A01.07_Appendix_4_-_Environmental_Checklist_for_Cafeteria_at_Bldg_16.pdf

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:

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

a. Gut the entire kitchen including disconnecting and removing all kitchen appliances, ice machine, tables, faucets/fittings, sinks, walk-in cooler/refrigerator, freezer, commercial dishwasher and all existing equipment.

b. Remove and replace existing hood and ventilation system to include dry chemical.

c. Remove and replace existing ceramic tiles on walls and floors in the snack bar.

d. Upgrade/repair electrical service to include panels, light fixtures and all accessories to accommodate new high-capacity equipment.

e. Upgrade/repair plumbing/ sewage system to repair blocked drains.

f. Replace ceiling tiles in the dining room.

g. Remodel existing toilet in the kitchen snack bar area. Replace wall/ floor tiles and fixtures and repaint walls.

h. Replace all of the access doors.

i. Heavy/deep clean the dining area including floors and walls at men's and women's restrooms.

j. Paint or touch up the walls in the entire cafeteria.

2. Please email the Air Quality Program Manager the BTU ratings of the MAUs and the ice machine's R-404A refrigerant total charge in pounds. Also, email the refrigerant types and charges of the refrigerator units. -LB

3. Should any pest infestation be discovered during work contact the Installation Pest Mgt Coordinator at 209-839-4862 or 4065. -LB

4. Ensure proposed floor drains have mesh screen to prevent pests such as cockroaches from entering kitchen. -SG

5. Ensure existing backflow prevention device/s is/are adequate or ensure a central backflow prevention device is installed for all new water piping and appliances. -SG

6. No NEPA and/or Natural/cultural issues noted. -SG

7. Adhere to the Depot general environmental controls document. -SG

8. Maintain a hazardous material inventory list; ensure SDSs are available. –EM

9. Store hazardous material in accordance with state and federal safety and environmental regulatory requirements. –EM

10. Remove all fluorescent tubes from existing fixtures and handle, package and store removed fluorescent tubes in a manner that will prevent damage. –EM

11. If fluorescent tubes (if equiped) are considered waste then dispose of in accordance with State Universal Waste management and manifesting requirements. -EM

12. Inspect old ballast for PCBs. If contains PCBs, remove ballast from existing fixtures and dispose of ballast in accordance with State regulatory hazardous waste requirements. –EM

13. Coordinate with Property Accounting Officer when turning in equipment items and real property into DLA Disposition Services. –EM

14. All hazardous waste manifests and BOLs must be reviewed and certified by the environmental office. –EM

2. Submit Injury Illness and Prevention Plan. KS

3. Submit OSHA 300 log if has 10 or More Employees. KS

4. Submit Safety Data Sheets for any chemicals that will be used during the project. KS

5. Delineate work site to keep personnel form entering hazardous construction areas. KS

6. Adhere to NFPA 70E for electrical work if any (LOTO, PPE, ETC.) KS