Beruflich Dokumente
Kultur Dokumente
Date:
Project Classification:
Project:
Project Location:
FPC-
Project Manager:
Phone Number:
Start Date:
Work Activities:
End Date:
ESICRA
Department
Print Name
Signature
DEPARTMENTS AFFECTED
Vertical Flooring
Horizontal Flooring
Above:
North:
West:
East:
Project
Project
Below:
South:
SECTION VIEW
PLAN VIEW
Comments:
Description
Inspection and non-invasive activities
Include, but not limited to:
* The removal of ceiling tiles for visual inspection (limited to one tile per 50 sq. ft).
* Painting (but not sanding).
Wall covering, electrical trim work, minor plumbing, and activities that do not generate dust or
*
require the cutting of wall or access to ceilings other than for visual inspection.
Small-scale, short-duration activities that create minimal dust
Include, but are not limited to
* The installation of telephone and computer cabling.
* Access to chase spaces.
* The cutting of wall or ceilings where dust migration can be controlled
Work that generates a moderate to high level of dust or requires demolition or removal of any fixed
building components or assemblies
Include, but are not limited to
* The sanding of wall for painting or wall covering
* The removal of floor coverings, ceiling tiles, and casework
* New-wall construction
* Minor duct-work or electrical work above ceilings
* Any activity that cannot be completed within a single work shift
Major demolition and construction projects
Include, but are not limited to
* Activities that require consecutive work shifts
* Activities that require heavy demolition or the removal of a complete cabling system
* New construction
Medium Risk
High Risk
Highest Risk
Clinic Areas
Radiology/MRI
EKG/Laboratories (specimen)
Isolation Room
General Storage
Outpatient Clinics
Pharmacy
Negative Pressure
Volunteer Services
Optometry
Medical Records
Contract Services
Triage/Emergency Room
Oncology
Meeting/Class Room
Operating Room
Environmental Services
Photography
Anesthesia
Echography
LOW
MEDIUM
HIGH
HIGHEST
Type A:
Inspection
and NonInvasive
Activity
I
I
I
II
Type B:
Type D:
Major demolition or
construction activities
requiring consecutive work
shifts
III/IV
III/IV
IV
IV
Note: Provide additional ICRAs for "Secondary Containment Areas" (if applicable) and attach to the end of this document.
CLASS I
CLASS II
CLASS
III
CLASS
IV
Complete all critical barriers, (sheetrock, plywood, plastic) to seal area from non-work
area or implement control cube method (cart with plastic covering and sealed connection
to work site with HEPA vacuum for vacuuming prior to exit)
Seal holes, pipes, conduits and punctures appropriately. Place dust mat at entrance and
exit of work area.
Maintain negative air pressure within work site utilizing HEPA equipped air filtration
units.
Contain construction waste and transport in tightly covered & sealed containers before
transporting.
Isolate HVAC system in area where work is being done to prevent contamination of duct
system Seal unused doors with tape.
Complete all critical barriers, (sheetrock, plywood, plastic) to seal area from non-work
area or implement control cube method (cart with plastic covering and sealed connection
to work site with HEPA vacuum for vacuuming prior to exit)
Construct ante room & require all personnel to pass through so they can be vacuumed
using a HEPA vacuum cleaner before leaving work area or they can wear cloth or paper
coveralls that are removed each time they leave the work area.
Personnel entering work area are required to wear shoe covers. Shoe covers must be
changed each time worker exits work area.
Contain construction waste and transport in tightly covered & sealed containers before
transporting.
Maintain negative air pressure within work site utilizing HEPA equipped air filtration units.
No
Yes
Comments:
Not a Risk
Risk
Action/Comments
Noise
Vibration
Air Quality
Emergency
Procedures
Utility Failures
Operational impact
Contractor Access
Route
Parking Lot
disturbance
Site Access Security
Equipment
Danger/Risk
Additional Requirements: