ATTACHMENT PCRA Re-slurry and Re-stripe

PCRA 612A4-27-013 Re-slurry and Re-stripe
Safety Permit Request #661
Pre-Construction Risk Assessment (PCRA)
NorCal

Initiated by Lye Saechao
Submitted 8/14/2026

1: Project Information
1.1: Project Number

1.2: Project Name *

612A4-27-013

Re-slurry and Re-stripe

1.3: Project COR/Lead Name (Last, First) *

Lye Saechao
1.4: Campus *

x McClellan
1.5: Building/s

1.6: Room/s

N/A

1.7: Project Description *

The purpose of this project is to reseal and restripe three (3) existing McClellan Clinic parking lots at building 98 and 88. Phasing includes closure of one entire lot at a time and reopen when re-seal and re-striping is cured. Alternate parking is planned at Building 911.
1.8: Phases *

x Yes
1.8.1: If yes, list phases with estimated start/stop dates below.

Phase I: B88 Parking Lot, from 11/16/26 to 11/20/26.
Phase II: B98 North Parking Lot, from 11/27/26 to 11/31/26. Phase III: B98 South Parking Lot, from 12/3/26 to 12/7/26. 1.9: Start Date *

1.10: End Date *

11/02/2026

12/31/2026

2:

Infection Control

Pre-Construction Risk Assessment (PCRA)

Continued on the next page.

2.1: Dust will be generated (i.e. from drilling, cutting, sawing, etc.) in or adjacent to patent care areas. *

x No
2.1.1: If yes, complete ICRA and implement measures identified. 2.2: Work is being performed in a patient care area. *

x No
2.2.1: If yes, complete ICRA and implement measures identified. 2.3: Construction area is greater than 110 ft2 and/or >3 ceiling tiles will be removed. *

x No
2.3.1: If yes, complete ICRA and implement measures identified.

3: Fire/Life Safety
3.1: General construction, renovation, or significant repairs will take place in an occupied building. *

x No
3.1.1: If yes, complete ILSM action items 6, 7, and 9.
3.2: Egress pathways or exits will be blocked or partially obstructed by construction activities, partitions, or Infection Control measures. *

x No
3.2.1: If yes, complete ILSM action items 1, 8, 10, and 11. 3.3: Smoke or fire walls will be breached where a temporary seal cannot maintain barrier integrity. Consult Fire and Smoke Barrier Diagrams. *

x No
3.3.1: If yes, complete ILSM action items 2, 3, 7, 8, and 9. 3.4: Building emergency responder or fire equipment, fire hydrant, standpipe or connection blocked or obstructed, or removed from service. Note: This includes both interior and exterior access. *

x Yes
3.4.1: If yes, notify appropriate emergency services (Local Fire Department). Take actions to provide alternate access points, if possible. (Must be approved by Safety Department)