A 02 CES HEC Equipment Survey_Nov_19_Safety.xlsx

XLSX spreadsheet 224 KB Posted Aug 25, 2020

Attached to: Hazardous Energy Control Procedures
Solicitation number: W50S9G20Q0010
Issued by: Department of the Army Wisconsin Army National Guard

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File	Type	Posted
b 08 QA HEC Procedures 8SEP20.docx	DOCX document	Sep 8, 2020
FAR 52.204-24 Offeror Representations.pdf	PDF	Aug 25, 2020
B 04 SCA Wage Determination.pdf	PDF	Aug 25, 2020
FAR Clause 52_204_25 Prohibition.docx	DOCX document	Aug 25, 2020
A 02 Scope of Work - CE HEC_Final.pdf	PDF	Aug 25, 2020

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INSTRUCTIONS FOR SURVEY

General information on LOTO

- If in the Survey you identified that personnel are exposed to any type of hazardous energy you must have a Hazardous Energy Control program and written procedures for that task.

- Here are the exceptions to the Hazardous Energy Control Procedures:

-Minor tool changes, replacing or changing drill bit on drill press, changing tool on mill or lathe, ect.
-If there is a plug and cord that can be controlled by the employee and there are not any other sources of energy.
-Employees do not perform any routine service or maintenance on machine or equipment. The Authorized	Employee, maintenance technician, who is performing maintenance will apply their LOTO procedures while they	perform maintenance.

This describes the survey process working from left to right on the spreadsheet. First block is the equipment #, second column is the Machine/Equipment column and so on.

1. Survey work place for any machines or equipment that may need Hazardous Energy Control procedures. Annotate in Spreadsheet in appropriate column.

2. After all machines/equipment have been identified describe any servicing, maintenance, or repairs that your personnel would perform. Utilize one block per task and be sure to include tool changes or point of operation tasks that may endanger personnel.

3. Identify all hazards that personnel will be exposed to. One hazard per block.

4. Identify who specifically will be exposed the hazard

5. Using the categories on the right side of the page, input severity and likelihood to get initial risk without any control measure in place.

6. Now describe any control measures that have been put in place. These would be LOTO procedures, JSA, Locally Written instructions, PPE, Guarding, ect.

7. Now fill in the Residual Risk after control measures are in place. The Severity cannot change unless you eliminate the task or equipment only the likelihood can change.

CLIN0001 Base Bid

	WORKCENTER HAZARDOUS ENERGY SURVEY
		Group:	MSG	Squadron:	CES	Shop:
		Date:		Supervisor:		STATE EMPLOYEE
	#			Job/Task	Hazards
			Machine / Equipment		Hazard & Effect	At Risk
		BLDG
#	Basic description of tasks performed	Description and effect of existing and potential hazards based on observations and experience.	Personnel or groups exposed.
	1	104	OVERHEAD GARAGE DOORS				1
	2	127	OVERHEAD GARAGE DOORS				2
	3	208	MITSUBISHI A/C UNIT, FCU-1				4
	4	208	TRANE A/C UNIT FCU-3
	5	208	MITSUBISHI A/C UNIT, FCU-2
	6	208	AIRCRAFT HANGER A/C				1
	7	208	ATLAS COPCO, AIR COMPRESSOR AIR DRYER, R134A				2
	8	208	MARLEY ENTRANCE HEADER NORTH EAST ENTRANCE				3
	9	208	MARLEY ENTRANCE HEADER SOUTH EAST ENTRANCE				4
	10	208	MARLEY ENTRANCE HEADER WEST ENTRANCE				5
	11	208	DIRECT DRIVE EXHAUST FAN EF-5
	12	208	EXHAUST FAN #28
	13	208	EXHAUST FAN EF-3
	14	208	EXHAUST FAN EF-4
	15	208	EXHAUST FAN EF-1
	16	208	EXHAUST FAN #18
	17	208	EXHAUST FAN #19
	18	208	EXHAUST FAN EF-20
	19	208	EXHAUST FAN EF-11
	20	208	EXHAUST FAN #2
	21	208	EXHAUST FAN #6
	22	208	EXHAUST FAN #7
	23	208	EXHAUST FAN #8
	24	208	EXHAUST FAN #9
	25	208	EXHAUST FAN #10
	26	208	EXHAUST FAN #12
	27	208	EXHAUST FAN #13
	28	208	EXHAUST FAN #14
	29	208	EXHAUST FAN #15
	30	208	EXHAUST FAN #16
	31	208	EXHAUST FAN #17
	32	208	EXHAUST FAN #21
	33	208	EXHAUST FAN #22
	34	208	EXHAUST FAN #23
	35	208	EXHAUST FAN #24
	36	208	EXHAUST FAN #25
	37	208	EXHAUST FAN #26
	38	208	EXHAUST FAN #27
	39	208	EXHAUST FAN EF-1
	40	208	EXHAUST FAN EF-2
	41	208	EXHAUST FAN EF-3
	42	208	EXHAUST FAN EF-4
	43	208	GAS FURNACE
	44	208	HEAT EXCHANGER RTU-6
	45	208	HEAT EXCHANGER
	46	208	HEAT EXCHANGER, UH-12
	47	208	HEAT EXCHANGER, UH15
	48	208	HANGAR UNIT HEATERS, AIR CONDITIONING CONDENSING UNITS, 1206
	49	208	HANGAR UNIT HEATERS, AIR CONDITIONING CONDENSING UNITS, 1207
	50	208	2 HEATING AND VENTILATION HANGAR UNIT HEATERS ,1213
	51	208	3 HEATING AND VENTILATION HANGAR UNIT HEATERS, 1214
	52	208	HANGAR UNIT HEATERS, 1215
	53	208	HANGAR UNIT HEATERS, 1216
	54	208	HANGAR UNIT HEATERS, 1217
	55	208	MAKE UP AIR UNIT #2
	56	208	MAKE UP AIR UNIT #1
	57	208	MAKE UP AIR UNIT MUA-3
	58	208	MAKE UP AIR UNIT #3
	59	208	RCP-1

RADIANT CEILING PANEL (ELECTRIC)

60 208 RCP-2

RADIANT CEILING PANEL (ELECTRIC)

61 208 RCP-3

RADIANT CEILING PANEL (ELECTRIC)

62	208	IR HEATER # 1
63	208	IR HEATER # 2
64	208	IR HEATER # 3
65	208	IR HEATER # 4
66	208	IR HEATER # 6
67	208	IR HEATER # 7
68	208	IR HEATER # 8
69	208	IR HEATER # 9
70	208	IR HEATER # 10
71	208	IR HEATER # 11
72	208	IR HEATER # 12
73	208	IR HEATER # 13
74	208	IR HEATER # 14
75	208	ROOFTOP PACKAGE UNIT - RTU-4
76	208	ROOFTOP PACKAGE UNIT - RTU-3
77	208	ROOFTOP PACKAGE UNIT - RTU-5
78	208	ROOFTOP PACKAGE UNIT - RTU-8
79	208	ROOFTOP PACKAGE UNIT - RTU-16
80	208	ROOFTOP PACKAGE UNIT - RTU-12
81	208	ROOFTOP PACKAGE UNIT - RTU-1
82	208	ROOFTOP PACKAGE UNIT - RTU-13
83	208	ROOFTOP PACKAGE UNIT - RTU-2
84	208	ROOFTOP PACKAGE UNIT - RTU-11
85	208	ROOFTOP PACKAGE UNIT - RTU-7
86	208	ROOFTOP PACKAGE UNIT - RTU-17
87	208	ROOFTOP PACKAGE UNIT - RTU-6
88	208	ROOFTOP PACKAGE UNIT - RTU-10
89	208	ROOFTOP PACKAGE UNIT - RTU-17, AAON
90	208	ROOFTOP PACKAGE UNIT - RTU-9
91	208	ROOFTOP PACKAGE UNIT - RTU-11
92	208	UNIT HEATER UH-1
93	208	UNIT HEATER UH-2
94	208	UNIT HEATER UH-3
95	208	UNIT HEATER UH-4
96	208	UNIT HEATER UH-5
97	208	UNIT HEATER UH-6
98	208	UNIT HEATER UH-7
99	208	UNIT HEATER UH-8
100	208	UNIT HEATER UH-9
101	208	UNIT HEATER UH-10
102	208	UNIT HEATER UH-11
103	208	UNIT HEATER UH-13
104	208	UNIT HEATER UH-14
105	208	UNIT HEATER UH-16
106	208	UNIT HEATER UH-17
107	208	UNIT HEATER UH-18
108	208	UNIT HEATER UH-19
109	208	UNIT HEATER UH-20
110	208	UNIT HEATER UH-21
111	208	UNIT HEATER UH-22
112	208	CABINET UNIT HEATER, CUH-1
113	208	CABINET UNIT HEATER, CUH-2
114	208	CABINET UNIT HEATER, CUH-3
115	208	CABINET UNIT HEATER, CUH-4
116	208	CABINET UNIT HEATER, CUH-5
117	208	CABINET UNIT HEATER, CUH-6
118	208	CABINET UNIT HEATER, CUH-7
119	208	CABINET UNIT HEATER, CUH-8
120	208	CABINET UNIT HEATER, CUH-9
121	208	CABINET UNIT HEATER, CUH-10
122	208	CABINET UNIT HEATER, CUH-19
123	208	CABINET UNIT HEATER, CUH-12
124	208	CABINET UNIT HEATER, CUH-13
125	208	HANGER DOORS, WEST
126	208	HANGER OVERHEAD DOOR, EAST
127	208	HANGER OVERHEAD DOOR , NORTH
128	208	HANGER OVERHEAD DOOR, SOUTH
129	208	ENGINE SHOP OVERHEAD DOOR
130	208	AVIONICS OVERHEAED DOOR
131	304	INGERSOLL RAND AIR DRYER
132	304	PHEUMATECH AIR DRYER
133	304	AIR HANDLER UNIT # 1
134	304	AIR HANDLER UNIT # 2
135	304	AIR HANDLER UNIT # 3
136	304	AHU-2

MAKEUP AIR UNIT

MEZZANINE UNIT

137 304 AHU-1

MAKEUP AIR UNIT

WELDING SHOP

138	304	AIR HANDLER AHU-3
139	304	IR-1

CO-RAY-VAC INFRA RED

N.E.

140	304	EXHAUST FAN EF-1
141	304	EXHAUST FAN EF-2
142	304	EXHAUST FAN EF-3
143	304	EXHAUST FAN EF-4
144	304	EXHAUST FAN EF-9
145	304	EXHAUST FAN EF-10
146	304	EXHAUST FAN EF-5
147	304	EXHAUST FAN EF-6
148	304	EXHAUST FAN EF-8
149	304	EXHAUST FAN EF-7
150	304	NORTH A/C NOSE DOCK GEN,HVAC INFARED HEATING
151	304	MAU-4

SOUTHSIDE DOCK

152 304 FMU-1

STANDING FLOOR UNIT

153 304 FMU-3

STANDING FLOOR UNIT

154	304	X-1 UPPER NORTH MAKEUP AIR UNIT
155	304	X-2 UPPER NORTH MAKEUP AIR UNIT
156	304	MUA-1

WEST HANGAR

157 304 IR-2

CO-RAY-VAC INFRA RED

S.E.

158 304 IR-3

N.W. UNIT

INFRA-RED HEAT

159 304 IR-4

INFRA-RED HEAT

S.W. UNIT

160	304	UNIT HEATER, UH-1
161	304	UNIT HEATER, UH-2
162	304	UNIT HEATER, UH-3
163	304	UNIT HEATER, UH-4
164	304	UNIT HEATER, UH-5
165	304	UNIT HEATER, UH-6
166	304	UNIT HEATER, UH-7
167	304	UNIT HEATER, UH-8
168	304	HANGER DOOR, NORTH WEST
169	304	HANGER DOOR, SOUTH WEST
170	304	HANGER OVERHEAD DOOR SOUTH
171	304	HANGER OVERHEAD DOOR, EAST
172	304	HANGER OVERHEAD DOOR, METALS TECHNOLOGY
173	304	OVERHEAD DOOR CORROSION EXTERIOR
174	304	OVERHEAD DOOR CORROSION TO HANGER
175	304	OVERHEAD DOOR BLAST ROOM TO PAINT ROOM
176	304	OVERHEAD DOOR METALS TECHNOLOGY EXERIOR, EAST
177	306	OVERHEAD DOOR STRUCTURAL REPAIR EXERIOR
178	306	OVERHEAD DOOR BETWEEN METALS TECH AND STRUCTRUAL REPAIR
179	306	OVERHEAD DOOR FIRE SUPPRESION SYSTEM
180	306	MAKEUP AIR UNIT #3

LOWER ROOF TOP

181 306 AHU-3

OLD WELD SHOP

LOCKER ROOM

182 306 ACCU-4

SPLIT A/C SYSTEM

WELD SHOP OFFICE

183	306	EXHAUST FAN 1
184	306	EXHAUST FAN 2
185	306	EXHAUST FAN 3
186	306	EXHAUST FAN 4
187	306	EXHAUST FAN 1L
188	306	EXHAUST FAN 2L
189	306	CUH-1

FAN/COIL UNIT

FLIGHT LINE

190 306 CUH-1

FAN/COIL UNIT

FLIGHT LINE

191	306	FLIGHTLINE,HVAC SYSTEMS GENERAL
192	306	ROOF TOP UNIT #2
193	306	RTU-3

LOWER ROOF

ROOF TOP UNIT

194 306 RTU-2

UPPER ROOF

ROOF TOP UNIT

195 306 RTU-1

LOWER ROOF

ROOF TOP UNIT

196 306 RTU-4

S/M OFFICE

EAST UNIT

197	306	FLIGHT LINE LOWER ROOF TOP UNIT
198	306	FTR-1

VINYL ROOM

HW HEAT

199 306 U.H-8

HANGING UNIT

SHEET METAL SHOP 19

FAN/COIL

200 306 U.H-9

SHEET METAL SHOP

HANGING UNIT

FAN/COIL

201 306 U.H-6

HANGING UNIT

FIRE SUPPRESSION

FAN/COIL

202	308	AIR COMPRESSOR DRYER
203	308	AIR HANDLER UNIT-1
204	308	FLOOR HEATER UNIT# 2
205	308	FLOOR HEATER UNIT#1
206	308	FLOOR HEATER UNIT#1
207	308	AHU-1 MEZZAININE UNIT
208	308	AHU-2 MEZZAININE UNIT
209	308	BOILER #1	AERCO
210	308	BOILER #2	AERCO
211	308	BOILER #3	AERCO
212	308	BOILER #4	AERCO
213	308	BOILER #5	AERCO
214	308	BOILER #6	AERCO
215	308	P-1, 2-CIRC. PUMPS	WILO
216	308	P-2, 2-CIRC. PUMPS	TACO
217	308	AC-2 CONDENSOR UNIT 2
218	308	AC-1 CONDENSOR UNIT
219	308	AC-1 CONDENSOR UNIT, ACCU-1
220	308	EXHAUST FAN EF-1
221	308	EXHAUST FAN EF-2
222	308	EXHAUST FAN EF-3
223	308	EXHAUST FAN EF-4
224	308	EXHAUST FAN EF-5
225	308	EXHAUST FAN EF-6
226	308	EXHAUST FAN EF-1A
227	308	EXHAUST FAN EF-6
228	308	EXHAUST FAN EF-7
229	308	EXHAUST FAN EF-8
230	308	EXHAUST FAN EF-9
231	308	EXHAUST FAN EF-10
232	308	EXHAUST FAN EF-11
233	308	EXHAUST FAN EF-12
234	308	MAU-1
235	308	MAU-7
236	308	PUMP, BCP-1
237	308	PUMP, BCP-2
238	308	PUMP, BCP-3
239	308	PUMP, BCP-4
240	308	PUMP, BCP-5
241	308	PUMP, BCP-6
242	308	ROOF TOP UNIT, RTU-1
243	308	ROOF TOP UNIT, RTU-8
244	308	ROOF TOP UNIT #1
245	308	IR-1, WEST HANGAR

INFRA RED HEATER

246 308 IR-2, EAST HANGAR

INFRA RED HEATER

247	308	AC-1, CONDENSING UNIT
248	308	UNIT HEATER
249	308	WATER HEATER 100 GAL
250	308	SOUTH A/C DOCK,STRUCT HANGER DOORS
251	308	SOUTH A/C DOCK,OVERHEAD DOORS

CLIN0002 Opt 1

	WORKCENTER HAZARDOUS ENERGY SURVEY
		Group:	MSG	Squadron:	CES	Shop:
		Date:		Supervisor:		STATE EMPLOYEE
	#			Job/Task	Hazards
			Machine / Equipment		Hazard & Effect	At Risk
		BLDG
#	Basic description of tasks performed	Description and effect of existing and potential hazards based on observations and experience.	Personnel or groups exposed.
	1	401	AIR_CONDITIONER ACCU-1					1
	2	401	AIR_CONDITIONER ACCU-2					2
	3	401	AIR_CONDITIONER, UNIT #74					4
	4	401	AIR_DRYER, AD-1
	5	401	AIR_CONDITIONER, UNIT #70
	6	401	AIR HANDLER UNIT ABOVE MEZZ CENTER					1
	7	401	AIR_HANDLER, SZ AHU BOSS					2
	8	401	AIR_HANDLER AHU-1
SOUTH							3
	9	401	AIR_HANDLER AHU-2
NORTH							4
	10	401	AIR_HANDLER AHU-1
SIMULATOR							5
	11	401	BOILER-1
	12	401	BOILER-2
	13	401	BOILER-3
	14	401	BOILER B-1
	15	401	BOILER B-1 Simulator
	16	401	BOILER B-3
	17	401	CHILLER, CH-1
	18	401	COMPRESSOR SIM
	19	401	ENTRANCE HEATER, EH-1
	20	401	ENTRANCE HEATER, EH-2
	21	401	SIMULATOR EVAPORATOR
	22	401	EXHAUST FAN, EF-153
	23	401	EXHAUST FAN, EF-154
	24	401	EXHAUST FAN, EF-165
	25	401	EXHAUST FAN, EF-166
	26	401	FAN/ COIL, FCU-2 SIM
	27	401	FAN/ COIL, FCU-1 SIM
	28	401	SIMULATOR HUMIDIFIER
	29	401	BOSS HUMIDIFIER
	30	401	CIRCULAR PUMP-1
	31	401	CIRCULAR PUMP-2
	32	401	CIRCULATION PUMP - MEZZANINE
	33	401	PUMP-1
	34	401	PUMP-2
	35	401	PUMP MOTOR, P-1
	36	401	PUMP MOTOR, P-2
	37	401	PUMP MOTOR, P-3
	38	401	PUMP MOTOR, P-4
	39	401	PUMP MOTOR, P-5
	40	401	PUMP MOTOR, P-6
	41	401	ROOF TOP UNIT
	42	401	DOMESTIC HOT WATER RECIRCULATION PUMP, P-1
	43	401	ROOF TOP UNIT-48
	44	401	ROOF TOP UNIT-47
	45	401	ROOF TOP UNIT-37
	46	401	ROOF TOP UNIT-74
	47	401	ROOF TOP UNIT, YORK
	48	401	ENERGY RECOVERY VENTILATION, ERV-1
	49	401	RELIEF FAN NORTH RF-1
	50	401	RELIEF FAN NORTH RF-2
	51	401	UNIT HEATER NORTH GATE
	52	401	UNIT HEATER, UH-3
	53	401	UNIT HEATER, UH-4
	54	401	UNIT HEATER, UH-5
	55	401	UNIT HEATER, UH-6
	56	401	UNIT HEATER, UH-7
	57	401	UNIT HEATER, UH-8
	58	401	UNIT HEATER, UH-9
	59	401	UNIT HEATER, UH-11
	60	401	UNIT HEATER, UH-12
	61	401	UNIT HEATER, UH-13
	62	401	UNIT HEATER, UH-14
	63	401	UNIT HEATER, UH-15
	64	401	UNIT HEATER, UH-16
	65	401	UNIT HEATER, UH-17
	66	401	UNIT HEATER, UH-19
	67	401	UNIT HEATER, UH-150
	68	401	UNIT HEATER, UH-166
	69	401	UNIT HEATER, UH-165
	70	401	UNIT HEATER, UH-1
	71	401	UNIT HEATER, UH-2
	72	401	50 GALLON WATER HEATER
	73	500	HEATING UNIT-PHARMACY
	74	500	CONDENSING UNIT #29
	75	500	CONDENSING UNIT #30
	76	500	AC-30 A/C SPLIT SYSTEM DSS
	77	500	A/C SPLIT SYSTEM-4
	78	500	AC-5 A/C SPLIT SYSTEM
	79	500	AC-6 A/C SPLIT SYSTEM
	80	500	AC-29 A/C SPLIT SYSTEM

HSS

81	500	A/C SPLIT SYSTEM AC-1
82	500	A/C SPLIT SYSTEM

EAST OFFICES

83	500	SUPPLY BLDG,HVAC AIR DISTIBUTION
84	500	BOILER, B-1
85	500	BOILER, B-2
86	500	CUH-1

NE ENTRANCE WALL HEATER

87	500	EXHAUST FAN 4
88	500	EXHAUST FAN EF-1
89	500	EXHAUST FAN EF-2
90	500	EXHAUST FAN EF-3
91	500	FAN/ COIL FCU-1
92	500	FAN/ COIL FCU-2
93	500	MAKEUP AIR UNIT, MAU-1
94	500	PACKAGE UNIT #27
95	500	PACKAGE UNIT #28
96	500	PUMP P-15
97	500	PUMP P-16
98	500	PUMP P-17
99	500	PUMP P-18
100	500	RTU-1

ROOF TOP UNIT-27 NORTH ROOF

101 500 RTU-2

ROOF TOP UNIT-28 NORTH ROOF

102 500 RTU-3

HAZ-MAT BUILDING

103 500 RTU-4

2ND FLOOR

104 500 PRV-1

POWER ROOF VENT

105 500 PRV-2

POWER ROOF VENT

106 500 PRV-3

POWER ROOF VENT

107 500 DSS-1

FAN/COIL/SALT

BREAKROOM COOLING

108 500 DSS-2

COOLING (SALT)

109	500	FTR-1 HEAT
110	500	HEATER, TRANE
111	500	OH HEATER-13, UH-1
112	500	OH HEATER-13, UH-2
113	500	OH HEATER-13, UH-3
114	500	OH HEATER-13, UH-4
115	500	OH HEATER-13, UH-5
116	500	OH HEATER-13, UH-6
117	500	OH HEATER-13, UH-7
118	500	OH HEATER-13, UH-8
119	500	CUH-1

WALL HEATER

NE ENTRANCE

120	512	EMERGENCY GENERATOR
121	512	AIR DRYER-43
122	512	AIR COMPRESSOR-4
123	512	AIR_CONDITIONER, AAON UNIT
124	512	AC-82

AC SPLIT SYSTEM-82

125	512	AIR_CONDITIONER, AAON UNIT -1
126	512	A.C.50

A/C SPLIT SYSTEM-50

127 512 A.C.50

A/C SPLIT SYSTEM-51

128 512 A.C.50

A/C SPLIT SYSTEM-52

129 512 A.C.50

A/C SPLIT SYSTEM-53

130 512 A.C.50

A/C SPLIT SYSTEM-54

131 512 A.C.50

A/C SPLIT SYSTEM-55

132	512	A.C.50 A/C SPLIT SYSTEM-56
133	512	A.C.50 A/C SPLIT SYSTEM-65
134	512	A.C.50 A/C SPLIT SYSTEM-61
135	512	A.C.50 A/C SPLIT SYSTEM-62
136	512	A.C.50 A/C SPLIT SYSTEM-63
137	512	A.C.50 A/C SPLIT SYSTEM-64
138	512	A.C.50 A/C SPLIT SYSTEM-65
139	512	A.C.50 A/C SPLIT SYSTEM-66
140	512	A.C.50 A/C SPLIT SYSTEM-38
141	512	A.C.50 A/C SPLIT SYSTEM-68
142	512	A.C.50 A/C SPLIT SYSTEM-69
143	512	A.C.50 A/C SPLIT SYSTEM-40
144	512	A.C.50 A/C SPLIT SYSTEM-81
145	512	AHU-1

AIR HANDLER UNIT-13

146	512	FCU-2 AIR HANDLER UNIT-45 FILTER BOX CREDIT UNION
147	512	FCU-1

AIR HANDLER UNIT-44

148 512 CUH-6

FAN COIL-11 EAST ENTRY

149 512 CUH-1

FAN/COIL-7

150 512 CUH-4

FAN/COIL-12

151 512 CUH-3

FAN/COIL-15

152 512 CUH-5

FAN/COIL-14

153	512	COIL, CUH-2
154	512	COIL

CENTER HALL CEILING

155	512	CONDENSING UNIT-38
156	512	CONDENSING UNIT-40
157	512	CONDENSING UNIT-36
158	512	ENTRANCE HEATER
159	512	ENTRANCE HEATER
160	512	ENTRANCE HEATER
161	512	ENTRANCE HEATER
162	512	ENTRANCE HEATER
163	512	ENTRANCE HEATER
164	512	EXHAUST FAN, EF-1
165	512	EXHAUST FAN, EF-2
166	512	EXHAUST FAN, EF-3
167	512	EXHAUST FAN, EF-4
168	512	HUMIDIFIER

LAN ROOM

169 512 P-20

PUMP-2 CIRCULATION

170 512 P-19

PUMP-48A CIRCULATION

171 512 RTU-6

ROOF TOP UNIT-35 CSC

AHU ONLY

172 512 RTU-5

ROOF TOP UNIT-70

173 512 RTU-4

ROOF TOP UNIT-37 SERVER/LAN ROOM, ROOF

BACK-UP UNIT

174 512 RTU-3

ROOF TOP UNIT-79 EAST ROOF H+C

175 512 RTU-2

ROOF TUP UNIT-71

176 512 RTU-1

ROOF TOP UNIT-60 CLUB

177	512	RTU #1
178	512	ROOF TOP UNIT #3
179	512	ROOF TOP UNIT #4
180	512	ROOF TOP UNIT #5
181	512	ROOF TOP UNIT #6
182	512	ROOF TOP UNIT #2
183	512	WH-1

WATER HEATER-2

CLIN0003 Opt 2

	WORKCENTER HAZARDOUS ENERGY SURVEY
		Group:	MSG	Squadron:	CES	Shop:
		Date:		Supervisor:		STATE EMPLOYEE
	#			Job/Task	Hazards
			Machine / Equipment		Hazard & Effect	At Risk
		BLDG
#	Basic description of tasks performed	Description and effect of existing and potential hazards based on observations and experience.	Personnel or groups exposed.
	1	POL	EXHAUST FAN #1					1
	2	POL	FILTER SEPERATOR #1					2
	3	POL	FILTER SEPERATOR #2					4
	4	POL	FILTER SEPERATOR #3
	5	POL	FILTER SEPERATOR #4
	6	POL	FILTER SEPERATOR #5					1
	7	POL	AC-1
SPLIT A/C SYSTEM							2
	8	POL	AC-2
SPLIT A/C SYSTEM							3
	9	POL	EXHAUST FAN #1					4
	10	POL	EXHAUST FAN #2					5
	11	POL	EXHAUST FAN #3
	12	POL	KOHLER 200KW GENERATOR
	13	POL	FILTER SEPERATOR #6
	14	POL	FILTER SEPERATOR #7
	15	POL	EXHAUST FAN, EF-1
	16	POL	MAKEUP AIR UNIT MUA-1
	17	611	A/C CONDENSING UNIT, AC-3
	18	611	ACCU# 2 MEDICS
	19	611	ACCU#1
	20	611	A/C UNIT-16 MEDICS, SMALL
	21	611	AHU-4

AIR HANDLER UNIT KITCHEN

22	611	AIR HANDLER UNIT DINING HALL
23	611	AIR HANDLER UNIT#1 MEDICS-LARGE
24	611	AHU-3

DINING HALL (19)

25	611	BOILER, B-1
26	611	BOILER, B-2
27	611	ENTRANCE HEATER
28	611	CUH #1 ENTRANCE HEATER
29	611	CUH #2 ENTRANCE HEATER
30	611	CUH #3 ENTRANCE HEATER
31	611	CUH #5 ENTRANCE HEATER
32	611	EXHAUST FAN EF-1
33	611	EXHAUST FAN EF-13
34	611	EXHAUST FAN EF-3
35	611	EXHAUST FAN EF-4
36	611	EXHAUST FAN EF-5
37	611	EXHAUST FAN EF-6
38	611	EXHAUST FAN EF-7
39	611	EXHAUST FAN EF-8
40	611	EXHAUST FAN EF-9
41	611	EXHAUST FAN EF-10
42	611	FTR-6

HEATER

43	611	CIRCULATION PUMP
44	611	PUMP #1
45	611	PUMP #2
46	611	PUMP #3
47	611	PUMP #4
48	611	PUMP #5
49	611	HOT WATER RECIRCULATION PUMP (KITCHEN)
50	611	HOT WATER RECIRCULATION PUMP DOMESTIC WATER
51	611	CUH-2

SOUTH MAIN ENTRY HEATER

52 611 CUH-1

NORTH MAIN ENTRY HEATER

53 611 CUH-4

CEILING HEATER

54 611 FTR-5

HEATER

55 611 FTR-8

HEATER

56 611 FTR-10

HEATER

57 611 FTR-1

FINTUBE

DINNING HALL WINDOW

58 611 FTR-2

DISHWASHER HEATER

59 611 FTR-3

JANITORS CLOSET

60 611 FTR-4

STORE ROOM EAST

FINTUB

61 611 FTR-5

MENS RESTROOM

HALLWAY HEATER

62 611 FTR-6

WOMENS RESTROOM HEAT

HALLWAY (RADIATION)

63 611 FTR-7

WEST ENTRANCE

64 611 FTR-8

WOMENS RESTROOM

FINTUBE

65 611 FTR-9

KITCHEN

WOMENS SHOWER

FINTUBE

66 611 FTR-10

MENS KITCHEN RESTROOM DINNING HALL

67 611 FTR-11

MENS KITCHEN

SHOWER RESTROOM HEATER

FINTUBE

68	611	UNIT HEATER, UH-1
69	611	UNIT HEATER, UH-2
70	701	AIR COMPRESSOR (SHOP AIR)
71	701	AIR COMPRESSOR
72	701	ACCU-1

AIR CONDITIONING ROOF UNIT -UNIT#34

J/C CONDENSING UNIT

73	701	COMM ROOM DUCTLESS SPLIT SYSTEM
74	701	VEHICLE BAY AIR HANDLER
75	701	AIR HANDLER - CARPENTER SHOP
76	701	AHU-1

AIR HANDLER UNIT-1

77	701	AIR HANDLER UNIT-2
78	701	BOILER, B-1
79	701	BOILER, B-2
80	701	P-4

CIRCULATING PUMP - HEATING WATER

81	701	DUST COLLECTOR -UNIT #29
82	701	EUH-1

ELECTRIC HEATER

83	701	ENTRANCE HEATER - UNIT#16 OFFICE
84	701	H-1

ENTRANCE HEATER -WEST ENTRANCE -UNIT#17

85 701 EXHAUST FAN, EF-1

WEST ROOF

86	701	EXHAUST FAN, EF-3
87	701	EXHAUST FAN, EF-4
88	701	EXHAUST FAN, EF-5
89	701	EXHAUST FAN, EF-6
90	701	EXHAUST FAN, EF-2
91	701	EXHAUST FAN, EF-7
92	701	UH-3

OVERHEAD HEATER - UNIT #

93 701 UH-4

OVERHEAD HEATER - UNIT #4

94 701 UH-7

OVERHEAD HEATER UNIT #7

95 701 UH-8

OVERHEAT HEATER UNIT #8

96 701 UH-9

OVERHEAD HEATER UNIT #9

97 701 UH-10

OVERHEAD HEATER UNIT #10

98 701 UH-11

OVERHEAD HEATER UNIT #11

99 701 UH-12

OVERHEAD HEATER UNIT #12

100	701	OVERHEAD HEATER, SUPPLY RM, UH-1
101	701	OVERHEAD HEATER, PAINT ROOM, UNIT#22
102	701	OVERHEAD HEATER #12
103	701	PUMP, NOW 2009
104	701	PUMP
105	701	PUMP, P-3
106	701	P-1

BOILER PUMP

107 701 P-2

BOILER PUMP

108	701	ROOF TOP UNIT
109	701	ROOF VENTILATOR -UNIT #7
110	701	ROOF VENTILATOR -UNIT #6
111	701	ROOF VENTILATOR -UNIT #26
112	701	IR HEAT, IR-1
113	701	IR HEAT, IR-2
114	701	IR HEAT, IR-3
115	701	SF-1

OFFICE SUPPLY FAN

116	701	UNIT HEATER, UH-1
117	701	UNIT HEATER, UH-2
118	701	UNIT HEATER, UH-13
119	701	WATER HEATER - UNIT#15
120	701	CE BLDG.,OVERHEAD DOORS
121	706	AIR CONDITIONER, AC-1
122	706	AIR HANDLER UNIT, AHU-1
123	706	AIR HANDLER UNIT, AHU-2
124	706	AIR HANDLER UNIT, AHU-3
125	706	B-1

BOILER # PF514

MECH

126	706	BOILER ROOM EXHAUST FAN #1
127	706	BOILER ROOM EXHAUST FAN #2
128	706	BOILER ROOM EXHAUST FAN #3
129	706	EXHAUST FAN #4
130	706	EXHAUST FAN #1
131	706	EXHAUST FAN #6
132	706	EXHAUST FAN #7
133	706	EXHAUST FAN, EF-1
134	706	EXHAUST FAN, EF-2
135	706	EXHAUST FAN, EF-3
136	706	EXHAUST FAN, EF-4
137	706	EXHAUST FAN, EF-5
138	706	EXHAUST FAN, EF-6
139	706	EXHAUST FAN, EF-7
140	706	EXHAUST FAN, EF-8
141	706	EXHAUST FAN, EF-9
142	706	EXHAUST FAN, EF-10
143	706	EXHAUST FAN, EF-11
144	706	EXHAUST FAN, EF-12
145	706	PUMP P-1
146	706	PUMP P-2
147	706	COIL PUMP, CP-2
148	706	COIL PUMP, CP-3
149	706	UNIT HEATER, UH-1
150	706	UNIT HEATER, UH-2
151	706	UNIT HEATER, UH-3
152	706	UNIT HEATER, UH-4
153	706	UNIT HEATER, UH-5
154	706	VEHICLE MAIT,OVERHEAD DOORS
155	723	HEAT PUMP, HP-1
156	723	HEAT PUMP, HP-2
157	723	HEAT PUMP, HP-3
158	723	ENERGY RECOVERY VENTILATOR, ERV-1
159	723	ENERGY RECOVERY VENTILATOR, ERV-2

Risk Matrix

		Risk Matrix		Likelihood / Probability					Residual Risk Level
				Improbable / Rarely (L1)	Very Unlikely (L2)	Unlikely (L3)	Likely (L4)	Very Likely (L5)
				Little or no chance of occurrence	Expected to occur at some point	Could occur and is Likely to occur several times	Could occur and is Very Likely to occur frequently	Frequent, continuously occurs	Level of Risk Acceptance	Risk Level
		Severity	Catastrophic (S4)
(Death, Loss of Asset, Perminant Disability)	Moderate Risk	Substantial Risk	High Risk	Very High Risk	Very High Risk		Wing Commander	Very High Risk
				4	8	12	16	20		16 - 20
			Critical (S3)
(Severe injury, Partial Disability or Damaged Equipment)	Low Risk	Moderate Risk	Substantial Risk	High Risk	Very High Risk		Group Commander	High Risk
				3	6	9	12	15		12
			Moderate (S2)
(Minor Injury, Medical Attention, minor damage to equipment)	Low Risk	Moderate Risk	Moderate Risk	Substantial Risk	High Risk		Squadron Commander	Substantial Risk
				2	4	6	8	10		9
			Negligable (S1)
(First Aid or less, insignifianct damage to equipment)	Very Low Risk	Low Risk	Low Risk	Moderate Risk	Moderate Risk		Flight Chief	Moderate Risk
				1	2	3	4	5		6
									Shop Chief	Low Risk
										3
									Shop Chief	Very Low Risk
										1

Sample

Job Risk Analysis
Dept:		Job:		Assessors:				Date:
#	Job Steps	Hazards		Initial Risk			Controls	Residual Risk
		Hazard & Effect	At Risk	Severity	Likelihood	Risk Rating		Severity	Likelihood	Risk Rating
	Basic description of tasks recorded in sequence.	Description and effect of existing and potential hazards based on observations and experience.	Population or groups exposed.	S Code	L Code	Priority Risk Code	Describe necessary controls for each hazard using the Hierarchy of Controls method.	S Code	L Code	Priority Risk Code
1	Worker reaches into bin next to machine, grasps with one hand a 15-pound casting and carries to grinding wheel 10’ away every 2 minutes.	1) MSD to back, and hands from bending into bin and lifting;	Metal workers in Metal shop	3	3	9	1) Open-side, tilted and self-adjusting bins to reduce reach	2	1	2
		2) lacerations to hand from sharp burrs/edges of casting;		2	3	6	2) Cut-resistant gloves and sleeves	1	2	2
		3) tripping or slipping on items while carrying parts		3	2	6	3) 5S system, hose reels, pre-inspection, and housekeeping	2	1	2
2	Worker holds piece with both hands at grinder to deburr edges for ~ 1 minute	4) MSD to hands from static muscle loading	Same	3	3	9	4) Use fixture to hold piece while grinding	2	2	4
		5) abrasions from grinder		2	3	6	5) Use fixture to hold piece while grinding	2	2	4
		6) eye and face injury from flying particles from grinding		3	4	12	6) Use ANSI Z87 eye protection and face shield	2	2	4
3	Place piece in finished bin adjacent to grinder	7) MSD to back twisting & tossing pieces	Same	3	3	9	7) Place bin in position where twisting is not required	2	2	4

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File details come from the government source that posted it. Updated Aug 25, 2020.