MEMORANDUM FOR A1 - Air Force E-Publishing

AFI91-202 5 AUGUST 2011 135
Attachment 9
INSTRUCTIONS FOR COMPLETING AF FORM 1118, NOTICE OF HAZARD
A9.1. AF Form 1118. Qualified safety, fire protection, and health (Bioenvironmental
Engineering, PH, flight surgeon and (or) occupational medicine physician) officials are the sole
issuing authorities for AF Form 1118.
A9.2. Control Number. The control number for the AF Form 1118 will be the agency code (S,
F, H), date of hazard identification, and sequential number (Example: S-20061201-1). The
numbering system will coincide with the corresponding Hazard Abatement Plan (AF Form 3).
A9.3. Location. Note the building number, room number and function involved where the
hazard is located, and nomenclature of the hazardous item or procedure (Example: Building 18,
Room 217, Civil Engineering Carpenter Shop, Table Saw).
A9.4. Hazardous Condition. Describe in detail the nature of the hazard, including a reference
to the standard or requirement violated, if any.
A9.5. Risk Assessment Code. List RAC, followed by RAC description. (Example: "1
[Imminent Danger].")
A9.6. Interim Control Measures. Identify temporary measures needed to reduce the degree of
risk associated with the hazard to an "acceptable degree‖ until permanent corrective actions are
implemented. Assigned RAC code will remain until completely abated even though interim
control measures are in effect.
A9.7. Permanent Corrective Action. List the action that will permanently eliminate the
identified hazard. Include associated document number. Examples: Install new exhaust system;
CE work order and project number.
A9.8. Contact Point. Name, grade, office symbol and telephone number of individual
responsible for elimination of the hazard.
A9.9. Estimated Completion Date. Self-explanatory.