Attachment VIII - PCRA - Elevator Modification.pdf

Preconstruction Risk Assessment and Exposure Control Checklist

Project Name/Project No.: __________________________________________ Date: ______________

Scope of Work Overview:

Other Requirements for above project:

Preliminary Analysis – Project Engineer

Hazard Concern?

(Y/N) Remarks

Asbestos

Lead Base Paint

Confined Space

Dust

Fire & Smoke Walls

Moisture/Water Leaks/Mold

Vapors/Fumes

Noise

Vibration

Air Pressure Relationships

Electrical Modifications

Revised 8/31/22

583-22-101 01/02/2024

Modernize existing A and D wing Elevators which are suffering from control related issues and modify the elevators to meet current criteria and surpass expected life range. The extent of the elevator modernization includes but not limited to the following Control Systems, Electrical Wiring, Door Equipment, Operating Fixtures, Elevator Hoisting Machines with required Deflector Sheaves, Governors and Tail Sheaves, Roller Guides, Elevator Cabs on S11 and S12, Hoistway Door Panels on Elevators P8, P9, P10 and S7, Complete Replacement of the Blood Work DW elevator.

Y Y Y Y Y N N Y Some of the work in blood draw may have to be done after hours

Y Y

Crane Operation

Traffic Flow

Open Outside Walls

Impact to Levels Above and Below

Proximity of Air Intakes

Pest Control Within Construction Area

Proximity of Immune Suppressed Patients

Security Issues/Concerns

ICRA Assessment

ILSM Assessment

Hot Work Permit

TB Risk Assessment

Radiation Safety

National Environmental Policy Act (NEPA) Evaluation – GEMS Coordinator, Jeff Abshire Note: All construction projects shall have a NEPA evaluation conducted per the requirements of Engineering Policy Memorandum 138-48.

NEPA Evaluation Evaluation Completed (Y/N)

Date NEPA Submitted Remarks

NEPA Evaluation submitted to the facility GEMS Manager?

Revised 8/31/22

Y N N

Y N N

Y

N

Y

Y

Y

Y

N

Yes 1/16/2024 Follow guidance in NEPA Document.

Specific Control Measures

Asbestos – Industrial Hygiene (Laura Totten)

Yes/No Measure

Contractor to hire an asbestos abatement contractor for control and cleanup.

VA to hire independent Industrial Hygienist to inspect and clear area for re-occupancy based on monitoring and/or professional judgment.

Published asbestos protocol to be followed for work through ceilings.

Published asbestos protocol to be followed for work above ceilings.

Perimeter barrier to be constructed in the interstitial space to isolate the construction area with other areas in the interstitial.

Project area to be encased with spray-applied hard surface encasement material.

Provide mini containments under negative air in public areas.

Sealed gypsum board barrier to be constructed to isolate the construction area from the public.

Transit panels to be removed, which is considered Class B removal.

Comments:

Lead Base Paint – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

LBP reports available for testing results?

If none are available, hire environmental company for testing.

LBP is present, hire a lead remediation contractor to remove paint according to OSHA’s lead safe work.

Comments:

Revised 8/31/22 n/a n/a n/a n/a n/a n/a n/a n/a n/a

LMT 1/30/2024 - Only if the known ACM will be impacted during this project, requires abatement prior.

Y n/a

LMT 1/30/2024 - Only if the known LBP will be impacted during this project, requires abatement prior or workers trained for OSHA Lead Safe Work Practices.

Confined Space – Safety (Dan Woody)

Yes/No Measure

Obtain an “Entry Permit” from Safety Services prior to entering the confined space.

The Entry Team must be trained as an Entry Supervisor, Attendant, or Entrant.

A specific confined space entry plan and rescue plan must be approved prior to entry into a permit-required confined space.

Safe entry conditions must be achieved before and during confined space entry.

Comments:

Dust – Infection Prevention (Diana Greathouse, Jennifer Buchs, and or Kevin Kniery)

Yes/No Measure

Sealed gypsum board barrier to be constructed to isolate the construction area from the public.

Trash carts will be covered when transported through the building.

Provide negative air machine exhausted too outside.

Provide mini containments under negative air in public areas.

Provide negative air machine in space as air scrubber.

Provide walk off mats at entrances to work area.

Perimeter barrier will be constructed in the interstitial space to isolate the construction area with other areas in the interstitial.

Mist area to decrease dust (outside work)

Provide anteroom under negative pressure at entrance to project zone.

Comments:

Revised 8/31/22

Y Y

Y

Y

LMT 1/30/2024 - See Dan Woody for Entry Permit

Yes Yes

Yes

NA

NA

Yes

NA

NA

Yes

For the dumbwaiter in the blood draw area, negative airflow will be required, but there is no way to exhaust to an outside window.

DLG 2/16/24

Fire & Smoke Walls – Engineering Supervisor and Safety (James Wallace and Bryant Garibay)

Yes/No Measure

Review latest LSC drawings to determine if existing fire and/or smoke walls will be affected.

Risk to be mitigated with ILSM.

2-hour gypsum barrier to be constructed.

Comments:

Moisture/Water Leaks/Mold – IH (Laura Totten)

Yes/No Measure

Contain any water from core drilling activities.

Dike any floor penetrations to minimize risk of leaks from construction zone.

Request assessment for IAC ICRA from Safety. Follow VHA M3P.

Comments:

Vapors/Fumes – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

Use of products with low Volatile Organic Compounds (VOCs).

Provide negative air in construction zone exhausted to outside, away from intakes.

Seal work area airtight barrier.

Cut all metal outside the building.

Seal any floor penetrations to minimize risk of fumes through construction zone.

Shut down air handler to minimize infiltration of fumes from outside.

Use carbon or activated charcoal filters on air scrubbers or negative air machines.

Comments:

Revised 8/31/22

Y Y n/a

LMT 1/30/2024 - Elevator Shaft JPW 13FEB24 - Must have plan to maintain 2 hr fire protection if elevator shaft is open n/a n/a n/a

LMT 1/30/2024

n/a n/a n/a n/a n/a n/a n/a

LMT 1/30/2024

Noise – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

Schedule demolition work after normal work hours.

Cut all metal outside the building.

Comments:

Vibration – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

Schedule demolition work after normal work hours.

Coordinate with occupants in surrounding areas to explain the work occurring.

Comments:

Air Pressure Relationships – Infection Prevention and HVAC Supervisor (Diana Greathouse & Nate Fair)

Yes/No Measure

Provide negative air during asbestos abatement.

Provide negative air during construction.

Seal off supply and exhaust Heating, Ventilation, and Air Conditioning (HVAC) registers.

Comments:

Revised 8/31/22

N Y

LMT 1/30/2024

N Y

LMT 1/30/2024

Y Y

SMR 2/16/24 in basement areas where coring will take place for sump installation

Electrical Modifications – Electric Shop Supervisor (Steve Poynts)

Yes/No Measure

Additional circuits added.

Outlets or lighting moved.

Follow VA Project Electrical Inspection Checklist.

Comments:

Crane Operation – Safety (Dan Woody)

Yes/No Measure

Contact Safety Services for review for any project crane operations.

Comments:

Traffic Control – Engineering Supervisor (James Wallace)

Yes/No Measure

Access construction area via exterior door.

Schedule delivery of large quantities of material and demolition haul out after hours.

Comments:

Open Outside Walls – Engineering Supervisor (James Wallace)

Yes/No Measure

Construct temporary outside wall to limit the infiltration of wind, air, and temperature differences into the project site.

Comments:

Revised 8/31/22

N N Y

None

Y

LMT 1/30/2024 - See Dan Woody - Require Lift Plan for Dan to review prior.

Y Y

Must minimize disruption in elevator lobbies and egress routes. Significant service disruptions must take place outside of core business hours.

NA

JPW

Impact to Levels Above and Below – Safety/IH (Dan Woody or Laura Totten)

Yes/No Measure

Coordinate with occupants in surrounding areas to explain the work occurring.

Follow asbestos protocol when doing under floor work.

Vacate areas when doing below floor work off of the catwalk.

Comments:

Proximity of Air Intakes – HVAC Shop Supervisor and Safety (Nate Fair and Laura Totten)

Yes/No Measure

Shut down air handlers to reduce infiltration of fumes from exterior activities such as painting, gasoline powered engines, roofing operations, equipment, etc.

Comments:

Pest Control Within Construction Area – EMS Supervisor (Robert Franklin)

Yes/No Measure

Provide barriers to any open outside walls.

Contact pest controller if any evidence of pests is found during the course of the work.

Comments:

Proximity of Immune Suppressed Patients – IP (Diana Greathouse, Jennifer Buchs, or Kevin Kniery)

Yes/No Measure

Relocate patients away from construction zone for entire project.

Relocate patients away from construction zone during demolition operations.

Revised 8/31/22

Y N n/a

LMT 1/30/2024 - See Asbestos Comments above.

n/a

LMT 1/30/2024

N/A Y

NO ISSUES FOR EMS -2/13/24

Yes Yes

Work will be done after hours to decrease risk

Comments:

ICRA Assessment – Infection Prevention (Diana Greathouse, Jennifer Buchs, and or Kevin Kniery)

Yes/No Measure

Meet with Infection Prevention to complete ICRA assessment.

Class Assigned – I, II, III, IV, V

Comments:

ILSM Assessment – Engineering Supervisor and Safety (James Wallace and Bryant Garibay)

Yes/No Measure

Meet with VA resident LSC expert to complete ILSM assessment.

ILSM Required

Comments:

Hot Work Permit – Engineering Supervisor (James Wallace)

Yes/No Measure

A Hot Work Permit is required to be issued by the Project COR/Safety prior to completing any welding or brazing on site.

Comments:

Revised 8/31/22

There will be work on the Awing elevators. The infusion clinic is in close proximity to this work.

Yes

II/IV

Elevator shaft and Mechanical spaces will be a class II The lab and the blood draw areas will be a class IV

DLG 2/16/24

Y Y

LMT 1/30/2024

JPW

JPW - Hot Work Permit is required

TB Risk Assessment – IP (Diana Greathouse, Jennifer Buchs and or Kevin Kniery)

Yes/No Measure

The contractor must provide written certification that all contract employees assigned to the work site have had a pre-placement tuberculin screening within 90 days prior to assignment of the worksite and been found to be negative TB screening reactions. (This can be CDC two-step skin testing or an FDA approved blood test). If a positive screen identified, please defer to VHA directive 7715.

Contractors will be required to show documentation of negative TB screening reactions for any additional workers who are added after the 90-day requirement before they will be allowed to work on the site.

Comments:

Radiation Safety – Radiation Safety Officer (Jeff Mason or Mary Ann Spilker)

Yes/No Measure

Radiation shielding and testing will be required during this project.

Comments:

Approval Signatures:

Project Engineer or COR:

GEMS Coordinator:

Industrial Hygiene:

Safety Officer:

Infection Prevention:

Supervisory Engineer or Chief Engineer:

HVAC Supervisor:

Electric Supervisor:

EMS Supervisor:

Radiation Safety Officer:

Revised 8/31/22

No

No

Risk for TB is low, due to work locations and barriers will be in place to separate patients from the work area.

DLG 2/16/24

No

No radiation safety concerns.

LAURA TOTTEN Digitally signed by LAURA TOTTEN Date: 2024.01.31 12:05:43 -05'00'

LAURA TOTTEN Digitally signed by LAURA TOTTEN Date: 2024.01.31 12:06:01 -05'00'

STEPHEN POYNTS

Digitally signed by STEPHEN

POYNTS

Date: 2024.02.13 11:25:10 -05'00'

MARY SPILKER Digitally signed by MARY SPILKER Date: 2024.02.13 11:51:07 -05'00'

ROBERT FRANKLIN Digitally signed by ROBERT FRANKLIN Date: 2024.02.13 12:16:56 -05'00'

JEFFREY ABSHIRE Digitally signed by JEFFREY ABSHIRE Date: 2024.02.13 13:28:45 -05'00'

MALAK K IBRAHIM 3595684

Digitally signed by MALAK K IBRAHIM 3595684 Date: 2024.02.13 13:46:48 -05'00'

JAMES WALLACE Digitally signed by JAMES WALLACE Date: 2024.02.13 15:31:43 -05'00'

SEAN ROSENFELD Digitally signed by SEAN ROSENFELD Date: 2024.02.16 14:53:51 -05'00'

DIANA GREATHOUSE

Digitally signed by DIANA

GREATHOUSE

Date: 2024.03.05 13:15:52 -05'00'