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I I ATTACHMENT J <br />HAZARD ANALYSIS AGREEMENT CHECKLIST AND CAMECIFM GUIDE <br />Facility Information (CAMEOfm Facility Page) <br />Facility Name 1per Attachment C1 (Facility Page) <br />Facility Physical Address (Facility Page) <br />Latitude and Longitude in Decimal Degrees lex. 30.197, -84.3621) (Map Data Tab on Facility Page) <br />Facility Phone Number (Facility Phones Tab on Facility Page) . . i <br />-Facility Emergency Coordinator Name, Title and 24-hour Emergency Phone Number (Contact Tab on Facility Page) <br />Transportation Route($) (From County Une to theFacility) (Notes Tab on Facility Page) <br />-Evacuation Route(s) to exit the Vulnerable Zone (Notes Tab on Facility Page) <br />-Historical Accident Record Of 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 oi� not subject.to section 112r or section 302 (10 and Regs Codes Tab on facility Page) <br />Ma rd Identification (CAMEOfm Chemical in lnventorV Page). (for each Extremely Hazardous Substance on site) <br />I Proper chemical Nani (Chemical in Inventory PaSefs)) <br />Chemical Abstract Service CAS) Number (Chemical in Inventory Page(s)) <br />Physical State In Storage fex. mixture, pure, liquid, gasl (Chemical In Inventory Page(sl, Physical State and Quantity Tab) <br />Maximum Quantity On-site In Pounds (Chemical in Inventory Pagefs P hysIS State and Quantity Tab) <br />Maximum mount in Largest Container or Interconnected COmaincrs'jChe_,iuEI in Inventory Page(s), Physical State and Quantity <br />— Tab) (This figure will be used as the release mount to detemine the vulnerable zone in the Scenario) <br />— -Type/Design, Pressure and Temperature of Comalri icrinder, biifte, amVient etc.1 (Chemical in Inventory Pagefsjo Location Tab) <br />Nature of the Hazard (ex. acute, chronic, fire, pressure, etc.1 Chernical in Inventory Page(s), Physical State and Quantity Tab) <br />Vulnerability Analysis (CAMEOfin 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 />fMust match the Chemical in Inventory Page, Physical State and Quantity Tab, maximunt mount 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 usedl (Scenario Description tab) <br />Enter estimate of Total Exposed Population (Notes Tab on Scenario Page(sL) <br />Enter Critical Facilities (name of critical facilfty(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 5V. If its a telephone call for the sulfuric acid exception the name <br />of the facility rep spoken to and date of oil 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 all wed but not required.1 <br />Sufficient Detail to IdentifV: <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 Stre - et(s) (At minimurn street facility where facility is located and the nearest intersection or cross street) <br />Identify Pertinent Access and Egress Points . , I <br />Note Additional Features Pertinent to Hazardous Ma erials and Medical Response <br />33 <br />P219 <br />