隧道安全风险评估表.doc

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蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿芈膆薂罿羈蒂蒈薅肀芄莄薄膃蒀蚂薃袂芃薈蚃羅蒈蒄蚂肇芁莀蚁腿肄蝿蚀罿荿蚅虿肁膂薁蚈膃莈蒇蚇袃膀莃蚇羅莆蚁螆肈腿薇螅膀莄蒃螄袀膇葿螃肂蒂莅螂膄芅蚄螁袄蒁薀螁羆芄蒆螀聿葿莂衿膁节蚁袈袁肅薆袇羃芀薂袆膅肃蒈袅袅莈莄袅羇膁蚃袄聿莇蕿袃膂膀蒅羂袁莅莁羁羄膈蚀羀肆莃蚆罿 隧道安全风险评估 历史记录 Tunnel History编号No.:项目和问题 Topic And Questions 评价Comments1现有隧道的历史情况Existing tunnel conditions?1.1.1隧道是否有可燃、有毒气体环境的历史记录?Does the tunnel have a history of flammable or toxic gas environment?无1.1.2隧道是否出现过坍塌? Does the tunnel have a history of collapse?无1.1.3隧道是否有溶洞/人为孔洞的历史记录？Does the tunnel have a history of karstic/man made voids?无1.1.4隧道是否出现过突水？Does the tunnel have a history of sudden water inflow?无24 安全评估Tunnel Safety Evaluation检查和评估程序Inspection and Evaluation Procedures隧道/位置:Tunnel/Location:日期: Date:检查人员:Inspector: 编号No.:评估项目Evaluation Topic评价Comments质量评级权重Weighting总权重Actual Overall评估问题Evaluation Questions1 - 31安全管理体系Safety Management SystemTBD431.1安全管理体系要求Safety management system requirements1.1.1有无安全管理体系？Does a safety management system exist?AA39BC1.1.2作为质量管理体系一部分的安全管理体系是否得到贯彻执行？As a part of the quality management system,is the safety mangement system implemented on the construction site ?AA39BC1.1.3现场相关人员是否能获得安全管理体系的资料？Are the documents of the safety mangement system available on site?AA39BC1.1.4现场是否设有安全工程师？Is a safety engineer on site?AA26BC1.1.5是否告知当地相关部门（公安、消防、医院、安监等单位）正在进行施工？Are the local authorities (police, fire department, hospitals,safe production inspection department) informed of the ongoing construction?AA26BC1.1.6紧急疏散计划是否与当地相关部门进行了协调？Are the emergency evacuation plans coordinated with the local authorities?BA24BC2施工人员的安全Workers Safety642.1个体防护装备/劳动保护用品 (PPE)Personal protective equipment (PPE)2.1.1是否所有施工人员都接受过个人综合安全培训？是否定期进行？Have all workers received comprehensive personal safety training? Is it conducted at regular intervals?AA3B9C2.1.2是否所有施工人员都配备/佩戴个体防护装备，包括防护眼镜、防尘口罩、耳塞、便携式手提灯或帽灯？Are all workers in posession/wearing PPE, including safety glasses, dust masks ,ear plugs, and portable hand lamp or cap lamp?BA3B6C2.1.3是否所有施工人员都熟悉不佩戴个体防护装备的风险？Are all workers familiar with the risk of not wearing PPE?A1AB3C2.2应急培训和程序，包括疏散计划Emergency training, procedures, including evacuation plans2.2.1是否所有施工人员都可获得准备好的自救呼吸装置？Do all workers have self-rescuing breathing equipment readily accessible for each worker?AA2B6C2.2.2是否已进行了紧急疏散演习？上次演练是什么时候？Have emergency evacuation exercises been carried out? When was the last training?BA2B4C2.2.3急救箱的数量是否足够？急救箱的位置是否适当，在隧道的所有工作区都易获得使用？Is the amount and location of first aid kits sufficient and are they readily accessible in all working areas of the tunnel?BA3B6C2.2.4有无紧急疏散救援计划？Does an emergency evacuation and rescue plan exist?AA3B9C2.2.5施工人员紧急集合点及疏散线路有无标识？Are worker emergency gathering points and evacuation route identified?AA2B6C2.3安全工程师Safety Engineer2.3.1是否一直有安全工程师在场？Is a safety engineer present at all times?BA3B6C2.3.2是否所有施工人员都能认出安全工程师，都能与安全工程师取得联系？Can all workers identify and contact the safety engineer?AA2B9C3隧道现场安全控制程序Tunnel Site Safety Control Procedures1933.1签到/登记离开程序 Check-in/check-out procedures3.1.1所有施工人员必须在隧道进口的签到板上签到/登记离开（一个签到标签放在签到板上，另一个由施工人员持有）。All workers must check-in/check-out at the board at the tunnel entrance. (One sign-in tag is placed on the board, the other remains with the worker)AA3B9C3.1.2隧道内出工的施工人员数量是否正确？Is the number of workers on the sign-in board and in the tunnel represented correctly?AA2B6C3.1.3安全工程师有无隧道内施工人员的名单？Does the safety engineer keep a list of of workers in the tunnel?BA1B2C3.1.4换班时是否有专人清点人数？Is a man count performed during shift changes?AA2B6C3.2进出控制Control of access and egress应急车辆是否能进入所有隧道进场区？Are all tunnel acces areas accessible for emergency vehicles?AA2B6C3.2.2是否能通过安全的人行道或公路进入隧道内的所有施工区？是否有足够可用的施工便道？Are all working areas in the tunnel accessible either by properly secured walk- or roadways? Are sufficient access ways available?AAB26C3.2.3是否所有未使用的孔洞包括滑道和人行巷道都被严密覆盖、设置隔板、拦网或栅栏，并张贴警告标志，标明“切勿入内”或类似标语？Are all unused openings, including chutes and man ways, tightly covered, bulk headed, barricaded, or fenced off, and posted with warning signs that read, Keep Out or similar language?AA2B6C3.3洞口及沉降区的地面支护Ground support of portal and subsidence areas 3.3.1是否所有洞口及进洞区域都有临时支护、护栏、端墙、喷混或类似防护措施保证工作人员和设备能够安全进入这些区域？Are all portal openings and access areas guarded by shoring, fencing, head walls, shotcreting or equivalent protection to ensure that employees and equipment have a safe means to access these areas?AA2B6C3.3.2是否所有的沉降区都有临时支护、设置了路障和警示标志以防他人进入？Are all subsidence areas similarly guarded by shoring, filling in, or placing barricades and warning signs t