Attachment J - AHA Activity hazard analysis.pdf
PDF 171 KB Posted
- Solicitation number
- 36C26222B0009_1
About this file
This document contains an activity hazard analysis form and details of a related federal contract opportunity. The activity hazard analysis form is for a pharmacy building breaker replacement and wire installation project at a VA medical center. It lists job steps, hazards, required actions to address hazards, needed equipment, training, and inspections.
The related federal contract opportunity is a solicitation from the VA Long Beach Healthcare System for construction project 600-17-108 involving site preparation for new sterilizers and equipment in building B126. The work includes general construction, alterations, mechanical and electrical work, and necessary demolition to accommodate the new equipment in accordance with specifications, drawings, and applicable building codes. The contracting agency is the VA's Veterans Health Administration VISN 22.
View the file
Other files
Show all 32
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Please wait...
If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.
You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.
For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.
Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.
ACTIVITY HAZARDS ANALYSIS
NWW Form 385-1 (Revised) April 2008 S e v e r i t y Risk Assessment Code Matrix Assess the impact of each hazard in terms of potential loss and cost, based on the probability and severity should an incident occur.
E = Extremely High Risk H = High Risk Probability M = Moderate Risk L = Low Risk E E H H M E H H M L H M M L L M L L L L
JOB STEPS
Break down the job into individual steps, e.g., mobilization, erect forms, erect scaffolding, install reinforcement bar, remove forms, demobilization.
HAZARDS
Identify the hazards, what are the man, machine, and environmental hazard factors of an operation. Note: include hazards that could potentially change the risk, such as weather, changing site conditions, abnormal operating procedures, etc. Do a change analysis when site conditions change.
ACTIONS TO ELIMINATE OR MINIMIZE HAZARDS
List the controls needed to eliminate or reduce the risks. Controls can be in the form of educational controls (training), physical controls (barriers, guards, signs, etc.), Administrative Controls, Personal Protective Equipment, or Engineering Controls. Risk avoidance is another alternative, are there ways to do the job differently so that risks aren't encountered.
RAC
EQUIPMENT
List equipment needed for the job.
TRAINING
List any specialized training or certifications needed for the job.
INSPECTION
List any inspection requirements, before, during, or after the job is completed.
8.0.1291.1.339988.308172 Building 164 outlet install M
| ResetButton1: |
| PrintButton1: |
| Date AHA form was prepared or last revised.: |
| List project name: |
| For multiple job steps, use the highest obtained Risk Code. Note: the risk code is the residual risk after controls have been implemented. The following codes require the appropriate personnel approvals: |
E = Division Commander (E = Extremely High Risk). Equates to loss of ability to accomplish mission if hazards occur during mission.
H = District Commander (H = High Risk). Results in significant degradation of mission capabilities if hazards occur during mission.
M = Program Manager, Project Manager, Project Engineer (M = Moderate). Minor injury, lost workday accident, compensable injury or illness, minor system damage, or minor property damage.
L = First Line Supervisor, Quality Assurance Representative (L = Low). Little or no impact on mission accomplishment.:
| Continuously experiences or occurs very often. Likely to occur often in the life of an item with a probability of occurrence greater than 10-1 in that life.: |
| Occurs frequently. Several times in the life of an item with a probability of occurrence less than 10-1 but greater than 10-2 in that life.: |
| Occurs several times. Likely to occur some time in the life of an item with a probability of occurrence less than 10-2 but greater than 10-3 in that life.: |
| Unlikely but can reasonably be expected to occur. Unlikely but possible to occur in the life of an item with a probability of occurrence less than 10-3 but greater than 10-6 in that life.: |
| Unlikely to occur but possible. So unlikely, it can be assumed occurrence may not be experienced with a probability of occurrence less than 10-6 in that life.: |
| Click to add row: |
| Click to delete row: |
| Could result in injury or occupational illness resulting in one or more lost work days, loss exceeding $10K but less than $200K, or mitigable (minor) environmental damage without violation of law or regulation where restoration activities can be accomplished for the environment. Lost day due to injury or illness not exceeding 3 months (accident risk).: |
| Could result in injury or illness not resulting in a lost work day, loss exceeding $2K but less than $10K, or minimal environmental damage not violating law or regulation. A first aid or minor medical treatment (accident risk). Slight equipment or system damage but fully functional and serviceable. Little or no property or environmental damage.: |
| Describe specific activity in which this AHA form is being prepared for, i.e., Unit 2 Annual Maintenance.: Breaker replacement and wire installation |
| Give location, i.e., McNary Dam Fish Facility.: Building 164 Pharmacy |
| Who prepared this analysis?: Mommerency, Micheal |
| JobSteps: Remove panel cover and deadfront |
| JobSteps: Remove existing wire and breaker |
| JobSteps: Install new breaker and wire |
| JobSteps: Reinstall panel cover and dead front |
| Hazards: Electrocution |
| Hazards: Arc Flash |
| Hazards: Electrocution |
| Hazards: Electrocution |
| Actions: Wear proper PPE and use insulated tools. Ensure the area is clear of debris and all unnecessary tools and equipment. |
| Actions: Inspect panel for anything issues. Use insulated tools and ensure all parts removed from the panel are at a safe distance form the energized panel. Have additional personnel providing safety watch. |
| Actions: Wear proper PPE and use insulated tools. Ensure the area is clear of debris and all unnecessary tools and equipment. |
| Actions: Wear proper PPE and use insulated tools. Ensure the area is clear of debris and all unnecessary tools and equipment. |
| Select risk assessment code from drop down list based on matrix above: 2 |
| Select risk assessment code from drop down list based on matrix above: 2 |
| Select risk assessment code from drop down list based on matrix above: 2 |
| Select risk assessment code from drop down list based on matrix above: 2 |
| Equipment: Insulated tools |
| Equipment: PPE |
| Training: |
| Inspections: |
| TextField9: Becerra, Eddy |
Truong, Nghiem Rattanasavanh, Austin SignatureField1:
File details come from the government source that posted it. Updated .