Activity Hazard Analysis (AHA)
Activity/Work Task: DE-MOBILIZATION
Project Location: NAVAL AIR FACILITY ATSUGI
Contract Number: N40084-16-D-0026
Date Prepared: September 9, 2022
Prepared By: TO BE ANNOUNCE
Reviewed By: TO BE ANNOUNCE
Notes: Field Notes, Review comments, etc.
Job Steps
Site-specific/Job-specific training for workers
Put on your personal protective equipment.
IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
Overall Risk Assessment Code (RAC) (Use highest code) L
Risk Assessment Code (RAC) Matrix
Probability
Severity
Frequent Likely Occasional Seldom Unlikely
Catastrophic E E H H M
Critical E H H M L
Marginal H M M L L
Negligible M L L L L
Step 1: Review each "Hazard" with identified safety "Controls" and determine RAC (See above)
"Probability" is the likelihood to cause an incident, near miss, or accident and identified as:
Frequent, Likely, Occasional, Seldom or Unlikely. RAC Chart
"Severity" is the outcome/degree if an incident, near miss, or did occur and identified as: E = Extremely High-Risk
Catastrophic, Critical, Marginal, or Negligible H = High Risk
Step 2: Identify the RAC (Probability/Severity) as E, H, or L for each "Hazard" on AHA. Annotate M = Moderate Risk
the overall highest RAC at the top of AHA L = Low Risk
Hazards Controls RAC
- Use this Activity Hazard Analysis and other
formal and informal training as a means to train
workers.
NOTE: If the scope of work detailed below
Employees not trained in the safe execution of their
changes in any way, contact the Safety L
tasks may harm themselves or others
Department and complete an AHA amendment
detailing the new scope of work.
EM 385-1-1, Sect., 1.B.1 - 1.B.3
- Workers entering the job site must wear a
hard hat and Class II reflective vest AT ALL
TIMES. Routinely inspect hard hats for dents,
cracks or deterioration. Replace hard hat after
any hard blow or electrical shock.
- Safety glasses or face shields must be worn
any time work operations can cause foreign
objects to get into the eye.
- Workers must wear safety-toed work boots
with slip-resistant and puncture-resistant soles
Head, foot, or eye injury
AT ALL TIMES.
Personnel being struck by equipment/trucks L
- Wear gloves when handling sharp objects.
Hearing damage
Gloves should fit snugly. Wear the right glove
for the job.
- Workers shall wear earplugs/earmuffs in high
noise work areas where loud or heavy
equipment is being used. Clean or replace
earplugs regularly.
- Do not wear clothing or jewelry that could
easily get snagged or caught by equipment or
machinery.
EM 385-1-1, Sect. 5.A, 5.B, 5.C, 5.D, 5.E, 5.F
 Job Steps Hazards Controls RAC
- Do not use electrical cords with cuts, worn
insulation, or visible conductors.
- All frayed, patched, oil-soaked or worn
electrical cords shall be taken out of service
immediately.
- Use cords rated for hard or extra-hard usage.
- All cords shall have a double-insulated or
grounding plug.
- Use factory-assembled cord sets as much as
possible. Repairs must preserve the original
Electrical Shock
Check electrical cords (portable flexible cords) electrical and mechanical integrity of the cord. L
Electrocution/Death
- Electrical tape fixes are prohibited and
replacement plugs must be properly sized and
provided with strain relief clamps.
- Check that the ground prong is intact.
- GFCI protection shall be provided on all
circuits serving portable electric hand tools. Use
only GFCI protected circuits.
- All electrical systems shall comply, with the
NEC.
EM 385-1-1, Sect. 11.D.05, 11.A.06
- Remove defective tools from the job site.
- Wooden handles for tools are secured tightly
in the tool and free of cracks and splinters.
- All saws are equipped with properly
functioning manufacture installed guards.
- Hand held power tools (saws, drills, grinders)
are equipped only with a constant pressure
Injury due to defective or improperly functioning
switch.
power tools
- Pneumatic nailers have a functioning safety
Inspect tools Electric shock from defective tools. L
device on the muzzle to prevent ejection unless
Impact injuries, splinters
muzzle in contact with work surface.
Impact injuries from spinning tool
- Only use tools for their intended use.
- GFCI protection shall be provided on all
circuits serving portable electric hand tools. Use
only GFCI protected outlets.
- Tag defective tools and remove them from the
workplace.
EM 385-1-1, Sect. 11.D.05, 13.A, 13.B, 13.C, 13.D
- Use only approved metal safety cans to store
and dispense fuel.
- Place oily or fuel soaked rags and other
Re-fuel gas powered tools Fires, explosions, burns L
combustibles in approved containers.
- DO NOT SMOKE WHILE REFUELING.
EM 385-1-1, Sect. 9.B, 26.D

IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
 Job Steps
Verify Power Line Clearances
Roll out tools and set up equipment
Cleaning surfaces with compressed air
Lift and move Equipment/Material/Ductwork
IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
Hazards Controls RAC
- Verify no power lines are within 20' of the
crane's work zone(crane's maximum working
360 degree radius).
- No part of a crane, load line, or load is allowed
Damage to Power Lines
below a power line unless confirmed by the
Power lines Falling
utility that the power line has been de-energized L
Damage to Crane
and grounded.
Electrocution, Death
- It is to be assumed that ALL power lines are
energized unless confirmed by the utility
company.
EM 385-1-1, Sect. 16.G.09.(a)
- Keep corridors and high traffic areas free of
cords, hoses, & other equipment.
- Completely unroll all hoses and cords, avoid
tangles.
- Arrange hoses and cords in an orderly fashion.
- Clean up scrap materials and debris before
Tripping - Hoses, Cords, Compressor and after working in an area. L
- Maintain Good housekeeping.
- All trash and debris shall be put in appropriate
locations.
- Do not leave tools and materials laying around
on the ground.
EM 385-1-1, Sect. 14.D
- Never use compressed air to blow dirt from
hands, face, or clothing and pressure should not
exceed 30 psi.
Airway irritation, silicosis
- DO NOT HORSEPLAY WITH COMPRESSED AIR.
Injection of foreign material into the body through L
- Wear a dust mask and goggles in addition to
the skin
the standard PPE when cleaning with
compressed air.
EM 385-1-1, Sect. 20.B.05
- Do not place body parts near or between pinch
Pulls and Strains from lifting
points.
Unexpected movements
- Do not wear loose clothing that could get
Materials striking and injuring workers L
caught.
Crushed by falling material
- Be aware of how pipe may move suddenly.
Swinging loads striking and injuring workers
EM 385--1-1, Sect. 5.A, 5.B, 5.C, 5.D, 5.E, 5.F, 14.A
 Job Steps
Moving material
Working around Hazardous Chemicals/Materials
Control of Hazardous Energy - Lock Out/Tag Out
IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
Hazards Controls RAC
- Team lift heavy or awkward materials.
- Use safe lifting techniques.
- Use material handling aids whenever possible.
- Be aware of your surroundings and watch
where you are going while carrying material.
- Never move materials above coworkers.
- When receiving/stocking material through a
Strains from lifting wall or floor opening, do not stand in front or
Striking and injuring co-workers with materials above the opening where you could fall. L
Crushed by - (See training and inspection requirements for
reach-lifts below.)
- When stocking material above ground level up
to 35-feet , a reach-lift will place the pallet as
close to the material's final destination as
possible, then hand stocking will occur.
EM 385-1-1, Sect. 14.A, B. See Activity Hazard
Analysis on forklift operation
- Wear eye protection as required
- Read through the SDS for every
chemical/material that you will be using.
Burns, dizziness, nausea, sickness, or cumulative
- Don't assume that a material is not hazardous, L
damage due to long term occupational exposure
just because it doesn't produce any immediate
effects.
EM 385-1-1, Sect. 6.A, 6.B, 23.A.03
- Except for work that must be performed on
energized equipment, all circuits or equipment
that are energized or may become energized
must be locked out and tagged before
beginning work on those circuits or equipment.
- Make sure the locking device is installed
correctly.
Electrocution - Death - The lock should be your personal lock and the
L
Fires, explosions, burns tag should have your name, the date and time
on it (a pager or cell phone number is also
helpful).
- Make sure that the right circuit or equipment
has been locked-out.
- Double check that there are no hot wires or
equipment at the location of the work.
EM 385-1-1, Sect. 12
 Job Steps Hazards Controls RAC
- Install the shoring system and components in
accordance with the manufactures'
recommendations. If you don't know, read the
owner's manual, call the manufactures' rep. or
ask your supervisor. Don't guess.
- Do not ride or allow co-workers to ride in or on
a trench box when it is raised or lowered into
Electrocution, burns from hot water or steam,
position.
Shut off/Cap Utilities explosions- gas L
- Do not enter an unprotected trench to install
Explosion or fire- burns
shoring.
- Make sure the excavation is never deeper than
2' below the base of the shoring system.
- Set up lighting in a location or in such a
manner that provides good illumination but will
not fall over, or create a trip hazard.
EM 385-1-1, Sect. 25.D.04, 25.D.05
- All designated entries to the building must be
protected from falling objects by sidewalk sheds
or canopies.
Entering and exiting the building Delayed egress, or injuries from falling objects L
- Use only exits or entrances designated in the
demolition plan.
EM 385-1-1, Sect. 23.A.09, 23.A.10
- Always use the right tool for the job.
- Make sure the piece you are cutting is properly
supported and secured.
- Never cut pieces from stock which is shorter
than 8"
- Do not cut too fast.
- Hold the saw steady (parallel with the direction
of the cut).
- Do not cut a radius with a circular or worm
drive saw.
Workpiece moving unexpectedly
- Keep fingers at least 6" from the blade. Use a
Saw kick backs
clamp to hold small pieces.
Cutting fingers
- Never pin back the guard on a worm drive
Cutting/Grinding Material Cuts, abrasions L
saw.
Flying particles- eye damage
- Take your finger off the switch when carrying a
Splinters or abrasions
plugged in tool.
Hazardous noise- hearing loss
- Unplug all tools before making any repairs or
adjustments.
- Wear goggles or safety glasses with side
shields
- Wear gloves when handling rough cut lumber
or sharp steel.
- Wear foam ear plugs when using any saws or
other noisy power tools or when working in
noisy areas.
EM 385-1-1, Sect. 13.A, 13.B, 13.C, 13.F

IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
 Job Steps Hazards Controls RAC
- Waste material shall be placed in appropriate
containers or stored in piles for
loading/trucking.
- Materials shall be divided by type and placed
in corresponding containers, per the approved
Solid Waste Management Plan.
- Hazardous Materials shall be disposed of per
Material Disposal Improper disposal of hazardous materials the approved abatement plan and per all L
applicable Local, State, and Federal laws.
- Hazardous Material Waste shall be manifested,
as required, prior to leaving the project site.
- Hazardous substances shall be stored and
disposed of in accordance with all regulations
pertaining to factors of incompatibility.
EM 385-1-1, Sect. 14.F
- Make sure you always have an adequate
supply of cold water available. If your water
supply is running low talk to your supervisor.
- Take scheduled cool down breaks.
- Provide ventilation or air cooling equipment
for enclosed work areas.
- Use sunscreen.
Heat Stroke, Heat Exhaustion, Heat Cramps
Working in hot weather - Respond quickly and decisively in case of an L
Sunburn
accident. Call 911 immediately.
- Know where the emergency numbers are
posted, where the first aid kit is, and who is
trained in first aid.
- Only persons trained in first aid should be
allowed to administer first aid.
EM 385-1-1, Sect. 6.J
- Store equipment out of the way. Roll up hoses
and cords at end of day.
- Clean up work area at the end of each shift.
Stack materials in designated lay down areas.
- Never throw or drop scrap and debris to a
Roll up Equipment & Clean-up Slipping, Tripping, or falling, and Delayed Egress L
lower level unless that drop area has been
cautioned/barricaded off to prevent workers
from entering the area.
- Place combustibles in approved containers.
EM 385-1-1, Sect. 2.B
- Wear a dust mask or respirator when
Sweep floor Dust inhalation sweeping. L
EM 385-1-1, Sect. 5.G

IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
 Job Steps Hazards Controls RAC
- Respond quickly and decisively in case of an
accident. Call 911 immediately.
- Know where the emergency numbers are
posted, where the first aid kit is, and who is
trained in first aid.
Delayed emergency response- further injury or loss
Responding to an emergency - Post Project Address and ensure all employees L
of life
know the project address/location.
- Only persons trained in first aid should be
allowed to administer first aid.

EM 385-1-1, Sect. 3.A, 3.B

- Use appropriate PPE when administering first
aid such as gloves, masks, eye protection and/or
resuscitation equipment especially when blood
is present.
- Wash after contact with blood or other body
Administering First Aid Exposure to blood-borne pathogens L
fluids.
- Dispose of soiled material in a labeled leak-
proof container.

EM 385-1-1, Sect. 3.A, 3.B.

Training Requirements/Competent or Qualified Personnel
Equipment
name(s)
Forklift Operator Training and Certification/License
Forklift Review of Manufacturer's Operating Manual
Activity Hazard Analysis Review
Current Scissor lift training is required for all
Scissor lift employees operating lifts. Activity Hazard Analysis
Review for each worker.
Current boom lift training is required for all
Boom lift employees operating lifts. Activity Hazard Analysis
Review for each worker.
Field workers are trained on the proper usage of a
Ladders ladder
Activity Hazard Analysis Review for each worker.
All workers will be trained in the proper donning and - Inspect personal fall arrest equipment (lanyard, harness,
Personal Fall Protection System use of Personal Fall Arrest Equipment before
beginning work.
Trained by site supervisor and authorized to use
Power Tools
power tools.
Inspection requirements
- Conduct Daily Inspection prior to Use
- including Back-up Alarm and Maintenance Records.
- Operators Manual shall be on ALL equipment.
- Forklift will be equipped with Fire Extinguisher.
- All lifts will be inspected prior to delivery to job, as well
as before each shift of work. Any lift with defective parts
will be red-tagged until repairs are made. Daily inspection
reports shall be completed and submitted to appropriate
authority.
- ALL lifts will be inspected prior to delivery to job, as well
as Before each shift of work. Any lift with defective parts
will be red-tagged until repairs are made.
- Ladders to be in good working condition. Metal
conductive ladders are not allowed on job-site.
- All stickers must be undamaged, clear, and legible.
- Inspect daily for broken parts, loose components etc.
Any ladder found defective will be tagged, taken out of
service and replaced immediately.
D-rings), for frays, burns, hair line cracks, or other defects
prior to use.
- Inspected daily for broken parts, damaged cords etc.
Any equipment found defective will be tagged, taken out
of service and replaced immediately.

IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
 Training Requirements/Competent or Qualified Personnel
Equipment Inspection requirements
name(s)
- Inspected daily for broken parts, loose handles or
Hand Tools Trained by site supervisor before use. components etc. Any equipment found defective will be
tagged, taken out of service and replaced immediately.
- Activity Hazard Analysis Review for each worker.
- Vehicle must be properly maintained and in good
Valid Driver's License Required. Valid Insurance working order.
Field/Work Truck Certificate Required. Review Owner's Manual. Activity - Owner's Manual must be with vehicle.
Hazard Analysis Review for each worker. - Any chemical transported in vehicle requires an SDS be
kept with vehicle.
- Inspect daily prior to each shift.
Personal Protective Equipment (PPE) All workers will be trained in the proper donning and - Inspect ALL PPE prior to each use. Any damaged PPE will
use of PPE before beginning work. be replaced immediately.
A MINIMUM of 2 individuals trained in CPR/First Aid - First Aid Kits will be inspected weekly for damage and/or
First Aid Kits
will be on-site and available to render aid at all times. missing items which shall be replaced immediately.

Competent Person Signature

IAW EM 385 01.A.14 Contractor-Required AHA “Work shall not begin until the AHA with RAC for the work activity has been accepted by the GDA and discussed with all engaged in the activity
The AHA shall be reviewed and modified as necessary to address changing site condition, operations or change of competent/qualified persons.
Activity/Work Task: DE-MOBILIZATION - 01 71 16
Contract Name: SMART GRID FOR UTILITIES AND FACILITY CONTROLS
Contract Number: N40084-16-D-0026

Competent Persons:
Name: Signature: Date: Name: Signature: Date:

Meeting Attendees:
Name: Signature: Date: Name: Signature: Date: