TF SAFE - DRAFT PWS Attachment B - UFC Inspection Templates.pdf

Preliminary Evaluation Checklist for Building Occupancy

BUILDING DESCRIPTION:

LOCATION: BLDG NO.:

INSPECTOR: DATE/TIME:

General Personal Safety:

Basic parameters to ensure safety when conducting occupancy assessments:

• Always wear standard issue personal protective equipment (PPE).

• Work in teams of at least 2 or have means of communication to response personnel

• Be alert for falling objects or tripping hazards Equipment:

See Chapter 3 of the UFC for a list of equipment typically used for these evaluations.

Evaluation Process:

Complete the checklist in the order it is arranged. Initially assess the building from the exterior. Then perform an initial interior walk-thru to expeditiously assess issues that may prevent occupancy. Finally, assess interior discipline-specific issues.

PRELIMINARY EVALUATION SUMMARY

Complete summaries below and outline results of the evaluation regarding the following:

• Any conditions discovered that restrict/prevent occupancy

• Any required or recommended mitigations to allow safe occupancy

• Any conditions requiring “Reachback” assistance

Entries must be signed by each inspector and the Officer in Charge If resources are available, Preliminary and Detailed Evaluations should be performed together.

Discipline/System Inspection Summary Structural Systems

Inspector Signature:

Fire Protection

Inspector Signature:

Electrical/ Telecom

Inspector Signature:

Mechanical/ Plumbing

Inspector Signature:

INSPECTION RECOMMENDATION

PRELIMINARY EVALUATION

Building can be occupied as-is for 90 days (no deficiencies found) Building can be occupied for 90 days following mitigations summarized above Prior to initial occupancy “Reachback” is required as outlined above Building occupancy can be extended for an additional 90-day period

Officer-in-Charge Signature:__________________________

ATTACHMENT 3

LOCATION: BLDG NO.:

INSPECTOR: DATE/TIME:

PRELIMINARY EVALUATION

Note: The Preliminary Evaluation is a limited assessment to identify extreme hazards that pose an imminent risk to life safety or health, and to provide limited safety for immediate but limited-use occupancy.

Due to the minimal scope of the preliminary evaluation, significant risks may exist even with a successful evaluation. Valid for 90 days. For extended occupancy, Primary and Detailed Evaluations can be performed concurrently

BUILDING CHARACTERISTICS

Proposed Building Usage Number of Stories Building Height Footprint Area (square feet) Past Building Usage Type of Construction Year Constructed GPS Coordinates

HISTORY OF BUILDING/FACILITY DATA

Note: the following valuable information can be obtained from Host Nation or local residents

Building documentation (as-builts) available?

When was building last occupied?

Who lived/worked in building?

Are prior occupants still in area?

What activities were performed in the building?

BUILDING SKETCH

INSPECTOR:

CONDITION ASSESSED

CONDITION

FOUND? SUGGESTED ACTION

Exterior Assessment Collapse or partial collapse of building Do not enter Building noticeably leaning Do not enter Building shifted off foundation Do not enter Numerous cracks more than 1/8 in. wide in exterior walls

Do not enter

Building has significant blast or fire damage Do not enter Items that could fall on personnel

- Loose pieces of building walls

- Broken or loose parapets

- Built up snow or ice on roof

- Damaged low roof over entrance

Remove loose items or block access to areas under loose items.

Downed power lines De-energize power systems Damaged or displaced gas lines Shut off gas, or vacate area Signs of previous industrial operations or hazardous material/waste release. Signs of hazardous material/waste releases include:

- Open or damaged containers

- Observed spills or releases

- Detection of odors or physical reactions (e.g., dizziness, nausea, eye/skin irritation)

- Broken or ruptured piping

Do not enter, report in accordance with reporting requirements

Partial control of site by DoD Do not occupy unless control allows safe occupancy Initial Walk-Thru

Partial control of building by DoD Do not occupy unless security controls allow safe occupancy

Existence of unexploded ordnance, explosives, or chemicals

Evacuate and report in accordance with reporting requirements

Rodent, insect or animal infestations Do not occupy Waste, sewage or standing water in bldg. Do not occupy Signs of excessive mold Do not occupy Exposed/disturbed insulation Do not occupy unless determined not to be hazardous Isolated collapse of building structure Evacuate collapsed area Open flames Evacuate Evidence of gas leaks Evacuate Inspect roof for loose equipment and falling hazards Mitigate hazard Structural Interior Issues Walls or columns visibly leaning, bent, cracked, or broken

Do not occupy

Floor or roof structural members sagging, cracked, broken, or separated from their supports

Do not occupy or if problem areas are localized, block access to damaged areas.

Structural members significantly deteriorated – rust, rot, or infested by termites

Do not occupy or if problem areas are localized, block access to damaged areas.

Structural members badly burned or twisted/sagging from fire

Do not occupy or if problem areas are localized, block access to damaged areas.

CONDITION

FOUND? SUGGESTED ACTION

Items that could fall on personnel

- Loose pieces of walls, ceilings, or finishes

- Loose ductwork or overhead equipment

- Other miscellaneous non-structural items

Remove loose items or block access to areas under loose items.

Fire Protection Issues Building occupied at levels more than 2 stories above grade

Building occupied in a sub-basement (more than one story below grade).

(Occupancy includes use of the space for other than mechanical/electrical rooms, lookout/security rooms, or storage rooms)

Locate occupied spaces of building only 2 stories above grade. Do not occupy sub-basements.

Conduct detailed evaluation to determine if allowable to occupy higher stories.

Areas inside buildings occupied by fueled airplanes or vehicles

Mitigation measures (complete one of the following prior to and during occupancy):

1) Remove airplanes, vehicles from building,

2) Remove fuel from this equipment, store fuel outside building Hazardous Areas or equipment that is not enclosed by walls on all sides (cut-off rooms).

- An area with flammable liquid use or storage, fuel storage, or flammable gas storage

- Battery storage with batteries sized over 10 cu. ft.

(0.283 m3) in volume (total size)

- An area with fuel-fired equipment (boilers, air handlers, hot water heaters)

- An area with Oil-filled transformers

- Areas with over 1,000 sq. ft. (92.9 sq. m) of stored combustible materials (paper, plastic, or wooden materials)

- An area with combustible storage stacked over 12

ft. (3.66 m) high above the floor

-An area with hazardous waste storage (flammable, corrosive or noxious chemicals)

Prior to occupancy:

1) Remove flammable liquids use and storage from premise,

2) Remove hazardous equipment from service,

3) For storage areas, remove storage, or provide a minimum 50 ft. (15.2 m) of space separation between occupied space and storage and a 24 hour fire watch,

4) Remove hazardous waste from building prior to occupancy.

CONDITION

FOUND? SUGGESTED ACTION

Deficient Egress Issues exist, including:

- Number of exits from any building story is less than two (exits are doors to the exterior, an exterior stairway, or an interior stairway enclosed by walls)

- Dead-bolt type locks on egress doors from occupied spaces

- Paths to exits from occupied spaces through storage areas with no other exit path available

- Paths to exits from occupied areas through hazardous areas with no other exit path available

- Paths to exits are blocked by storage.

- Exit stairs are used for storage.

Prior to occupancy:

1) Do not occupy a story with less than 2 exits.

2) Remove dead bolt type locks from egress doors.

3) Remove storage or hazardous process from building.

4) Remove hazardous process from service.

5) Provide additional exit option avoiding storage area or hazardous area.

6) Remove storage from exit paths.

Exposed plastic foam insulation or corkboard on walls or ceilings in occupied spaces

Remove insulation or corkboard prior to occupancy

Mechanical and Plumbing Issues Sanitary piping and venting is not properly configured and traps are not sealed

Occupy, but do not use systems and apply warning signs

Roof drainage and overflow drainage piping show evidence of leakage

Occupy, but perform any readily achievable drainage system repairs prior to occupancy

Roof drains show evidence of blockages Occupy , but remove any roof drain blockages prior to occupancy

Fuel-fired heating system is in operation Occupy, but de-energize heating system until Detailed Evaluation is completed

Hazardous or chemical storage areas do not have appropriate containment, ventilation and safety features

Occupy, but do not store chemicals in these areas

*Electrical and Telecommunications Systems

Is existing electrical system de-energized Do not energize electrical system until Detailed Evaluation is completed

Is existing electrical power system energized and was facility recently occupied

Do not de-energize and do not use electrical power system until proven safe through completion of a Detailed Evaluation

Survey the building and look for any exposed conductors.

Occupy, close off any rooms with exposed wiring and provide a warning sign. Where exposed wiring is found in areas that cannot be closed off, de-energize the systems per info below.

*Note: De-energized existing electrical systems cannot be energized until a Detailed Evaluation is conducted. Energized existing electrical systems cannot be used until a Detailed Evaluation is conducted.

Additional Notes on Preliminary Evaluation Issues and Mitigation Actions:

UFC 1-201-02

Draft – 1 January 2014

APPENDIX E DETAILED EVALUATION CHECKLIST

This checklist can be printed and used to assess existing facilities being considered for extended occupancy up to 5 years. The checklist covers Detailed Evaluations and correlates to the technical content within Chapter 4 of this UFC.

Detailed Evaluation Checklist for Building Occupancy

DETAILED EVALUATION SUMMARY

Complete the summaries below and outline the results of the building evaluation regarding the following conditions:

• Any conditions discovered that restrict/prevent occupancy

• Any required or recommended mitigations to allow safe occupancy

• Any conditions requiring “Reachback” assistance Entries must be signed by each inspector and the Officer-in-Charge.

Discipline/System Inspection Summary Structural Systems

Inspector Signature:

Fire Protection

Electrical/ Telecom

Mechanical/ Plumbing

INSPECTION RECOMMENDATION

DETAILED EVALUATION

Building can be occupied as-is for 5 years (no deficiencies found) Building can be occupied for 5 years following mitigations summarized above Prior to extended occupancy “Reachback” is required as outlined above

Officer-in-Charge Signature:__________________________

DETAILED EVALUATION

Note: The Detailed Evaluation identifies hazards that pose near-term risks to life safety and health, and provides minimal safety and habitability for longer-term occupancy (5 years) than the preliminary evaluation. The Detailed Evaluation does not address all safety and habitability requirements that are specified in UFC 1-201-01 and addressed in an Engineering Assessment. For items answered as “Yes”, see section number reference in UFC for mitigation options.

BUILDING CHARACTERISTICS

Proposed Building Usage Number of Stories Building Height Footprint Area (square feet) Past Building Usage Type of Construction Year Constructed GPS Coordinates

BUILDING SKETCH

STRUCTURAL SYSTEMS INSPECTOR:

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Overall Structural Damage Collapse or partial collapse 4-3.3 Building or story leaning more than 4 in.

(100 mm) or H/200 (H=bldg or story height in inches)

4-3.3

Foundation damage or building shifted off foundation

4-3.3

Building in zone of suspected slope instability, sinkholes, or erosion

4-3.3

Building below region of potential landslide 4-3.3 Significant exterior wall cracks or offsets 4-3.3 Significant blast or fire damage 4-3.3 Items that could fall on personnel

- Loose pieces of parapets and facades

- Built up snow or ice on roof

- Damaged or poorly attached entrance canopies

Damage to Structural Framing Components

Leaning: Columns, piers, or bearing walls more than 4 in. (100 mm ) or H/200 (H=bldg or story height in inches)

Buckling: Columns, piers, diagonal bracing, or bearing walls

4-3.3

Damage to horizontal framing members:

Cracking with vertical or horizontal displacement in any horizontal framing member.

Roof or floor framing sloping or sagging in excess of L/180, or separation from walls or other supports

Damage to vertical framing members:

Cracking with vertical or horizontal Displacement in any vertical framing member.

Connections: Visible damage to connections

4-3.3

Bracing: Broken, bent, or damaged bracing members

4-3.3

Connection to foundation: Damaged connections between structural members and foundations.

Fire: Section loss, twisting, warping, or spalling in structural members from fire

STRUCTURAL SYSTEMS INSPECTOR:

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Deterioration: Rotting or insect infested wood, corroded steel, spalled concrete, freeze-thaw damaged masonry or concrete.

Falling Hazards: Any loose or damaged structural framing, finishes, equipment, or other items that could fall on occupants

Additional Notes on Structural Systems and Mitigation Actions:

DETAILED EVALUATION (continued)

FIRE PROTECTION ISSUES

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Conditions Requiring Field Mitigation or Reachback

Building separation not adequate. 4-4.2.1 Seal up openings in exterior walls.

Planned occupancy of floors more than 3 stories above grade.

4-4.2.2

Occupy building only to a maximum of 3 stories above grade. Contact Reachback for assistance.

Planned occupancy of floors more than 2 stories above grade in building with any of the following:

a. Combustible construction.

b. No automatic sprinkler system

c. Vertical openings connecting more than 2 stories.

4-4.2.2 Occupy building only to a maximum of 2 stories above grade. Contact Reachback for assistance.

Planned occupancy of basement levels by billeting, institutional or assembly occupancies.

4-4.1.2 Occupy basement levels by occupancies other than billeting, institutional or assembly.

Planned occupancy of sub-basement levels.

4-4.1.2 Do not occupy sub-basement levels.

Travel distance to exits exceeds allowable maximum distance.

4-4.2.4

Do not occupy remote space, occupy space by an occupancy with longer allowable travel distance, provide an additional exit option, or provide means of escape.

Dead end corridors longer than 25 ft. (7.6 m).

Provide additional exit path, means of escape, or do not occupy area with dead end corridor.

Less than 2 exits on each occupied level.

Provide additional remote exit or remote means of escape. Do not occupy floor with less than 2 exits.

Suite over 2,000 sq. ft. (186 sq m) with single exit path.

4-4.2.4 Provide additional remote exit path, remote means of escape, or do not occupy this area.

Assembly occupancy with less than 2 exit paths available from space.

4-4.2.4 Provide additional remote exit path or relocate assembly occupancy

Exit capacity is insufficient for any occupied area.

4-4.2.4 Provide additional exits, means of escape, or only allow what the exit capacity allows.

Exits blocked, obstructed, or enclosed stairs contain storage.

4-4.2.4 Remove obstructions or storage

Exit doors are locked, or not under control of occupants.

4-4.2.4 Remove locks or do not occupy area not controlling egress.

Exit paths routed from occupied areas through hazardous areas or areas of storage.

4-4.2.4 Provide exiting so it is not routed through hazardous areas or storage.

FIRE PROTECTION ISSUES

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Billeting occupancy without an automatic sprinkler system.

4-4.2.5

Area < 7,000 sq. ft. (650 sq. m.): Provide fire watch, direct exits to the exterior, subdividing walls separating this billeting area from other areas of the building including other billeting areas, and smoke alarms in billeting units; or limit occupancy to less than 10 beds.

Area > 7,000 sq. ft. (650 sq. m.): Contact Reachback

Billeting occupancy with no installed fire evacuation alarm system.

4-4.2.6 Provide fire watch.

Kitchen grill/fryer with no hood. 4-4.2.5 Remove kitchen grill from service, or provide fixed wall around kitchen area.

Kitchen hood with no fixed fire suppression system

4-4.2.5 Provide fixed wall around kitchen area.

Assembly occupancy with partial, or no fire alarm system in building.

4-4.2.6 Provide manual notification and a fire watch when occupied.

Institutional occupancy with partial, or no fire alarm system in building.

4-4.2.6 Provide manual notification and a fire watch.

Business occupancy over 5,000 sq. ft.

(465 sq m) in basement, second or third floors with partial, or no fire alarm system in building.

4-4.2.6 Provide manual notification and a fire watch when occupied.

Hazardous areas or hazardous equipment are not segregated from other occupancies by fixed walls.

4-4.2.7

Remove hazardous equipment from service, relocate equipment or materials, or provide fire suppression system (kitchen hood system) or automatic sprinkler system.

Hazardous or chemical storage areas are not provided with containment or ventilation.

4-4.2.7 Remove hazardous material storage.

Interior finishes consists of exposed combustible (plastic, foam) insulations, cork board, fabric assemblies, or combustible decorations.

4-4.2.8

Remove combustible finishes or cover with noncombustible fire barrier. Remove combustible decorations.

Vertical openings connecting more than 2 stories.

4-4.2.9, 4.4.2.2

Provide gypsum wallboard around one level to limit floor opening to 2 stories. See building height restrictions also.

Additional Notes on Fire Protection Issues and Mitigation Actions:

Partial Definition List:

Building Separation: The horizontal separation distance between the building under consideration and neighboring buildings on all sides. For multiple buildings on the same compound, assume an imaginary line halfway between buildings. The distance from building under consideration to adjacent existing buildings, or from the building under consideration to the imaginary line, whichever is shorter, is the fire separation distance.

Dead end corridor: A section of corridor that does not lead to an exit stair or an exterior exit door. For example, for a building with 2 interior exit stairs and a corridor connecting these 2 stairs, any extension length of the corridor “outboard” of the 2 exit stairs is a dead end corridor length. The maximum dead end corridor limit for all occupancies of this document is 25 feet (7.6 m).

Egress: The path of travel for persons from occupied areas through rooms or exits to reach areas outside of a building.

Exit: A door in the exterior wall of the building accessing the outdoors, a stairway interior to the building that is enclosed by walls and leads to the outdoors, or a stairway located on the exterior of the building, leading to the outdoors.

Exit Capacity: The calculated number of persons a given exit component (stair or exit door) can accommodate for determining the maximum allowable occupant load. Door width is the width of the opening through the door. Stair width is the width of a flight of stairs.

If the stairs vary in width, measure at its narrowest point. Stairs are assumed to have inconsistent rise and run; however the run should not be less than 6 inches (127 mm).

If the egress path consists of a door and a stair, the occupant load is limited by the smaller of the two exit capacities. For example, if the door is 34 inches wide (exit capacity of 145) and the stair is 44 inches wide (exit capacity of 120), the stair is the limiting factor for determining the Exit Capacity.

Where there are two or more exits from a room or floor, the maximum allowable occupant load is determine by adding the exit capacities for each exit from that room or floor.

An Occupant Load greater than the Exit Capacity is unsafe.

Occupied Spaces: Spaces that are normally used by personnel other than building maintenance persons. Occupied spaces do not include unmanned storage rooms, lookout towers, guard positions, mechanical/electrical equipment rooms, or computer server rooms.

Occupancy: For purposes of this document, occupancy consists of one or more of the following building uses:

a) Billeting (sleeping areas with more than 10 beds)

b) Institutional (hospital, confinement) areas over 1,000 sq. ft. (92.9 sq. m.)

c) Assembly (gathering places, cafeterias, etc.) exceeding 500 sq. ft. (46.5 sq. m.)

d) Business (offices) exceeding 1,000 sq. ft. (92.9 sq. m.)

e) Factory-Industrial (shops, mechanical spaces) areas over 1,000 sq. ft. (92.9 sq. m.)

f) Storage (including hangars and parking garages) areas over 1,000 sq. ft. (92.9 sq. m.)

Exit Capacity Clear Width Occupants per in (mm) Door Stair 24 (610) 100 65 28 (710) 120 75 30 (762) 130 80 32 (812) 135 85 34 (863) 145 90 36 (915) 155 100 40 (1,015) 170 110 44 (1,117) 185 120

Spaces of a lesser size than noted above are considered a part of the overall occupancy. If no occupancy as defined above exists, use the area of the largest use that exists.

Occupant Load: The total number of people on a given floor. This number is calculated based on the number of chairs, desks, beds, or other suitable number. To calculate occupant loads for the given occupancies use the following:

a) Billeting: Use the maximum number of beds to be used.

b) Institutional: Use the maximum number of beds or maximum number of persons in detention.

c) Assembly: Number of seats if seats are provided. If seats are not provided, use 7 sq. ft. (0.65 sq.

m.) per person through the area of Assembly use, deducting area for access/circulation paths that are maintained in the space.

d) Business: Use number of desks.

e) Factory/Industrial: Use 300 sq. ft. (27.9 sq. m.) per person, using the overall area of the occupancy.

f) Storage: Use 300 sq. ft. (27.9 sq. m.) per person, using the overall area of the occupancy.

An Occupant Load greater than the Exit Capacity is unsafe.

Travel Distance Limit (Maximum Allowable): The distance a person needs to travel from the point that is most remote on a given floor to the nearest exit. Travel distance is measured along normal walking paths, taking a direct route. Allowable travel distance limits for occupants are established for occupancies as follows:

a) Billeting: 175 ft. (53.3 m.)

b) Assembly: 200 ft. (61.0 m.)

c) Institutional: 150 ft. (45.7 m.)

d) Business: 200 ft. (61.0 m.)

e) Factory/Industrial: 200 ft. (61.0 m.)

f) Storage: 200 ft. (61.0 m.)

Vertical Openings: Openings in the floor of a building such as atriums, open stairs, air shafts or pipe chases that are not enclosed by wall assemblies. Multiple vertical openings that are not separated horizontally by a wall are considered one vertical opening (e.g., a vertical opening connecting Levels 1 and 2, and a separate vertical opening connecting Levels 2 and 3, without a contiguous wall between them, are considered one vertical opening connecting Levels 1 through 3).

PLUMBING AND MECHANICAL SYSTEM ISSUES INSPECTOR:

CONDITION ASSESSED

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Visual Inspection and Tests Domestic water unsafe based on testing? 4-5.2.1 Any evidence of plumbing systems leaking?

4-5.2.1

Any domestic water system cross connections?

4-5.2.1

HVAC system does not function properly, is unsafe or not operational?

4-5.2.5

Exposed or above-ceiling HVAC pipes leaking?

4-5.2.6

Visual Inspection and Field Surveys Hot water systems are not configured properly or do not have appropriate safety equipment?

4-5.2.2

Hot water equipment does not function properly or has inappropriate temperature settings?

Sanitary piping and venting is not configured properly and/or not all traps are sealed?

4-5.2.3

Vents through roof show signs of blockage?

4-5.2.3

Roof and overflow drainage systems are obstructed by debris or not configured properly?

4-5.2.4

Fuel system components are inappropriate or unsafe to operate?

Additional Notes on Plumbing and Mechanical System Issues and Mitigation Actions:

ELECTRICAL SYSTEM ISSUES

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Field Measurements and Calculations

Equipment short circuit ratings are less than minimum requirements?

4-6.2.1

Distribution System Grounding does not meet NFPA 70 (60 Hz) or BS 7671 (50 Hz) and UFC 3-550-01?

4-6.2.2

Branch circuit conductors, conduit and breakers’ sizes do not comply with NFPA 70(60 Hz) or BS 7671 (50 Hz)?

4-6.2.3

Feeder circuit conductors, conduit and/or breakers’ sizes do not comply with NFPA 70 (60 Hz) or BS 7671 (50 Hz)?

Visual Inspection and Field Surveys

Lightning Protection System is not installed per NFPA 780.

4-6.2.4

Raceway applications do not comply with NFPA 70? (60 Hz) or BS 7671 (50 Hz)

4-6.2.5

Branch and Feeder conductors;

installations do not comply with NFPA 70? (60 Hz) or BS 7671 (50 Hz)

Emergency and Exit Lighting equipment and placements do not comply with NFPA 101 and IBC?

4-6.2.6

Transformers’ application and installation do not comply with NFPA 70(60 Hz) or BS 7671 (50 Hz)?

4-6.2.7

Grounding type and GFCI receptacles do not comply with NFPA 70(60 Hz) or BS 7671 (50 Hz)?

4-6.2.8

Procedural Reviews Military unit does not have appropriate circuit lock-out procedures?

4-6.2.9

Additional Notes on Electrical System Issues and Mitigation Actions:

TELECOMMUNICATIONS ISSUES

CONDITION

FOUND?

MITIGATION

SECTION # SUGGESTED MITIGATION

Distribution System Grounding does not meet NFPA 70 (60 Hz) or BS 7671 (50 Hz) and UFC 3-550-01?

4-6.2.2

Additional Notes on Telecommunications System Issues and Mitigation Actions:

ADDITIONAL NOTES AND ACTION ITEMS

NOTES ACTIONS

Sample – Electrical Panel Schedule

Blank – Electrical Panel Schedule

Sample – Electrical One-Line Diagram