Exhibits.pdf

Exhibit A - Site Map

Dated Prepared Dec 2018 Project : Mowing at LRS

LRS Mowing AHA Example Format 1 of 5

Previous Versions are Obsolete and Should Not Be Used

Prepared By: Reviewed By: Risk Assessment Code (RAC): L

Frequent Likely Occasional Seldom Unlikely

E E H H M

E H H M L

H M M L L

M L L L L

Inspect vehicle before using, including lights, warning/signaling devices, brakes & etc.

Inspect trailer and test lighting.

Drive defensively.

Wear seat belts.

Do not operate vehicles when road conditions make operation unsafe.

Use warning/signaling devices when needed.

Use lights in fog or other weather conditions that decrease visibility.

Maintain vehicles in proper and safe working order.

Foot Protection 05.E Face Shields (as needed) 05.B Hand Protection 05.A.08 Hearing Protection 05.C Long Trousers 05.A.06 Short Sleeve shirt 05.A.06

Recommended Protective Clothing & Equipment:

Head Protection 05.D Eye Protection 05.B

JOB STEPS HAZARDS

Driving truck with materials and mowing equipment to and from work site.

P r o b a b i l i t yE = Extremely High Risk H= High Risk

ACTIONS TO ELIMINATE OR

MINIMIZE HAZARDS

EM 385-1-1

(PARA REF)

S e v e r i t y

M= Moderate Risk L = Low Risk

Catastrophic

Critical

Marginal

Negligible

Accidents (traffic)

Exhibit B - Sample Activity Hazard Analysis

LRS Mowing AHA Example Format 2 of 5

Previous Versions are Obsolete and Should Not Be Used

14.A

Accidents (other) Use emergency brakes and blocks when parking on steep grades.

Be alert to the possibility of deer crossing in front of moving vehicle.

Use warning flashers when traveling slow or parking along roadways.

Do not transport personnel in the beds of trucks.

Use backup alarms/spotters.

Loading and unloading trucks and trailers with mowing equipment and other related materials.

Lifting Injuries. Use proper lifting techniques.

Get help with heavy or awkward items.

Use lifting devices when possible.

Accidents (pedestrian) Check in all directions before moving vehicle.

Drive defensively.

Use care when operating a vehicle in near visitors, or other areas where persons might unexpectedly enter the path of the moving vehicle.

Use backup alarms/spotters.

05.A.8 05.E.

Use gloves.

Take care not to set object down on supporting fingers.

Examine object to be lifted to see if there are any sharp or jagged protrusions/edges.

Wear protective footwear.

Use care not to drop loads on foot, or snag load on legs.

Foot and hand injuries during loading and unloading.

LRS Mowing AHA Example Format 3 of 5

Previous Versions are Obsolete and Should Not Be Used

Slips, trips and falls with loads. Use care when walking with loads.

Move obstructions from path.

Get help with heavy or awkward loads.

Use dolly or other lifting device when possible.

Walk slowly with loads.

Do not jump to different levels with or without loads (e.g. truck bed to ground).

Mower blades throwing objects. Pick up visible debris from grounds before mowing.

Do not remove or disable grass discharge guard.

Stop mower when persons walk in path of clippings being discharged by mower, and whenever possible, direct mower clipping discharge away from persons, vehicles and other property which might be injured or damaged by a thrown object.

Inspect areas to be mowed for debris, holes, slipping banks and washouts.

Remove dangerous debris, and hand cut/grass in and around holes, slipping banks and washouts.

All riding mower equipment will have certified rollover protection and seat belt.

No slopes with a gradient of 4 horizontal to 1 vertical will be mowed when the ground is soft or the grass is wet.

Rolling tractor over.Mowing and trimming grass at work sites.

LRS Mowing AHA Example Format 4 of 5

Previous Versions are Obsolete and Should Not Be Used

Mowing and trimming grass at work sites.

Mower blades throwing objects. Wear protective footwear when mowing.

Avoid using power mowers on areas having a lot of stones (i.e. gravel compounds and parking areas). Or have the area clear before mowing is started.

Whenever possible, conduct mowing during periods when fewer persons are in the area. Or have a Government employee clear the area until mowing is complete.

Disengage mower deck or PTO when traveling across pavement or other areas with debris.

Keep other workers and public a safe distance from mowers.

Fires during refueling. Shut down equipment before refueling.

If equipment is very hot, allow a cool down period before refueling.

Use flammable liquid containers that comply with EM 385.09.B Appropriate type fire extinguisher shall be located within 25 feet of refueling site.

Eye injuries from grass cutting debris. Grass cutting operators will wear eye protection all the time.

LRS Mowing AHA Example Format 5 of 5

Previous Versions are Obsolete and Should Not Be Used

Noise

Slips, trips, and falls. Take care when climbing on and off riding mower equipment.

When using push mowers: Check for tripping hazards; push the mower, pull only when absolutely necessary; mow banks horizontally; keep firm footing;

do not mow wet or slippery slopes.

When using weed trimming devices on uneven ground, use care to maintain firm footing.

Injuries from rotating blades or moving machinery.

Shut down mower equipment before serving.

Do not leave running mower equipment unattended.

Wear protective footwear.

Disengage PTO when not mowing.

Do not let anyone approach a running mower.

Maintain protective guards over moving parts.

Mowing and trimming grass at work sites.

Riding mower operators must check in all directions before moving or changing directions.

All self-propelled construction and industrial equipment shall be equipped with reverse signal alarms.

Running over persons with mower.

Hearing protection shall be utilized by all employees in the areas were sound level exceeds 85 dba.

05.c

6.

2. 3.

PREPARED ORAL NOTIFICATION RETURNED BY CONTRACTOR ACTION COMPLETE

4. DISCREPANCY OR PROBLEM (Describe in Detail: Include reference in PWS / Directive: Attach continuation sheet if necessary.)

5. SIGNATURE OF CONTRACTING OFFICER

7.

8. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. ATTACH

1. CONTRACT NUMBER

9. SIGNATURE OF CONTRACTOR REPRESENTATIVE 10. DATE

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, rejection: attach continuation sheet if necessary)

12. GOVERNMENT ACTIONS (Payment deduction, cure notice, show cause, other.)

CONTRACT DISCREPANCY REPORT

For use of this form, see DA PAM 5-20; the proponent agency is ACSIM.

TO: (Contractor and Manager Name)

DATES

CLOSE OUT

CONTRACTOR

NOTIFIED

NAME AND TITLE SIGNATURE DATE

QAE

CONTRACTING

OFFICER

CONTINUATION SHEET IF NECESSARY. (Cite applicable Q.A. program procedures or new A.W. procedures.)

DA FORM 5479, MAR 2008 APD LC v1.01ES

FROM: (Name of QAE)

TO: (Contracting Officer) FROM: (Contractor)

PREVIOUS EDITIONS ARE OBSOLETE.

Exhibit C - Contract Discrepancy Report