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f <br /> ���i <br /> � y <br /> t'ypy�y . <br /> H2H <br /> tC O <br /> pH hpt <br /> "+�1 N'i1 <br /> N <br /> �xp 1991~:�IFORM FlRE CODE A-II-E•1 <br /> r3o . , <br /> OH . <br /> O <br /> ��n Ph�sfcsl Haurds Heallh Hatards <br /> y �1� F = FR 1 = Immcdiate(Acute) <br /> zH <br /> ��,,�y . P = Sudden Releau of Prcssure D = D��ayed(Chronicl <br /> g tn R = Rcactiviry <br /> n�y I1 R'ute Only. For each wasie, pmvide the toul atimatcd amoum of haur�dous <br /> � r w aste handied throughoui the course of ihe ynr. <br /> O� <br /> y SECTIOV I[I—SEPARATIOti A\D NO�RORING <br /> (:) Part A—Abo�xeround { <br /> Fill out liems 1 ttvough 6,or provide similu infortnation for each storage area t <br /> shown on the facility map.Use additional shats u neccssary. � <br /> (b) PaA B—Cndereround ; <br /> L Complete a separate pagc for cach unde:g�vund tank,sump,vault,below'•grade f <br /> ueatment system,ett. <br /> ?. Check thc rype o(tank and mcthod(s) �hat applia to your unk(s) and piping, <br /> and answer ihe appropriatc questions.Provide aiy addiUonal informatiun m the : <br /> space providcd or on o scpara�e shcet. _ <br /> : <br /> F <br /> SECTION IV—N'ASTE DISPOSAL � <br /> Chak all that apply and list�he assixiated w aztes for each meihod checked. <br /> '�1 SECTIOV 1'—RECORD KEEP[NG <br /> Irxlude a brief description of your inspection pra-�dwss.You arc also icquired to <br /> ��' keep an inspection log and recordable dischmge lo�,which ue designed to be uscd in <br /> conjunction w iih rowine inspections for xll siorage fxilitia or areas•Sample fortns <br /> '�' are attached for yow uu.Place a check in wcA box that dexribes your fortns.if you <br /> ' ' --J do not use the sampie fortns,provide copies of yau fams for review and approval. { <br /> � j <br /> � SECTIO\VI—ENERGEVCI'-RESPOVSE PLAN <br /> � 1 (a) This plan should describe the personnel, procedurrs u�d equipmem availabl: tor <br /> ' ' rcsponding to a releau or thrcatened rcicase of hazudous materials that arc stored. <br /> � handled M used on site. <br /> 1 (b) A chtck or a irsponx under wch ilem indicates that a specific procedure is followed <br /> ' a�tAe facilitp,or that Ihe�quipment specified is maintained on site. <br /> (c) If tF�e facili�y mainuins a morc dcuiled emergcnc)•rcsponu plan on site, indicale <br /> �' <br /> �his in Item S.This plan shall be made available for�eview by the inspecting juris- <br /> diction. <br /> I� SEC7'IOV VII—E�IERGENCY•RESPONSE TRAI\P1G PLAN <br /> (a) This plan should deuribt the basic tnining plan useC a�tlx facility. <br /> �+1 (b) A check in ihe appropriate boz indicates�he vaining is provided or the rccords ue <br /> ' mainuined. <br /> . (c) If the facility maintains a morc deWiled emergency-rcsponse training plan,indicale <br /> this in I�em 4. This plan shall be made available for rcvicw by the inspecting � <br /> jurisdiction. <br /> 485 <br />