PWS Appendix F _FMP DGA_08.12.25.xlsx

Administrative

Building 17 Dahlonega, GA 30506

Appendix K - Facility Maintenance Plan

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Instructions:

This table shows the minimum information required. Additional details should be included based on site specific requirements. Additional POCs may be required.

General Facility Descript

States Army Forces Command. TMP M0395 is a government owned and operated facility which receives, stores, and issues diesel and motor gasoline (mogas) fuels.

Fuels are received via direct fill port located inside spill buckets by over-the-road transport and stored in two shop-fabricated, fiberglass reinforced plastic (FRP), double-walled (DW), USTs (USTs M0307 and M0308). Each UST has overfill prevention through flapper valves (FVs) on the receipt piping drop tubes. Fuels are each issued via pressurized underground (UG), DW, FRP piping to two single-hose, retail-style dispensers with under dispenser containment (UDC). Each of the two UG DW piping sections are equipped with electronic LLDs. The USTs are equipped with a monitoring system consisting of a Veeder Root (VR) panel that provides automatic tank gauging (ATG), monitoring of the UST interstices and UST issue sumps.

Appendix K - Facility Maintenance Plan

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Instructions:

Include a general facility overview and description of each fuel system for the sites in accordance with UFC 3-460-01. Examples include: Bulk Storage Facilities, Aircraft Fueling Facilities, Marine and Dispensing Facilities, Ground Products Fueling Facilities, Alternate POL Facilities, and Support Facilities. Also include facility #s, facility names, fuel type, photos, and any other pertinent information.

Include Site Specific Conditions and Restrictions in this tab.

Communication Plan

Appendix K - Facility Maintenance Plan

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Instructions:

Communication plan shall address in/out briefs, lines of communication, coordination for access, etc.

Safety

Appendix K - Facility Maintenance Plan

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Instructions:

This tab shall reference the site specific accident prevention plan information

PM Schedule

Instructions:

Link PM schedule here

Task Matrix

&"Times New Roman,Bold"&14APPENDIX F - Facility Maintenance Plan

Instructions:

1. Input all data as indicated on the sheet.

2. Additional documents referred to in the Special Considerations column shall be included as an appendix to this FMP.

3. The contractor shall generate a Component Unique Identifier (CUID) for each component utilizing the Component Acronym Sheet within this Work Book. The unique identifier must use the following:

Three letter Site Code - Facility # - Component Acronym - Sequential number Example: AAD-00063A-RCVL-0001

If component acronym is not listed, the contractor shall request an acronym be established through the HNC Project Manager and Project Engineer via email. Contractors may utilize other means of tracking/labeling assets such as QR codes in addition to the required CUID however, tracking/labeling must correlate with the CUID. This CUID shall be the standard for all DLA capitalized equipment. Base Asset ID if used by site shall be cross referenced with CUID appropriately.

4. Utilize the UFC Section Reference Work Category as noted on the Component Acronym Sheet.

5. Enter any applicable manufacturer requirements not stated in the UFC. References are acceptable with attachments.

6. Enter any applicable operator support or government owned equipment required to complete the RM task.

7. Enter impact on system availability by performing the RM task. This could include shutdown, lockout, or similar impacts.

8. Enter contract information for any other contract, contractor, or government personnel performing the applicable task. This is applicable to other Centrally Managed Programs, SRM, MILCON, or Public Works/Civil Engineering projects.

9. Print Hard Copies as 11x17.

FS-PF Schedule

Instructions:

1. Input all data as indicated on the sheet.

2. Additional documents referred to in the Special Considerations column shall be included as an appendix to this FMP.

3. The contractor shall generate a Component Unique Identifier (CUID) for each component utilizing the Component Acronym Sheet within this Work Book. The unique identifier must use the following:

Three letter Site Code - Facility # - Component Acronym - Sequential number Example: AAD-00063A-RCVL-0001

If component acronym is not listed, the contractor shall request an acronym be established through the HNC Project Manager and Project Engineer via email. Contractors may utilize other means of tracking/labeling assets such as QR codes in addition to the required CUID however, tracking/labeling must correlate with the CUID. This CUID shall be the standard for all DLA capitalized equipment.

4. Utilize the UFC Section Reference Work Category as noted on the Component Acronym Sheet.

5. Enter any applicable manufacturer requirements not stated in the UFC. References are acceptable with attachments.

6. Enter any applicable operator support or government owned equipment required to complete the RM task.

7. Enter impact on system availability by performing the RM task. This could include shutdown, lockout, or similar impacts.

8. Filter Separators and Pre-Filters identified here shall also be provided in the Task Matrix Tab.

9. Print Hard Copies as 11x17.

Component Acronym

&"Times New Roman,Bold"&14APPENDIX F - Facility Maintenance Plan of 4

Versions and Notes

image1.jpeg

Microsoft_Word_Document.docx

SITE-SPECIFIC ADDENDUM FOR

CAMP FRANK D. MERRILL, GEORGIA

RECURRING MAINTENANCE & MINOR REPAIR

SOUTH ATLANTIC DIVISION – ARMY

Prepared for

US ARMY ENGINEERING & SUPPORT CENTER

HUNTSVILLE, AL

Prepared by

WESTON Solutions, Inc.

5655 Peachtree Parkway, Suite 150

Peachtree Corners, GA 30092

Contract No.: 47QSHA18D0016

Task Order No.: W912DY22F0081

March 2022

Weston Solutions, Inc. – Emergency Response and Contingency Plan

1-1

12-4

List of Acronyms

ANSI American National Standards Institute

APP Accident Prevention Plan

BBP bloodborne pathogen

CP Competent Person

CPR Cardiopulmonary Resuscitation

DGA Camp Frank D. Merrill

EM Engineering Manual

EMS Emergency Medical Services

ERCP Emergency Response and Contingency Plan

HAZCOM Hazard Communications Program

PAN Preliminary Accident Notification

PPE personal protective equipment

POC Point of Contact

QAE Quality Assurance Evaluator

QCM Quality Control Manager

RMMR Routine Maintenance and Minor/Emergency Repair

SAD South Atlantic Division

SDS Safety Data Sheets

SM Site Manager

SSA Site-Specific Addendum

SSHO Site Safety and Health Officer

TOSM Task Order Safety Manager

USACE United States Army Corps of Engineers

WESTON Weston Solutions, Inc.

Weston Solutions, Inc. – Emergency Response and Contingency Plan ii

1. CONTRACTOR NAME: Weston Solutions, Inc. (WESTON®)

2. CONTRACT NUMBER: 47QSHA18D0016

TASK ORDER NUMBER: W912DY22F0081

3. PROJECT NAME: DGA – Camp Frank D. Merrill

4. SITE PROJECT LOCATION: Camp Frank D. Merrill (DGA), Georgia. An aerial view of the site project location (DGA) is identified below in Figure 1.

Figure 1 Camp Frank D. Merrill, Georgia

5. Weston Project Staff

· PROJECT MANAGER: Ken Coggins

· TASK ORDER SAFETY MANAGER (TOSM): Don Glenn

· QUALITY CONTROL MANAGER: Michael Wise

· SITE MANAGER: Erick Ruiz Herrera

· REGIONAL SAFETY MANAGER: Russ Reynolds

The Site Manager (SM)/Site Safety and Health Officer (SSHO) is responsible for emergency response procedures for the duration of the project and will contact the appropriate personnel or authorities as determined by the type and nature of incident. Attachment 1 lists emergency contacts and serves as documentation of this site-specific chain-of-command.

To minimize confusion and to leave no doubt as to who has decision-making authority in the event that an emergency situation develops, the chain-of-command is established in the Program Accident Prevention Plan (APP). This includes the roles of the SM/SSHO, TOSM, Regional Safety Managers, and Project Manager.

6. Installation Information

· QAE NAME & CONTACT INFORATION: Mr. Brett Allen

6650 Meloy Drive, Bldg 6, Suite 409

Fort Benning, GA 31905

(256) 312-7148

· OPERATIONAL HOURS: Monday-Friday 0700-1600 (7:00am – 4:00 PM)

7. EMERGENCY RESPONSE PLAN

This Emergency Response and Contingency Plan has been prepared by WESTON to describe actions that will be taken by WESTON site personnel in the event of an emergency. The purpose of this plan is to:

· Anticipate emergency events and ensure proper contingency planning and preparation.

· Act as a guide in the event of an emergency.

· Minimize hazards to human health and environment from anticipated emergency events.

· Familiarize response personnel with emergency roles, responsibilities and procedures.

7.1 General

During an emergency, the following actions will be taken, with some actions conducted concurrently.

· No one will attempt an emergency response/rescue until the situation has been assessed and the appropriate response is outlined by the SM/SSHO or local responders.

· It will be determined prior to work initiation, whether any tasks on-site are critical operations requiring one or more persons to shut down sensitive equipment in a time-critical manner.

· General guidelines for rescue/response are detailed in Section 9.2.1 in the APP.

· In the event of a severe fire or chemical release, the site may have to be evacuated.

· A safe meeting area will be designated during the initial site worker orientation and reconfirmed during the daily safety meetings, where workers will assemble and check in with the SSHO. The location of the assembly area will vary based on the work locations. The assembly zone location will be reconfirmed at the safety briefings. The SSHO or designated alternate will use the sign-in sheet to confirm all personnel have evacuated.

7.2 Procedures and Test

Inclement Weather Procedure: The Program WESTON APP details various emergency situations with common responses to emergency events. In addition, the General Site Safety/Mobilization AHA (AHA #40) and Section 7.9 of this SSA contain controls for severe weather and/or other emergency events. The work crew upon arrival at installation will contact the Quality Assurance Evaluator (QAE) or designated installation Point of Contact (POC) to discuss the work to be performed during the visit and receive information on site conditions, weather information, and establish evacuation procedures in the event of severe weather or other emergency event such as a fuel fire or explosion. Depending on the severity of the weather event all personnel will seek shelter or rendezvous with the QAE/POC at the installations pre-designated evacuation area for accountability purposes. If the installation does not have a pre-designated area, the WESTON SM and/or SSHO will establish a location prior to starting work and this information will be provided during the Daily Tailgate Safety briefing. The pre-work tailgate discussion will be documented on the WESTON Daily Tailgate Safety Checklist and/or the WESTON Site Managers Daily Report.

Inclement Weather Test: During the first visit to the installation to perform service order work or Routine Maintenance and Minor Repair (RMMR), WESTON will perform a severe weather exercise to test both the orderly evacuation, routes to assembly point, and accountability for all WESTON employees including subcontractors. The onsite SSHO (i.e., Level 1, Level 2, or Level 3) shall have the action to assess the exercise and prepare a written report to be included in the WESTON Site Managers Daily Report.

Medical Support Procedure: The Program WESTON APP (Section 6.0 and Section 9.2) detail various medical support procedures in various parts. Personnel should also review Section 7.7 of this SSA for additional information on medical support and first-aid/CPR qualified personnel. The work crew upon arrival at installation will contact the QAE or designated installation POC to discuss the work to be performed during the visit and receive information on site conditions, emergency contacts, and the local medical facilities. The SSHO will post the emergency contact numbers (Attachment 1) and hospital route (Attachment 2) at the project site. A copy of each listing should also be present in each vehicle onsite. The SSHO will verify that each vehicle contains a first aid kit as required by the Program APP. The SSHO will also verify that the emergency numbers identified in Attachment 1 are correct. The SSHO will review the medical support policy prior to starting work and this information will be provided during the Daily Tailgate Safety briefing. The pre-work tailgate discussion will be documented on the WESTON Daily Tailgate Safety Checklist and/or the WESTON Site Managers Daily Report.

Medical Support Test: During the initial site safety briefing of a service order or RMMR activity, WESTON will perform a medical support test. This test will ensure personnel onsite and certified on first aid procedures are aware of their surroundings and the location of first aid equipment. The test will involve one (or more) site employees that become injured with one receiving a deep laceration. Site employees will locate the first aid kit onsite and apply first aid measures. These measures include wrapping a wound, applying pressure, and using a site vehicle to transport to the nearest medical facility for evaluation and follow-up treatment. Personnel will identify roles, discuss the outcome, and ensure the hospital route map is correct. Personnel will also discuss and identify what actions would be necessary should additional care be warranted, or emergency services be needed onsite. Reporting procedures will be discussed as well. The onsite SSHO (i.e., Level 1, Level 2, or Level 3) shall have the action to assess the exercise and prepare a written report to be included in the WESTON Site Managers Daily Report.

7.3 Small Spill

In the event of a small spill, appropriate actions will be taken to prevent the spill from reaching groundwater, surface water, or drains. Actions include:

· Verification of spilled material, volume, and hazards.

· Determine appropriate response procedures including personal protective equipment (PPE) [see Safety Data Sheets (SDS) or Chemical Data Sheet].

· Assess quantity and size of the spill to determine the level of response to contain and clean it up.

· Confine or contain spill with booms, pads, or berm.

· Neutralize spill with appropriate agents (if safe/possible).

· Notify SSHO/SM.

WESTON will collect spilled material including absorbent material and place in appropriate containers. All hazardous materials shall be disposed of in accordance with all applicable hazardous waste regulations and client requirements. Additional information regarding WESTON’s procedures for spills can be found in the Section 9.2.2 of the Program APP.

7.4 Fire-Fighting Plan

A small fire is defined as a fire that can be extinguished by a trained person with a 2A:10BC type fire extinguisher or incipient stage fires, which can safely be extinguished with material readily at hand. In the event of a small fire, site personnel will take the following actions:

· Evacuate all unnecessary personal from the area, if possible, to an upwind location.

· Notify SSHO/SM.

· Attempt to extinguish fire using portable fire extinguishers or by smothering from an upwind location.

· Request emergency response assistance, as appropriate.

· Notify the Regional EHS Manager and Project Manager.

In the event of a large fire, or a small fire, which cannot be extinguished, the following actions will be taken:

· Sound alarm.

· Evacuate all unnecessary personnel from the area, if possible, to an upwind location.

· Notify local fire department; request other emergency response services (police, ambulance, and hospital) as needed.

· Notify Regional EHS Manager and Project Manager and other appropriate personnel or agencies.

As stated in the Program APP, in the event of a fire (any size) the fire department shall be called (Attachment 1) to respond even if portable fire extinguishers were used to extinguish the fire. Only the installation fire department can give an all clear following a fire event. Each vehicle working onsite will also carry a minimum 10-pound ABC fire extinguisher. Fire extinguishers will be strategically placed onsite near areas where combustible and flammable materials are stored and used.

In addition, personnel working on WESTON site operations (WESTON persons and subcontractors) will permitted to smoke only in designated smoking areas identified at the facility. Additional information regarding WESTON’s procedures for firefighting can be found in Section 9.2.3 of the Program APP.

7.5 Emergency Response Contact Information

Emergency Response Contact Information for the Site is located in Attachment 1.

7.6 Confined Space Emergency Responder Rescue Plan

As stated in the Program APP, the confined space work will be implemented by WESTON or a WESTON subcontractor, when required by a service order. All entries will be planned by a Competent Person (CP) for confined space entry planning and using only qualified entrants, attendants and supervisors. Detailed entry plans and entry permits will be prepared in addition to task-specific AHAs prior to the commencement of work. The CP will discuss the entry plans with the QAE (or appropriate site personnel) prior to arriving onsite to ensure all requirements are in place to complete the entry safety. However, dependent on the schedule, the QAE (or site meeting) may not be accomplished until arrival at the project site where a site meeting can be held at the space. Regardless, the preparatory meeting must be completed prior to actual entry. Certifications for the CP and all entrants, attendants, and supervisors will be verified by the TOSM prior to starting field activities and their certifications available to HNC for review.

WESTON’s confined space entry program is discussed in Section 9.58 and Section 9.59 of the Program APP. WESTON will coordinate with the installation confined space contact identified in Section 9.0 of this Site-Specific Addendum (SSA) prior to starting work.

In the event of an emergency, site personnel will contact the Fire Department identified in Attachment 1 and the facility confined space contact identified in Section 9.0 of this SSA. The CP will coordinate with the Fire Department to ensure rescue services are provided within 5 minutes of call and personnel are available for immediate needs. Rescue operations will be confirmed and tested by site personnel and approved by the TOSM prior to starting confined space operations.

7.7 Medical Support

Hospital Route information is located in Attachment 2.

Cardiopulmonary resuscitation (CPR) and First Aid Qualified Personnel are identified in Section 6.0 and Section 9.2.5 of the Program APP. In the event specialized/elevated care is necessary, either WESTON or the local on-call ambulance service will transport the injured person to the hospital. The local Fire and Emergency Medical Service (EMS) Department will be notified of emergency situations by using the telephone numbers listed in Attachment 1. There will be fewer than 100 people on-site; therefore, WESTON will not be providing on-site medical support.

As stated in the Program APP, at least two team members (WESTON and subcontractor) with first aid/CPR and bloodborne pathogen (BBP) training will be on-site and will be available to provide on-site first aid support and immediate lifesaving action pending arrival of emergency responders. A first aid kit complying with the criteria contained in American National Standards Institute (ANSI) Z308.1-2009 will be located on the jobsite in the project trucks. Minimal actions to be taken are as follows:

· For minor injuries, routine first aid procedures will be used and documented.

· For major injuries, an ambulance will be called immediately, and the appropriate first aid administered while awaiting the arrival of the ambulance.

· Trained personnel will use approved measures for treatment based on the training they have received.

Table 1 presents first aid and CPR training for key personnel.

Table 1 First Aid and CPR Training for Key Personnel

Name

Project Title

First Aid (Expiration Date)

CPR

(Expiration Date)

BBP

(Expiration Date)

Ken Coggins

Project Manager

12/13/2023

12/13/2023

7/28/2021

Don Glenn

TOSM

1/24/2024

1/24/2024

3/4/2022

Michael Wise

QCM

3/7/2024

3/7/2024

3/7/2023

Erick Ruiz Herrera

SM/SSHO/QC

3/8/2024

3/8/2024

2/9/2023

* Key personnel training and certifications will be updated prior to starting work. Personnel with expired certifications will be required to update them before the project begins.

BBP = bloodborne pathogen

CPR = cardiopulmonary resuscitation

QCM = Quality Control Manager

7.8 Security Issues

Work will take place on secured military installations, and as such, security issues are not anticipated. In the event of unauthorized access, site personnel will avoid any confrontation (verbal or physical) and contact the QAE for assistance. Continued presence by unauthorized persons will require the suspension of immediate site activities and a team member to notify the QAE and local police force. Additional site activities may need to be halted in the event unauthorized persons create an adverse risk to themselves, to WESTON personnel, or to subcontractor personnel. The site-specific hazard communication plan will be followed as described in the Program APP and Attachment 3 of this SSA.

7.9 Severe Weather/Natural Disasters

In the event of adverse weather conditions occurring on-site such as lightning, high winds, tornado, hurricane or extreme heat, the SSHO will instruct the workers to discontinue or modify field operations. These natural phenomena complicate work activities and add an increased risk of incident to all site personnel. Work will be stopped whenever lightning is detected within 10 miles of the site. The following actions will be evaluated or taken in the event of severe weather:

· SSHO or designee to notify all personnel to stop work.

· Secure all loose materials, toolboxes, plywood, and trashcans. etc.

· Bring all workers to safe areas indoors when lightning or severe weather is in the immediate area.

· Verify that all buildings and trailer doors are secure and windows closed.

· Shut down and disconnect all non-critical electrical equipment to protect the equipment from electrical surges and abrupt power loss.

· Take shelter or evacuate to the assembly point discussed during the start of work with the QAE or installation personnel.

· For a lightening event, do not return to work until 30 minutes following the last detected lightning strike within 10 miles.

· For natural disaster events, the SM will consult with the SSHO and determine the course of action for returning to work.

Additional information regarding WESTON’s severe weather plan is discussed in Section 9.2.6 of the Program APP.

8. SECURITY CONTACT INFORMATION (if applicable): Police Department –

(787) 707-4911

9. CONFINED SPACE MANAGER’S NAME & CONTACT INFORMATION: Not designated. For questions or in emergencies contact QAE Brett Allen at (706) 545-8524.

10. RADIATION SAFETY OFFICER’S NAME & CONTACT INFORMATION: Not designated. For questions or in emergencies contact QAE Brett Allen at (706) 545-8524.

11. OFFICE/ORGANIZATION POC RESPONSIBLE FOR DIG PERMIT NAME & CONTACT INFORMATION: Not designated. For questions or in emergencies contact QAE Brett Allen at (706) 545-8524.

12. OFFICE/ORGANIZATION POC RESPONSIBLE FOR HOT WORK PERMIT NAME & CONTACT INFORMATION: Hot Work Permit Coordinator at (787) 707-5911.

13. LEAD & ASBESTOS POC NAME & CONTACT INFORMATION: Not designated. For questions or in emergencies contact QAE Brett Allen at (706) 545-8524.

ATTACHMENT 1

Emergency Contact Information

A copy of this form is to be posted near the site telephone and available in all site vehicles

ATTACHMENT 1EMERGENCY CONTACTSCamp Frank D. Merrill, Georgia

EMERGENCY CONTACTS AND PHONE NUMBERS

SERVICE

TELEPHONE NUMBER

Ambulance Service

Police (emergency/non-emergency)

Lumpkin County Police Department

911 / (704) 638-5333

Fire (emergency/non-emergency)

Lumpkin County Fire Department

911 / (704) 638-5352

Hospital: Northeast Georgia Medical Center 227 Mountain Drive, Dahlonega, GA 30533

(770) 219-9000

Contract Representative:

Benjamin Barclay

(214) 927-6606

Quality Assurance Evaluator (QAE):

Brett Allen

(706) 545-8524

WorkCare (Weston Occupational Medicine Provider)

Dr. Peter Greaney and Heather Greaney (Program Administrator)

From 6 am to 4:30 pm Pacific Time call 800-455-6155 and dial 0 for the Operator or ext. 475 for Heather Lind to request the on-call clinician.

4:31 p.m. – 5:59 a.m. Pacific Time, all day Saturday, Sunday, and Holidays call 800-455-6155 Dial 3 to reach the after-hours answering service. Request that the service connect you with the on-call clinician or the on-call clinician will return your call within 30 minutes.

(800) 455-6155 dial 0

(800) 455-6155 ext.: 475

WorkCare Delta Team:

Tony Vo – Account Manager

Felicia Sollo – Delta Team Rep.

You will be able to reach a WorkCare employee during weekdays between the hours of 7:30 a.m. and 7:30 p.m. Eastern Time Zone

800-455-6155 ext. 2111 (Tony Vo).

800-455-6155 ext. 2402 (Felecia Sollo)

If a member of Team Delta cannot be reached dial ext. 2110 (Paula Sandrock).

WESTON Corporate Environmental Health and Safety (West Chester, PA):

Herold Hannah

(610) 701-3024 (Office)

(267) 516-0274 (Cell)

WESTON Risk Management (West Chester, PA):

Steve Blarr

(303) 729-6103 (Office)

(303) 881-7260 (Cell)

WESTON Health and Safety MISHAPS Hotline 24-hr Health & Safety

1-855-MISHAPS

(855-647-4277)

Client or Media Contact:

Dennis Bacon

(256) 895-2528

WESTON Regional EHS Manager:

Russ Reynolds

(864) 906-7309 (Cell)

WESTON Program Executive:

Mark Starnes

(770) 325-7960 (Office)

(770) 329-8354 (Cell)

WESTON Project Manager:

Ken Coggins

(770) 325-7911 (Cell)

WESTON Task Order Safety Manager:

Don Glenn

(770) 377-4425 (Cell)

WESTON Task Order QCM:

Michael Wise

(318) 507-7516 (Cell)

WESTON Site Manager:

Erick Ruiz Herrera

(501) 533-7628 (Cell)

ATTACHMENT 2

hospital route

A map depicting the best route to the local hospital from the work site is provided on the following pages.

ATTACHMENT 3

SITE-SPECIFIC HAZARDOUS COMMUNICATION PROGRAM

SITE-SPECIFIC HAZARD COMMUNICATION PROGRAM

MINOR/EMERGENCY REPAIR AND MINOR CONSTRUCTION SERVICES

To ensure an understanding of and compliance with the Hazard Communication Standard, WESTON will use this checklist/document (or similar document) in conjunction with the WESTON Written Hazard Communication Program as a means of meeting site- or location‑specific requirements.

Although responsibilities for activities discussed in this document are the primary responsibility of the WESTON Site Safety and Health Officer (SSHO), it is the responsibility of all WESTON and subcontractor personnel to ensure compliance. Responsibilities under various conditions can be found within the WESTON Written Hazard Communication Program.

To ensure that information about the dangers of all hazardous chemicals used by WESTON is known by all affected employees, the following hazard communication program has been established. All affected personnel will participate in the hazard communication program. This written program, as well as WESTON’s Corporate Hazard Communication Program, will be available for review by any employee, employee representative, representative of Occupational Safety and Health Administration (OSHA), National Institute for Occupational Safety and Health (NIOSH), or any affected employer/employee on a multi-employer site.

|X|

Site or other location name/address:

Camp Frank D. Merrill, Georgia

|X|

Site/Project/Location Manager:

PM: Ken Coggins; SM: Erick Ruiz Herrera

|X|

Site/Location Safety Officer:

TOSM: Don Glenn, SSHOs: TBD on Service Order scope of work

|X|

List of chemicals compiled format: |_| HASP

|X| Other:

On-site binder in SM’s Vehicle

|X|

Location of SDS files:

On-site binder in Site Manager’s Vehicle

|X|

Training conducted by: Name:

Site Safety Officer (SSHO)

Date:

Daily

|X|

Indicate format of training documentation: |_| Field Log:

|X| Other:

Sign-in Sheet

|X|

Client briefing conducted regarding hazard communication:

Yes – Daily Safety Briefing

|X|

If multi-employer site (client, subcontractor, agency, etc.), indicate name of affected companies:

(Client, Subs, Agencies, etc.)

USACE-Huntsville, Camp Frank D. Merrill, Weston Solutions, Inc. and Subcontractors (TBD)

|X|

Other employer(s) notified of chemicals, labeling, and…