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ATTACHMENT J <br /> HAZARD ANALYSIS AGREEMENT 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 and Regs Codes Tab on facility Page) <br /> Select correct check boxes for facilities subject or not subject to section 112r or section 302(ID and Regs Codes Tab on facility Page) <br /> Hazard Identification(CAMEOfm Chemical in Inventory Page) (for each Extremely Hazardous Substance on site) <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 Tab) <br /> Maximum Quantity On-site in Pounds(Chemical in Inventory Page{s},Physical State and Quantity Tab) <br /> Maximum amount in Largest Container or Interconnected Containers(Chemical in Inventory Page{s},Physical State and Quantity <br /> Tab) )This figure will be used as the release amount to determine the vulnerable zone in the Scenario) <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 /> )Must match the Chemical in Inventory Page.Physical State and Quantity Tab.maximum amount in largest container figure) <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 Description tab) <br /> Determine the natural Physical State of the chemical at room temp(specified in CAMEO Chemicals)and enter into the Physical State <br /> 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 From 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&maintenance 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 /> See scope of work for alternatives. <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. If it's a telephone call for the sulfuric acid exception the name <br /> of the facility rep spoken to and date of call must be noted on the form. 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 applicable 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 is acceptable) <br /> Name and Location of Street(s) (At minimum street facility where facility is located and the nearest intersection or cross street.( <br /> Identify Pertinent Access and Egress Points <br /> Note Additional Features Pertinent to Hazardous Materials and Medical Response <br /> 33 <br />