Activity Hazard Analysis (AHA)

Lagco
Date:
12/06/2022 0 – 5 = Low Risk
RISK ASSESSMENT RATING (RAR) Low
Job Name: UK Frazee Hall 6 – 10 = Moderate Risk
11 – 15 = High Risk Severity of Potential Consequences
Job Number: 16 – 25 = Unacceptable Risk Insignificant – 1 Minor – 2 Moderate – 3 Major – 4 Catastrophic – 5
Rare – 1 1 2 3 4 5

Likelihood of
Occurrence
Location: Lexington KY Unlikely – 2 2 4 6 8 10
Occasional – 3 3 6 9 12 15
Activity: Chill Water Shut Down and Tie Likely – 4 4 8 12 16 20
Almost Certain – 5 5 10 15 20 25
in
Company Name: Lagco Superintendent: Greg Profit
Project Manager: Bruce Kuntz Foreman:

Safety Manager: Kathy Coffey Competent Person: Noah Patrick

STEPS OF THE JOB POTENTIAL HAZARDS ACTIONS TO ELIMINATE OR MINIMIZE HAZARDS RAR
1.
Underground utilities Confirm Scope of task
Confirm Site

2.
Pesdrition Traffic-Other Barricade area Have laydon area know to delivery
Lay down area Trades
3.
GC not being aware of Notifity Client
Notify Client of activity activity
4.
Unknow actions Clearify with all involved every employee
Employees meeting of eack task acknowledges by signature
5.
Keep other trades out of area
Barricade work area

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 Activity Hazard Analysis (AHA)
EH&S

STEPS OF THE JOB POTENTIAL HAZARDS ACTIONS TO ELIMINATE OR MINIMIZE HAZARDS RAR
6.
Underground utilities Confirm Scope of task
Not confined space
7.
Gases Teat air quality
Drop air quality moniter
8.
Shut down system Shut down/ Drain off/ Verify shut down
Identify outages -Isolate
9.

Enter tunner and procceed

10.

Tie in
11.
System back up on chill line Agreed time to reinstate
Notify client of completion
12.
Reinstate system

13.

14.

15.

To Create Additional Row: Right Click Within Any Individual Cell On The Last Row click Insert click Insert Rows Below.
 Activity Hazard Analysis (AHA)
EH&S

PERSONNEL ATTENDING
NAME (printed) SIGNATURE COMPANY

10

11

12

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 Activity Hazard Analysis (AHA)
EH&S

Potential Fall Hazards Accounted For Potential Struck-By Hazards Accounted For

1. Confirm Site 1.
2. Lay down area 2.
3. Notify Client of activity 3.
4. Employees meeting of 4.
eack task work area
Barricade
5. 5.
Potential Electrical Hazards Accounted For Potential Caught In-between Hazards Accounted For
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
Required Personal Protected Equipment
Hard Hat Fall Protection* Welding Hood Identified Specialty PPE*
Gloves* Life Vest Welding Leathers
Respirator* Hearing Protection* Welding Gloves
Safety Boots Face Shield High Vis Vest
Rubber Boots Cutting Goggles High Vis Pants
Safety Toed Boots Safety Glasses Blasting Hood
Coveralls (Tyvek, etc.) Safety Goggles Other
Required Equipment and Tools
Circular Saw Roto-Hammer Welding Machine Other Equipment & Tooling
Sawzall Vibrator 4” Angle Grinder
Concrete Saw Power Trowel 7” Angle Grinder
Chop Saw Generator Grinding Wheels
Portable Band Saw Hand Tools Vacuum Assisted
Concrete Bucket Powder Actuated Wet Cutting Tools
Pump Sprayer Laser GFCI Pigtail
Jack Hammer Cutting Torch Other
Required Traffic Control Equipment Utilities Located / Marked
Lane Closure Signs Gas
Barrier Rail Trench Plates Electric
CMS Board Fencing Fiber
Flagger Station Sewer/Water
Pilot Car Cable/Phone
Trucks Crossing Overhead
Posted Speed Limit (mph) Locate Number:

Onsite Competent Person Overseeing this Work Required Training & Certifications
1. 1.
2. 2.
3. 3.
4. 4.