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CERS Consolidated Emergency Response / Contingency Plan <br /> INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR BY (Check all that apply): CIL <br /> ❑ 1 . VERBAL WARNINGS ; [:12 . PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑ 3 . TELEPHONE; <br /> ❑ 4 . PAGERS ; ❑ 5 . ALARM SYSTEM; ❑ 6. PORTABLE RADIO <br /> NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY (Check all that apply): C12. <br /> ❑ 1 . VERBAL WARNINGS ; ❑ 2. PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑ 3 . TELEPHONE; <br /> ❑ 4. PAGERS ; ❑ S. ALARM SYSTEM; ❑ 6. PORTABLE RADIO <br /> EMERGENCY COORDINATOR CONTACT INFORMATION: C13 . <br /> PRIMARY EMERGENCY COORDINATOR NAME: PHONE NO . : PHONE NO . : <br /> ALTERNATE EMERGENCY COORDINATOR NAME: PHONE NO. : PHONE NO . : <br /> ❑ Check if additional Emergency Coordinator contact and address information is available onsite or by calling PHONE NO . : <br /> Note: If more than one alternate emergency coordinator is designated, attach a list in order of responsibility. <br /> D . EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES <br /> Check the applicable boxes to indicate your facility' s procedures for containing spills and preventing and mitigating releases, fires and/or explosions. <br /> D1 . <br /> ❑ 1 . MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP, ETC. ; <br /> ❑ 2. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e. g. , Portable spill containment walls, built-in berms); <br /> ❑ 3 . PROVIDE ABSORBENT PHYSICAL BARRIERS (e.g. , Pads, spill pigs, spill pillows); <br /> ❑ 4. COVER OR BLOCK FLOOR AND/OR STORM DRAINS ; <br /> ❑ 5 . LINED TRENCH DRAINS AND/OR SUMPS ; <br /> [:16. AUTOMATIC FIRE SUPPRESSION SYSTEM; <br /> ❑ 7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS ; <br /> ❑ 8 . STOP PROCESSES AND/OR OPERATIONS ; <br /> ❑ 9. AUTOMATIC / ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM; <br /> ❑ 10. SHUT OFF WATER, GAS , ELECTRICAL UTILITIES ; <br /> ❑ 11 . CALL 9- 1 - 1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE AND/OR MEDICAL AID; <br /> ❑ 12. NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AND/OR IMPACTED AREAS; <br /> ❑ 13 . ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION ; <br /> ❑ 14. PROVIDE PROTECTIVE EQUIPMENT FOR ON-SITE EMERGENCY RESPONSE TEAM; <br /> ❑ 15 . REMOVE CONTAINERS AND/OR ISOLATE AREAS; <br /> ❑ 16 . HIRE LICENSED HAZARDOUS WASTE CONTRACTOR; <br /> ❑ 17. USE ABSORBENT MATERIAL FOR SPILL CONTAINMENT; <br /> ❑ 18 . VACUUM SUCTION USING APPROPRIATE VACUUM (e. g. , Intrinsically safe) FOR SPILL CONTROL AND/OR CLEANUP; <br /> ❑ 19. DECONTAMINATE PERSONNEL AND EQUIPMENT WITHIN DESIGNATED AREA AND DISPOSE OF WASTEWATER AS HAZARDOUS WASTE; <br /> ❑ 20. PROVIDE SAFE TEMPORARY STORAGE OF HAZARDOUS WASTE GENERATED DURING EMERGENCY ACTIONS ; <br /> ❑ 21 . OTHER (Specify): D2. <br /> E. FACILITY EVACUATION <br /> THE FOLLOWING ALARM SIGNAL(S) WILL BE USED TO BEGIN EVACUATION OF THE FACILITY (Check all that apply) : El . <br /> ❑ 1 . BELLS ; E2. <br /> ❑ 2. HORNS/SIRENS; <br /> ❑ 3 . VERBAL (i. e. , Shouting); <br /> ❑ 4. OTHER (Specify): <br /> THE FOLLOWING LOCATION(S) WILL BE USED FOR AN EMERGENCY ASSEMBLY AREA(S) (e.g. , Parking lot, street corner): E3. <br /> Note: The Emergency Coordinator must account for all onsite employees and visitors atter evacuation. <br /> EVACUATION ROUTE S AND ALTERNATE EVACUATION ROUTES ARE DESCRIBED AS FOLLOWS : E4. <br /> [11 . WRITTEN PROCEDURES DESCRIBING ROUTES, EXITS , AND ASSEMBLY AREAS; <br /> ❑ 2. EVACUATION MAP(S) DEPICTING ROUTES, EXITS , AND ASSEMBLY AREAS ; <br /> ❑ 3 . OTHER (Specify) : Es. <br /> Note: Evacuation procedures and/or maps should be posted in visible facility locations and must be included in the Contingency Plan. <br /> F. ARRANGEMENTS FOR EMERGENCY SERVICES <br /> ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (Check one of the following) : Fl . <br /> ❑ 1 . HAVE BEEN DETERMINED NOT NECESSARY; <br /> ❑ 2. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (Specify): F2. <br /> Note: Advance arrangements with local fire and police departments, hospitals, state and local emergency response teams, and/or emergency services <br /> contractors should be made for your facility, if necessary. Large Quantity Generators must describe arrangements in the Contingency Plan, <br /> Rev. 03/07/17 Page 2 of 4 <br />