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ENVIRONMENTAL HEALTH DEPARTMENT <br /> A4,u.!N SAN JOA QUIN COUNTY Unit Supervisors <br /> ). <br /> Donna K.Heran,R.E.H.S. Carl Borgman,R.E.H.S. <br /> m: Director 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> ' :. Al Olsen,R E.H.S. Stockton, California 9202-2708 Douglas W.Wilson,R.E.H.S. <br /> Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> Laurie A.Cotulla,R.E.H.S. Fax: (209) 464.0138 Robert McClellon, <br /> Program Manager Mark Barcellos,R.E.H.S. <br /> SITE HEALTH AND SAFETY PLAN <br /> PART II <br /> PART IEVALUATION OF POTENTIAL HAZARDS <br /> GENERAL SITE INFORMATION <br /> 1. Site Name:TRACY DODGE CHRYSLER JEEP HYUNDAI 1. Chemicals Hazards <br /> Address:3464 NAGLEE ROAD TRACY CA 95304 E Carcinogens: <br /> Contact Person:MIKE CURTIS f Phone No: 209 820-1800 ❑Corrosives: — <br /> Sweeps Number. — ®Dusts: -- <br /> Proposed Date of investigation/inspection August 20 2003 EJ Explosives: <br /> E Flammables: <br /> —— <br /> 2. Description and brief narrative of inspection activity: ❑ Inorganic Gases: — <br /> ❑New UST installation. ❑UAR Investigation. E Metals: — — <br /> ❑Tank Closure in Place. ❑Tank/Pipe Repair. ❑Oxidizers: — <br /> ❑Tank/Pipe Removal. ❑Re-excavation. ❑PCB's: — <br /> ❑Installation of Borings f Monitoring Wells. <br /> E Hazardous Waste Inspection ❑Sampling. PART III <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> 3. Specific Site Information: 1. Monitoring Equipment(note:Monitoring instruments must be used for all <br /> 'rank No.: Tank Capacity: operations unless appropriate rationale or restrictions are provided) <br /> 'tank Content: Tank Age:_r�.——_ --- ❑Combustible Gas/Oxygen Meter. <br /> Other: ❑Detector Tubes(Specify) <br /> ❑ Photo ionization Detector. <br /> 4. Type of Operation:AUTO REPAIR �_ --- ❑Organic Vapor Analyzer. <br /> ❑Other,specify. <br /> 5. Release History: if monitoring instruments are not used,rationale or activity/azea restrictions: <br /> Evidence of leaks f soil contamination: ❑YES ❑NO — <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 <br /> D <br /> E Hard Hat. <br /> 6. Potential Health and Safety ®Safety Glasses/gaggles- <br /> physical Concerns:(check all that apply&describe) E Steel toed/shank shoes or boots. <br /> ❑Hear or Cold Stress: °F(high ambient temp.) ❑Flame retardant coveralls. <br /> E Noise Sources: EOUiP__ MENT - -- ® Hearing protection. <br /> ❑Oxygen Deficiency: ❑Tyvek. <br /> ❑Excavation:(falls,trips,slipping,cave-ins):. <br /> ❑ Respirator: ❑APR ❑SCBA <br /> R Handling and Transfer of a Hazardous Substance:(fire,explosions, A/P cartridge: <br /> etc..): ®Safety vest. <br /> []Confined space entry:(explosions): ®Two-way communication. <br /> ❑Heavy equipment(physical injury&trauma resulting from moving <br /> equipment): PART IV_PLAN APPROVAL <br /> ❑Other,specify <br /> 7. Anticipated Biological Hazards: Plan Prepared by: <br /> Date: <br /> d Snakes ❑Insects ❑Rodents ❑Poisonous Plants <br /> ❑ <br /> other/Unknown(specify): <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.):UNKNOWN <br /> EH 23091 (12/1712002) <br />