INCIDENT ACTION PLAN The items checked below are included in this Incident Action Plan:
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1 1. Incident Name PREP Hampton Roads 3. Approved by Incident Commander(s): ORG NAME USCG CAPT Trapp (FOSC) 2. Operational Period to be covered by IAP (Date/Time) From: 16 Nov 0600 To: 17 Nov 0600 CG IAP COVER SHEET USCG VADEQ MAERSK CDR Kenvon (DFOSC) John Giese (SOSC) Reinhart (RPIC) INCIDENT ACTION PLAN The items checked below are included in this Incident Action Plan: ICS 202-CG (Response Objectives) ICS 203-CG (Organization List) OR ICS 207-CG (Organization Chart) ICS 204-CGs (Assignment Lists) One Copy each of any ICS 204-CG attachments: ICS 205-CG (Communications Plan) ICS 206-CG (Medical Plan) ICS 208-CG (Site Safety Plan) or Note SSP Location Map/Chart Weather forecast / Tides/Currents Other Attachments Initial Salvage Plan 4. Prepared by: Date/Time CG IAP COVER SHEET (Rev 4/04)
2 1. Incident Name PREP Hampton Roads 2. Operational Period (Date/Time) From:16NOV 0600 To: 17NOV 0600 INCIDENT ORGANIZATION CHART ICS 207-CG Coaches/Evaluators: Evaluation Team Leader: LT Colmer PSC: LCDR Allen and Manny Garcia FSC: Sharon Palustre OPS: LT Hanson LOGS: CWO Moulton, CWO Berg UC: CDR Haynes and Janet Quiesser Safety Officer: Dale Schultz Information Officer: LCDR Kevin Ivey Liaison Officer: Dave Ormes RPIC Coach: Larry Bowling UC ICS FACILATATORS LCDR Pickett, USCG Dennis Giordano, USCG UNIFIED COMMAND FOSC Captain Trapp, USCG CDR Kenyon, USCG SOSC John Giese, VA DEQ Richard Parker, VA DEM RPIC Reinhart/Carmel, MAERSK INFORMATION OFFICER Mr. Crooks, LT Warren-USCG Bob Lambert-VDEM, BJ Talley, Barb Garrow, Meagan Patrick-MAERSK SAFETY OFFICER LTJG Bernhardt, PO Cheatwood USCG Ann Latimer, MAERSK, David Atkins, VDEQ, (2 MLC MBRS) INTELIGENCE OFFICER LT J. Harper, USCG Exercise Coordinators: LCDR Anderson, USCG Lee Foresman, USCG Dennis Cashman, NSFCC John Higgins, USCG LTJG Burrill, USCG LOSC Battalion Chief Todd Cannon, Norfolk FD Battalion Chief Greg Parsons, City of Portsmouth LIAISON OFFICER Mr. Tomlinson, LT Hettler- USCG, GeorgeRoarty,VDEM OPERATIONS SECTION CHIEF LCDR s Condit, Tarrants, USCG Fred Turgeon, Cal Hayden-MAERSK Dave Barry-GMS PLANNING SECTION CHIEF Don Jansen-GMS CDR Novotny, Deputy PSC LCDR Harrison, Deputy PSC LOGISTICS SECTION CHIEF CDR Lombardi, USCG Al Collado MAERSK John Hielscher -NARCO FINANCE/ADMIN SECTION CHIEF LCDR Midkiff, Kacey Harmon-MAERSK, Deputy FSC, Nancy Gudonis GMS, Deputy FSC, Francis Campbell - DEQ SPILL RECOVERY BRANCH LT Demo, USCG ON-WATER RECOVERY Division MST1 Piper, USCG SHORESIDE RECOVERY DIVISION MST TBD from Prevention Dept EMERGENCY RESPONSE BRANCH Bill Burket, MIRT SOURCE CONTROL GROUP Jerry Ecker, MAERSK LT Kevin Saunders, USCG ENVIRONMETAL PROTECTION GROUP LT Tony Soliz, USCG WWM Branch LT s Clark and Funck WILDLIFE BRANCH Susan Lingenfelser- USFW, Glen Askins, VDGIF Wildlife RECOVERY/REHAB Group Cynthia Kane- USFW AIR OPERATIONS BRANCH AuxiliaristTBD SITUATION UNIT LEADER LT s Bard and James, USCG Thomas Marquette-GMS Eric Marquette - GMS RESOURCE UNIT LEADER LT s Dewey, K. Harper, USCG Thomas Buhl MAERSK Brian Getzellar -NARCO CHECK IN / SECURITY LTJG Talbot, LTJG Mitchell, and CWO Healy SUPPORT BRANCH DIRECTOR LT Blackmore, USCG SUPPLY UNIT LEADER PO Harrell, USCG SERVICE BRANCH DIRECTOR COMMUNICATIONS UNIT LEADER SCC Mbr COST UNIT LEADER Judy Suttles, USCG TIME UNIT LEADER PROCUREMENT UNIT LEADER PO Bauer, USCG COMPENSATION UNIT LEADER Maria Gilliam, USCG SALVAGE//LIGHTERING GROUP Don Jon, Salvage (Paul Hankins) DOCUMENTATION UNIT LEADER LTJG Porter and Winn, USCG David Callahan-MAERSK ADMIN UNIT LEADER CWO Christiansen, USCG Control: T/V Master Captain Walker (MAERSK) Captain Sam Moore Portsmouth FD Ray McCoy NARCO Rep MSTC Stewart FOSCR Steve Lehmann NOAA SSC LT Davis SCC Rep Brandon Baldwin Norfolk EOC NSFCC Control Personnel: LCDR Borders LCDR Olson LTJG Dehnz LTJG Naranjo LTJG Jack CWO Brewer CPO Beard PO Goldsmith PO Blaisdell Robin Forehand Jason Maddox Jackie Stephens ENVIRONMENTAL UNIT LEADER Frank Csulak-NOAA, John Settle - VDEQ MTS RECOVERY UNIT LEADER LTJG Francisco, USCG LCDR s Falk and Becker, LT Russell Steve Baum, ACOE VDEM = Virginia Department of Emergency Management VDEQ = Virginia Department of Environmental Quality VDGIF = Virginia Department of Game and Inland Fisheries MAERSK = Maersk Line, Limited NARCO = National Response Corporation GMS = Gallagher Marine Systems, Inc ICS-207-CG (updated 11/24/2010)
3 DIVISION ASSIGNMENT LIST 1. Branch Operations 2. Division/Group Air Ops 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief Condit Division/Group Supervisor PAUL HANKINS Branch Director BILL BURKET Air Attack Supervisor No. 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Trans. Needed Drop Off PT./Time LIGHTERING TEAM SALTY SAM 5 N/A N/A N/A NRC BARGE NRC PERSONNEL 2 N/A N/A N/A TUG 1 TUG MASTER 3 N/A N/A N/A TUG 2 TUG MASTER 3 N/A N/A N/A Pick Up PT./Time 7. Control Operations Lightering Team will offload bbl of DFM from #1/2 COT and wing tanks IAW attached salveage plan. 8. Special Instructions Lightering team will berth aboard the Rhode Island, no transpotation or berthing required from logistics. One member f the lightering team includes a safety officer. The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel Command 16 Logistics Tactical Div/Group Air to Ground 18A Prepared by (Resource Unit Leader) Tom Buhl Approved by (Planning Section Chief) Don Jensen Date 15Nov06 Time 1800 ICS 204 NFES 1328
4 DIVISION ASSIGNMENT LIST 1. Branch Spill Recovery 2. Division/Group On-Water Recov 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief Division/Group Supervisor TBD Branch Director TBD Air Attack Supervisor No. TBD 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Trans. Needed Drop Off PT./Time On-Water Recovery P.O. Piper SA2 / ancillary gear SA2 / OSRV SA2 / Portable Barge 32 SA2 / 0530 Pick Up PT./Time 7. Control Operations Currently on site and working: On-Water recovery of free-floating oil (Daylight only) - As directed by overflights or ground observation. 8. Special Instructions Division Supervisor is to call group supervisor with updates very 3 hours beginning at Call at The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident.. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel 16 Command Logistics 156.8MHz Tactical Div/Group 156.9MHz 18A Air to Ground Prepared by (Resource Unit Leader) Approved by (Planning Section Chief) Date Time Tom Buhl Don Jensen 15 Nov ICS 204 NFES 1328
5 DIVISION ASSIGNMENT LIST 1. Branch Prot & Recovery 2. Division/Group North Div 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief CONDIT Division/Group Supervisor TBD Branch Director TBD Air Attack Supervisor No. 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Trans. Needed Task Force #1 Vsl Cleaning SA Workboats Pressure washer Bales Sweep Radios Workboats Boom Watch ,000' 18" Boom Radios 1730 Volunteers Pre-Debris Cleanup Rolloff box Control Operations Vessel Cleaning at Portsmouth Marine Terminal as directed (24hrs) Conduct Boom Watch and Deployment of additional as directed Conduct pre-oiling debris cleanup on shorline (daylight only). Drop Off PT./Time Pick Up PT./Time 8. Special Instructions The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel Command 156.8MHz Logistics 16 Tactical Div/Group 156.9MHz Air to Ground 18A Prepared by (Resource Unit Leader) TOM BUHL Approved by (Planning Section Chief) DON JENSEN Date 15NOV06 Time 1800 ICS 204 NFES 1328
6 DIVISION ASSIGNMENT LIST 1. Branch Operations 2. Division/Group EAST DIV 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief Division/Group Supervisor TBD Branch Director TBD Air Attack Supervisor No. 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Boom Wtch / Deploy 4 2 Workboats 2 Radios 10,000' Boom Trans. Needed Drop Off PT./Time Pick Up PT./Time Pre-Impact cleanup 20 2 Radios 1 Roll-off box 7. Control Operations 1. Conduct boom watch operations (24hr) & Deploymnt of boom as directed (daylight only) 2. Conduct Pre-oiling debris cleanup on shoreline as directed (daylight only). 8. Special Instructions The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel Command 16 Logistics Tactical Div/Group Air to Ground 18A Prepared by (Resource Unit Leader) Tom Buhl Approved by (Planning Section Chief) Don Jensen Date 15Nov06 Time 1800 ICS 204 NFES 1328
7 DIVISION ASSIGNMENT LIST 1. Branch Operations 2. Division/Group Air Ops 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief CDR Condit Division/Group Supervisor Branch Director Satko Air Attack Supervisor No. 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Aux Aircraft fixed 4 2 Helo / long ranger Trans. Needed Drop Off PT./Time Pick Up PT./Time 7. Control Operations Surveillence and patrol. 2. Conduct aerial surveillandce of oil and direction of on-water recovery resources. 3. Conduct wildlife monitoring operations. 8. Special Instructions The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel Command Logistics Tactical Div/Group Air to Ground UHF 345.0MHZ Prepared by (Resource Unit Leader) Approved by (Planning Section Chief) Date Time Tom Buhl Don Jensen 15Nov ICS 204 NFES 1328
8 DIVISION ASSIGNMENT LIST 1. Branch Operations 2. Division/Group Air Ops 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief Condit Division/Group Supervisor Branch Director Satko Air Attack Supervisor No. 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Trans. Needed Drop Off PT./Time Pick Up PT./Time HELO - CONTRACT WILDLIFE FLIGHT HOSP PT 0800 HOSP PT HELO - CONTRACT WILDLIFE FLIGHT HOSP PT 1700 HOSP PT 7. Control Operations 0800 WILD BIRD FLIGHT 1700 WILD BIRD FLIGHT 8. Special Instructions The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel Command Logistics Tactical Div/Group Air to Ground UHF 345.0MHZ Prepared by (Resource Unit Leader) Approved by (Planning Section Chief) Date Time Tom Buhl Don Jensen 15Nov ICS 204 NFES 1328
9 DIVISION ASSIGNMENT LIST 1. Branch Operations 2. Division/Group Air Ops 3. Incident Name Maersk Rhode Island 4. Operational Period Date: 16 Nov 2006 Time: Operations Personnel Operations Chief Condit Division/Group Supervisor Branch Director Satko Air Attack Supervisor No. 6. Resources Assigned this Period Strike Team/Task Force/ Resource Designator Leader Number Persons Aux Aircraft fixed 4 Trans. Needed Drop Off PT./Time Pick Up PT./Time 7. Control Operations 0800 Surveillence and patrol. 8. Special Instructions The MAERSK RHODE ISLAND incident is a dynamic and changing situation. ALL responders, site workers, and staffs are reminded to maintain situational awareness around the incident area. Supervisors are responsible for workers to wear appropriate PPE and mange fatigue. All responders are reminded of traffic safety hazards to/from incident area. Al accidents/mishaps SHALL be communicated to the proper chain of command. Be safe and take care of your shipmates on this incident. 9. Division/Group Communication Summary Function Frequency System Channel Function Frequency System Channel Command Logistics Tactical Div/Group Air to Ground UHF 345.0MHZ Prepared by (Resource Unit Leader) Approved by (Planning Section Chief) Date Time Tom Buhl Don Jensen 15Nov ICS 204 NFES 1328
10 1. Incident Name MAERSK RHODE ISLAND 3. Medical Aid Stations 2. Operational Period (Date / Time) From: 16 NOV 06/0600 To: 17 NOV 06/0600 Name Location Contact # Portsmouth Naval Medical Center 620 John Paul Jones Cir. Portsmouth, VA Emergency Room (757) MEDICAL PLAN ICS 206-CG Paramedics On site (Y/N) X 4. Transportation Ambulance Service Address Contact # LAND: City Services as Req'd. Local (Norfolk/Portsmouth) Dial 911 WATER: Boats To Hospital Point Paramedics On board (Y/N) 5. Hospitals Hospital Name Address Contact # Portsmouth Naval Medical Center Chesapeake General Hospital DePaul Medical Center Mary Immaculate Hospital Riverside Regional Medical Center Sentara Careplex General Hospital Sentara Norfolk General Hospital 620 John Paul Jones Cir. Portsmouth, VA Battlefield Blvd. North Chesapeake, VA 150 sley Lane Norfolk, VA 2 Bernadine Drive Newport News, VA 500 J. Clyde Morris Blvd. Newport News, VA 3120 Victoria Lane Hampton, VA 600 Gresham Drive Norfolk, VA Emergency Room (757) Travel Time Air Ground X Burn Ctr? x X X Heli- Pad? X X 6. Special Medical Emergency Procedures All responders should maintain awareness of personal and responder safety. If an injury or other emergency arises, report IMMEDIATELY to the chain of command for assistance. If incident occurs on the water, that person should be transported back to Hospital Point and taken the ER at Portsmouth Naval Medical Center. 7. Prepared by: (Medical Unit Leader) Date/Time 8. Reviewed by: (Safety Officer) Date/Time LTJG Jonathan B. Bernhardt 11/15/06==1100L MEDICAL PLAN ICS 206-CG (Rev.07/04)
11 Site Safety and Health Plan ICS-208-CG (rev 9/06) Incident Name: MAERSK RHODE ISLAND Date/Time Prepared: 15 NOV 06 Operational Period: NOV 06 Purpose. The ICS Compatible Site Safety and Health Plan is designed for safety and health personnel that use the Incident Command System (ICS). It is compatible with ICS and is intended to meet the requirements of the Hazardous Waste Operations and Emergency Response regulation (Title 29, Code of Federal Regulations, Part ). The plan avoids the duplication found between many other site safety plans and certain ICS forms. It is also in a format familiar to users of ICS. Although primarily designed for oil and chemical spills, the plan can be used for all hazard situations. Questions on the document should be addressed to the Coast Guard Office of Incident Management and Preparedness (G-RPP). Table of Forms FORM NAME FORM # USE REQUIRED OPTIONAL ATTACHED Emergency Safety and Response A Emergency response phase (uncontrolled) X Plan Site Safety Plan B Post-emergency phase (stabilized, cleanup) X Site Map C Post-emergency phase map of site and hazards X Emergency Response Plan D Part of Form B, to address emergencies X Exposure Monitoring Plan E Exposure monitoring Plan to monitor exposure X Air Monitoring Log E-1 To log air monitoring data X* Personal Protective Equipment F To document PPE equipment and procedures X* Decontamination G To document decon equipment and procedures X* Site Safety Enforcement Log H To use in enforcing safety on site X Worker Acknowledgement Form I To document workers receiving briefings X Form A Compliance Checklist J To assist in ensuring HAZWOPER compliance X Form B Compliance Checklist K To assist in ensuring HAZWOPER compliance X Drum Compliance Checklist L To assist in ensuring HAZWOPER compliance X Other: * Required only if function or equipment is used during a response
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13 EMERGENCY SAFETY and RESPONSE PLAN 5. Organization IC/UC: UC (USCG, MAERSK) 6.a. Physical Hazards and Protection 6.c. Tasks & Controls Air Monitoring (group) Salvage Assessment (group) East (Division) North (Division) South (Division) Staging Area 1. Incident Name MAERSK RHODE ISLAND 2. Date/Time Prepared 15 NOV 06/ Operational Period NOV Attachments: Attach MSDS for each Chemical: DIESEL (DFM) NO. 4 Safety: Bernhardt, Latimer, Hilton, Entry Team: Backup Team: Decon Team: Cheatwood, Atkins Div/Group Supv: 6.b. Confined Space Noise Heat Stress Cold Stress Electrical Animal/Plant/Insect Ergonomic Ionizing Rad Slips/Trips/Falls Struck by Water Violence Excavation Biomedical waste and/or needles Fatigue Other (specify) 6d Entry Permit 6.e. Ventilate 6f. Hearing Protection On member all times On member all times On member all times On member all times On member all times On member all times On member all times 6g. Shoes (type) Steel toed safety Steel toed safety Steel toed safety Steel toed safety Steel toed safety Steel toed safety Steel toed safety 6.h. Hard Hats In hot zone In hot zone In hot zone In hot zone In hot zone In hot zone In hot zone 6i. Clothing (cold wx) 6j. Life Jacket On Water On Water On Water On Water On Water On Water On Water 6l. Work/ Rest (hrs) 12/12 5days on 12/12 5days on 12/12 5days on 12/12 5days on 12/12 5days on 12/12 5days on 12/12 5days on 6.m. Fluids (amt/time) 7.a. Agent 7.b. Hazards 7.c. Target Organs 7.d. Exposure Routes 7.f. PPE 7.g. Type of PPE Diesel Gas Oil DMF Explosive Flammable Reactive Biomedical Toxic Radioactive Carcinogen Oxidizer Corrosive Specify Other: Inhalation Absorption Ingestion Injection Membrane Splash Suit for recovery 8. Instruments: 8.a. Action Levels O2 CGI 100ppm 8.b. Chemical Name(s): Diesel Gas Oil 8.c. LEL/UEL % Flam in air % Eyes Nose Skin Ears Central Nervous System Respiratory Throat Lungs Heart Liver Kidney Blood Lungs Circulatory Gastrointestinal Bone Other Specify: 8.d. Odor Thresh Ppm UNK 8.e. Ceiling/ IDLH UNK 8.f. STEL/TLV TWA- 100ppm By skin No TLV 12oz/hr 12oz/hr 12oz/hr 12oz/hr 12oz/hr 12oz/hr 12oz/hr 8.g. Flash Pt/ Ignition Pt (F or C) 60-70C 6.n. Signs & Barricade 6.p. Fall Protect 6.q. Post Guards Face Shield Eyes Gloves Inner Suit Splash Suit Level A Suit SCBA APR SAR Cartridges Fire Resistance 8.h. Vapor Pressure (mm) Public interest 8.i. Vapor Density 6.r. Flash Protec t 6.s. Work Gloves Chem resist Chem resist Chem resist Chem resist Chem resist Chem resist Chem resist 6.t. Other Level D for all other workers 8.j. Specific Gravity >1 UNK UNK 8.l. Boiling Pt F or C C
14 Radiation Total HCs Colorimetric Thermal Other ICS-208-CG SSP-A Page 1 (rev 9/06): Page of
15 EMERGENCY SAFETY and RESPONSE PLAN (Cont) 1. Incident Name MAERSK RHODE ISLAND 2. Date/Time Prepared 15 NOV 06/ Operational Period NOV Attachments: Attach MSDS for each Chemical DMF Diesel (MSDS and CHRIS) 9. Decontamination: Instrument Drop Off Outer Boots/Glove Removal Suit/Gloves/Boot Disposal Suit Wash Decon Agent: Water Other Specify: Bottle Exchange Outer Suit Removal Inner Suit Removal SCBA/Mask Removal SCBA/Mask Rinse Inner Glove Removal Work Clothes Removal Body Shower Intervening Steps Specify: If in contact, wash skin with soap and water. DO NOT INDUCE vomiting if injested. 10. Site Map. Include: Work Zones, Locations of Hazards, Security Perimeter, Places of Refuge, Decontamination Line, Evacuation Routes, Assembly Point, Direction of North Attached, Drawn Below: Vessel Location Circle is Safety zone 11.a. Potential Emergencies: Fire Explosion Other 12. a. Communications: Radio Phone Other 13.a. Site Security: Personnel Assigned 11.b. Evacuation Alarms: Horn # Blasts 5 Bells #Rings Radio Code Other: 11.c Emergency Prevention and Evacuation Procedures: Safe Distance: If large spill, zone should be at least 1000 for downwind. 12.b. Command #: x c. Tactical #: x8913 (OPS) 12.d. Entry #: 13.b. Procedures: 13.c. Equipment:
16 14.a. Emergency Medical: Personnel Assigned YES 15. Prepared by: Incident Safety Team 14.b. Procedures: REFER TO MEDICAL PLAN (ICS-206). On water incidents/persons should be transported to Hospital Point at Portsmouth Naval Medical Center. Skin contact should be washed with soap/water. DO NOT INDUCE vomiting if ingested. Any eye contact should be flushed with water for 15minutes. ALL PERSONNEL SHALL UNDERGO BLOODBORNE PATHOGENS TRAINING PRIOR TO START OF NEXT OP PERIOD AT THE TAILGATE SAFETY MEETINGS. 16. Date/Time Briefed: 15 November 2006/ c Equipment: ICS-208-CG SSP-A Page 2. (rev 9/06): Page of
17 CG ICS SITE SAFETY PLAN (SSP) HAZARD ID/EVAL/CONTROL 1. Incident Name MAERSK RHODE ISLAND 5. Supervisor/Leader 6. Location and Size of Site Norfolk, Elizabeth River. Near Hospital Point. Safety zone established (see Ops section) 10.a. Job Task/Activity Staging Area 10.b. Hazards* Physical/Safety, Explosion/Fire, Ergonomic, Noise, Dermatitis, Drowning, Fatigue, Vehicle 2. Date/Time Prepared 15 NOV 06/ Site Accessibility Land Water Air Comments: 10.c. Potential Injury & Health Effects Slips, Trips, Falls. Cuts, burns, hypothermia and potential for hearing loss. Fatigue is a possibility. Traffic accidents. 3. Operational Period NOV For Emergencies Contact: Proper Supervsior or call d. Exposure Routes Inhalation Absorption Ingestion Injection Membrane 4. Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Attachments: Attach MSDS for each Chemical DMF, Diesel (UN 1993) 10.e. Controls: Engineering, Administrative, PPE Staging Areas present significant hazards to managers, workers, responders and all others. Most of the hazards can be mitigated through Admin. Low speed limits, and safe work practices. Level D is required for all. Air Monitoring Group Physical/Safety, Explosion/Fire, Oxygen Deficiency, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle Slips, Trips, Falls. Cuts, burns, hypothermia and potential for hearing loss. Fatigue is a possibility. Traffic accidents Inhalation Absorption Ingestion Injection Membrane See above for staging areas safety hazards. Any higher numbers should be reported immediately to supevisors and SOFR. Vessel Salvage/Lightering North (Division) South (Division) Physical/Safety, Explosion/Fire, Oxygen Deficiency, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving Physical/Safety, Explosion/Fire, Oxygen Deficiency, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving Physical/Safet, Explosion/Fire, Oxygen Deficiency, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving Slips, Trips, Falls. Cuts, burns, hypothermia and potential for hearing loss. Fatigue is a possibility. Traffic accidents. Divers should be aware of decompression sickness. Slips, Trips, Falls. Cuts, burns, hypothermia and potential for hearing loss. Fatigue is a possibility. Traffic accidents Slips, Trips, Falls. Cuts, burns, hypothermia and potential for hearing loss. Fatigue is a possibility. Traffic accidents Inhalation Absorption Ingestion Injection Membrane Inhalation Absorption Ingestion Injection Membrane Inhalation Absorption Ingestion Injection Membrane Any personnel on the vessel should be aware of ship confined spaces. All potential spaces should be cleared as safe and properly ventilated. Personnel operated near the tanks should have a O2 clip. A PFD is mandatory on water along with hearing, hardhat and Level D. As the division includes LE safety zone recovery, spill recovery and all other operations and work assignments, the safety concerns are tremendous. On water members shall wear PFDs. In hot zone should have hearing protection, splash suits, hard hats. Driving to work areas can be dangerous members shall drive safe and at low speeds, especially with trailers. Sups are responsible for workers. As the division includes LE safety zone recovery, spill recovery and all other operations and work assignments, the safety concerns are tremendous. On water members shall wear PFDs. In hot zone should have hearing protection, splash suits, hard hats. Driving to work areas can be dangerous members shall drive safe and at low speeds, especially with trailers. Sups are responsible for workers.
18 East (Division) 11. Prepared By: LTJG Jonathan B. Bernhardt Physical/SafetY, Explosion/Fire, Oxygen Deficiency, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving 12. Date/Time Briefed: 15 November 2006/1200 Slips, Trips, Falls. Cuts, burns, hypothermia and potential for hearing loss. Fatigue is a possibility. Traffic accidents Inhalation Absorption Ingestion Injection Membrane *HAZARD LIST: Physical/Safety, Toxic, Explosion/Fire, Oxygen Deficiency, Ionizing Radiation, Biological, Biomedical, Electrical, Heat Stress, Cold Stress, Ergonomic, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving As the division includes LE safety zone recovery, spill recovery and all other operations and work assignments, the safety concerns are tremendous. On water members shall wear PFDs. In hot zone should have hearing protection, splash suits, hard hats. Driving to work areas can be dangerous members shall drive safe and at low speeds, especially with trailers. Sups are responsible for workers. ICS-208-CG SSP- B (rev 9/06): Page of
19 CG ICS SSP: SITE MAP 5. Supervisor/Leader CAPT TRAPP/UC 10. Sketch of Site: Attached. Drawn Here 1. Incident Name MAERSK RHODE ISLAND 6. Location and Size of Site See below 2. Date/Time Prepared 15 NOV 06/ Site Accessibility Land Water Air Comments: 3. Operational Period NOV For Emergencies Contact: Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Include: - Work Zones - Locations of Hazards - Security Perimeter - Places of Refuge - Decontamination Line - Evacuation Routes Vessel Location Circle is safety zone 11. Prepared By: Bernhardt/SOFR 12. Date/Time Briefed: 15 NOV 06/1200 HAZARD LIST: Physical/Safety, Toxic, Explosion/Fire, Oxygen Deficiency, Ionizing Radiation, Biological, Biomedical, Electrical, Heat Stress, Cold Stress, Ergonomic, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving ICS-208-CG SSP-C (rev 9/06): Page of
20 CG ICS SSP: EMERGENCY RESPONSE PLAN 5. Supervisor/Leader CAPT Trapp (UC) 1. Incident Name MAERSK RHODE ISLAND 6. Location and Size of Site Eliz. River near Town Point Park 2. Date/Time Prepared 15 NOV 06/ For Emergencies Contact: Proper Supervisor or Operational Period NOV Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Attachments: INCLUDE ICS FORM 206 and EMT Medical Response Procedures Attached to IAP (verified correct) 9. Emergency Alarm (sound 10. Backup Alarm (sound and 11. Emergency Hand Signals 12. Emergency Personal Protective Equipment Required: and location) location) 5 Short Blasts. Open hand signifies STOP or emergency. Local/State HAZ MAT crews to maintain air monitoring. 13. Emergency Notification Procedures 14. Places of Refuge (also see site map form 208B) Radios/Phones may be used for Hospital Point for near vessel and Staging Areas. All staging areas should be notification. Contact Staging Area accessible to emergency vehicles. Managers or Division/Group Sups to pass info 15. Emergency Decon and Evacuation Steps Decon suit/dispose of contaminated materials. Any skin contact can be washed with soap/water. DO NOT INDUCE vomiting if injested and flush eyes with water for 15 minutes. 16. Site Security Measures OPS will coordinate security measures 17. Prepared By: LTJG Bernhardt 18. Date/Time Briefed: 15 November 2006/1200 HAZARD LIST: Physical/Safety, Toxic, Explosion/Fire, Oxygen Deficiency, Ionizing Radiation, Biological, Biomedical, Electrical, Heat Stress, Cold Stress, Ergonomic, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving ICS-208-CG SSP-D (rev 9/06) Page of
21 CG ICS SSP: Exposure Monitoring Plan 5. Specific 6. Survey Task/Operation Location HAZ MAT monitoring Hospital Point 1. Incident Name MAERSK RHODE ISLAND 7. Survey Date/Time 8. Monitoring Methodology continual Personal Breathing Zone Area Air Monitoring Dermal Exposure Monitoring Biological Monitoring: Blood Urine Other Obtain bulk samples Other: 2. Date/Time Prepared: 9. Direct- Reading Instrument Model: Manufacturer: Last Mfr Calibration Date: 3. Operational Period NOV Air Sampling 11. Hazard(s) Sampling/Analysis Method: PID Collecting Media: Charcoal Tube Silica Gel 37 mm MCE Filter 37 mm PVC Filter Other:_PID to Monitor DMF Diesel 4. Safety Officer (Method of Contact): 12. Monitoring Duration 13. Reasons to Monitor continuous Regulatory Compliance Assess current PPE adequacy Validate engineering controls Monitor IDLH Conditions Other 14. Laboratory Support for Analysis Personal Breathing Zone Area Air Monitoring Dermal Exposure Monitoring Biological Monitoring: Blood Urine Other Obtain bulk samples Other: Model: Manufacturer: Last Mfr Calibration Date: Sampling/Analysis Method: Collecting Media: Charcoal Tube Silica Gel 37 mm MCE Filter 37 mm PVC Filter Other: Regulatory Compliance Assess current PPE adequacy Validate engineering controls Monitor IDLH Conditions Other Personal Breathing Zone Area Air Monitoring Dermal Exposure Monitoring Biological Monitoring: Blood Urine Other Obtain bulk samples Other: Model: Manufacturer: Last Mfr Calibration Date: Sampling/Analysis Method: Collecting Media: Charcoal Tube Silica Gel 37 mm MCE Filter 37 mm PVC Filter Other: Regulatory Compliance Assess current PPE adequacy Validate engineering controls Monitor IDLH Conditions Other 15. Prepared By: LTJG Jonathan B. Bernhardt Personal Breathing Zone Area Air Monitoring Dermal Exposure Monitoring Biological Monitoring: Blood Urine Other Obtain bulk samples Other: 16. Date/Time Briefed: 15 November 2006/1200 HAZARD LIST: Potential Health Effects: Bruise/Lacerations, Organ Damage, Central Nervous System Effects, Cancer, Reproductive Damage, Low Back Pain, Temporary Hearing Loss, Dermatitis, Respiratory Effects, Bone Breaks, & Eye Burning 18. Safety Officer Review: Bernhardt Reporting: Monitoring results shall be logged in the ICS-208-CG SSP-E-1 form (Air Monitoring Log) and attached as part of a current Site Safety Plan and Incident Action Plan. Significant Exposures shall be immediately addressed to the IC and General Staff for immediate correction. Model: Manufacturer: Last Mfr Calibration Date: Sampling/Analysis Method: Collecting Media: Charcoal Tube Silica Gel 37 mm MCE Filter 37 mm PVC Filter Other: Regulatory Compliance Assess current PPE adequacy Validate engineering controls Monitor IDLH Conditions Other ICS-208-CG SSP-E (rev 9/06) Page of
22 CG ICS SSP: AIR MONITORING LOG 5. Site Location Hospital Point 9.a. Instrument, ID Number Calibrated? Indicate below. 1. Incident Name MAERSK RHODE ISLAND 6. Hazards of Concern DMF Diesel 2. Date/Time Prepared 15 NOV 06/ Operational Period NOV Action Levels (include references): 100ppm Current (1100L) is 30ppm near vessel. 4. Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Weather: Temperature: 50s Precipitation: afternoon chance Wind: 15-20KTS Relative Humidity: Cloud Cover: partly cloudy 9.b. Monitoring Person Name(s) 9.c. Results (units) 9.d. Location 9.f. Time 9.g. Interferences and Comments Local Haz Mat team PID Local Haz Mat team 30ppm Adjacent to MAERSK RHODE ISLAND 1320L Action level is 100ppm (TWA 8hour work day average).* UC action level is 50ppm. 10. Safety Officer Review: LTJG Jonathan B. Bernhardt Potential Health Effects: Bruise/Lacerations, Organ Damage, Central Nervous System Effects, Cancer, Reproductive Damage, Low Back Pain, Temporary Hearing Loss, Dermatitis, Respiratory Effects, Bone Breaks, & Eye Burning ICS-208-CG SSP-E-1 (rev 9/06): Page of
23 CG ICS SSP: PERSONAL PROTECTIVE EQUIPMENT 5. Supervisor/Leader CAPT TRAPP/UC 1. Incident Name MAERSK RHODE ISLAND 2. Date/Time Prepared 15 NOV 06/ Operational Period NOV Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Location and Size of Site See site map 7. Hazards Addressed: Slips, Trips, Water, Product 8. For Emergencies Contact: Chain of command, Equipment: Hardhat PFD Safety Boots (Steel Toes) 10. References Consulted: Gloves Goggles or Face Shield Splash suit- CPC CHRIS Manual and MSDS 11. Inspection Procedures: Each person will be responsible for insection of their ssignned PPE prior to donning and to utilize PPE per the manufctures instructions. 12. Donning Procedures: Gloves quick check to ensure that gloves are air tight, not degrading from use or environmental factors. Hadhat check to ensure that hat has not 13. Doffing Procedures: Each person will be responsible for PPE checks during doffing and will replace all PPE tht is not suitable for use. 14. Limitations and Precautions (include maximum stay time in PPE): sustained any form of damage. PFD check to ensure that PPE has not sustained any form of damage. Safety Boots ensure soles and upprs of boots are intact and provide the necessary measure of safety. Goggles/Face shield ensue there are no cracks in face shield, goggles lenses are intact and restraint system is adequate. CPC ensure that suit is right type and has no tears or areas where protection could be compromised. 15. Prepared By: LTJG Jonathan B. Bernhardt 16. Date/Time Briefed: 15 November 2006/1200 Potential Health Effects: Bruise/Lacerations, Organ Damage, Central Nervous System Effects, Cancer, Reproductive Damage, Low Back Pain, Temporary Hearing Loss, Dermatitis, Respiratory Effects, Bone Breaks, Eye Burning ICS-208-CG SSP-F: (Rev 9/06) Page of
24 CG ICS SSP: DECONTAMINATION 1. Incident Name MAERSK RHODE ISLAND 2. Date/Time Prepared 15 NOV 06/ Operational Period NOV Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Supervisor/Leader 6. Location and Size of Site 7. For Emergencies Contact: 8. Hazard(s) Addressed: 9. Equipment: 10. References Consulted: 11. Contamination Avoidance Practices: 12. Decon Diagram: Attached, Drawn below 13. Decon Steps 14. Prepared By: 15. Date/Time Briefed: Potential Health Effects: Bruise/Lacerations, Organ Damage, Central Nervous System Effects, Cancer, Reproductive Damage, Low Back Pain, Temporary Hearing Loss, Dermatitis, Respiratory Effects, Bone Breaks, Eye Burning ICS-208-CG SSP-G (rev 9/06): Page of
25
26 CG ICS SSP: ENFORCEMENT LOG 1. Incident Name MAERSK RHODE ISLAND 2. Date/Time Prepared 15 NOV 06/ Supervisor/Leader 6. For Emergencies Contact: Division Supervisors/911 (all incidents to be report through SOFR) 3. Operational Period NOV a. Job Task/Activity 8.b. Hazards 8.c. Deficiency 8.d. Action Taken 4. Safety Officer (include method of contact) Bernhardt, Latimer, Hiton, Cheatwood. Extension x Attachments: MSDS/CHRIS Manual 8.e. Safety Plan Amended? 8.f. Signature of Supervisor/Leader 9. Prepared By: LTJG Jonathan B. Bernhardt 10. Date/Time Briefed: 15 November 2006/1200 HAZARD LIST: Physical/Safety, Toxic, Explosion/Fire, Oxygen Deficiency, Ionizing Radiation, Biological, Biomedical, Electrical, Heat Stress, Cold Stress, Ergonomic, Noise, Cancer, Dermatitis, Drowning, Fatigue, Vehicle, & Diving ICS-208-CG SSP-H (rev 9/06): Page of
27 CG ICS SSP WORKER ACKNOWLEDGEMENT FORM 1. Incident Name MAERSK RHODE ISLAND 2. Site Location: Staging Areas 3. Attachments: MSDS/CHRIS Manual 4. Type of Briefing 5. Presented By: 6. Date Presented 7. Time Presented Safety Plan/Emergency Response Plan Start Shift Pre-Entry LTJG Jonathan B. Bernhardt/SOFR 15 November Exit End of Shift Specify Other: 8.a. Worker Name (Print) 8.b. Signature* 8.c. Date 8.d. Time * By signing this document, I am stating that I have read and fully understand the plan and/or information provided to me. ICS-208-CG SSP-I (rev 9/06): Worker Acknowledgement Page of
28 CG ICS SSP: Emergency Safety & Response Plan Compliance Checklist (Form A) 1. Incident Name MAERSK RHODE ISLAND 2. Date/Time Prepared 15 November 2006/ Operational Period NOV Site Supervisor/Leader CAPT TRAPP/UC 6.a. Cite: b. Requirement(sections that duplicate or explain are omitted) 6.c. ICS Form 6.d. Check 6.e. Comments 5. Location of Site Norfolk/Portsmouth on Elizabeth River (q)(1) Is the plan in writing? SSP-A (1) Is the plan available for inspection by employees? N/A Performance based (q)(2)(i) Does the plan address pre-emergency planning and coordination? SSP-A (ii) Does it address personnel roles? SSP-A (ii) Does it address lines of authority? SSP-A (ii) Does it address communications? SSP-A (iii) Does it address emergency recognition? SSP-A (iii) Does it address emergency prevention? SSP-A (iv) Does it identify safe distances? SSP-A (iv) Does it address places of refuge? SSP-A (v) Does it address site security and control? SSP-A (vi) Does it identify evacuation routes? SSP-A (vi) Does it identify evacuation procedures? SSP-A (vii) Does it address decontamination? SSP-A (viii) Does it address medical treatment and first aid? SSP-A (ix) Does it address emergency alerting procedures? SSP-A (ix) Does it address emergency response procedures SSP-A (x) Was the response critiqued? N/A Performance based (xi) Does it identify Personal Protection Equipment? SSP-A (xi) Does it identify emergency equipment? SSP-A (q)(3)(ii) All the hazardous substances identified to the extent possible? N/A Performance based (ii) All the hazardous conditions identified to the extent possible? N/A Performance based (ii) Was site analysis addressed? N/A Performance based (ii) Were engineering controls addressed? N/A Performance based (ii) Were exposure limits addressed? N/A Performance based (ii) Were hazardous substance handling procedures addressed? N/A Performance based (iii) Is the PPE appropriate for the hazards identified? N/A Performance based (iv) Is respiratory protection worn when inhalation hazards present? N/A Performance based (v) Is the buddy system used in the hazard zone? N/A Performance based (vi) Are backup personnel on standby? N/A Performance based (vi) Are advanced first aid support personnel standing by? N/A Performance based (vii) Has the ICS designated safety official been identified? SSP-A (vii) Has the Safety Official evaluated the hazards? N/A Performance based (viii) Can the Safety Official communicate with IC immediately? N/A Performance based (ix) Are appropriate decontamination procedures implemented? N/A Performance based ICS-208-CG SSP-J (rev 9/06) Page of
29 CG ICS SSP: COMPLIANCE CHECKLIST (Form B) 1. Incident Name 2. Date/Time Prepared 3. Operational Period 4. Site Supervisor/Leader 5. Location of Site 6.a. Cite: b. Requirement(sections that duplicate or explain are omitted) 6.c. ICS Form 6.d. Check 6.e. Comments (b)(1)(ii)(a) Organizational structure? 203 (B) Comprehensive workplan? IAP Incident Action Plan (C) Site Safety Plan? SSP-B (D) Safety and health training program? N/A Responsibility of each employer (E) Medical surveillance program? N/A Responsibility of each employer (F) Employer SOPs? N/A Responsibility of each employer (G) Written program related to site activities? N/A (b)(1)(iii) Site excavation meets shored or slope requirements in 1926? N/A (b)(2)(i)(d) Lines of communication? (b)3(iv) Training addressed? N/A Responsibility of each employer (v)-(vi) Information and medical monitoring addressed? N/A Responsibility of each employer (b)4(i) Site Safety Plan kept on site? N/A (ii)(a) Safety and health hazard analysis conducted? N/A (B) Properly trained employees assigned to right jobs? N/A (C) Personnel Protective Equipment issues addressed? SSP-F (E) Frequency and types of air monitoring addressed? SSP-E (F) Site control measures in place? SSP-B (G) Decontamination procedures in place? SSP-G (H) Emergency Response Plan in place? SSP-D (I) Confined space entry procedures? SSP-B (J) Spill containment program SSP-B (iii) Pre-entry briefings conducted? SSP-I (iv) Site Safety Plan effectiveness evaluated? SSP-H (c)(1) Site characterization done? N/A (c)(2) Preliminary evaluation done by qualified person? N/A (c)(3) Hazard identification performed? SSP-B (c)(4)(i) Location and size of site identified? SSP-B (ii) Response activities, job tasks identified? SSP-B (iii) Duration of tasks identified? SSP-B Operational period (iv) Site topography and accessibility addressed? SSP-C (v) Health and safety hazards addressed? SSP-B (vi) Dispersion pathways addressed? SSP-B (vii) Status and capabilities of medical emergency response teams? 206 (c)(5)(i)(iv) Chemical protective clothing addressed and properly selected? SSP-F (ii) Respiratory protection addressed? SSP-B and F (iii) Level B used for unknowns? N/A ICS-208-CG SSP-K (rev 9/06): Page 1. Page of
30 CG ICS SSP: COMPLIANCE CHECKLIST Form B (cont) 1. Incident Name 2. Date/Time Prepared 3. Operational Period 6.a. Cite: b. Requirement(sections that duplicate or explain are omitted) 6.c. ICS Form 6.d. Check 6.e. Comments (c)(6)(i) Monitoring for ionization conducted? SSP-E (ii) Monitoring conducted for IDLH conditions? SSP-E (iii) Personnel looking out for dangers of IDLH environments? N/A (iv) Ongoing air monitoring program in place? SSP-E (c)(7) Employees informed of potential hazard occurrence? SSP-B (c)(8) Properties of each chemical made aware to employees? SSP-B (d)(1) Appropriate site control procedures in place? IAP, SSP-B (d)(2) Site control program developed during planning stages? IAP, SSP-B (d)(3) Site map, work zones, alarms, communications addressed? IAP, SSP-B (g)(1)(i) Engineering, admin controls considered? SSP-B (iii) Personnel not rotated to reduce exposures? N/A (g)(5)(i) PPE selection criteria part of employer s program? N/A Responsibility of employer (ii) PPE use and limitations identified? SSP-F (iii) Work mission duration identified? SSP-F (iv) PPE properly maintained and stored? N/A Responsibility of employer (vi) Are employees properly trained and fitted with PPE? N/A Responsibility of employer (vii) Are donning and doffing procedures identified? SSP-F (viii) Are inspection procedures properly identified? SSP-F (ix) Is a PPE evaluation program in place? SSP-F (h) (3) Periodic monitoring conducted? SSP-E (k)(2)(i) Have decontamination procedures been established? SSP-G (ii) Are procedures in place for contamination avoidance? SSP-G (iii) Is personal clothing properly deconned prior to leaving the SSP-G site? (iv) Are decontamination deficiencies identified and corrected? SSP-H (k)(3) Are decontamination lines in the proper location? SSP-C (k)(4) Are solutions/equipment used in decon properly disposed of? N/A (k)(6) Is protective clothing and equipment properly secured? N/A (k)(7) If cleaning facilities are used, are they aware of the hazards? N/A (k)(8) Have showers and change rooms provided, if necessary? N/A (l)(1)(iii) Are provisions for reporting emergencies identified? SSP-D (iv) Are safe distances and places of refuge identified? SSP-B and C (v) Site security and control addressed in emergencies? SSP-D (vi) Evacuation routes and procedures identified? SSP-D (vii) Emergency decontamination procedures developed? SSP-D (ix) Emergency alerting and response procedures identified? SSP-D (x) Response teams critiqued and followup performed? SSP-H (xi) Emergency PPE and equipment available? SSP-D ICS-208-CG SSP-K (rev 9/06): Page 2. Page of
31 CG ICS SSP: COMPLIANCE CHECKLIST Form B (cont) 1. Incident Name 2. Date/Time Prepared 3. Operational Period 6.a. Cite: 6.b. Requirement(sections that duplicate or explain are omitted) 6.c. ICS Form 6.d. Check (l)(3)(i) Emergency notification procedures identified? SSP-D (ii) Emergency response plan separate from Site Safety Plan? SSP-D (iii) Emergency response plan compatible with other plans? SSP-D (iv) Emergency response plan rehearsed regularly? SSP-D (v) Emergency response plan maintained and kept current? SSP-H (b)(2) Can alarms be seen/heard above ambient light and noise N/A levels? (b)(3) Are alarms distinct and recognizable? N/A (b)(4) Are employees aware of the alarms and are they accessible? SSP-D (b)(5) Are emergency phone numbers, radio frequencies clearly 206 posted? (b)(6) Signaling devices in place where there are 10 or more workers? IAP (c)(1) Are alarms like steam whistles, air horns being used? IAP (d)(3) Are backup alarms available? IAP (m) Are areas adequately illuminated? IAP (n)(1)(i) Is an adequate supply of potable water available? IAP (ii) Are drinking water containers equipped with a tap? IAP (iii) Are drinking water containers clearly marked? IAP (iv) Is a drinking cup receptacle available and clearly marked? IAP (n)(2)(i) Are non-potable water containers clearly marked? IAP (n)(3)(i) Are their sufficient toilets available? IAP (n)(4) Have food handling issues been addressed? IAP (n)(6) Have adequate wash facilities been provided outside hazard IAP zone? (n)(7) If response is greater than 6 months, have showers been IAP provided? 6.e. Comments 7. Prepared By: ICS-208-CG SSP-K (rev 9/06): Page 3. Page of
32 CG ICS SSP: DRUM COMPLIANCE CHECKSHEET 1. Incident Name 2. Date/Time Prepared 3. Operational Period 4. Safety Officer (include method of contact) 5. Supervisor/Leader 6. Location and Size of Site 7. For Emergencies Contact: 8. Note: tanks and vaults should also be treated in the same manner as described below [ (j)(9)]. Many can also pose confined space hazards. 9.a. Cite: (Cites that duplicate or explain requirements are omitted) 9.b. Requirement 9.c. Check 9.d. Comments (j)(1)(ii) Drums meet DOT, OSHA, EPA regs for waste they contain, including shipment? (iii) Drums inspected and integrity ensured prior to movement? (iii) Or drums moved to an accessible location (staging area) prior to movement? (iv) Unlabelled drums treated as unknown until properly identified and labeled? (v) Site activities organized to minimize drum handling? (vi) Employers properly warned about the hazards of moving and handling drums? (vii) Suitable overpack drums are available for addressing leaking and ruptured drums? (viii) Leaking materials from drums properly contained? (ix) Are drums that cannot be moved, emptied of contents with transfer equipment? (x) Are suspect buried drums surveyed with underground detection system? (xi) Are soil and covering material above buried drums removed with caution? (xii) Is the proper extinguishing equipment on scene to control incipient fires? (j)(2)(i) Are airlines on supplied air systems protected from leaking drums? (ii) Are employees at a safe distance, using remote equipment, when handling explosive drums? (iii) Are explosive shields in plane to protect workers opening explosive drums? (iv) Is response equipment positioned behind shields when shields are used? (v) Are non-sparking tools used in flammable or potentially flammable atmospheres? (vi) Are drums under extreme pressure opened slowly & workers protected by shields/distance? (vii) Are workers prohibited from standing and working on drums? (j)(3) Is the drum handling equipment positioned and operated to minimize sources of ignition? (j)(5)(i) For shock sensitive drums, have all non-essential employees been evacuated? (ii) For shock sensitive drums: is handling equipment provided with shields to protect workers? (iii) Are alarms that announce start/finish of explosive drum handling actions in place? (iv) Are continuous communications in place between the drum handling site & command post? (v) Are drums under pressure properly controlled for prior to handling? (vi) Are drums containing packaged laboratory wastes treated as shock sensitive? (j)(6)(i) Are lab packs opened by trained and experienced personnel? (ii) Are lab packs showing crystallization treated as shock sensitive? (j)(8)(ii-iii) Are drum staging areas manageable with marked access and egress? (iv) Is bulking of drums conducted only after drum contents have been properly identified? 10. Prepared By: Form SSP-L (rev 9/06) Page of
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