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ACTIVITY HAZARD ANALYSIS Date Submitted: August 18,2010 Contract No.: W912CN-10-C-0044 Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii Activity Start Date: ___________________________ Date of Pre-Phase Meeting:______________________________________ Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature) __________Safety Officer ______________ ____________________________________ (Title) (Title) (Date) PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN Spec. Sec. 01 90 00 Mobilize on Site Set up Traffic & Pedestrian Controls Place Traffic Barriers & Signs Hit by automobiles Traffic congestion & accidents Foreign Objects in Eyes Foreign Objects in Eye Hit by automobiles Barriers hit by on coming autos Two person crew minimum, wear orange safety vests, stay alert to traffic; have flag person or use stop sign Strictly adhere to approved Traffic Control Plan diagrams and descriptions Must wear safety glasses at all times while on jobsite Two person crew minimum, work out of back of truck, wear safety vests, stay alert Two person crew minimum, work out of back of truck, wear EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTS Flashing Traffic Barriers & Approved Directional Signs Daily, notify safety systems if any flashers are not working OJT/Surrounding environment awareness POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete) (Sheet 1 of 2 Sheets) 16 Oct 98

Sample AHA

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Page 1: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18,2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date: ___________________________ Date of Pre-Phase Meeting:______________________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

__________Safety Officer______________ ____________________________________ (Title) (Title) (Date)Comments by Govt. Rep:____________________________________________________________________________________________

__________________________________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec. 01 90 00

Mobilize on Site

Set up Traffic & Pedestrian Controls

Place Traffic Barriers &

Signs

Hit by automobiles

Traffic congestion & accidentsForeign Objects in Eyes

Foreign Objects in Eye

Hit by automobiles

Barriers hit by on coming autos

Traffic confusion & accidents

Two person crew minimum, wear orange safety vests, stay alert to traffic; have flag person or use stop sign

Strictly adhere to approved Traffic Control Plan diagrams and descriptions

Must wear safety glasses at all times while on jobsite

Two person crew minimum, work out of back of truck, wear safety vests, stay alert

Two person crew minimum, work out of back of truck, wear safety vests or reflective clothing, stay alert

Use traffic barriers with flashing lights from safety

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTS

Flashing Traffic Barriers &Approved Directional Signs

Daily, notify safety systems if any flashers are not working

OJT/Surrounding environment awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete) (Sheet 1 of 2 Sheets) 16 Oct 98

Page 2: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Temporary Control Fences

Temporary Electrical Power

Hand pinch and cut injuries

Eye Injury, Foot & Head Injury

Sunburn

Dehydration

Public Entry and tripping

Public Injury

Prevent Electrocution

All Potential Hazards

Wear leather gloves and use both hands to lift and open barricades for placement when necessary

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Wear Sunscreen on all exposed skin and face, Wear long pants and shirt with sleeves

Make sure personnel stays hydrated

Install temporary construction fence to enclose area of sidewalk work

Stay within construction areaPost signs stating construction area; “hard hat area” etc.

Overhead lines will be flagged with (orange) marking ribbon.Upon completion DPW will be notified of where the circuit is located.

Assess work area prior to starting work on any task.Appropriate AHA's to be reviewed during Weekly Safety Meeting.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 3: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

__Safety Officer________________ _______________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.

02 41 00

Demolition

Foot and skin punctures

Tripping / falling

Inhalation of dust

Eye Injury, Foot & Head Injury

Remove any protruding nails from debris

General jobsite requires daily cleanup.Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Must wear two banded dust mask whenever generating dustUse wet method, if possibleUse half mask respirator when required.

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPEWheel Barrow

DailyPrior to each useDailyDaily

OJTTradesmenOJTOJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 4: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Debris falling and Hitting people below

Cuts

Loss of hearing

All Potential Hazards

Immediately pick up and bag all debris as it is createdTie trash bag down until ready to remove

No throwing debris from different levels unless proper precautions are taken

Wear leather gloves when handling debris

Use of ear plugs if noise exceeds DOD Noise exposure levels

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 5: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:_______________________________________ Date of Pre-Phase Meeting:___________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

______Safety Officer_____________ _____________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.

02 83 13.00 20LEAD IN

CONSTRUCTION

Inhalation, Skin Exposure

Foot and skin punctures

Tripping / falling

Inhalation of dust

Lead Paint Removal only by trained personnel from R&D TechnologyFollowing their approved Lead Plan and asbestos removal plan

Remove any protruding nails form debris

General jobsite requires daily cleanup.Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Must wear two banded dust mask whenever generating dust

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsRespiratoryPPE

DailyPrior to each useDaily

TradesmenTradesmenOJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 6: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Eye Injury, Foot & Head Injury

Cuts

Debris falling and Hitting people below

All Potential Hazards

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Wear leather gloves when handling debris

Immediately pick up and bag all debris as it is createdTie trash bag down until ready to remove

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 7: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:_______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_______Safety Officer______________ ___________________________________ (Title) (Title) (Date)Comments by Govt. Rep:____________________________________________________________________________________________

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.13280A

Asbestos Abatement

Asbestos Dust exposure

Foot & Head Injury

Back Injury

Exposure to Public of LCP

Shocks, Electrocution

Falls

All workers must comply with approved asbestos Removal Plan Operation Requirements

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Use correct Lifting Procedures, 2 people if needed

Wet Removal Methods to be used, Only R&D Personnel allowed in the containment area

Use GFCI on all power toolsInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsRespiratorsPPEHarness/Lanyard

DailyPrior to each useDailyDaily, Prior to each use

TradesmenOJT; fittingOJTFall Protection Awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 8: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

All Potential Hazards Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 9: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:_____________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_____Safety Officer______________ ______________________________________ (Title) (Title) (Date)Comments by Govt. Rep:____________________________________________________________________________________________

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.09100N

Metal Studs

Cut on hands

Back Injury

Dust when drilling

Shocks, Electrocution

Excessive Noise

Saws must have operable guards, Wear GlovesUse sharp hand saw, wear gloves when necessaryBend over sharp edges. Do not walk thru stud walls.

Use correct Lifting Procedures, 2 people if needed

Wear 2 banded particulate mask

Use GFCI on all power toolsInspect power and extension cords.

Use of ear plugs if noise exceeds DOD Noise exposure levels

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 10: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Trips & Falls

Eye Injury, Foot & Head Injury

Foot or hand puncture

All potential hazards

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyardAttached to anchor

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Keep site and work area clean of excess screws and debris.

Use proper handling of cut off pieces of metal and proper disposal methods.

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets) 16 Oct 98

Page 11: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

____Safety Officer_______________ ____________________________________ (Title) (Title) (Date)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.26 20 00

INTERIOR DISTRIBUTION

SYSTEM

Shock, electrocution

Excessive Noise

Trips & Falls

Eye Injury, Foot & Head Injury

Visual inspections shall be conducted to ensure that equipment or lines are de-energizedInspect power and extension cords.Use GFCI on all power toolsInspect power and extension cords.

Use of ear plugs if noise exceeds DOD Noise exposure levels

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchorClean up site daily

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTS

Hand ToolsPower ToolsPPEHarness/Lanyard

DailyPrior to each useDailyPrior to each use

Tradesman-ElectricianOJTOJTFall protection & awareness training, if used

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete) (Sheet _1_of _2_ Sheets)16 Oct 98

Page 12: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Install new conduit runs

Cut on hands

Back Injury

Dust when drilling

Excessive Noise

Fire

All Potential Hazards

Saws must have operable guards, Wear Gloves if necessaryUse sharp hand saw, wear gloves when necessary

Use correct Lifting Procedures, 2 people if neededTwo or more person(s) lifting teamsUse mechanical aide such as hand truck

Wear 2 banded particulate mask when creating dust

Use of ear plugs if noise exceeds DOD Noise exposure levels

Current Burn permit on person doing hot workHave fire extinguisher where hot work being performedClean threading machine daily of excess shavingsUse clean, absorbent material to catch excess oil. Remove material from site if soiled.

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets) 16 Oct 98

Page 13: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:_______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

______Safety Officer______________ ______________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.06 20 00

FinishCarpentry

Dust

Back injury, muscle strain

Cut on hands

Falls

Foot, Head & Eye Injury

Wear 2 banded particulate mask when generating dust

Use caution lifting

Saws must have operable guards, Wear Gloves as necessary.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPEHarness/Lanyard

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall Protection Awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 14: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Shocks, Electrocution

Excessive noise

All Potential Hazards

Use GFCI on all power tools.Inspect power and extension cords.

Use of ear plugs if noise exceeds DOD Noise exposure levels

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets) 16 Oct 98

Page 15: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_______Safety Officer_______________ ___________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.09 29 00

Gypsum Board

Foot and skin punctures

Tripping / falling

Inhalation of dust

Eye Injury, Foot & Head Injury

Remove any protruding nails from debris

General jobsite requires daily cleanup.Watch power cords. Keep out of walk areaUse proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Watch extension cords so not a tripping hazard

Must wear two banded dust mask when generating dustUse vacuum attachment to minimize dust

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 16: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Cuts to Hands & Body

Skin Irritation From GB Dust

Falls from Step Ladders

Punctures to hands

Shock / electrocution

All Potential Hazards

Use sharp knives and drywall saws

Use barrier cream on exposed skin

Use adequate height stepladders to reach work withoutStepping on top two steps

Use Gypsum Board Screws and screw gun to assemble

Use GFCI on all power tools.Inspect power and extension cords.

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets)

16 Oct 98

Page 17: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

________Safety Officer____________ _____________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________

__________________________________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.09200A

EFIS

Fire

Fumes/Vapors

Foreign object in eyes

Foot & Head Injury

No coatings to be stored on site – must be removed daily

Wear half face respirator during application of coatings

Must wear safety glasses at all times

Must wear steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 18: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Skin Irritation

Falls

All Potential Hazards

Must wear gloves during install. Wash hands immediately if compound is on skin.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2of 2 Sheets) 16 Oct 98

Page 19: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: _______________________________ (Signature) (Signature)

_________Safety Officer___________ _____________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.09 90 00

PAINTS AND COATINGS

Airless spraying

Fire

Fumes/Vapors

Foreign object in eyes

Foot & Head Injury

Skin Irritation

No flammable paints or coatings to be stored on site - must be removed daily

Wear half face respirator during application of coatingsHave adequate ventilation (bring fan if necessary)

Must wear safety glasses at all times

Must wear steel toe shoes, and hard hat at all times while on jobsite

Wear gloves during install as necessary. Wash hands immediately if compound is on skin.

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSAirless sprayer equipmentElectric Saw

PPE

DailyPrior to each use

Daily

TradesmenTradesmen

OJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 20: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Falls

Trips

Shock / electrocution

All Potential Hazards

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Watch hoses and power cordsClean up daily

Use GFCI on all power tools & equipmentInspect power and extension cords.

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 21: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

____Safety Officer_______________ _______________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.06200A

Carpentry, Finish

Dust

Back injury, muscle strain

Cut on hands

Falls

Foot, Head & Eye Injury

Wear 2 banded particulate mask

Use caution lifting

Saws must have operable guards, Wear Gloves.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPEHarness/Lanyard

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall Protection Awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 22: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Shocks, Electrocution

Excessive Noise

All Potential Hazards

Use GFCI on all power toolsInspect power and extension cords.

Use of ear plugs if noise exceeds DOD Noise exposure levels

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 23: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

__Safety Officer____________________ _____________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________

__________________________________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.07 84 00

Firestopping

Fire

Fumes/Vapors

Foreign object in eyes

Foot & Head Injury

Skin Irritation

No coatings to be stored on site - must be removed daily

Were half face respirator during application of coatings

Must wear safety glasses at all times

Must wear steel toe shoes, and hard hat at all times while on jobsite

Recommended wear gloves during install. Wash hands immediately if compound is on skin.

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 24: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Cut on hands

Eye Injury, Foot & Head Injury

Shock, electrocution

Falls from Step Ladders

All Potential Hazards

Saws must have operable guards, Wear Gloves

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Must Use GFCI on all electrical toolsInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 25: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_________Safety Officer_____________ __________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.08 14 00

Install Wood Doors

Mount jams and hinges

Back injury Strains

Eye injury, foot & head injury

Falls

Shock

Trips, Falls

Skin Irritation

Face Cuts

Gunshot Nail Penetrations

Use adequate number of people to carry door

Must wear safety glasses, steel toe shoe and hard hat at all times while on jobsiteUse proper ladder setup for correct working height

Use GFCI at all times

Clean up site daily

Wear gloves and/or clean hands immediately if compound is on skinWhen saw cutting metal, use face shield over glasses

All powder actuated tool operators must be certified for the particular tool

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric Saw * DrillsCaulk gun, Hand ToolsPPEPowder Actuated Tools

DailyPrior to each useDailyDailyPrior to each use

TradesmanTradesmanOJTOJTOperators certification

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 26: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Cutting & Fabricating

Unloading

Eye injury, foot & head injury

Falls

Foreign Objects in Eyes

Dust Inhalation

Shock / electrocution

Trips, Falls

Crush Injuries

Sunburn

Shock when vacuuming

All Potential Hazards

Must wear safety glasses, steel toe shoe and hard hat at all times while on jobsite

Use proper ladder setup for correct working height

Must wear safety glasses at all times while on jobsite

Wet sweeping and vacuuming. Wear 2 banded particulate mask.

Use GFCI at all timesInspect power and extension cords.

Clean up site daily

Stay clear of load at all times, use bobcat with fork to unload and stack

Wear Sunscreen on all exposed skin and face, Wear long pants and shirt with sleeves

Must use GFCI for all extension cord sources of power.

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 27: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:_______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

________Safety Officer______________ _________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.08 11 13

Doors, Hollow Metal & Frames

Back injury Strains

Eye injury, foot & head injury

Falls

Shock / electrocution

Trips, Falls

Use adequate number of people to carry doorUse mechanical aid when possible

Must wear safety glasses, steel toe shoe and hard hat at all times while on jobsite

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Use GFCI at all timesInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPEHarness/Lanyard

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall Protection Awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 28: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Foreign Objects in Eye

Face Cuts

Skin Irritation

Excessive noise

All Potential Hazards

Must wear safety glasses at all times

When saw cutting metal, use face shield over glasses

Wear gloves and/or clean hands immediately if compound is on skin

Use of ear plugs if noise exceeds DOD Noise exposure levels

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets) 16 Oct 98

Page 29: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520 & 525, Fort Shafter, Oahu,

Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_____Safety Officer______________ ____________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.10440

Signage, Interior

Eye Injury, Foot & Head Injury

Back and Muscle Strain

Excessive Noise

Trips & Falls

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Use adequate number of people to carry and lift sign

Use of ear plugs if noise exceeds DOD Noise exposure levels

Watch power cords to avoid tripping hazardUse proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPE

DailyPrior to each useDaily

OJTTradesmenOJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 30: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Shock / electrocution

All Potential Hazards

Inspect power and extension cords.Use GFCI on all power tools

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets) 16 Oct 98

Page 31: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520 & 525, Fort Shafter, Oahu,

Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_________Safety Officer_______________ ________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec. 16410A

Electrical, A.T.S & BP/ISO

SW

Shock, electrocution Lockout/Tag out all circuits prior to work. Key to be kept by electrician and Project Manager (unless another person has been designated). Phone number must be posted

Tags must be legible and understood by all authorized personnel.

Circuit breakers shall clearly indicate whether they are in the open or closed position.

Inspect power and extension cords.

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsTag out system

DailyDaily

Tradesman-ElectricianEmployees shall be trained in the limitations of tagsDaily inspections shall be conducted to ensure that all requirements are being followed

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete) (Sheet _1_of _1_ Sheets)16 Oct 98

Page 32: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Eye Injury, Foot & Head Injury

Trips & Falls

Hearing loss

All Potential Hazards

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Clean up site daily

Use of ear plugs if noise exceeds DOD Noise exposure levels

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet _2_of _2_ Sheets) 16 Oct 98

Page 33: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

____________Safety Officer___________ ____________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.16415A

Electrical, Interior Lt.

Fixture

Shock, electrocution

Trips & Falls

Eye Injury, Foot & Head Injury

Must Use GFCI on all electrical toolsInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Make sure extension cords are not in excess to cause tripping

Clean up site daily

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawLadderPPEHarness/Lanyard

DailyPrior to each usePrior to each useDailyPrior to each use

Tradesman-ElectricianOJTOJTFall protection and awareness training, if used

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete) (Sheet _1_of _2_ Sheets) 16 Oct 98

Page 34: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

__________Safety Officer_____________ _________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.16375A

Electrical Underground

Heat Stress/ Heat Exhaustion

Cuts

Sunburn

Heart Attack

Keep and drink plenty of water during work dayWear sunscreen

Refer to all other AHA’s, keep Bio Hazard and First Aid Kits on site at all times

Wear Sunscreen on all exposed skin and face, Wear long pants and shirt with sleeves

2 CPR Trained people on site at all times

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSWater Cooler with Cup DispenserFirst Aid Kits

PPE

Daily

Weekly

Daily

OJT

Checklist on site

OJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 35: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Shock, electrocution

Trips & Falls

Eye Injury, Foot & Head Injury

Back strain and sprain

All Potential Hazards

Must Use GFCI on all electrical toolsInspection of Frayed & exposed extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Make sure extension cords are not in excess to cause tripping

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Use mechanical aide when possibleUse proper lifting techniquesUse two – man lifting team when possible

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 36: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_______Safety Officer_______________ ___________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.09 51 00

Acoustical Ceilings

Dust

Back injury, muscle strain

Cut on hands

Falls

Foot, Head & Eye Injury

Wear 2 banded particulate mask

Use caution lifting

Saws must have operable guards, Wear Gloves.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPEHarness/Lanyard

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall Protection Awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 37: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Shocks, Electrocution

All Potential Hazards

Use GFCI on all power toolsInspect power and extension cords.

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 38: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

___________Safety Officer____________ ________________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec13851A Fire Alarm

Cut on hands

Eye Injury, Foot & Head Injury

Shock, electrocution

Falls from Step Ladders

Saws must have operable guards, Wear Gloves

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Must Use GFCI on all electrical toolsInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 39: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Dust inhalation

Back injury, muscle strain

Excessive noise

All Potential Hazards

Wear 2 banded particulate mask when creating dust

Use caution lifting and mounting equipment

Use of ear plugs if noise exceeds DOD Noise exposure levels

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 40: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

________Safety Officer______________ _______________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.13930A

Fire Sprinkler System

Cut on hands

Eye Injury, Foot & Head Injury

Shock, electrocution

Falls from Step Ladders

Saws must have operable guards, Wear Gloves

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Must Use GFCI on all electrical toolsInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 41: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Dust

Back injury, muscle strain

All Potential Hazards

Wear 2 banded particulate mask

Use caution lifting and mounting equipment

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 42: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

__________Safety Officer____________ ____________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.09 30 00

Ceramic Tile, Quarry Tile, and Paver Tile

Apply Leveling Compound / Adhesive

Dust inhalation

Fires

Eye, Foot & Head Injury

Wet Vacuum Floor Area, Wear Dust MaskWear half mask respirator when sanding

No Compounds or Adhesives to be stored on site - must remove from site dailyFire extinguisher at location

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsCaulk gun, Hand ToolsPPE

DailyDailyDaily

TradesmenTradesmenOJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 43: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Shocks, Electrocution

Skin Irritation

Fumes/Vapors

Cuts on hands

All Potential Hazards

Use GFCI on all power tools. Inspect power and extension cords.

Use barrier cream on exposed skin or appropriate gloves

Were half face respirator during application of adhesive, if necessary

Use of sharp bladesCut away from body or other people

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 44: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_________Safety Officer____________ ______________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.02300

Earthwork Excavation

Mobilization

Traffic Accidents

Cut on hands

Eye Injury, Foot & Head Injury

Back and Muscle Strain

Watch and have traffic control Flagman to wear visible clothing

Obey base traffic laws, deliver to site designated and approved on Project Site Map

Saws must have operable guards, Wear Gloves if necessary

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Use adequate number of people to carry and lift

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPEBrooms/VacuumSurveying Equipment

DailyPrior to each useDailyDailyVisual

OJTOJTOJTSkilled Tradesmen

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 45: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Dust

Noise

Public Entry and tripping

Shock / electrocution

Sunburn

All Potential Hazards

Must wear appropriate dust maskUse wet method for dust controlCover dirt pile with cloth

Use of ear plugs if noise exceeds DOD Noise exposure levels

Install temporary construction fence to enclose area of sidewalk work

Must use GFCI for all extension cord sources of power.Inspect power and extension cords.

Wear sunscreen on all exposed skin and face. Wear long pants and shirt with sleeves

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 46: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

____________Safety Officer____________ ______________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.02360

HTRW Soil Treatment

Eye Injury, Foot & Head Injury

Back and Muscle Strain

Dust inhalation

Traffic Accidents

Back and Muscle Strain

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Use adequate number of people to carry and lift

Must wear appropriate dust mask

Obey base traffic laws, deliver to site designated and approved on Project Site Map

Use adequate number of people to carry and lift

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPE

DailyPrior to each useDaily

TradesmenTradesmenOJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 47: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Sunburn

Skin Irritation

Inhalation of fumes

All Potential Hazards

Wear adequate Sunscreen

Wear gloves and/or clean hands immediately if chemical is on skin

Wear half face respirator during application

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 48: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_______Safety Officer_____________ ____________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.02770A

Concrete Curbs, Gutters S/W

Concrete Dust Inhalation

Falls

Foot & Head Injury

Eye Injury

Back injury, muscle strain

Wear 2 banded particulate mask.

Harness & Lanyards must be used in man lifts

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Must wear safety glasses

Use caution lifting

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPEHarness/Lanyard

DailyPrior to each useDailyPrior to each use

OJTOJTOJTFall protection class

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 49: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Heat Stroke/ Heat Exhaustion

Cuts

Sunburn

Heart Attack

All Potential Hazards

Keep and drink plenty of water during work day

Refer to all other AHA’s, keep Bio Hazard and First Aid Kits on site at all times

Wear Sunscreen on all exposed skin and face, Wear long pants and shirt with sleeves

2 CPR Trained people on site at all times

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 50: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: October 1, 2009

Contract No.: W9128A-09-C-0006 Name of Project: Restore Showers and Replace Water Heaters with Solar Heaters, Bldg. 520& 525, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:_____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

____________Safety Officer___________ _____________________________________________ (Title) (Title) (Date)

Comments by Govt. Rep:____________________________________________________________________________________________PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.04200

Masonry

Dust Inhalation

Falls

Foot & Head Injury

Eye Injury

Back injury, muscle strain

Wear 2 banded particulate mask.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Must wear safety glasses

Use caution lifting

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand Tools

PPEHarness/Lanyard

Daily

DailyPrior to each use

Tradesmen

OJTFall Protection Awareness

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 51: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Disassemble forms and remove

Cut on hands

Hand injury

Back injury, muscle strain

Heat stress

All Potential Hazards

Wear Gloves

Use screw gun to disassemble formwork and remove screws

Use caution when liftingTwo man teams to lift or move heavy itemsUse mechanical aide when possible

Wear sunscreenStay hydrated

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 52: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:____________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_______Safety Officer_____________ ____________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.23 00 00

Air supply, Distribution, Ventilation &

Exhaust Systems

Cut on hands

Eye Injury, Foot & Head Injury

Shock, electrocution

Falls from Step Ladders

Saws must have operable guards, Wear Gloves

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

Must Use GFCI on all electrical toolsInspect power and extension cords.

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsPower ToolsPPELadder

DailyPrior to each useDailyPrior to each use

TradesmenTradesmenOJTFall protection/awareness training

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 53: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Dust inhalation

Back injury, muscle strain

All Potential Hazards

Wear 2 banded particulate mask when dust is created

Use caution lifting and mounting equipment

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98

Page 54: Sample AHA

ACTIVITY HAZARD ANALYSIS

Date Submitted: August 18, 2010

Contract No.: W912CN-10-C-0044Name of Project: Tunnel Renovation, Bldg.1292, Fort Shafter, Oahu, Hawaii

Activity Start Date:______________________________________ Date of Pre-Phase Meeting:___________________________

Submitted by Contractor: _________________________________ Accepted by Govt. Rep.: ______________________________ (Signature) (Signature)

_________Safety Officer___________ _____________________________________________ (Title) (Title) (Date)PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Spec. Sec.22 00 0022 07 19

22 33 30.00 10

Plumbing, General Purpose

Mobilization

Concrete Dust Inhalation

Slips, Trips & Falls

Eye Injury, Foot & Head Injury

Two person lifting team or mechanical aide used to unload material, equipment or tools

Jobsite Cleaning & sweepingWear two banded dust mask

Use proper ladder setup for correct working height. Height exceeds 6 feet must be fully harness and lanyard attached to anchor

Clean up site dailyUse of absorbent material under/around machines with oil

Must wear safety glasses, steel toe shoes, and hard hat at all times while on jobsite

EQUIPMENT TO BE USED INSPECTIONS REQUIREMENTS TRAINING REQUIREMENTSHand ToolsElectric SawPPEVacuumTemp. Fencing & posts

DailyPrior to each useDailyDailyVisual

TradesmanTradesmenOJTOJTOJT

POD Form 184-R (REV) (Edition of 22 Apr 91 is obsolete)16 Oct 98

Page 55: Sample AHA

ACTIVITY HAZARD ANALYSIS (Continuation)

PHASE NO. ACTIVITY POTENTIAL HAZARDS PRECAUTIONARY ACTION & CONTROLS TO BE TAKEN

Hand pinch and cut injuries

Sunburn

Back injury, muscle strain

Excessive Noise

Fire

Shock / electrocution

All Potential Hazards

Wear leather gloves, when necessary

Wear sunscreen on all exposed skin and face. Wear long pants and shirt with sleeves

Use caution picking upUse mechanical aid when possibleUse two (or more) man lifting team

Use of ear plugs if noise exceeds DOD Noise exposure levels

Current Burn permit on person doing hot workHave fire extinguisher where hot work being performedClean threading machine daily of excess shavingsUse clean, absorbent material to catch excess oil. Remove material when soiled.

Inspect power and extension cords.Use GFCI on all power tools

Appropriate AHA's to be reviewed during weekly safety meeting.Assess work area prior to starting work on any task.

POD Form 184-R (Rev) (Sheet 2 of 2 Sheets) 16 Oct 98