Predictive Risk Impact and Complexity Evaluation Tool

This Predictive Risk Impact and Complexity Evaluation (PRICE) Tool Worksheet will allow EHS to assign a Field Representative early on in the planning and design phase.

More importantly, the RIC Score questionnaire will allow PIMD and EHS to define the RIC Score of specific aspects of construction projects. RIC Score can be defined as an aggregate number of defined inputs (risk, impact and complexity) that represent upstream quantitative data points to assist with strategic decision making and project planning. This includes, but is not limited to the following:

Determining the required Subcontractor Onsite Health and Safety Representative option (A,B, or C)
Determine the overall RIC Score for each project
Determining the overall RIC score for individual Project Managers, Construction Managers, and EHS Field Representative
Determine the Safety Critical Tasks associated with each project
Identify potential hold points associated with projects
Allow for leveling of work loads among project oversight personnel
Establish data driven criteria for inspections, project oversight, and project scheduling

We define Risk in this manner as the level of potential negative effect to the people involved in the work; the internal people or equipment related to the task or project. Impact is the potential threat to external entities – resources not involved in the work but may be directly affected by it. Complexity is how challenging and complicated organizing and performing the work will be, which involves qualifications, specialty equipment, experience level, multiple groups or organizations involved, etc. The basic rule is that the complexity of the task is directly related to the likelihood of encountering difficulty.

This form must be completed as early on in the design and planning phase of a project as possible. This will not only allow EHS to assign an EHS Field Safety Representative, but will also allow the project team to begin understanding what sampling may be required, allow for early identification of hazards associated with the work, and ensure the project incorporates all safety related cost into the project budget.

This form must be filled out completely and as accurately as possible before submitting. It is understood that some answers may change or may not reflect the means and methods chosen by the contractor at the time of contract award. A good faith attempt to capture the actual tasks and hazards is all that is required.

Enter the name of the person submitting this form*

Enter the phone number of the person submitting this form*

Phone

Enter the email of the person sumitting this form*

Master Project List Index*

(Format: MPL### or FPL###)

Project Location*

Select or enter value

Hazard Identification

The checklist in this section includes those activities which are subject to specific controls based on the hazards of the work, or have the potential to affect natural resources including storm water, wetlands, streams, air quality, vegetation and wildlife. Check yes to all activities that will be performed as part of this project.

This checklist is presented in part for project planning and characterization purposes.

This form is intended to document project specific hazards that present specific Risk, Impact, and Complexity that are of interest to the project.is in no way intended to be inclusive of all LBNL, Federal, State, or Local requirements.

Mobile Elevated Work Platforms

Mobile Elevated Work Platforms can be vertically adjusted by manual or powered means and may be self-propelled, towed, or manually moved. They include equipment such as scissor lifts, one-man-lifts, and boom lifts. Minimum requirements can be found in the ES&H Manual Pub-3000 Chapter 35 Elevated Work, Chapter 30 Fall Protection Program, and Chapter 10 Appendix A Section 14 Fall Protection. Any project requiring the use of a Mobile Elevated Work Platform will require the Subcontractor to submit a project specific Fall Protection Work Plan, Job Hazard Analysis, and associated training records.

All use of Mobile Elevated Work Platforms requires an LBNL Fall Matrix Permit prior to working at heights. This permit should be coordinated by you LBNL Construction or Project Manager.

Is the project likely to require the use of Mobile Elevated Work Platforms? (MEWP 2)*

Yes

Is the project likely to require the use of a scissor lift? (MEWP 1)*

Yes

Is the project likely to require the use of an articulating boom/aerial lift? (MEWP 3)*

Yes

Asbestos Containing Materials

Asbestos can be found in many common building materials. Examples of building materials at LBNL facilities that may contain asbestos as part of construction, renovation and demolition projects include, but are not limited to: pipe and boiler insulation, taping compound on gypsum wallboard (including gypsum wallboard itself in Building 70), 9”x9” and 12”x12” floor tiles and mastic, building exterior paints/coatings, roofing material, "transite" wallboard, and fire rated doors (both wooden and metal) in offices, shops, labs, mechanical rooms, etc. Consequently, walls, floors, ceilings or other suspect Asbestos Containing Material (ACM) should not be disturbed or damaged without determining whether ACM is present. If ACM is found or suspected, special procedures will be required to ensure proper employee protection, prevention of environmental contamination, and proper waste disposal.

Details regarding asbestos requirements at LBNL can be found in ES&H Manual PUB-3000 Chapter 10 Appendix A Section 17, Specification Section 028200 Asbestos Abatement, and ES&H Manual PUB-3000 Chapter 36 Asbestos Hazards and Controls. Any project requiring asbestos cleanup, removal, or disturbance will require the Subcontractor to submit a project specific Asbestos Compliance Work Plan, Job Hazard Analysis, and associated training/medical surveillance records. For additional information see the Facilities and Construction Field Guide 18-Summary and highlights of LBNL Master Specification 28200 Asbestos Abatement and the project specification section itself.

Is there a potential for asbestos containing materials in the work location including existing building materials or materials being used? (Asbestos Use/Distrubance 1)*

Yes

Is the project likely to require work near the asbestos containing materials? (Asbestos Use/Distrubance 2)*

Yes

Is the project likely to require the disturbance or use of asbestos? (Asbestos Use/Distrubance 3)*

Yes

Blocking of Exits/Pathways

Any project that results in the blocking of pedestrian or building egress is required to submit a site logistics plan that includes affected areas, alternate routes, duration, and any other critical information.

Is the project likely to require the blocking of building or pedestrian egress? (Blocking of Exits 1)*

Yes

Surface Penetrations

Surface Penetration is defined as an opening made by excavating, drilling, cutting, hammering, or otherwise piercing a wall, floor, ceiling, roof, or ground surface specifically with respect to preventing contact with hidden hazards such as live electrical conductors and other significant hazards such as natural gas, water lines, and compressed air as they relate to the construction activities on LBNL sites.

Subcontractors are required to obtain an LBNL Surface Penetration Permit prior to performing any surface penetrations. This includes all work that requires excavating, drilling, or driving stakes or poles 2 inches or deeper into any non-concrete surface or penetrating any depth into existing concrete surfaces such as floor

slabs, walls, beams, or columns.

Details regarding building and surface penetration requirements at LBNL can be found in ES&H Manual PUB-3000 Chapter 10 Appendix A Section 39 Building Surface Penetrations and Section 10 Excavations.

Specification. Any surface penetration will require the contractor to submit a project specific program or plan that details the locations, depths, and methods of penetration. In addition, any associated JHAs including drilling, cutting, or chipping, excavation, demolition, or any other associated tasks must be submitted.

Is the project likely to require penetrating any surfaces including the ground or building structures? (Surface Penetrations 1)*

Yes

Is the project likely to require penetrations to existing wall surfaces? (Surface Penetrations 2)*

Yes

Is the project likely to require the penetration of ground surfaces? (Surface Penetrations 3)*

Yes

Is the project likely to require floor or ceiling penetrations? (Surface Penetrations 4)*

Yes

Chemical Use

Chemicals of all kinds must be handled with care at LBNL. The use of any chemicals require the subcontractor to follow all requirements in the Safety Data Sheet (SDS). The use of chemicals onsite that contain any hazardous constituents require specific controls for their use to be documented and followed. Some chemicals are considered by LBNL to be extremely hazardous and have additional requirements for bringing on LBNL property. Extremely hazardous materials at LBNL include the following classes of chemicals:

Alkali metals
Beryllium
Perchloric acid/peroxide-forming chemicals
Unstable, reactive, pyrophoric
Highly flammable, or explosive chemicals
Hydrofluoric acid
Radioactive materials
Highly toxic chemicals and reproductive toxins
Pesticides/herbicides

Use of these chemicals at LBNL may necessitate additional control mechanisms such as establishing dedicated use areas, specific postings/warning signs, notification to adjacent workers, ventilation controls, decontamination procedures, personal hygiene facilities, etc.

Details regarding Chemical Use requirements at LBNL can be found in ES&H Manual PUB-3000 Chapter 45 Chemical Hygiene and Safety Plan as well as ES&H Manual PUB-3000 Chapter 10 Appendix A, Sections 29 General Commercial Product/Chemical use, Section 20 Chemical Spills, Section 16 Industrial Hygiene, and Section 37 Hazard Communication Program.

Any chemical use will require the contractor to submit a project specific program or plan that details the specific controls for the chemicals being brought onsite. Any use of chemicals onsite requires the contractor to submit a project specific Hazard Communication Program, CHemical Use Program, and a JHA for Chemical Use.

Is the project likely to require the use of chemicals containing any hazardous constituents? (Chemical Use 1)*

Yes

Is the project likely to require the use of any highly hazardous chemicals as listed above? (Chemical Use 2)*

Yes

Confined Space

Confined Spaces are defined by OSHA, as a space that meets the following criteria:

Is large enough and so configured that an employee can bodily enter and perform assigned work; and
Has limited or restricted means for entry or exit (for example, tanks, vessels, silos, storage bins, hoppers, vaults, and pits are spaces that may have limited means of entry.); and
Is not designed for continuous employee occupancy.

Entries into confined spaces must be controlled either through administrative controls for non-permit confined spaces or through the permit procedure for permit-required confined spaces.

Controls for confined space entries include, but are not limited to:

Mechanical ventilation;
Atmospheric Monitoring
Use of isolation procedures (LOTO);
Cleaning of confined space;
Electrical precautions;
Fire precautions;
PPE; and
Communication procedures

When the configuration of an excavation is such that the excavation is deemed to be a confined space, the provisions above also apply.

Details regarding Confined Space can be found in ES&H Manual PUB-3000 Chapter 34, Confined Spaces, as well as Chapter 10 Appendix A, Section 38 Confined Spaces. Any project involving confined space entry of any kind requires the subcontractor to submit the company specific Confined Space Program, Confined Space Entry JHAs, and all applicable training documentation.

Is the project likely to create or be in proximity to confined spaces including Non-permit required confined spaces, Permit required confined spaces, or reclassified confined spaces? (Confined Space 1)*

Yes

Is the project likely to require employees to enter Non-Permit required confined spaces or Reclassified Permit required confined spaces? (Confined Space 2)*

Yes

Is the project likely to require personnel to enter Permit Required Confined Spaces or Non-permit required confined spaces where the work will introduce any known hazards into the space? (Confined Space 3)*

Yes

Is the project likely to require personnel to enter a confined space that has the potential for an atmosphere that is Immediately Dangerous to Life and Health (IDLH) or is configured in such a way that requires detailed rescue planning? (Confined Space 4)*

Yes

Hoisting and Rigging (Cranes)

Persons involved in crane or hoist operations at Lawrence Berkeley National Laboratory (Berkeley Lab) must:

Be aware of the hazards related to the equipment and the load
Know the methods for controlling those hazards
Follow the proper operating procedures applicable to the type of lift and equipment

The designated operator must be qualified and authorized to use specific equipment. Crane, hoist, and rigging equipment must be properly inspected, tested, and maintained. Berkeley Lab’s Crane Safety Program is implemented through planning, authorization, qualification, and the appropriate use of properly inspected and rated hoisting equipment and rigging.

Details regarding Hoisting and Rigging can be found in ES&H Manual PUB-3000 Chapter 27, Cranes, Hoists, and Rigging Safety, Chapter 28, Forklifts and Other Powered Industrial Trucks, as well as Chapter 10 Appendix A, Section 12 Hoisting and Rigging and Section 5.2.2 Material Handling and Storage. Also see Construction Field Guide 5 Hoisting and Rigging for additional supplemental information

Any Hoisting or Rigging operations or Non-Conventional Material Handling will require the contractor to submit a project specific Hoisting and Rigging Plan and/or under some conditions a project specific Material Handling Plan. In addition, any associated JHAs including Crane Use and/or All Terrain/Powered Industrial Trucks.

Is the project likely to require the use of a crane? (Crane Use 1)*

Yes

Is the project likely to include a critical lift? (Crane Use 2)*

Details regarding what constitutes a critical lift can be found in ES&H Manual PUB-3000 Chapter 27, Cranes, Hoists, and Rigging Safety, Work Process D.

Yes

Discharge to Sanitary Sewers Systems or Storm Water Drainage Systems

Details regarding discharges to Sanitary Sewers can be found in ES&H Manual PUB-3000 Chapter 55 Sanitary Sewer Program and Chapter 57 Stormwater Pollution Prevention.

Is the project likely to require any discharge to sanitary sewer systems or Storm Water Drainage Systems? (Discharge to Septic 1)*

Yes

Electrical Work

Electrical work is defined as any task that involves a shock or arc flash hazard or could create potential shock or arc flash hazards for future users. This includes both live and de-energized work for building, servicing, maintaining, and repairing equipment. For differentiation on what constitutes electrical work, see the Electrical Safety Manual.

Details regarding Electrical Safety can be found in ES&H Manual PUB-3000 Chapter 8, Electrical Safety Program, Chapter 18, Lockout/Tagout Program, as well as Chapter 10 Appendix A, Section 9 Electrical Safety and the LBNL Electrical Safety Website.

Is the project likely to require electrical work of any kind including rough in work, energized electrical work, or de-energized electrical work under LOTO? (Electrical Work 1)*

Yes

Is the electrical work likely to require exposure to voltages greater than 50 volts or 5 milliamps? (Electrical Work 2)*

Yes

Is the electrical work likely to require exposure to voltages greater than 120 volts? (Electrical Work 3)*

Yes

Is the electrical work likely to require exposure to voltages greater than 600 volts? (Electrical Work 4)*

Yes

Excavations

Excavation is the process of moving things like earth, rock, or other materials with tools, equipment, or by other means. It includes earthwork, trenching, wall shafts, tunneling, and underground. Excavation has several critical purposes, including exploration, environmental restoration, mining, and construction.

Details regarding Excavations can be found in ES&H Manual Pub-3000 Chapter 10 Appendix A, Section 10 Excavations and Section 38 Confined Spaces,as well as, ES&H Manual PUB-3000 Chapter 34, Confined Spaces.

Any project involving excavation of any kind requires the subcontractor to submit the project specific Excavation Plan, Excavation JHAs, all applicable training documentation, and in some cases their company specific Confined Space Program.

Is the project likely to require excavation work? (Excavation 1)*

Yes

Is the project likely to require excavation work no greater than five feet Type A Soil, greater than four feet Type B Soil, greater than ten feet Stable Rock, or will any excavation of any depth have the potential for any introduction of asphixiants (e.g. nitrogen, argon, or most commonly carbon monoxide) into the excavation? (Excavation 2)*

Yes

Is the project likely to require excavation work between five and twenty feet or any depth greater than four feet Type C Soil? (Excavation 3)*

Yes

Is the project likely to require excavation work greater than twenty feet? (Excavation 4)*

Yes

Fall Protection

Work on any walking or working surface having an unprotected side or edge that is 6 feet high or more requires protection. Surfaces can include leading edges, roofs, tanks, manholes, unguarded machinery, aerial lifts, ladders, slopes steeper than 1.2:1 (horizontal to vertical), hillsides, roofs, and surfaces with open holes or skylights.

Details regarding Fall Protection can be found in ES&H Manual Pub-3000 Chapter 30 Fall Protection Program, Chapter 35 Elevated Work, as well as, Chapter 10 Appendix A, Section 14 Fall Protection

Any project involving work at hieghts of any kind requires the subcontractor to submit the project specific Fall Protection Plan, Fall Protection JHAs, and all applicable training documentation.

Is the project likely to require the use of fall protection including passive systems or active personal fall protection systems? (Fall Protection 1)*

Yes

Is the project likely to require the use of Fall Restraint Systems to prevent falls? (Fall Protection 2)*

Yes

Is the project likely to require the use of Fall Arrest or Rope Access Systems to prevent falls? (Fall Protection 3)*

Yes

Is the project likely to require the use of administrative controls including infeasibility plans, non-conforming guardrail, controlled access zones, or any other type of administrative controls to prevent falls? (Fall Protection 4)*

Yes

Ladder Use

Ladder work at LBNL includes all work involving the use of extension ladders, a-frame ladders, fixed ladders, job-made ladders, or any other structure meeting the OSHA definition of a ladder.

Details regarding ladder use can be found in ES&H Manual Pub-3000 Chapter 30 Fall Protection Program, Chapter 35 Elevated Work, as well as, Chapter 10 Appendix A, Section 14 Fall Protection.

Any project involving work at hieghts of any kind requires the subcontractor to submit ladder use JHAs, and all applicable training documentation.

Is the project likely to require the use of ladders? (Ladder Use 1)*

Yes

Is the ladder use likely to require the workers feet to be above six feet? (Ladder Use 2)*

Yes

Is the project likely to require workers to climb ladders greater than twenty four feet? (Ladder Use 3)*

Yes

Hand and Power Tools

The subcontractor is responsible for the safe condition and maintenance of all tools and equipment to be used by all contractor employees. The subcontractor superintendent must ensure that his or her employees know how to safely use the tools they work with.

Details regarding ladder use can be found in ES&H Manual Pub-3000 Chapter 10 Appendix A, Section 7 Hand and Power Tools.

Any project involving the use of hand and power tools of any kind of any kind requires the subcontractor to submit Hand and Power Tools JHAs, Powder Actuated Tool JHAs, and all applicable training documentation.

Is the project likely to require the use of hand tools? (Hand and Power Tools 1)*

Yes

Is the project likely to require the use of power tools? (Hand and Power Tools 2)*

Yes

Is the project likely to require the use of powder actuated tools? (Hand and Power Tools 3)*

Yes

Hazardous Waste

LBNL holds the necessary Resource Conservation and Recovery Act (RCRA) generator identification numbers to conduct waste generation and collection activities. LBNL prohibits treating (evaporation, neutralization, dilution, or reduction of volume or toxicity) or disposing

of hazardous waste on site.

For more information, reach out to your LBNL Construction Manager or Project Manager. In addition, see Facilities Planning and Field Guide 1 Waste Management Plan for Large and Non routine Generate Waste.

Is the project likely to generate hazardous waste? (Hazardous Waste 1)*

Yes

Hoisting and Rigging (Non-Crane)

Hoisting and rigging (Non-crane) operations in the context of this question refers to the use of chain falls, come-alongs, manual or mechanical hoists, and any other hoist not related to cranes.

Persons involved in hoist operations at Lawrence Berkeley National Laboratory (Berkeley Lab) must:

Be aware of the hazards related to the equipment and the load
Know the methods for controlling those hazards
Follow the proper operating procedures applicable to the type of lift and equipment

The designated operator must be qualified and authorized to use specific equipment. Berkeley Lab’s Hoisting and Rigging Safety Program is implemented through planning, authorization, qualification, and the appropriate use of properly inspected and rated hoisting equipment and rigging.

Any Hoisting or Rigging operations or Non-Conventional Material Handling will require the contractor to submit a project specific Hoisting and Rigging Plan and/or under some conditions a project specific Material Handling Plan. In addition, any associated JHAs including Hoisting and Rigging and/or All Terrain/Powered Industrial Trucks.

Is the project likely to require the use of non-crane related hoisting and rigging? (Non-Crane Hoisting and Rigging 1)*

Yes

Heavy Equipment

Operation of heavy equipment such as excavators, loaders, graders, rollers, and bulldozers, should always be done by highly skilled operators who have demonstrated the ability and necessary skills to operate safely. Ground-based workers should be trained in how to work safely around the equipment, and how to stay clear. Unsafe practices by either the operator or those around the equipment can create very dangerous situations. Serious injuries can occur if the equipment strikes a worker, or if the equipment is rolled over.

Any use of Heavy Equipment requires the subcontractor to submit a company specific Heavy Equipment Program and associated Heavy Equipment JHAs prior to use.

Is the project likely to require the use of heavy equipment? (Heavy Equipment Use 1)*

Yes

Laser Use

Class 1 laser systems incorporated into commercially available devices for use by the general public are exempt from these requirements, unless opened, serviced or modified. Laser equipment must bear a conspicuously displayed label to indicate hazard classification.

Users of Class 1, Class 1M, Class 2, Class 2M, Class 3a, or Class 3R lasers must read and abide by the safety documentation provided in the operator’s manual. Only qualified and trained personnel may service, adjust, or repair laser equipment. Employees, when working in areas in which a potentially hazardous exposure to direct or reflected laser radiation exists, must be provided with anti-laser protection devices.

Details regarding Lasers and Laser Use at LBNL can be found in ES&H Manual PUB-3000 Chapter 16, Laser Safety.

Is the project likely to require the use of lasers? (Laser Use 1)*

Yes

Is the laser likely to be Class 3B or greater? (Laser Use 2)*

Yes

Is the laser likely to be Class 4? (Laser Use 3)*

Yes

Lead Containing Material

Most painted surfaces at LBNL have lead in some layer of paint at or beneath the surface. Though not currently used for painting at LBNL, lead was commonly used in the past as an ingredient in paints. Most of these painted surfaces do not pose a significant health risk to LBNL employees or subcontractors unless lead aerosols are produced by disturbance activities that include, but are not limited to:

sanding, grinding, welding or hot cutting painted metal surfaces.

For actual lead abatement, or other lead generating activities such as lead related welding or hot cutting, lead dust disturbance/clean-up, etc., LBNL’s Lead Specification (028300) must be followed.

Lead bricks used for shielding are another common source of lead at LBNL. Moisture can react with unprotected lead to produce lead oxide dust (white dusty appearance) on the surface. Because it can easily become airborne, this powdery material can become a hazard when these bricks are disturbed. Even when lead oxide and carbonate have not been produced; loose lead particulate can be spread when the brick surface is handled. Ingestion or inhalation of this dust can be hazardous.

Settled dust on horizontal and vertical surfaces in older buildings, including air handling systems, has the potential to contain some lead due to environmental lead from the use of lead in gasoline, as well as other sources, and should also be factored into work in these areas.

Details regarding Lead Work requirements at LBNL can be found in ES&H Manual PUB-3000 Chapter 10 Appendix A Section 22 Lead, Specification Section 028300 Lead Abatement, and ES&H Manual PUB-3000 Chapter 37 Lead Hazards and Controls. Any project requiring lead cleanup, removal, or disturbance will require the Subcontractor to submit a project specific Lead Compliance Work Plan, Job Hazard Analysis, and associated training/medical surveillance records. For additional information see the Facilities and Field Guide 7-Lead Hazards and Controls.

Is there a possibility of lead containing materials in the work location including existing building materials or materials being used? (Lead Work 1)*

Yes

Is the project likely to require work near the lead containing materials? (Lead Work 2)*

Yes

Is the project likely to require the disturbance or use of lead containing material? (Lead Work 3)*

Yes

Lock Out / Tag Out

All personnel who perform work on or near equipment in which the unexpected energization or start-up of the equipment, or the release of hazardous stored energy, could cause injury shall personally lock out the equipment for the duration of their work.

Lockout/Tagout (LOTO) is required whenever construction, service, maintenance, modification, or demolition is being performed on or near equipment in which the unexpected energization or start-up of the equipment, or the release of hazardous stored energy, could cause injury to people.

Hazardous energy is any form of energy that can cause personal injury, including but not limited to:

Electrical
Mechanical
Rotational
Gravitational
Chemical
Pressure or vacuum
Hydraulic
Pneumatic
Non-ionizing radiation sources
Thermal

Details regarding Lockout/Tagout requirements at LBNL can be found in ES&H Manual PUB-3000 Chapter 18 Lockout/Tagout Program, and Chapter 10 Appendix A Section 8 Control of Hazardous Energy, Lockout/Tagout. Any project where exposure to hazardous energy sources is required, subcontractor must submit a company specific LOTO Program and associated training records. In addition, any JHA involving Hazardous Energy must include LOTO controls.

Is the project likely to require Lock Out Tag Out to control any hazardous energy sources? (LOTO 1)*

Yes

Is the contractor likely to establish LOTO as part of the project or will they join an existing LOTO? (LOTO 2)*

Yes

Is the project likely to require complex LOTO? (LOTO 3)*

Yes

Material Handling

Material handling in the context of this question includes but is not limited to manually moving objects or material around using personnel, using pallet jacks, forklifts, or Telescopic material handlers, and the use of Backhoes, Trackhoes, or similar mobile equipment.

Persons involved in material handling operations at Lawrence Berkeley National Laboratory (Berkeley Lab) must:

Be aware of the hazards related to the equipment and the load
Know the methods for controlling those hazards
Follow the proper operating procedures applicable to the type of lift and equipment

The designated operator must be qualified and authorized to use specific equipment. All equipment must be properly inspected, tested, and maintained including rigging, fork attachments, and any other material handling equipment. At Berkeley Lab, the use of material handling equipment is implemented through planning, authorization, qualification, and the appropriate use of properly inspected and rated hoisting equipment and rigging, material handling equipment such as Telehandlers, Forklifts, Backhoes, Trackhoes, or similar mobile equipment to handle material on forks, on fork attachments, or from rigging.

Is the project likely to require manual material handling? (Material Handling 1)*

Yes

Is the project likely to require the use of powered industrial trucks/forklifts? (Material Handling 2)*

Yes

Is the project likely to involve the use of a telescopic material handler/reachfork/trackhoe/backhoe to move material or equipment? (Material Handling 3)*

Yes

Is the powered industrial truck/forklift/trackhoe/backhoe/telescopic material handling use likely to require traveling with an elevated boom or lifting with suspended loads? (Material Handling 4)*

Yes

Plumbing/Pipefitting/Hot Tap

Details regarding Plumbing/Pipe Fitting/Hot Tap can be found in ES&H Manual PUB-3000 Chapter 10 Appendix A, Section 11.3.2 Hot Work Permit and Section 10.4.2 Underground Service/Utilities. Any project involving Plumbing/Pipe Fitting/Hot Tap of any kind requires the subcontractor to submit a Plumbing/Fitiing JHA, and/or Hot Tap JHA.

Is the project likely to involve plumbing modification or installation? (Plumbing/Pipefitting/Hot Tap 1)*

Yes

Is the project likely to involve plumbing modification or installation on an energized system? (Plumbing/Pipefitting/Hot Tap 2)*

Yes

Is the project likely to involve plumbing modification or installation on an energized system containing any hazardous materials? (Plumbing/Pipefitting/Hot Tap 3)*

Yes

Silica Use/Disturbance

Silica is the main component found in sand, quartz, and granite rock. Excessive amounts of silica dust may be generated during activities including, but not limited to, sandblasting, rock drilling, grinding concrete, stone cutting, drilling, quarrying, brick concrete cutting, gunnite operations, asphalt grinding, opening and pouring bags of cement products, demolition operations, jack hammering, chipping and sweeping concrete or masonry dust.

Silica can cause silicosis, a serious and sometimes fatal respiratory disease. Silicosis develops from breathing silica dust on the job. Symptoms of silicosis can either be chronic, appearing after 5 to 10 years of being exposed to invisible silica dust without using respiratory protection. Symptoms can also be acute appearing after only a few weeks of working in thick clouds of silica without respiratory protection.

Silica is also capable of causing lung cancer with prolonged heavy occupational exposures. Workers with impaired lung function due to silica exposure are also more susceptible to other respiratory disease such as tuberculosis.

Details regarding Silica Dust can be found in ES&H Manual PUB-3000 Chapter 10 Appendix A, Section 24 Silica Dust. Any project involving the disturbance silica dust of any kind requires the subcontractor to submit a project specific Silica Exposure Control Plan, Core Drilling/Saw Cutting/Concrete or Asphalt Cutting JHA, and/or Concrete Work JHA. In addition, a company specific Respiratory Protection Program may be required. In addition, Silica Awareness Training, Respirator Training, Fit Test Records, and Medical Release to wear respiratory protection may be required.

Is the project likely to involve the disturbance or use of Silica based products? (Silica 1)*

Yes

Scaffold Building/Use

Minimum requirements for scaffold use at LBNL can be found in the ES&H Manual Pub-3000 Chapter 35 Elevated Work, Chapter 30 Fall Protection Program, and Chapter 10 Appendix A Section 42 Scaffolding. Any project requiring the building or use of Scaffold Systems will require the Subcontractor to submit a project specific Scaffold Plan, Job Hazard Analysis, and associated training records.

All use of Scaffold that is not green tagged requires an LBNL Fall Matrix Permit prior to working at heights. During scaffold erection and dismantling, the designated competent person overseeing the

operation must determine the feasibility of positive fall protection. If positive fall protection is deemed infeasible, the competent person must put a fall protection plan in writing that meets the LBNL requirements and obtain a fall matrix permit. This permit should be coordinated by you LBNL Construction or Project Manager.

Is the project likely to require the use of scaffold? (Scaffold 1)*

Yes

Is the scaffold likely to be green tagged? (Scaffold 2)*

Yes

Is the scaffold likely be yellow tagged? (Scaffold 3)*

Yes

Is the project likely to require scaffold building? (Scaffold 4)*

Yes

Traffic Control

Minimum requirements for traffic control can be found in the ES&H Manual Pub-3000 Chapter 60 Traffic and Pedestrian Safety and Chapter 10 Appendix A Section 6 Traffic Control. Any project requiring the blocking or control of LBNL roadways or walkways will require the Subcontractor to submit a project specific Traffic Control Plan and associated training records.

Is the project likely to require work near or in roadways? (Traffic Control 1)*

Yes

Is the project likely to directly impact the flow of traffic? (Traffic Control 2)*

Yes

Hot Work

Minimum requirements for Hot Work at LBNL can be found in the ES&H Manual Pub-3000 Chapter 33 Welding, Joining, or Thermal Cutting, Chapter 12 Fire Prevention and Protection Program, and Chapter 10 Appendix A Section 30 Welding & Hot Cutting and Section 11.3.2 Hot Work Permit. Any project requiring Hot Work will require the Subcontractor to submit a project specific Fire Protection Plan and Job Hazard Analysis. The subcontractor must obtain an LBNL Hot Work/Fire Permit permit. This permit should be coordinated by you LBNL Construction or Project Manager.

Is the project likely to require hot work of any kind? (Hot Work 1)*

Yes

Is the project likely to require soldering? (Hot Work 2)*

Yes

Is the project likely to require brazing or grinding? (Hot Work 3)*

Yes

Is the project likely to require welding or torch cutting? (Hot Work 4)*

Yes

Environmental Protection

Minimum requirements for the protection of the environment at LBNL can be found in the ES&H Manual Pub-3000 Chapter 50 Environmental Radiological Protection Program, Chapter 51 Environmental Releases, Chapter 11 Environmental Protection, Chapter 54 Transporting and Shipping Hazardous Materials, Chapter 61 Soil and Groundwater Management, Chapter 62 Environmental Monitoring, and Chapter 10 Appendix A Section 40 Environmental Requirements.

Is the project likely to require excavating soils? (Environmental 1)*

Yes

Is the excavating likely to produce more than twenty cubic yards of soils or have historical/olfactory evidence of contamination? (Environmental 2)*

Yes

Is the excavating likely to produce more than one hundred cubic yards of soil? (Environmental 3)*

Yes

Demolition

Prior to permitting employees to start demolition operations, a qualified person, designated by the subcontractor, must make an engineering survey. This survey must determine the condition of the framing, floors, and walls, and will also determine the possibility of an unplanned collapse of any part of this structure. Adjacent structures will be checked for structural integrity. Written evidence of the results of this survey is to be given to the Berkeley Lab Project Manager.

Demolition work must at all times be under the immediate supervision of a qualified person with the authority to secure maximum safety for employees engaged in demolition work. Prior to beginning demolition operations, the Berkeley Lab Project Manager will obtain a site survey identifying the locations of asbestos- and lead-containing materials.

The subcontractor must employ a testing agency that can identify and/or verify areas suspected of containing these materials prior to their disturbance during the demolition operation.

The Berkeley Lab Project Manager must be responsible for developing and documenting a detailed Utility Isolation Plan. All electric, gas, water, steam, sewer, and other service lines must be shut off, capped, or otherwise controlled outside the building line before demolition

work is started.

Prior to cutting any electrical conduits, all wiring shall be removed. If the wiring cannot be removed, approval to cut the conduit without removing the wires must be obtained from the Projects and Infrastructure Modernization Division (PIMD) Electrical Safety Officer (ESO) and

the PIMD Division Director.

Prior to seeking approval, the development of a project specific written safety plan describing alternative methods to help ensure worker safety must be completed. The written safety plan must be prepared and signed by the requestor (Construction Manager, Project Manager, or

Project Director) and will describe the reasons why the wiring in question cannot be removed. The written safety plan will describe all additional safety measures to be implemented to help ensure worker safety.

If electric, gas, water, steam, sewer, or other utilities are necessary during demolition, their lines must be temporarily relocated and protected. Before demolition begins, the building will be checked by Berkeley Lab management to determine whether any hazardous chemicals, gases, explosives, flammable materials, or similarly dangerous substances have been used in pipes, tanks, or other equipment on the property. If found, such substances will be decontaminated or eliminated before demolition is

started.

Minimum requirements for Demolition Work at LBNL can be found in the ES&H Manual Pub-3000 Chapter 10 Appendix A Section 41 Demolition. Any project requiring Demolition Work of any kind will require the Subcontractor to submit a project specific Utility Isolation Plan and/or Demolition Plan and Job Hazard Analysis.

Is the project likely to require the demolition of any structures, systems, or equipment? (Demolition 1)*

Yes

Is the project likely to require demolition of exisitng systems, that are still connected to utilities of any kind, have been connected to utilities of any kind, or will require the modification of exisitng systems or building structures? (Demolition 2)*

Yes

Is the project likely to require the complete demolition of structures or equipment? (Demolition 3)*

Yes

Ioniizing Radiation

Minimum requirements for the use of radioactive materials or radiation genertating devices at LBNL can be found in the ES&H Manual Pub-3000 Chapter 21 Radiation Safety.

Is the project likely to require the use of radioactive materials or Ionizing radiation-generating devices? (Ionizing Radiation 1)*

Yes

Increased Risk Characterization

The following questions are designed to further characterize the Risk Impact and Complexity of projects using non-task specific aspects.

Is this likely to be a Capital Project (>$10 million)? (Capital Project)*

Yes

Are there potential aspects of the project that are highly specialized or uncommon in the construction industry? (New Construction Type)*

This could be any number of activities not normally part of standard construction operations including but not limited to, tower climbing, abrasive blasting, soil stabilization, explosives demolition, bridge or tunnel construction, Electrical Transmission construction, Hazardous Materials Operations (HAZMAT), and any other construction work not usually encountered on a conventional construction project.

Yes

Will there be more than three trades working on the project? (Multiple Trades)*

Yes

Is the project duration scheduled to last more than twelve months including only hands on field work? (Project Duration)*

Yes

Will the number of workers on the project exceed fifteen at any given time? (Worker Load)*

Yes

Will any of the project work be performed on any hillside greater than 66 percent slope or 33 degree angle? (Terrain)*

See the linked website to help visualize and quantify these characteristics by entering an 8 in 12 pitch.

Yes

Is the project likely to require the use of specialized equipment that is uncommon to the construction projects at LBNL? (Specialized Equipment)*

This can include a wide range of specialty equipment that is not used normally on conventional construction projects and more specifically not used on any projects at LBNL in approximately the previous two years. While this description does not include a formal list of specialty equipment, it should be equipment that requires very specialized training, very specific manufacturer work procedures, or any unique characteristics that make it unlike standard construction equipment.

Yes

Does the building or room where the work is occuring have historical radiological impacts or are there radiological impacted soils in the work area? (Radiological)*

Yes

What is the approximate age of the building where the project will be performed? (Building Age 1)*

Building built in the past 30 years

Building greater than 30 years old but less than 50 years old

Building greater than 50 years old

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