Loading...
HomeMy WebLinkAboutApplication APPLICANT 4/17/2009 '~, City of Springfield. Development Services Department 225 Fifth Street" I Springfield, OR 91477 'i Drinking wafer Protection Overlay District Development Applicant Name: I I 1 Carolyn Duquette, Executive Director US Oncoloqy . I Fax: 683-5001 683-1422 Company: Address: 520 OR 97401 IAOOlicant's Reo.: I Icompany: I IAddress: 1 Loren Berrv I ~hone I Fax: 485-3970 485-3402 Berry Architects , 460 East 2nd Avenue, I I I I I I I lLV d I I OR 97401 I Property Owner: 1 Tamara Miller Icomoanv: 1 PeaceHealth, Property & Planninq Div: IAddress: 1123 International Way, Sprinqfield, OR 97477 I I TAX LOT ASSESSOR'S MAP, NO: 17-03"22-00 NOeS): gw. .t.tID2- I Property Addres~: 3377 RiverBend Drive, Sprinqfield, OR 97477" I Size of I Acres 0 Phone 686-7198 Fax: " 984-4215 [zoning: I Existing Use: I lI:1edical Services I . lI:1edical Services I " If you areJilling in this form by hand, please attach your proposal description to this application. I .' l Description of VYillamette Valley Cancer Center to be constructed on exi?ting vacant 5th Floor of ProDosal:, RiverBend Pavilion buildinq,. ' ISi natures: PleasJ siqn and rint your name and date in the a , ,~~ I A_.,' . \ ':u" C, Associated Cases: t.::ffT'1 ~7 -()();r8'o &:. ..7'--' I lease NO.:.tll2chs-OQ-VCX:JIS' I Date: 'I-( /1'7/ 09 IReviewed bY:~_~ IAPPlication Fee: J IO?O .00 I Technical Fee: $ 'r:; (.00 I Postage Fee: $0 . TOTAL FEES: $ ',10'1 \. Db I PROJECT NUMBER: uate KeCelVea: APR 1 7 2009 C riginal Submittal Revised 1(15(09 ddk , i , " !-J:?::~p,"-:n. IN - - -./ 1 of 5 Signatures Applicant: The undersigned acknowledges that the information in this application is correct and accurate. I ,r (J"" k J~ ) ,Du...u.;flt?5' Date:.t11 f b ~ 0 I Signature (J . 1 (!t1A-/J ~ j "" ~ "9!'~ Print ( U I If the applicant IS not thiile owner the owner hereby grants permiSSIon for the applicant to act In his/her behalf. I . M1~k ti [)CJ- L-~ a-... - Date: 4/1 G /00 Signature I I '. -_._-.~- Owner: Print __~ark H. Dahl:J1!'!Iar~ E. Mille.!........ . c Date Received: , APRi' 1 7 2009 . Original SUDmitt~1 Revised 1(15(09 ddk 2 of 5 DWP Oyerlay District Development Submittal Requirements Checklist NOTE: If you feellan item does not apply, please state the reason why and attach the explanation to this form, [gJ Submitted Concurrently with Site Plan Review or Minimum Development Standards applications, where applicable, [gJ Application Fee - refer to the Development Code Fee Schedule for the appropriate fee calculation formula. A copy of the fee schedule is available at the Development Services Department, The applicable application, technology, and postage fees are collected at the time of complete application submittal. [gJ DWP Overlay District Development Application Form D Copy of the Deed (See Narrative) D Copy of a Preliminary Title Report issued within the past 30 days documenting ownership and listing all encumbrances. (See Narrative) [gJ . Narrative explaining the proposal and any additional information that may have a bearing in determining the action to be taken, including findings demonstrating compliance with the Standards for Hazardous Materials within Time of Travel Zones (TOTZ) listed in SDC 3,3-235, [gJ [gJ NOTE: Before the Director can approve a DWP Overlay District Development request, information submitted by the applicant must adequately support the request, All of the Standards for Hazardous Materials within TOTZ must be addressed. Incomplete applications, as well as insufficient or unclear data, will delay the application review process and may result in denial. In certain circumstances, it is advisable to hire a professional planner or land use attorney to prepare the required findings, Three (3) Copies of a Plot Plan reduced to 8 '12" by 11" outlining the applicable TOTZ boundaries in relationship to the property boundaries Three (3) Copies of the Following: [gJ Use of hazardous materials that pose a risk to groundwater that existed on the property prior to May 15~ 2000, if applicable [gJ Hazardous Material Inventory Statement and Material Safety Data Sheet for all materials entered on the Statement, Hazardous material weights shall be converted to volume measurement for purposes of determining amounts (i,e, 10 pounds shall b'e considered equal to one .gallon) [gJ List of chemicals to be monitored through the analysis of groundwater samples and a monitoring schedule if groundwater monitoring is anticipated to be required [gJ Detailed description of the activities conducted at the facility that involve the storage, handling, treatment, use, or production of hazardous materials in aggregate quantities greater than 500 gallons [gJ Description of the primary and any secondary containment devices proposed, and, if applicable, clearly identified as to whether the devices will drain to the sanitary sewer . or stormwater system . [gJ Proposed Hazardous Material Management Plan forlt~le,faejlit:y.~hat,jl'1dicates L (iLe "'''''''V':>U. . procedures to be followed to prevent, control, collec I anJ'dispose of any unauthorized release of a hazardous material APR 1 7 2009 Revised 1(15(09 ddk 4 of 5 Original Submittal ~ Description ofthe procedures for inspection and maintendnce of containment devices and emergency equipment ~ Description of the plan for disposition of unused hazardous materials or hazardous material waste products over the maximum allowable amounts, including the type of transportation and proposed routes Date Received: APR 1 7 2009 Original Submittal Revised 1/15/09 ddk 5 of 5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone "f'!INQFlIl1., ~IirI",' Wii'." . C' 'If Springfield Official Receipt D~. dopment Services Department Public Works Department RECEIPT #: 1200900000000000273 Date: 04/17/2009 10:58:58AM Paid By LEE CONSTRUCTION Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 9961 In Person . Payment Total: Amount Due 1,020.00 51.00 $1,071.UU Job/Journal Number DRC2009-000 15 DRC2009-000 15 Description CTY Drinking Water Protection + 5% Technology Fee Payments: Type of Payment Check Amount Paid $1,071.00 $1,U7I.UU Date Received: APR 1 7 2009 Original submittal cRcccintl Page I of 1 4/17/2009 ~, :.\ CITY OF SPRINGFIELD VICINITY MAP DRC2009-00015 3377 RiverBend Drive Riverbend Pavilion Bldg - 5tb Floor , P. 904 !.32 ~. ~"'fp' 'PCL2 U78I3 19.'~3' :0.... SITE Map 17-03-22-00 Tax Lot 4102 North .. I') N I') o " ~ D.. ~ tn\tn\AL-~tn\ I.&J RECEIVE) APR 1 7 2009 By: -.' Willamette Valley Cancer Center at RiverBend Pavilion , Drinking Water Protection Overlay District Development Application Narratiye Applicant: . US Oncology 520 County Club Road Eugene, OR 97401 Representative: Loren Berry Berry Architects 460 East 2nd Avenue, Eugene, OR 97401 Phone: (541) 485-3970; Fax: (541) 485-3402 Iberrv(ci)berrvarch.com 1, land Use Reauest The Applicant seeks approval of this Drinking Water Protection (DWP) Overlay District Development Application in support of the project to develop the Willamette Valley Cancer Center atthe RiverBend Pavilion, 5th Floor on the RlverBend Medical Campus in Springfield, Oregon (hereinafter referred to as "WVCC"). The WVCC in Springiield, Oregon will be a medical services facility to be located on the 5th Floor of the RiverBend Pavilion at 3377 RiverBend Drive. The RiverBend Pavilion, owned by PeaceHealth was previously granted Site Plan approvai (DRC2006-0059) and DWP Overlay District Development Application approval (DRC2008-00072). In addition, a copy of the deed and preliminary title report for this property was previously submitted to the City as part of the Site Plan approval process for the . RiverBend Pavilion by PeaceHealth. This Application is limited to the US Oncology development and operation of theWVCC on the vacant 5th floor of the RiverBend Pavilion., Springfield Development Code (SDC), Chapter 5.1-125 establishes Type I review of the DWP Overlay District Development Application. The Application includes this narrative and all supporting materials consistent with SDC; Chapters 3.3-200 and 5.4-105 and the DWP Overlay District Development Application requirements. 2. Prior Use The DWP Overlay District Development Application requires identification of past uses of hazardous materials on site that pose a risk to groundwater but existed on the,property before May 15, 2000. As described in previous PeaceHealth submittals, the prior property owner of the PeaceHealth RiverBend Date Received: APR 1 7 2009 __1-- Original Submittal Drinking Water Protection Overlay District ,Development Application Willamette Valley Cancer Center at RiverBend Pavilion Anril R 2009 Page 2 property commissioned a Phase 1 Environmental Site Assessment (Omnicon Environmental Management, May 21, 2001) to Identify potential environmental exposures on-site. The assessment found that the site has been in small-scale agricultural and rural Jesidential uses, and that past uses have posed no demonstrable risk to groundwater. Sorinafield Develooment Code. Chaoter 3.3-200 Springfield Development Code (SDC), Chapter 3.3-200, Drinking Water Protection (DWP) Overlay District, sets forth procedures and standards protecting the City of Springfield's groundwater resources. SDC, Chapters 3.3-210 and 3.3-220 establish Time of Travel Zones (TOTZ) within the City and areas subject to the provisions of SDC, Chapter 3.3-200. For the subject site, the footprint of the PeaceHealth RiverBend Pavilion property was overlaid onto a digital file taken from the City's adopted Drinking Water Protection Area Maps to illustrate the applicable TOTZ in relation to planned Improvements (refer to Attachment 1, which was previously submitted with the RiverBend Pavilion DWP Application). SDC 3.3-220 Time of Travel Zones The WVCC in the RiverBend Pavilion is located within Tax Lot 902 and both the 1-5 year TOTZ and the 5-10 year TOTZ cross this taxM. The boundary line crosses through the RiverBend Pavilion building itself. SDC, Chapter 3.3-220 C.3. states that for tax lots covering more than one TOTZ, regulations in the more restrictive zone would govern. Therefore, the WVCC is governed by the more restrictive provisions of the 1-5 year TOTZ established in the SDC. . SDc 3,3-225 Review This DWP Overlay District Development Application is required when criteria under SDC, Chapter 3.3-225 A.1. and 2. are met. Since the subject site previously had agricultural and/or rural residential uses and Is now proposed to house a medical services building, the change in land use meets criterion A.1. Although no use, storage, or sale of materials associated with the property's use will pose any risk to groundwater, the proposed use will result in an increase in the quantity of "hazardous materials," which the Code defines as "those chemicals or substances which are physical or health hazards as defined and classified in Chapter 27 of the Springfield Fire Code..." Because the nature of the use requires materials that are so classified in Chapter 27 of the Springfield Fire Code (SFC), the proposal meets criterion A.2. Having met criteria from SDC, Chapter 3.3-225 A.1. and 2.. this application is therefore required. Application requirements outlined under SDC, Chapter 3.3-225 D. are addressed below. 1. A Hazardous Material Inventory Statement and a Material Safety Data Sheet for any or all materials entered into the Statement unless exempted under Section 3,3-230 of this article. Hazardous material weights shall be converted to volume measurement for purposes of determining amounts - 10 pounds shall be considered equal to 1 gallon as specified in Springfield Fire Code 2703.1.2; An inventory of hazardous materials is included in tabular format (Hazardous Material Inventory Statement) in Appendix A of the WVCC Hazardous Material Management Plan (HMMP), which is included with this application. Material Safety Data Sheets (MSDS) for each material or product listed on the HMIS will be provided in electronic format. Date Received: APR 1 7 2009 Original Submittal Drinking Water Protection Overlay District Development Application Willamette Valley Cancer.Center at RiverBend Pavilion Aoril 9 2009 Page 3 2. A list of the chemicals to be monitored through the analysis of groundwater samples and a monitoring schedule if groundwater monitoring is anticipated to be required; There is nO need for ongoing groundwater sampling and monitoring at the WVCC because no products containing DNAPLs will be used or stored on site, and there will be no releases of hazardous chemicals into the environment that could pose a risk to groundwater quality. 3. A detailed description of the activities conducted at the facility that involve the storage. handling, treatment, use, or production of hazardous materials 'in quantities greater than the maximum allowable amounts as stated in Section 3.3-235 A.; SDC, Chapter 3.3-235 A.1. establishes quantity limitations for hazardous materials within the 0-1 year TOTZ. No portion of the subject site is within the 0-1 year TOTZ; therefore, the above criterion is not applicable to this project. . . 4. A description of the primary and secondary containment devices proposed, and, if applicable, clearly identified as to whether the devices will drain to the storm or sanitary' sewer; WVCC will provide secondary containment for hazardous materials to be stored at the WVCC in accordance with the SDC, Chapter 3-3-200, which incorporates SFC 2704.2.2 by reference. Secondary containment provisions for hazardous materials and applicabie personnel training are described in the HMMP. 5. A proposed Hazardous Material Management Plan for the facility that indicates procedures to be followed to prevent, control, collect, and dispose of any unauthorized release of a hazardous material; The attached HMMP describes the procedures for protection, control, collection. and disposal of hazardous materials, including any unauthorized releases of hazardous materials. 6. A description of the procedures for inspection and maintenance of containment devices and emergency equipment; . The HMMP outlines the procedures for inspection and maintenance as required. 7. A description of the plan for disposition of unused hazardous materials or hazardous material waste products over the maximum allowable amounts including the type of t,ansportation and proposed routes. The attached HMMP describes as required above the protocols and procedures for proper disposition of hazardous materials and waste materials. The WVCC is unlikely to generate regulated hazardous waste at this time. All expired hazardous materials will be returned to the product vendor. Any hazardous' materials or waste materials that must be disposed will be collected by an approved waste material disposal vendor and disposed in accordance with State and local requirements. The waste material disposal vendor will collect these items from the WVCC waste storage area of the RiverBend Pavilion 5th Floor for transport off the RiverBend property via RiverBend Drive and MLK Parkway. SDc 3,3-230 Exemptions Prior communications with Springfield Utility Board staff for PeaceHealth RiverBend DWP approval and implementation indicated that materials designed for human consumption, including ingested or administered medications, may be considered exempt from DWP provisions. However, those materials Date Received: APR 17 2009 Original Submittal Drinking Water Protection Overlay District Development Application Willamette Valley Cancer Center at RiverBend Pavilion Aoril 9 2009 Page 4 which may be considered hazardous materials would not be exempt from appropriate storage requirements where there is a risk to groundwater. SDC 3.3-235 Standards for Approval of DWP Overlay District Applicati.ons Within Time of Travel Zones Since the '-5 year TOTZ Standards are applicable to the WVCC, the standards in SOC, Chapter 3.3-235 B. apply. 1. The storage, handling. treatment, use, application, or production or otherwise keeping on premises of more than 20 gallons of hazardous materials that pose a risk to groundwater in aggregate quantities not containing DNAPLs are allowed only upon compliance with containment and safety standards specified by the most recent Fire Code adopted by the City. No products containing ONAPLs will be used or stored or sold at the WVCC. Other hazardous materials meeting the above criterion and identified herein shall comply with all containment and safety standards established in Chapter 27 of the SFC. 2. Unless exempted, all hazardous' materials that pose a risk to groundwater shall be stored in areas with approved secondary containment in place (Springfield Fire' Code 2702.1 and 270422). As identified in response to SOC, Chapter 3.3-225 0.4. above, secondary containmentwill be provided as required in accordance with the above criterion. Such containment features within the WVCC are outlined in Section 5.0 of the attached HMMP and comply with the above-cited provision in the SFC and this criterion. . 3. All new use of DNAPLs shall be prohibited. No products containing ONAPLs will be used or stored at the WVCC, so the proposal complies with the prohibition of this criterion. . , 4. Any change in type of use or an increase in the maximum daily inventory quantity of any DNAPL shall be considered a new use and shall lie prohibited. The proposed medical service activities at the WVCC will not include the use or storage of any products containing DNAPLs, which is consistent with this criterion. 5. The following certain types of facilities or changes in chemical use and/or storage of hazardous materials that pose a risk to' groundwater shall be prohibited: a. Hazardous material product pipelines used to transport the hazardous material off of the tax lot where iUs produced or used; b. Injection wells, except dry wells for roof drainage; , c. Solid waste landfills and transfer stations; d. Fill materials containing hazardous materials; e. Land uses and new facilities that will use, store, treat, handle, and/or produce DNAPLs. The proposed medical service activities at the WVCC will not include any of the listed activities.or facilities, consistent with this criterion. Date Received: APR 1 7 2009 Original Submittal Drinking Water Protection Overlay District Development Application Willamette Valley Cancer Center at RiverBend Pavilion Aoril 9 2009 Page 5 6. Requirements found in Springfield Fire Code 2704.2.2.5 for a monitoring program and in 2704.2.2.5 for monitoring methods to detect hazardous materials in the secondary containment system shall be met for all amounts of hazardous materials that pose a risk to groundwater except those exempted. The attached HMMP includes provisions in Section 5.0 and 10.0 for monitoring methods and monthly inspections. 7. Requirements found in Springfield Fire Code 2704 for inspection and recordkeeping procedures for monthly in-house inspection and maintenance of containment and emergency equipment for all amounts of hazardous materials that pose a risk to groundwater shall be met untess exempted. The attached HMMP includes provisions in Section 10.0 for monthly inspections and in Section 11.0 for record keeping procedures. I .f Date Received: APR 1 7 2009 Original Submittal ATTACHMENT 1 LOCATION MAP WITH TOTZ Date Received: APR 1 7 2009 Original Submittal o ::I. to :;' ~ C/l c: CT 3 a ~ I r-:::L. L ~J 0'. - l,-, 1-1': - 1.11'< ....v lNUWAIt.t< '1lJE'""" O' TRAVEL; ONt - 2 "R - 5YR ;RC JNDWA TER TIME 0' TRAV(l i ONf > " :=0 l _ \ '::~~, ~~- \ -" ~__'-.C'= '-",- -"",\\, /<~ y--~-- ""'':'.. ..~.- '~\'\. {' .. , ~" " '" " '~, \\, \ J\ Ii '( \\ II 12YR - 5YR CROUNDW ~ER TI ~ or TRAvtL ZONE \~ 1\ --==_ t fiYR - 10YR GROUND\ ",kR TI~~- ! t>r TRAVEL ZONE ~ {II CII' J: ::: 1. I J{ , " " f, " . " . " ,"! I, I, ~ ~ I,,, "-_ ) '1/ '" -", : Ii; .. - ~ -.. '" = = CD I 1'('11'1 I III I 11l'~'111 . 1,1 '. . I' ~ II . ./ '? \ - 'M:LLHEAD lONE----A OF CONTRIBUTION ~ "-. I! I , ~I II i~ 'I Ij NORTH I~ I ~ SI1EET NO SCAlf Cl.O ~ ~ ~ ,--....-, <>'. ...-..c....._ ~ ~ /7 . I KTA ASSOC'kJ'~ Inc. KTA Associates, Inc. Phone 206.447.1450 800 Fifth Avenue, Suite 4100 Fax 206.374.2279 Seattle, WA 98104 www.KTAinc.net Hazardous Material and Waste Management Plan RiverBend Pavilion Willamette Valley Cancer Center April 2009 KTA A Professional Em'ironmental Seryice Corporation Date Received: APR 1 7 2009 Original Submittal .' , T F CONTENTS 1.0 HAZARDOUS MATERIAL AND WASTE MANAGEMENT PLAN PURPOSE AND OBJECTIVES ............................. ............... .................................... .............................. .......... ...... 1 2.0 PLAN REVIEW AND REViSiONS............. ......3 3.0 HAZARDOUS MATERIAL AND WASTE MANAGEMENT ROLES AND RESPONSIBILITIES. 4 4.0 HAZARDOUS MATERIAL INVENTORY STATEMENT AND STORAGE............. ................. 6 5.0 HAZARDOUS MATERIAL SECONDARY CONTAINMENT AND SPILL PREVENTION ......... 8 6.0 WASTE DETERMINATION AND MANAGEMENT REQUIREMENTS ..,..... .....10 7.0 CHEMICAL EMERGENCY / SPILL RESPONSE,......................................... ...............13 8.0 WASTE DISPOSAL AND SHIPMENT .....................................................................,.........,.......15 9.0 PERSONNEL TRAINING FOR HAZARDOUS MATERIAL AND WASTE MANAGEMENT..... 17 10.0 MONTHLY INSPECTIONS OF HAZARDOUS MATERIAL AND WASTE MANAGEMENT AND CORRECTIVE ACTION SySTEM..................................................................,...... .......... ... ........... 19 11.0 RECORDKEEPING ................................ ......................................20 Attachments - Forms Waste Determination Form 1 Hazardous Waste Monthly Inspection Form 2 Maintenance/Corrective Action Form 3 Training Record Form 4 Environmental Coordinator Assignment Form 5 Hazardous Materials Storage Monthly Inspection Form 6 ~ Annexes A - Hazardous Material Inventory B - Hazardous Material Storage Location Drawings APRIL 9, 2009 Date Received: APR 1 7 2009 Original Submittal . . , .1.0 HAZI:'RDOUS MATERIAL AND WASTE MANAGEMENT PLAN PURPOSE AND OBJECTIVES The Hazardous Material and Waste Management Plan ("Plan") for the organization medical facility ("Facility") has two purposes. First, the Plan establishes responsibilities, policies, prevention measures and procedures for storage of hazardous materials used at the Facility. Requirements for hazardous materials have been established by the Springfield Utility Board (SUB) Drinking Water Protection (DWP) Overlay District and rely on the Springfield Fire Code. One purpose of the Plan is to meet DWP requirements and protect the groundwater used as a city drinking water supply from contamination by discharges of hazardous materials that pose a risk to groundwater. The Plan addresses the following hazardous material management processes (the applicable section of the Plan is identified in parentheses): . Allowable hazardous materials to be used at the Facility (Section 4.0); . Hazardous material storage locations (Section 4.0); . Secondary containment for hazardous material containers and spill prevention measures (Section 5.0); . Spill control, collection and disposal procedures (Section 7.0), and; . Inspection and maintenance of containment devices and emergency equipment (Section 10.0). Second, the Waste Management portion of the Plan for the organization hospital or clinic establishes responsibilities, policies, work practices, and proceduies to ensure that solid, hazardous,and medical wastes are handled, packaged, collected, treated and disposed of in accordance with applicable regulations' This Facility is unlikely to generate hazardous wastes in quantities that require special management, however, the information is provided in this Plan to be consistent with the overall RiverBend medical campus plans. The Facility's wastes generally fit within four major categories: hazardous wastes, universal wastes, non-hazardous wastes, and medical wastes. The purpose of the Plan is to meet Hazardous Waste requirements and address the relationships between waste streams. that are managed as hazardous wastes and waste streams that are managed under other programs at the facility. Hazardous wastes are defined by the federal Resource Conservation and Recovery Act (RCRA) and corresponding Oregon. laws and primarily includes waste chemicals. Universal wastes are a separately regulated subset of hazardous waste, including fiuorescent ligtit bulbs and batteries. Non-hazardous solid wastes are comprised mainly of paper, plastic and food wastes. Non-hazardous liquid wastes are discharged to the sanitary sewer. Medical wastes include sharps and non-hazardous infectious solids and liquids. In addition pharmaceutical wastes are generated at the Facility which may be hazardous, medical or non- hazardous wastes. . This Plan addresses the following waste management processes (the applicable section of the Plan is identified in parentheses): . Waste management roles and responsibilities (Section 3.0); Date Received: APR 1 7 2009 KTAASSOCIATES. INC. APRIL 2009 1 Other wastes such as radioactive medical wastes are addressed by separate plans. Original Submittpl 1 ,1 o Waste identification to determine applicable storage, use, and disposal requirements (Section 6.0); o Waste disposal and shipment (Section 8.0); o Personnel training (Section 9.0); o Inspections (Section 10.0); o Emergency response (Section 7.0); and . Recordkeeping (Section 11.0). This Plan addresses requirements for the environmental regulation areas described above. Although there are several hazardous materials safety and use guidelines included in this Plan, Health and "- Safety and Hazard Communications are covered by a separate program at the Facility, , Date Received: KTAASSOCIATES, INC. APRIl2009 APR 1 7 2009 2 Original Submittal 2.0 PLAN REVIEW AND REVISIONS The Facility will'ensure the Plan is kept current and updated as necessary to reflect any change in the storage of hazardous materials. It is anticipated that the list of hazardous materials submitted to the SUB is comprehensive would only occasionally require updating for additional materials. Hazardous material storage, management and spill response procedures in this Plan will be reviewed periodically and updated as necessary. In addition, the Facility will ensure the Plan is kept current and updated as necessary to reflect any . change in the types or quantity of waste generated. Generation of a new or different waste will require preparation of a Waste Determioation Form (WDF) (see Section 6.0, below). Under applicable RCRA and state hazardous waste regulations, the Facility may generate unregulated quantities of hazardous waste and is classified as a "Conditionally Exempt Small Quantity Generator" (CESQG). A CESQG must generate less than 220 Ibs/mo. of hazardous waste and store 2,200 Ibs. or less on"site. A SQG generates more than 220 Ibs/mo. but less than 2,200 Ibs/nio. or stores more than 2,200 Ibs. on-site (see "Determining Your Generator Category," in the Oregon DEQ Small Quantity , Hazardous Waste Generator Handbook at htto:/lwww.deoetAt..oruslwmclhw/r..elibhwoen.html).Anincrease in the quantity of hazardous waste generated exceeding the SQG threshold would subject the Facility to additional requirements. A change to SQG status will require a revision of this Waste Management Plan. If hazardous waste is generated, the monihly inspections will review the need for new Waste Determination forms or changes in RCRA generator status. Date Received: KTA ASSOCIATES, INC. APRIL 2009 APR 1 7 2009 3 Original SubmittRI " 3.0 HAZARDOUS MATERIAL AND WASTE MANAGEMENT ROLES AND RESPONSIBIUTI~S The Facility will assign hazardous material management and waste management roles and responsibilities to carry out the Plan. Individuals will be assigned to roles by Facility management. Individuals will be trained to fulfill roles and carry out responsibilities as described in Section 9.0. The Facility organization for hazardous material and waste management is shown as follows: Facility Manager , IEnvironmental Coordinator H Peace Health Environmental I Coordinator 3.1 Erwiron, .:...1 Coord", . " The Environmental Coordinator (EC) will have primary responsibility for hazardous material and waste management within the hazardous waste guidelines and regulations. The Facility management will assign a person to fulfill the role of Environmental Coordinator. The EC assignment will be documented on Form 5 and maintained in the file. The EC'will have the following responsibilities. . Own the facility Hazardous Material and Waste Management Plan, including an annual review and update as necessary. Provide waste management support to facility personnel as requested-be the "Go To" person for hazardous material and waste management. . Manage the environmental file including the Plan, Hazardous Material Inventory Statement, the Waste Determination Forms (WDFs) with backup materials and required recordkeeping. . Receive training on' hazardous materials and waste management, and applicable regulations and requirements. . Ensure that hazardous materials are stored in secondary containment,' if required by the Plan. . Conduct monthly inspections of hazardous material storage locations, as described in Section 10.0 . Review new products with the SUB Water Quality Protection Coordinator to ensure that products do not contain DNAPLs; update the Hazardous Material Inventory Statement as needed. . Be familiar with the waste streams generated by each work group of department. Prepare and WDFs for new reguiated waste streams as needed. . KTAASSOCIATES, INC. APRIL2009 Date Received: 4 APR 1 7 2009 Original Submittal . If any hazardous waste is generated at the Facility, determine the facility hazardous waste generator status each, month. If necessary, the Environmental Coordinator wili: 1) Conduct inspections; 2) Coordinate shipping and disposal for universal and haiardous wastes for departments in the facility and for solid wastes where appropriate to ensure hazardous waste requirements are met; 3) Establish arrangements with waste disposal contractors and coordinate waste disposal services, and 4) Maintain records of inspections, corrective actions and waste disposai as described in 11.0. . If a spill or release occurs, contact the Facility Emergency Coordinator. Take initial response and cleanup actions as appropriate for the material. Coordinate with the PeaceHealth Environmental Coordinator for consistency on environmental issues and obtain assistance on hazardous material or waste management questions, support or policies. The environmental coordinators for the facilities on the RiverBend medical campus may establish a, networl< of periodic meetings. Date Received: KTA ASSOCIATES, INC, APRIL2009 APR 1 7 2009 5 Original Submittal 4.0 HAZARDOUS MATERIAL INVENTORY STATEMENT AND, STORAGE The hazardous materials management requirements include maintaining an inventory of hazardous materials used at the Facility and identification of the storage locations. The hazardous materials covered by this Plan are a unique subset of the broad classification of "hazardous material", it is important to understand the definition of hazardous material asit applies to this Plan. 4.1 t.-' :onofHaurdousl\:c.,j._:....r Hazardous materials are substances, as defined in City of Springfield Land Use Development Code Chapter 3.3-200 for the Drinking Water Protection (DWP) Overlay District that may be stored, handled, treated, used or produced at the Facility. As the Facility. is located in area specified to be a drinking water wellhead Time of Travel Zone of 1-5 years, restrictions apply to hazardous materials to protect groundwater. The Springfield Development Code defines Hazardous Materials as those substances (liquid or solid) which pose a risk to groundwater quality (Chapter3.3-205 A.1.) a class of liquid chemicals or substances which are physical or health hazards to groundwater). The class of hazardous materials is based on Chapter 27 of the Springfield Fire Code (SFC) which has been as adopted and amended by the City, including materials in both usable or waste conditions. City of Springfield Land Use Development Code, Chapter 3.3-230 exempts several types of SFC hazardous materials because they do not pose a risk to groundwater, these exemptions include: (1) Hazardous materials in fuel tanks and fluid reservoirs attached to (i) a private or commercial motor vehicle and used directly in the motoring operation of that vehicle, or (ii) machinery, including but, not limited to fuel, engine oil and coolant; (2) Fuel oil used in existing heating systems; (3) Hazardous materials contained in properly operating sealed units (transformers, refrigeration units, etc.) that are not opened as part of routine use; (4) Local natural gas distribution lines; (5) Fuel for emergency generators located at facilities that provide essential community services (hospitals, fire/life safety, police, public shelters, telephone systems etc.); (6) Any commonly used office supply - such as correcting fluid for typewriters, toner for computer printers or cleaners for windows and bathrooms.,. where the supplies are purchased off- site for use on-site. 4.2 Hazardous MateriaUnWntory ~,:-~,....ant The Facility has developed a comprehensive Hazardous Material Inventory Statement which lists all hazardous materials used at the Facility, maximum quantity and storage location within the building. This list accompanies this Plan and is located in Annex A. 4.3 Hazardous Material S:. c",_ L. _:.;__.~ The hazardous material storage locations are listed in the Hazardous Material Inventory Statement in Annex A. :In addition; the hazardous material storage locations are marked on a floor plan drawing. This drawing is included in Annex B. The Hazardous Materials and Waste Management Plan with the Hazardous Material Inventory Statement list and facility drawings with hazardous material storage locations are to be submitted to the SUB with the DWP Overlay Development Application. KTAASSOCIATES,INC, APRIL2009 D~te Received: 6 APR 1 7 2009 Original Submittal. " 4.4 Hazardous Material Ma c"'~ ,em All hazardous materials defined above, will be stored, handled, treated, used or produced at the Facility according to the guidelines outlined in this Plan. Hazardous materials will be purchased only where necessary and used only for the intended purpose. Hazardous materials will only be stored indoors, with secondary containment. Hazardous materials will not be stored outdoors. Hazardous materials will only be used outdoors with precautions to prevent hazardous materi?1 from entering stormwater or infiltrating into the ground. Personnel will take precautions to prevent releases of hazardous materials during storage and use, and any releases that do occur will be controlled, cleaned-up up promptly and disposed of appropriately. Individual containers of products that are not highly hazardous or toxic, and which are frequently used may be kept at the use location without. secondary containment. Examples would be household products such as dish detergent or hand soap on or under the sink in employee break rooms or restrooms. Another example is a quart bottle of isopropyl alcohol kept on the counter of an exam room; the bottle would be easily visible and any spills could be cleaned up quickly. Pharmaceuticals may be hazardous materials and will be managed appropriately. The Facility will not purchase, store or use any Dense Non-Aqueous Phase Liquids (DNAPLs). A DNAPL is one of a group of hazardous materials that are denser than water, have low solubility rate, and degrade slowly to other compounds that are even more of a health hazard. (A list of DNAPLs regulated within the Drinking Water Protection Overlay District is maintained by the SUB). Examples of DNAPLs are Perchloroethylene or 1,1,1- Trichlorethane. MSDSs for new hazardous materials proposed to be used at the Facility must be reviewed by the SUB Water Quality Protection Coordinator before purchase to ensure.the product does not contain any DNAPLs. The Facility will maintain a log of all products reviewed for potential DNAPLs. The Facility will submit an updated HMIS to the SUB when new hazardous materials are added or removed from the HMIS. The HMIS will be updated with new products as they are approved; the HMIS will be submitted to the SUB in electronic format. when new hazardous materials are added or removed from the HMIS, or upon request by the SUB. Date Received: . KTAASSOCIATES, INC. APRIL 2009 APR 1 7 2009 7 Original Submittal 5.0 HAZARDOUS MATERIAL SECONDARY CONTAINMENT AND SPILL PREVENTION Hazardous materials will be stored, handled and used with precautions to avoid spills. 5.1 Secondary Containment r Secondary containment for storage of hazardous materials that pose a risk to the groundwater will be provided in accordance with the applicable regulatory requirements, Chapter 3.3,235 B.2. of the DVIIP Program. This requirement specifically states that:: Except those exempted, all hazardous materials that pose a risk to groundwater shall be stored in areas with approved secondary containment in place (Springfield Fire Code 2702.1 and 2704.2.2. Secondary containment may be provided by one of the following means: . Liquid-tight sloped or recessed floors; . Liquid-tight floors with raised or recessed sills or dikes; . Sumps and collection systems; . Drainage systems leading to a controlled location; . Secondary containment devices, such as spill pallets, decks, tubs or trays for containers. Secondary containment systems will be ,sized to accommodate a spill from the largest container. In addition, the sizing needs to accommodate fire-protection water (20 minute discharge volume). The materials of construction of the secondary containment system must be compatible with the hazardous materials to be stored. Incompatible hazardous materials will be separated from each other in the secondary containment system. The secondary containment system will have a monitoring method, such as visual observation. Materials.. should be stored away from doorways and drains to prevent spills or leaks from leaving the secondary containment area. Most of the hazardous materials to be stored and used at this Facility are cleansers and disinfectants in 1'gallon (or less) contain,ers. All liquid hazardous .materials and hazardous materials that could be dissolved in water (e.g., powdered products), will be stored in secondary containment. The secondary containment devices, such as plastic tubs, will allow easy access and quick inspection to determine if any release of hazardous materials has occurred. The secondary containment tubs or trays will have sufficient depth to contain the at least 11 0% volume of the largest container. In hazardous material use areas where products are. used frequent.ly and easily visible, individual containers of products that are not highly hazardous or toxic do not need to be kept in secondary containment. Examples would be a quart bottle of isopropyl alcohol in an exam room or dish detergent or hand soap at or under a sink. Materials not in current use should be returned to storage in secondary containment. Hazardous materials that. are individually packaged in sealed foil or plastic packets will not require storage in secondary containment, unless the material poses a high risk to groundwater. ,,. Date Received: KTAASSOCIATES, INC. APRIL2009 8 APR 1 7 2009 Original Submittal Storage devices such as Pixis medication dispensing units and drawer carts, such as a crash cart provide adequate secondary containment. 5.2 Spill Prevention In addition to secondary containment, Facility personnel will follow precautions in hazardous material storage and use to prevent spills. . The following measures will be used for spill prevention: . Containers of hazardous materials will be stored in designated areas in each clinic. Individual clinics and departments will be responsible for their hazardous materiais and will establish guidelines and training for safe storage and use, in conjunction with Facility safety procedures. . Hazardous materials should not be left on the loading docks, freight elevator lobbies, hallways or any other unrestricted locations. . All containers of hazardous materials will be labeled with the identity of contents and chemical components. . Hazardous material containers must be in good condition, compatible with the materiai stored therein, and not in danger of leaking. Containers should be kept closed except when the material is in use. Non-compatible materials should not be stored next to each other. . Containers stored in cabinets, closets and on-shelves should be at eye-level or below. . Storage areas should be well-lit. Hazardous material storage areas should be secured or locked, if appropriate, to protect against unauthorized access. . Hazardous material storage areas should have signs to provide safety information and spill cleanup procedures. . Spill cleanup kits should be available near hazardous material storage areas. . Floor drain mats should be kept in all hazardous material storage area with floor drains to prevent accidental spills from reaching the sanitary sewer system. . Hazardous material containers must not be opened,handled, or stored in a manner that may rupture' the container or cause them to leak . . Proper handling and storage information is explained in Material Safety Data Sheets, available for all hazardous materials used at the Facility. . Empty containers previously used for storage of hazardous materials will be free of residual material before appropriate disposal. Date Received: KTAA.sSOCIATES, INC. APRIL 2009 APR 1 7 2009 9 Original Submitt"l 6.0 WASTE DETERMINATION AND MANAGEIVIEtjlT REQUIREMENTS 6.1 Waste Detenninatioo Forms and Waste Management Requirements Specific waste handling, storage and disposal requirements for each type of hazardous, universal, solid and medical waste are specified in the Waste Determination Form 1 ("WDF") maintained in the WDF "file. Example WDFs are provided in Attachment 1. This Plan describes generally applicable requirements related to handling and storage of wastes, particularly hazardous wastes. 6.2 Waste c.o : _.... ties Some waste streams are not classified as "solid wastes" and are excluded from further consideration as hazardous wastes. Examples'are' . liquid wastes which are discharged to the sanitary sewer as permitted by the Publicly Owned Treatment Works. . Materials that are reused, recycled, recovered or reclaimed. Waste streams that cannot be excluded are considered solid waste streams, which are classified into four major categories: . Solid waste, for example, office waste, used oil, recovered silver and construction waste. . Hazardous waste: Chemical waste regulated under RCRA and Oregon hazardous waste regulations, for example,organic solvents, chloroform, inorganic and organic solids such as reactive wastes, mercury based waste, and lead based waste. . Medical waste: Non-hazardous waste that is potentially infectious. Medical waste is any solid waste generated in the diagnosis, treatment or immunization of humans or animals or related research, or in the production or testing of biologicals. Examples include sharps, cultures and stocks, pathological wastes, biological waste, such as human blood and blood products. . Universal wastes, for example, fluorescent lights and ballasts, and batteries. Pharmaceutical wastes may be reyclables, reusables, medical wastes or hazardous wastes. 6.3 C_..~.JWasteMa ..._ "entl \., atioo A Waste Determination Form (WDF) will be prepared for each waste stream generated by the Facility, unless it is a general solid waste, where no specific question has arisen .or . management requirement is necessary. It is anticipated that few WDFs will be necessary for this Facility. The PeaceHealth Environmental Coordinator maintains an extensive file of WDFs for the RiverBend Medical Center; these WDFs would likely cover any needed for this Facility, and would provided a con~istent waste management process. Date Received: KTAASSOCIATES, INC. APRIL 2009 APR 1 7 2009 10 Original Submittal Unless allowed by the pertinent WDF, no waste may be dumped down a drain, discharged to a sanitary sewer, be discarded with regular trash or be allowed to evaporate to the atmosphere; '6A HazardousWaste-;~..~..JMa c",_ _ lProcedures It is anticipated that very little hazardous waste will be generated at the Facility. It is unlikely that the hazardous waste management procedures below will be necessary. 6.4.1 Hazardous wastes may be stored either at the point of generation or in a central location. The appropriate storage requirements for each hazardous waste stream will be described in the WDF for that waste stream. 6.4.2 Hazardous waste may be stored in a clinic or department, at or near the point of generation, e.g., labs, and under the control of the personnel who generated the waste. By regulation, no more than 55-gallons of hazardous waste (or one quart of acutely hazardous waste, P-waste) may be accumulated in a single location, and waste exceeding the 55-gallons limit must be moved to the central storage area within 72 hours. However, to maintain CESQG status, satellite accumulation containers will be allowed to contain no more than 10 gallons. When a container accumulates 10 gallons, it will be moved to the central waste storage area. Typically, the hazardous waste will be collected by the waste disposal vendor directly from the container location, so that moving hazardous waste to a central location will not be necessary. Each department's hazardous waste accumulation container will be marked "Hazardous Waste" and with words that identify the contents of the container (see WDF for proper labels.) 6.4.3 The Facility also stores hazardous waste in one or more central locations, described in the WDFs. Hazardous waste is stored for no more than 180 days before it is shipped off-site for disposal or recycling. In general, storage and handling in these areas must adhere to the following precautions: . Incompatible materials are not stored near each other. . Chemical in small containers are segregated and the labeled chemical containers are packaged in strong cardboard packing boxes. Containers are sorted by chemical compatibility using separate boxes for each group. . Adequate ventilation, lighting and security are provided. . All hazardous waste is stored below eye ievel. . Hazardous waste containers must be inspected at least monthly. 6.4.4 The Hazardous Waste containers and packaging requirements are: . Hazardous waste containers must be in good condition, .compatible with the waste stored therein, and not in danger of leaking. . Hazardous waste containers must not be opened, handled, or stored in a manner that may rupture the container or cause them to leak. Date Received: KTAASSOCIATES, INC. APRIL 2009 11 APR t 7 2009 Original submittal . Hazardous waste containers must be closed at all times during storage, except when waste is being added. In the case of liquid chemical hazardous waste, regulations do not permit funnels to remain in waste containers after filling. . Hazardous waste must never be left on the loading docks, freight elevators, lobbies, hallways or any other unrestricted locations. . Secondary containment is required for containers of liquid hazardous waste. Plastic tubs can be used as secondary containments. 6.4.5 Labeling requirements are: . For Hazardous Waste: Generally, all hazardous wastes must be labeled at the time the waste is first placed into the container. The following information must be completed on the label: 0 Chemical name of the contents in words, not abbreviated and no formulas (e.g., "Waste Sulfuric Acid, not H2S04). The associated hazard(s) of the waste (Ignitable, Corrosive, Reactive, or Toxic) The date on which.the accumulation began. Labels may be re-dated when the waste has been transferred to a central storage area; with the date storage begins in the central storage area, as indicated on the label. If the waste is a mixture, identify the chemical waste constituents by proper chemical name including any deactivators/disinfectants used and the approximate quantity or concentration. See WDFs for specific la~eling requirements. . Universal Wastes: Waste Lamas and Ballasts and Batteries RCRA and staie hazardous waste regulations promote the collection of universal wastes, such as waste lamps and ballasts and batteries. Fluorescent lamps and high intensity discharge lamps, including mercury vapor, high pressure sodium and metal halide can contain levels of mercury and lead that make them a hazardous waste when disposed. Batteries include the common types of batteries used in electronic equipment and flashlights, but do not include lead-acid batteries (which are subject to a different set of requirements). The Facility stores these types of universal wastes in central locations (See WDFs). Specific storage, handling and disposal requirements are described in the WDFs for "Waste Lamps and Ballasts" and "Waste Batteries." / Date Received: KTAASSOCIATES, INC. APRIL 2009 APR 1 7 2009 12 r Original Submittal 7'.0 CHEMICAL EME~GENCY I SPILL RESPONSE 7.1 c:."..".~1 Personnel who work with or around chemicals will be trained in these procedures (see Section 9.0). Hazardous material and hazardous waste container storage areas will be managed to minimize the possibility of fire, explosion or any unplanned release of chemicals or hazardous waste to the environment. 7.2 en-gency Requ.o O...J The Facility maintains an emergency plan which includes the following elements required for hazardous material and hazardous waste management: . Communications and fire control equipment, including periodic testing to ensure equipment will operate properly in time of emergency. . Arrangements with local authorities. . An Emergency Coordinator for the Facility has been designated with the responsibility' for coordinating all emergency response measures . Spill response procedures: the level of response to a chemical spill will depend upon the physical characteristics and volume of materials being handled, their potential toxicity, and the potential for releases to the environment. The following are general guidelines to be followed for a chemical spill: - o The individual who caused or discovers the spill is responsible for immediate response and cleanup until the Emergency Coordinator arrives. o Immediately alert area occupants and supervisor, and evacuate the area, if necessary. o If a volatile, flammable material is spilled, immediately wam everyone, control sources of ignition and ventilate the area. o If there is a fire that cannot be extinguished with a portable fire extinguisher, call the local Fire Department at 911. o Atlemptto contain the spill (with absorbent material) to the smallest practical area. o As appropriate, spills should be cleaned up by chemical treatment, absorption, or neutralization. If the spill is too large for the responsible individual or Emergency Coordinator to handle, or may' pose a risk to groundwater: . Call 911to contact: . Fire Department hazardous materials unit . Police Department KTAASSOCIATES, INC. APRIL2009 Date Received: 13 APR 1 7 2009 Original Submittal . Springfield Utility Board . PeaceHealth RiverBend, Emergency Coordinator o Attend to any people who may be contaminated. Contaminated clothing , must be removed immediately and the skin flushed with water for no less than fifteen minutes. . o Wear personal protective equipment, as appropriate to the hazards. Refer to the Material Safety Data Sheets or Waste Determination Forms for appropriate personal protective equipment. o Consjder the need for respiratory protection. o Protect floor drains or other means of environmental release. Floor drain mats or spill socks and absorbents may be placed around drains. o Bulk absorbents and many spill pillows do not work with acids. POWERSORB (3M) products and their equivalent will handle acid. Acids should be neutralized if possible. o When spilled materials have been absorbed, use brush and scoop to place materials in an appropriate container. Polyethyiene bags may be used for small spills. Five gallon pails with polyethylene liners may be appropriate for larger quantities. o For spills of hazardous material, the waste product and spill control materials . might be classified as a hazardous waste. For spill of hazardous material, label the container to identify the material as Spill Material Involving "XYZ Chemical". Contact the Emergency Coordinator for advice on storage and packaging for disposal. o For spills of known hazardous waste, complete a hazardous waste sticker identifying the material as Spill Material Involving "XYZ Chemical" and affix onto the container. Spill control materials should be disposed of as hazardous waste. Contact the Emergency Coordinator for a9vice on storage and packaging for disposal. o Decontaminate the surface where the spill occurred using a mild detergent and water, when appropriate. . The Emergency Coordinator will complete or assign necessary reporting to authorities and agenCies on an incident form. The Emergency Coordinator will assess environmental reporting by talking with the Environmental Coordinator. The Emergency Coordinator and Environmental Coordinator may contact or coordinate with the PeaceHealth Emergency Coordinator and Environmental Coordinator for assistance. Date Received: KTAASSOCIATES; INC. APRIL 2009 APR 1 7 2009 14 Original Submitt~1 8.0 WASTE DISP - ND SHIPMENT The disposal method for each waste stream is based on the type of waste. The disposal methods for each type of waste are described below. The WDFs specify more specific requirements, where applicable. In particular, hazardous waste disposal methods vary for the individual waste and specific disposal determination is made for each hazardous waste and documented on the WDF. 8.1 GeneraJ/NorWfazardous Waste Office waste should be dispOsed of in a trash receptacle that is lined with a plastic bag. The housekeeping personnel will collect it on a daily basis. Note: Office areas may generate hazardous waste in the form of unused cleaning products or other specialty items. Discarded materials will be recycled as practical to reduce waste that must be disposed. Glass/plastic lab ware that cannot readily be decontaminated must be disposed of as medical waste. 8.2 Sanitary Sewage Wastewater Only allowable wastewater should be discharged to the sanitary sewer. Disposal of any hazardous waste/material into the sanitary sewer is not allowed. Any materials that may interfere with sanitary sewage plant operations may not be disposed into the sanitary sewer. When the Facility obtains a pretreatment permit from the sanitary sewage system operator, it will specify the types of materials that may be discharged. Generally, the materials that can be discharged into the sanitary' sewer system include: . Sterilization wastewater . Liquid formalin, formaldehyde and gluteraldehyde . Cidex and other cleaning and wastewaters The sanitary sewage system operator may restrict the disposal of some pharmaceuticals to the sanitary sewer. . 8.3 Medical Wastes In general, medical wastes are managed according to a separate facility procedure. Medical wastes that are classified as Infectious Wastes by Oregon regulation include four categories: biological waste, cultures and stocks, pathological wastes and sharps. Infectious wastes must be treated, .typically by incineration or autoclaving, before disposal in landfills. The infectious medical waste must also be collected and stored in special bags and containers marked "Biohazard". Hazardous waste or outdated pharmaceuticals are not managed with infectious waste. If pharmaceuticals can'not be retumed to suppliers and must be discarded, each product must be reviewed for possible hazardous waste classification before disposal. Date Received: KTAASSOCIATES, INC. APRIL2009 15 APR 1 7 2009 Original Submittal 8.4 Hazardous Wastes Although unlikely at this Facility, many chemicals, e.g., acids/alkalines, organic solvents, are classified as a hazardous waste and must meet applicable shipping and disposal requirements. The WDF for each waste stream will specify whether it is a hazardous waste and identify .any unique storage, shipping and disposal requirements. Hazardous waste will be removed from the facility by a hazardous waste' contractor and disposed of at a RCRA licensed facility. The WDF will specify whether a waste stream is subject to RCRA Land Disposal Restrictions. Prior to shipment, responsible Facility personnel must ensure that the containers are marked as a "HAZARDOUS WASTE", and include date waste was first added and information on the waste characteristics or hazards. In addition, a proper manifest is prepared. (An example hazardous waste manifest is Includ~d in the file). The transporter shall be responsible for: . Having a valid EPA 10. No. . Keeping copies of the manifest in the vehicle. . Proper DOT placarding. . Signing the manifest. . Returning the manifest to the Facility and distributing copies of the manifest as specified on the form, postmarked within five business days of shipment. The Facility must keep copies of manifests for at least three years. . Filing an exception report if the receiving facility manifest copy is not received within 45 days of the waste leaving the Facility. 8.5 Universal Wastes Universal wastes, such as fluorescent lamps and batteries will have specific requirements for shipping and disposal. Typically, the requirements are more stringent than general non- hazardous solids wastes and less stringent than hazardous wastes. Refer to the Waste Determination Form for specific requirements for individual universal wastes. " Date Received: KTAASSOCIATES, INC. APRIL2009 APR 1 7 2009 16 Original Submittal 9.0 PEIJSONNEL TRAINING FOR HAZARDOUS MATERIAL AND WASTE MANAGEMENT In general, Facility personnel will receive direction or training from their supervisors, as necessary for each position, in hazardous material and general waste management and recycling. General training given to all employees in their group does not need to be documented. All employees receive training for awareness of the sensitive area that the Facility occupies and special precautions needed to protect the drinking water. In addition, the SUB representatives may talk with facility personnel during visits to increase awareness of groundwater protection roles. Facility personnel who handle hazardous materials or hazardous waste will receive basic training and direction for: . Awareness of the sensitive area that the clinic occupies and special precautions needed to protect drinking water. . Familiarization with the HMMP. . Precautions in using hazardous materials such as cleansers and disinfectants. . Storing hazardous materials in secondary containment. . Determining what is a hazardous waste. . 'Adding hazardous waste into containers. . Transporting hazardous waste from the department generation and storage area. . Responding to spills or other hazardous waste or hazardous material related ~mergencies. At the Facility, specific hazardous waste training that requires documentation would oniy be required if hazardous waste will be generated. The Environmental Coordinator will have waste management training with annual update training. Training will be documented on the Training Record (Form 4) 9.1 Em- . ental Coordinator Training The Environmental Coordinator (EC) will be familiar with the regulatory requiremenis and DWP permit conditions for hazardous material management. The EC will be familiar with the hazardous material storage and use requirements and the waste management requirements of this Plan: . Types of hazardous materials used at the Facility . Types of wastes generated at the Facility (non-hazardous solid, medical waste, hazardous waste, universal waste). . General hazardous material storage and use guidelines. . General waste management guidelines, induding need for special waste storage, shipping and disposal for hazardous wastes. . Date Received: KTAASSOCIATES"INC. APRIL 2009 17 APR 1 7 2009 Original $ubmittal . Preparation ofthe Waste Determination Form. . VVho to contact if a spill or release occurs. Initial response for spill or releases. KTA ASSOCIATES, INC. APRIL 2009 Date Received: A~R \ 7 2009 . Original submittal 18 (; ~ r )' 10.0 MONTHLY INSPECTIONS OF HAZARDOUS MATERIAL AND WASTE MANAGEMENT AND CORRECTIVE ACTION SYSTEM Monthly inspections of hazardous materials and hazardous wastes will be conducted. This Facility is unlikely to generate regulated hazardous wastes, therefore, only the hazardous material monthly inspections would be required. However, any quantities of hazardous wastes are hazardous materials, must be stored in secondary containment and included in the monthly hazardous material inspection. As necessary, documented periodic inspections of storage areas are required for hazardous material and hazardous waste management at the Facility. 10.1 Hazardous Waste Manag _ _ t Monthly I. .....~_lions The quantities of hazardous wastes generated at this Facility are unlikely to require monthly inspections, If necessary, monthly inspections of hazardous waste storage areas would be performed using the standard Hazardous Waste Monthly Inspection Sheet Form 2 (attached). The Inspection Sheet includes a list of items to be checked at each area. Each Inspection Sheet has sufficient space to record inspection of four hazardous waste management areas. The inspector will check the posted WDF for each waste stream and determine if any additional wastes are generated in the area that are not documented by a WDF. The inspection will also include confirmation that the facility has not triggered Small Quantity Generator (SQG) status and recommendations, if appropriate, on waste accumulation and storage procedures to maintain CESQG status. . When the inspection discovers compliance issues, corrective action will be performed. The Environmental Coordinator will assure that corrective action is performed and fill out the Maintenance/Corrective Action Form 3 (attached). 10.2 Hazardous Material Storage Monthly Inspections Monthly inspections of hazardous material storage areas will be performed using the standard Hazard~us Material Monthly Inspection Sheet Form 6 (attached). The Inspeclion Sheet includes a list of items to be checked at each area. In particular, secondary containment devices (tubs and trays) and emergency equipment must be inspected. The inspector will look for events or practices which could lead to an unintended release of hazardous material. The inspection form must also be reviewed a'nd signed by the Office Manager. Completed inspection forms will be maintained in a binder or file. When an inspection discovers compliance Issues, corrective action will be performed. The Facility may use a computer-based maintenance management system to initiate and track' both preventative and corrective maintenance activities. The Environmental Coordinator will assure that corrective action is performed and fill out the Maintenance/Corrective Action Form 3 (attached). Date Received: KTAASSOCIATES, INC. APRIL2009 APR 1 7 2009 19 Original Submittal f V 11.0 RECORDKEEPING 11.1 Recordkeeping The Environmental Coordinator will establish and maintain an environmental file. Generally, all environmental files should be kept for a minimum of 3 years. As necessary, the filing system should include: . Hazardous Material and Waste Management Plan . Hazardous Material Inventory Statement and location drawings. . Correspondence with agencies, consultants, etc. (Keep 3 years) . Reports submitted to environmental agencies . Completed hazardous waste'monthly inspection forms (Form 2) . Completed maintenance/corrective action forms (Form 3) . Personnel Training records (Form 4) . Responsibilities including Environmental Coordinator assignment form (Form 5) . Waste Determination Forms (Form 1) ina folder for each waste stream . Waste disposal vendor information and any Waste Manifests Exception Reports, and Land Disposal Restriction Paper Work for shipping wastes to disposal . Completed hazardous material monthly inspection forms (Form 6) 11.2 R _.". I"ng As long as the Facility maintains status as a Conditionally Exempt Small Quantity Generator, submission of written reports to the Oregon DEQ or other agencies should not be required. Hazardous material management does not involve any required reporting, although approval of new hazardous materials added to the Hazardous Material Inventory Statement (HMIS) by the SUB would be necessary by submitting the MSDS and the updated HMIS: KTAASSOCIATES, INC. APRIl2009 Date Received: APR 1 7 2009 20 Original submittal. , ~ . r;-' ATTACHMENTS- FORMS Date Received: : APR 1 7 2009 . . _. .... VII!::jlllcll \5UUIIIIUc::Il ./ C-- WASTE DETERMINATION FORM 1 I Waste Name: Medical wastes - .solids I Waste ID ~umber: I Date: 2/25/04 . [ Is the Waste Hazardous as Defined by Oregon Administrative Rules ("OAR") Chapter 340, Division ,101 (includes RCRA Hazardous Waste Definition)? Yes _ No ~ Medical waste solids are solid waste, but do not meet any criteria of hazardous waste. Medical waste that may be infectious is regulated in Oregon as infectious waste under OAR 340-093-0190. Infectious waste must be treated before disposal, cultures and stocks must be incinerated or autoclaved, and pathological wastes must be incinerated (with some exceptions). In addition, infectious waste definitions, handling, treatment, and storage times and temperatures are addressed by the Health Services Oregon Administrative Rules OAR 333-056-0010 through 333-056-0050. . Products Included in the Waste: Infectious medical wastes solids include: 1) Biological waste: which includes blood and blood products, excretions, exudates, secretions, suctionings and other body fluids that cannot be directly discarded into the municipal sewer system, and waste materials saturated with blood or body fluids. 2) Cultures and stocks: which includes etiologic agents and a'ssociated biologicals, including specimen cultures and dishes and devices used to transfer, inoculate and mix cultures, wastes from production of biologicals, and serums and discarded live and attenuated vaccines. 3) Pathological waste: which includes biopsy materials and all human tissues, anatomical parts that emanate from surgery, obstetrical procedures, autopsy and laboratory procedures. Infectious medical wastes solids does not include liquid or soluble semi-solid biological wastes (WDF SH- 6), sharps (WDF SH-5) or pharmaceuticals (WDF SH-7l Source of Information use for Hazardous Waste Determination (attached): Process knowledge Waste Generation Description: Medic~1 waste solids are generated from medical procedures, laboratory and patient care. Analysis. 1. Does the waste exhibit the ignitability, corrosivity, or reactivity characteristics as defined by 40 CFR!i 261.21-23? Yes -'- NoL Not Applicable_ Explanation: The medical solids waste is not.an ignitable waste because it is a solid material, although may contain absorbed liquids. The waste is dry or water-based and does not have exhibit a flash point. The medical solids waste is not a corrosive waste because it is a generally solid material with absorbed 'Iiquids, and it not known to exhibit pH outside the range of 2.0 -:- 12.5. - The medical'solids waste does not react violently with water or appear to be reactive. Therefore, it is concluded that the waste does not exhibit the reactivity characteristic. 2. Does the waste contain contaminants that fail the TCLP level as defined by 40 CFR !i 261.24? Yes _ No.lL Not Applicable _ Explanation: The medical solids waste of the types described above does not potentially contain any of the chemicals on the TCLP constituent list. . I 3. Is the waste a listed waste as identified in 40 CFR !i 261,30-.34? Date Received: APR 1 7 2009 Original Submittal '/. .. Waste Name: WASTE DETERMINATION FORM 1 Medical wastes - solids I Waste 10 ~umber: Yes _ No..L Not Applicable_ I Date: 2/25/04 Explanation: The mediCal solids waste is not a listed waste. 4. Does the Waste fall under the'Additional Waste Definitions included in OAR 340-101-033? Yes _ No L Not Applicable ~ Explanation: The medical waste solids does not potentially contain any of the chemicals on the list of constituents in OAR 340-101-033 5. How will the Waste be stored, labeled, and disposed? Universal Waste _; Hazardous Waste _; Conditionally-Exempt Hazardous Waste _; Medical Waste _; Solid Waste _; Other.lL . Explanation: The medical waste solids will be managed as follows: . Medical waste solids must be collected and stored in leak-resistant bio-hazard bags which are stored in labeled leak-proof containers according to procedure or guideline?_. . Medical wastes will be stored in the Bio Waste area. . Medical waste solids will be transported, treated and disposed by company?_. Date Received: APR 1 7 2009 Original Submittal , / WASTE DETERMINATION FORM 1 I Waste Name: Fluorescent light bulbs I Waste 102Number: I Date:. 2/1/05 Is the Waste Hazardous as Defined by Oregon Administrative Rules ("OAR") Chapter 340, Division 101 (includes RCRA HazardousWaste Definition)? Yes L No Fluorescent lamps and ballasts may be hazardous waste due to mercury, barium and lead, and are assumed to be hazardous waste by the DEQ and EPA unless tested or determined not to be hazardous. Fluorescent lamps may be handled as Universal Wastes per 40 CFR S 273 and Ojl,R Chapter 340, Division 113. Although the universal waste requirements are less stringent than hazardous waste' requirements, universal wastes must be ultimately be treated, disposed or recycled at universal waste destination facilities I Products Included in the Waste: Mercury, Barium and Lead I Source of Information use for Hazardous Waste Determination (attached): P'rocess knowledge Waste Generation Description: Disposal of fluorescent lights containing small amounts of mercury, barium and lead. ^ . Analysis 1. Does the waste exhibit the ignitability, corrosivity, or reactivity characteristics as defined by 40 CFR !i 261.21-23? Yes _ No..x.' Not Applicable _ Explanation: The material is a solid and is not capable, under standard temperature and pressure, of causing fire through friction, absorption, or moisture or spontaneous chemicai changes. Therefore, it does not exhibit the ignitability characteristic. The material is a solid. Therefore, the waste does not exhibit the corrosivity characteristic. The waste does not react violently with water or appear to be reactive. Therefore, it is concluded that the soil does not exhibit the reactivity characteristic. '. 2. Does the waste contain contaminants that fail the TCLP level as defined by 40 CFR!i 261.24? Yes...x.- No _ Not Applicable _ Explanation: Typically, fluorescent light bulbs fail the TCLP'level for mercury and lead. Fluorescent light bulbs will be presumed to fail the TCLP but will be managed as Universal Wastes. 3. Is the waste.a listed waste as identified in 40 CFR!i 261.30-.34? Yes _ No L Not Applicable_ Explanation: This waste stream is not a listed waste. Date Received: APR 1 7 2009 Original Submitt"'l WASTE DETERMINATION FORM 1 Waste Name: Fluorescent light bulbs I Waste 102Number: I ~ate: 2/1/05 4. Does the Waste fall under the Additional Waste Definitions included in OAR 340-101-033? Yes _ No l Not Applicable_ Explanation: DEQ requirements indicate that if the waste contains over 3 percent of a constituent identified in 40 CFR S 261.33(e) or 10 percent of a constituent identified in 40 CFR S 261.33(1), the waste must be classified as an Oregon hazardous waste. As indicated above, the contaminants of concern are Mercury, Barium, and Lead. Because this waste is presumed to fail the TCLP test, this question is not applicable and is answered "No". ' 5, How will the Waste be stored, labeled, and disposed?' Universal Waste l; Hazardous Waste _; Conditionally-Exempt Hazardous Waste _; Medical Waste _; Solid Waste _; Other _' Explanation: Although the.facility qualifies as a conditionally-exempt hazardous waste generator, it has chosen to manage the Waste as a Universal Waste (40 CFR 273 and OAR 340, Div. 113) subject to the following requirements: . Waste lamps will be stored in cardboard boxes or fiber drums, which are adequate to prevent breakage, at maintenance shop. Preferably, they will be stored in their original containers. . The containers will be closed. ' . Lamp breakage will be minimized and immediately cleaned up. . Broken lamps will be stored in a closed, structurally sound container. . Each container will be labeled with one of the following phrases: "Universal Waste-Lamps," "Waste Lamps:' or "Used Lamps." . Waste lamps will be stored for no longer than one year. . Waste lamps will be disposed of at a universal waste destination facility for recycling or disposal (such as Ecolights Northwest or other, see "Waste Disposal Vendor" file for currently approved vendors). . Employees who handle waste lamps will receive training on proper handling and emergency procedures. Date Received: APR 1 7 2009 'Original Submittal ~ HAZARDOUS WASTE MONTHLY INSPECTION SHEET - FORM 2 Storage Area or Satellite Accumulation Area(s) Date/time Name HGf!M!m' Work An>-a Lab/storage area/accumulation area is maintained secure; door is locked, when unattended. I No smokinQ in area is oermitted. I "Oanaer-H"azardous Waste-Unauthorized Personnel Keeo Out" sian is cested. I ~ Eme~ncv ~ouinrrv!nt Fire extina~ishef is Dresen! and fully charoed, Date of last frre extinauisher insoedion. Spill control equipmen"t (neutralizers, absorbent pads). Safety shower working and nol blocked. I Dale of last safelv shower insoectlon. I H(:ommllnir:minn ~v,o;.lF!""", Phone accessible. Emeruencv phone numbers casted next to ohone. I Protective EnuiDfllP.nt Chemical soiash aoaales are available. Prooer aloves are available_ Area ll/o{aste Slream(s) 10 Number(s) Comments: "" -~a n -....-:.''''....' UGH .i"'_..-~. ArK. I ( t.UU~ Original Submittal Waste Manaaement Waste container's contents are identified and container is-labeled as "Hazardous Waste" or as "Universal Waste-Lamps: "Waste Lamps," 'Used Lamps: "1lniversal WAste-Batteries," "Waste 8atterif'fi" or "llfied Batteries." 9O--dav waste containers are labeled with'the'daie accumulation beqan. W:>'fite r.onl.'linem ;lre kenl rJm;erl Waste containers are stored within secondarY containment. Inr~mpatible wastes are seariwated in secondarY Containment. r:~ntainers are not lea kino. rusted, bulr1inf1 or damaned. -p,e base under COntainers is in,good.condition Jfree of cracks_ oao.s and irnoP.rVious to leaks.\ Waste is not allowed to be stored more than 90 days in container stOfage area. The facility has not generated more than 220 Ibsfmonth of hazardous waste and is storin.!J.less than 2200 Ibs. Waste in container storage area is s~io~ off-site for disoosal within 90 davs. Waste in satellite accumulation areas may not exceed _Ibs, L gallons). V\ttlen that volume is met. waste is moved to container storaae area. Universal wastes have been stored less than one year. All oersons manaoino hazardous waste have received proper trainino. .. Waste Oetelll1ination Fonns ~e Determination Form (WDF) comoleted for each waste generated in area. WDFs posted information u~lo-date. WDFs oosted or available at waste aeneration area Inspection,Topic General Work Area Emergency Equipment COmmunications Systems Protective Equipment Waste Management Waste Determination'Forms General Work Area Emergency Equipment Communications Systems Protective Equipment Waste Management Waste Determination Forms General Work Area Emergency Equipment Communications Systems Protective Equipment Waste Management Waste Determination Forms General Work Area Emergency Equipment , Communications Systems Protective Equipment Waste Management Waste Determination Forms IOK Comments /' . MAINTENANCE/CORRECTIVE ACTION - FORM 3 Forward to the Environmental Coordinator upon completion for review and filing in the facilitv Waste Maintenance/Corrective Action file 1. What is the problem being resolved through the corrective action: 2. Who performed the maintenance or corrective action: 3. What date was the maintenance or corrective action completed: 4. Describe the maintenance or corrective action performed: 5. Describe whether any follow-up evaluation shouli! be performed to ensure the maintenance or corrective action is effective: 6. Signature indicating the maintenance or corrective action is complete: Signature: Date: Date Received: APR 1 7 2009 Original Submittal f' TRAINING RECORD - FORM 4 Forward to the Environmental Coordinator upon completion for review and filinq in the facility Waste Traininq file 1. Date of training: 2. Description of training provided (should be consistent wtth the training requirements'fromthe Waste Management Plan): 3. Personnel who attended the training: Name Deoartment Sionature 4. Signature of training instructor indicating the information on this form is accurate: Name: Date: Position: Date Received: APR 1 7 2009 Original Submittal Date of change F- ENVIRONMENTAL COORDINATOR ASSIGNMENT. FORM 5 Forward, to the Environmental Coordinator upon completion for review and filing in the facility Waste Roles & Responsibilities file Name of Environmental Coordinator Name & Position of Authorizing Individual " Date Received: APR 1 7 2009 Original Submittal Storage Area(s) HAZARDOUS MATERIAL MONTHLY INSPECTION SHEET. FORM 6 C,;p,lV!rnl WnrtS.Arna lab/storaae area is maintained secure: door is locked. when unattended. No smokina in area is oermitted. I Inspection Topic l---c;eneral Work Area I Emergency Equipment I Communications Systems I Protective Equipment I Secondary Containment 8plll Prev~ntion Measures General Work Area Emergency Equipment Communications Systems Protective Equipment I Secondary Containment I Spill pr=-,v~ntion Measures ~alWorkArea I Emergency Equipment I Communications Systems I Protective Equipment Secondary Containment I t:!.eUl Preven~or:!. Measures General Work Area . I Emergency'Equipment I Communications Systems I Protective Equipment I Secondary Containment I Spill Prevention Measures =.,.....'''.-....., El1uioment Fire extinQuisher is oresent and fully charoed. Date of last fire extinauisher-inspection. . Spill control eauipment (neutralizers. absorbent cads\. P.:lmmlJni...~nn Svstems Phone accessible. Emeraencv ohone numbers costed next to chane. Pmtf!(':tivl'! Er..,i......- -chemical sclaShaOOQles and crooer Qloves are available. Area Hazardous Materials Com"EJ'~te Received: APR 1 7 2009 Original Submittal. Date/time Name Reviewed bv ~t:nnd;lrv Coryt~illrrKmt Hazardous material containers stnmd in secondalV r.ontainment Containers are not leakina, ruste'd bulaina or damaQed. .. ,. The base under containers is in Qood condition (free of cracks. Qaps and I~uid-t~qht.l Sumps and collections systems in oood condition. draina{le system to controlled location Containers of stronq acids are stored In polvethvlene lravs or tubs Incompatible materials stored separatelv Soil! P~v"nt~n M":l';:Ii~ Hazardous material containers are labeled Hazardous material containers are kept closed All oersons manaoino hazardous materials have received praDer trainino. Storaae areas clean. well--liohted. aood condition No hazardous materials stored inapprooriate locatiot'l.~ Emptv containers rnanaQed properly OK Comments I I J ..; j I 1 I I 1 I I I I I 1 ) , , . ANNEX A- HAZARDOUS MATERIAL INVENTORY STATEMENT Date Received: . APR 1 7 2009 Original Submittal ,..,,"'-,.... ,.04 1",1u.- "- H_do....""'_.ntl ... ONAPL. J'Ntorlll C",nin, ProducII C<>mo< "-'-" Clllawn~. Nono ..... -, - - ,. Nono 1311-63.<88'l\. '-'" lmOl_ p....~'*' - ''''- IiNIlh.SIlghl(IJ -- PoMl.-CI__WIIh EVSclc>Mt.15 R.I'" ~... tb>e(0) "'" C_ -~. f'leadMly. None (0) CONfJ.-R-OUST """""'~. ,-...... " '" 1J38...43.8,<5'11o: 19....",P8IEVS15I1~OI.... ",",eo. .... """'" --".S6Ighl{11 -- ,. ~~m ........ 74-~.<5'11o, cIoMIl.3g'" F.2.... ~I<e. 58_.(41 "'" :eobl"Uo,. 76-2&-5.<10'll0: qNdrvlly_None(O) UghlfWIphtt.nlcd.BlIIllII. ~141""""2,10- 1"P8fat1inlC ..... 84142....~ .-. ~,<10'll0 ::O"ll'wIdeO...... s_ Nono No~ No~ 148Qll.-4lG.1: 19a1loopelEVS ,,,aIonOl'" F'IeItIcbollle - StOlage >iedt>.Slighl!11 -- ,. C........ '" .OOle 21116-81-0; ;:Io&eI"Jllallo.. ...,~ F... None (0) "'" oW IlOI6-45-g R...d",~y.Nonoo(OI ......"" ::.--.o..cyT_ "'alkyl0l<nelhyl8enzyl CUroow HeelhHal.-d " 56424-8S-1. 19a1loope<EVS 1".....01_ "- ..... .... '...... -lMItl.H'IIh(3) J-.Ion8lcloHts ,. ....0-- .......... )06'110; 1841-01-C1DMII.3g..... N.l'" F...None(OJ :EVS) .- 0.23% Q"'df'/lly. Slighl (I) er- N<<*. NA ....-...... =--...- ,,~ " 5ll3ll1'()1-5,<I!l"" 1 gallon 1* EVS IgllllooOl'" "- ..... - """'" ......$IIghl(11 --. ,. -- ~1N.<U% ~.3g"'" ...,~ Fir............(21 EVS) t,Io;yl_hyl~. !1~J...O,<5'11o q~"None(OJ If'J'll'J"OOOIUmchkJod. ,.mOft ,.,,"~ F.............G_ ""'... " 10&01-8. tJO.10'll0: I geIIon pel Ev5 15n~OI"" $pIeyCan ,. '- ........~(11 -- ,. C*-'u G..... R__ ........ 74-88-tl,2O-3O"ll.. '*-811.311..... F.2'" F....s.-.(..) EVS) ,-""'"' EIhyl.lo::ahll 54-11-5 q~.None(O) k-.HD23Bowl -- CUroow ......alhHazard " 7G41.()I.o.23"". IlIalloope<EVS IgalonOl_ PI~bollle - -.,. ~.High(J) JwvtooaldoMlS ,. CO- ...."" ;J016-45-9 cloHI.JII..... ...,~ F....None(O) EVS) RMdMly"S/IwhI(I] Coulwid.0<8tIg.Gal ~I.cnoxylale Nono No~ No~ 1101l1:i--4"1l.1t>o 1 gallon pe<toVS IgallooOlIeu. PI_bOlIle - SIOfage _1th"Sll\lhl(l) J"""'lal doHls ,. ""- can. _1Iet. "%. cloHIl.3gellonol N.l.4 Fir..tb>e(O) "'" ~Q-54-0.5G-1MI ~eedMty. None(O) ~eO<""II.OI "".ngeOll Nono No~ No~ /IUll,<I:>"". 18a1Ioope<EVS IgallooOf.... PllOllbcbOftle .,., SIOf8lJ" _nh. SII\lhl 1') J"",lonaldDMII. ,. ...." .MlXed __ 01 &.\lv ead "<15"4 i:loe:8l..Jg..... ...,~ F...SI9ltIII EV" RNdrvIlv..f<<Jne(OI t::ollslwKl..ReIlecboo "'......alapltltll ~lIimmabiol>quld " " 54141-85-',26- 1 gallon~ EvS z::;nOUl1l;8801"1M& $p'.vClIn .",. SI01""II" _1IIl.Mod"'81et2 JlII1IIorIal~ ,. ....- ...., 84141..(16. ::to...c.38811o.... F.2'" FIf..S._.(4) evs) ,.., \,' .... !."o-5O'll.. 812. 'l:eedMty" None (0) 1ol.....0ll )0..4.<$"". .,,, UqUlliedpetraleu'nIl_ 41-6,1S,2O'!l., 5&U6-M-1. 1~ Shin.up Lemon ,...~ Fll\l1101ablellquid " " 10&-91-8. <~"". ".""""'1"".-..... Sp'.VC.o .,., Slofl>ge IHufth. None (0) J8nIlornolcl::lMlts ,. ........ 14-N-8,<5'11o cIoseI.JIIIIlIo F-2-4 F....S._.(4) EV" ,......... 16-2&-5.<5"". 'l:iMdrvity..None(O) -.--. S41"1-&&.e, s_ 8314&-82.0 SlrldeC~rus Sup.. >\k:ohoI.ttlO.yIal_ ,.~ H_hH&Z.iIrd " 3431il&-01'1, ,~ 19a1loope<EVS 19<>lIooOl".... PlMibCbolUe - S1orag. IiNlIh"Mod..81.t2 J.monaIdo8oIQ ,. Sod,um.yten....lIonat. ""' cIo&eI..3I1RIlo.. N.l.4 F....None(O) 'EVSI 1300.12.1 ReM:If'/lly" None (01 ::\Itc !'1~c~i' 'Cll" I _ _.. .. WVCC HMIS Pll9.1 APR 1 7 2009 ::>riginal Submittal I H.."dm M~""1",7nIO Statemlnt tor WiIlamltt. v'~:41:..r Cu~ April', 2001 . -- _......&.. - - I .....,"'_,.... ".04.. OfCtsfC CfC/SFC Haufd -I... - ~~ ,..-:::- ._... ""1''''''. I ''':M<] "I 1_- Condition. a..-of .,.. t--..., --. [-- ._- CAS' ~(.i'nit OltUIM,ISI&" (ClIlTK hb"" M....III1 Clanlfk:ahon LGCMiGoIt C_~ Mat.'IaIN_ ._IIIIC.... tCIlTKhb..', lunlt...otIIdl DMAI"U G,8S8CleAr.---..... ~emo'":;rat:- -~-~ - None /l84~6-3.s. 19a1loop:"E\!S ;':8IonorleM PlMllcbollle .... Slofeg. IHMllnaSlighl(11 J8IllIOfialctos.olla -Ill" ConcentlltleSulll8lnable NoniontcMlICllInl ''''' 68\1$1- ::loMC=311"lkmll N-'.... :....None(O) (EVS) Earth (11 t&-G,5-10% ~udiYCy" None (0) N_IIlMulI.......Cleaner H\<drogenpero...ide No" No" NoM 7722_84-1.""%: 1 gallon per EvS 11IalIonorlBall Pl....tiebonltl .... StorllQ8 l1eaKh*Slight(1) Janitorialclo$ats ,,, SU8t.._bIeEarth64 Ak;ohoIIllh<>Jlylal.. :l843~46-3.1o- ::lo5eIa3galklllf N-'. :n..None(O) EVS) ,,% 'l:8lIQllnty" None (O) ......vyDuly Gener.1 clYdrogenperol<ida No" No" No" M3QI-0l-5.<3%: Igallon~EvS 19a1looor_ Plasll<;boltlto ~quid Storage 'ielI1th=Sloghl(1) lanl!<.>nalck>6ela ,. I'>ur-poseCleaner AA:oha'eCh'''yllrl" ~()Q.2J..O.I5- ::lo5eI_3gallo.. N-'. Fif""None(O) eVS) SUOll8lllableEarth65 "'" ROItdrv'y'" None (0) SE6tlO....Iad.llrI "'kyldomethylbenzyt TOJIic H.....IlhHazard " il83111-01-5,5%; 19a1lonperEVS Igallonor....... PlastJcbollle .... Slorag. rlf;allh = Mooel.,. d Janrtortel do&8l$ ,. Senibl"r iIIlYTlOnlUmd*lnd. !5409-23-0,5% :10&81 = 3g&IIo/'lll N.l.... ~ir. = Slight(l) ,EVS) 'lkyldimelhyl9l11ylbMlZJ 'lsadiYlly" Nooe (0) lIITlmOniumchlond. ....estvoom C"-- ~ydrog811pero.id. """. ~" No" aB3fll-ll1-5,<3%: IgallonperEVS 'llallonor...... Ph...bebollle .... Slorage ,....Ilh= Slighl(l) JanIlofialdo6ets ,. Su.teonablo Earth 70 \b:!holelho.y\aI. il6409-23-0,I5- :Io5eI=3galloflOl N-'~ =". = None (0) EVS) "'" 'boaCllvrty " Nor>e(O) ColUltwideVIef'r&llh oflablo bederl8l cull.... """. NoM No" .......5-15%; 'lIe1lonperEVS 19a1lon"'.... P185bcbolll. ."'" Storag. ",earthsSlIght!l) Janrtonaldosata ,. """"0.., ~sylaledfeny8lcol'o1 Ml221_Z1-0,<5% =loeel"3galloflOl N-'. 1"'-_'01 EVS) Readrvlty '" None (0: C"""UBnI.Boy E...... """. No" ~~ 114-17-5.5,3%: ,....". EI"."~"" F'l85bcbol1le liquid Slorage """'llh=None(O) Jarvtorialc:lloMls ,. ^"'"""" 1004-41.7,1.6% do&el"3gallo N-H =ir. s None (0) EVS) Reaa....rty" None (0) C~,Ga~.. - - - -- - . -- Oxygen Tanks (Soz. E) 0._ OxodoZ>"Il G.. Phyaoeal~d 51.22 "112....7 'SX1.ooll l.'C<.llLc~ C._ - s"",," '__"_rO) n"'oreg. ,. ",","", l-2""" ~... '" None (01 nlu8'OfllOOm .144001'1 luc~Wy. ~ (01 1ll:Ir"ll" SPeC;OeI-OXY OxyyltnTaoks(Sil.E) :::'xygen O>Jdizlnv G.. Pllya;c.l11uar<l 6.1:22 1182"'4-7 lXZ.oo,1l ~.1ClJfLc~ C_ ... """ _.... " None (0) ,Jr,...t>eeIodcart ,. ~8l1l l-2""" ~i,,," None (0) _48cu,1l "leacR.,tysNOI'\8(0) nlusionroorn ~_oxy Co",-_ H.allhHaZBrd - - - " '7681.52-9.615%,'lgllllo.- '1 gallon or""'" Plast1o;botueljugl liquid 13Io.1J..2,"'1% N.I-4 ',0 1681-52-U, "'1% '........ 3Qxol5pollndsor Bo. w"' _-100 K_1-4 nd,vidualtypackag. .,. " 51-63-0,10% S boxes (s1ofaglt 1 1b0l Ie6s box 01 Bo. '"'" l"=1611 lJd,vdualpackell> K.I-4 51""_ ."'t."lIIl" Uod_1t(:Z"Tnag"lIlorag8 ~ir.: None (0) ar.... ~eactn/Ity.. None(O) ,. r..., 'P'....... . - . 'ft' . ~.tljnt Tl1IltrIlltnl & SUfport ........ Ind PNrmuy aleed1 s&.lllm hypo<:hlor~" l:c,...__ H.lIllh Hazard !Cloooxor aimilB') Sod'OO1hydrol<id. 5IeachW"",(Alcavie) Sod'llmhypochlolillt SIot_ -leaIlh=I.lQd"r81e(~ PhlUTnllCY Fif"_None(O) ~88dM1y" Nor>.. (0) ,. \la>I101.....~& 11IOpropyIaloohol alooholprappada :Webcx>I) Trll'illll$ Ie_Ie Flammabl&l.iquid Slorage ....aIIh.S1ighl:(l) Infusionroorn. ~ir. a H'lIh (3) Trlaga.w.-age ~9ItdNIty. None (0) "-811, ....... <l;IOfJl&.mnlilJft ~ ,. Date Received: WVCC HMIS Pag"2 APR 1 7 2009 Original Submittal - ~-~ """ lI4-11-5.J&.40%: 1~21-(1.'!>- l2%; 8000-13- S.3-<4%; lbo~MtlO 10ampuleapertxn ImpUIMIboX8nd 3.33m11""""""l lmlzeO.\ "'00 IChIorllPrepfREPP 1I&opr1)pylBla;!hol ,....- ,B_tC .. ~7.aJ..O. 10"ll0; lbo:",,,"2Sx Il.5m1per""P'Jllicalof Plashcyialin AppIICBI<K1.5m1 ChkKheJr.idlrMlgkK:llnale Flammable liquid 18412-51-0,2% 15m1_15rn1" 11 packag... 25 po>r .,..". cOlgallon box R.'''' C.r8BlIllRXdeodonzer INo hazardous iflg,erhnl CDmbl.ooWe l.JquId .. '" E6t20CII"=~ '?5MOI.nC86OfI_ Spray Can speaf>8donMSDS T.... F-2-4 ..... ..... 1"""'~""'_ITo' ...~ ''''''''-''''''''' ..... No_ ""'H~ NonaSpeci6Bdon 'gallon IgallonDfI8ll4 PlasIJcboltJe """ Storage Of comparable) tIiod"'llrmableamofllc IoISDS N-'~ Madam. 10Ish de1erllunll pOwd.... Sodium Cart>onala; - - ""'H~ 4\)7.111--8; 5pounda 5p<>U1ldboxor1e5s ... lioO~d Slor"'ll<' (CIIIiCIIde01 colt1parllble: Sod'OOlS~icat.. 13<<-011-8: K.l-'1 Sod,umPerCltlbonala; '563().f1~ Hl!f'IdS","I)l"...-IP..elOf :lhI'lAlootlol: Flsmmabl81tquid " .. 114-17-5.62"iIo; lllal:loo& 16 ft Oun<;8 or I..... PIaslH;bot\18 ..... Storage ~ab"'l "'- 87-63-0.<5% N-1-4 -- Hydlogll<1P..-ou:la, Flltmm_Uqo..Id " ." 1122-84-1.'"-5%; Ig8llon 8OZo'....... PlaGbcbotlle ..... $loragll IElhllflCH.me1hanoll\1l,o; !lOl~52-3.~ N-'~ IHydrog9llJlO'O'4da3% HydR>!Jenperoula - ,- f>ho&p/1oficacid Y8l<iwlpalilerTrOcide laopropylaloohol T..ataa " - 1000al8mary amomum FlammablelJquld C"PO l,4etriguard I80PIOP""OI Flammable liquid' " aurf_dl6lllllltCtantJ Elhyl8nelJlycol ~ec:ontamnanl ca-r rnonobutylulhtM SupelS~ l80propylalcohol T...at.... " 3&rmiddalWope(POI) OualernalYUlT'IJnrurTl FlammlIbleLiquld '"PO "=''''"''1''''''''''' P'.IIChlo~n...laxytenol ..... No_ Ernoll'8OlS8nd ""''''''.... 1'00__- -- T..."'.... " SulytE5IlWofF'VMIMA FlalTWTJ8blellQUld :opo!ymefwlullOn "-<:8IytlnbutylCltfale So_ -.c,llazard01...inyred,etil- No", -None spea(oedonMSDS Date Received: APR 1 7 2009 Oriainal Submittal ,- 1722-.84-1,3%, L_lhanl 16 II ouno:e P'IastictoolllB ~qllrl ,~~ 1664-3&-2 ,Om N-l-4 33 61-63-0.55%; Zcont.m--s.{131b0f1es4p1aslK: P'lasllCcont_ ~.. Storage 68391-01-5/6656- b=61b ~1&p<lfl&Bf COl1l3lnef N-l-4 7~6.<1'lto " 1174J3-0,I7,2%; E3I20_.. 12llounceOfIeo>l; PlasllCbonlelj14 ..... ,~~ 111-16-2,3% 12llol=5 N-l-4 T.... ... e7-63-0.S5%; ,",TO 31b0fleo>l;plIIfitic Pla6tlCcont_ .,,, SIO....{Ie 68391-01-51 ;:on!a1nBl1l.31b ~I6pBfJS8fCOf~_ N-l-4 t181l!;6-7tl-6.<1% .". No", !lB-04-1.3<lIo: "" 5POllndS Ind.\l'lduellyW\'epped """" ~quicl SIOfage nBo.Ofp\8flt!C Fl-l-4 lcont_er a 12 IbOf Ie66 bOJI 01 51. ... ~.. Storage ndlVldualpad<e18 K-l-4 ., 61-63-0: 25119-88-0: 17-f#G.l No", "" Zgallorvl 121l0unc:e0l1e68 P'Iastictoonle N-'~ - WVCC HMIS "'PA1a" Cl...if!f;euon 1_-,- -I~ baluatetl .. L~' ~ ~~ D,.':;.L. InIusionroom V_ >0..,,,,,,, "K>neSpealiedon ,,",SOS Slofege IiBaIlh=Slighl(l) nfus.ionlOOm Fir8=Hlgh(3) ~ead:MlycN<>oe(O) SIotage Heallh= Slighl(1) Infuslonroom. Fire=Slighl(l) TrUtgeGlor"lle ReadMty" None (0) .........em l)(>fn&,conauft -~ HeaKh=Sllghl(1) IBreakroom Fir8=SlIlIhI(1) tIlutntional.... Reactivily=tIlone(O) H8a11hc$l'llhl(1) :lrOPltroom ~ife = None (0) ~eadlYoty" None (0) Heallh " Slighl (I) Vanouswon. Fire = H'Ilh(3) ~allD"" Reactivity" None (0) HeaIlh=Mod....ale(2 nlusionroom. Fife "Modefale(2) Tn"gell1orage ~eactiv1tY" ...........am \4oderlJ\8(2) ~.QDfI5U. -, -- H....1Ih= SlIghl(11 Fn = Slighl (1) 'teadlvoty "None (0) nlusiOfllOOm. TriagelJlorage "u -1eallh"S1ighl(l) Tn"llillJloragll jFire= Hig/l (3) ...... Reactiv~y"None(O) HeaIlh"Sfigl1l(1) Infu5lOnroom. Fire=t.4od....ale(2) Triage6lor"lle R....d:rvlty=NonejO) Jrea.elUUTl ~_COfl""'. -1&al1l1"S1ighl(II Infusoonroom. Fife-HIfJh(3) Tnagestorage ReaclMly"tIlone(O) ........e....m roornI.COOSlln - >iealthaSlighlll1 :>harmaCy, ~lre" None (0) Triage &Ior8ge Reacl,vlty a None (01 ....... -1eallha S1lghl (I) "n!uIIIonlDDfll Firil "H'Ilh (3) Readiv~y" None (O) SID/age :-IeafthaSlighl(l) nfu&ionlOOm. ~ife" None (0) rriage *"age ~ead:ivity" None (0) ..........em 'OOmS.conauJ -. '- Sautlbrumw<th "CMXdeleryenl -- ,- ,- ,~ ,- ,- ,- ,- ,- ,- ,- ,~ ,- ,.,., I t..mdO", ur"ri"'.".to'Y .....m..t lor WIlIom... V,II., em,,' ~'" Apri", "01 ~;rII:iiT~::M' I~' - - I - I - - ~r I' i -,-.. Stof.... . O'CtaFC OFC18'C HaufO I r "alIliI Open 01 ..F'A704 _am. I~':':i J ::... ~ Haurlllo". NQ..4ou. .r: \ fjlWlll CAS. M.. Qll"ntJty 'OtC'ontaiOi.t 111.1" C:onditlonl ~-: C..... CI...iftcatlon ,....... III' -'-181"'_ ~ialC".. ICIl:TKh,...1 lunllnOModI luniJ""'"l tCIl:T1(T.b". - -ffr- [s..~........_ c:;;:::-..=:-- -,:::::-- -lI/l,I- -....1 "".!I-""'" ,'1'- I ~~Ii i ~ Coo -- SIo.lt!}9 Healh.Slight(l) Tflt\IelllDrag8 powd...(oo""....llblIllo So<llumcarbona1e 4Ql-1Q-8; F-l.... "ire_None(O} 0" Bon Ami) "eIdapar 08476-25-5 'l.MdIY'y"'N<lo8(O) Slrl....SaI.. Sodiuml'lypochlorile To.;';; H_h HBZMd " 'll81-[;2-1I.2%: '..... 1 gallon or IeM Pl88bcbonle "'" SkMage -ieafth.Uod....le(' '0- ''" Sod,umhydrolUda 1313-73-2. N-'''' "ir...None(O) Sod'umlaurytsullllle cQ07%. 'l.eadivty_ 151-21-3 '.Iod<lrale(2) ?ovrlonelOdine PovidolMtlod.....a>mpIe' - "~ Non. Specified 2SllS5-4141,3'llo '" llborles6bo.ol5C" ... ... SlDr&g" -I8aIlhcSbllhl(l) rnagesto.age ''" twabStid<I(Betlld,no) onUSeS ndMdualpacklltl K.l.... ".,"'None(O) .ea..xam 'l.8ltClivily._(O) QOf1'W.,COl1S1Jft - .,niSolveWipes llOpropylalcohol Tlul"" " " '1-63-0; 1 bOx. "41b lIl>OfI~boltof5t Bo. ... Slorage .ieaIh ~ Slight (I) Tfiag"sIor8IJ" ,. CIQ-1111lOp/ir"ffin FlanYnablellquod G4142"'a.,,: nd,Vldualpackal5 K-I-4 Fire ~ High (3) v...."ltaITI OIpropyleneglyoolnKllh, 3ol5llO-g,4..8 'lead'Ylty ~ No"" (0) "00""', CO/'''IU~ - ~ iAbW:torY iI>Jcoh:>lpoepp8ds I'SOpn:lpylalwhol TrMas 18_1C " ~l.ll3-O. 10% 2110.._411> '~lborl_boxof Bo. ~.. Sk>l&g" '-iea/lh ~ $Irgl1l(1) .." ,. :WebcoVCunty) F_...... oo'vdualpadllN K.I-4 F.... High (3) Reedivity.. Nooe (0) ::lharolr~1of ;lhyllllcotd F_...... " " 34-11-6.~: 12ft~c 12f1ouncesorkoss pt"r;bcbollkl '''''' StOlag" Heafth..Slllll1l(l) .." ,. TOSOH ,Methyl alcohol 51-66-1.5'1.: )~galloo8 N.I'" Fir,,_High(3) :.:lPlopylalcohol 51-63-0.5'1. Q...dlV1ly.. None (D) :lecdownAnl'microblal No hazardouaingred..,.,. - NoM NOM '" 1 gallon 12 ftounc:esOf 1_ Ptasbcbollle ..... Sloreg" i"leallh..Nooe(D) ~, ''" '""'~., opecdiedonMSDS N-'~ F.,,_None(D) 'l:..adMl'f-/IO.>nIi(OI :JaOOown Gel IElhylalcohol FlammabIeUquid " " 34-11-5.62% ,....., 12ftolft:8&orlesll PllI5bcbollle ..... Slorrog" -iee1th_None(OJ .." ,,, N-'''' rir" " High (3) ReedlVfty..No",,(O) !larJ< 1I CIeen up K. Nonhazilrd<:></llZorbrlol - NoM NoM '" ,. 5lborle&s Bo. .... Slo'age -leallll" None (0) -." ''" PlIapotl'f"M K.'-4 FirecNone(D) Read,VlIY" None (0) Benzall\OniUmchlonde Non..> 1'1. No". ""'" No". '^ ~ box...... 4lb ZIbOf......boxol Bo. .... Stolage 1"_"_'" '"",, ,,, :Owel8l1911 ndiVldu81pacl<eta K.I'" F......None(D) Reed"'."... None (0) , ".." ISodlUmilypodllol... COlTOoi.... Heall.tll'lazard I " '681-52-1:1.5,25% :lOftounces..D,~ .34ftoullC(t5wl_ PlastIcbottl&'jo-. ..... -... 'l-Ieallh=Slighl(1) lL8b ,. J..... N-1'" F.....None(D) Reed,viIy" None (0) SuperSllI1icloth I'"'''''''''''''' T".a1as " " al-63-0.55%; ". <llbofind,""'ua1 Bo. solid SkU8g.. l1ee/lh=Slighl(l) ... ,,, G"nm;:o::I8IWIPl> QuatBfn"'Y8n.,mum FIemm8bleUquod 583"'-0'-51 -.. K.I.... F~e" Hrgh(3) .8loodb0m8Pil1hog.... C"'" $8lI56-1Q-6.<I% ~....dJYlly",No.....(O) '_por,,;..k~) BonAmldaarni<tf ICalciumC41llollltttl - NoM NoM 1311-60-3: ,. IlbOft..8 Pltperlubttl'Clln -- Storage 1-i8alth.Sllghl(1) ~, ''" Sod,umcartx>nat.. '''1-1~8: R-1.... t..,,_None(D) F_, 58416-25-5 j;l83dlYlIy '" Non" (D) IC_"'''''~'' 1".- I'-~'. " " 57-56-1. 84-g4%; 1.25gallon I gaRon Of 1_ Plasltcbolllel)""'l ~quid S~... -leallh"Mod...-ItI..(2 _lib ,,, QutdcSIeinFIltaI....8 """".. 5;2-5G-8.<1% N-'. F..... Hlgh (3) 'leect....y" None (0) ::hkKaprep2,Q% IISOpropa"lOl FlammablttL/quld " " Gf.c3-0.1D%: lbo.....=.lb llbOfI_bQxol Gl/I&8viBl "". ,~... -ieellh _ Moder_(2 .." ,.. ..-... Chlo/heXld....gluwnal.. 180672-51-2.2% nd,wualpacl<elsol M.l.... =ir.._Higtl(3j ~lasa vial ill5lde 'l:eectMly" None (0) _m /""","",,."",m..- ,....."... Ja NoM - NoM !l8-O4-O. L25~ Ig8110n 1 gallonorl8u ~-I ..... -... -1....lIh.No.....(D) .." Used in lab liOep ,.. IotionliOap . N.I'" F.,,-None(DJ - IJ.:m:o ~~C'~~\_" : R....dMly .. None (0) V'NCCHMIS p.... APR 1 7 2009 Original Submittal I H'I.,d SIot'II', r..II"_r.......odll Haulclolls l",'''_nb OpHor NfPA1U .- CI..lificatiotl CAS' C.... C"nlfiutll>n 1(;~TKT.~...) Envy F09lnll'll ......y1dlmlllhylbenzy1 flammabklLiquld " 32 tlB3Ul.o'.5.,'"4; 'gallon l5 nOU0C8SOf 1_ Spray Can .... ..- HezlIIh_Sloghl(l) '"" YM :lir;in!ectlrnlcleaner IofTlITlOfliumchlolide iSllIl56-1H,,1%; f-2-4 Fire_ExIreme(.t) 'l-A1kyld"'**'yt 145gMI4-8.<5%; 1teadMly"Nor.e(Q) lIthylbonzyla........mum 15-2&.5,<5% ""'.... O1propylonegl'fallmetnl 1::O~a... FOlmallnlO% 4%; ,,~ Health Hazard " ~.4%; 12WJl......wml"\omlYlal G'" _ - Storage "Iea1lh_Mod...-lIIe!2 -"" ?n><ludcontaroer YM SO::llumPhosphal" 1()()4g..21':;,<I'Yo; 2880mI"_ M+4 Fir..Shllhl(l) .epllns68ied 1>OfIObasic."'I%: 155a.lg..4.<1% ihan11lallon R...cflVlty.No.....(Q) :Jlasticbag Sod,umF'tm6ph.at.. .:loasic.<l% 3asOust. 1,1.0 .. Flammable gas loquidfied " 15-31-G 1118110n zsnoUllC8SOflesa $pfllyCan .... SIoUll18 """"kh_Shghl(l) '"" YM f-2-4 F....Sever.I..) RMctiv.y.Slighl(lJ We,", G~ Heel and ham Sodoum acelale ""~ Noo. .... lu-og..3 .,. ~ l/bofond,,"dUIII """ - ''''- ",..aJ\h"Slighl{l) -"" YM ..- -.. K.1-4 F.... "S11Q1ll (1) ReadMly" None (0) -- ~~anPr'~~ FIom"'_lJ4.Od " " 1122.&4-'.<5"4; .._than 1 aozorleM Pllllillcbollle ..., StOfl'lIe -woallhot.lod9<ale(2c.ab YM 9Ot~52_3.~ ~"'''n N-'. ~inl"Moder"'e(2) RNd'wy= Moderele(2) Hydrochloril:&e*l(HCI) t-tydroehloncacld ....... He"llhH~rd .. 7041.01.0.3,65% 15OOmI"0_13 """" G..._ .... Storage HeaanoHIQh(3) '"" YM IN8Olulion ~a1lon M_'''' ~ife" None (0) Read.lVityII 5light(1l H'fIlrogenperoxld.3% Hyd.ogenperoXKle - - N_ lU24U---l.J"JIo; Ig"'lon 12nouncee.o.-l..... ..._cbollle ,,~ 51"'_ Health " Sllght(l) -"" Y- PhosphoncltCid rll64-a&-2 N-'''' ~"e. Sfighl (1) ReadiV1ly = None (OJ "-- SodlUmhypc;idlIont" ~- H....lthHazard .. rti81.52-Q,0525% . pounds 3oxor..poundsOf ,," -" ,~- He.a1lh*Mod",,"e(2..ab YM .....-100 K.I-" F... 0 None (OJ ndl\fiduallypackag& Reaclwdy "'None (0) - Ifl1mMSIOn o~ ~hazard~ - N_ N_ NA 1 gallon 12 n ounces Of""'" P186l1cbollle liquid ~- t-t"altn " None (OJ ~, Y- .., ,leq>henyl N-'. Fino- None{Ol llI1dttMpheny\ R...d''Iify=None(o) 10000!.-p<tJJ>If_1 ,-"""""'" f'lernmable~ " " 57~.10"Jl0 32 nOUflCN '" 12oz, Of leas P1asticbottt" - SIOf"'il" -ltNlllhaSI'll"'(1) .... YM 'WbbngAloono' 025gaf/on$ -,,- N-l--f .,u, " Hlgh (3) R....wv~y = None (0) Kleen and O'Y. comput... l""pfOpyI...~hoI flllalas lEl_1C " 57-63-0.30%: lbox..."'4lb 2 1b0l """'box 01 "'. -" Star"!!,, -leallh=Shghl(l) _00 YM fO"eM>clea.- Ammonlum hydroxide FlamrnableUquld 71164-41_7.0_05%; nd'w.!ualpackl'ltsor K-l'" F"..=H'IIh(31 ,lJkytdomolhyt~ ll83"'-Ol-5,O.l%; ~asbcdlSJ>OflS'lf ReadMly" None (0) ammonium c:tIIolid.. 1189$6.7\1-(\.01% ..mla,ntM I". ,-"" """ benzyl"rrtTIOfUum -.... r'~- ,-"""""'" Flammable Uquod " " ~1-63-0.172%: 19a1lon 12ftoWlOll P1astiC"fl'8y .quid ,~- ~1tIl=Skght(l) -"" 'M .....acedl&inlect..-cl Elhylen&lIlyool 111-76-2.3% ...,. IFire = Mod...-81" (2) d..... .deane. -- N-I-" ReadlVlly " None (0) "'"' Trielhy!eoelllyOOl FlarrrnableUquid " " '12-21-6,6%: 19a11on 25 ft()uncesorlasa S",ayC..., ,- Slo.age -ltNl'U.,"'H.eIIh(21 .... 'M IlIObut_ 15-211-5,<13%: 1'.2'" ~.." Se.....'.(4) _0. 14-91l-t1;<13%; RINIdl'i~y ~ Noo..(O) I'"~ 106-"7-8.<20%, ,- ~11_5.<70% Date Received: APR 1 7 2009 WVCC HMIS Pag,,5 Original Submittal I HIZUdoUII Material Inventory Statement for WIII.mette Viney Cane., Cut~prll'. 200. r --- J - - - j .,o;,e -I-O'~'C I H~ I l--~'~"-'~'j .... - ~ -a_...=- - C'''":::' ".., """!.=1. :,::.::" .:=::-.:.. . .:=~~::.. l;::;~:::;' .... ~::~~-::::''7 ..~:::~ ,e;~;:'=':. .-.. Open 01 HfPA704 L....... 1II_1a1 e..... CIa..~lon :k:r!:l\;:!;" ~_ 'i=tJi;1.l-/1- " i7..Jf~ rJ~I!l.- Iii,. "'_""'. ..'" -... l-iH~h ~ Hlgh(3) 'Jl'-- ?oIyvinVlAlc:oholfi1.ative~K;acid .....w H&aIlhHlIZMd " $4-1Q.l.5%; ... M.l"", F.e_Hogh(31 ;JolyWlylltloohol ';1002-89-5.5%; ",eactlV~y ~ Nooe (0) l,4...curicchlonde '''81.04-7,3.4%; :otycerol >6.81-6.1_6%: Hydrod*mc acid 7647.01.0,14% Par,..PakZn-PVA Glycerol FlammablelJquod " " ~1-5.1_Q%: 1118100 ~olorleM.III_ Glaasbollle -- Storage '-l""Ilt1"Uoderlll.(i~ ,~ GlaciallOC8licadd To~1C HoalttlHazaro " fl4.1g.7,4.lI%; ""'" M'l-. ~..... H'Ilh(3) ZlI>Csu"ate 144l>20-0,7.fI'Io "l.lOllcb'tlly"Nooe(OI Poly vIflyl8k:ohol 1lOO2-89-5.46%; Reagente~~ fl4-11-5.2$%. Reag...ntnl8lhy1alwhol 51056-1.1.4%: Fl:eago.>nlilOOprOpyt 87-63-0,1.4% """"" :>rotoooIBLdI.....WI'l!iIIi.s Sodlumphosphale ~~ .... .... 15-g-8-7~."1%: 11lalbn Ig.al!ooOfI8A P\asllCbotIleJjUll liquid Storage >i....Ith"'Sllghl(ll "" ,. iJuffll,$ot.Jbon pH 6." jibasic 1118-11-fJ,<1% N-'~ ~ife = NonIl(OI JoIlydrogenpola&alum 38'124-ll5-1,<1% ~lNldiv~y: Nane(O) *"_. -lyllffWW3500 ~nbawOpClcs(H~C:O) 'lofl-.elcoholaolwent .... ,- .... '^ 1 gallon 12l1Of..nC8lJOflll&a P18611cboltle .,,,, ,~- H....Ilh"'Slight(t) -., ,. "Y"lIlasade...... SurlaGtant N-l." ~ife"' NonIl(O) C:_'Ullbklod ~eadMty"' None (0) SpeIIkle""1 SodllJmcerbonale Toxic Healtt1Hazard " 4111.1ll-8,<3O%; ,. 5 IbOf I..... So. "'''' ,~- -lealth= Mode'aI..(J ~ V. ......ydf0U6 aGl6-45-II.<IO%; K-l" ~if"" None (0) Ethy\enllDI<id. 25155-30-0,<10% R.lNldivlly a None (0) ~-- Sodium Jodecylben~lQnat IS....._~(KlfIr.land leopropytak.ohol Tr..al.... '" ,,' 81-63-0.8%; Zbol<....="1b ZIbOf less bol<of So. """ Sto,age -lealh a None (0) -., 'n ......"""', Qualemaryammonium FlammilbleUquid ZHN-28-3,<1% ndMdualpadlelSDf K-I." ~","Mod..ate(2) Ct.4PO ~B6lJCd~ ~...d"'lly ~ None (O) 00'- ND-"O 6Jlph8lH;pIlIn>Ieum FlammaDleLlQuld '" " llO52..1.3,10%; 1 gallon 25 . Dune- Of IeH C.. liquid StOfIl\lIl i"iIlalth"' Mod8lale(<llab 'n dlStdlale6 "'1"2-&5-0,20% F.2.4 F.e" Moderale(2) P"cn:>leumba&&DfI Readllllly = Noott(O) l(.() PlUIl Odol N_81IZEI E:._aloils COfTlPDf;nd .... .... .... "".1%; 'gallon 32 II ouncas 01 IIlSS P181ilicboltle Mquid ,~- H6a1lh = None (0) .." ,~ A1kylpolYIIlyooaidll 11061lH7.1I,1%; N-'~ Fife" None (0) Quaternary ammonlUff1 !lOO4-24.(l.I% ReadiWlly" None (0) ~-"" C81ylpyrid,niumdllolide 0 ~ ~t''''- <E' ceu..o ~ 'N.fI_ HOB OuaterneIY ammon""" TDI<1e H"""hHua<d " NA.3.57%; 'x~Oml~376i~n~ Pl85llcc:onl_ -- Slorag. -tea1lh"t.4odelate(2~ IorkilIiooIllCEU.. 'n '3' 'NOCll'"' ... !IOOl.!>4.5,3.57%; Tllalgallon N-'~ F... " None (0) DYNnHlIgf"fl."'" III BfllWHkonIumehk>ridll 81,63-0.286%, ~ll&dlVlly=NooIl(O) ,.on-haz",dous. / 11IOpropylalc:ohol 541ll-11-1.168% "'rthle/t....slBl'"9 (fJ )> Q) ioiydn;ll<yIa<rrnanlUtl1 '10 MSDS'* - C ""t:J CD """"". ...- C' ::0 I"m.o," eN-On o.ff Qu8lllffi8fYllrrmonium CombustfbleLJquK " '/A,30% 1l<3.8~lo.,.:1 3.81118111 Plao;t,cc:onlaln.. ..... SIOIagll Haalh '" None (0) .." ,~ 3 :;0 lyseReagWll ... 57-63-0.2.66% ~aalo.... N-'~ FIf.'" ModIl,,""(2) ;:;: CD 'eopropylakohol ~fIIlCI''''''y. None (0) - ..... 0 III lem"'," " 'bhalaJdOUSIh9'IId'...JI 121<3m1..36mt3m1 PI8$licc:onlain", ,,- -... -lllakh" None (0) '"" ,. '" CD .... ,- ,~ '^ = <' H<<naIologyControII,lI, specifNMlDnMSDS :<0.1I1a/1on N-t..4 ~illl '" NooIl(O) = '" R....d'w~y.. None (0) u:> CD a. =EU.oVNt':nzym.l.ic ."'. To~1C HealthHlIza"d " NA.22.33%; SOml"'<O.1 "''" PIMlicc:onta..,.. ~quid Storage HeeKh"'ModIlf.e(i Lab ,. C1e8"er Concenlralll 1,2-propyt_gIVCOl 51.55-8,2025%, ~...Ion N-1-4 FN.= None (0) '"oIyol<yelhylfmeeth... NA,5.3O%; R....d'Wlly=None(O) Subtlli6in aGI4.01-1,2,67%, NA.l.56"t. WVCC HMIS Pll\le6 Hlurdoul Ult.rilllnvlntory SUitlmlnt' r Willam.n. Villi)' Clnclr C. 't Atril I. 200. ~"j 1 o'~'e I o'","e .....~ 'T""'""" 81Of",' - -1I1Of",. 1--- I _Uj__j "_.. I Mh. Q....,llty ~ '.l~1 , .J.' .1, C0n4ItkMl, a- of o~ 0' IiI'PA7lH lval...ted .l,;;,t, . , ......... "....., ......." "_..~. CI..,mc.Wi1 CA8' l..nll"",") ~=~":"' ICIIITKTa~"4 .....1.11 CIo.... C:la..If1cMlOn L....... C_tt for MMfi,IaIN_ ....'..IC.... ICJIITKTa~~~ ,_..._. DNAPl' ~, , -~-- .-... . ...- ....- ....-..,..-. -- - rtrrcrrt:tt Sod,umllLide TOKlC H83IlhH_d " 2662&-22-8.<1%: h.l00ljl:400{IOOljl Plasticw"'lIin do ""'- 1"'1lh" Moderllle(~ "'" ,. ConeentraleSet ......,"'" '110\.<1'110 .,,,,,,,, N+4 'Ne"NoneIO) 'l....ctMty..None(O) rA-PAeKW""'-Ll""~""" To~ic HealU1HlIl.-d " 2662&-22-8.<1%. 12 hlen." 32 2 1rt81 contaonen; P1I111lieCOflla;n8' ~quid SIof-U. -wallh" Mod_e(2 ,uob ,. SolutIon ProcIin300 ~.<1'" ,..... N.I-4 F....NoneIO) 'l....dJvlly "None(O) ,t,1A-P,t,CKDd.-.t Sodiumlllide TO~I(: HeallhHazanl " 2002&-22-8."1%; hlOOml"4Od ",,'" Plasllccont_ .,.., ,,,- Heallh.Moderalej2 "'" ,. ConcenlraleSel 111"0,1 gallon N-1-4 "we_ None (0) 'leadivrlV" None (0) o\JA..PACKR""II&nt Sodoumazide TO~I(: HeallhHllZJIrd " 2662&-22.8.<1%; 32 ~ 1 mi. 32 mI IOml I'1lI8ticcont&lll8' "',. '''- "'....IUl:Mod...81eli Lab ,. ,- ",<O,lgallon ...,~ File "N<lne (0) 'leadJv~V" Noroe(O) AIA-PACKCalibralion Sod'umiOZide TOlUc HeallhHlIDrd " 2662&-22-8.<1%: 4 ~ 100g" 400, l00ljl Pla6bcwntainer .... Slor_ H.....1Ih..Moderele(2 Lab ,. SBIlM(sohd) "- N-1_4 Fire" None (0) <taadlV~V" None (0) 41A-PACK CMbrabon Sodiurnazrde Toxic H....IlhHIl.l.l"d " 2662&-22-8."1%; .6~ 1 m1~ 48~ 1 ml PlaalK:wntainel ..... ,,,- H9aIlh:Moderllle!i Lab ,. $81_(IoqUld) ""0.1 gallon ...,~ Fre" None (0/ ~eadivily" None (0) '1A-PI\CKClIirbre\oon Sod,umazide To~ic HeallhHlIzlIrd " 26e26-22-8.<1%: .x100g*400,IOOg PlIl8tiCconllllnBl ~" '''- 'ieallh ~ Mod8lelet1 Lab '. "eriflC8l00n Sel (soh:l) .,,,,,,,, ...,. Fire ~ None (0) F'teadlVlly" None (0) AIA_PI\CKCelibrat;oo Sodium azide '''"'' HeallhHQZard " 26628-22_6.<1%: 40~ 5m1.. 200 rI I; mI Plll8ticoonlaineo .,.., ..- .....lIh.Mod...llle(i ..ab ,. VanficationSel(liquid) ~ <0,1 gallon N-l-4 Fire "None\O) ~eadiv~y" None (0) 41A-PACKSublltrlll.aII Sod,umllZlde TO.I(: He.allhHlI.Z.IIrd " 26628-22-8.<1%: 8x 10011 ~ 800~ 100 II Plll8ticcontain.. "'. ""'- Heallh"ModBrllte(2 Lab ,. '0 :2pounds N-l-" F... ~ None (0) ~eadlV~Y" None (0) o ~ cO' :;' ~ en c CT 3 a I!!. )> -0 :;:0 o III - CD ::u CD o CD <' CD a. - ...... "" <=> <=> u:> Wl/CCHMIS ,..., .. .1 . ANNEX B - HAZARDOUS MATERIAL STORAGE LOCATlON DRAWINGS Date Received: APR 1 7 2009 Original Submittal NVld 3:lN'.'''. J~'I!!! Ulilli'~ ., . .....""'.....- '..- -..---..... l~. i_ . < "'"""-""""^'":':J~ _..~ f II ~!'" ' YV." ,!~ ~ ~ . " , 1,...--...-...-..-.- -~._.- rJ-ll- o. ........ ...0....... . If ~ :l i J. 1 H :) "y J. l1li II iI 8 . - .' ~Lt . ~r; ,. iH-. ~~. ~I~~ ~ 1.i1 1" . '.. >.' , . . It', f ."l . Ii' !IlL !ii~~I! i~:!L i"~; ; ,~!i~~~~~i!r.:r;ln; J!1"r' . + 'IJrl"I"W t tt n . \ - @\ , \ \ \ \ \ -0 o G ~ '" ~ is in ~ ~ ;;; " . o o 'E ~ N ~ J: c ~ ~ . o I . . . ~ '" '" ~ . . ~ <> E o u ~ ~ Date Received: APR 1 7 2009 Ori(;linal Su?mittal -"-~_.,j . " " .' " " . .. I , , , ,I(~TNU'E I ~~ri::LEGE"fQUR,lDm ~ --- ~---------- -- C5Q , --- ' --- \ --- --- -Y \-- --- \ . --- ,--- '\ --- ----0 : I I" ~.._- , 0I'f, ,un ~ :i7lf21' :VEVYE~~._~l ----:;----~ I I~ -'aWiIl1Jm:: 11 !I<<)TW"TEROlSPE~ , I 12 1olMUfoIO'l"'LYZHI 'Fl.OORORAJHIE~D I:~ ~~ I , ::'~1i"', ~1~Pf)(JE1!> ,g POSTALsCA&. " ....m ::;\I.;"ll',"'~ ~=~VE t=I= LJCF~EZER 26 v[NOWGMAC~.NIC 11- CJlEOO CARD w.c_ I :~I:'~":r~~:= en . " I- _ U . --- ey-' ~___,..---8 --- \ .----@ lIJo. : o. t- .. a . , o ; :z: ' u u ~ a: ;j .1 <C 0 oj - ~ .- --- --- --- --- '- --- CD ---- !.?I 0l \..-- ' --- ' ~~ -\ (K) ,y,---' )....--..--- , \ \ \ \-- \ ,......., --- \. \ ___ __..Ii _ cjy----' '~. --- ---,'\ \ \ ~ >- :2 ~ .. ~ g: ~ ~ --- --- --- --- IIJ o.! --- CD ~ ; --- --- ~ ---0 ~~"* ~, , &" ~,,' --- o o cb cb o @ 'I -+0 ~ 'f I, I ~~ , I ~" fJ " ., , ~L::"iJ I I " l '.~: I J , c I '" -4~ U " Z "~. -~ S U II " I c: a. , ..81' I <Il ::(0 , u w ,. u I ]! z (ij w , > 0: 1) I '" w (I c:T) :: u. '" w , = , E 0: 'ii = I ~ "" (ij :;:: lti ....... - - - - ---r<D 0:: 'E c::: .c , C) a.. => I .. <( en c, (ij , () c I 'a' .;:: , 0 I -- '"'' , -. ... -+0 --. "'" 02.12-'5 , 0 0 "~'1" . -~ --- @'- '- I (iy,flf171"" Compressed gases--oxygen Hazardous Material Storage ~ -~ " I i . u A1.1 I, I, '. I, I, I.