Dd Form 2993 - Environmental Baseline Survey (Ebs) Checklist Page 19
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b. INDUSTRIAL OPERATIONS IN SURROUNDING AREA
(Describe nearby industrial operations [for example, power plant or factories]. What is approximate distance from camp boundary? What can be observed from
camp: smoke, odors, and so forth? Include 8-digit grid coordinates of each facility, name of industry, type of industry, and active or inactive. Provide a description
of the facility - if processes are present, material used and stored, operating schedule, and environmental impacts. Take photographs.)
North of Site
South of Site
East of Site
West of Site
c. SPECIFIC NEARBY INDUSTRIAL FACILITIES
(3)
(1)
(5)
Type of Industry
Location
(2)
(4)
Description
(For example, power
(8-digit grid
Name
Active?
(Describe facility, processes present, material used and stored there,
production, petrochemical,
coordinates.)
operating schedule, environmental impacts, and so forth.)
or agricultural. )
8. INFORMATION SOURCES AND SUPPORTING DOCUMENTS
(Document sources of information gathered. Provide summaries of environmental sampling and studies, aerial photographs, topographic maps,
previous environmental baseline survey or Occupational and Environmental Health Site Assessment referenced, base camp master plans, and other
documents reviewed. Document personnel interviewed by providing their name and contact information for verification, if necessary, as well as the
name of the interpreter if one was used.)
a. SOURCES OF INFORMATION (Who did you talk to or interview? How can they be contacted again? Attach interview notes.)
PERSONNEL CONTACTED
(2)
(1)
Contact Information
(3)
(4)
Name
(Address, telephone number, e-mail, and
Title
Location
so forth.)
DD FORM 2993, AUG 2015
Page 19 of 20 Pages
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Parent category: Business