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3500 - Local Oversight Program
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PR0545706
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Last modified
5/28/2020 12:29:51 PM
Creation date
5/28/2020 12:26:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545706
PE
3528
FACILITY_ID
FA0006829
FACILITY_NAME
RICHIE & CARROLL
STREET_NUMBER
443
STREET_NAME
SYCAMORE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
443 SYCAMORE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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%W01 N0� <br /> PERSONAL PROTECTIVE EQUIPMENT <br /> The required personal protective equipment level is: [ ]A,[ ]13,[ ]C,VJ D. n <br /> Specific protective equipment required: Hp`s �T Gi_4oms STEL- d <br /> _7nE6 COV, <br /> Protective clothing required: pc M-rZ Aflo !R <br /> Respiratory equipment required: 1—F h <br /> Cartridge type: .. O R.CA I C— <br /> This cartridge is expected to provide protection for S hrs <br /> [A All site personnel have been trained in the use of protective equipment <br /> DECONTAMINATION PROCEDURES <br /> Personnel and equipment shall be decontaminated as follows: N Wash and rinse all exposed skin and equipment. <br /> []Other: <br /> HEAT STRESS MONITORING <br /> The anticipated air temperature is degrees F. <br /> Adjusted air temperature{Tadj,Tair(fo)+ (13 X%Sunshine)]is not expected to exceed degrees F. <br /> [] A Health Alert Warning(temperature over 95 degrees F)has been issued by the weather service. <br /> �Q Workers are trained to recognize and treat heat stress symptoms. The site safety officer will monitor pulse and <br /> temperature of workers showing signs of heat stress. No person shall work with a temperature exceeding 100 degrees <br /> [] Drinking water is available at: <br /> EMERGENCY PROCEDURES <br /> Injury: The Site Safety Officer and Project Team Leader should evaluate the injury and contact an ambulance and/or the <br /> designated medical facility as needed. An incident report form should be filed for any injury. <br /> Fire/Fxplosian: All personnel should immediately move to a safe location away from threat of fire and/or explosion. Sound <br /> alarm if available and call fire department. <br /> Emergency escape route and meeting place: o p�p- S 1 T i- <br /> EMERGENCY MEDICAL FACILITIES <br /> Hospital name and location: <br /> SFF7 kTTA-C4 -b HAS To a" 40$01 Tki. ©F H ec,/ - <br /> Hospital phone number: 2 3 <br /> A map to the hospital is attached. <br /> a first aid kit,eye wash and other emergency equipment is located in the Site Safety Officer's vehicle. <br /> Police Number: 1911 Fire Number: C?y <br /> Office Number: 1"510)— 420—0 400 Client Number: (1D q)�5Z—3x`80 <br /> Any injury sustained while working are covered under Workers Compensation insurance. Any injured Cambria employee <br /> should inform the medical care facility that this is a Worker's Compensation claim and that our insurance policy is 1 T7 �4kTFtgD <br /> Copies of the doctor's report on the injury should be forwarded to our insurance carrier at P,0,42-91 Cambria employees <br /> must notify )TT on the same day so that we can properly file this claim. 14Ae_'TFe•Rb, CT 010104 <br /> Any injured sub-contractor or sub-contractor employee will be covered under their employer's policy. <br /> Emergency medical treatment due to chemical exposure to compounds anticipated to be at the site is presented on the attached <br /> MSDS forms. <br /> All site workers have read the plan and are familiar with and will abide by its provisions_ <br /> Name Signature <br /> Project Team Leader <br /> Site Safety Officer <br /> Field Team Leader <br /> Field Team Member <br /> Field Team Member <br />
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