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YL ' <br /> SITE KZxM`H w� SATf PLAN ( iSP) zGR^. <br /> jr1n� <br /> A. On+tmc+4l 3� -9G W.a. . X733 <br /> Prepared E3y Date <br /> I. General Infor.;ation r� <br /> A. Proixt Identifica:'o lti/rgy Xr'oc fOYJ <br /> Cror, 2. Cepa`�nt/Office <br /> 1. Division Client SaIIli <br /> c <br /> . e <br /> � T•n u;n CDL,.Ity <br /> rV��s � c�G� r- <br /> 4. Site t7a,�re �un�an — <br /> ,. 5 S, S,.,�te-r S acic� I—A 952�"L <br /> 5. Work Location Address (state) (zip) <br /> (Street Ad-'...cess) (CI'Y) { 1 <br /> S. bite H�lsnz]' f llI7G�EfClotrnfl J���G 7GY1s�S Gv�rGl <br /> brief�y S;�z � prz Vlpus h/ L�Xc�Vcr —. <br /> 1. Describe ibbe� a5olrr� ,. Now ::ra o� �ant� r. r'L <br /> � <br /> of Work on-yek, S ad6 sih <br /> C. SCC"' ' •� n �n�/e �c✓���r <br /> 1. Describe briefl}� hill C�r,� Ca�rSfracf 5 neon„ r,r we��s E1eve% �rta�.rt,��� <br /> Ie -I,G Soir/n�a . <br /> Sits Visit oral Site HASP not necess list rsonrtel here & sicM-off belcw: <br /> I Hazard pssessmesit and Reaulato Status <br /> to types of hazards anticipated. ( } Physio-che�ica1: <br /> 1. Indicate Yes (Y)ATO (N) , !� >TLU-Sim, (^V ) >IDLH; (^J) Bio-Hazards: <br /> Toxic Chemical - Levels (N) >71,V-1WA, ( ) <br /> (r.I) Radiation; ( �) Physical: (t�) Construction type; (rl) Industrial type: <br /> ( r+l) Nuclear Industry type S te, (rJ) NPL Site; <br /> 2. Site Regulatory Status: CA/SARa - (IJ} U.S. EPA, { ) <br /> RCRA - ({j) U.S. EPA, { rr) State; OSHA - ([�) 1910, ('`r) 1925, ( ) S AL Force; <br /> NRC - (rl ) 10 CFR 2o; other Fed. Agency - (�} DOE, (r<J) USA'IHAriF+, ( ) <br /> arxi R�latory Status, determine the Standard HASP(s) <br /> Based on the Hazard AssessmentHasp}aa will be used and <br /> applicable to this project. Indicate below which Standard <br /> + append the appropriate pages of is Form along with the Standard Plan. <br /> this <br /> Stack Best (N) Air Erldssions (!J ) Asbestos <br /> 3. Standard Plan to be used: ( } Hazardous rat. (//) Construian <br /> p)) Industrial Hygiene (,,/) Life SYyst Air Force <br /> (0) NRC/DOE (,-j) e <br /> D. Review and oroval Docturerstation <br /> a. P.M. �,� Date <br /> 1. ReviesJed By: Dates . <br /> b. P.D. Date <br /> c. Cho Gate S •r a <br /> d. SHSC <br /> Cate ^_r <br /> 2. Approved BY: <br /> ( a. Corperate lth and Safety Director (L--5 D) <br /> { ) b. 3 0 r (only th specific delec7ation by CHSDZ <br /> 9 S 20 ;End Date /0-10 <br /> This site HASP nnxst be <br /> �j� Stag Date 11'`fa <br /> Reissued roved for any activities conducted after:Date =— 5 <br /> A7enctr.e nt Cate(s) 1. 2.— <br /> 1 of 40 <br />