Construction Committee Rounds Compliance Checklist

Project Title Replace bi-Plane IR b500- 691-CSI-125 (Code: 5,2,0,0)

Date 11/4/2021
Location (Bldg. floor/room) B500- 5th Flr- Room 5218
Contractor & Superintendents Name & Phone Ron: Ph #626.203.9928
Project Engineers Name & Phone Tom Phan

Construction Barricade (Prevent dust travel) Yes No N/A Target Abatement Date Date Corrected
Construction site door locked from unauthorized entry X
Temporary walls sealed, no penetrations X
Temporary doors have closers X
Door frames have gasket, doors close and seal properly X
Approved plastic barriers installed (7days or less) X
Walk-off mats (clean & adequate to contain dust) X
Adjacent floor areas clean, no dust tracks X
Adjacent ceiling areas intact or restored within same day. X
Interstitial properly sealed and maintained to prevent dust
X
travel
Comments:

Negative Air Machine/s (Construction) Yes No N/A Target Abatement Date Date Corrected
Negative Air Machine on Site X
Negative air machine(s) (connected) running (24/7) X
Negative air machines filters clean X Corrected immediately
Negative air discharge hoses intact X
Negative air discharge hose properly vented X
Negative air filter record posted on unit and updated X
All windows and doors closed behind in construction area X
Comments:
 Jobsite Yes No N/A Target Abatement Date Date Corrected

Construction site door locked from unauthorized entry X

Project area clean, debris removed daily X
Floors sweep and kept clean X
Debris removed daily and in suitable containers
X
(closed/covered, wheels cleaned prior to transport)
Construction personnel & materials transported on dedicated
X
service elevator
Construction personnel wearing required PPE (e.g., hardhat,
X
protective eyewear, footwear).
Construction workers wearing proper ID X
Signs posted for construction area X
All permits properly pulled and posted (ILSM’s & Infection
X
Control Permits, Hot Work, etc.)
Corridors kept clean and clear X
Proper exit signage posted X
Cutting and Welding operations safely conducted X
Lock/tagout procedures used X
Exits provide free and unobstructed access X
Alternate exits are clearly identified in and around
X
construction
Other safety/fire issues noted (Please comment) X
Temporary partitions to protect VA property & individuals
from dust, debris and infection control measures. X

Comments: Other safety/fire issues noted (Please comment)

 Fire Safety (Fire Protection) Yes No N/A Target Abatement Date Date Corrected
Fire sprinkler heads unobstructed X
Fire sprinkler heads protected after installation X
Smoke detectors uncovered at end of shift X
Temporary fire alarm, detection and suppression
X
systems inspected and tested monthly

Fire extinguishers properly mounted and checked A new fire extinguisher

monthly, own occupational safety station during X brought to the site
construction by contractor. immediately

Penetrations (Floor, Wall, Ceiling) must be sealed

X
and smoke fire proofed
Comments:

Additional Notes: Address corrections within 24 hours or provide correction plan.

 Construction Committee Rounds Compliance Checklist
Project Title 691-18-109 Pharmacy Compliance, B500, Room 4028 (Code; 1, 7, 2, 2)
Date 11/4/2021
Location (Bldg. floor/room) B500 - Room 4028
Contractor & Superintendents Name & Phone D - Square
Project Engineers Name & Phone Tom Phan

Target
Construction Barricade (Prevent dust travel) Yes No N/A Abatement Date Corrected
Date
Construction site door locked from unauthorized entry X
Temporary walls sealed, no penetrations X
Temporary doors have closers X
Door frames have gasket, doors close and seal properly X
Approved plastic barriers installed (7days or less) X
Walk-off mats (clean & adequate to contain dust) X
Adjacent floor areas clean, no dust tracks X
Adjacent ceiling areas intact or restored within same day. X
Interstitial properly sealed and maintained to prevent dust travel X
Comments:

Target
Negative Air Machine/s (Construction) Yes No N/A Abatement Date Corrected
Date
Negative Air Machine on Site X
Negative air machine(s) (connected) running (24/7) X
Negative air machines filters clean X 11/10/2021
Negative air discharge hoses intact X
Negative air discharge hose properly vented X
Negative air filter record posted on unit and updated X
All windows and doors closed behind in construction area X
Comments: Machine air filter log missing
 Target
Jobsite Yes No N/A Abatement Date Corrected
Date
Construction site door locked from unauthorized entry X
Project area clean, debris removed daily X
Floors sweep and kept clean X
Debris removed daily and in suitable containers (closed/covered, wheels
X
cleaned prior personnel
Construction to transport)
& materials transported on dedicated service
X
elevator
Construction personnel wearing required PPE (e.g., hardhat, protective
X
eyewear, footwear).
Construction workers wearing proper ID X
Signs posted for construction area X
All permits properly pulled and posted (ILSM’s & Infection Control
X
Permits, Hot Work, etc.)
Corridors kept clean and clear X
Proper exit signage posted X
Cutting and Welding operations safely conducted X
Lock/tagout procedures used X
Exits provide free and unobstructed access X
Alternate exits are clearly identified in and around construction X
Other safety/fire issues noted (Please comment) X
Temporary partitions to protect VA property & individuals from dust, X
debris and infection
Comments: control measures.
Other safety/fire issues noted (Please comment)

Target
Fire Safety (Fire Protection) Yes No N/A Abatement Date Corrected
Date
Fire sprinkler heads unobstructed X
Fire sprinkler heads protected after installation X
Smoke detectors uncovered at end of shift X
Temporary fire alarm, detection and suppression
X
systems inspected and tested monthly

Fire extinguishers properly mounted and checked

monthly, own occupational safety station during X
construction by contractor.

Penetrations (Floor, Wall, Ceiling) must be sealed

X
and smoke fire proofed
Comments:

Additional Notes: Address corrections within 24 hours or provide correction plan.

 Construction Committee Rounds Compliance Checklist
Project Title Replace Linear Accelerator- 691CSI-121 (Code: 1,3,5,7)
Date 11/4/2021
Location (Bldg. floor/room) B500- Grnd Flr- Room 0867
Contractor & Superintendents Name & Phone Dave Olsen - ph:562-254-1033
Project Engineers Name & Phone Tom Phan

Target Abatement
Construction Barricade (Prevent dust travel) Yes No N/A Date Corrected
Date
Construction site door locked from unauthorized entry X
Temporary walls sealed, no penetrations X
Temporary doors have closers X
Door frames have gasket, doors close and seal properly X
Approved plastic barriers installed (7days or less) X
Walk-off mats (clean & adequate to contain dust) X 11/10/2021
Adjacent floor areas clean, no dust tracks X 11/10/2021
Adjacent ceiling areas intact or restored within same day. X
Interstitial properly sealed and maintained to prevent dust
X 11/10/2021
travel
Comments: Soda cans and debris lying on the floor.

Target Abatement
Negative Air Machine/s (Construction) Yes No N/A Date Corrected
Date
Negative Air Machine on Site X
Negative air machine(s) (connected) running (24/7) X
Negative air machines filters clean X 11/10/2021
Negative air discharge hoses intact X 11/10/2021
Negative air discharge hose properly vented
Negative air filter record posted on unit and updated X
All windows and doors closed behind in construction area X
Comments: Found holes in air discharge hose.
 Target Abatement
Jobsite Yes No N/A Date Corrected
Date

Construction site door locked from unauthorized entry X

Project area clean, debris removed daily X 11/10/2021
Floors sweep and kept clean X 11/10/2021
Debris removed daily and in suitable containers
X
(closed/covered, wheels cleaned prior to transport)
Construction personnel & materials transported on dedicated
X
service elevator
Construction personnel wearing required PPE (e.g., hardhat,
X
protective eyewear, footwear).
Construction workers wearing proper ID X
Signs posted for construction area X
All permits properly pulled and posted (ILSM’s & Infection
X
Control Permits, Hot Work, etc.)
Corridors kept clean and clear X 11/10/2021
Proper exit signage posted X
Cutting and Welding operations safely conducted X
Lock/tagout procedures used X
Exits provide free and unobstructed access X 11/10/2021
Alternate exits are clearly identified in and around
X
construction
Other safety/fire issues noted (Please comment) X
Temporary partitions to protect VA property & individuals
from dust, debris and infection control measures. X

Comments: Other safety/fire issues noted (Please comment)

 Target Abatement
Fire Safety (Fire Protection) Yes No N/A Date Corrected
Date
Fire sprinkler heads unobstructed X
Fire sprinkler heads protected after installation X 11/10/2021
Smoke detectors uncovered at end of shift X
Temporary fire alarm, detection and suppression
X
systems inspected and tested monthly
Fire extinguishers properly mounted and checked
monthly, own occupational safety station during X
construction by contractor.
Penetrations (Floor, Wall, Ceiling) must be sealed
X
and smoke fire proofed
Comments: Fire sprinkler heads do not have wire cages..

Additional Notes: Address corrections within 24 hours or provide correction plan.

 Construction Committee Rounds Compliance Checklist
Project Title 691-20-151WL
Date 11/4/2021
Location (Bldg. floor/room) b297- Warehouse- North West End
Contractor & Superintendents Name & Phone Oscar Campos- 619-392-4210
Project Engineers Name & Phone Naveed Subhan *40475

Target Abatement
Construction Barricade (Prevent dust travel) Yes No N/A Date Corrected
Date
Construction site door locked from unauthorized entry X
Temporary walls sealed, no penetrations X
Temporary doors have closers X
Door frames have gasket, doors close and seal properly X
Approved plastic barriers installed (7days or less) X
Walk-off mats (clean & adequate to contain dust) X
Adjacent floor areas clean, no dust tracks X
Adjacent ceiling areas intact or restored within same day. X
Interstitial properly sealed and maintained to prevent dust
X
travel
Comments:

Target Abatement
Negative Air Machine/s (Construction) Yes No N/A Date Corrected
Date
Negative Air Machine on Site X
Negative air machine(s) (connected) running (24/7) X
Negative air machines filters clean X
Negative air discharge hoses intact X
Negative air discharge hose properly vented X
Negative air filter record posted on unit and updated X
All windows and doors closed behind in construction area X
Comments: Industrial area. Negative air machine not required.
 Target Abatement
Jobsite Yes No N/A Date Corrected
Date

Construction site door locked from unauthorized entry X

Project area clean, debris removed daily X
Floors sweep and kept clean X
Debris removed daily and in suitable containers
X
(closed/covered, wheels cleaned prior to transport)
Construction personnel & materials transported on dedicated
X
service elevator
Construction personnel wearing required PPE (e.g., hardhat,
X
protective eyewear, footwear).
Construction workers wearing proper ID X
Signs posted for construction area X
All permits properly pulled and posted (ILSM’s & Infection
X
Control Permits, Hot Work, etc.)
Corridors kept clean and clear X
Proper exit signage posted X 11/10/2021
Cutting and Welding operations safely conducted X
Lock/tagout procedures used X 11/10/2021
Exits provide free and unobstructed access X 11/10/2021
Alternate exits are clearly identified in and around
X 11/10/2021
construction
Other safety/fire issues noted (Please comment) X
Temporary partitions to protect VA property & individuals
from dust, debris and infection control measures. X

Comments:
There was no construction activity on job sitete. Scafolding toeboard is missing
 Target Abatement
Fire Safety (Fire Protection) Yes No N/A Date Corrected
Date
Fire sprinkler heads unobstructed X
Fire sprinkler heads protected after installation X 11/10/2021
Smoke detectors uncovered at end of shift X
Temporary fire alarm, detection and suppression
X 11/10/2021
systems inspected and tested monthly
Fire extinguishers properly mounted and checked
monthly, own occupational safety station during X 11/10/2021
construction by contractor.
Penetrations (Floor, Wall, Ceiling) must be sealed
X
and smoke fire proofed
Comments:
Fire extinguishers on site, not mounted and no inspection record present at the site.

Additional Notes: Address corrections within 24 hours or provide correction plan.

 Construction Committee Rounds Compliance Checklist
Project Title 691-19-111 Reconstruction North Tower Pod C

Location (Bldg. floor/room) B500 1st & Ground floor

Contractor & Superintendents Name & Phone Diego Pena, 805.657.4061
Project Engineers Name & Phone Cisco Silva

Target
Construction Barricade (Prevent dust travel) Yes No N/A Date Corrected
Abatement Date

1 Construction site door locked from unauthorized entry

2 Temporary walls sealed, no penetrations
3 Temporary doors have closers
4 Door frames have gasket, doors close and seal properly
5 Approved plastic barriers installed (7days or less)
6 Walk-off mats (clean & adequate to contain dust)
7 Adjacent floor areas clean, no dust tracks
8 Adjacent ceiling areas intact or restored within same day.
Interstitial properly sealed and maintained to prevent dust
9 travel
Comments:

Target
10 Negative Air Machine/s (Construction) Yes No N/A Date Corrected
Abatement Date
11 Negative Air Machine on Site
12 Negative air machine(s) (connected) running (24/7)
13 Negative air machines filters clean
14 Negative air discharge hoses intact
15 Negative air discharge hose properly vented
16 Negative air filter record posted on unit and updated
17 All windows and doors closed behind in construction area
Comments:
 Jobsite Yes No N/A

18 Construction site door locked from unauthorized entry

19 Project area clean, debris removed daily
20 Floors sweep and kept clean
Debris removed daily and in suitable containers
21 (closed/covered, wheels cleaned prior to transport)
Construction personnel & materials transported on dedicated
22 service elevator
Construction personnel wearing required PPE (e.g., hardhat,
23 protective eyewear, footwear).
24 Construction workers wearing proper ID
25 Signs posted for construction area
All permits properly pulled and posted (ILSM’s & Infection
26 Control Permits, Hot Work, etc.)
27 Corridors kept clean and clear
28 Proper exit signage posted
29 Cutting and Welding operations safely conducted
30 Lock/tagout procedures used
31 Exits provide free and unobstructed access
Alternate exits are clearly identified in and around
32
construction
33 Other safety/fire issues noted (Please comment)
Temporary partitions to protect VA property & individuals
from dust, debris and infection control measures.
34
Comments: Other safety/fire issues noted (Please comment)
 Target
Fire Safety (Fire Protection) Yes No N/A Date Corrected
Abatement Date

35 Fire sprinkler heads unobstructed

36 Fire sprinkler heads protected after installation
37 Smoke detectors uncovered at end of shift

Temporary fire alarm, detection and suppression

systems inspected and tested monthly
38
Fire extinguishers properly mounted and checked
monthly, own occupational safety station during
39
construction by contractor.
Penetrations (Floor, Wall, Ceiling) must be sealed
40 and smoke fire proofed
Comments:

Additional Notes: Address corrections within 24 hours or provide correction plan.

Contractor’s representative to make corrections on noted deficiencies: