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Safety and Health Plan Proposed Distribution Center Stockton, California February 18, 2022 Terracon Project No. NA227001 10 Most persons who are infected with West Nile virus will have no noticeable symptoms, or have -10 days. Common symptoms of West Nile Fever include headache, fever, and extreme muscle weakness, occasionally accompanied by vomiting or skin rashes. In some cases, West Nile virus infection will cause severe neurologic disease such as meningitis, paralysis, or encephalitis (swelling and inflammation of the brain). Symptoms of West Nile meningitis or encephalitis may be intense headache, dizziness, stiff neck, marked weakness, muscle tremors, disorientation, mental confusion, or convulsions. Workers should protect themselves from mosquito bites by applying insect repellent to exposed skin. Generally, the more active ingredient a repellent contains, the longer it can protect from mosquito bites. A higher percentage of active ingredient in a repellent does not mean that protection is better just that it will last longer. Choose a repellent that provides protection for the amount of time that you will be outdoors. Repellents may irritate the eyes and mouth. Whenever an insecticide or insect repellent is used, workers must read and follow the manufacturer's DIRECTIONS FOR USE, as printed on the product. Insect repellent containing diethyltoluamide (DEET) can be sprayed on skin or clothing to provide protection from mosquitoes. A repellent containing permethrin can also be sprayed on clothing. Repellents containing permethrin should not be applied directly to exposed skin. Workers should wear long-sleeved shirts and long pants whenever outdoors. Workers should consider staying indoors at dawn, dusk, and in the early evening, which are peak mosquito biting times. Note: Vitamin B and "ultrasonic" devices are NOT effective in preventing mosquito bites. Tick borne diseases Lyme Disease, Ehrlichiosis, Tularemia, Southern Tick-Associated Rash Illness (STARI), and Rocky Mountain Spotted Fever (RMSF) are diseases transmitted by ticks and may occur throughout the United States during spring, summer, and fall. Lyme Disease is a potentially serious disease caused by the bacteria Borrelia burgdorferi. Humans can become infected following the bite of an infected deer tick also called the black legged tick (see figure below). Persons bitten by ticks carrying Lyme Disease may have symptoms such as a rash or a peculiar red spot (Bulls Eye) that expands outward in a circular manner (see photo below). Headaches, weakness, fever, a stiff neck, swelling and pain in the joints, and eventually, arthritis may also occur. The primary symptom of RMSF is the sudden appearance of a moderate to high fever. The fever may persist for two to three weeks. A severe headache, deep muscle pain and chills may also occur. A rash will appear on the hands and feet on about the third day and eventually spread to all parts of the body (see photo on the following page). RMSF may cause death if untreated. Ehrlichiosis refers to a disease caused by the bacteria Ehrlichia from the bite of the Lone Star Tick (see figure below). Symptoms of ehrlichiosis will