Exhibit E - AHA Example ENG Form 6206.pdf

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LRL FORM 1259, JAN 2023

U.S. Army Corps of Engineers, Louisville District

ACTIVITY HAZARD ANALYSIS (AHA)

The proponent agency is CELRL-SO.

Gloves 05.A.08 Gloves Safety Glasses 05.B.01 Safety Glasses Hard Hat 05.D.01 Hard Hat Fall Protection 05.H Fall Protection Safety Boot 05.E Safety Boot Reflective Vests 05.F Reflective Vest

E = EXTREMELY HIGH RISK H = HIGH RISK

P r o b a b i l i t y

M = MODERATE RISK L = LOW RISK

FREQUENT

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.

LIKELY

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.

OCCASIONAL

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.

SELDOM

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

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.

Catastrophic Could result in death or permanent total disability (accident risk). Loss of major system or equipment. Major property (facility) damage exceeding $1M. Severe or irreversible environmental damage that violates law or regulation.

E E H H M Critical Could result in permanent partial disability, injuries or illnesses, that may result in the hospitalization of at least 3 personnel or temporary total disability exceeding 3 months time (accident risk). Extensive (major) damage to equipment or systems or property exceeding $200K but less than $1M. Reversible environmental damage causing a violation of law or regulation.

E H H M L Marginal 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).

H M M L L Negligible 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.

M L L L L S e v e r i t y Job Steps Hazards Actions to Eliminate or Minimize Hazards

EM 385-1-1 (PARA REF)

RAC

EQUIPMENT

TRAINING

INSPECTION

COMPETENT/QUALIFIED PERSON(S) - SIGNATURE

TITLE

DATE

Personnel Involved - SIGNATURE

TITLE

DATE

mary.a.herrick@usace.army.mil Forms Design Team Mary Ann Herrick 20230131 2022-08-24

LRL 1259 JAN 2023 ACTIVITY HAZARD ANALYSIS

LRL 1259 JAN 2023 ACTIVITY HAZARD ANALYSIS

M

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.: