COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

O.P�u I N• C z ENVIR AENTAL HEALTH D*ARTMENT Donna K.Herrin,R.E.H.S. SAN JOAQUIN COUNTY program Coordinators Director 600 East Main Street, Stockton, California 95202 Kasey L.Foley,R.E.H.S. Telephone:(209)468-3420 Fax:(209)468-3433 Robert McClellon,RE.H.S. Jeff Carruesco,R.E.H.S. Web:www.sjgov.org/ehd Linda Turkatte,R.E.H.S. SITE HEALTH& SAFETY PLAN PART I PART H GENERAL SITE INFORM TION EVALUATION OF POTENTIAL HAZARDS 1. Site Name: �7f7• 1. Chemicals Hazards Address: P`f'1 Carcinogens: Contact Person: 9Corrosiv t/G Phone#: 7 — 2�✓� ❑Dusts: Proposed Date of investiga'on/inspect n: 0 / ❑Explosives: lammables: , 2. Description and brief narrai ive of inspe tion activity: ❑Inorganic Gases: ❑New UST installation ❑U kR Investigation ❑Metals: ❑Tank Closure in Place ❑T Pipe Repair Wxidizers:QwAe n ❑Tank/Pipe Removal ❑ R -excavation ❑PCBs: ❑Sampling ❑B oring/Monitoring Well installation Other: IkK' IMI k7 Lt)a4-Ie 19 Hazardous Waste insp tion ❑T'ered Permitting inspection PART III 3. Specific Site Information: REQUIRED PERSONAL PROTECTIVE EQUIPMENT Tank No.: Ta nk Capacity: I. Monitoring Equipment(Note:Monitoring instruments must be used for all Tank Content: Ta rik Age: operations unless appropriate rationale or restrictions are provided): Other: ❑Combustible Gas/Oxygen Meter ❑Detector Tubes(specify): 4. Type of Operation: hj B a ❑Photo ionization Detector ❑Organic Vapor Analyzer 5. Release History: ❑Other(specify):J,��,{`I Evidence of leaks/soil con urination: [:1 YES ❑NO one(see below) Documented Groundwater ntaminati : ❑YES ❑NO If monitoring instruments are not used,rationale or activity/area restrictions: Background and description of any preous investigation or incidence: 2. Personal Protective Equipment 6. Potential Health&Safety PI ysical Con ems:(✓all that apply&describe) Level of Protection: ❑A ❑B ❑C ® D ❑Heat or Cold Stress: °F(iigh ambient temp.) ®Hard Hat ❑Noise Sources: ®Safety Glasses/Goggles ❑Oxygen Deficiency: ®Steel toed/shank shoes or boots ❑Excavation(falls,trips,s'pping,cav -ins): ❑Flame retardant coveralls Handling and Transfer o a Hazardo Substance(fire,explosions,etc.): ®Hearing protection ❑Tyvek ❑Confined space entry(explosions).— ❑Respirator ❑APR ❑SCBA ❑Heavy equipment(physical injury&traurna resulting from moving A/P Cartridge: equipment): ®Safety vest ❑Other(specify): laTwo-way communication 07L,'— [I Other(specify): 7. Anticipated Biological H 5Dnakes �(.ects odents ❑Poisonous Plants PART IV ❑Other/Unknown(specify)E PLAN APPROVAL 8. Narrative(provide all information which ould impact Health and Safety, Plan Prepared be--7 Date:�O e.g.,power lines,integrity of dikes,terra' ,etc.): Plan Approved by: Date: •1�•t EH 23081(9/15/2010)