Bldg_4_NW_&_SW_Entrances_&_Stairs_SOW_Attach_3_Activity_Hazard_Analysis_(AHA)_form.pdf

Page 1 of 1 SOW Attachment 3

Activity Hazard Analysis (AHA) Activity/Work Task: Overall Risk Assessment Code (RAC) (Use highest code) X

Project Location: Risk Assessment Code (RAC) Matrix

Contract Number:

Severity

Probability

Date Prepared: Frequent Likely Occasional Seldom Unlikely

Prepared by :

Catastrophic E E H H M

Critical E H H M L

Reviewed by :

Marginal H M M L L

Negligible M L L L L Notes: (Field Notes, Review Comments, etc.)

Step 1: Review each “Hazard” with identified safety “Controls” and determine RAC (See above)

“Probability” is the likelihood to cause an incident, near miss, or accident and identified as: Frequent, Likely, Occasional, Seldom or Unlikely. RAC Chart

“Severity” is the outcome/degree if an incident, near miss, or accident did occur and identified as: Catastrophic, Critical, Marginal, or Negligible

E = Extremely High Risk H = High Risk

Step 2: Identify the RAC (Probability/Severity) as E, H, M, or L for each “Hazard” on AHA. Annotate the overall highest RAC at the top of AHA.

M = Moderate Risk

L = Low Risk

Job Steps Hazards Controls RAC