Attachment 9 - Pre-Construction Risk Assessment (PCRA) - MTZ Parking Structure.pdf

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Y1LZ--Construct Parking Structure Replacing Expiring Lease Design-Build - Martinez - 612-165 (VA-22-00043313)
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36C77623R0068
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Pre-Construction Risk Assessment (PCRA) VA Northern California Health Care System

Attachment A Policy Statement 138-56 March 1, 2019

Pre-Construction Risk Assessment

Project Name: Planned Project Start Date:

Project Number:

PM / COR P.O.C.: P.O.C. extension:

Location of Construction: Estimated Duration:

Safety/Life Safety Risk Assessment-Safety officer should be involved in the design/planning of all projects

Y N FIRE AND LIFE SAFETY IMPACTS

Will egress routes and exit signage from occupied areas remain unchanged? If No, ILSM is needed.

Will exit stairs remain unobstructed with appropriate fire protection? If No, ILSM is needed.

Will fire & smoke compartments remain intact & unchanged? If No, ILSM is needed.

Will fire alarm and detection systems remain functional & unimpaired; outages <4 hours?

If No, ILSM is needed.

Will fire suppression systems remain functional & unimpaired; outages <10 hours? If No, ILSM is needed.

Will construction area be separated by solid non-combustible smoke tight partitions? If No, ILSM is needed.

Will emergency access by Fire Department remain unobstructed? If No, ILSM is needed.

Will hot work be performed? If Yes, submit hot work permit to Safety

Will the project introduce other significant hazards? If Yes, describe below

Y N CONSTRUCTION ACTIVITY

Will there be any anticipated utility shutdowns? (Communications, electrical, heating/cooling, HVAC, medical gases, vacuum, water, sewer)

If Yes, describe necessary mitigation below

Will there be nuisance noise levels for adjacent areas? If Yes, describe necessary mitigation below Will vibration levels be affect operations of sensitive medical equipment? If Yes, describe necessary mitigation below

Y N PHYSICAL SECURITY IMPACTS

Will the construction compromise security? If Yes, describe necessary mitigation below

Y N CONTRACT COMPLIANCE

Will contract clauses be included for enforcement of identified risks? If Yes, describe necessary mitigation below

Y N ENVIRONMENTAL

Will the project require a NEPA assessment? Contact GEMS for a determination. If Yes, submit draft NEPA to GEMS

Will the project require a permit from the Air Quality District? Contact GEMS for a determination. If Yes, submit draft to GEMS

Will this project require a storm water permit? Contact GEMS for a determination. If Yes, submit draft to GEMS

Y N HAZARDOUS MATERIALS

Will this contract disturb known asbestos containing material (ACM)? Contact Safety for a determination. If Yes, describe necessary intervention:

Will this contract complete work with a biological area such as a lab? If Yes, Facility Specific Training required.

Will contract require the use of hazardous chemicals? If Yes, review by facility IH is required

Y N INFECTION CONTROL

Will this contract require an Infection Control Risk Assessment? If Yes, ICRA shall be completed prior to construction start.

Additional Requirements and Description of Mitigation:

Construction Safety Specialist / Safety Specialist Signature: Date:

Infection Control Representative Signature: Date:

VA Police Signature: Date:

Project Section Manager Signature: Date:

Safety/Life Safety Risk Assessment-Safety officer should be involved in the design/planning of all projects
Y
N
FIRE AND LIFE SAFETY IMPACTS
Y
N
CONSTRUCTION ACTIVITY
Y
N
Y
N
Y
N
Y
N
Y
N
Project Name: Construct Parking Structure Replacing Expiring Lease
PM COR POC: Hari Kushwaha
POC extension: 925-372-2529
Location of Construction: MTZ campus-AB5,AB6 and AB7
Estimated Duration: 400 days
Additional Requirements and Description of Mitigation: This Project Includes the following:

Demolish Bldgs AB5,AB6 and AB7, Construct Parking Structure Replacing Expiring Lease.

The Project is not connected to any existing Bldgs, and located approximately 200 meters from TBI and CREC(B20). A diagram showing the location of the construction site is enclosed for reference.

1-The construction area will be fenced out .

2-During the demolition activities water will be sprayed to keep the dust down.

Project Number: 612-165
Date1_af_date: 1/21/2021
2020-06-25T10:28:43-0700
GARRETT S. OLVERA 1014406
2020-06-25T12:17:39-0700
JEFFREY S. DAILEY 459086
2020-06-25T10:53:31-0700
George Ponce 362482
2020-07-10T09:27:16-0700
Jonathan L. Bassignani 326635
Date6_af_date: 6/25/20
Date7_af_date:
Date8_af_date: 6/25/20
Date9_af_date: 7/10/20
Check Box1: Yes
Check Box2: Off
Check Box3: Yes
Check Box4: Off
Check Box5: Yes
Check Box6: Off
Check Box7: Yes
Check Box8: Off
Check Box9: Yes
Check Box10: Off
Check Box11: Yes
Check Box12: Off
Check Box13: Yes
Check Box14: Off
Check Box15: Yes
Check Box16: Off
Check Box17: Off
Check Box18: Yes
Check Box19: Yes
Check Box20: Off
Check Box21: Off
Check Box22: Yes
Check Box23: Off
Check Box24: Yes
Check Box25: Off
Check Box26: Yes
Check Box27: Off
Check Box28: Yes
Check Box29: Yes
Check Box30: Off
Check Box31: Off
Check Box32: Yes
Check Box33: Yes
Check Box34: Off
Check Box35: Off
Check Box36: Yes
Check Box37: Off
Check Box38: Yes
Check Box39: Off
Check Box40: Yes
Check Box41: Yes
Check Box42: Off
Text43:

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