Attachment_5__Blank_Activity_Hazard_Analysis_(AHA).docx
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- W912P4-17-T-0025
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Text version
Attachment 5 – Blank Activity Hazard Analysis (AHA)
EM 385-1-1
30 Nov 14 Activity Hazard Analysis (AHA)
| Activity/Work Task: |
| Overall Risk Assessment Code (RAC) (Use highest code) |
| Project Location: |
| Risk Assessment Code (RAC) Matrix |
| Contract Number: |
| Severity |
Probability
Date Prepared:
| Frequent |
| Likely |
| Occasional |
| Seldom |
| Unlikely |
Prepared by (Name/Title):
| Catastrophic |
| E |
| E |
| H |
| H |
| M |
| Critical |
| E |
| H |
| H |
| M |
| L |
Reviewed by (Name/Title):
| 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”. Determine RAC (See above) |
Probability: likelihood the activity will cause a Mishap (near miss, incident or accident). Identify as Frequent, Likely, Occasional, Seldom or Unlikely.
RAC Chart
| Severity: the outcome if a mishap occurred. Identify as Catastrophic, Critical, Marginal, or Negligible |
| E = Extremely High Risk |
H = High Risk
| Step 2: Identify the RAC (probability vs. 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 |
1.
2.
1.
2.
1.
2.
1.
2.
| Equipment to be Used |
| Training Requirements & Competent or Qualified Personnel name(s) |
| Inspection Requirements |
Involved Personnel
Official Forms can be found:
http://www.publications.usace.army.mil/Portals/76/Publications/EngineerManuals/EM_385-1-1.pdf
File details come from the government source that posted it. Updated .