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6 0 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> SITE HEALTH AND SAFETY PLAN <br /> PART I PART II <br /> GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS <br /> 1. Site Name:Delta Truck Center 1. Chemicals Hazards <br /> Address: 10182 S.Harlan Rd„French Camp <br /> ®Carcinogens: <br /> Contact Person:Ed Collum Phone No:983-2400 ❑Corrosives: <br /> Sweeps Number: <br /> ®Dusts: <br /> Proposed Date of investigation/inspection:November,13,2003 ❑Explosives: <br /> ®Flammables: <br /> 2. Description and brief narrative of inspection activity: ❑ Inorganic Gases: <br /> ❑New UST installation.. ❑UAR Investigation. <br /> ❑Metals: <br /> ❑Tank Closure in Place.. ❑Tank/Pipe Repair. <br /> ❑Oxidizers: <br /> ❑Tank/Pipe Removal. ❑Re-excavation. ❑PCB's: <br /> ❑Installation of Borings/Monitoring Wells. <br /> ®Hazardous waste inspection ❑ Sampling PART III <br /> 3. Specific Site Information: REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Tank No.: Tank Capacity: i. Monitoring Equipment(note:Monitoring instruments must be used for all <br /> Tank Content; Tank Age: operations unless appropriate rationale or restrictions are provided) <br /> Other ❑Combustible Gas/Oxygen Meter. <br /> ❑Detector Tubes(Specify). <br /> 4. Type of Operation: ❑Photo ionization Detector. <br /> ❑Organic Vapor Analyzer. <br /> ❑ <br /> 5. Release History: Other,specify. <br /> Evidence of leaks/soil contamination: <br /> ❑YES ❑NO If monitoring instruments are not used,rationale or activity/area restrictions: <br /> Documented Groundwater contamination: ❑YES ❑NO Ph paper,camera,samplinu equipment <br /> Background and description of any previous investigation or incidence: <br /> 2. Personal Protective Equipment <br /> Level of Protection: ❑A ❑B ❑C ED D <br /> & Potential Health and Safety Hard Hat. <br /> Physical Concerns:(check all that apply&describe) Safety Glasses/goggles. <br /> ® <br /> E]Heat or Cold Stress °F(high ambient temp.) Steel toed/shank shoes or boots. <br /> ❑'Flame retardant coveralls. <br /> ®Noise Sources: <br /> ❑Oxygen Deficiency: ❑Hearing protection. <br /> [IExcavation:(falls,trips,slipping,cave-ins): El Tyvek. <br /> ❑ ❑ ❑ <br /> E]Handling and Transfer of a Hazardous Substance:(fire,explosions, Respirator: APR SCBA <br /> etc..): A/P cartridge: <br /> ❑Confined space entry:(explosions): ®Safety vest. <br /> Heavy equipment(physical injury&trauma resulting from moving ❑Two-way communication. <br /> equipment): <br /> ❑Other,specify PART IV-PLAN APPROVAL I� <br /> 7. Anticipated Biological Hazards: Plan Prepared by: OC 0-111 ^-1-1 Dater ��f <br /> ❑Snakes ❑Insects ❑Rodents ❑Poisonous Plants 2 <br /> ❑Other/Unknown(specify): Plan Approved by: Date: <br /> 8. Narrative(provide all information which could impact Health and Safety, <br /> e.g.,power lines,integrity of dikes,terrain,etc.) <br /> EH 23081 (02/19/03) <br />