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Attachment D <br /> ltfAZAR.DS ANALYSIS CONTRACCTCHECICUSTAND CAMEO CVM, E <br /> FACIUTY INFORJ\IATION <br /> Facility Name {per Attachment B) ( Facility page ) <br /> Facility Physical address ( Facility page ) <br /> SERC Code identification number {per Attachment B , i . e . SERC#XXXXX} ( Department Field on Facility page ) <br /> Latitude & Longitude in degrees/minutes/seconds (i . e . 30 . 1917 - 84 . 3621 ) ( Map Data tab on Facility page ) <br /> Facility Emergency Coordinator name , title , phone # {including 24 hr. number} ( Contact tab on Facility page ) <br /> Transportation Route(s ) (from county line to the facility} ( Notes tab on Facility page ) <br /> Evacuation Route ( s ) to exit the vulnerable zone ( Notes tab on Facility page ) <br /> Historical Accident Record ( If none , please note} ( Notes tab on Facility page ) <br /> I-tAZ,AR.D IDENTIFICATION (for each Extremely Hazardous Substance on site) <br /> Proper chemical name (s ) ( Chernical in Inventory page{s }) <br /> Chemical Abstract Service ( CAS ) number ( Chemical in Inventory page(s)) <br /> Natural physical state (i . e . mixture , pure , liquid , solid , gas} ( Chemical in Inventory page(s) , Physical State and Quantity tab <br />) <br /> Maximum quantity on-site in pounds ( Chemical in Inventory page{s}, Physical State and Quantity tab ) <br /> Amount in largest container or interconnected containers ( Chemical in Inventory page {s) , Physical State and Quantity tab ) <br /> Type and design of storage container(s ) {i , e . cylinder, steel drum , carboy etc . ) ( Chemical in Inventory page{s }, Location tab ) <br /> Nature of the hazard ( i . e . , acute , chronic , fire , pressure etc. ) ( Chemical in Inventory page(s ), Physical State and Quantity <br /> tab ) <br /> V LALLN5RAF> lL1jY ANALYSlS (for each Extremely Hazardous Substance on site) <br /> Estimate vulnerable zone {threat zone} radius ( bottom of Scenario page(s ) ) <br /> Facility Population {unmanned facilities minimum of one is required for maintenance personnel} ( ID Codes tab on Facility page ) <br /> Critical Facilities { name of facilities and max occupancy for each) [ if none , please note ] ( Notes tab on Scenario page (s) ) <br /> Estimate Total Exposed Population (s ) {facility + general population + critical facilities) ( Notes tab on Scenario page(s ) ) <br /> RIsfe ANAL.- lsls (for each Extremely Hazardous Substance on site) (Scenario page{s) ) <br /> The three ratings fRisk Assessmentj at the bottom of the SCENARIO PACES will meet the four requirements below <br /> Rate probability of release ( i . e . , low, medium or high) <br /> Rate severity of consequences of human injury ( i . e , , low, medium or high ) <br /> Rate severity of consequences of damage to property ( i . e . , low, medium or high) <br /> Rate severity of consequences of environmental exposure ( i . e . , low , medium or high } <br /> ON -SITE VISITS (within the contract period) <br /> Completed hazards analysis site visit certification form (submitted electronically or hard copy ) <br /> Site plan map (submitted electronically) for each facility , with SERC code number and with sufficient detail to identify ; <br /> Location of major building (s ) <br /> Location of container(s ) of Extremely Hazardous Substance(s ) <br /> Location of major street(s ) and entrance (s ) <br /> North arrow <br /> The data in the Facility Information , Hazard Identification , Vulnerability Analysis and Risk Analysis <br /> sections noted above shall be submitted electronically in a CAMEOfm version 2. 1 zip file format. <br />