Laserfiche WebLink
Pacific Coast Producers <br /> Lodi Plant <br /> Title: Document Number: <br /> Emergency Incident Report CAP-001-LP <br /> Issue Date: Supersedes Date: Version: <br /> 12/07/17 6/7/2010 2 <br /> Purpose: <br /> 22 CCR 466264.56(i) <br /> The owner or operator shall note in the operating record the time, date and details of any incident that requires <br /> implement the contingency plan. Within 15 days after the incident, the owner or operator shall submit a written <br /> report on the incident to the Department. The report shall include: <br /> (1) Name, address and telephone number of the owner or operator; <br /> (2) Name, address and telephone number of the facility; <br /> (3) Date, time and type of incident(e.g.,fire, explosion); <br /> (4) Name and quantity ofmaterial(s)involved; <br /> (5) The extent of injuries, if any; <br /> (6) An assessment of actual or potential hazards to human health or the environment, where this is <br /> applicable;and <br /> (7) Estimate quantity and disposition of recovered materials that result from the incident. <br /> Section A. B, and C <br /> Self-explanatory. Make sure,however,that all required information is included. <br /> Section II <br /> D&E Relate what material was involved(e.g., spent sulfuric acid,TCE. etc.). <br /> Relate the quantity of material that was involved. <br /> F. Describe what kind of emergency took place. Was it a release?A fire?An explosion? <br /> G. List the date and time of the incident. <br /> H. Describe how many persons were injured,if any as a result of the incident. <br /> Describe the injuries(e.g., acid bums,eye irritation, and lung damage). <br /> I. Describe the assessment you made during the incident as to the hazard or potential hazard the incident <br /> presented to human health or the environment(e.g.,groundwater contaminated). If none,clearly state <br /> this. <br /> J. Relate what you did with the spilled, etc.Waste you cleaned up and quantity of it. hi other words, did <br /> you recycle the waste?Treat it? <br /> K. State the quantity of spilled material you recovered. <br /> Author: Document Owner: Approval: <br /> T Tran Safety/Environment M Van Gundy (signature on file) page 1 of2 <br />