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SEF -30-93 THU 16:45 27667E•6 9163811622 P.02 <br />SON <br />I, MAA01 6809 McComber Street <br />EN G IN EERI N GSacrame .95828 <br />I N C O R P O R A T E D (916) 381-1600 <br />®e T 0 1 1993 <br />SITE SPECIFIC HEALTH AND SAFETY PLAN E IRONM q�� <br />/S�� CT11 <br />This form must be completed a minimum of one ( 1) week prior to t�i�E <br />start of work. It is the responsibility of the project engineer to <br />complete all items. All project personnel must receive a copy of <br />this form and familiarize themselves with its contents prior to <br />the start of activities. <br />1. Site Mame and Address: Pacific Bell <br />345 N. San Joaquin Street <br />Stockton, Ca. <br />2, Site Personnels <br />Project Manager: Gary Nygren <br />Project Superintendent: Mike Fuller <br />Job Foremant Ted Combrinks <br />3. Site Description and Background (See attached map and Area Nap) <br />The project entails the removal of a (3) 25.000 gallon single <br />wall Diesel underground storage tank, and the installation on <br />(1) 25,000 gallon double wall tank. <br />4. List of Known Chemical Contaminants: <br />Contaminate Source Medium Anticipated <br />Concentrations <br />Diesel UST Soil/vapor Unknown <br />5. List of Known Physical Hazards (ie. heavy traffic areas, <br />overhead construction areas, work around excavations. work <br />inside buildings, etc.) <br />Hazard Description Location Procedures to <br />Reduce Hazard <br />Excavation Open Trench On -Site Barricades/Tape <br />Heavy Equip. Backhoe/Crane On -Site -Safety Mgt. <br />**NOTE: AT THE START OF EVERY WORK WEEK. THERE WILL BE A <br />ON-SITE JOB SAFETY MEETING CONDUCTED BY THE SITE <br />FOREMAN. (TAILGATE SAFETY MEETING LOG ATTACHED) <br />