7. ILSM 612A4-27-020 Replace Flooring in McCellan.pdf

ILSM 612A4-27-020 Replace Flooring in McCellan

Safety Permit Request #595

Initiated by Lye SaechaoInterim Life Safety Measures (ILSM)

NorCal Submitted 6/25/2026

Engineering Review: Approved by vhamacstettw 6/30/2026

1: Project Infomration 1.1: Project Number

612A4-27-020

1.2: Project Name *

Replace Flooring in McCellan 1.3: Project COR/Lead Name (last, first) *

Lye Saechao 1.4: Location of activity

McClellan 1.5: Building x 2 1.6: Room(s)

209 and 949 rooms with carpet 1.7: Project Description *

Replace existing carpet and wall base with new.

1.8: Does this project include multiple tasks/phases? * x Yes 1.8.1: If yes, list phases with estimated start/stop dates below.

Phase 1: 209 1st level, 20 days, 10/21/26-11/10/26.

Phase 2: 209 2nd level, 20 days, 11/11/26-12/1/26.

Phase 3: 949 1st level, 20 days, 12/2/26-12/22/26.

Phase 4: 949 2nd level, 20 days, 12/23/26-1/12/27.

Phase 5: 949 3rd level, 20 days, 1/13/27-2/2/27.

1.9: Start Date *

10/01/2026

1.10: End Date *

02/02/2027

2: Action Item 1: Exits 2.1: Ensure free and unobstructed exits.

Ensure that, at a minimum, the number of exits required by NFPA 101 are accessible (Note per paragraph 7.4 not less than two exits). Post signage identifying the location of alternate exits to everyone affected. Ensure that staff gets additional training when alternative exits are designated. Buildings or areas under construction must maintain escape routes for construction workers at all times and the means of exiting construction areas are inspected daily. * x Yes 2.2: Impacted area/floors (Note: multiple floors may be impacted, particularly if stairwells are involved)

Interim Life Safety Measures (ILSM) 1Continued on the next page.

Impacted area/floors (Note: multiple floors may be impacted, particularly if stairwells are involved) continued

All levels of 209 and 949

2.3: Minimum number of exits required on each impacted floor?

2.4: Number of exits impacted on each floor by this project?

2.5: Number of exits impacted on each floor by other construction projects?

2.6: Total number of accessible exits remaining on each floor?

2.7: Exits requiring signage:

2.8: Information on sign(s):

"INTERIM LIFE SAFETY MEASURE IN PROGRESS USE ALTERNATE EXIT"

2.9: Exit signs to be removed:

Stairwell and corridor signs will be covered in phases, not simultaneously

2.10: Exit signs to be added:

2.11: Attach maps if alternative escape routes will be required.

3: Action Item 2: Emergency Services 3.1: Ensure free an unobstructed access to emergency services.

Emergency equipment, fire alarm pull stations, fire extinguishers, external connections, and other emergency equipment necessary for emergency personnel are clear and accessible at all times. Inspect on a daily basis. * x N/A 3.2: List equipment and locations that must be kept clear and inspected.

Interim Life Safety Measures (ILSM) 2Continued on the next page.

4: Action Item 3: Fire Alarm, Detection, and Suppression 4.1: Ensure that fire alarm, detection, and suppression systems are in good working order.Will any fire alarm, detection or suppression system be out of service more than 8/10 hours respectively in a 24-hour period?If yes, notify the occupants and fire department and have VA Police initiate a fire watch. Notification and fire watch times must be documented. Provide temporary but equivalent system fire alarm and detection systems for use. Inspect, test, and document temporary systems monthly. (JC LS.01.02.01 EP 1). A fire watch may not always be needed if construction activity is planned and proper separation with ILSMs in place.Note: The 2015 edition of the Life Safety Code now refers to the requirements of NFPA 72 where the time requirement is 8 hours. NFPA 101 has referred to the requirements of NFPA 25 since the 2012 Edition of the Life Safety Code, where the time requirement is 10 hours in a 24-hour period. * x No 4.2: Will a temporary system other than fire watch be used?

x N/A 4.2.1: Identify temporary system:

4.3: Will a fire watch be established?

x N/A 4.3.1: Who is responsible for ensuring firewatch activities are completed (i.e. COTR, contractor, ect.)?

4.3.2: Frequency of firewatch walkthroughs (i.e. Every half hour, hourly, ect.) Depending on deficiency.

4.4: Who needs to be notified?

4.5: If VISN fire protection must be notified please indicate date notification was made:

4.6: Ensure telephone operator or after hours the AOD is aware of deficiency(i.e. Fire alarm system disconnected from the city, locations where fire alarm/suppression work is being performed) as thy interact with emergency responders.

4.7: Other Notifications:

4.8: Attach Fire Watch Log

5: Action Item 4: Temporary Construction Partitions

5.1: Temporary construction partitions must be smoke tight and built of noncombustible or limited combustible materials that will not contribute to the development or spread of fire. Any temporary partition that is replacing a fire wall/partition, will maintain the same rating and integrity as the original assembly.

If the level of construction is deemed hazardous and/or the fire suppression system will be impaired for a period of time, a fire barrier of at least 1-hour will be installed between construction and occupied areas. All penetrations must be sealed and ductwork capped at wall, if not continuous. *

Interim Life Safety Measures (ILSM) 3Continued on the next page.

Temporary construction partitions must be smoke tight and built of noncombustible or limited combustible materials that will not contribute to the development or spread of fire. Any temporary partition that is replacing a fire wall/partition, will maintain the same rating and integrity as the original assembly. If the level of construction is deemed hazardous and/or the fire suppression system will be impaired for a period of time, a fire barrier of at least 1-hour will be installed between construction and occupied areas. All penetrations must be sealed and ductwork capped at wall, if not continuous. continued * x No 5.2: Is a partition replacing a fire wall/partition?

x N/A 5.2.1: If yes, identify rating of existing fire wall/partition (i.e. 1 hour, 2 hours, etc.):

5.2.2: If yes, identify rating of the temporary construction partition:

6: Action Item 5: Additional Fire Fighting Equipment 6.1: Provide additional fire-fighting equipment in accessible locations sufficient for the hazards present, if needed. * x N/A 6.2: Is additional equipment required?

x No 6.3: Identify number and location of additional firefighting equipment:

7: Action Item 7: Housekeeping 7.1: Housekeeping Storage, housekeeping, and debris removal practices will be developed and enforced to reduce the combustible fire load to the lowest feasible level. Combustible construction debris will be removed from the site in a timely manner. * x Yes 7.2: Identify project expectations (i.e. work areas will be clean at the end of the shift, inspected daily, etc.)

Work areas shall be kept clean throughout construction to prevent creating obstructions and hazards. Inspections shall be ongoing by the Contractor's Safety Officer to ensure compliance. VA COR may accompany the Contractor's Safety Officer or perform an independent safety inspection at will.

Interim Life Safety Measures (ILSM) 4Continued on the next page.

8: Action Item 8: Fire Drills 8.1: Fire Drills Conduct a minimum of 2 fire drills per shift, per quarter. [Note: This is only required if temporary alarm system is used.] x N/A 8.2: Will a temporary alarm system be used?

If NO, fire drills are not required. No Further requirements for this item.

x No 8.3: Indicate areas where fire drills must be conducted, if temporary alarm system is to be used.

9: Action Item 9: Hazard Surveillance 9.1: Hazard Surveillance Increase hazard surveillance of buildings, grounds, and equipment to manager hazards during construction with attention given to areas, such as construction areas, temporary buildings, combustible storage, excavations, and emergency accessibility and egress. * x N/A 9.2: What hazard surveillance will be performed?

9.3: Who is responsible for hazard surveillance?

9.4: Frequency of surveillance (i.e. daily, weekly, etc.).

10: Action Item 10: Staff Training 10.1: Staff Training Train staff to compensate for impaired structural or compartmentalization features of life safety. * x N/A 10.2: Who requires training?

10.3: Who is responsible for conducting training?

Interim Life Safety Measures (ILSM) 5Continued on the next page.

10.4: Date by which this will be accomplished.

11: Action Item 11: Organization-Wide Life Safety Education 11.1: Organization-Wide Life Safety Education Provide organizational education programs to promote awareness of life safety building deficiencies, construction hazards, and ILSM. * x N/A 11.2: Public Announcements?

x NA 11.2.1: Identify 11.3: Other:

12: Action Item 12: Comments or Other Requirements

* = required field

Interim Life Safety Measures (ILSM) 6This form was generated by LEAF on 7/7/2026