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S�`t JOAQLZN COL -VRON?tiL� L �L.i-� DIVZSiON <br /> SIT=, =A-LTH Ati-D SALTY PLAN <br /> PART i PART II <br /> C-EN� AL. Sl:r. IN-FOR T VALVA ION OF POT=?vT1AI. PADS <br /> Site Name: 6Y4r �� S'7132f � 1. Chemicals 'r_aza_ras <br /> Address: I'V101 S (J Ca-rc�nogens: <br /> Contac pe_-son: en PISWZ2- ?hone No.931 - 0-64-e 9?tamosives: <br /> Sweeps N=ber. [ I mss: <br /> Proposed Date of i:jvestiarion/inspecrion. 7AJO4 [ I -=losives: <br /> ? Descipd.on and 'brier= arive of iaspe^'on acrivity: ( j Inorganic Gases: <br /> ( 1 New UST, Lzszzlllarson [ I UA.R rnvesrganon [ I Mme: <br /> [ 1 Tans (ZosL-e :,-- ?lace ( 1 �k/p� � [ 10�daize_-s: <br /> [ ] T amk/Dipe Re-oval (J PC3's: <br /> ( ] 1-n-milarion of 3or-gs/MoniMr�ng Wells <br /> ?AAT iz <br /> 3. Sce- c Site TL-fb ario= R"QL== PE32SOI�IAI DRO' CIVE <br /> 2^k No. K C.=pacry: EQUEPma i <br /> a Contents: T� Vie = <br /> k <br /> oniror;- =quiDmenz (note: MO ikor3n <br /> : -=amts must be used for iii ape_�nars <br /> Type of Operatic= L,=less appropr'ace zrionaie or---es--c--;ons are <br /> or---es--c--;ons <br /> nrovided� <br /> 3. Resease Fiszorj [ J Combusfoe le Gzs/OM/-. Me:e-- <br /> videace of leets/so11 cam==im rion: NO [ j De:er-or Tabes (Soe /) <br /> Doc=, eared GrVUndwate-_ coa�inarion: ( j "YES [ I NO ( I ?horoior rion De:ecor <br /> 3act,grottad and descpcon of any previous ---vesrigarion [I <br /> Organic Vapor? aiy= <br /> Orhe-, spe <br /> or incidence: ( 1, cry <br /> II =onto—, -. ins` are nOL 'ISe^ <br /> rzrionaie or ac:i rt/area res��c=ors: <br /> S. Pocem-Lal c e2ith and Sarery <br /> physic:_i Conc_- Cc,e-,-.r all C+ar appiy & descDe) <br /> "IT aen a= --*re--D.) <br /> ( ] creat or Cold Suess: C 2. oo.Sonal Proze--ve gmpment <br /> ( ] Noise SoLrTMe: <br /> ( Lever of P-nre =or;: [ ]A [ IE [ IC [ ]D <br /> j Oxygen Derice^.cy: <br /> [ ) _ , ( ':mrd oat <br /> =c3varion. (ra??s, cave-ins) <br /> [ I c:analing and T:ansfe_ of arazardous Substance: [v]'Safeey basses/gog�es <br /> (Ere, espiosions, etc.)) (4.J�SCeei coed/shank woes or boon <br /> ( J Confined Space en=7: (esaiosions) ( ] :same retardant cove•aiLs <br /> [ ] -eavy equipmers (paynC:31 =jury& ,a=a resulring („}�`:e-ring prorec--on <br /> =om mm <br /> oving egliperti [ I i7vek <br /> [ I Respirator, Acle: A.PR or SC3A <br /> [ specify <br /> c=:d;e: <br /> ] Orbe=, spe <br /> [ ] Szfe y vesz <br /> i . <br /> Ano �rion <br /> 7. �cpar_d 3io ogir_� 'ram-ds: <br /> [ ] Snakes Lnsec*s ( ] Rodents ( ] Poisonous Piano Varwo-way cora== <br /> DART IV <br /> (,,yOther nlclot (spe i1,): <br /> PI-AN APPROVAL <br /> 8!va-*mrive (provide all intoe'.-az:on wnica co dd mac_Hea1t <br /> plat Prepared by. M I Date: 7 <br /> and Safety, e.g., power L--es, inreg*rj of dikes, :e--ain, ere): , <br /> plan a.Dproved by. Dare: — <br /> ='v?08i (2/7/92), <br />