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Attachment D <br /> F4CI (_I INFORM 4T11-fftZARDA4 <br /> S ANLYSIC <br /> IS CONTRaAaTCUECUSTA4ND CA4ME0 � I.LIDE <br /> — SER Cndp identification numbei fiper Attachment B , SFRC1234561 ( Department Field on Facility page .) <br /> — Latitude & I angittidp in t1primal/degrees jPx 30 1917 - 84 36211 ( Map Data tah on Facility page) <br /> — Facility Emergency Coordinator name , title , Phone # jonrluding 24 hr- numbea ( Contact A 9 MAMA MAMA page) <br /> — Transportation Route (s) �frorn cou ty line to the farilityl ( Notes tah on Facility page ) <br /> — Fvacuafinn Route (s) to exit the vulnerable zone ( Notes tah on Facility page ) <br /> iHi -qtnrir.ql Accident Recard (if none , please notel ( Notes tab on Facility paup .) <br /> for each Extremely Hazardous Substance on site <br /> — Proper chemical namp ( �,.) ( Chemical 4 n Inventory pagaisl ) <br /> — Chemical Ahqtrqrt Spryorp (CAS) number (Chernical in Inventory page(s )) <br /> — Natural physical statp jPx mixture , pure liquid , salid , gasl (Chemical On Inventory page(s) , Physical State and <br /> Quantity tab ) <br /> Maximum quantity on- site in pounds ( Chemical An 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 tah ) <br /> in of storage container(s) -ex . cylinder , stPPI drum , rarhoy Ptc- 1 hemical A aga(s ) Location tab) <br /> — Nrqtijrp nf the hazard jex . acute , rhronir , fire pres ure etc -1 ( Chem 6 cal in Inventory page(s), Physical State <br /> and Quantity tab ) <br /> t_ L for each Extremely Hazardous Substance on site <br /> — Facility Population junmannPd facml 'fips minimurn f one As required for maintenance personnell ( 113 Codes tab on Facility page <br />) <br /> + general poPtilatmon + <br /> for each Extremely Hazardous Substance on site Scenario page(s) <br /> { Risk Assessment at the bottom of the CAMEO Scenario Pages(s) will meet the four requirements below} <br /> Rate probability of release {ex . low , medium or high} <br /> Rate severity of consequences of human injury (ex . low , medium or high) <br /> Rate severity of consequences of damage to property {ex . low, medium or high} <br /> Rate severity of consequences of environmental exposure {ex . low, medium or high} <br /> ON -SITE VISITS (for each facility and within the contract period ) <br /> Completed hazards analysis site visit form (submitted in CAMEO with SERC code in file name, SERC123456SV) <br /> Site plan map (submitted in CAMEO with SERC code in file name , SERC123456SP ) with sufficient detail to identify ; <br /> Location of major building (s) <br /> Name and Location of Extremely Hazardous Substance (s) (Ifmultiple extremely hazardous substances are co-located , noting FHS is acceptable . <br /> ) <br /> Name and Location of street (s) <br /> Identify pertinent access and egress point(s) <br /> The data shall be submitted electronically in a CAMEOfm version 2 . 3 zip file format. <br /> 22 <br />