COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT SITE HEALTH AND SAFETY PLAN PART I PART II GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS 1. Site Name: QB Rebuilder 1. Chemicals Hazards Address: 2325 W. Charter Way, Stockton ® Carcinogens: waste oil, lead Contact Person: Kosal Vong Phone No: 467-0490 x 106_ ❑ Corrosives: Sweeps Number: ❑ Dusts: Proposed Date of investigation/inspection: March 2010 ❑ Explosives: ❑ Flammables: 2. Description and brief narrative of inspection activity: ❑ Inorganic Gases: ❑ New UST installation.. ❑ UAR Investigation. ❑ Metals: ❑ Tank Closure in Place.. ❑ Tank/Pipe Repair. ❑ Oxidizers: ❑ Tank/Pipe Removal. ❑ Re -excavation. ❑ PCB's: ❑ Installation of Borings / Monitoring Wells. ® Hazardous waste inspection ❑ Sampling PART III ❑ Tiered Permitting inspection 3. Specific Site Information: REQUIRED PERSONAL PROTECTIVE EQUIPMENT Tank No.: Tank Capacity: 1. Monitoring Equipment (note: Monitoring instruments must be used for all operations unless appropriate rationale or restrictions are provided) Tank Content: Tank Age: ❑ Combustible Gas/Oxygen Meter. Other. ❑ Detector Tubes (Specify). F1 Photo ionization Detector. 4. Type of Operation: Auto Parts Manufactuer ❑ Organic Vapor Analyzer. E] Other, specify. 5. Release History: If monitoring instruments are not used, rationale or activity / area restrictions: Evidence of leaks /soil contamination: C3 YES ❑ NO Documented Groundwater contamination: ❑ YES ❑ NO Background and description of any previous investigation or incidence: 2. Personal Protective Equipment Level of Protection: ❑ A ❑ B ❑ C ® D ® Hard Hat. 6. Potential Health and Safety ® Safety Glasses/goggles. Physical Concerns: (check all that apply & describe) ® Steel toed/shank shoes or boots. F-1Heat or Cold Stress: °F (high ambient temp.) ❑ Flame retardant coveralls. F-1 Noise Sources: ® Hearing protection. El Oxygen Deficiency: El Tyvek. F-1Excavation: (falls, trips, slipping, cave-ins): El Respirator: [I APR ❑ SCBA C] Handling and Transfer of a Hazardous Substance: (fire, explosions, A/P cartridge: etc..): ❑ Confined space entry: (explosions): ® Safety vest. ® Heavy equipment (physical injury & trauma resulting from moving ❑ Two-way communication. equipment): ❑ Other, specify PART IV - PLAN APPROVAL 7. Anticipated Biological Hazards: Plan Prepared by: Ray von Flue Date: 3/16/10 ❑ Snakes ❑ Insects ❑ Rodents ❑ Poisonous Plants ❑ Other/Unknown (specify): Plan Approved by: Date: 8. Narrative (provide all information which could impact Health and Safety, e.g., power lines, integrity of dikes, terrain, etc.) EH 23081 (02/19/03)