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CERS Consolidated Emergency Response / Contingency Pian INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR BY (Check all that apply): CIL ❑ 1. VERBAL WARNINGS; ❑ 2. PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑ 3. TELEPHONE; ❑ 4. PAGERS; W. ALARM SYSTEM, ❑ 6. PORTABLE RADIO NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY (Check all that apply): C12. ❑ I _ VERBAL WARNINGS, ❑ 2. PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑ 3. TELEPHONE; ❑ 4. PAGERS; . ALARM SYSTEM, ❑ 6. PORTABLE RADIO EMERGENCY COORDINATOR CONTACT INFORMATION: C13. �} PRIMARY EMERGENCY COORDINATOR NAME: M Q '9 ` e PHONE NO.: .2,t9--7 61-)- MONE NO.: 2Z9 61 W ALTERNATE EMERGENCY COORDINATOR NAME: M a�,V% A J<mLA OPHONE NO.: ?Z - 7&7-1 �P ONE 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. ,/� � r . MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP, ETC.; DI. ❑ 2. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e.g., Portable spill containment walls, built-in berms); [13. PROVIDE ABSORBENT PHYSICAL BARRIERS (e.g., Pads, spill pigs, spill pillows); ❑ 4. COVER OR BLOCK FLOOR AND/OR STORM DRAINS; ❑ 5. LINED TRENCH DRAINS AND/OR SUMPS; ❑ 6. AUTOMATIC FIRE SUPPRESSION SYSTEM; ❑ 7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS; ❑ 8. STOP PROCESSES AND/OR OPERATIONS, ❑ 9. AUTOMATIC / ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM, V10. SHUT OFF WATER, GAS, ELECTRICAL UTILITIES; [XI 1. CALL 4-I-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE AND/OR MEDICAL AID; ❑ U. NOTIFY AND EVACUATE PERSONS IN ALL THREATENED ANDIOR IMPACTED AREAS-, ❑ H. 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 CON'T'AINMENT; ❑ 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; [:120. PROVIDE SAFE TEMPORARY STORAGE OF HAZARDOUS WASTE GENERATED DURING EMERGENCY ACTIONS; El21.OTHER (Specify): D2. E. FACILITY EVACUATION THE FOLLOWING ALARM SIGNAL(S) WILL BE USED TO BEGIN EVACUATION OF THE FACILITY (Check all that apply): El. ❑ 1. BELLS; E2 [a1. HORNS/SIRENS; 511S. VERBAL (i -e, Shouting); ❑ 4. OTHER S ec THE FOLLOWING LOCATION(S)SILL BE USED FOR AN EMERGENCY ASSEMBLY AREA(S) (e.g., Parking lot, street comer): E3 PCCOkL� (-- Note: The Emergency Coordinator must account for all onsite employees and visitors after evacuation - EVACUATION ROUTE S AND ALTERNATE EVACUATION ROUTES ARE DESCRIBED AS FOLLOWS: E4 WRITTEN PROCEDURES DESCRIBING ROUTES, EXITS, AND ASSEMBLY AREAS; ❑ 2. EVACUATION MAP(S) DEPICTING ROUTES, EXITS, AND ASSEMBLY AREAS; ❑ 3. OTHER (specify): rs. Note: Evacuation procedures and/or maps should be posted in visible facility locations and must be included in the Contingency Plan. F. ARRANGEMENTS FOR EMERGENCY SERVICES ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (Check one of the following): FI - Ll'( HAVE BEEN DETERMINED NOT NECESSARY; ❑ 2. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (Specify)- F2. Note: Advance arrangements with local fire and police departments, hospitals, state and local emergency response teams, and/or emergency services contractors should be made for your facility, if necessary. Large Quantity Generators must describe arrangements in the Contingency Plan, Rev. 03/07/17 Page 2 of 4 L