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Attachment K <br />Hazard Analysis Contract Checklist and CAMEOfm Guide <br />Facility Information (CAMEOfm Facility Page) <br />Facility Name {per Attachment D} ( Facility Page) <br />Department field is where the SERC number goes. {Do not add the SERC acronym just the number} <br />Enter the current Tier II report year (Top right-hand corner main 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 />Facility Page (ID and Regs Tab) (Mark correct 112 R and 302 check boxes, max occupancy, facility manned or unmanned) <br />Hazard Identification (CAMEOfm Chemical in Inventory Page) (for each Extremely Hazardous Substance on site) <br />Update Chemical in Inventory page for each Extremely Hazardous Substance Present over the TPQ (Chemical in Inventory Page{s}) <br />Enter Chemical Abstract Service (CAS) Number and Proper Chemical Name (Chemical in Inventory Page{s}) <br />Type/Design, Pressure and Temperature of Container(s) cylinder, battery, ambient etc. (Chemical in Inventory Page{s}, Location Tab) <br />Physical State in Storage {ex. mixture, pure, liquid, gas) (Chemical in Inventory Page{s}, Physical State and Quantity Tab) <br />Enter max daily, average daily amount in lbs. (Chemical in Inventory Page{s}, Physical State and Quantity Tab) <br />Enter amount in Largest Container or Interconnected Containers (Chemical in Inventory Page{s}, Physical State and Quantity Tab) {this <br />is the amount to be used in the scenario release} <br />Nature of the Hazard {ex. acute, chronic, fire, pressure, etc.} Chemical in Inventory Page{s}, Physical State and Quantity Tab- Hazards) <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 />(This amount must be the same as the Chemical in Inventory page Maximum amount in largest container tab amount) <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 (specified in CAMEOfm Chemicals) and enter into the Physical State field (Scenario Description <br />tab) <br />Weather Information - Use the weather default settings or enter average wind speed (do not enter a value in the Wind from field) <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 etc.} (Scenario <br />Description tab) <br />Extent of Vulnerable Zone {CAMEOfm 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, Statements of Determination, and Site Plans (For each Facility within the Contract Period.) <br />Site Visit Certification Form (Upload 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. Phone call updates for the Sulfuric Acid Battery Exemption <br />Facilities must indicate who made the call, the name of the facility representative spoken to, and the date of call.) <br />Statement of Determination (SOD) if applicable (Upload to Site Plan Tab on Facility Page) {file name must contain at minimum SERC <br />number if applicable and proper acronym SOD - if SERC number is not available facility name and SOD, if applicable}. <br />Site Plan (SP) (Upload 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 encouraged but not required.) <br />Sufficient Detail to Identify: North Arrow <br />Location of Major Buildings <br />Name and Location of Extremely Hazardous Substance(s) (if Extremely Hazardous Substances are co -located, noting EHS is acceptable) <br />Name and Location of Street(s) ) (list the street the facility is on and at a minimum one cross street) <br />Identify Pertinent Access and Egress Points and other features pertinent to Emergency Response <br />34 <br />