Attachment 4 504-24-009 Swing Space ILSM.pdf

Interim Life Safety Measures (ILSM) Evaluation Attachment A

ILSM No. Date:

Project No.

Project Title:

The following ILSM will be evaluated individually and initiated as needed to compensate for hazardous conditions as a result of construction or existing significant life safety code deficiencies. ILSM implementation will be documented on Attachment A-2.

1. Please provide summary of work to be completed in the space provided below:

2. Ensuring free and unobstructed exits. Buildings or areas under construction must maintain escape routes at all times for all occupants including construction workers. Affected personnel will be trained on any designated alternate exits. Exits in construction areas will be inspected daily.

Will any exit paths (means of egress) be obstructed or compromised? Yes No N/A

NOTE: All contracted construction projects shall have this specified as descried in the VA Master Construction

Specification Section 01 00 00, Part 1.5.G & H, Means of Egress and Egress Routes, respectively.

3. Ensuring that fire alarm, detection and suppression systems are in good working order. A temporary, equivalent system will be provided when any fire system is impaired. Temporary systems will be inspected and tested monthly and results recorded.

Will any fire system(s) be impaired? Yes No N/A

NOTE: All contracted construction projects shall have this specified as described in the VA Master Construction

Specification Section 01 00 00, Part 1.5.L, M & N, Sprinklers, Existing Fire Protection and Smoke Detectors, respectively.

4. Providing additional fire-fighting equipment.

Does the affected area warrant placement of additional fire protection equipment? Yes No N/A

NOTE: All contracted construction projects shall have this specified as described in the VA Master Construction

Specification Section 01 00 00, Part 1.5.I, Fire Extinguishers.

5. Ensuring that temporary construction partitions are smoke tight and built of noncombustible or limited combustible materials that will not contribute to the development or spread of fire.

Will construction involve the use of temporary partitions? Yes No N/A

NOTE: All contracted construction projects shall have this specified as descried in the VA Master Construction

Specification Section 01 00 00, Part 1.5.E, Temporary Construction Partitions.

Interim Life Safety Measures (ILSM) Evaluation

6. Increasing hazard surveillance of buildings, grounds, and equipment with special attention to excavations, construction areas, construction storage, and field offices.

Does project/deficiency present added hazards, such as: excavations; construction Yes No N/A storage; or field offices, which warrant increased hazard surveillance?

NOTE: All contracted construction projects shall have this specified as descried in the VA Master Construction

Specification Section 01 00 00, Part 1.5.J & P, Flammable and Combustible Liquids and Fire Hazard Prevention and Safety

Inspections, respectively.

7. Developing and enforcing storage, housekeeping, and debris removal practices that reduce the flammable and combustible fire load of the building to the lowest feasible level.

Does project/deficiency involve the storage of flammable/combustible materials? Yes No N/A

NOTE: All contracted construction projects shall have this specified as descried in the VA Master Construction

Specification Section 01 00 00, Part 1.5.J, Flammable and Combustible Liquids.

8. Providing additional training to those who work in the hospital on the use of firefighting equipment.

Does project/deficiency warrant additional training on use of firefighting equipment? Yes No N/A

9. Conducting one additional fire drill per shift per quarter. The Project Engineer/COR will inform the Safety Manager of the need to conduct more fire drills. The Safety Manager/Specialist will assume responsibility for completing the drills.

Does project/deficiency warrant additional fire drills? Yes No N/A

10. Inspecting and testing of temporary systems monthly. The completion date of the tests shall be documented.

Will project/deficiency require installation of temporary systems? Yes No N/A

NOTE: All contracted construction projects shall have this specified as descried in the VA Master Construction

Specification Section 01 00 00, Part 1.5.F & N, Temporary Heating and Electrical and Smoke Detectors, respectively.

11. Training staff to compensate for impaired structural or compartmentalization features of fire safety.

Will project/deficiency affect structural or compartmental fire safety features? Yes No N/A

12. Conducting organization-wide or specific to affected area occupants safety education programs to promote awareness of any life safety building deficiencies, construction hazards, and ILSM.

Does project/deficiency present Life Safety Code deficiencies or construction hazards, Yes No N/A which warrant facility-wide education of personnel concerning these Interim Life Safety Measures?

ILSM Evaluation completed by: ___________________________________________ Date: _______________

Additional Notes/Comments:

Interim Life Safety Measures (ILSM) Attachment B

ILSM No. Date:

Project No.

Project Title:

Description of Interim Life Safety Measures to be Implemented and Maintained:

Instructions: Based on the responses to the evaluation questions, provide a description of the Interim Life Safety Measures that will be implemented during the project to compensate for the deficiency or condition. Form to be posted at entrances to project areas.

Signatures required as indicated below. Completed form will be maintained in the Safety and Project files.

Issued by:

Safety Manager: ___________________________________________ Date: _______________

This project will:

- Install Walls from Deck to Ceiling and install various Mechanical, Electrical and Plumbing lines in Building 12.

- Install Walls from Deck to Deck and install various Mechanical and Electrical in Building 44.

- Will Construct a new for Office Space / Mail Room and Storage Space for EMS and Mailroom.

- Will cause various shutdowns that will be localized to the area being worked on other than Fire Suppression updates as needed.

Textfield0: Standard ILSM Requirements:

- ILSM #1. Prompt notification to the Amarillo fire department and Allstate Security and initiation of a fire watch in the event a fire alarm is out of service 4 hours in a 24 hour period OR sprinkler system is out of service more than 10 hours in a 24 hour period in an occupied building. Notification and fire watch times are documented.

NOTE: If proper separation and ILSM is appropriately implemented, it is considered that no parties are left unprotected by the renovation. Therefore, neither a fire watch or evacuation is required.

- ILSM #2 If egress paths and/or exits are effected, signage identifying location of alternative exits must be posted for everyone effected.

- ILMS #3. Contractors will cooperate with facility Safety staff (e.g., Construction Safety Specialist) during daily and routine inspections. Additionally, all deficiencies noted must be corrected within the same business day or have an action plan approved by the COR and AVAHCS Safety Officer.

Life Safety Deficiencies as a Result of Construction Activities:

Life Safety Deficiencies as a Result of Construction Activities:

ILSM 1- Will any exit paths (means of egress) be obstructed or compromised? During construction exit paths will be not be blocked a) If egress paths and/or exits are effected, signage identifying location of alternative exits must be posted for everyone effected.

ILSM 2- Will construction involve the use of temporary partitions? At this time no actions are scheduled that are expected to generate dust. If the barriers are erected they will not block any signage or exits.

ILSM 3- Does project/deficiency present Life Safety Code deficiencies or construction hazards, which warrant facility-wide education of personnel concerning these Interim Life Safety Measures? No.