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9 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> SITE HEALTH AND SAFETY PLAN <br /> PARTI PARTII <br /> GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS <br /> 1. Site Name:Stockton Scavengers 1. Chemicals Hazards <br /> Address:1240 Nary Dr Stockton CA 95206 ®Carcinogens: <br /> Contact Person:Buck Edmonson Phone No:209.460.3919 ®Corrosives: <br /> Sweeps Number: ®Dusts: <br /> Proposed Date of investigation/inspection April 12,2004 ❑Explosives: <br /> ❑Flammables: <br /> 2. Description and brief narrative of inspection activity: ❑Inorganic Gases: <br /> ❑New UST installation.. ❑LAR Investigation. ®Metals: <br /> ❑Tank Closure in Place.. ❑Tank/Pipe Repair. ❑Oxidizers: <br /> ❑Trunk/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: <br /> El Combustible Gas/Oxygen Meter. <br /> ❑Detector Tubes(Specify). <br /> 4. Type of Operation:Rack Manufacture ❑Photo ionization Detector. <br /> ❑Organic Vapor Analyzer. <br /> 5. Release History: El Other,specify. <br /> Evidence of leaks/soil contamination: [I YES El 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 /> ®Hard Hat. <br /> 6. Potential Health and Safety <br /> Physical Concerns:(check all that apply&describe) ®Safety Glasses/goggles. <br /> [I Heat m Flame reetarddananCold Stress: °F(high ambient temp.) ® lt tart shoes or boots. <br /> ❑Frt coveralls. <br /> ❑Noise Sources: <br /> ❑Hearing protection. <br /> ❑Oxygen Deficiency: ❑Tyvek. <br /> ®Excavation:(falls,trips,slipping,cave-ins): <br /> ❑Respirator. [I APR ❑SCBA <br /> ❑Handling and Transfer of a Hazardous Substance:(fire,explosions, A/P cartridge: <br /> etc..): <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: Plan Prepared by:Dina Abate Date:April 12,2004 <br /> ❑Snakes ❑Insects ❑Rodents ❑Poisonous Plants <br /> ❑Other/Unknowm(specify): Plan Approved by: 5ki,A 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 />