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0 0 <br /> SITE HEALTH AND SAFETY PLAN <br /> PART I <br /> GENERAL SITE INFORMATION PART II <br /> 1. Site Name:Idealease of Stockton,Inc EVALUATION OF POTENTIAL HAZARDS <br /> Address: 1137 S Stockton 1. Chemicals Hazards <br /> Contact Person:A A Stroh Phone No:944-0909 <br /> Carcinogens:waste oil <br /> Sweeps Number: <br /> ❑Corrosives: <br /> Proposed Date of investigation/inspection: ❑ Dusts: <br /> ❑ Explosives: <br /> 2. Description and brief narrative of inspection activity: 'I�Wanunables:diesel fuel <br /> ❑New UST installation. ❑UAR Investigation. ❑Inorganic Gases: <br /> ❑Tank Closure in Place. ❑Tank/Pipe Repair. <br /> ❑Metals: <br /> ❑Tank/Pipe Removal. ❑Re-excavation. ❑Oxidizers: <br /> Installation of Borings/Monitoring Wells. ❑PCB's: <br /> Hazardous Waste Routine Inspection <br /> 3. Specific Site Information: <br /> Tank No.: Tank t7' <br /> Ca aci PART III <br /> Capacity: <br /> Tank Content: Tank Age: REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Other.: 1. Monitoring Equipment(note:Monitoring instruments must be used for all <br /> operations unless appropriate rationale or restrictions are provided) <br /> 4. Type of Operation:shipping trucking&freight services for commercial& ❑Combustible Gas/Oxygen Meter. <br /> residential shippers ❑Detector Tubes(Specify). <br /> ❑Photo ionization Detector. <br /> 5. Release History: ❑Organic Vapor Analyzer.. <br /> Evidence of leaks/soil contamination: ❑YES ❑NO ❑Other,specify. <br /> Documented Groundwater contamination: ❑YES ❑NO If monitoring instruments are not used,rationale or activity/area restrictions: <br /> Background and description of any previous investigation or incidence: <br /> 2. Personal Protective Equipment <br /> 6. Potential Health and Safety Level of Protection: ❑A ❑B ❑C )KD <br /> Physical Concerns:(check all that apply&describe) Hard Hat. <br /> ❑Hear or Cold Stress: °F(high ambient temp.) Safety Glasses/goggles. <br /> X Noise Sources: Steel toed/shank shoes or boots. <br /> ❑Oxygen Deficiency: ❑Flame retardant coveralls. <br /> ❑Excavation:(falls,trips,slipping,cave-ins): )&Hearing protection. <br /> ❑Handling and Transfer of a Hazardous Substance:(fire,explosions, ❑Tyvek. <br /> etc..): ❑Respirator: ❑APR ❑SCBA <br /> ❑Confined space entry:(explosions): A/P cartridge: <br /> 'rgtHeavy equipment(physical injury&trauma resulting from moving ,Safety vest. <br /> equipment): ❑Two-way communication. <br /> ❑Other,specify <br /> PART IV-PLAN APPROVAL <br /> 7. Anticipated Biological Hazards: <br /> ❑Snakes ❑Insects ❑Rodents ❑Poisonous Plants � ✓ <br /> ElOther/Unknown(specify): Plan Prepared by:A • U� f *4--� Date: 'I <br /> 8. Narrative(provide all information which could impact Health and Safety, Plan Approved by: Date: <br /> e.g.,power lines,integrity of dikes,terrain,etc.) <br /> EH 23081(12/17/2002) <br />