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CERS Consolidated Emergency RZ,csponsc/Contingency I'Ian I ERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOT'IFICA'TION WILL OCCIM BY(Check all that apply): to t L'Ofl.VERBAL WARNINGS; ❑2.PUBLIC ADDRINS Olt INT'E14COM SYSTEM; ❑7.T1iLh1'llOfl1i; ❑4.PAGERS; [:1.5,ALARM SYSTEM; _❑6.POII'1'AII1.11 RADIO NOTIFICATIONS TO NEIGHBORING FACILffIFS T IAT MAY Illi AFFECTED BY AN OFF-SIT11,I(ELBASE WILL OCCUR BY(Check all that apply): 02. t44.VERBAL WARNINGS; ❑2.PUBLIC ADDRESS Olt INT'11WOM SYS'T'EM; ❑3.'1"lil.l;l'IION1i; ❑4.PAGERS, ❑5.ALARM SYSTEM; ❑6 I'Ult"I'AB1.Is RADIO EMERGENCY COORDINATOR CONTACTINFORMATION: cu. PRIMARY EMERGENCY COORDINATOR NAME: PHONE NO.: PHONE NO.: ALTERNATE EMERGENCY COORDINATOR NAME: PHONE NO.: PHONE NO.: ❑Check if additional Emergency Coordinator contact and address information is available onsite or by calling PHONE NO.: Note:If more than one alternate emergency coordinator is designated,attach a list in order of responsibility. D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES Check the applicable boxes to indicate your facility's procedures for containing spills and preventing and mitigating releases fires and/or explosions. DI 4A-1- MONITOR FOR LEAKS,RUPTURES,PRESSURE BUILD-UP,ETC.; R2. PROVIDE STRUCTURAL PHYSICAL BARRIERS(e.g.,Portable spill containment walls,built-in berms); 3. PROVIDE ABSORBENT PHYSICAL BARRIERS(e.g.,Pads,spill pigs,spill pillows); ❑4. COVER OR BLOCK FLOOR AND/OR STORM DRAINS; J.;A"5. LINED TRENCH DRAINS AND/OR SUMPS; ❑6. AUTOMATIC FIRE SUPPRESSION SYSTEM; ®7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS; E2-'li. STOP PROCESSES AND/OR OPERATIONS; [:19. AUTOMATIC/ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM; ❑10.SHUT OFF WATER,GAS,ELECTRICAL UTILITIES; '911.CALL 9-1-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE AND/OR MEDICAL AID; �L12.NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AND/OR IMPACTED AREAS; 9-13.ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION; ❑ 14.PROVIDE PROTECTIVE EQUIPMENT FOR ON-SITE EMERGENCY RESPONSE TEAM; ❑15.REMOVE CONTAINERS AND/OR ISOLATE AREAS; 16,HIRE LICENSED HAZARDOUS WASTE CONTRACTOR; 17.USE ABSORBENT MATERIAL FOR SPILL CONTAINMENT, ❑18.VACUUM SUCTION USING APPROPRIATE VACUUM(e.g,Intrinsically safe)FOR SPILL CONTROL AND/OR CLEANUP; ❑19.DECONTAMINATE PERSONNEL AND EQUIPMENT WITHIN DESIGNATED AREA AND DISPOSE OF WASTEWATER AS HAZARDOUS WASTE; ❑20.PROVIDE SAFE TEMPORARY STORAGE OF HAZARDOUS WASTE GENERATED DURING EMERGENCY ACTIONS; DI ❑21.OTHER(Specify): E. FACILITY EVACUATION THE FOLLOWING ALARM SIGNALEl.WILL BE USED TO BEGIN EVACUATION OF THE FACILITY(Check all that apply): E. ❑L. BELLS; 2. HORNS/SIRENS; VERBAL(i.e.,Shouting); 4` OTHER(Specify): El. THE FOLLOWING LOCATION(S)WILL BE USED FOR AN EMERGENCY ASSEMBLY AREA(S)(e.g.,Parking lot,street comer): Note:The Emergency Coordinator must account for all onsite employees and visitors atter evacuation. Ey EVACUATION ROUTE S AND ALTERNATE EVACUATION ROUTES ARE DESCRIBED AS FOLLOWS: ❑1.WRITTEN PROCEDURES DESCRIBING ROUTES,EXITS,AND ASSEMBLY AREAS; ,a2EVACUATIONMAP(S)DEPICTING ROUTES,EXITS,AND ASSEMBLY AREAS; ❑3. OTHER(Specify). Es. Note;Evneuatioe procedures and/or maps should be posted in visible facility locations and must be included in the Contingency Plan. F. ARRANGEMENTS FOR EMERGENCY SERVICES X6VANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES(Check one of the following): Ft' HAVE BION DETERMINED NOT NECESSARY; ` #MLC1 G ARRANGEMENTS HAVE BEEN MADE(Specify): A yAtlCtlarj>�t�Etiti with local fire and police departments,hospitals,slate and local emergency response teams,and/or emergency services f `6)r your facility,ifnecessary. Large Quantity Generators must describe arrangements in the Contingency Plan. Or �, , Page 2 of 4 11�17 Scanned by CamScanner