Attachment 5 Activity Hazard Analysis Form.docx
DOCX document 28 KB Posted
- Attached to
- NSWCPD BLDG 77H Remove/Replace HP Split-Systems Federal contract opportunity
- Solicitation number
- N6449823R4040
About this file
This document contains an Activity Hazard Analysis (AHA) form and details of a related federal contract opportunity for building services. The AHA form outlines job steps, anticipated hazards, required controls, and risk assessment codes for work removing and replacing split-system air conditioning units. It specifies training needs, inspections, and signatures required from the prime contractor, safety and health supervisor, and quality control manager.
The related federal contract opportunity is issued by the Naval Sea Systems Command to remove and replace split-system air conditioning units in Building 77H at the Naval Surface Warfare Center in Panama City, Florida. It provides information on the solicitation number, opportunity type, and awarding agency.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 14 Jobsite Pictures.pdf | ||
| N6449823R4040 Amendment 0001.pdf | ||
| N6449823R4040.pdf | ||
| Attachment 8 Condenser Layout.pdf | ||
| Attachment 4 Mobile Construction Equipment Checklist.pdf | ||
| Attachment 13 Bid Bond SF24.pdf | ||
| Attachment 9 HP Main Distribution Panel between Columns D13 and D14.pdf | ||
| Attachment 2 Contractor Production Report Form.doc | DOC document | |
| Attachment 11 HP-data.xlsx | XLSX spreadsheet | |
| Attachment 10 Integrated Ship Control and Diagnostic Facility 03051999.pdf | ||
| Attachment 3 Requirements for Contractor Lift Operations.pdf | ||
| Attachment 7 AHU Layout.pdf | ||
| Attachment 1 Site Map - PNBC.pdf | ||
| Attachment 6 SECNAV 5512.pdf | ||
| Attachment 12 Past Performance Questionnaire (PPQ).doc | DOC document |
Show all 15
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
EM385-1-1 (30NOV14) UFGS 103526 11/15
Activity Hazard Analysis (AHA)
Contractor Name ( Performing the Work):
Overall Risk Assessment Code (RAC) (Use highest code )
Foreman Signature (Pe r forming the Wor k):
AHA Prepared by (Name/Title):
| Activity/Work Task: |
| Risk Assessment Code (RAC) Matrix |
AHA Signature Log #
Probability
| Contract Number: |
| Severity |
| Frequent |
| Likely |
| Occasional |
| Seldom |
| Unlikely |
| Date Prepared: |
| Catastrophic |
| E |
| E |
| H |
| H |
| M |
| Project Location: |
| Critical |
| E |
| H |
| H |
| M |
| L |
| PRIME CONTRACTOR SECTION: REV IEW ED BY: SIGNATUR E REQUIRED |
| Marginal |
| H |
| M |
| M |
| L |
| L |
| SSHO Signature: |
| Negligible |
| M |
| L |
| L |
| L |
| L |
| QC Manager Signature: |
| Step 1: Review each Hazard with identified |
"Controls". Determine RAC (see above).
Prime Superintendent Signature:
RAC CHART
| Notes: |
| Probability: Likelihood the activity will cause a Mishap (Near Miss, Incident, or Accident). Identify as Frequent, Likely, Occasional, Seldom or Unlikely |
E = Extremely High Risk
| Identify as Catastrophic, Critical, Marginal, or Negligible |
| H = High Risk |
Step 2: Identify the RAC (probability vs. severity) as E, H, M, or L for each "Hazard" on AHA.
Annotate the overall highest RAC at the top of the AHA
M= Moderate Risk
L = Low Risk
| Job Steps (Work Sequences) |
| Specific Anticipated Hazards |
| Controls |
| RAC |
| Job Steps (Work Sequences) |
| Specific Anticipated Hazards |
| Controls |
| RAC |
| Equipment to be used |
| Training Requirements & Competent or Qualified Personnel Name(s) |
| Inspection Requirements |
UFGS 013526 11/15 1.9 Government reserves the right to require the Contractor to revise and resubmit the AHA if it f ails to ef f ectively identif y the w ork sequences; specific anticipated hazards, site conditions, equipment, materials, personnel and the control measures to be implemented.
UFGS 013526 1.9.1 Review the AHA list periodically (at least monthly) at supervisory safety meetings, update w hen procedures, scheduling or hazards change.
UFGS 013526 1.9.2 Each employee perf orming w ork...must review the AHA and sign a signature log f or that AHA prior to starting w ork. The SSHO must maintain a signature log on site f or every AHA
SOW Attachment 5 Activity Hazard Analysis Form
File details come from the government source that posted it. Updated .