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Emergency Preparedness andosponse Plan, Leprino Foods Trao , CA Facility t Additional Expert Contacts Mike Chambers, The Ammonia Group Office: 9-1-530-389-8074 Cell: 9-1-530-559-2896 Chris Harmon or Kent Harmon Chris Office: 9-1-918-274-8639 Industrial Consultants Chris Cell: 9-1-918-630-9273 Kent Cell: 9-1-918-630-9401 5,4 Information Reported to Agencies Refer to Appendix G for the Incident Commander's Checklist/Hazardous Material Release Information Sheetand possible script to assist in making Agency notifications. Notifications should not interfere with the initial responsibility of the IC to mitigate the response. The Agency Liaison should take on this responsibility immediately. Information given at the time of the Agency Notification should include the following: + The name, title, affiliation, address, and facility telephone number of the person reporting the incident. + Information regarding the extent of the release including: A release has occurred which will probably not have an off-site impact; or A release has occurred which will probably have an off-site impact. + The time, or estimated time, of the release, the projected duration, and a brief description of the measures taken to terminate the release. The exact location of the discharge including the name of the site, the street address, the municipality, and the county. The chemical name and an estimate of the quantity of the hazardous substance(s)discharged. Weather conditions, including wind direction and speed, and any expected off-site effects. + The date and time at which the discharge began, was discovered, and ended. The actions taken to contain, clean up, and remove the hazardous substance(s)discharged. Appendix G also includes a help list for Size Up/Action/Post Op/Clean Up, and a LogofEmergency Responders& Detector Readings to assist in data collection for the formal report to be submitted as defined in Section 5.8, Incident Documentation 1 Reporting Requirements. Make sure to obtain and record the National Response Center's case number for the incident supplied by the agency, and the name of the individual the incident was reported to and document on the Agency Notification Log (Appendix M). When contacting the California Office of Emergency Services, they will provide a separate case number. Also record this separate number on the Agency Notification Log(Appendix M). California OES will then forward the case information to the LEPC (San Joaquin County OES). Any incident involving a hazardous material release should be investigated using the forms and guidelines established in Section 3.6 Critique of Responses and Follow Up. 5.5 Agency Notification 1. Emergency notification must be made to the agencies as indicated above. The initial notification of a release or potential release should include as much of the information contained on the National Response Center Incident Report Form(Appendix N)as possible. 2. Fallow-Up Report Section 304(c), Emergency Notification, of Title 111, Emergency Planning and Community Right-to-Know law requires the National Response Center Incident Report to be submitted as soon as practical after the release and 1 or spill. 3. The follow-up report must contain the following information: a. Actual response actions taken. b. Any known / anticipated data or chronic health risks associated with release. C. Advice regarding medical attention necessary for exposed individuals. 11Lep 4461users\psmlelement 12 emergency plan and responseMacy Emergency Preparedness and Response Plan.doc Rev.July 16,2002 Section 5, Page 3