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COMPLIANCE INFO_2021
Environmental Health - Public
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PR0520719
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COMPLIANCE INFO_2021
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Last modified
10/19/2021 2:21:57 PM
Creation date
8/11/2021 10:45:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0520719
PE
1921
FACILITY_ID
FA0011171
FACILITY_NAME
COSTCO WHOLESALE #172
STREET_NUMBER
25501
Direction
S
STREET_NAME
GATEWAY
STREET_TYPE
BLVD
City
TRACY
Zip
95377
APN
20911050
CURRENT_STATUS
01
SITE_LOCATION
25501 S GATEWAY BLVD BLDG C
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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REF#: <br /> INCIDENT INVESTIGATION REPORT FORM <br /> CAUSE & DESCRIPTION <br /> Location of Incident: Receiving middle Aisle near(EV40/41) Evaporator <br /> Date&Time of Incident: 5/26/21 , 1135 am Duration of the Incident: 2 min <br /> Quantity of Ammonia Released(if applicable): less than 1 Ib <br /> NOTE: If release exceeds 100 lbs.in a 24-hour period,contact the 3E Company immediately. See Emergency Planning <br /> and Response section of the PSMIRMP document for additional contact requirements. <br /> Describe Event as Incident Unfolded including: chronology of events,witness statements,photographs,release <br /> quantity calculations as appropriate(attach additional pages as needed): <br /> The ammonia alarms went off,employees were evacuated and accounted for.APCCO technicians were onsite and <br /> responded to the leak.The APCCO technicians went to the computer and seen that the sensor was at 0 ppm.They <br /> proceeded into the building towards EV42 to investigate the leak further.They determined that it was slightly <br /> seeping from the hot gas pilot strainer cap.APCCO then proceeded to tighten the cap and placed the Evap unit into <br /> defrost and further checked for leaks.They determined that there were no more leaks and placed the unit back into <br /> regular service. <br /> Team's Assessment of Causes of Incident including Root Cause(attach additional pages as needed): <br /> Loose Hot Gas Strainer Cap <br /> Team's Assessment of Potential Solutions/Corrective Actions(attach additional pages as needed): <br /> The Strainer cap is fairly new and possible temperature swings may have loosened the cap <br /> Actions or Circumstances Which Helped(attach additional pages as needed): <br /> APCCO just happened to be onsite for their weekly pm service call <br /> Continue on additional pages i needed. <br /> Page 3 of 5 II FORM(7/2018) <br />
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