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SAN JOAQUIN COUNTY HAZARDOUS MATERIALS PROGRAM This survey form is intended to identify food industry businesses which need to comply with the hazardous materials emergency planning and reporting requirements of Chapter 6.95 of the California Health and Safety Code. This statute requires businesses which handle hazardous materials, including Carbon Dioxide, to prepare emergency plans for their employees to use in an emergency. Businesses must submit a copy of this plan, along with an annual inventory of their hazardous materials, to public safety agencies for use in protecting emergency responders and the public. In San Joaquin County, the Environmental Health Department (EHD) is the Certified Unified Program Agency or CUPA responsible for administering this program. Should you have any questions on this program or this form, please call our office at (209) 468-3420. Please consider the following guidelines when completing the questions on the front of this form. Question 1 The law defines "hazardous material" for purposes of this program as any material that, because of its quantity, concentration, or physical or chemical characteristics, poses a significant present or potential hazard to human health and safety or to the environment if released into the work place or the environment. This includes Carbon Dioxide, as well as other chemicals, such as fuels, petroleum products, paints, propane, oxygen, ammonia, chlorine, pesticides, fertilizers, and hazardous wastes. Answer "Yes" if you use Carbon Dioxide in any quantity at least once in the year. If you are unsure, contact our office at (209) 468-3420 for assistance. If you answer "No" and at a later date your business, or a tenant on your property, begins handling Carbon Dioxide or other hazardous materials, you must inform the Environmental Health Department within 30 days. Question 2 If you use Carbon Dioxide over the limits shown in the question, answer "Yes". If the answer is "Yes", you must meet the requirements of Chapter 6.95 of the California Health and Safety Code by electronically submitting your hazardous materials information in the California Environmental Reporting System (CERS) found at cers.calepa.ca.gov. These requirements must be met prior to issuance of a Certificate of Occupancy, if applicable. If you answer "No", our office may conduct an inspection after you begin operations to verify your exemption. CARBON DIOXIDE FACTS • Carbon Dioxide is a colorless and odorless gas so you will not be able to see or smell a release. • The vapor density of Carbon Dioxide is 1.53 (heavier than air) which means it will stay close to the ground and will be slow to disperse. • Carbon Dioxide acts as an asphyxiant by displacing oxygen. • One pound of Carbon Dioxide will fill 8.741 cubic feet. • The presence of Carbon Dioxide in a concentration of 4.0% of volume or 40,000 ppm has been determined by the National Institute for Occupational Safety and Health to be immediately dangerous to life and health. • The presence of Carbon Dioxide in a concentration as low as 7.0% of volume or 70,000 ppm will displace enough oxygen to have an oxygen deficient atmosphere which may result in death. • Carbon Dioxide leaks in restaurants have resulted in serious injury and deaths to unsuspecting workers and customers.