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ENVIRONMENTAL HEALTH DEPARTMENT <br /> °P SAN JOAQUIN COUNTY <br /> Unit Supervisors <br /> Donna K.Heran,R.E.H.S. 304 East Weber Avenue, Third Floor <br /> � ���� ` Director Carl Bor an,R.E.H.S. <br /> Mike Huggins,R.E.H.S.,R.D.I. <br /> Al Olsen,RE.H.S. Stockton, California 95202-2708 <br /> Program Manager Douglas W.Wilson,R.E.H.S. <br /> Z� <br /> cq — .��v Telephone: (209)468-3420 Margaret Lagorio,R.E.H.S. <br /> F o a Laurie A.Cotulla,RE.H.S. <br /> Program Manager <br /> Fax: (209)464-0138 Robert McClellon,R.E.H.S.SITE HEALTH AND SAFETY PLAN Mark Barcellos,R.E.H.S. <br /> PART I PART II <br /> GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS <br /> 1. Site Name:PACIFIC PRE-CUT PRODUCE. 1. Chemicals Hazards <br /> Address: 100 W.VALPICO ROAD BUILDING A.TRACY,CA 95376 ®Carcinogens: <br /> Contact Person:WOODY BARRETT Phone No:(209)835-6300 ❑Corrosives: <br /> Sweeps Number: <br /> ®Dusts: <br /> Proposed Date of investigation/inspection:August 18,2003 ❑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:_ 1. 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:WAREHOUSE _ ❑Photo ionization Detector. <br /> ❑Organic Vapor Analyzer. <br /> 5. Release History: <br /> ❑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 <br /> Background and description of any previous investigation or incidence: <br /> 2. Personal Protective Equipment <br /> Level of Protection: ❑A ❑B ❑C ®D <br /> 6. Potential Health and Safety ®Hard Hat. <br /> Physical Concerns:(check all that apply&describe) ®Safety Glasses/goggles. <br /> ❑Hear or Cold Stress: °F(high ambient temp.) ®Steel toed/shank shoes or boots. <br /> ®Noise Sources: EOUIPMENT ❑Flame retardant coveralls. <br /> ❑Oxygen Deficiency: ®Hearing protection. <br /> ElExcavation:(falls,trips,slipping,cave-ins): El Tyvek <br /> ❑ <br /> E]Handling and Transfer of a Hazardous Substance:(fire,explosions, Respirator: F-1 APR El 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 <br /> 7. Anticipated Biological Hazards: <br /> Plan Prepared b ate: d <br /> ❑Snakes ❑Insects ❑Rodents ❑Poisonous Plants <br /> ❑Other/Unknown(specify): <br /> 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.):UNKNOWN <br /> EH 23081(12/17/2002) <br />