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P41Ul,y <br /> ENVIR10*1ENTAL HEALTADEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> • �q••.....[ 'kP• Donna K.Heran R.E.H.S. Program Coordinators <br /> 304 East Weber Avenue, Third Floor Carl Borgman,R.E.H.S. <br /> Director Stockton, California 95202 Mike Huggins,R.E.H.S.,R.D.I. <br /> Laurie A.Cotulla,R.E.H.S. Kasey L.Foley,R.E.H.S. <br /> Assistant Director Telephone: (209) 468-3420 <br /> Margaret Lagorio,R.E.H.S. <br /> Fax: (209) 464-0138 Robert McClellon,R.E.H.S. <br /> Web: www.sjgov.org/chd Jeff Carruesco,R.E.H.S. <br /> SITE HEALTH&SAFETY PLAN <br /> PARTI PARTII <br /> GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS <br /> I. Site Name:Coca-Cola <br /> Address:1467 EI Pinal Drive.Stockton <br /> ❑Carcinogens:rClick here and Noel <br /> Contact Person:Shaun Willis Phone No:513-7017 ❑Corrosives:(Click here and Npel <br /> Sweeps Number:(Click here and Npel <br /> ❑Dusts:!Click here and type! <br /> Proposed Date of investigation/inspection: 12-15-09 ❑Explosives:[Click here and Nuel <br /> X Flammables:Solvents <br /> 2. Description and brief narrative of inspection activity: ❑Inorganic Gases:(Click here and NDe] <br /> ❑New UST installation.. ❑UAR Investigation. ❑Metals:[Click here and NDe] <br /> ❑Tank Closure in Place.. ❑Tank/Pipe Repair. <br /> ❑Oxidizers:(Click here and Npel <br /> ❑Tank/Pipe Removal. ❑Re-excavation. ❑PCB's:[Click here and NDeI <br /> ❑Installation of Borings/Monitoring Wells. <br /> X Hazardous waste inspection ❑ Sampling PART III <br /> ❑Tiered Permitting inspection <br /> 3. Specific Site Information: REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Tank No.:[Click here and Noel Tank Capacity:[Click here and NDeI I. Monitoring Equipment(note:Monitoring instruments must be used for all <br /> Tank Content:[Click here and NDeI Tank Age:(Click here and tvpel operations unless appropriate rationale or restrictions are provided) <br /> Other:[Click here and Noel ❑Combustible Gas/Oxygen Meter. <br /> ❑Detector Tubes(Specify). <br /> El Photo ionization Detector. <br /> 4. Type of Operation:[Click here and type] <br /> ❑Organic Vapor Analyzer. <br /> 5. Release History: ❑Other,specify. <br /> Evidence of leaks/soil contamination: E]YES ❑NO If monitoring instruments are not used,rationale or activity/area restrictions: <br /> Documented Groundwater contamination: OYES ❑NO Stay away from hazardous waste sources <br /> Background and description of any previous investigation or incidence: <br /> (Click here and Noel <br /> 2. Personal Protective Equipment <br /> Level of Protection: ❑A ❑B ❑C So <br /> 6. Potential Health and Safety [9 Hard Hat. <br /> Physical Concerns:(check all that apply&describe) ®Safety Glasses/goggles. <br /> ®Steel toed/shank shoes or boots. <br /> ❑Heat or Cold Stress:[Click here and Noel OF(high ambient temp.) <br /> ❑Flame retardant coveralls. <br /> X Noise Sources:Compressor <br /> ®Hearing protection. <br /> ❑Oxygen Deficiency:[Click here and Npel <br /> ❑Tyvek. <br /> ❑Excavation:(falls,trips,slipping,cave-ins):[Click here and NDeI <br /> ❑Respirator. ❑APR ❑SCBA <br /> x Handling and Transfer of a Hazardous Substance:(fire,explosions,etc..): <br /> Motor Oil A/P cartridge:[Click here and tvcel <br /> ❑Confined space entry:(explosions): Click here and ®Safety vest. <br /> ❑Heavy equipment(physical injury&trauma resulting from moving ❑Two-way communication. <br /> equipment):[Click here and Noel <br /> ❑other,specify:rClick here and Noel PART IV-PLAN APPROVAL <br /> 7. Anticipated Biological Hazards: Plan Prepared by: Garrett Backus Date: 12-15-09 <br /> ❑Snakes ❑ Insects ❑Rodents ❑Poisonous Plants <br /> ❑Other/Unknown(specify):[Click here and Noel 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.)[Click here and NDeI <br /> EH 23081 (02/19/03) <br />