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SITE HEALTH AND SAFETY PLAN PART I PART II GENERAL SITE INFORM TION EVALUATION OF POTENTIAL HAZARDS 1. Site Name:Valero 1. Chemicals Hazards Address: 153 E I Ph St Tra y CA 4Care;flegees: Contact Person:Jackie Hol is Phone No:(209)832-8815_ ❑Corrosives: Sweeps Number: ®-Dusts: Proposed Date of investiga ion/inspect on:February 12,2008 Explosives: XFlammables: 2. Description and brief natra've of inspt ction activity: Er Inorganic Gases: ❑New UST installation. ❑U kR Investigation. ❑Metals: ❑Tank Closure in Place. ❑T 'pe Repair. ❑Oxidizers: ❑Tank/Pipe Removal. ❑R.--excavation. ❑PCB's: ❑ Installation of Borings/Monitoring Wells. )(Hazardous Waste Inspectio PART III 3.,`Specific Site Information: Tank No.: Tik Capacity: REQUIRED PERSONAL PROTECTIVE EQUIPMENT Tank Content: T k Age: 1. Monitoring Equipment(note:Monitoring instruments must be used for all operations unless appropriate rationale or restrictions are provided) Other: ❑Combustible Gas/Oxygen Meter. 4. Type of Operation: ❑Detector Tubes(Specify). ❑Photo ionization Detector. 5. Release History: ❑Organic Vapor Analyzer. Evidence of leaks/soil con mination: ❑YES ❑NO ❑Other,specify. Documented Groundwater ntaminati n: ❑YES ❑NO If monitoring instruments are not used,rationale or activity/area restrictions: Background and descriptio of any prei ious investigation or incidence: '_. Personal Protective Equipment 6. Potential Health and Safety Level of Protection: ❑A ❑B ❑C D Physical Concerns:(check a I that appl5 &describe) Hard Hat. .� F1 Hear or Cold Stress: °F high ambient temp.) Safety Glasses/goggles. IKSteel toed/shank shoes or boots. FI Noise Sources: Traffic ❑Flame retardant coveralls. ❑Oxygen Deficiency: ❑ Hearing protection. ❑ Excavation:(falls,trips, lipping,care-ins): ❑Tyvek. ❑Handling and Transfer o a Hazardoi s Substance:(fire,explosions, F1 Respirator: El APR ❑SCBA etc..): ❑Confined space entry:(e3 plosions): A/P cartridge: ❑Heavy equipment(physi<al injury&trauma resulting from moving Safety vest. equipment): ❑Two-way communication. ❑Other,specify PART IV-PL APPROVAL 7. Anticipated Biological Hazal ds: ❑Snakes ❑Insects Rodents ❑Poisonous Plants Plan Prepared by: Date: ( U ❑Other/Unknown(specify]: Plan Approved b e� ate: 8. Narrative(provide all info tion whic could impact Health and Safety, e.g.,power lines,integrity o dikes,tetra n,etc.)Unknown EH 23081(12/17/2002)