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Title - SAF - Safety Manual Section 07 - Incident Reporting and Investigation Procedure <br /> Revision 4 Revision Date Document Owner Reason <br /> THEIYWECROUP 12 07/19/2019 Meyers,Scott Updated contact information <br /> Date of Release: I I-7-1 - StartTime: 14:07*em End Time: to-30F,4& <br /> Material Released: Quantity Release(lbs): Method used to determine quantity <br /> released: <br /> �Mf4`10f)1a z <br /> �NEfAkCttL_ Ex?oS'JM <br /> Gas or liquid? �.- v1 sOpC cwlpe <br /> Area(s)of facility impacted: Weather Conditions: Media (air, land,water) Impacted: <br /> ARBA 5 Kr_cir_cuLA-roV, A/PL <br /> 55 V <br /> Date National Response Center(NRC)was Incident Number(from NRC): Date and time that the incident <br /> notified: investigation began (no later than <br /> 24 hours after the release): <br /> Time of notification: Date: I i-?,I -Z2)_0 <br /> Time: `7:cOew-. <br /> Date that California Office of Emergency Services California CES Report Actions taken to control or mitigate <br /> (OES)was notified: 11-23-2Dzn Number: the release if any taken(ex.engaged <br /> emergency stop system): <br /> Time of notification: ,2!20gw, ?,O -Co543 :LsoLA'rtota eF 111& Yc- 7umo�D <br /> Investigation team members including at least Description of the incident and an evaluation of the factors that <br /> one person knowledgeable in the process contributed to the incident. <br /> involved (possibly an outside C ZA"-�L- SEMI.-- WC-RT OUT CAU siaG Aynrwr%kA :o <br /> contractor): 5RC-7c 4 IRy4wey Comft OUT <br /> MARK Mti_ a ori <br /> Description of the incident and an evaluation of If any employees were injured or exposed during the incident,all <br /> the factors that contributed to the incident. relevant medical information and injury investigation information. <br /> /TOME <br /> Recommended corrective actions with assigned persons and due dates: <br /> Worm Qizvetz WID714017-7 ASsIGtlrap -ro Bir F4umi>yzert bye- DecyiyeK zozcc, <br /> V4oRk Old IS Fol RSRAJMMgr of S6RL-Dnp RectaC V-brA? <br /> Make follow-up call to CAL OES and report the actual quantity of material released. <br /> Date/time of call: 12.-2.-20zb /1:ZD,4M Total quantity of material released, 20 lbs. <br /> Location-The Wine Group Document Polder:SOP, Document 0 02174 and File Name SAF-Safety Manual Section 7-Incident Reporting and Investigation Procedure-3-19-191 Am, Page 22 of 22 <br />