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SAV 10AQULN COUN-771." DivISION <br />k LI rz 1 AND IN -D S A FE= PLA <br />PART 12 <br />GaNEELAL SI—I-E IN-FOPN=ON FV <br />ALU_A=ON OF POTS —11AL F-AZARDS <br />Site N—e: v w r- <br />Chle--micals Hazards <br />Add -cess' dill SVk [19 <br />4rc�nog-­:: <br />comra= Pe=on: PhLaae No. Wxrzosives: <br />Sweeps --'4=be:- <br />C I Dusts' <br />Proposed Dare of rves-_igariom/!n=ec-_4o=: ;Vl� /in C I = IOSIVeS: <br />C les: <br />2. Desc:zpdon and brief Or IMSDectom activiry ;c Gases: <br />C I New UST T-smilarson UAIR. Investigation <br />Tank Closure i_- Place Tank/10-me Repair C�dize= <br />7prVDjDe R <br />. L C I ke--=CZVZ=Orl PCB's: <br />_-.azion of Borrgs/Moniro =.g Wells <br />C�-%*L - -M <br />3. Specidc Sire P=_RSON.Al PR0'r-=-C.7LV'7 <br />K NO. amic Capacirr. Eqmmmeq-L <br />Tank Conre-mrs: T a=, Age.. <br />Ctien 1. Monitoring Equipmemmr_ (note: Mcnilrornc <br />-=:_-_e-_= =usz oe, used for all ope:-azons <br />y <br />pe of CDe_-zdo='ace.-adonzie or: -es <br />unless ariuroar. --c-o= a -re <br />provide_? <br />Re_; ease <br />C I Co=buseble Gas/Om/gen- Merez- <br />E,riden-ce of leaks/sail cor_m=i=zzio=: I -fZS C I NO C J De::e=or Tubes (Spe�/) <br />Doc-_,-emrad Groundwater- courazziinado= r.10 <br />3 <br />3ack,-ound and des=mdom of any ?revious --ves-digadon <br />[I Orgamc Vapor A=-,.:7zer <br />or incidence: 01:±-,er, spe=ry- <br />If -_oniroI-6=" -, a== -=e= mor -.=e,.4 <br />rzrio-ale or ac:iw.r-,r /area <br />6. Pocen-tai H-ealt: and SaZery <br />PI:ysical Come=s: Cc: --e---- all car apply & des= -be.) <br />.3oat or Coid Stress: OF (high a=bie--- m --D.) <br />L&Y'NOise Sou.-ce: I Pe=onal 0-mcect-ve Ez m-ome-_- <br />C=yge= 01euciemcj- Level of Pore tion: C )A [ IB C IC <br />Zicavarion: (faills, "=vs sL*ippm*- cave-ins) Bar <br />I Handling and Transfer of a Hazardous Subspace:r-7 gi2sses/goggies <br />0 <br />(Ere, expiosims, etc.) <br />(L?tteez Coed/shank shoes or boors <br />11 Confined Space enr=T. (explosions) .----=e retardant cove -alis <br />I :'-.-eavv equip=emr (physics! injury & zauzza resulting t 1 Hear_img prorec--;on <br />fro= =Oving TYvek <br />Respirator, circle: A-P.R. or SC3A <br />j od2er, spec:if <br />AZP'-�_-=dge: <br />C2iery vest <br />7. Anticipated Biological 'ate rds: <br />C ITwo-way cQ=_-u=iczdOr_ <br />C j Snakes C I :Insects C I Rodents C J Poisonous Plants <br />C I OL,,e:-/Un!movn (specify): PAR- IV <br />PLAN APPROVAL <br />8. Na_*mrive (provide a imfor=ation which could irrrpa c-- Healtz <br />and Safety, e.-, power L --es, inre-ptry of erc_): Plan Prepare,-; by. 1 -,are: <br />Plan approved by, Date: <br />='3081 (2/7/92) <br />