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Attachment I <br />Hazard Analysis Contract Checklist and CAMEOfm Guide <br />Facility Information (CAMEOfm Facility Page) <br />Facility Name {per Attachment C) ( Facility Page) <br />Facility Physical Address (Facility Page) <br />Latitude and Longitude in Decimal Degrees (ex. 30.197, -84.3621) (Map Data Tab on Facility Page) <br />Facility Phone Number (Facility Phones Tab on Facility Page) <br />Facility Emergency Coordinator Name, Title and 24-hour Emergency Phone 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 />Facility Maximum Occupancy (a minimum of one is required for unmanned facilities) (ID Codes Tab on facility Page) <br />Hazard Identification (CAMEOfm Chemical in Inventory Page) (for each Extremely Hazardous Substance on si e) <br />Proper Chemical Name(s) (Chemical in Inventory Page(s)) <br />Chemical Abstract Service (CAS) Number (Chemical in Inventory Page{s)) <br />Physical State in Storage (ex. mixture, pure, liquid, gas) (Chemical in Inventory Page(s), Physical State and Quantity Ta ) <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 Quanti Tab) <br />Type/Design, Pressure and Temperature of Container(s) (cylinder, battery, ambient etc.) (Chemical in Inventory Page(s), Location Tab) <br />Nature of the Hazard (ex. acute, chronic, fire, pressure, etc.) Chemical in Inventory Page(s), Physical State and Quantity Tab) <br />Vulnerability Analysis (CAMEOfm Scenario Page) (for each Extremely Hazardous Substance on site) <br />Enter maximum amount in largest container or interconnected containers in the Amount Released field (Scenario —Description tab) <br />Enter the concentration percentage in the Concentration field (Scenario Description tab) <br />Enter Release Duration (10 minutes for gases, solids in solution or powders; no entry for liquids is required) (Scenario escription tab) <br />Determine the natural Physical State (specified in CAMEO Chemicals) and enter into the Physical State field (Scenario Description tab) <br />Weather Information - Use the weather default settings or enter average wind speed (don't enter a value in the Wind F om field) and <br />Urban or Forest is recommended in the Ground Roughness field. (Scenario Description tab) <br />Risk Assessment - Rate the Risk, Consequences and Overall Risk of a release occurring {based upon release history & m intenance etc.) <br />(Scenario Description tab) <br />Extent of Vulnerable Zone (CAMEO automatically calculates Threat Zone Radius when Edit button and Estimate Threat Zone Radius <br />buttons are used) (Scenario Description tab) <br />Enter estimate of Total Exposed Population (Notes Tab on Scenario Page{s)) <br />Enter Critical Facilities (name of critical facility(s) and max occupancy for each; if none, state No Critical Facilities) (Notes Tab on Scenario Page(s)) <br />On -Site Visits (for each Facility and within the Contract Period) <br />Site Visit Certification Form (Attached to Site Plan Tab on Facility Page) {file name must contain at minimum the SERC number if <br />applicable and SV— if SERC number is not available facility name and SV — additional info allowed but not required.) <br />Site Plan (Attached to Site Plan Tab on Facility Page) {file name must contain at minimum the SERC number if applicabl and —SP— if <br />SERC number is not available the facility name and SP — additional info allowed but not required.) <br />Sufficient Detail to Identify: <br />Location of Major Building(s) <br />Name and Location of Extremely Hazardous Substance(s) (if extremely hazardous materials are co -located, noting EHS i acceptable) <br />Name and Location of Street(s) <br />Identify Pertinent Access and Egress Points <br />Note Additional Features Pertinent to Hazardous Materials and Medical Response <br />All data shall be submitted electronically via CAMEOfm version 3.0.1 in a .zip file format. <br />29 <br />163 <br />