Laserfiche WebLink
!OAQLTN COL?v i"1.,- Et-VIRO-tNaN. 7,;:,EAL.T°H DIVISION <br />SIT � 1~ � -A-LH' Ati-D SAS i Y PLS -N <br />? ART i <br />GD, rr--R.AL Sl:s INFOR,MA=ON <br />11►I �1 i� I'.Li.' <br />1 <br />o • - <br />2_ DesCiDdon and brief n`= ive of imspec•=on ac . iry: <br />(1 New US Ln-srzilarion [ I UA.R Investigation <br />[ 1 Tank ?lac. (] TanVP?pe I- e?air <br />[ 1 <br />7, --VD . ipe R'3i [ I Vie-- 'CZ7 oa <br />(] !r H adon of 3ori=gs/Monirp * g Wells <br />3. Spec?^^c Si e tr- <br />. =.�'C <br />PART II <br />zV-ALUA'ION OF PO'r?vTiAL F--AZARDS <br />tmm <br />;?tzrcinoge=s: 79 <br />� . Che�Cals cz rQS <br />(j Co�osives- <br />[ I Dusts: <br />[] plosives: <br />(I F a==zbles- <br />(j Ivor; an:c Gas <br />Metals: �„ <br />PART uN <br />RSQTJ= PrRSONAL PROTrGZli7E <br />E,QUIPMEN'1 <br />^t:1er Q Temki - f ®' _. Noniron-, EauiDtnena (note: Monitor' - <br />4.T, pe of ODe--anot: f <br />Ar <br />�. R esease Historr. <br />- <br />,)idence of leaks/soil camar^in?riot:: rzs [ ] NO <br />Doc--,-e.--red Groundwater cor-^_sT-nimadon: = [ I NO <br />Bac ,gotyd and dese-'pr_on or any ?revious investigation <br />or mac ^ce: <br />107 <br />6. Pocennal Realty and Safer/ <br />?� c�..l Conce_= (c::er?r all ...=at apply & destine) <br />] .eat or Coid Stress: o: (n gti atnbier* temp.) <br />Noise Sot:=-= <br />( I Oxygen De^cie-- <br />l" 1 Excavation: (_`ai?s, =-, us ,siit)ping; cave-ins) <br />e :andira; and T.aasnster of a r--aza=otas Substance: <br />(L'T'e, explosions, erG.) <br />(I Condned Space end: (explosions) <br />f neavv equipment (pnysicai injury & ua=a resulting <br />=ort roving-ecui==r) <br />[ 1 Odier, specify <br />i. Anticipated 3ioiogic_l Ha. rds: <br />[ j Snakes (I Insects ( ] Rodents CJ Poisonous Piano <br />[ ] Ocre_/Un.L sown (specify): <br />8. Na---tive (provide a1 imormadon which could bpac- Health <br />and Saner/,e -., ?owe -r Les, inregssy of diKes, _ermin, etc): <br />=:--23081 (2/77/92) <br />o <br />=use be used. :or ad, ope_amors <br />unless appropriate-ar-ona-,e or7w :c=ors are <br />orovided7 <br />Combtsifole Gzs/Oxygpr Mere-- <br />[ j Detector Tubes (Seems/) <br />[ 1 Phoroio T -tion Detector <br />1 Organic Vapor A.nalyzeer <br />Orre-, speciry: <br />,oniroryg yin=—=e^ts are noc ::sec, <br />2^onale or activirj /area- reset=ons: <br />2. Personal ?rocec--�ve EcmDmenr <br />Tavel of Prore rion: [ ]A [ IS ( IC .D <br />anti hat <br />Safety glasses/go01es <br />,(Steel coed/shank shoes or 'boors <br />( 1 • .ame r e=danr coveralls <br />iezrimg ?rprecr'on <br />(j Tyvezc <br />(I Rzspiraror, circle: APR. or SC3A <br />A/D. cz :dQa- <br />Safe y vest <br />wo-way cora--unicadon <br />PART IV <br />PLAN APPROVAL <br />,17 <br />Przr Prepare_ y." Date: r <br />Plan approved by. Date: Lb �fz.900 <br />