MEMORANDUM FOR A1 - Air Force E-Publishing

AFI91-202 5 AUGUST 2011 137
A10.4.2.7. Item 10 (Exposure). Enter the average number of personnel exposed to the
hazard daily.
A10.4.2.8. Item 11 (Description). Give a word description of the hazard to illustrate its
potential impact if not abated.
A10.4.3. Part II—Abatement Information:
A10.4.3.1. Item 12 (Description). Give a description of the permanent abatement action
taken or programmed to eliminate or reduce the hazard.
A10.4.3.2. Item 13 (Method). List the work method or avenue by which the hazard is to
be abated. Examples include self-help, civil engineering work order, contract and local
purchase.
A10.4.3.3. Item 14 (Project Number). Include document numbers associated with work
requests, work orders, job orders, or projects. Also include supply requisitions and
maintenance work orders.
A10.4.3.4. Item 15 (Completion Date). If programmed in current fiscal year (FY),
provide month and year. If programmed in future FY, indicate FY. If abatement has been
completed, indicate actual completion date.
A10.4.3.5. Item 16 (Cost). Indicate whether estimated for unabated hazards or
deficiencies or actual for completed abatement actions.
A10.4.3.6. Item 16a (Project Cost). Indicate total cost associated with project identified
in item 14.
A10.4.3.7. Item 16b (Abatement Cost). If the cost to abate the hazard is not the total cost
of the project, enter only the cost associated with correction of the hazard. For example, a
$500,000 facility renovation project will correct hazardous electrical wiring estimated to
cost $25,000. Item 16a would show $500,000 while item 16b would show $25,000.
A10.4.3.8. Item 17 (Status). Indicate status of project identified in item 14; include major
milestones, reasons for delay, percent complete. Other examples include ―in design,‖ ―in
procurement,‖ ―under construction,‖ ―awaiting materials,‖ and ―closed.‖
A10.4.3.9. Item 18 (Interim Control Measures). List temporary measures taken to reduce
the risk associated with the hazard pending completion of permanent abatement action.
Examples include issuance of personal protective equipment (specify type), termination
of operations and work around procedures (specify).
A10.4.3.10. Items 19 through 21. (Functional Manager; Signature; Date). Selfexplanatory.
A10.4.3.11. Item 22 (Review Record). Use this area for functional manager and
commander reviews.
A10.4.4. The qualified safety, fire protection or health official assigns a control number for
new inputs and completes items 23 through 32 of AF Form 3 based on information furnished
by the functional manager in Parts I and II. Once signed and completed retain one copy and
send the second copy to the installation safety office to be included in the installation master
hazard abatement plan.