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Home My WebLink AboutCorrespondence CON 7/1/2008 , L1MBIRD Andrew From Sent To Cc Subject Tim Hovet [lhovel@sycan com] Tuesday, July 01, 2008 11 21 AM L1MBIRD Andrew CHINITZ Amy C FW Attachments 20080701111041656 pdf ~ 200807011110 ;56 pdf (435 KB Andy, Per Amy's ema1.1 Tlffi Hovet -----Orlglnal Message----- From rlcoh@sycan com [mallto rlcoh@sycan com] Sent Tuesday, July 01, 2008 8 11 AM To Tun Hovet SubJect ThlS E-mall was sent from "RNP9A525B" (AbclO 3228C) Scan Date 07 01 2008 11 10 41 (-0400) Querles to rlcoh@sycan corn 1 -. " Date Received Planner. AL 7 J; /Joof I Date ~eceived 7// /"Mofj Planner" AL -X.j..:. Holiday Inn Eugene North-Springfield Hazardous Materials Inspection Form Department Instructions 1 Department Manager or designated responsible Individual will Inspect every two weeks 2 Evaluate dunng Inspection for breakage, odors, etc and Items listed below to ensure safe storage conditions 3 Initial block for date each Item was Inspected COMPLETED INSPECTION SHEETS ARE TO BE MAINTAINED IN THE FILES OF THE APPROPRIATE DEPARTMENTAL MANAGER AND MADE AVAILABLE FOR REVIEW UPON REQUEST \ Month I Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 I Area IS free from leaks and/or spills I Appropriate emergency equIpment (spill kit) In place I All chemlcals are segregated I All containers are properly labeled I All containers are closed and sealed Secondary leak proof containers were Inspected and no damage noted Tubmg and hoses In good condition and leak free Notes Problems Detected Resolution '/1 /bt,D~ . , " , LGIVed. - ~1l..llliit;;'" AL Hazardous Matenals Inventory Statement Holiday Inn - Spnngfield f)eoartment Aaent Quanlltv Chemica/ii CAS No Percent Total Amount Front Desk MARC 66 Odor Neutralizer 640z Isopropyl alcohol 67-63-0 o oz Front Desk OasIs 255 SF 640z 2-butoxyethanol 111-76-2 009 5 76 oz Front Desk OasIs 255 SF 640z Propylene plycol n-propyl ether 1569-01-3 02 1280z Front Desk OasIs 255 SF 640z Amrnonlum hydroXide 1336-21-6 002 1280z Front Desk OasIs 255 SF 640z Ethanolarnme 141-43-5 005 320z Front Desk OasIs 255 SF 640z Amphotenc and Anionic surfactants mix 005 320z Front Desk OasIs 270 Up N' Away odor elimmator 640z Amphotenc and Anionic surfactants rnlx 005 320z Front Desk OasIs 270 Up N' Away odor ellmmator 640z Smk salt of 12-hydroxy-9-octadecanOlc ac 13040-19-2 001 0640z Front Desk OasIs 270 Up N' Away odor ellmmator 640z Ethanol 64-17-5 005 320z . .----..--........:J . \ffitlla::~:::J. ::I~c..-. & :::..i>e::-. ~ ~:;;'-:~~; 3-GE 3 3 ~~I H~IIr:gkg9raIRg ^ RtI8:::~:-:-.:-,' ~:-~ ~. ':"'"''""*~. : ~-~ .j-~':; v ~ Bdf Housekeepmg Antlbactenal Clean & Smooth 6 gal 7647-14-5 005 03 gal Housekeeping Lemon Lift 576 oz Sodium hypochlonte 7681-52-9 002 11520z Housekeeping Lernon Ltft 576 oz sodium salt 5324-84-5 005 28 8 oz Housekeeping Stam Blaster A 3 gal benzenesulfonlc aCid 27323-41-7 01 03 gal Housekeeping Stam Blaster A 3 gal propan-2-o1 67-63-0 004 012 gal Housekeepmg Stam Blaster A 3 gal glycenn 56-81-5 02 06 gal Housekeeping Slam Blaster A 3 gal tnpropylene glycol monornethyl ether 25498-49-1 005 015 gal Housekeeping Slam Blaster A 3 gal alcohols, c12-16, ethoxylated 68551-12-2 005 015 gal Housekeepmg Stam Blaster A 3 gal sodlurn metablsulphlte 7681-57-4 005 015 gal Housekeeping Stam Blaster A 3 gal a-amylase 9000-90-2 001 o 03 gal Housekeepmg Stam Blaster Power Pak 2 2 64 gal tnphosponc aCid, pentasodlum salt 7758-29-4 011 o 2904 gal Housekeeping Slam Blaster Power Pak 2 2 64 gal sodium perborate, monohydrate 1 0332-33-9 035 o 924 gal Housekeepmg Stain Blaster Power Pak 2 2 64 gal D,sod,um metaslllcate 6834-82-0 035 o 924 gal Housekeepmg Stam Blaster Power Pak 2 2 64 gal Sodium carbonate 794-19-8 035 o 924 gal Housekeepmg Stam Blaster Power Pak 2 2 64 gal poly(oxy-, 1,2-ethandedlyl) 9016-45-9 005 0132 gal Housekeeping Stamless Steel Cleaner & Polisher 1020z LtqUlfied petroleum gas 68476-85-7 015 1530z Housekeeping Stamless Steel Cleaner & Polisher 1020z AliphatiC hydrocarbon 8092-41-3 005 510z Housekeepmg Stainless Steel Cleaner & Polisher 1020z Polyglycerol ester of oleiC aCid unknown 005 51 oz Page 2 ..,~ ' ,,,,celved 7/,/;;003 - , '-,2i,lI1e( AL Hazardous Matenals Inventory Staternent Holiday Inn - Springfield Deoartment Aaent OuantJtv J;hemlCals CAS No percent Total Amoun( Mamtenance Aqua Balance Chlorlnatmg Tablets 2 gal Calcium hypochlorite 7778-54-3 065 13 gal Mamtenance Essentials Gerrnlcldal Ultra Bleach 4 gal Sodlurn Hypochlorite 7681-52-9 007 o 28 gal Mamtenance Hydrochloric aCid 12 gal Hydrogen Chloride 7647-01-0 1 12 gal Mamtenance Magic Scrub 05 gal Ethylenediamine tetraacetlc aCid 64-02-8 002 001 gal Mamtenance Magic Scrub 05 gal Sodlurn carbonate 497-19-8 011 o 055 gal Mamtenance MagiC Scrub 05 gal Sodium dlchlorolsocyanurate dihydrate 51580-86-0 001 o 005 gal Mamtenance Marc 50 Bowl Cleaner 05 gal Hydrochloric aCid 7647-01-0 o gal Maintenance Stamless Steel Cleaner & Polisher 680z llqUlfred petroleum gas 68476-85-7 015 1020z Maintenance Stainless Steel Cleaner & Polisher 680z Allphalic hydrocarbon 8092-41-3 005 340z Maintenance Stamless Steel Cleaner & Polisher 680z Polyglycerol ester of oleic aCid unknown 005 340z Mamtenance Xylol 10 gal Xylene 1330-20-7 075 75 gal Kitchen Essentials Germicidal Ultra Bleach 2 gal Sodium hypochllte 7681-52-9 007 o 14 gal Kitchen First Impressions metal pohsh 704 oz Ammomurn hydroxide 1336-21-6 001 704 oz Kitchen llme-A-Way 8 gal Phosphoric aCid 7664-38-2 03 24 gal Kitchen OasIs 255 SF 64 oz 2-butoxyethanol 111-76-2 009 576 oz Kitchen OasIs 255 SF 640z Propylene plycol n-propyl ether 1569-01-3 02 1280z Kitchen OasIs 255 SF 640z Arnrnomum hydroxide 1336-21-6 002 1280z Kitchen OasIs 255 SF 640z Ethanolamme 141-43-5 005 320z Kitchen OasIs 255 SF 640z Arnphoterlc and Amomc surfactants rnlx 005 320z Kitchen Silver Power sllvelWare pre-soak 2 gal Sodlurn cabonate 497-19-8 022 o 44 gal Kitchen Solid Power sllvelWare detergent 12 gal Sodium hydroxlde 1310-73-2 041 4 92 gal Kitchen Solid Power sllvelWare detergent 12 gal Sodium carbonate 497-19-8 02 24 gal Kitchen Solid Power sllvelWare detergent 12 gal Sodium phosphate. tribasIc 7758-29-4 027 3 24 gal KItchen Solitaire 3 gal Sodlurn dodecylbenzenesulfonate 25155-30-0 04 12 gal Kitchen Solitaire 3 gal Sodium lauryl ether sulfate 9004-82-4 012 o 36 gal Kitchen Urnex Urn & Brewer cleaner 02 gal Sodium carbonate 497-19-8 o gal Kitchen Urnex Urn & Brewer cleaner 02 gal Sodium SIlicate 1344-09-8 o gal Kitchen Urnex Urn & Brewer cleaner 02 gal Sodium Trlpolyphosphate 7758-29-4 o gal Kitchen Urnex Urn & Brewer cleaner 02 gal Sodium Perborate 7775-29-4 o gal KItchen Urnex Urn & Brewer cleaner 02 gal Dodecyl Benzene Sodium Solfonate 25155-30-0 o gal Kitchen Wash N Walk floor cleaner 2 gal Ethanolarnme 141-43-5 005 01 gal Kitchen Wash N Walk floor cleaner 2 gal BOriC aCid compound With 2-arnmoethanol 26038-87-9 02 04 gal Kitchen Wash N Walk floor cleaner 29al Surfactants mix 02 04 gal Page 1 "... ~- ~~..." 1/ ~ ~., .",u"IVed 7,' boo Ii' Planner AL Hazardous Materials Inventorv Statement Holldav Inn-Sorln.rneld peDartment Al!!ent puanltv Chemlcal~ CAS No Percent Total Amount HousekeepIng OasIs 270 Up N' Away order ehmInator 640z Amphoteric & AnJOInJc surfactants mIx DOS 320z HousekeepIng OasIs 270 Up N' Away order ehmInator 640z SInk salt of 12-hydroxy-9-octadecanOlc 13040-19-2 001 o 64 oz HousekeepIng OasIs 270 Up N' Away order elrnlnJator 640z Ethanol 64-17-5 ODS 320z HousekeepIng Forrnula 1 640z Tnposphonc aCId, Pentasodlum salt 7758-29-4 023 14 2 oz HousekeepIng Formula 1 640z Alcohols, c12-16, Ethoxylated 68551-12-2 02 12 8 oz HousekeepIng Formula 1 640z SodIum Carbonate 497-19-8 DOS 320z HousekeepIng Formula 1 640z 2-ArnInoethanol 141-43-5 DOS 320z HousekeepIng Formula 1 64 oz Bonc ACId 10043-35-3 001 o 64 oz HousekeepIng Formula 1 640z SubtlhsIn 9014-01-1 <001 <0 640z HousekeepIng OasIs Pro 81 Carpet Extractor Cleaner 640z SodIum BIcarbonate (11) 144-55-8 001 064 oz HousekeepIng OasIs Pro 81 Carpet Extractor Cleaner 640z AcetIc aCId, (ethylenedInltnlo) tetra-, Tetrasodlum salt 64-02-8 001 o 64 oz HousekeepIng OasIs Pro 81 Carpet Extractor Cleaner 640z Sodlurn Carbonate 497-19-8 001 o 64 oz Page I of I .' L1MBIRD Andrew From Sent To Cc Subject Attachments CHINITZ Amy C [AmyC@sububl com] Tuesday, July 01, 2008 11 06 AM L1MBIRO Andrew Tim Hovet Holiday Inn Final OWP Inspection Haz Comm Program_Holiday Inn doc Andy, On June 30, 2008, I conducted a final inspection at the Holiday Inn at 919 Kruse Way (DRC2006-00038) The applicant has met all conditions of the Dnnklng Water Protection permit I have attached the Holiday Inn's HMMP for your files I will ask the applicant to send two additional documents (the updated HMIS and the inspection sheet) to complete the file Thank you, Amy Chlnltz AmyE ChmItz,MCR.P,MS Water Quality Protection Coordinator Springfield Utility Board 202 South 18th Street Springfield, OR 97477 Phone 541744 3745 Fax 541 7477348 Date !',ac€'lved Planner. AL "7 j, / ;hJof I / 7/1/2008 WRITTEN HAZARD COMMUNICATION PROGRAM Holiday Inn - Springfield EFFECTIVE JUNE 10, 2008 To be reviewed and updated as needed on each anniversary thereafter Responsible reviewing parties: General Manager and Head of Maintenance GENERALINFO~TION The management staff of the HolIday Inn - Spnngfield IS comrmtted to the preventIOn of IncIdents or happemngs that result m mJury and/or Illness and to comply WIth all applIcable federal and state health and safety rules We requlfe that management spare no effort In proVidIng a safe and healthful work envIronment for all employees, that all levels of supervIsIOn be accountable for the health and safety of those employees under theIr dIrectIOn, and through thIS wntten hazard commumcabon program share asSIgned responsIbIlIty The CIty of Spnngfield supplIes the water for the hotel from groundwater wells The management wIll spare no effort In protectIng the groundwater by lImItIng the chemIcals on sIte and proVIdIng for proper dIsposal when necessary The management shall also comply WIth Spnngfield Development Code Section 3 3-200 In order to comply WIth Oregon OccupatIOnal Health and Safety Code Hazard CommunIcatIOn, 19101200, the folloWIng wntten hazard commumcatlOn program has been establIshed for Gopura, LLC employees All company departments are Included m tlus program The wntten program WIll be avaIlable In the Wntten PrograIn BInder located m the office for revIew by any Interested employee We wIll meet the reqUIrements oftlus rule as follows SECONDARY CONTAINMENT Secondary contaIners are deSIgned to contaIn chemIcals In the case of a rupture or leak of the pnmary contaIner All chernlcals WIll be stored m secondary contaIners, capable ofretammg the capacIty of the largest pnmary contamer plus 10% Secondary contaInment wIll also be constructed to prevent pnmary contaIners from tlppmg or fallIng over under normal cIrcumstances Each department manager WIll be responsIble for ensunng that all Items are properly stored In secondary contamers, the secondary contaInment IS mtact, and the secondary contamer IS clean and free of product Any product found WIll be recaptured or dIsposed of per manufacturer's recommendatIOns Transfers of chellllcals between pnmary contaIners shall take place over a secondary contamer I '7/' / )-oot Date Recelved.~ Planner AL CONTAINER LABELING Each department manager or supervIsor WIll venry that all contaIners receIved to theIr department for use WIll clearly lIst contents on the label, note the appropnate hazard warnIng, and lIst the manufacturer's name and address It IS the polIcy ofthIs company that no contaIner WIll be released for use untIl the above data IS venfied The supervIsor In each department WIll ensure that all secondary contaIners are labeled WIth eIther an extra copy of the ongInal manufacturer's label or WIth the "central stores" genenc labels that have IdentIficatIon and hazard warmngs For help WIth labehng, see our safety!health officer MATERIAL SAFETY DATA SHEETS (MSDS) CopIes ofMSDSs for all hazardous chemIcals to whIch employees oftlus company may be exposed WIll be kept m the folloW1llg locatIOns Each department supervIsor WIll maIntaIn a MSDS bInder In a general locatIOn for all department employees contalmng copIes of all MSDSs for that department, The company's Wntten Program BInder shall be located m the Front Office and contaIn copies of all MSDSs applIcable to the entIre buIldIng ThIs mformatlOn shall be maIntamed by the AssIstant General Manager MSDSs WIll be aVaIlable to all employees In theIr work area for revIew dunng each work shIft If MSDSs are not avaIlable or new chemIcals m use do not have an MSDS, the AssIstant General Manager WllInnmedJately contact the rnanufacturer The General Manager or desIgnee WIll be responsIble for InformIng and sendmg a copy of new MSDSs to Spnngfield UtIlIty Board's Water QualIty Project CoordInator or eqUIvalent (phone 744-3745) to ensure that no prohIbIted chemIcals are beIng used EMPLOYEE INFORMATION AND TRAINING Pnor to startmg work, each new employee wIll attend a health and safety onentatlOn and wIll receIve InformatIOn and traInIng on the folloWIng An overvIew of the reqUIrements contaIned m 1910 1200 - Hazard CommunIcatIOn Standard Cherrucals present In theIr workplace operatIOns LocatIon and aVaIlabIlIty of our wntten hazard program PhYSIcal and health effects of the hazardous cherrucals Methods and observatIOn techmques used to determIne the presence or release of hazardous chemIcals In the work area How to reduce or prevent exposure to these hazardous chemIcals through use of control/work practIces and personal protectIve eqUIpment Steps the company has taken to reduce or prevent exposure to these cherrucals Safety emergency procedures to follow Ifthe employee IS exposed to these cherrucals How to read labels and revIew MSDSs to obtaIn appropnate hazard InformatIOn 2 d "7/I//'1u i Date Receive Planner. AL r Proper handlIng of chemIcals Appropnate contamment and rnarkIngs of chemIcals Steps to follow to properly contam and dIspose of spIlled or leaked chemIcals The reasons for and the Importance of Spnngfield' s DnnkIng Water Overlay ordmance *Ajier attendmg traIning, each employee WIll Sign aform to verify that he or she attended the training, received our wrztten materzals, and understood thiS company's polzcles on hazard communicatIOn Pnor to a new hazardous chemIcal bemg Introduced Into any sectIOn oftlus company, each employee of that sectIon wIll be gIven mformatlOn as outlmed above Spnngfield UtIlIty Board's Water QualIty ProJect Coordmator (phone 744-3745) IS avaIlable to asSISt WIth tramIng of employees HAZARDOUS CHEMICALS LIST The attached IS a lIst of all known hazardous chemIcals used by employees More mformatlOn on each chemIcal noted IS aVaIlable by revIeWIng MSDSs located m the wntten program bInder located In the office A current lIst of all chemIcals stored on sIte WIll be submItted to Spnngfield UtIlIty Board's Water Quality ProJect CoordInator or eqUIvalent (phone 744-3745) annually by the General Manager or deSIgnee (NOTE: The hazard-commumcatlOn standard requITes a lzst of all hazardous chemicals; however, Identifymg locations and processes may help you carry out the program.) HAZARDOUS NON-ROUTINE TASKS , Penodlcally, employees must perform hazardous non-routme tasks Before startmg work on such proJects, each affected employee WIll be gIven mformatlOn by theu supervIsor about hazardous chemIcals to whIch he or she may be exposed dunng such actIVIty ThIS mformatlOn wIll Include SpeCific cherrucal hazards ProtectIve/safety measures employees can take Measures the company has taken to reduce the hazards, IncludIng ventIlatIOn, respIrators, presence of another employee, and emergency procedures CONTAINMENT DEVICE INSPECTION AND MAINTENANCE Each department supervIsor WIll be responsIble for Inspectmg all contamers and secondary contamment deVIces on a regular basiS, at a mlrumum of monthly, to aVOId leaks and spIlls If a leakmg contamer IS found, the chemIcals WIll be moved to a new, properly labeled contamer Allleakmg contamers WIll be reported to the Safety COmmIttee 3 Date Received. 7;'/ /{Jo i I I Planner AL The MaIntenance department WIll also Inspect the pool sarutlZIng system for any leaks or cracks m the accessIble plpmg Any leaks WIll be addressed ImmedIately to prevent chemIcals from entenng the storm draIn or sarutary sewer systems or ground drrectly Each department supervIsor wIll also Inspect all applIcable emergency eqUIpment at least once a month to ensure aVaIlabIlIty and functIOnalIty The Safety Commltlee WIll conduct quarterly mspectlOns of the property to ensure that the proper protectIve and emergency eqUIpment IS m place and In good workmg order All mspectlOns shall be conducted m accordance to the rnanufaclurer's recommendatIOn SPECIFIC AREA - LANDSCAPING AND GROUNDSKEEPING Alllandscapmg and ground keepIng shall be performed by outSIde contractors No employees of the hotel WIll be Involved In landscapmg or ground keepmg actIVItIes No chemlcals for landscapmg or grounds keepmg wIll be stored or kept on the property OutSIde contractors WIll be reqUIred to meet the laws of the State of Oregon concermng IIcensmg, bondmg, and contmumg educatIOn reqUIrements OutSIde contractors WIll be reqUIred to read and acknowledge the wrItten hazard commumcatlOn program polIcy of the hotel Contractors WIll not be allowed to bnng more chemIcals on sIte than necessary to perform the speCIfic Job beIng undertaken Contractors WIll be reqUIred to submlt to the head of mamtenance MSDS sheets on all chemIcals that WIll be m common use on the property The head ofmallltenance WIll revIew all MSDS sheets to lllsure that DNAPL contaInmg chemIcals are not used Any questIOns should be dIrected to the Spnngfield UtIlIty Board The head of maIntenance wIll dISCUSS WIth all outSIde landscaplllg contractors the procedures for contaImng, rnltIgatmg and reportmg any unauthonzed release of chemIcals SPECIFIC AREA - MAINTENANCE OFFICE No chemIcals for maIntenance wIll be stored m any room other than the chemIcal storage room m pool room (see sectIOn on pool room chernlcal storage) The mallltenance office wIll have located In an obvIOUS locatIOn a spIll kIt ImmedIately avaIlable for use m any locatIOn In the hotel SPECIFIC AREA - LAUNDRY AND HOUSEKEEPING CARTS All chemIcals for the laundry WIll be located on shelvlllg on the extractor pad Only those chemIcals normally and routmely used In day to day operatIOns wIll be stored In the laundry room All chemIcals WIll be m closed contamers and clearly labeled as to then content A spIll kIt wIll be kept m a clearly vlSlble and accessIble locatIOn on the shelves All shelVIng used to store chermcals WIll be strapped to the wall to prevent overturmng In addItIOn, all 4 Date ~eGelved 7 f/ Hot Planner AL secondary contamment devIces If above the level of the bottom shelf shall be strapped to the shelvIng umt All chemIcals kept on the shelvIng or In any other locatIOn In the laundry shall be placed In a secondary contamment devIce such as a plastIc tub The tub shall be capable of holdIng at least 110% of the volume of the largest contaIner stored In the contaInment devIce Only those chemIcals normally and routInely used In day to day operatIons wIll be stored on laundry carts The chemicals WIll be m closed contaIners In caddIes The caddIes WIll be on the laundry carts and each cart shall have a "lIp" that prevents spIlled lIqUIds from rurmIng onto the floor SPECIFIC AREA - CHEMICAL STORAGE ROOM/POOL ROOM All chemIcals used m the pool or for maIntenance m the property wIll be stored In the chemIcal storage room In the pool room Only those cherrucals normally and routmely used m day to day operatIOns of the hotel wIll be kept on property All chemIcals WIll be kept In closed contaIners, clearly labeled WIth the contents A spIll kIt WIll be located m the chemIcal storage room In a locatIon whIch IS clearly VISIble and accessible All chemIcals stored or used m the pool chemIcal storage room shall be placed m a secondary contamment devIce such as a plastIc tub The secondary contaInment devIce shall be capable of holdIng at least 110% of the volume of the largest contamer stored In the contamment devIce SPECIFIC AREA - KITCHEN Only those chemIcals normally and routmely used m day to day operatIOns of the kItchen WIll be stored on property All chemIcals WIll be stored m closed contaIners, clearly labeled WIth the contents No chemIcals shall be stored m the kItchen WIth the exceptIOn of the pre-set dIspensers of soap and detergent used on a dally basIs to wash dIshes A spIll kIt WIll be located m the kItchen In a locatIOn whIch IS clearly VISIble and accessIble HAZARDOUS CHEMICALS CLEAN-UP Whenever a spIll occurs that can be handled ImmedIately by properly traIned employees, the employees shall clean up the spIll per manufacturer's recommendatIOns Care should be taken to protect the employees and patrons of the bUIldIng by USIng the proVIded clean up eqUipment Whenever possIble, reclamatIOn and reuse ofthe chemIcal IS recommended IntentIOnal IntroductIon of any chemIcals mto the samtary sewer system IS not to occur If a spIll occurs outside of the bUIldIng, storm draIn Inlets shall be protected to prevent the chemIcal from entenng the storm draIn and nver systems Two rubber mats of suffiCIent sIze to completely cover a standard storm catch basm Inlet shall be kept on sIte to be used to stop spIlls from entenng the storm system The mats shall be located near the trash enclosure and m the mechanIcal enclosure on the south SIde of the bUlldmg CHEMICALS IN PIPES 5 Date Received ~/:J-o"{ Planner AL Work actIVItIes are often performed by employees m areas where chemIcals are transferred through pIpes Pnor to startmg work m these areas, employees Wlll contact Mamtenance for mformatlOn regardmg The chemIcal m the pIpes or the msulatlOn matenal on the pIpe PotentIal hazards Safety precautIOns to be taken INFORMING CONTRACTORS When contractors are at our workslte for Jobs such as roof or floor repaIr, Janltonal servIces, pestIcIde applIcatIOn, etc , they WIll be mformed of hazards related to our processes or operatIOns they rnay be exposed to They wIll also mform us of any hazards that may be related to the operatIons conducted by theIr employees or ansmg out of theIr work processes It IS the responsIbIlIty of HolIday Inn - Spnngfield to provIde contractors (WIth employees) the folloWlng mformatlOn Hazardous chemIcals to whIch they may be exposed whIle on the Job sIte and the procedure for obtalmng MSDSs PrecautIOns employees may take to lessen the pOSSIbIlIty of exposure by usmg appropnate protectIve measures and an explanatIOn of the labelmg system used Also, It IS the responsIbIlIty of the contractor(s) to IdentIfy and obtam MSDSs for the chemIcals the contractor IS bnngIng mto the workplace EMERGENCY CONTACTS Whenever a spIll occurs that IS larger than can be handled ImmedIately by properly tramed employees, or any sIze spIll that threatens the groundwater dIrectly, the followmg shall be notIfied llnmedIately Department SupervIsor / Manager (only If they are on the property) FIre Department - 911 Front Desk - 0 (to dIrect the fire department upon arnval) Head of Mamtenance - Carleton Hegl 501-3872 General Manager - Colleen Arruda 554-4221 6 Date Received ~/J.vc;j Planner AL ThIS IS to certIfY that I have been tramed and mformed about the hazards and precautIOns assocIated wIth the use of hazardous chemIcals In my work as reqUIred m the company's wntten hazard commumcatlOn program To confirm my understandmg of such tralmng and mstructlOns, revIewed them WIth me and he/she mdlcated luslber salIsfactlOn by check:mg the box before each of the tOpICS hsted below OvervIew of the requlfements contaIned In the Hazard CommumcatlOn Rules, CFR 1910 1200 ChemIcals present In my workplace operatIOns LocatIOns and aVaIIablhty of our wntten hazard commumcatlOn program and the MSDSs for the hazardous chemIcals PhYSIcal and health effects of these hazardous chemIcals Methods and observatIOn techmques used to determIne the presence or release of hazardous cherrucals m my work area . How to lessen or prevent exposure to these hazardous chemIcals through control and work practIces and use of personal protectIve eqUIpment Steps the company has taken to lessen or prevent exposure to these chemIcals Safety emergency procedures to follow In the event of exposure to these chemIcals How to read contamer labels, reVIew, and mterpret MSDSs to obtam appropnate hazard mformatlOn Proper handhng of chemIcals Appropnate contamment and markmgs of chemIcals Steps to follow to properly contaIn and dIspose of spIlled or leaked cherrucals Employee's name Date Tramer Date Note to employee: Tlus form WIll be made a part of your personal file Please read and understand ItS contents before SIgnIng Notes on trammg: TraImng shall be provIded at the lIme ofImtIal asslgrrrnent to task where occupatIOnal exposure to a hazardous cherrucal may take place TramIng shall be repeated whenever a new chemIcal or a new hazard IS Introduced m the work area It 7 Delte f{ecl'Jlved Planner AL 7 ! / :roo j I I should be establIshed that the employee understood the trallllllg eIther by an oral or wntten test 8 Date Hecelved ~/:laJ,/' Planner AL