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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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SEQUOIA
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2900 - Site Mitigation Program
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PR0505768
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/25/2020 9:40:24 AM
Creation date
5/13/2020 2:04:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0505768
PE
2960
FACILITY_ID
FA0006988
FACILITY_NAME
ALDEN PARK CHEVRON
STREET_NUMBER
500
Direction
N
STREET_NAME
SEQUOIA
STREET_TYPE
AVE
City
TRACY
Zip
95376
APN
23416001
CURRENT_STATUS
01
SITE_LOCATION
500 N SEQUOIA AVE
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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€ - a. "Poisonous Liquid, n.o.s. NA •9UZS". <br /> b. "Limited Quantity" (or Ltd. Qty. " ) . <br /> C. Net weight or net volume (weight -or volume may be abbre- <br /> viated) , <br /> bbre- <br /> viated) , just before or just after "Poisonous Liquid, <br /> n.o.s. " <br /> 3. Include a Chain-of-custody record, properly executed, in <br /> container or with cylinder if legal use of samples is re- <br /> quired or anticipated. <br /> 11 .4.4 Transportation <br /> --------------------- <br /> ' Transport unknown hazardous substance samples classified as Poison <br /> A only by ground transport or Government-owned aircraft. Do not <br /> use air cargo, other common carrier aircraft, or rented aircraft . <br /> 12.0 FORMS <br /> e' The following forms are enclosed in this section: <br /> - Plan Feedback Form <br /> ' - Accident Report Form <br /> - Plan Acceptance Form <br /> - Exposure Form <br /> +' - Calibration Check Sheet <br /> The Plan Acceptance Form should be filled out by all employees working <br /> on the site. The Plan Feedback. Form should be filled out by the Site <br /> Safety Officer and any other onsite employee who wishes to fill one <br /> out. The Accident Report Form should be filled out by the Project <br /> Manager if an accident occurs. <br /> ALL COMPLETED FORMS SHOULD BE RETURNED TO THE OFFICE SAFETY COORDINATOR <br /> WHO WILL FORWARD THEM TO THE WRHSO. <br /> F 1 i <br /> 0 <br /> 8 ' i <br /> i <br /> 3 <br /> S <br /> 1 - <br /> 26 <br />
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