Laserfiche WebLink
ZZ <br /> SCHUTZE&ASSOCIATES,INC <br /> 44358 S.GRIMMER BOULEVARD,FREMONT.CA 94538 0 TELEPHONE:(51 O)226.9944 0 FAX(51 O)226-9948 <br /> SITE HEALTH AND SAFETY PLAN <br /> I. GENERAL SITE INFORMATION <br /> Site Name: Commercial Properly <br /> Site Address: 2327 East Mariposa Road, Stockton, CA 95205 <br /> Contact Person: Mr. Jan Schutze Phone: 510-226 9944 <br /> Site Identification No.: SCS700.2 Proposed Date of Work: TBD <br /> H. DESCRIPTION OF ACTIVITY <br /> Purpose of Activity Type of Site <br /> ❑ Monitoring Well Installation X Industrial/Commercial <br /> X Geoprobe Drilling ❑ Gas Station <br /> ❑ Domestic Well Installation ❑ Dry-Cleaners <br /> ❑ Agricultural Well Installation ❑ Landfill <br /> ❑ Other ❑ Other <br /> Provide a brief description of the proposed activities: <br /> Advancing 6 soil borings to 60ft, collecting soil and groundwater samples, and backf)lling borings <br /> Investigation-derived material disposal: <br /> Soil: stored in 55 gallon DOT-approved drums on-site pending waste characterization <br /> Water: <br /> Other: <br /> 11I. POTENTIAL HEALTH AND SAFETY HAZARDS <br /> Anticipated Physical Hazards: <br /> ❑ Heat(high ambient temperature) X Heavy equipment <br /> ❑ Cold X Physical injury/trauma resulting <br /> X Noise from moving machinery <br /> ❑ Oxygen depletion X General construction <br /> ❑ Asphyxiation X Physical injury/trauma <br /> ❑ Electrical hazards <br /> X Falls,trip, slipping <br /> ❑ Excavation ❑ Potential fire or explosion <br /> ❑ Cave-ins <br /> ❑ Falls,trip,slipping <br /> ❑ Other(specify): <br /> Health& Safety Plan <br /> Page 1 <br />