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San Joaquin County <br /> Environmental Health Department DIRECTOR <br /> 600 East Main Street Donna Heran, REHS <br /> AultStockton, California 95202-3029 PROGRAM COORDINATORS <br /> I_N5L1 _ Robert McClellon, REHS <br /> �.. Jeff Carruesco,REHS,RDI <br /> 0.- � W bslte: tNWW.S woI" /ehd Kasey Foley, REHS <br /> i F o R S 14999w�'�� J FETY PLAN Linda Turkatte,REHS <br /> Fax: (209)464-0138 <br /> PART I PART II <br /> GENERAL SITE INFORMATION EVALUATION OF POTENTIAL HAZARDS <br /> L Site Name:Lowes L Chemicals Hazards <br /> Address: ' 3 2 ?-r� ^4 <br /> B[Carcinogens: <br /> Contact Person: Phone No: Corrosives: <br /> Sweeps Number: ❑Dusts: <br /> Proposed Date of investigation/inspection:February 23,2012 ❑Explosives: <br /> (�Flammables: <br /> 2. Description and brief narrative of inspection activity: b Inorganic Gases: <br /> ElNew UST installation. [IUAR Investigation. <br /> ❑Metals: <br /> ❑Tank Closure in Place. C1Tank/Pipe Repair. <br /> ❑Oxidizers: <br /> E3Tank/Pipe Removal. ❑Re-excavation. ❑PCB's: <br /> .Hazardous Waste Inspection <br /> 3. Specific Site Information: PART III <br /> Tank No.: Tank Capacity: REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Tank Content: Tank Age: l. Monitoring Equipment(note:Monitoring instruments must be used for all <br /> Other: <br /> operations unless appropriate rationale or restrictions are provided) <br /> ❑Combustible Gas/Oxygen Meter. <br /> 4. Type of Operation: lL i r4ef", ❑Detector Tubes(Specify). <br /> ❑Photo ionization Detector. <br /> 5. Release History: ❑Organic Vapor Analyzer. <br /> Evidence of leaks/soil contamination: [I YES NO <br /> ❑Other,specify. <br /> If monitoring instruments are not used,rationale or activity/area restrictions: <br /> Documented Groundwater contamination: E]YES JJ NO <br /> Background and description of any previous investigation or incidence: <br /> 2. Personal Protective Equipment <br /> 6. Potential Health and Safety <br /> Level of Protection: ❑A ❑B ❑C /X1D <br /> Physical Concerns:(check all that apply&describe) ❑Hard Hat. <br /> C]Hear or Cold Stress: °F(high ambient temp.) ❑Safety Glasses/goggles. <br /> ❑Noise Sources: ❑Steel toed/shank shoes or boots. <br /> ❑Oxygen Deficiency: ❑Flame retardant coveralls. <br /> [I Excavation:(falls,trips,slipping,cave-ins): ❑Hearing protection. <br /> ❑ <br /> C]Handling and Transfer of a Hazardous Substance:(tire,explosions, Tyvek. <br /> etc..): ❑Respirator: ❑APR ❑SCBA <br /> ❑Confined space entry:(explosions): A/P cartridge: <br /> ❑Heavy equipment(physical injury&trauma resulting from moving ❑Safety vest. <br /> equipment): Two-way communication. <br /> Other,specify YA1191t—o' A <br /> I r <br /> PART IV-PLAN APPROVAL <br /> 7. Anticipated Biological Hazards: <br /> ❑Snakes ;C Insects ,Rodents ❑Poisonous Plants <br /> Plan Prepared by:Michelle HenryDate: February 21,2012 <br /> ❑Other/Unknown(specify): <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 />