Attachment 4 - 668-22-106 PCRA Pre-Construction Risk Assessment Checklist ver6

Project Number and Name:

Pre-Construction Risk Assessment

668-22-106 Correct Domestic Water Deficiencies Buildings 1 & 12

Location of Construction:

Building 1, Building 12

Planned Project Start Date:

10/01/2026

Estimated Duration:

6 Months

Safety/Life Safety Risk Assessment-Safety officer should be involved in the design/planning of all projects Y

N

1. FIRE AND LIFE SAFETY IMPACTS

a. Will egress routes and exit signage from occupied areas remain unchanged?

b. Will exit stairs remain unobstructed with appropriate fire protection? c. Will fire & smoke compartments remain intact & unchanged? d. Will fire alarm and detection systems remain functional & unimpaired; outages <4 hours?
e. Will fire suppression systems remain functional & unimpaired; outages <10 hours?
f. Will construction area be separated by solid non-combustible smoke tight partitions?
g. Will emergency access by Fire Department remain unobstructed? h. Will hot work be performed?

2. SAFETY

a. Will a confined space work permit be required?
b. Will the project introduce other significant hazards? Additional Requirements and Description of Mitigation:

If no, ILSM is needed.
If no, ILSM is needed.
If no, ILSM is needed.
If no, ILSM is needed.
If no, ILSM is needed.
If no, ILSM is needed.
If no, ILSM is needed.
If yes, submit hot work permit to Safety
If yes, submit permit
If yes, describe below

1. h) Pipe soldering may occur, hot work permits to be submitted to Safety

Construction Safety Specialist / Safety Specialist Signature:

Y

N

3. PHYSICAL SECURITY IMPACTS

a. Will the construction compromise security?

Date:

If yes, describe necessary mitigation
below

b. Will construction affect traffic control or cause road closures? c. Do badging requirements exceed non-PIV level?
Additional Requirements and Description of Mitigation:

VA Police Signature:

Date:

Rev 6

Page 1|3

Y

N

4. CONTRACT COMPLIANCE

a. Will contract clauses be included for enforcement of identified risks?

Y

N

5. CONSTRUCTION ACTIVITY

a. Will there be any anticipated utility shutdowns? (Communications, electrical, heating/cooling, HVAC, medical gases, vacuum, water, sewer) b. Will there be nuisance noise levels for adjacent areas? c. Will vibration levels affect operations of sensitive medical equipment?

d. Will construction require trenching?
e. Will radiographic examination be required of piping or structural steel? f. Will construction affect traffic control or cause road closures? g. Will this contract complete work with a biological area such as a lab?