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0 0 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> SITE HEALTH AND SAFETY PLAN <br /> PART I PART II <br /> GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS <br /> 1. Site Name:Pick N Pull Auto Dismantlers 1. Cbemicals Hazards <br /> Address:3927 Clark Drive,Stockton <br /> ®Carcinogens:waste oil,waste antifreeze,used absorbents <br /> Contact Person:Cori Cline Phone No:(916)858-3123_ ❑Corrosives: <br /> Sweeps Number: ❑Dusts: <br /> Proposed Date of investigation/inspection:August 2008 ❑Explosives: <br /> ❑Flammables: <br /> 2. Description and brief narrative of inspection activity: ❑Inorganic Gases: <br /> ❑New UST installation.. ❑UAR Investigation. <br /> ❑Metals: <br /> ❑Tank Closure in Place.. ❑Tank/Pipe Repair. <br /> ❑Oxidizers: <br /> El Tank/Pipe Removal. ❑ Re-excavation. ❑PCBs: <br /> ❑ Installation of Borings/Monitoring Wells. <br /> ®Hazardous waste inspection ❑ Sampling. PARI,III <br /> ❑Tiered Permitting inspection <br /> 3. Specific Site Information: REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Tank No.: Tank Capacity: I. Monitoring Equipment(note:Monitoring instruments must be used for all <br /> Tank Content: Tank Age: operations unless appropriate rationale or restrictions are provided) <br /> Other_ ❑Combustible Gas/Oxygen Meter. <br /> ❑ Detector Tubes(Specify). <br /> 4. Type of Operation:Auto Dismantler ❑Photo ionization Detector. <br /> ❑Organic Vapor Analyzer. <br /> ❑ <br /> S. Release History: Other,specify. <br /> Evidence of leaks/soil contamination: <br /> ❑ YES ❑NO If monitoring instruments are not used,rationale or activity/area restrictions: <br /> Documented Groundwater contamination: [--]YES ❑ NO <br /> Background and description of any previous investigation or incidence: <br /> 2. Personal Protective Equipment <br /> Level of Protection: ❑A ❑ B ❑C ®D <br /> 6. Potential Health and Safety Hard Hat. <br /> Physical Concerns:(check all that apply&c describe) Safety Glasses/goggles. <br /> Steel toed/shank shoes or boots. <br /> ElHeat or Cold Stress: °F(high ambient temp.) ❑ Flame retardant coveralls. <br /> ❑Noise Sources: <br /> ❑Oxygen Deficiency: Hearing protection. <br /> ® <br /> Excavation:(falls,tris slipping, ElTyvek.trips, pp� g,cave-ins}: <br /> ElHandling and Transfer of a Hazardous Substance:(fire,explosions, El Respirator: F1 APR F-1 SCBA <br /> etc..): A/P cartridge: <br /> ❑Confined space entry:(explosions): ❑safety vest. <br /> 13 Heavy equipment{physical injury&trauma resulting from moving ❑Two-way communication. <br /> equipment): <br /> ❑Other,specify PART IV-PLAN APPROVAL <br /> 7, Anticipated Biological Hazards: <br /> Plan Prepared by:Ray von Flue Date:.8/11108 <br /> ❑Snakes ❑Insects ❑Rodents ❑Poisonous Plants <br /> ❑Other/Unknown(specify): I Vol <br /> Plan Approved by: date: <br /> 8. Narrative(provide all information which could impact Health and Safety, <br /> e.g.,power lines,integrity of dikes,terrain,etc.) <br /> EH 23081(02/19/03) <br />