDS’s for all hazardous materials brought into the work area by themselves or their sub-contractors. All Personal Protective Equipment shall be worn at all times to protect from head, eye, face, and foot injuries.

Please contact any of the following personnel if any environmental, health or safety issues arise:

Cleveland District Name Office Phone Cell Phone SECM/EPS Garry Gavin 440-774-0827 630-945-5491 SECM/EPS Musa Abuzir 734-487-7323 734-353-5289

10. PRE-CONSTRUCTION CHECKLIST:

This checklist (see Attachments, below) is intended to be used as a tool by RE/COTRs, designated facility POCS, or SSC managers who oversee construction and maintenance activity that potentially have Occupational Safety, Health, and Environmental (OSH/E) related impacts on AT/AF operations. This tool shall be used, as appropriate, during critical phases of construction and maintenance activities (e.g. the pre-construction meeting, 30-60 days prior to commencement of work, weekly/daily construction meetings, etc.). Emphasis should be placed on using this checklist as a tool to assess as well as reassess hazards as the project progresses.

Specifically, this checklist is intended to:

• Promote sensitivity to potential OSH/E hazards associated with projects and stress the importance of not disrupting NAS operations. Assist in identifying and validating potential project hazards and associated risks

• Assist in preventing safety and health incidents/accidents and facility shutdowns

• Ensure appropriate contractor measures and controls are in place to address potential project hazards

• Facilitate discussion with the contractor regarding plans to prevent minimize potential incidents/accidents

• Enhance coordination between OSH/E professionals, project personnel and contractors

• Facilitate review of critical FAA OSH/E procedures with contractors

• Raise OSH/E awareness

This checklist relies on the training and professional judgment of the user. OSH/E personnel should be consulted as needed.

A facility POC with a thorough understanding of facility procedures and equipment considerations should participate in the site walk-through.

Central Service Area Environmental, Occupational Safety and Health (EOSH) Project Review Checklist

Rev. 05/06/2011 Page 1 of 4

PROJECT TRACON Restoration DPN 1218SW1104 DATE 1/14/2022

JCN 1701251 Transmittal

Revised? REGION

AGL DISTRICT ZOB

SSC Canton SSC

FACILITY

LOCATION

Canton, OH FACILITY

TYPE

ATCT FACILITY

ID

CAK ATCT

ENGINEER

TITLE

Ron Hubrich Project Engineer

EHS

Steven Myers EOSH Coordinator

SUPERVISOR

Doug Weaver Manager

CODE AJW-2C14A CODE AJW-2C16E CODE AJW-2C11A

SIGNATURE

Issue Yes No

Action Items and Notes

If YES, always coordinate with EOSH Specialist

AIR EMISSIONS

CLEAN AIR ACT

(CAA)

Replace and/or install new emission sources such as boilers, incinerators, storage tanks, engine generators, painting booths, space heaters, equipment using CFCs or Halon, etc.

1. Review federal and state requirements for new or modified sources.

ASBESTOS Will activity potentially impact presumed or known asbestos containing materials (ACM)?

The CAK ATCT has been inspected for asbestos. Licensed asbestos workers will be required to remove any impacted asbestos containing material in this project. Air monitoring will be required. Clearance air monitoring will be required. A demolition notification must be sent to the State of Ohio at least 10 days prior to the start of any asbestos abatement activities at the site. An approved CSA work permit should be posted at the facility for the duration of the project.

1. Check Index of Asbestos and Lead Paint Surveys to see if the facility has been surveyed for asbestos. Index available from the FOPOC .

FEDERAL

INSECTICIDE

FUNGICIDE AND

RODENTICIDE

ACT (FIFRA)

Does the project require the application of pesticides and/or herbicides?

1. Review FAA Order 1050.17, FIFRA implementing regulations, 40 CFR Parts 152, 162, and 171 and State regulations.

CHLOROFLUORO

-CARBONS (CFC)

Is CFC containing equipment being replaced, installed or disposed? (I.e. refrigeration systems, Halon systems, HVAC systems, etc.)

1. Review project plans and specifications

COMPRESSED

GAS

Are compressed gasses utilized?

1. Review Project plans, specifications and work procedures. Will welding or cutting take place?

ENVIRONMENTAL

DUE DILIGENCE

AUDIT (EDDA)

Acquire, lease and/or dispose of land property?

1. Review Project plans and specifications

NATIONAL

ENVIRONMENTAL

POLICY ACT

(NEPA)

Does the project potentially impact the environment with respect to noise, water quality, air quality, wetlands, flora and fauna, wildlife, historic and archeological sites, endangered species & other protected areas?

1. Review Project plans and specifications.

Rev. 05/06/2011 Page 2 of 4

ENERGY Install new lighting, HVAC, or environmental controls?

FLUORESCENT

LAMPS

Dispose, install or recycle fluorescent lamps?

FUEL STORAGE

TANKS

Install, remove and/or replace an underground or aboveground storage tank or piping? If the project is new construction, is an existing UST and/or piping near the project site being impacted?

1. Check Storage Tank Inventory available from the Regional FST Manager or the FOPOC or ANI Representative.

2. Review Project plans and specifications.

WASTE

MANAGEMENT

What types of waste will be generated as a result of the project?

Y N

Hazardous Wastes Construction / Demolition Debris Packaging wastes and/ or recyclable materials or items.

1. Determine if the waste generated is classified as a hazardous waste by determining if it is a listed hazardous waste or if it is characteristically hazardous.

2. Review FAA Order 1050.17 (Chapter 12), 40 CFR 260- 266, 273, 279, and state hazardous waste regulations.

3. Review AC No. 150/5320-15A (Management of Airport Industrial Waste)

LEAD-ACID

BATTERIES

Disturb, store, dispose or recycle lead acid batteries?

1.

LEAD BASED

PAINT

Disturb, store, dispose of lead paint?

1. Check Index of Lead Paint Surveys to see if sampling has been conducted.

2. If no paint sampling results available, then all impacted materials must be assumed lead containing or contaminated until sampled & tested.

LOCKOUT/

TAGOUT & HIGH

VOLTAGE

(Construction)

Are pressurized or electrical systems being impacted as part of the project construction?

If yes:

1. Only utilize fully trained personal to perform electrical work and lockout/tagout procedures.

LOCKOUT/

TAGOUT

PROCEDURE

(Post Construction)

Will a new LOTO plan need to be developed for new equipment being installed?

1. prepare a LOTO procedure in accordance with FAA orders and policies

2. Coordinate the LOTO procedure with the local SSC or facility contact.

ENERGIZED

ELECTRICAL

SYSTEMS

(construction)

Will the construction involve work on energized electrical systems greater than 50 volts?

1. Initiate two-person rule with first aid and CPR trained personnel.

2. Fill out and submit an energized electrical work permit prior to initiating the work.

3. Use proper PPE for arc flash hazards

ARC FLASH

HAZARD

(Post construction)

Based on the following conditions, an Arc Flash analysis is not required:

N Y

The circuit is rated 240 volts or more;

The circuit is supplied by more than one transformer, and;

The transformer supplying the circuit is rated greater than 125 kVA.

1. Perform a short circuit / arc flash hazard calculation.

2. label and mark off arc flash hazards

PCBs Relocate or dispose of PCBs and/or PCB containing equipment? (Fluorescent fixture ballast's, electric transformers and equipment)

1. Check the PCB Inventory available from each FOPOC.

2. Determine if the PCB component was manufactured before 1984.

Rev. 05/06/2011 Page 3 of 4

MERCURY Are Mercury Switches present that will be impacted by the work?

1. Check for Mercury switches

RADIOACTIVE

SOURCES,

RADON, ETC.

Relocate or dispose Radioactive tubes, or other hazardous waste? Is there evidence or potential for elevated radon levels in construction site?

1. Determine if radon will or is an influence at the site.

SAFETY -

General

Safety issues? I.e. Clear aisle space, electrical equipment clearances, toe boards, hand rails, stair clearances, safety cages, fire protection, fire life safety, ladders, Hazard Communication (HAZCOM), first aid, accident prevention, construction safety, etc.

1. Review FAA Orders 1050.17 & 3900.19C, and 29 CFR 1910 & 1926.

SAFETY –

Fall Protection

Will work be conducted on elevated surfaces?

Confined Space

Will work be conducted in a confined space?

Will work be conducted in a Permit required Confined space?

Personal Protective Equipment (PPE)

Will any of the following be required?

Safety Glasses, Safety Shoes, Reflective Vest, Hard hat, Gloves, Disposable clothing, Respiratory Protection, Hearing Protection, Climbing Harness and Lanyard

2. Review MSDS Sheets for any chemicals or materials.

Excavations and Trenches

Will any excavations or trenches be required for the project?

Runway Safety

Will the work take place in an aircraft operational area?

1910 & 1926. and AC 150/5210-20 (Ground Vehicle Operations on Airports), AC No. 150/5370-2E (Operational Safety on Airports During Construction) and AC No. 150/5380-5B (debris Hazards at Civil Airports)

TRAINING Are personal required to have training to be qualified to work?

All licensed abatement workers shall be current on their annual asbestos worker training.

WATER

CLEAN WATER

ACT (CWA) &

SAFE DRINKING

WATER ACT

(SDWA)

Does the project involve the clearing, grading, and excavation of over 1 acre; impact navigable waters; utilize equipment which can discharge to storm water or wastewater systems (cooling tower discharges or boiler blow downs)? State and local regulatory authorities may impose more stringent SWDP requirements.

1. Review pollution prevention under EO 12856, EO 12873: Federal Acquisition, Recycling, and Waste Prevention.

2. Clean Water Act implementing regulations, 40 CFR Parts 110, 112, 122, 136, 400-460, and 33 CFR Part 154, FAA Order 1050.15A

WATER

Potable water testing

Does the project involve the installation of new or modification of potable water supply plumbing or fixtures? (i.e. wells, pipes, sinks, drinking fountains, etc)

Rev. 05/06/2011 Page 4 of 4

CSA Engineering Services EHS CONTACTS

EOSH COORDINATOR Steve Diblik 847-294-7709 EOSH Coordinator Steven Myers 847-294-7591

Cleveland DISTRICT PHONE Cell SECM/EPS Garry Gavin 440-774-0827 630-945-5491 NISC EOSH Musa Abuzir 734-487-7323 734-353-5289

PROJECT

DPN

DATE

JCN

Transmittal

REGION

DISTRICT

SSC

FACILITY LOCATION

FACILITY TYPE

FACILITY

ID

ENGINEER

TITLE

EHS

SUPERVISOR

TITLE

CODE

CODE

CODE

SIGNATURE

SIGNATURE

Action Items and Notes

CSA Engineering Services EHS CONTACTS

2022-01-20T12:44:46-0600

RONALD M HUBRICH

2022-01-14T15:12:55-0600

STEVEN E MYERS

2023-09-14T12:47:09-0500

DOUGLAS E WEAVER

Design Risk Analysis Environmental and Occupational Safety and Health Checklist

FAA Form 3900-17 (03/15) Electronic Version (PDF) Page 1 of 12

Section A. Purpose

This checklist is intended to be used as a tool to identify environmental compliance and occupational safety and health (EOSH) requirements during project design.

Specifically, this checklist is intended to:

Ensure that the project is properly designed in regard to EOSH requirements; and

Ensure that the execution of the project will not disrupt NAS operations due to EOSH issues.

The scope, schedule, and cost of a project may be impacted if EOSH requirements are not addressed. In addition, failure to address EOSH requirements in a project could lead to regulatory action against the FAA. This checklist will be completed by the Project Engineer and/or Program Manager for the project. For plans/projects managed by Engineering Services, the cognizant Engineering Services EOSH Coordinator will review and sign the document. The Engineering Services EOSH Coordinator should be consulted at the planning stage. For turnkey plans/projects managed by Headquarters organizations, the national Program Office will ensure that sufficient EOSH technical support resources are provided. For non-Engineering Services projects managed exclusively by local facilities and/or field organizations, the appropriate manager (e.g., District Office Manager or SSC Manager) will request EOSH technical support. This form is required to be completed as per FAA Order JO 3900.57A.

If EOSH issues are identified on this checklist, then it is the responsibility of the organization managing the project to address those issues. The checklist is completed with available information. If that information is not complete or changes are made during design, the checklist may need to be revised. It may be necessary to use additional references for any design modifications. This checklist relies on the training and professional judgment of the user. EOSH personnel should be consulted as needed.

Section B. Project Summary Information

The purpose of this section is to provide a brief description of the construction or renovation project, and identify key personnel responsible for project completion. Fill in the requested site-specific information. In the project description below, indicate if this work will occur in or adjacent to an occupied space. Note: Provide further explanation of activities on additional sheets if necessary.

Project Name and Description: Check one: New Construction: Renovation:

Project Location: Facility:

Planned Start Date: Expected Completion Date:

Project/Design Representative Name: Phone:

EOSH Contact Name: Phone:

Originating Organization: Project Number/JCN:

Section C. EOSH Subject Areas

Evaluate the project and its potential hazards and risks. Consider sensitive NAS operations and all facility occupants that may be impacted by the project. For each potential project hazard, indicate (with a checkmark) a potential for exposure, release, or incident. The following questions cover the most common EOSH related areas that may be encountered. This list is not inclusive. Consult with your designated EOSH professional for additional guidance and assistance. Refer to the latest versions of the FAA Orders cited in the “References and Actions” column.

EOSH Subject Area Relevance to

Design (Yes / No / N/A)

References and Actions

Environmental Program Areas

FAA Form 3900-17 (03/15) Electronic Version (PDF) Page 2 of 12

EOSH Subject Area Design References and Actions

A. Environmental Review

1. Has the project performed the appropriate level of If the proposed project cannot be categorically excluded under environmental review in accordance with the current NEPA, an environmental assessment (EA) may be necessary.

version of FAA Order 1050.1 and the National Environmental Policy Act (NEPA)?

2. Will the project involve the acquisition and/or Environmental due diligence documentation must be completed if disposition of real property? real property is acquired and/or disposed of, per the latest version of FAA Order 1050.19.

Notes:

B. Water Pollution Control

1. As currently planned, will the construction activity Federal stormwater discharge permits from construction activities impact more than 1 acre of land? apply to disturbances of land equal to or greater than 1 acre.

National Pollutant Discharge Elimination System (NPDES) permits and stormwater pollution prevention plan (SWPPP) are required in accordance with 40 CFR Part 122.

2. Will the construction activity impact more than 5 Federal stormwater discharge permits from construction activities acres? have more stringent requirements for disturbances of land greater than 5 acres.

C. Air Pollution Control Management Program

1. Does the design include fuel-combustion equipment Investigate federal, state, and local permit requirements, including (e.g., emergency generators, boilers), paint spray requirements pursuant to Clean Air Act (CAA) implementing booths, degreasers or air pollution control devices? regulations, 40 CFR Parts 60 and 63, and the current version of

FAA Order JO 1050.17.

2. Are air quality “permits to construct” or “authorizations If yes:

to construct” applicable to the project as designed? 1. Permits to construct may need to be obtained while the project is in the design stage.

2. Permits to operate may need to be obtained before the equipment is turned over to the facility and prior to operations.

D. Wetlands

1. Will the activity including building, dredging or filling in Any person, firm, or agency planning to work in navigable waters of the vicinity of tidal waters, fresh water, or wetlands? the United States, or discharge (dump, place, deposit) dredged or fill material in waters of the United States, including wetlands, must first obtain a permit from the U.S. Army Corps of Engineers.

2. Will the activity cause the loss of more than one-tenth Depending on the type and location of the project, an individual acre of waters of the U.S., including wetlands, or is permit may not be required. The Corps has many general the volume of excavation or filling more than twenty- nationwide permits, which authorize minor activities without the five cubic yards? need for individual processing.

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E. Fuel Storage Tanks: Underground Storage Tanks (USTs)/Aboveground Storage Tanks (ASTs)

1. Does the project require that a new or replacement The tank must conform to FST Program Office baseline design fuel storage tank (FST) system be installed during the requirements and the latest versions of FAA Orders 1050.15, project? 1050.16, and JO 1050.17, National Fire Protection Association

(NFPA 30), and federal, state and local requirements. Only ASTs may be deployed without special approval from FST Program Office. Where state and local agencies require, use licensed UST/AST removers and installers.

2. Have state and/or local permits been obtained for Obtain necessary state and local permits.

installation of the FST? If not, please explain why in the notes.

3. Does the project include work on or impact to an Comply with the requirements stated above, maintain continuity of existing AST or UST? service to critical systems, and determine if temporary fuel supply may be necessary.

4. If an AST is included in the design, will the aggregate An aggregate aboveground capacity of oil greater than 1,320 capacity for the facility be greater than 1,320 gallons? gallons requires a spill prevention, control, and countermeasures

(SPCC) plan per 40 CFR 112.

F. Protected Species

1. Does the construction activity have the potential to Species include plants, wildlife and their habitats. Informal harm or otherwise impact federally- or state-protected consultation under Section 7 of the Endangered Species Act (ESA) species or their habitat? may be necessary to make the determination.

G. Drinking Water

1. Will the project involve installing or modifying any Newly plumbed systems at staffed facilities, as well as any plumbing systems or sources of drinking water, or will impacted by construction, require drinking water testing per the construction impact the facility’s water system? latest version of FAA Order JO 3900.61. Any fixtures must be compliant with NSF/ANSI Standard 61.

H. Hazardous Waste Disposal

1. Will hazardous and other regulated waste (e.g., Specify that all hazardous and other regulated waste will be asbestos, lead, polychlorinated biphenyl [PCBs], identified and require proper disposal of hazardous wastes spent solvents, silica dust) be generated as a result of including the use of hazardous waste manifests for shipments.

this project, or will legacy equipment containing Specify consultation with the Safety and Environmental Compliance hazardous materials require disposal? Manager (SECM) or facility manager to determine regulatory requirements based on facility generator status.

2. Have disposition requirements been identified for Compliant disposal options must be identified according to the hazardous waste materials originating from the latest version of FAA Order JO 1050.17. Ensure adequate funding project? for the removal and disposition of removed equipment and materials.

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I. Non-Hazardous Solid Waste Management

1. Has a solid waste management plan been developed outlining how all non-hazardous waste, trash and debris from the project will be handled?

2. Has a Construction and Demolition (C&D) waste Recycling of C&D waste, whenever feasible, is required by management plan been developed for the project? Executive Order 13514.

3. Will the project involve removal and/or disposition of Older equipment may contain PCBs or other hazardous materials.

equipment and/or electronic waste? Electronic waste must be managed through a recycling firm certified by an accredited certification standard (e.g., Responsible Recycling Practices (R2), e-Stewards). Ensure compliance with the approved National Disposition Plan, if applicable.

J. Energy Conservation Program

1. Has the project taken into account potential Review Energy Policy Act of 2005, the Energy Independence and opportunities for energy efficiency and/or applicable Security Act of 2007 (EISA), and the latest version of FAA Orders sustainable building requirements? 1053.1 and JO 1053.3.

2. Have alternative fuel supply/storage measures (i.e., clean energy initiatives such as solar or fuel cells) been evaluated?

Safety Program Areas

K. Asbestos Management Program

1. Has the facility asbestos survey or Operations and If yes:

Maintenance (O&M) plan (as applicable) been 1. Review available asbestos reports to see if the facility has been reviewed prior to design? surveyed.

2. If no survey report is available, then all suspect materials that will be impacted must be assumed to be asbestos-containing material (ACM) or sampled and tested. Presumed Asbestos Containing Material means thermal system insulation and surfacing material found in buildings constructed no later than 1980; however, ACM are still being installed in new buildings.

Samples may be required; contact SECM for guidance.

3. Review the latest versions of FAA Orders 1050.20 and 3900.19, bargaining unit agreements, CAA implementing regulations, 40 CFR Part 61 Subpart M, Toxic Substances Control Act (TSCA) implementing regulations, 40 CFR Part 763, 29 CFR 1910.1001, 29 CFR 1926.1101, and state and local regulations.

4. Include in specifications applicable regulatory and union agreement requirements along with safe work practices.

2. Does the facility asbestos survey or O&M plan An asbestos survey is required prior to renovation and demolition indicate the presence of any ACM? and is a means of estimating the cost of abatement and disposal.

3. Will the project involve installation of equipment in or demolition/renovation of facilities ACM or PACM?

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4. Will the project involve disturbance or removal of Requirements may include any or all of the following: latest floor and/or ceiling tiles, insulation, or roofing versions of FAA Orders 1050.20 and 3900.19, bargaining unit materials in buildings or facilities with ACM or agreements, CAA implementing regulations, 40 CFR Part 61, PACM? Subpart M, TSCA implementing regulations, 40 CFR Part 763, 29

CFR 1910.1001, 29 CFR 1926.1101, state, and local regulations.

5. Has the Facility Asbestos Coordinator been Per FAA Order 1050.20, the designated Facility Asbestos contacted regarding the appropriate procedures for Coordinator is responsible for asbestos issues at a facility.

ACM at the specific facility in question, as applicable?

L. Lead Management Program

1. Will the project involve disturbance or removal of Grinding, sanding, cutting or welding into surfaces coated with lead-based paint? lead-based paint may generate lead dust and/or fumes. Installation of new equipment may disturb lead-based paint. Review the latest versions of FAA Orders 3900.19, bargaining unit agreements, Toxic Substances Control Act (TSCA) implementing regulations, 40 CFR Part 745, 29 CFR 1910.1025, 29 CFR 1926.62, and state and local regulations. Include in specifications applicable regulatory and union agreement requirements along with safe work practices.

2. Will the project potentially impact any materials containing lead (e.g., lead sheathing on piping)?

M. Hazardous Materials Handling and Storage

1. Will the proposed building or renovated space be Ensure appropriately designed chemical storage areas are used to store hazardous materials? incorporated into the design.

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2. Do all hazardous materials storage areas meet Applicable standards include design, chemical International Building Code (IBC), International Fire segregation/compatibility, secondary containment, explosion-proof Code (IFC), and NFPA standards? ghting, drainage, fire wall rating, ventilation and accessibility.

N. Storage Space

1. Is adequate storage space allotted for routine Maintenance items should be stored in designated storage areas.

maintenance items (e.g., ladders or tools)? Items should not be stored under stairs or in stairwells.

O. Electrical Safety

1. Does the design, construction, or installation include If yes:

high voltage equipment? 1. Will proper clearances be met after installation?

2. Is there a plan to develop lockout/tagout (LOTO) procedures?

3. Will the equipment be capable of accepting lockout devices?

4. If electrical equipment is included in the design, sufficient clearance distance in front of the equipment must be included after installation in accordance with 29 CFR Part 1910 Subpart S, and NFPA 70.

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2. Does the design meet the definition of major If yes to either question, an Arc Flash Risk Assessment (AFRA) is modification in the latest version of FAA Order JO required to determine appropriate personal protective equipment 3900.64? Is the design a new facility? (PPE) and arc flash boundaries. Refer to FAA Order JO 3900.64 and NFPA 70E for requirements of the AFRA.

3. Is the energy isolating device of the new or modified After January 1990, energy isolating devices for new or modified equipment designed to accept a lockout device? equipment must be designed to accept a lockout device. Refer to

29 CFR 1910.147(c)(2)(iii).

4. Have the proper clearances around electrical Refer to the latest version of FAA Order JO 3900.64, 29 CFR equipment been included in the design, as 1910.303(g) (1), and NFPA 70 Article 110.26.

applicable?

5. Have LOTO procedures been developed for Refer to 29 CFR 1910.147 and the latest version of FAA Order JO equipment, as applicable? 3900.75.

6. Have appropriate short circuit calculations, protective Short circuit and protective device coordination calculations are device coordination, and Arc Flash Risk Assessment required per FAA Order 6950.27. An AFRA (previously known as (AFRA) been performed, as applicable? AFHA or arc flash hazard analysis) is required per FAA Order JO

3900.64, and NFPA 70E.

7. For equipment installed as part of the project, will If yes:

personnel maintaining the equipment be exposed to 1. Revise the design to eliminate the electrical safety hazards electrical safety hazards (e.g., risk of electrocution, 2. Ensure that proper training and PPE are available following electrical shock, burns, or falls associated with work installation. Refer to FAA Orders 6950.27 and JO 3900.64.

on or near energized electrical equipment)?

P. Fire/Life Safety (FLS)

P.1. FLS General

1. Is the design work under the review of a licensed fire protection engineer (FPE)?

As per code, a fire protection engineer is required for the following:

all new buildings containing operations areas; and renovations to existing buildings in which any existing fire protection system, fire alarm system, or major means of egress component is modified.

2. Has the engineer/designer reviewed appropriate Appropriate codes may include the IBC, NFPA codes and codes for a basis of design and referenced them in standards, 29 CFR 1910, 29 CFR 1960.20, FAA Standard Design the design package? Guidelines, and state and local requirements.

3. Is the engineer/designer using the Technical Note: The TIG is a compilation of practical solutions and lessons Implementation Guide (TIG) as a resource? learned to challenging fire safety issues. The TIG is a living document developed by experienced FLS project engineers/consultants and it is recommended to review during the engineering/design phase.

4. Has the engineer/designer verified if the work is This typically applies to sponsor owned and or leased facilities and subject to applicable codes/standards or may include state or local code compliance requirements, PE review/approvals by an authority outside of the FAA stamped designs, or General Contractor/Trade licenses and local (e.g., state or local jurisdiction)? approval by the authority having jurisdiction.

5. Will there be possible impairments of FLS systems Provide Impairment Plans (developed by the engineer), as due to project implementation? appropriate for: Sprinkler, Fire Detection and Alarm, and Stair

Pressurization systems. Qualified fire-watch requirements written into the scope are required if any system is to be out of service for more than four hours in a 24-hour period (NFPA 1, §13.1.9). Also ensure there are no impairments to egress paths.

6. Does the design consider or address the Ensure that the design is not only code compliant, but also maintainability or service life of fire protection addresses the maintainability of fire life safety equipment from a systems and features? practical standpoint (for example, systems requiring maintenance are easily accessible for service personnel).

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7. Has the project scope been classified in accordance The project scope affects the extent of new construction code with the International Existing Building Code compliance requirements. The project must be defined as a repair, (IEBC)? alteration (level 1, 2, or 3), a change of occupancy, or an addition.

8. Does the project change the height or area of the The maximum height and area of the building based on the existing building? construction type must be considered for building additions or expansions. See requirements in IEBC.

9. Will this project change occupancy and/or use in any of the spaces?

P.2. Means of Egress

1. Will the project involve alterations affecting means Travel distance, common path of travel, dead-end corridors, exit of egress compliance? remoteness, emergency lighting, exit signage, and exit discharge are examples of means of egress components. See NFPA 101, Life Safety Code, Chapter 7.

2. Are minimum head clearances considered in Refer to the TIG 1.11 for specific guidance.

stairwells and paths of egress?

3. Are all new interior finishes or proposed interior Refer to NFPA 101, Life Safety Code, Chapter 10.

finishes compliant?

P.3. Passive FLS Systems

1. Has the project taken into account and identified Determine where rated fire and/or smoke barriers are located and where fire resistance rated construction is located? how the project may affect them. This information is typically identified on architectural as-built drawings.

2. Is fire stopping required by the design? Any penetrations through fire rated barriers created by this project must be firestopped in accordance with the FAA firestopping specification. This includes labeling fire barriers and installed firestop systems.

3. Are mechanical components of HVAC penetrations Fire dampers, smoke dampers and combination fire/smoke of fire rated resistance construction affected or dampers are sometimes required for fire resistance rated required by the design? construction.

4. Are new openings through fire rated construction Examples of openings in fire rated construction include the protected appropriately? following: fire rated doors, door frames, door self-closing mechanisms, magnetic hold opens, fire rated floor, ceiling, and shaft hatches.

P.4. Active FLS Systems

P.4a. Fire Alarm System

1. Will all new construction or modifications to existing Refer to NFPA 72, National Fire Alarm and Signaling Code.

fire detection, alarm and communication systems be designed in accordance with appropriate FAA requirements?

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2. Will room or space modifications require changes to xamples of modifications that can affect the compliance of the existing fire alarm system layout? xisting fire alarm systems include: new partitions, removing artitions, space usage changes, etc.

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3. Will the fire alarm and/or interfacing systems be Documenting the existing condition of the fire alarm system prior to modified? modifications is critical to ensure improperly operating portions of the system are accounted for in the design. Examples of interfacing systems include elevator primary/secondary recall, fire/smoke dampers, sprinkler flow and sprinkler valve supervisory switches, HVAC shutdowns, stair fan monitoring, etc.

4. Will modifications to other building systems impact Fire alarm systems are often interfaced with mechanical systems.

the fire alarm system?

P.4b. Stair Pressurization System (ATCTs only)

1. Does the project design affect components of the Components of the stair pressurization system include the stair pressurization system? following: fan, fan controls, relief damper, and back-up power supply. Refer to Chapter 2 of the TIG.

2. Will the project indirectly affect the stair Examples of alterations that may affect stair pressurization system pressurization system? performance include secondary leakage paths, and new stair enclosure openings, Refer to Chapter 2 of the TIG.

3. When there are alternate types of smoke control These types of systems are provided as an alternative to stair present (vented vestibule, outside balcony), does the pressurization systems in some locations. If the design affects design alter the performance of such systems? these systems, the project must demonstrate compliant alterations.

P.4c. Automatic Sprinkler System

1. Will the project affect the sprinkler system layout? Ensure sprinkler spacing locations are adjusted as necessary and remain in compliance. For example, sprinkler clearances may be affected by new shelving, book cases, storage, partitions, etc. If placed within 18 inches of the sprinklers it may be necessary to adjust the sprinkler layout. Refer to NFPA 13.

2. Does the project affect the occupancy hazard A hydraulic calculation is required if the project is increasing the classification of the sprinkler system? occupancy hazard classification. The existing sprinkler system may, or may not be capable of providing increased protection to meet the design criteria.

3. Will physical alterations of the sprinkler system As per NFPA 13, hydraulic flow calculation is required if require a new hydraulic calculation? hydraulically remote area demands are affected.

P.5. Emergency Power

1. Will emergency power or…