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SAN J O q U I N dpi Department Page of 2 3 Administration C �+ /� GENERAL GENERAL HOSPITAL Policy/Procedure Effective Date Date Replaces 04/2015 07/2009 Title of Policy/Procedure Code Orange: Hazardous Material Spill of Incident Commander. Once more qualified personnel arrive to manage the incident, the following procedure shall be used: A. Utilize the Material Safety Data Sheet (MSDS) or the Safety Data Sheet (SDS) for that material and follow proper procedure. B. Evaluate the extent of the spill to determine the facility's ability to continue further containment and clean up efforts, first using a spill kit. C. Properly trained housekeeping personnel will maintain the appropriate hazardous materials spill kits and be responsible for spill clean-up D. After satisfactory clean up of the spill, housekeeping and / or engineering personnel will dispose of bagged hazardous or neutralized material in accordance with the Hazardous Materials and Waste Policy. E. The House Supervisor Department Manager, or designee, will document the date, time and location of the incident, names of affected personnel, type and amount of substance, actions taken, and any other pertinent information. A copy will be forwarded to the Emergency Management Coordinator and Safety Officer. This information will be forwarded to the appropriate agencies if the spill meets reportable quantities. The decision to activate the hospital's Emergency Operations Plan (EOP) shall be at the discretion of the Chief Executive Officer or his designee during normal operating hours 8 am to 5 pm, Monday thru Friday. After hours the House Supervisor will contact the Administrator on Call for authorization to activate the Emergency Operations Plan (EOP), and will act as the Incident Commander (IC) until the activated Incident Commander is in place. If the EP is activated, refer to the Hazardous Material Spill Incident Response Guide for specific staff assignments and tasks. Trained personnel from Engineering and Housekeeping and the House Supervisor or Department Manager will be responsible for responding to the spill area to determine the appropriate response procedures The House Supervisor or Department Manager on duty, along with Security personnel, will be responsible for maintaining patient and staff safety in the area of the spill and coordinating evacuation measures if necessary. Any affected staff, patients, or visitors will be triaged and treated as necessary. Refer to MSDS, SDS, EPA, federal, state and local regulations for clean-up and disposal guidelines of individual hazardous materials and waste.