A2 - Appendix 1- AHA.pdf

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SAW FORM 51, MAR 2023

FORM EDITION

U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT

ACTIVITY HAZARD ANALYSIS (AHA)

For use of this form, see DA Pamphlet 385-30 and EM 385-1-1; the proponent agency is CESAW-SO.

SECTION I - ACTIVITY DATA

SECTION II - RISK ASSESSMENT CODE (RAC) MATRIX

S E V E R I T Y

CATASTROPHIC

CRITICAL

MARGINAL

NEGLIGIBLE

FREQUENT

LIKELY

OCCASIONAL

SELDOM

UNLIKELY

PROBABILITY (Select - X only one)

L = LOW RISK

RAC CHART

STEP 1: REVIEW EACH “HAZARD” WITH IDENTIFIED SAFETY "CONTROLS" AND DETERMINE RAC.

“SEVERITY” IS THE OUTCOME / DEGREE IF AN INCIDENT, NEAR MISS, OR ACCIDENT AND OCCUR AND IDENTIFIED AS: CATASTROPHIC, CRITICAL, MARGINAL, OR NEGLIGIBLE.

STEP 2: IDENTIFY THE RAC (Probability / Severity) as E, H, M or L FOR EACH “HAZARD” ON THE AHA. ANNOTATE THE OVERALL HIGHEST RAC AT THE TOP OF AHA.

“PROBABILITY” IS THE LIKELIHOOD TO CAUSE AN INCIDENT, NEAR MISS, OR ACCIDENT AND IDENTIFIED AS: FREQUENT, LIKELY, OCCASIONAL, SELDOM OR UNLIKELY.

E E E H H H H H M M M M M L L L L L L L

E = EXTREMELY HIGH RISK

H = HIGH RISK

M = MODERATE RISK

1. ACTIVITY / WORK TASK.

PREVIOUS EDITIONS ARE OBSOLETE.

SECTION III - ACTIVITY HAZARD ANALYSIS (AHA) STEPS

a.

PRINCIPLE JOB STEPS

ITEM

b.

HAZARDS

c.

CONTROLS

d.

RAC

SECTION IV - ACTIVITY HAZARD ANALYSIS (AHA) EQUIPMENT

ITEM

a.

EQUIPMENT TO BE USED

(*if Scaffolding other than Frame scaffold is to be utilized include Manufacturer and Model Number) c.

INSPECTION REQUIREMENTS

b.

TRAINING REQUIREMENTS / COMPETENT OR QUALIFIED PERSONNEL NAME(s) (*Ensure Competent Person(s) by discipline are listed) Forms Design Team SAW FORM 51 Activity Hazard Analysis Mar 2023 Mark Cooper updated by Mary Ann Herrick SAW FORM 51 Activity Hazard Analysis Mar 2023 mark.a.cooper@usace.army.mil 2019115 20230308