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Spy .TOAQULN COU?7"Y EN-VaON? aN -k HE-AL, DIVIK N <br /> SITE ~�—-iITI 4.-1-D SANE 1 Y PLAN <br /> ?ate": j PART Z <br /> =-NO;Ai.S= Z7FORMA7ION FV- L U.AMON OF POT--N uAL HAZARDS <br /> I. Site N—e. 1. ChecicaLs 'raza-ds <br /> Address: J, <br /> Contac Pe-s No. C-n.osives: <br /> Sweeps N=be_. �= <br /> Pr000sed Date of j vescgation/!=e on: F�vlosives: <br /> 2. Desc:zodon and brie_nz-a*r*ve of i=e^on ac=v=y-. iaoroanic uses: _ <br /> [ 1 New UST I i anion [] UAR lnvesdipdon 1 me his: 1ec; <br /> ( 1 Tara Clos•...�-e ;: Place [ j Tank/.0—pe Repair Oacizrrs: <br /> ( j .a-k/PiDe Rp�ovai ( j Re-?rcavzz:oa P�'3's: <br /> C I I ll a:ion of 3or'ngs/Monirortng Well <br /> PPR: us <br /> 3. n--,'Fc Site L*o^_:ar:c_ RFQL= PERSONAL PRO•IrC = <br /> _,_k No. Capacity: EQUL 1 <br /> '7a--k Co=e---cs: Task Age.' <br /> Yfo=;tor;-; =C!iDtne^t: (note: yfo-M;torMI; <br /> its; be used or ail ope-gots <br /> -;r?e of Operarioc / .resS aDDrop^.ate=ztionaie or.es�:e=ores a:e <br /> ?rovide_j <br /> ?eie=se : torr ( j Cotaburnle Gzs/Ox7.- Meter <br /> ,ride_ce of leaks/sail cont *^;na^ot:: ( j ''� ( j NO f, 1, Deter'or Tabes (Spec^I) <br /> T-,o,__ ,-, er .—T•„ r v=' j No Z ?hotolonizza- on Detecor <br /> Docs - d G_aLawat_ cozi..�....:nacon: , j .� ( ( , <br /> Back, -d a_d desc:Dcion of any?revious Wives 49=on (j Crznic Vapor?-ay -_ <br /> or incidence: OrLe-, speLfr.. - <br /> Ti •_OnaLO.yg in=— '._.e^'S ar.. mol::see, <br /> r;roraie or ac:.ivirr/area reser r'ors: <br /> 5. ?ocan-tal ealc= and Safe:,/ <br /> ?bysic,l Conce..=.-: (c^.e-?f ail :ar aDpiy & descoe) <br /> C j meat or Cold S`ess: °F (thigh atebier-r re-D.) <br /> Noise Source: 2. Pe_-onal Prole-ve EcudDment <br /> ( 1 0.;/gen De-c ea-=l: i..eve of P-ore^on: C IA CIF C IC D <br /> l j c var?on: (!kLls, a Ds rsiiippino cave-ins) :.aTQ flat <br /> ia"Lin- and Transfer of a H:az rdous Substance.- Safety rises/gogaies <br /> (E-e, espiosiors, etc.) T Sued coed/shark shoes or boots <br /> C j Confined Space enty: (emiosions) [ j®Fta <br /> ame rerdant cove_•al?s <br /> -envy equiDme=t (paymc:i! injury& a=a resulting egg protec=an <br /> ='oc coving eqliptrert) 4M T37e <br /> b Respirator, cirde: R or SC3A <br /> ( j Other, specify AAP c,—dge: <br /> Szfery vest <br /> 7. Anticipated Bioiogic:z raza-ds: C I Two-way cat...^•-=czmon <br /> ( j Saakes ( j -^sec<s [ j Rodents [ I Poisonous Pura <br /> ( j Ocie-/Un_mown (specify): Pani rV <br /> PLaN APPROVAJ- <br /> 8. Naas ve (provide all- in:or-anon which could izaac Healrh <br /> and Safety, e.g., ?owe-- L:es, inte-g-iry of diKes, ce-----ain, etc.): Plan. Prepared by. Date: <br /> Plan Approved by: Dat_: C <br /> '23081 (2/7/92) <br />