Fillable Consolidated Emergency Response / Contingency Plan Template (Page 2 of 4) in pdf

CERS Consolidated Emergency Response / Contingency Plan – Page 2 of 4

Rev. 06/27/11

D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES

SPILL PREVENTION, CONTAINMENT, AND CLEANUP PROCEDURES: (Check all boxes that apply to indicate your procedures for containing spills, releases,

fires or explosions; and. preventing and mitigating associated harm to persons, property, and the environment.)

D1.

1. MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP, ETC.;

2. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e.g., Portable spill containment walls);

3. PROVIDE ABSORBENT PHYSICAL BARRIERS (e.g., Pads, pigs, pillows);

4. COVER OR BLOCK FLOOR AND/ OR STORM DRAINS;

5. BUILT-IN BERM IN WORK / STORAGE AREA;

6. AUTOMATIC FIRE SUPPRESSION SYSTEM;

7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS (e.g. Flammable liquids, Propane);

8. STOP PROCESSES AND/OR OPERATIONS;

9. AUTOMATIC / ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM;

10. SHUT-OFF WATER, GAS, ELECTRICAL UTILITIES AS APPROPRIATE;

11. CALL 9-1-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE / MEDICAL AID;

12. NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AREAS;

13. ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION CALL;

14. PROVIDE PROTECTIVE EQUIPMENT FOR ON-SITE RESPONSE TEAM;

15. REMOVE OR ISOLATE CONTAINERS / AREA AS APPROPRIATE;

16. HIRE LICENSED HAZARDOUS WASTE CONTRACTOR;

17. USE ABSORBENT MATERIAL FOR SPILLS WITH SUBSEQUENT PROPER LABELING, STORAGE, AND HAZARDOUS WASTE DISPOSAL AS

APPROPRIATE;

18. SUCTION USING SHOP VACUUM WITH SUBSEQUENT PROPER LABELING, STORAGE, AND HAZARDOUS WASTE DISPOSAL AS

APPROPRIATE;

19. WASH / DECONTAMINATE EQUIPMENT W/ CONTAINMENT and DISPOSAL OF EFFLUENT / RINSATE AS HAZARDOUS WASTE;

20. PROVIDE SAFE TEMPORARY STORAGE OF EMERGENCY-GENERATED WASTES;

D2.

21. OTHER (Specify):

E. FACILITY EVACUATION

THE FOLLOWING ALARM SIGNAL(S) WILL BE USED TO BEGIN EVACUATION OF THE FACILITY (CHECK ALL THAT APPLY):

E1.

1. BELLS;

2. HORNS/SIRENS;

3. VERBAL (I.E., SHOUTING);

4. OTHER (Specify):

E2.

THE FOLLOWING LOCATION(S) IS/ARE EVACUEE EMERGENCY ASSEMBLY AREA(S) (i.e., Front parking lot, specific street corner, etc.)

E3.

Note: The Emergency Coordinator must account for all on site employees and/or site visitors after evacuation.

E4.

EVACUATION ROUTE MAP(S) POSTED AS REQUIRED

Note: The map(s) must show primary and alternate evacuation routes, emergency exits, and primary and alternate staging areas, and must be prominently posted

throughout the facility in locations where it will be visible to employees and visitors.

F. ARRANGEMENTS FOR EMERGENCY SERVICES

Explanation of Requirement: Advance arrangements with local fire and police departments, hospitals, and/or emergency services contractors should be made as

appropriate for your facility. You may determine that such arrangements are not necessary.

ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (Check one of the following)

F1.

1. HAVE BEEN DETERMINED NOT NECESSARY; or

F2.

2. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (Specify):