Attachment_5_Environmental_Checklist.pdf
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- SP330017B0014
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Defense Logistics Agency Distribution
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Attachment 5 - Environmental Checklist
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ENVIRONMENTAL, SAFETY & INDUSTRIAL HYGIENE
CHECKLIST
Project proponent completes all sections. Please print clearly or type. Submit to Environmental, Safety & Occupational Health Division for review. Any questions Call ESOH Division Chief: 839-5537.
Section 1: General Information Project# Date:
Project Title:
Phone:
Phone:
Proponent/Department:
Project POC:
Section 2: Project Information
Planned Start Date: Planned Completion Date:
Purpose of the project (include any description of operations, functions, and activities associated with the project which will change or occur due to the project):
Attach any Statement of Work, Maps, Drawings or other relevant information.
ESOH Checklist Page 1 of 3 16 Jun 2015
Describe the location and area of the proposed project:
Section 3: Specific Project Questions (Check positive responses.)
Facility/Building demolition, renovation, alteration or retrofit?
Installation, repair or removal of fuel storage tanks or distribution facilities?
New heating units or boilers?
Emergency generators or other stationary internal combustion engines?
New sources of air emissions (e.g. paint booths, blasting operations)?
New drinking water services?
Generation or Disposal of domestic wastewater (e.g. rinsewater, washdowns, pressure washing, etc.)?
Installation or removal of potable water backflow prevention devices?
Use or storage of Hazardous materials:
Concrete?
Disposal of Solid wastes such as:
Asphalt?
Topsoil?
Electrical equipment?
Recyclable materials (e.g. steel, cardboard, wood, etc.)?
Asbestos or Asbestos containing building materials?
Disturbance or use of Hazardous substances such as:
Mercury?
PCBs?
Lead Based Paint?
Other?
Cleaners or solvents?
< 1 acre?
Hazardous material storage required?
Storage of HM more than 55 gal?
Will there be temporary or permanant storage of HM?
Potential to cause any concerns from the neighbors (e.g. dust, noise > 70dB, view)?
ESOH Checklist Page 2 of 3 16 Jun 2015
Project located in area of Land Use Controls? (See Appendix G Real Property Master Plan)
Cumulative excavation, trenching, or disturbance of soils?
> 1 acre but < 5 acres?
> 5 acres?
Environmental Requirements/ comments:
Date:
ENVIRONMENTAL, SAFETY & INDUSTRIAL HYGIENE
REQUIREMENTS
This page to be completed and returned by the Environmental, Safety & Occupational Health (ESOH) Division.
ESOH Checklist Page 3 of 3 16 Jun 2015
ESOH Officer review
Project#
Project Title:
While performing work at Defense Distribution Depot San Joaquin the contractor shall comply with all Federal, State and Local environmental protection and safety laws and regulations, the controls of this document, and all specific requirements stated elsewhere in contract specifications.
Safety & Industrial Hygiene Requirements/ comments:
IMPORTANT: YOU MUST CONTACT THE HW PROGRAM MANAGER, ED MCNAIR, PRIOR TO SETTING UP ANY HAZARDOUS WASTE ACCUMULATION/COLLECTION POINTS.
HW Generator Contact Information:
Edward McNair
Hazardous Material Hazardous Waste Program Manager and Hazardous Waste Manifest Certifier
Office phone number: (209) 839-5539 or 4528
Mobile phone number: (209) 507-1432
Fax number: (209) 839-4949
Email: edward.mcnair@dla.mil
Generator Manifest Information:
EPA ID:
CA4971520834
Generator’s Name and Mailing Address:
Defense Distribution Depot San Joaquin – Tracy Site
Attn: Environmental Office, P.O. Box 960001, Bldg 235
Stockton, CA 95296-0710
Generator’s Phone: (209) 839-5539
Generator’s Site Address:
Defense Distribution Depot San Joaquin – Tracy Site
25600 South Chrisman Road
Tracy, CA 95304
ENVIRONMENTAL, SAFETY & INDUSTRIAL HYGIENE
CHECKLIST
Project proponent completes all sections. Please print clearly or type. Submit to Environmental, Safety & Occupational Health Division for review. Any questions Call ESOH Division Chief: 839-5537.
Section 1: General Information Section 2: Project Information Purpose of the project (include any description of operations, functions, and activities associated with the project which will change or occur due to the project):
Attach any Statement of Work, Maps, Drawings or other relevant information.
ESOH Checklist Page 1 of 3 16 Jun 2015 ..\My Pictures\dlalogo.jpg Describe the location and area of the proposed project:
Section 3: Specific Project Questions (Check positive responses.)
Use or storage of Hazardous materials:
Disposal of Solid wastes such as:
Disturbance or use of Hazardous substances such as:
ESOH Checklist Page 2 of 3 16 Jun 2015 Cumulative excavation, trenching, or disturbance of soils?
..\My Pictures\dlalogo.jpg
ENVIRONMENTAL, SAFETY & INDUSTRIAL HYGIENE REQUIREMENTS
This page to be completed and returned by the Environmental, Safety & Occupational Health (ESOH)Division.
ESOH Checklist Page 3 of 3 16 Jun 2015 While performing work at Defense Distribution Depot San Joaquin the contractor shall comply with all Federal, State and Local environmental protection and safety laws and regulations, the controls of this document, and all specific requirements stated elsewhere in contract specifications.
8.2.1.4029.1.523496.503679
| TextField1: P.2017.01238 |
| DateTimeField1: 2017-06-01 |
| DateTimeField1: 2017-12-05 |
| DateTimeField1: 2018-07-05 |
| TextField2: Paint Interior Office Walls and Adjacent Areas @ Bldgs. 13, 14, 15, 16B-3, 17, 20, 21, 22, 28, 29-1, 201, 231, 247, 255 |
| TextField12: |
| TextField3: 209-839-4238 |
| TextField4: DS-FJIF |
| TextField4: Vivien Malazo |
| TextField6: Contractor is to furnish all labor, material, equipment, transportation, supplies and supervision necessaryto paint the interior walls of offices and adjacent areas on Buildings listed below: |
1. Paint the interior walls of offices and adjacent areas of Buildings 13, 14, 15, 16B-3, 17, 20, 21, 22, 28, 29-1, 201, 231, 247, 255, including surface preparation, primer (where needed), and finish coats of paint.
2. Paint hallways and exit doors at Buildings 13, 15, 20, and 28 including surface preparation, primer (where needed) and finish coats of paints.
3. Perform LBP abatement where needed.
4. Surface Preparation Procedures shall include, but not necessarily be limited to, the following:
a. Cleaning - Clean down and remove oil, grease and loose foreign matter, including, mold mildew, dirt and corrosion products, in a manner which causes neither undue damage to the substrate nor damage to, or contamination of, the surroundings or the paint system to be applied;
b. Glossy Surfaces - Adequately scuff and/or solvent or chemically etch as appropriate to provide satisfactory adhesion for subsequent paint coats;
c. Filling - Fill cracks and holes with fillers, sealers or grouting cements as appropriate for the finishing system and substrate, and sand smooth, to ensure all coats finish smooth;
d. Drying - Unless otherwise specified, ensure that surfaces are cured before applying additional coats of paint;
e. Tape non-painted surfaces adjacent to areas of painting to ensure that no brush or roller marks appear on doors, wood frames, or stone floor and skirting. Place painting canvas and tarps to prevent drip marks or spills onto carpet or stone floors.
f. Light sand away runs or rough surfaces noted between coats.
| TextField5: Buildings 201, 231, 247 & 255 are on Ennis Drive; Buildings 15 & 28 are between 'B' St. and Ennis Drive and 7th & 12th Streets; Buildings 16B, 19, 21 & 22 are between B and C Streets and 7th and 11th Streets; Buildings 13, 14, 17, 20 are between C and D Streets and 5th and 9th Streets; Building 29 is on D Street adjacent to Valpico Gate Entrance. |
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| TextField11: 1. Should any pest infestation be discovered during work contact the Installation Pest Mgt Coordinator at 209-839-4065 or 4862. -LB |
2. All construction equipment needs a thorough cleaning before entering DDD San Joaquin to eliminate the potential of invasive vegetation, from previous off depot work sites, migrating onto the Depot. -LB
3. Paint material being applied must meet San Joaquin Valley Air District Rule R4601 standards and not be thinned with VOC-containing material to exceed those standards. Paint and paint thinner containers (drums, buckets, cans, pails, trays, or other application containers) shall be closed when not in use to limit VOC emission. -SG
4. If abrasive blasting lead-based paint follow air pollution standards and requirements in Title 17 of the California Code of Regulations, sections 92000 through 92520. Use controls to limit fugitive dust if mechanically sanding lead-based paint. -SG
5. Portable equipment with internal combustion engines >50 bhp must be registered with either CA State or the San Joaquin Air Pollution Control District. Maintain all applicable registration documentation upon entrance to the installation. Portable generators <50 BHP must meet CA State emissions requirements. -SG
6. Removal of Hazardous Waste, Non-RCRA Hazardous Waste, Non-Regulated Hazardous Waste and Universal Waste: All Manifest, Non-Hazardous Waste Manifests, Special Waste Manifests, Straight Bill of Ladings will be signed by Environmental Office (DS-FJEE) personnel only; must distribute all Hazardous Waste Manifest through the Environmental Office (Ed McNair @ 209-839-5539) for Generator signature; provide advance copy of Manifest 5 days prior to hazardous waste shipment/pick up date. -EM
7. Package, mark, label and store hazardous waste in accordance with federal, state and local regulatory requirements; must coordinate hazardous waste accumulation point setup with the Environmental Office (Ed McNair @ 209-839-5539). -EM
8. Store hazardous material in accordance with state and federal safety and environmental regulatory requirements.
9. Maintain a hazardous material inventory list; ensure SDSs are available. -EM
10. Must refer to Generator's information contained in this package. –EM
11. Coordinate with Recycling Coordinator for the proper recycling of recyclable materials. -EM
12. There are no concerns from an Installation Restoration perspective. JP
13. No Natural/cultural issues noted. JP
14. No water quality issues noted. JP
15. This action is Is categorically excluded under NEPA in accordance with the provisions of Categorical Exclusion (CX) as listed in 32CFR Part 651 Appendix B section II (g)(1). JP
| SignatureField1: |
| TextField14: 1) Contact Bob Miller, contracted CIH, for lead and asbestos sampling results for each area being painted. KEM |
2) Ensure adequate ventilation when applying cleaners/solvents/paints. KEM
3) Submit copies of and have available Safety Data Sheets for all painting and cleaning products used on this project. KEM
4) Clearly delineate work zone with barriers/signs, etc. to ensure San Joaquin Employees do not enter hazardous areas. KEM
5) Proper PPE must be worn at all times. KEM
6) Contractor must have a written Injury and Illness Prevention Program (IIPP). This is a California requirements. For help in developing a plan go to http://www.dir.ca.gov/dosh/etools/09-031/index.htm. KEM
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