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Home My WebLink AboutSLOUNIFLOW_FS1 Admin iRC3926i Color_1473_001 rpt1wrwval-l0m rurF60)w-ffim Project No. 2018-27 PROJECT SUilMARY REPORT for ATOLL HOLDINGS, LLC 1150 Laurel Ln, San Luis 0bispo, CA 93401 APN 004-962-019 UNDERGROUND STORAGE TANK REMOVAL ASBESTOS SURVEY & DEMOLISH T},IO COI,IIIIERCIAL STRUCTURES 244 E. Princeton ave. Fresno, California 93704 wi t t i am sexg3li31lya h oo. co m PR0JECT SIIA{ARY REPORT for AT0LL 1150 Laurel Ln, San Luis 0bispo, H0LD}U0, cA 93,401 LLC T <-> APN 00/t-962-018 T*sr"E oF Co!ffEstrs .'':,COVER LETTER ;'t REGULATORY PERMITS ASBESTOS & LBP REPORT SITE HEALTH & SAFETY PLAN },ASTE I.IATER ANALYSIS S0IL AI,IALYSIS REP0RT C$4PACTION TESTING REPORT REGULATORY INSPECTION REPORTS TANK DISPOSAL REPORT HAZARD0US hIASTE MAI'IIFESTS I I -t I Project No, 2018-27 PROJECT SU}tr{ARY RTPORT for ATOLL HOLDINGS, LLC 1150 Laurel Ln, San Luis 0bispo, CA 93401 APN 004-902-018 UNDERGROUND STORAGE TANK REMOVAL ASBESTOS SURVEY & DEMOLISH TI.IO COMMERCIAL STRUCTURES I _t I {-l i .,1 E I I I -t I .t I lJ I-i l I j 1 .,1 I lJ i 0tr wL?gl-l 0m ilxwwl{xim November l, 2018 Project Nq. 2018-27 Mr. Hank Harbor ATOLL HOLDIiIGS, LLC 11S0-Laurel Lane San Luis Obispo, CA 93401 RE (USTR) Underground Storage Tank Removal, Asbestos Survey & Demolish Two Cormercial Structures at 1150 Laurel Lane, San Luis Obispo, Callifornia City of San Luis 0bispo > B&SD > Perfii.t No. Demo 1817-2018 & Permit No. Grad-l710-2018 City of San Luis 0bispo > Fire Dep.t Per.mit No. Fire-1708-2018 (USTR) Dear Mr. Harbor; Please find enclosed tno copies of the (final) project summary report preparedfor the above-referenced addre.s. If you have any questions regarding, this report, or the project in general, please contact us at your convenience. Sincerely, censee enclosure Jt{/cm Presi 244E. Princeton ave. Fresno, CaliforniaWTA wi lliamsexffi on@yahoo. com +! CONTRI\CTORS STATE LICENSE BONRD STATE OF CALIFORNIA A HHI, Punsuant b Chapbr 9 of Divislon 3 of he Business and hohssions Code and the Rules atd Reguhtions of frF Conhadorc Shb Ucense Board, the Regisharof Oonbactors does hereby lsenre tris lkEnse to: JIMMY THE JUNKER INC dba WLLIAMS EXCAVATION Rmsslgned License Number g'lffil to erqage ln ttre business or act in tre capaoity of a canhactor inthe following dassifications: A - aeNeRru- ENctNEERiNa cownAcroR ASB - ASBESTOS C21 . BIJLDING MOVING. DEMOLITION HM.. HAZAHDOUS SUBSTANCES REfiIOVAL e $litness my hand and sealthis dayi September 11,2015 lssued January 13, 1976 Rebsued Septemfer fO, aOt S e@ L Eddie Lang, Jr., Board Chair This llcens iE fie proparty of $e Rogisbgr of Contractofs, is nottan$erable, and shall be reumed to lhe Begistrar upon dernand vuhen suspende4 revoked, or hvalldatsd fur eny reason lt beconres rold if not ronamd. CIndi A. Christenson, Registrar of Contractors -t STATE ?f CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIMSION OF OCCUPATIONAL SAFEW AND HEALTH Permit tssued ro ANNUAL PERMIT (lnsert Contractor/Project Administrator's Name, Address and Telephone No.) lr^'y-t The Junker lnc dba Wiiliams Excavatiol 'Attn: Safety Mgr or Jim Williams 244'E Princeton Ave Fresno CA 93704-SZ2A , No: 2017-909553 i.No. I j i.Date 112512018 l'Region !District -,Tel. 2 5 I Gsgl zzz-toeo (55e) 445-5302 Type of Permit T1 TRENCH/EXCAVA Pursuant to Labor Code Sections 6500 and 6502, this Permit is issued to lhe above-namaod employer for the proiects described below. This Permit is issued upon the following conditions: 1. That the work is performed by the same employer. lf this is an annual permitit the appropriate District Office shall be notified, in writing, of dates and locatlon of Job site prlor to commencement. 2. The employer will comply with all occupational safety and health standards or'r orders applicable to the above projects, and any other lawful orders of the Division, 3. That if any unforeseen condition causes deviation from the plans or statemennts contained in the Pernit Application Form the employerwill notiff the Division immediately. 4. Any variation from the specification and assertions of the Permit Application f .t:orm or violation of safety orders may be cause to revoke the permit. 5. This permit shall be posted at or near each place of employment as provided I in 8 CGR 341-4 Received From JimWilliams lReceived By I Permit Unit trK Cash ghss( 4042 Amount $100.00 loarc l r,ru,,8 lnvestigated by 1t2st2018 Date State Conlractofs License Number 3',14407 Permit Vtalid through January 25,2A19 Description of Project Location Address City anrt'{ Coung Anticioated Dates .Rlartinn Comnletion Various Conditions of lssuance:Statewide Jan 25, 2018 Jan 25, 2019 L'V Approved by Manager/PermitUnit Date USAN Ticket Information Message Number: W82360024I-00W Received by USAN at 10:34 on 0B/24/18 by MHS Work Begins:. 0B/28/IB at 17:01 Night: NO lleekend: NO Expires: 09/21/LB aL 23:59 Notice: 26 hrs Priority: NORM Update By:. O9/I9/ 18 at 00:00 Page 1 of2 I 't Caller : JIM WILLIAMS Conpany: WILLIAMS EXCAVATION Address: 244 E. PRINCETON AVE City : FRESNO State: CA Business Phone: 559-978-5163 E-MaiI : williamsexcavationGyahoo . com CaII Reguested: NO Work order * / toA *: zip'.93704 Fax Fie1d Meet: NO Emergency: NO County: SAN LUIS OBISPO State: Lat: 35.2681 Long: -120 .6411_59 Nature Of lfork: EXCAVATOR TO ]NSTALL FUEL TANK Done For: ATOLL HOLDINGS LLC Explosives: NO Foreman: CALLER Ce1l TeI: 559-978-5163 Area Pre!trarked: YES Prenarked Method: WHITE PATNT Permit Type: CITY Number: UNK lyag /Pwr Eguip Use In The Approx Location Of Member Facilities Requested: N Excavation Enters Into Street Or Sidewalk Area: NO Location: Street Address : 1150 LAUREL Cross Street : ORCUTT RD 2nd Cross Street: Locate: REAR OF ADDRESS LN P].ace: SAN LUIS OBISPO Long: -I20 .63'125L CA Lat: 35.258219 ) Conments: PLEASE CONTACT CUSTOMER FOR GATE CODE TO ACCESS STTE Sent To: ATTCAL : AT&T TRANSMISSION CALIFORN]A CHASLO SAN LUIS OBISPO DIGWtrS : DIGITAL WEST NETWORKS, INC. trMLCFM LEVEL3COMM-CALIF MCIWSA : MCI WORLDCOM PACBEL DISTR SAN LUTS OBISP SCGSLO : SO CAL GAS SAN LUIS OBISPO SLOUSD SPRINT SPTTtrL : OWEST COMM (CA) Member Utility Main Contact # vacuum Contact *ArrcAL 113-660-2060 800-252-1133 3624 CHASLO 805-431-3047 30 41 crysl,o 805-781-7034 805-187-13r2 't372 DIGWES EMLCFM LEVCAL 120-BBB-2945 303-992-993r 4231 MCTWSA 469-866-4224 96"1 5 PACBtrL 570-645-2929 732r PGESLO 805-546-3873 800-743-5000 5000 SCGSLO B1B-700-3683 805-1Br-2452 : CHARTtrR COMM SLO : EMAIL CONF]RM QUtrUE : PACTFTC BELL : SLO UNIF]ED SCH D]ST # Energency Contact # 800-24r-3624 805-431-3947 805-781-?215 800-283- 4231 800-624-961 5 570-645-2929 800-743-5000 818-701-3360 After Hours Contact 800-241- 805-431- 805-781- 800-283- 800-624- I00-332- 800-743- B1B-701- CTYSLO : CITY LEVCAL : PGESLO : PGE SPRINT : ii, li \t.'|i ' '.. http : //newtin. usan. org/newtinweb/usan-singleticketlookup.html 912U20t8 USAN Ticket Information B 00-52 1- 800-283- -P;age 2 of 2 33 60 SLOUSD 595 0 SPRTNT 057 9 SPTTEL 4237 I 0 5-5 4 3-B 4s0 913-794-5141 800-283-4237 8q5-712,= J I J I J J J I 0 0-52 1-0s7 9 B 00-52 1-057 9 http : //newtin.usan. org/newtinweb/usan-singl eticketlookup.html " lt, l* f*r..1t''., 9/2U2018 I I Ticket Response Inquiry Page 1 of2 DIg Ticket Response Inquiry Ticket responses retrieved through this program are provided by participating utility owners and/or their authorized agents. Please note: Electronic Positive Response is a voluntary action for utility members, and not all utility members participate in the program. If a utility member does not post a response to your ticket through the electronic positive response program, it is your responsibility to ensure that you have received a response from the utitity member before beginning excavation work (paint markings in the field' email confirmation, phone confirmation, etc). USA North 811 assumes no liability for the provided response. Please enter your nine digit ticket number which will start with a W or X. Ft?gqqq i;q,ii; I Information for ticket w823600241 Work Date Response Due County Place Street Address 08/28118 17:01:00 08/28/18 17:01:00 SAN LUIS OBISPO SAN LUIS OBISPO 1150 LAUREL LN I l Responses for ticket w823600241 Member Name Type Revision Response Description DIGITAL CLEAR - DrcwES ST$o*"s, NEw oow oo1 No tNC. r:v' CONFLICT LEVEL3 CLEAR- LEVCAL COMM - NEW OOW OO1 NO CALIF CONFLICT CLEAR. PACBEL it;ft" NEw oow oo1 No CONFLICT CLEAR - SPRINT SPRINT NEW OOW OOl NO CONFLICT Response date 08/28/1 8 l4:22:16 By Comments WEBTMS:MWEDDIGE 08/2811 8 11:25:40 AAA UQ Responder08127118 12:.50:-19 081241t8 l0:40:13 Ard{ NORTH. 'i MBRCOD 00001 USANK 09/21/IB 2I:08:.23 W823600241-00w NORM NEW POLY LREQ Message Number: w823600247 Rev: O0W Received by USAN at 10:34 on 0B/24/fB Work Begins: 08/28/18 at 17:01 Notice: 026 hrs Niqht Work: Weekend Work: Explres: 09/2L/LB at 23:59 Update By: 09/79/18 at 00:00 Call Requested Prior.ity:2 Caffer: Company: Address: 9aLy. Bubiness Tef: Emaif Address JIM WILLIAMS WILLIAMS EXCAVATION 244 E. PRINCETON AVE. FRESNO 559-978-5163 williamsexcavationGyahoo . com State: CA Zip: 93704 Fax: I l l ) Nature of Work: trXCAVATOR TO INSTAI,L FUtrL TANK Done for: ATOLL HOLDINGS LLC Explosives Eoreman: CALLER Celf Tef: 559-978-5763 http://newtin.usan.org/newtinweb/gen_resp inquiry.nas 9t2!2018 I 'l ', I I ,-t I I I I -t I I 'iI 'l ,| I t 1 ,tl I I j T't J :j .t J I t'l + j ,I J 1 J TicketResponse Inquiry Area Prenarked: Y Prenark Method: WHITE PAINT Permit Tlpe: CITY Nunber: UNK yac / pwr Equip Use In The Approx Location Of Member Facilities Requested: N Excavation Enters fnto Street Or Sidewalk Area: N Location: Street Address: 1150 LAUREL LN Cross Street: ORCUTT RD Page2 ot2 Comments: PLEASE CONTACT CUSIOMER FOR GATE CODE TO ACCESS SITE REAR OF ADDRESS Place: SAN LUIS OBISPO Long/T,at Long: -120.637251 Lat County: SAN LUIS OBISPO State: CA 35.258279 Long: -120.647159 Lat: 35.268100 CHARTER COMMUNICATIONS SLO DIGITAL WEST NETWORKS, INC. MCI WORTDCOM PGE DISTR SAN LUIS OBISP StO UNTF]ED SCH DIST QWEST COMM (CA) Sent to: ATTCAI : CTYSLO = LEVCAL = PACBEL : SCGSLO = SPRINT : AT&T TRANSMISSION CALIFORNIA CHASLO CTTY SAN LUIS OBISPO DIGWES LEVEL 3 COMM - CALIF MCIWSA PACIFTC BEIL PGESLO SO CAL GAS SAN LUIS OBISPO SLOUSD SPRINT SPTTEL * http://newtin.usan.org/newtinweb/een resp inquiry.nas NORTH 9121120t8 I --l i -t I I BUSINESS LICENSE ANTD TAX CERTIFICATE Thts llcerlg€ doai nol cotlsblhrb ptool of comdlanca wi& olhet cily, couttty, 9tato, and bdgral r€gulauons. .Possasslon of lhts buslrFss [censs and Utr oodficde do.* not 6uthoriz6, pomlt, or allde lhe boar€r to do an, acl $hl$ boatgr ruqtd not olhanflko bo l.rrvfully entifled to db. .]hF lloens€ b l6s|led unhout \toti[catlqn lft8t tfte blislness B subJarc't lo or.exetnpt frojn [censh! by lho €ilala ol Catbmla Buslnsss N.mo: Williams Excavatlon WLUAMS EXCAVATION 244 EPRINCETONAVE FRESNO, CA937W5223 NOTTRANSFERABLEPLEASE POSTIN A CONSPICUOUS PLACE City of San Luis Obispo 9g) Palm Sil., San Luis Obbpo, CA S84034112 t8o5) 781-7{34 115217 029 Demolition & EnvironmEntal (Xeanup August23,2018 June 30, 2019 Buslnrss Looaton: lst oiirn8r itamsi 2ndOwnerl&nE: 2,14 E PRINCETONAVE FRESNO, CA 9370+5223 CERTIFICATEilO. BrnlnosstYpcl De3orlpffon: EftG!fircm: E:<plirdonffi: I -l J I J j Print Window https://mail.yahoo.com/d/folders/ I /messages/AL5EO-BRFIi3 WwRU.. Pemit No. EIRE - 1708-2018 subject1150 Laurel Lane, San Luis Obispo, CA. Underground Storage Tank Removal Permit Application; Permit Fee; and Related Details From: kboyle@slocity.org To: williamsexcavation@yahoo.com Date: Tuesday, May 22,2018, 10:32:54 AM PDT Good Morning Mr. Williams: I am sorry about the tardy response to your questions. I will be sending you the permit application shortly via e-mail attachment. Here are the important items you need to know: 1. Please send a copy of your SLO City Business License. 2. Please complete the UST Application for Permit for Permanent Closure. 3. The permit fee for UST removal is $4,551.05 made payable to "City of San Luis Obispo". Send the permit fee and the completed permit application to my attention at the address below. 4. Please send a copy of your Contractors State License along with the Hazardous Substances Certification. Also include the Workers Compensation certiflcation and your insurance. 5. Plans must be submitted to our Building Division to provide a scope of work and to obtain a "Grading Permit" ontact our localAir Pollution Control District to obtain a permit from them (805) 781-5912. to have an Underground Service Alert delineation of underground utilities (gas; electrical; fiber optic; telephone; sewer; water) 8. Provide hazmat training certifications for Dft\)e tJt$m;rs\- tF\$f ' A(t any employee working on this project Boo,r?p \o No work on the tank can begin until the permit is issued, and I will generally be on site for much of the time so be sure to alert me when work is to start. Thank you, Kerry Kerry Boyle Hazardous Materials Coordinator crrror sflnI,rffsoBrsm Fire Department Fire Prevention 2160 Santa Barbara Avenue, San Luis Obispo, CA 93401-5240 E kboyle@slocity.org T 805.781.7383 c 805.431.4437 ris!iiru!+ lofl 8114/2018';11:20 AIv I I -l Permit No.nQE -l1sY'&){&, San Luis Obispo City Fire Deparment 2160 Santa Barbara Avenue, San Luis Obispo CA 93401 805/781-7380 APPLICATION FOR PERMIT FOR TEI\{PORARY ORPERMANENT CLOST]RE/REIVIOVAL OF TJNDERGROI]ND HAZARDOUS STIBSTANCES STORAGE FACILITY Type of Application (FiU out one applicationper facility) [ ] Tenrporary Closure [ ] Pernanent Closure $"tou.r A. Facility Name:*o,o Address Telephone (days) Owner:A*ro Address: P5Plrvr ContactPerson: ( )f f, tJ (trights) I t"asr p 8- 3 : 9-3^{u t Operator; Address: 'lo-3b\ts l\Sc'L t ^.\ \-,-,!Ls t3{u ta Date Tank Insalled:Volume in Gallons: B. Water to Facility Provided by:C trll Depth to Groundwater: 5u \ Basis of Determiuation, €DesnL5 c.Tank Removal Contractor: tDtt$, Afrt Fxc+*uft gL License No. 3 t{t{or Address: Proposed Starting Date: Ilsurer D. Chemical Composition of Materials Stored: z. 1\ ss?"8rsn6$S Tank # I courmon Dates Stored l96u to4'stS Size Previous Chemical ?"'d "J l .J E. ['inal Destination of Tanlc: j'l ts J. ClteUcF A&Rc)X\rs trtlrslp,,, Cx 9s-t>s = I Untitled Map Write a description for your map.Legend of tank(s) if Applicable: Date: Attach Plot plan Showing: -loc,ation of all tank(s) and piping and their secondary conrainment Leak detection system _Ourrfi ll protection system Scale _North arrow Property line _Nearest intersection or road Equipment sumnary Existing equrpment and equipment to be removed. [S"A [] Fiberglass CoatedSreel [] Other I I Other I I Steel [ ] Fibergtass Coated Steet XOOq q}$O$Ut Was any part of the system cathodicallyprotec{ed? N}5If yes, which part(s)? Describe leak-detection system used,if t\9ur= Describe overfill protection system used:L\ta COMPIfrTED (INDERPENALTY OF PEKTURY AND TO THE BEST 1TRUE AT,TD CORRECT. J \\l\,AS1/ Date TIRE DEPARTMENT USE OI{LY Describb Method for Retrieving Saarples Samples Will be Analyzed For: taboratory That Will perform Analysis: Address: F. G. I l H.Type of Primary Containment: [ ] Concrere '[ ] Fiberglass {ipjnglMaterials of Consrrucion : &.$teel I J Fiberglass Tlpe of Secondary Conainment: [] Concrete [] Fiberglass I. J. K. THIS FORM HAS BEEN OF MY KNOWLEDGE IS -J H:FDY2694l9S 11.-L { J':\t$1'F...icilci\i si-lAtl tsE {N ijl 1 g c4lrFoqi\ti,*, SuiLDl$tG ccDE ?1,'l FESISENTL{L 1/VITH SHAILSOMPY 80 PSt 1.5 gPM @ 6G P$t { gd:F,"rui"} S{$Ti.}lG htffif frFL{*F {Elvb-:cff_Tts REUiFJtr Gsi i'fitAfi- *ifiS3ATG SE ffES#C4#il. AHflii-*[,F*T H.#T. CiJT{,iif FP'flFERTY Qnitu'sif;iR PR{3JS*T fuP,Fg" *g$*ftiFrfi#,ru *F 1,1.r c:J rv :016 2016 2416 2018 CAIi CALIFORNII.S VfITH THE FOLOVUIhIG: 4.303.1.1 WA.TER 43q3.1.7 4.303.1.3. .g (es] tr; -0 -fl\rttt'i{ t tesc: 0J t-) ")J j o 4 5e 6 # uJ E ? #fJ* Y'ifi-ura a4&*fr-< { 1 3 J d, cJ oreq. iO 0.5 GALI 1 < ereq. to FA{JCETS ,til ''.Jl/I r€Fi #ffiiF{*1s&if,l?fl{J'llET #*ff{"rPs${*Y sF.Gi-rF CGtrST" T\Pq #ITE. PU'N or FLLISH RESIDESITiAL iSVATOFY z.a aPM @ < oreg, T0 \ (* tfi = 1* ,l:l ;ii ii I I r I ll') -iJi lI ! t\ t tt i t I i t I I Rl( If R ON a cft it rrrh r !i!lii \\I grllr'nr rre J 6c F Ati I lt lqr Nr \+ri i itF \i I l/n IY AN 11. I r -l .Tjiii r\p I r ra i II r , .r,^rd ^^..^i^,I I fl EB .. Iltrm al ns nnl i tAi cI I roir ted to )ei v 'mii for,0r bval an)$I /I I L TAZgl-rri c)r '. ' r,l ,l tri iTt-i i.a i ,i j iii 1 i-{lt i!}ii i! $ riti Iilt :t:tatlai i iii i ii /t-i !Ei<F<f cl i i iq t t t t I I L'; l I 3HL \trju !Ve]TilIjI ; I iii!LI(it tl Il itlrFt I i I t!tliit j 22 litttli I j fi II l Itii r/t\ J,.,,L -r\ /lr \l itlttl nl'l"i-nhL;ffiff1r Jrs o i i-i*rs*o i i ittttiLt 0(i'tl hrf u t/ ,{iiti _i j i r l i i i l-\ ft PI*'*rf"4 UASCB.LE gf-,T, _,pF_ r Untitled Map Write a description for your map Legend 9t6t2018 1150 Laurel Ln - Google Maps I -l Go':gle Maps 1 1 50 Laurel Ln I I ;,.i :6.. ,*lt * 6l*o - lmagery @2018 Googlg Map data @2018 Google 20 ft G.; h I.i I I.J I J rt ,, I I httOs//iivww.google.com/maps/plac€/1150+Laur€l+Ln,+San+Luis+Obispo,+CA+93401/@35.26311U,-120.6460838,128a,35y,358.35h,45Udata=!3m,l1... 1l'l I $iin'Luts ogts po BUILDING PERMIT' Early Grading GRAD-I710-2018 lssuance Date: 81221201 I CALIFORNIA Bulldlng & SaEg DMsion . 919 Palm Steet . San Luts Obispo, CA 93401-3218 ProjectAddress: 1150 Laurel Ln Unit or Sulte(s): Project Descdption: FUEL TANK REMOVAL & BACKFTLL Contractor: Assessor's Parcel Number 004-962{18 Legal Desoiption: Ucenss Numben 314407 license Numben 314407 WILLIAMS D(CAVATION Business: (559) 227-1 080 Ucense Type: Calibmia S:tate Gonhastor Ucense Ucense Type: Calibrnla State Contnaclor Ucense Contrac-tgr Classification: A- Genenal Engineering Contragtor Classificaton: C21 - Bullding Movlng/Demolidon Ownen ATOLL HOLDINGS INCA CACORP Fire Sprinklers: Census: 750 - Grading Occupanclr Motel Rooms: Construc{ion Type: Dwelling Units:Siories 0.00 CodeYear: 2016 Dimensions Categorlr Valuation SQFT:Group Type Sg. Ft Factor Valuation Fee Name FeeAmount Receipt f Total Fees: Plan CheckAccount Payment by Contact Contact Name AccountName Total Account Balance: Balance Due:$0.00 Fees PaSrments Date Arriount 8t22t18 Status Total Gredlts Total Deblts Account Balanco lT Surcharge Grading - BLDG 17,M8{&Z-2018 Total Pald: Aots-z) 71( fvac*+rr) (h"9 ql.rn f" t.x-r) tI ? --> le,o L l-Aut 3 t ? ( Gsirtr egl:erl aq ) ArT t*up- 5cafto A,TgA I a {_ (I oAtn#ou{- ltoa-ots d 1?- --+{ tc offtcrL AL'ss' ?*'" A.c, ?,srr.,* \\ L ? LAl)o $ c- ? tp c\ JdCar. BlaP. 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AT.rr 'Su.o,.*J,',Jc- 6d" urui d*e"q) [r]q.ot16.o**-- o(f, 'te"\r nr:".e- l+ q{13*.t.q{a-.,8} $-\s\d. &rut. tsUti I 1) \c \ APPROVED r,sfta (" CorstC*Acaos' ruF,r -2) rASt ra\t& ( eA$€. I (\ t \\l \ E l-l t Lt+uR*L lnrre ' us*7 3{-*l-- Y10 uJ'1'l'o-- ${-ov,+g"-'x o ufi"t il*\- tJnrrcr*r Exe,mnfisu Aq\ e. (*ru.wa.s ,fto- \ F"*p g. iso-o\ -il.te.* Srt{isq -A -czt-rter "sEP 13 xl8 BUILDING DIVISION Jtn L)ur"te,r (dsl! ?tE6€ clrYOF sAt"r Lt,lsoglsPo rpur c-su-tud^(*[nr U Frgru t$6o,an' o> ,rb'c,s - ____l I Untitled Map Write a descript'lon for your map Legend gH2Aft 1150 Laurel Ln - Google Maps I I Goi,gle Maps 1 150 Laurel Ln -"'t I I lmagery @2018 Google, Map data @2018 Google I J L I J ! IJ I hftps://wrvtrv.google.com/maps/place/1150+Laurel+Ln,+San+Luis+Obispo,+CA+9%O1l@35.26311U,-120.il60838,128a,35y,358.35h,45Udatra=!3m1!... 'l11 BILLING CONTACT WILLIAMS EXCAVATION 244E, PrincetonAve Fresno, Ca 93704 I I -t l REFERENCE NUMBER FEE NAME TRANSACTION TYPE PAYMENT METHOD AMOUNT PAID DEMO-1817-2018 Demolition - Entire Building - BLDG Fee Payment Check #4475 lT Surcharge Fee Payment Gheck #4475 SUB TOTAL TOTAL 'as.D tvt" I )I I I -,1 I -i IJ September 06, 2018 Page 1 of 1 I -t PR0JECT'SUMMARY REPORT'for AT0LL HOLDING, .LLC < '> Project No. 2018-27 1150 Laurel Ln, San Luis 0bispo. CA 93401 <-> APN 004-962-018 >>>> ASBESTOS & LBP REPORT >>>>>>> -t l I "l lJ I I l Leon Environmental Services Richard "Danny" Leon CAC # 04-3708 Tommy Leon CAC # 05-3882 August 28,2018 Jim Williams Williams Excavation 244 E. Princeton Ave Fresno, CA 93704 Re: Asbestos & LBP Report Flammable Storage Buildings 1150 Laurel Ln, San Luis Obispo, CA LES Job No. C85-18 Dear Jim, Attached is the Asbestos and Lead Based Paint Report for the above-referenced site. The report includes bulk sample analysis results and recommendations concerning asbestos and lead containing materials identified at this site. lf you have any questions or need additional information, please do not hesitate to call. Thank you for using Leon Environmental Services. We look fonruard to working with you in the future. Respectfully yours, Richard Danny Leon Digitally signed by Richard Danny Leon DN: cn=Richard Danny Leon, o=Leon Environmental Services, ou, email=leonenviro@comcast.net, c=US Dater 2018.08.28 17:06:30 -07'00' Richard "Danny" Leon State of California Division of Occupational Safety and Health Certified Asbestos Consultant Certification No. 04-3708 California Dept. of Public Health Lead-Related Construction lnspector/Assessor lD# 51 56 4545 N. Brawley Ave., Suite 104, Fresno, CA 93722 Phone: 559.274.9200 Fax: 559.274.9240 Email: leonenviro@comcast.net + Leon Environmental Services I I l But Lottrtc Drscntplotrt On Wednesday, August 22,2018, asbestos and lead testing was performed at the two flammable storage buildings at 1150 Laurel Ln, San Luis Obispo, CA. The sample collection areas were determined by the information given to the inspector by Jim Williams of Williams Excavation about the impending work scheduled for these buildings. Flammable Storage Building #1 is a small storage space that is attached to the side of a much larger building. lt is approximately 500 square feet and 50 to 60 years old. lt has CMU block walls, bare concrete floor, and concrete roof. Flammable Storage Building #2 is approximately 650 square feet and 50 to 60 years old. lt has concrete and metal walls, built-up asphalt roof, and bare concrete floor. ASBESTOS ATnIySIS RESULTS All bulk samples of suspect asbestos containing materials were taken in accordance with US EPA Guidelines and accepted industry standards by a state certified asbestos consultant. Western Analytical Laboratory, Inc., a NVLAP accredited laboratory performed a total of 12 analyses from the 12 samples collected from the structure at this site. The samples listed on the following table were positive for asbestos. The full lists of all samples taken are on the following pages. Quantities listed are estimates, for sampling purposes only, and should be verified prior to asbestos abatement. ASBESToS CoIT,IueruTS AND RECOMMENDATIONS The sealanVexpansion material (sample 01) in between the concrete walls panels on the flammable storage #2 building is positive for asbestos at 1-2o/o by weight. This type of material is considered non-hazardous non-friable ACM and can be disposed of as construction waste in most cases after properly being abated. lt is required that a licensed asbestos abatement contractor remove this material prior to renovation and or demolition of this structure. 50 sq. ft. The roof mastic (samples 09, 12) on the HVAC ducts, vents & jacks and along the metal wall is positive for asbestos at 10% by weight. Roof mastic is considered non-hazardous non-friable ACM and can be disposed of as construction waste in most cases after properly being abated. lt is required that a licensed asbestos abatement contractor remove this material prior to demolition of this structure. 50 sq. ft. 4545 N. Brawley Ave., Suite 104, Fresno, CA 93722 Phone: 559.274.9200 Fax: 559.274.924O Email: leonenviro@comcast.net #Location Material o/o Friable Sq Ft 01 Storage #2 SealanVExpansion Material 1-2 No 50Concrete Wall Panels 09 Flammable Storage #1 Roof at MetalWall Roof Mastic 10 No 50 12 Flammable Storage #1 Roof HVAC Duct Roof Mastic 10 No See 09 -l Leon E nvironmental Services Asbestos & LBP Report C85-18 Flammable Storage Buildings 1150 LaurelLn, San Luis Obispo, CA l J I ) I -l ASBESToS CoI.ICLuSIONS AND REGULATIONS US EPA NESHAP 40 CFR Part 61 Based on our survey, sampling and subsequent laboratory analysis and regulatory guidelines affecting this site, the types of ACM identified in this report require removal (in most cases) prior to demolition and/or renovation procedures to comply with local, state and federal agencies. The US EPA NESHAP 40 CFR Part 61 requires materials containing greater than one percent asbestos by weight be removed prior to renovation or demolition. lf those materials are friable or likely to become friable due to the forces expected to act upon them during renovation or demolition, they become a regulated asbestos containing material (RACM) and require a 10-day notification to the local Air Pollution Control District prior to abatement. Non-friable and non- regulated ACM, in most cases, may be disposed of as construction debris in a landfill that accepts ordinary construction debris. All friable waste containing more than 1% asbestos (RACM) should be manifested as hazardous waste for disposal purposes. CAL OsHA--------Gonstruction lndu strv ------.8CC R. 1529 The construction industry standard covers employees engaged in demolition and construction, and the following related activities likely to involve asbestos exposure: removal, encapsulation, alteration, repair, maintenance, insulation, spill emergency cleanup, transportation, disposal and storage of ACM. CAL OSHA worker health and safety regulations apply during any disturbance of ACM by a person while in the employ of another. This is true regardless of friability or quantity disturbed. lf there is greater than 100 square feet of ACM which will be affected by the demolition, a California Licensed Contractor who is registered with CaI/OSHA for asbestos is required. The regulations regarding asbestos are found in Title 8 CCR Section 1529, and also include formal notification requirements to Ca|/OSHA at least 24 hours prior to removal. lt is required that removal be conducted with the material kept in a wetted state to contain dust and hazardous emissions. Demolition contractors typically require that a building owner/operator accept responsibility for removal of all ACM found during the building inspection prior to start of demolition activities. 4545 N. BrawleyAve., Suite 104, Fresno, CA 93722 Phone: 559.274.9200 Fax: 559.274.9240 Email: leonenviro@comcast.net 2 I l Leo n E nvironmenlal Services Asbestos & LBP Report C85-18 Flammable Storage Buildings 1150 LaurelLn, San Luis Obispo, CA LeRo BRseo PnIUT ANALYSIS ReSuIrS Thirty-nine samples of suspect lead based paint were analyzed on the painted surfaces of the two flammable storage buildings at 1150 Laurel Ln, San Luis Obispo, CA by Leon Environmental Services using a Niton XLp X-Ray Fluorescence (XRF) Elemental Analyzer, Model 3004, Serial Number 26902. The attached Table 1 contains the list of all samples taken. LBP CoMMENTS AND RECOVIIUeTDATIONS Three samples of paint from Flammable Storage #1 and six samples of paint from Flammable Storage #2 contain more than 1.0 mg/cm2 of lead and are therefore considered Lead-Based Paint. These include: For Flammable Storage #1. White paint on structural steel such as support columns and beams.. Red paint on exterior metal doors. For Flammable Storage #2o Blue paint on exterior metaltrim, louvers, and other metal components.. White paint on exterior metaltrim, doors, and other metal components.. GreyMhite paint on structural steel such as support columns and beams. . Red paint on structural steel such as support columns and beams. All other readings were below the level of 1.0 mg/cm2 and are therefore NOT LBP but could be considered lead containing. Leon Environmental Services recommends that only a qualified Contractor with properly LBP trained and equipped personnel be used to work on or near these LBP painted surfaces. All loose and flaky LBP should be removed prior to demolition or renovation, collected and handled as one waste stream. Procedures and engineering controfs must be designed to follow CAL-OSHA (CFR 1926.62) and Department of Health Services (Title 17 April 2008) requirements. LBP CoNCLUSIoNS AND REGULATIoNS The federal and CAL OSHA regulations for lead in construction do not speciff a level of lead in paint that classifies it as LBP, although the Department of Housing and Urban Development (HUD) considers a paint to be a lead-based paint when the content of the paint exceeds 1.0 mg/cm' or 0.5 percent lead by weight and the Consumer Product Safety Commission (CPSC) has determined that for a paint to be considered as "lead free", it must contain less than 0.06% or 600 parts per million (PPM). However, federal and state OSHA regulations specify airborne lead levels that should not be exceeded during construction without appropriate protection and training. phone:rurr1'.1i1;"?],ll'rtli;;iir*13-;',llii"lilff ft iurrrrrrt Leo n Environmental Services Asbestos & LBP Report C85-18 Flammable Storage Buildings 1150 LaurelLn, San Luis Obispo, CA Title 8 of the California Code of Regulations (CCR) section 1532.1 requires employers to provide sufficient worker protection when any detectable concentration of lead is present. lt also requires a wide variety of responses including, personal protective equipment (PPE), respiratory protection, blood testing for lead and hand washing facilities if the action level of 30 ug/m' or the permiisible exposure level of 50 ug/m3 are exceeded. This standard applies to all sources of lead, including lead in painted surfaces. Lead-Containing paint, defined as any detectable concentration of lead, does not necessarily require special handling, mitigation or disposal. Factors that determine the appropriate mitigation strategy include the concentration of lead, the condition of the lead-containing material, and the proposed contractor work methods. Federal Occupational Safety and Health (OSHA 29 CFR 1926.62) regulations require employee personnel monitoring at any detectable levels until statistically reliable results indicate that exposure will remain consistently below the OSHA Action Level of 30 micrograms/m2 and the Permissible Exposure Level of 50 micrograms/m3 for an 8 hour day. The employer must then produce a "Negative Exposure Assessment" to indicate that it is not possible with the specific lead- based paint product to create excessive lead exposure levels. California Environmental Protection Agency, Department of Toxic Substances Control, California Heath and Safety Code 25157.8 states waste that contains total lead (TTLC) in excess of 350 to 1000 parts per million (ppm) will be disposed of as a non-hazardous waste at a Class I hazardous waste disposal facility, or a designated facility with appropriate permit modifications. Wastes with total lead less than 350 ppm will not need a hazardous waste manifest or registered hazardous waste transporter when transporting the waste. Further, lead waste streams exceeding 1,000 ppm of Total Lead (TTLC) and/or waste streams with soluble lead exceeding 5.0 mg/l (via soluble threshold limit concentration [STLC] and/or total characteristic leachate concentration [TCLP]) are considered a hazardous waste under federal and/or state regulations. LIMITATIoNS OF LIABILITY Conclusions and recommendations presented in this report are qualitative judgments based on the prevailing regulations and accepted industry standards at the time of the report issuance. Leon Environmental Services provides no other guarantees, either expressed or implied. All quantities of materials listed herein are estimates for sampling purposes only, and should be verified by owner representative or an abatement contractor prior to abatement and or demolition. 4545 N. BrawleyAve., Suite 104, Fresno, CA 93722 Phone: 559.27 4.9200 Fax: 559.27 4.9240 Email: leonenviro@comcast.net 4 Leo n E nvi ro nme ntal S erv ice s Asbestos & LBP Report C85-'t 8 Flammable Storage Buildings 1150 Laurel Ln, San Luis Obispo, GA The nature of demolition and asbestos abatement is such that materials can be uncovered which previously were unknown to exist. Therefore, Leon Environmental Services cannot be responsible for materials not previously detected due to lack of accessibility or concealment, although every effort was made during the inspection to detect all suspect materials. lf suspect asbestos or LBP materials other than those included herein are discovered during renovation or demolition, it must be assumed that the materials are Positive, and should be treated accordingly until further testing and ahalysis is performed. The data interpretations and recommendations are based solely on information available to Leon Environmental Services at the time of our inspection. The customer recognizes that site conditions or accessibility may vary, from those encountered at the time of our inspection and sample collection. Varying conditions or access could result in additional information that would lead us to revise conclusions and recommendations. Leon Environmental Services will not be responsible for the interpretation or use by others of information contained within this report. Richard Danny Leon Digitally signed by Richard Danny Leon DN: cn=Richard Danny Leon, o=Leon Environmental Services, ou, email=leonenviro@comcast.net, c=US Date: 2018.08.28 17:06:52 -07'00' Richard "Danny" Leon State of California Division of Occupational Safety and Health Certified Asbestos Consultant Certification No. 04-3708 California Dept. of Public Health Lead-Related Construction lnspector/Assessor lD# 51 56 DATE .Abbreviation Key: Asbesfos Containing Mateial - ACM (Contains greater than 1%o asbestos by weight) Asbesfos Containing Construction Material - ACCM (Contains /ess than 1/" asbestos by weight) Vinyl Asbestos Tile - VAT /Vo Asbestos Detected - N.A.D or N.D. Homogeneous - H A/of Samp/ed - A/S 4545 N. Brawley Ave., Suite 104, Fresno, CA 93722 Phone: 559.27 4.9200 Fax: 559.27 4.9240 Email: leonenviro@comcast.net 5 .t Leon Environmental Services Richard "Danny" Leon CAC Certification No. 04-3708 Tommy Leon CAC Certification No. 05-3882 Job C85-18 Samnle Location Diagram Flammable Storaee Buildines / 1150 Laurel Ln. San Luis Obispo. CA Jim Williams / Williams Excavation Drawins not to Scale 07 ll, 08 R R Flanmable Storage # I R 09 10 (Building Not Part of Survelt) 11 R.t2 Y : Exterior Samples X = Interior Samples R: Roof Samples 4545 N. Brawley Ave., Suite 104, Fresno, CA 93722 Phone: 559.274.9200 Fax: 559.274.9240 Email: LeonEnviro@comcast.net 6 N 1 ) l J I .l Leon Environmental S ervices Richard "Danny" Leon CAC Certification No. 04-3708 Tommy Leon CAC Certification No. 05-3882 Job C85-18 Samnle Location Diasram Flammable Storaee Buildinss / 1150 Laurel Ln. San Luis Obispo. CA Jim Williams /Williams Excavation Drawins not to Scale 01 I x-* Flanmable Storage #2 -^ --'03 4545 N. Brawley Ave., Suite 104, Fresno, CA 93722 Phone: 559.274.9200 Fax: 559.274.9240 Email: LeonEnviro@comcast.net 06 05 Y = Exterior Samples X: Interior Samples R = Roof Samples 6 N I ^) e!)tt'ltit {/Ut SaaLv, f/gVn Nsrln ru+?en.ci( ntr( lhltsrtl €o<C'ta g &.tNC-a"4g (P4 n"tg o rt ft 4ce&/uf Autf uf /2v'S-1 hL,+r^alvr4r3 Cont (e'Vv h*t Cc+fe //rr€ lwlq i'"/"t/1ieafi-vf A u, hhk c/t uS/"r{e {y't h h'o<-. hue I \,Q,,1.-_Date 44fit"t tTFltt,^ -s h/u6< 4 / ru,uh,,6k sltfutge g 2 &NG,,rr.._ wnll P,, Ccr'h*s it Phn Svrur"e E\/e'^^nSt-rtl Ia( ,( Ll ue/ Pnr, ,\ t1 wfil(so{U rw6e Hl t/,ta/k*,,LFLfur". -t dt uLa (Ant' f&+ rtT l+nlrl((t< tt Lt c1 aaqll Lt clAt4 &(4 PLry*, tt-o.uct # L-KntA I ental Services l9>7aa{i4J A'. vryonmLeon En 9J722 Phone: 559.274.9200 Fca: 559.274.9210 Ennil:Ave.. Suite 10.1. Fresno. CA Tum Around:PLM /.-nSlte: Quantity dt Materlal Same2hr t P Location ( r\lo Date: lcefi/c Srw OL o-l oqo5 0r o9 (). i,o LI lL o WESTERN ANALYTICAL LABORATORY, lnc TEST REPORT lESNNG REPORT NO: DATE COLLECTEDT DATE RECEIVED: DATE REOUIRED: SUBJECT: METHODOLOGY ACCREDITED: 132-388 August 22,2018 August 23,20'18 August 28,2018 CLIENT: c85-r 8 Jim Williams - Williams Excavation 1 1 50 Laurel Lane San Luis Obispo, CA Polarized Light Microscopy Analysis for Asbestos; 12 samples "Method for the Determination of Asbestos in Bulk Building Materials" (EPA 600/R-93/116)' National lnstitute of Standards and Technology (NVLAPI # 2AOO37 Leon Environmental Services 4545 N, Brawley Ave., Suite 104 Fresno CA93722 Danny Leon (CAC# 04-3708)ATTENTION: REFERENCE: SAMPTE ID NUMBER SAMPI.E LOCATION AND DESCRIPTION NON.FIBROUS MATERIATS OTHER FIBROUS MATERIALS ASBESTIFORM MINERALS Flammable Storaqe #2 o1 Concrete Wall Panels Sealant / expansion material Granular Minerals Organics Fiberglass 1oh Chrysotile 1-2o/o 02 Slab / Foundation Concrete Granular Minerals Mortar None Detected None Detected 03 Walls Concrete Granular Minerals Mortar None Detected None Detected 04 Ceiling Coatins on fiberolass Granular Minerals Organics None Detected None Detected t: Trace (> 1% = greater than 1016, <1% = less than 1%) Note: Sample #6 was gravimetrically reduced by ashing before PLM analysis Opdcal Microocodst Mike Maladzhikyan, This report only applies to tha sample(sl t€sted. This repon must not be rcproduced except in full. unless approved by Westem Analytical. Tho cli€nt is solely responsible for the use 8nd interpretataon of t€st resuhs and reports requested from Westem Analytical. This r€port must not be used by the ctient to claim product endorsement by NVIAP or any other agency of the U.S, Govemment. WESTERN ANALYTICAL IABORATOBY, lnc. 12734 Branford St. Suhe #19, Adsta, CA 91331 . Tel: 18181 899-0949 r Emall: wsst€mAnah/ucal@gmafl.com Page 1 ot 2 -t -1 l REPORT # 132-388 continued: REFERENCE: C85-18 / Jim Williams - Williams Excavation / 1 150 Laurel Lane San Luis Obispo, CA t: Trace )1Vo = greater than 106 ( 1 = less than 1% /^^ ) I I a Opdcal Microecopist Mike Maladzhlkyan, This report only applies to the sample(sl tested. This report must not be reproduced excopt in full, unless approvod by W€stem Anslylical. The client is solely osponsible for the use and interpretation of test resuhs and reports requested fiom Westem Analytical. This rsport must not be used by the client to claim product endorsement by NVLAP or any other agency ol the U,S. Govemment. WESTERN ANALYTICAL I.ABORATORY, Inc, 12734 Branlord St. Suite #19, Adeta, CA 91331 r Tet (8181 899-{t949 r Ernal: WostemAnalydcal@gmail.oom Page 2 of 2 SAMPLE ID NUMBER SAMPI"E LOCATION AND DESCRIPTION NON.FIBROUS MATERIALS OTHER FIBROUS MATERIALS ASBESTIFORM MINERAISi 05 Ceiling / Roof Panels White block material Granular Minerals Organics Gypsum Cellulose 1oh None Detected 06 Roof Built-up roofinq Granular Minerals Organics (tar) None Detected None Detected Flammable Storaoe #1 07 Slab / Foundation Concrete Granular Minerals Mortar None Detected None Detected o8 Roof Concrete Granular Minerals Mortar None Detected None Detected 09 Roof at MetalWall Roof mastic Granular Minerals Organics (tar) None Detected Chrysotile 1oo/o 10 Roof HVAC Duct Sealant w/ cloth old Granular Minerals Organics Cellulose 600,6 None Detected 11 Roof HVAC Duct White Sealant w/ cloth new Granular Minerals Organics Cellulose 20o/o None Detected 12 Roof HVAC Duct Roof mastic Granular Minerals Organics (tar) None Detected Chrysotile 100/6 "t Leon Environmental Services 1of1 5('J7 N. I i! (idRlail l ,r.. Silitc 101. I'i'esno, (','l 93722 l'honc: 559.271.9200 I'a\: i59.271.92lu Dn.ul: cti€ni Jim Williams combanv WilliemsExcavationI ) Drie'Auousl 22- 2O18 lob No. C85-18 site: 2 Demo Buildings,1150 Laurel Lane, San Luis ObisDo. CA Anatvsis: Nlton XLp X-Rav Fluorescence IXRF) Elemental Analvzer, Model 3004,Number 26902 LBP Table 1 safi nd No LJnits Buildino Room Side Comoonent Color substrale Results Pbc 1 mq/cm"2 FLAM S I9T{AGb 2 EX thKtot<TRIM BLUE METAL Positive 1 2 4 mq/cm^2 FLAM STORAGE 2 EXTERIOR LOUVRES WHI IE ME IAL Positive 1.7 3 5 mdlcm^2 FLAM STORAGE 2 EXTERIOR EI WALL WHITE CONCRETE Neoative 0.05 4 €mo/cm^2 FLAM STORAGE 2 EXTERIOR B WALL WHITE CONCRETE Neoative o.17 7 mo/cm^2 FLAM STORAGE 2 EXI ERIOR ts uoot{WHITE METAL Positive 2.3 6 I mo/cm^2 FLAM STORAGE 2 EXTERIOR B DOOR FRAME WHITE METAL Neoative 08 7 9 molcm^2 FLAM STORAGE 2 EXTERIOR B DOOR FRAME WHITE METAL Neoalive 0.6 I 10 mol cm"z FLAM STORAGE 2 EXTERIOR B DOOR FRAME WHITE METAL Neoative 0.4 11 molcm^2 FLAM STORAGE 2 EXTERIOR C LOUVRE WHITE METAL Neoaiive 0.9 10 12 mo/cm"2 FLAM SIORAGE 2 EXTERIOR c TRIM BLUE METAL Positive 1.2 13 md/cm^2 FLAM STORAGE 2 EXTERIOR D WALL WHITE CONCRETE Nedalive o.o2 12 14 mo/cm^2 FLAM STORAGE 2 INTERIOR A LOUVRE WHITE METAL Neoative 0.11 13 15 mo/cm^2 FLAM STORAGE 2 INTERIOR c LOUVRE WHITE METAL Neoative 0.07 14 '16 mo/cm^2 FLAM STORAGE 2 INTERIOR B WALL GREY CONCRETE Neoative 0.01 15 17 mo/cm^2 FLAM S IOTIAGE 2 INTERIOR D WALL GREY CONCRETE Neoative 0.03 '16 18 molcm^2 FLAM STORAGE 2 INTERIOR B COLUMN WHITE METAL Null 0.8 17 19 mo/cm"2 FLAM STORAGE 2 INTERIOR B COLUMN WHITE METAL Neoative o.7 1 20 mo/cm^2 FLAM STORAGE 2 INTERIOR D COLUMN GREY ME IAL Positive 1.4 19 21 mq/cm^2 I-LAM S IOTTAGE 2 IN IET<I(JT{D BEAM RED METAL Positive 1.5 2(22 m6 lcm^2 FLAM STORAGE ,I INTERIOR WALL WHITE (;MU Nedative 0 21 23 mo/cm^2 FLAM STQRAGE 1 INTERIOR D WALL WHITE CMU Neoative 0 >.2 24 molcm^2 FLAM STORAGE 1 INTERIOR c WALL WHITE CMU Neoative 0 23 25 mo/cm^2 FLAM STORAGE 1 INTERIOR B WALL WHITE CONCRETE Neoative 0.01 24 molcm^2 FLAM STORAGE 1 INTERIOR B COLUMN WHITE METAL Ne0ative o7 25 27 mo/cm^2 FLAM STORAGE 1 INTERIOR B COLUMN WHITE METAL Neoative 0.7 26 2A mo/cm^2 FLAM STORAGE 1 INTERIOR B COLUMN WHITE METAL Neoative 0 27 29 m(llcm^2 FLAM STORAGE,I INTERIOR B OOLUMN BLACK METAL Neoetive 0.9 28 30 mq/cm^2 INTERIOR B COLUMN WHITE METAL Positive 1.7 29 3't mo/cm^2 FLAM STORAGE 1 INTERIOR D DOOR FRAME WHITE METAL Neoalive 0_04 30 32 mal cm"z FLAM STORAGE 1 INTERIOR D DOOR FRAME YELLOW CONCRETE Neoative 0 31 33 mo/cm^2 FLAM STORAGE 1 INTERIOR B DOOR FRAME YELLOW CONCRETE Nedalive 0.06 32 34 mo/cm"2 FLAM SIOKAGE 1 EX I Et{tut{B DOOR RED METAL Positive 6.4 33 35 mdlcm^2 FLAM STORAGE 1 EXTERIOR B WALL WHITE CONCKE I E Naoalive 0.01 34 36 mo/cm^2 FLAM STORAGE 1 EXI ERIOI<c WALL BLUE CMU Neoative 0 5 37 mdlcm^2 FLAM STORAGE.l EXTERIOR D WALL BLUE CMU Neqative 0 36 38 mo/cm^2 FLAM STORAGE 1 EXTERIOR WALL BLUE CMU Neoalive 0.01 molcm^2 FLAM STORAGE 1 EXTERIOR D DOOR RED METAL Neoative 0 38 40 mo/cm^2 FLAM STORAGE 1 EXTERIOR IJ DOOR FRAME RED METAL Neoalive 0.01 41 molcm^2 FLAM STORAGE 1 EXTERIOR D DOOR REt]ME IAL Positive I l lil' t4lilit' -l il; l -tl ll PRoJEcr SUMMARY'REP0RT for ATOLL H0LDING, 'LLc < > project No. zarc-zl1150 Laureil Ln, san Luis 0bispo. cA 9340r <-> ApN 004-962-0lg - l; 1i I I. 1i lj' l;jf j li lri. ,l lr .Jj' \ -'i I I , 1 J -l l I _l 1 _i 1 -i I -i l I:/ ..:-. '1 I I I I I I I I l j J J 0F (5s)227_10m ru{F60}227-(Fm Project ltlo. 2018-27 Site Specific Health and Safety Plan (HASPI FOR ATOLL HOLDINGS, LLC 1150 LAUREL LN, SAN LUIS OBISPO, CA 93401 UNDERGR0UND SToRAGE TAIIK REtilloVAL ASBESTOS SURVEY BEEMLI$I .TUq C$OI.{ERC IAL, STRI'CTURES 244 E. Princeton ave. Fresno, California 93704 wi I tiamsexggljon@yahoo. com 1 I I I I It ALENT Sefety -THE BESTWAJ ISTHE SAFE WAY THE SAFEWAY IS THE BEST WAY tg--- ACCIDENTS DciH'T JUST HAPPEN - = TFIEV ABE CAUSED 1 _l I "J I -i -J _l ALENTIIE Snfety -THE BESTTI'AJT lsTHE SAFE WAY THE SAFEWAYIS THE BESTWAY Ss tE-- AEC|DENTS DON'T JUST HAPPEN - . THEV ARE CAUSED a SITE HEALTH & SAFETY PLAN for AToLL HoLDrNGs, LLc < 1150.Laurel Ln, San Luis Obispo, Ca (3401 > Prdject No. 2018-27 Do the Right Thing: $top and Think Before you Act III|I :ge.1t.r.rr-r- _ . a.- "..iYour first instinct,* 3 elSerg€ncy is probably a;r,*p in and help, particularly if a oo-worker is in touble- But in a hazardous *tarirlr"r*..g.oy, trying to save someone,siife could cost you your own. You could do more harm than good. lvorkers whorespond to hazardous materials emergencies need speciat training-up to 40 hours-and special equipment :. J srrE HEALTH & SAFETY pLAN'for AT0LL H0LDTNGS, LLc < 1150.Laure'l Ln, San Luis 0bispo, Ca (3401 > Project No. 2018-27 Do the Right Thing: Stop and Think Before you Act Your first instinctt * *o*ffi*rr rrffi? herp, parricularly ;'ul-worker is in trouble' But in a na"uaous *ut .i.t*L"rg.o"y, trying to save someoue,sIi& could cost you your olryn. yoJ courd do more harm thau good. workers whorespond to hazardous materials emergencies oe"a special traiuing-up to 40 ho'rs-and special equipment :. Site Specific Health and Safety Plan (HASPI Project No. 2U-18-27 FOR ATOLL HOLDINGS, LLC I15O LAUREL LN, SAN LUIS OBISPO, CA 93401 UNDERGROUND STORAGE TANK REMOVAL ASBESTOS SURVEY DEEOLI.SH IAL-STRI'GTURES I -l J J J -t I -t l SITE HEALTH & SAFETY PLAN for ATOLL H0LDINGS, LLC < 1150 Laurel Ln, San Luis 0bispo, Ca (3401 TAELE OF COHTThIIS 1.0 PROJECTSUMilIARY AO OR@NEqTIO'{AL STRUCTURE > Project No. 2018-27 3.0 oNstTE 4I} HAZARD EVALTIATION 5.0 PERSOIIIAL FROTEgnvE EGU|PMENT .....r.Eur-_.r.......rEr.. i ,........6 6.CI MEDIGAL SURVEILI-ANCE REAUREIfrENTS ......_...:..... 7.0 SITE CONTROLMEASURES 6.0 EMERGEI'{CY PRocEDuffis g.O EONFINEtr SPACE 1O.O DOCIJMET\ffATION FIGUREg Figure 1.0 - VICINITY l,lAP Figure 2.O - SITE l,lAP Fisure 3,0 - HOSPITAL ROUTE HAP 1 1 2 2 o 7 7 I E I _i 'ning Maps - Directions, trip pianning;trifnt Camerii a more ' SITE HEALTH & SAFETY PLAN for ATOLL H0LDINGS, LLC < 1150. Laurel Ln, San Luis 0bispo, Ca (3401 p l$ng mapc 1150 Laurel Ln. San Luis Obispo, CA 93401 Location: 35.26356, -120.64392 ?- Page 1 of1. > Project No. 2018-27 Figure 1.0 Vicinity Map Doi Honiier 4 t Lffi9inc Wa@t bri l!o, tr'tdt ffii ann i, t CrHqria . F 25 rrru".tompoc g!nh l( Dctsm Dinubr lfislia https://www.bing.com/maps/?FORM:MsNMAP&toWww:1&redig:8114939340CC44A.'. 812112018 I I I l I -l i This page intentional$ Ieft blank. I I I I i .J I J J Bing Maps -.Directions, trip planning, traffic cameras & more ' SITE HEALTH & SAFETY pLAN for AT0LL H0LDINGS, LLc < 1150. Laurel Ln, San Luis 0bispo, Ca (3401 lp bing maps 1L50 Laurel Ln, San Luis Obispo, CA 93401 Location: 35.26356, -120.64392 Page 1 of1 > Project No, 2018-27 Figure 2.0 Site Map. _l l https://www.bing.com/maps/?FORM:MsNMAP&toWww:1&redig:8114939340CC44A... 8l2ll20l8 I -t I l SITE HEALTH & SAFETY PLAN foT ATOLL HOLDINGS, LLC < 1150 Laurel Ln, San Luis Obispo, Ca (3401 > Project No. 2018-27 Page I 1.0 PROJECT SUNNMARY Th'is Site Health & Safety Plan (SHSP) was prepared by l,lilliams Excavation to accompany,.the services at the above-referenced project site. The field activities generally include; l. Underground storage tank (UST), line removal, soil samp'ling'and backfill. 2. Asbestos Survey. 3. Demolish, remove, dispose ',of two (2) Conmercial 'structures. 2.0 ORGANIZATIOI{AL STRUGTURE Mr. Jim Williams is the owner and licensee of Williams Excavation and is the companfs Health & Safety Coordinator (HSC)- The project field staff has compteted 40 hours of comprehensive heatth and safety tnaining which meets the reguirements of Title 29 Code of Federal Regulations part 1910.120. The designated Site Safety Officer: (SSO) has the authority to monitor and conect health and safety problems as noticed on site. The Health & Safety Coordinalor {HSC) is responsible for generaiing, organizing and compiling the SFISP which describes all planned field activities, identifies specific site health hazards, and describes appropriate safety and heatth control procedures. The HSG is also responsible for assuring that adequate taining and safety briefing(s) for the project are provided to the project team- The HSC will provide a copy of this SHSP to each member of the project field team and other appropriate persons involved in the project. The HSC is responsible for developing and coordinating the Health and Safety Program. For specific projects, he is responsible for reviewing and approving the draft SHSP for accuracy and incorporating new information or guidelines which aid the S$O in turther definition and conirol sf the potentiat health and safeg hazards associated with the project. The deslgnated Site Safety fficer (S$O) has the authority to moniior and conect health and safety problems as noticed on site. The SSO is responsible for ensuring that all data acquisitlon is performed in accordance with the projecfs scope and SHSP, and that deviations from the projeci are based upon field conditions encountered and are well documented in the field noies, The SSO '.has on€ite responsibilrty for ensuring that all team members, including all subcontraciors, comply 1 J .J SITE HEALTH & SAFETY PLAN for ATOLL HOLDINGS, LLC < 1150 Laurel Ln, San Luis 0bispo, Ca (3401 > Project No. 2018-?7 Paae 2 I with ihe SHSP. lt is the SSO's responsibilig to inform all field personnel of chemical and physical hazards as he or she becomes aware of them. AdditionalSSO responsibilities include: 1. Providing sitre safety bdefing for team members. ?. Updating equipment or procedures to be used on site based on new informalion gEthered throughout ihe duration of the projec-t. 3. lnspecting all personalprotective equipment priorto on-site use. 4. Assisting in and evaluating the effecliveness of decontamination procedures for personnel, protectve equlpment, sampling equipment and containers, and heavy equipment and vehicles. 5. Enforcing the 'buddy sysiem' as appropriate for sile activities. 6. Posting location and route to the nearest medical facility; ananging for emergency transportatian to ihe nearest medical facility. 7. Posting the telephone numbers of local public emergency seMces; i.e., police, fire and ernergency number 91 1. 8- Stopping operations that thrcaten the health and safety of the lield team or sunsunding populace. 9. Entering the exclusion area in emergencies after he/she has notified emergency services. 10. ObseMng field team members for signs of exposure, stress, or other conditions related to pre-existing physical conditions of team members. i- 1 I l 1 I l l The following is a reference list of project contacts: Health & Safety Coordinator: Project Manager: Site Safe$ Officer: Mr. Jim Williams Mr. James \Mlliams Mr. James Williams I l l l 3.0 ONSITE CONTR.OL The work area will be-defined by the $SO with the use of boundary tape or other appropriate rnarkers, if necessary. The work area(s) will be redefined and moVed as necessary. The area outside the designated work area boundary is the support zone. 4.0 HAUARD EVALUATION The potential hazards to personnel working at this site have been identified as health, physical hazards of working around heavy equipment. noise, and heat andlor cold stress. Th" u"" of real- time air monitoring instruments as well as the judgment of ihe SSO will provide the basis for modifying levels of protection. Each potential hazard relative to the potential for exposure is described below. I.,j I l lJ I -l SITE HEALTH & SAFETY PLAN for AT0LL HOLDINGS, LLC < 1'150 Laurel Ln, San Luis Obispo, Ca (3401 > Project Nc. 2018-27 Page 3 l I 4.{ Health Hazards Exposure to hazardous levels of niirates is the primary potential health hazard identified at the site. Nitrate is highty soluble in water and is found in drinking water from sources such as fertilizers, sewage, and animal manure. Nitrate is hazardous because once ingested or inhaled, it converts into nitrite in the saliva of people of all age groups. Nitrite is much more hazardous to the btood stream. Short term effects include blood disorders in infants and pregnant women if rRore than 50 ppm is ingested from drinking water. Long term, chronic side effects include various forms of cancer. This is because when the nitrate is ingested, reaciions in the body transform them into potent cancer causing chemicals. Thus, the EPA has set a Maximum Contaminant Level of 1 ppm to avoid blood disorders and cancer development in the human body. The SSO will assure that no employee ingests or inhales nitrate in excess of one part of nitrate per million parts of water or air (1 ppm) as an 8-hour time-weighted average. 4.2 Physical Flazards On-site physical hazards are heavy and/or moving equipment,'noise, and possible heat andlor cold stress. Mechanical hazards include cuts, contusions, slips, trips, falls, impacts, and muscular injury- Care shall be taken while perforrning work around excavations and trenches. Employees shatl remain a minimum of S-feet from the edge of any open excavation, Under no circumstances shall an employee is enter any trench or excavation deeperthan S-feet. 42.1 Equipment Wrile working at the site, field personnel must be aware of equipment movement and general traffic, and maintain communications or eye coniact with the equipment operator. Fietd personnel will exercise extreme caution during the field activities and will take precautions to stay out of tho equipment's path. 4.2.3 Noise Noise levels around heavy equipment may exceed comfortable range in which hearing protection willbe required. OSI-{A requires hearing protection be implemented if noise levels exceed 85 db. 42.4 Heat Stress The potential for heat stress is a concem wnen fielrl activities are performed on warm, sunny days, and is accentuatBd when chemical proteclive clothing is wom. Heat stress prevention measures and monitoring will be implemented if site temperatures are above 85 degrees Fahrenheit. SITE HEALTH & SAFETY PLAN for AT0LL H0LDINGS, LLC < 1150 Laurel Ln, San Luis Obispo, Ca (3401 > Project No. 2018-27 Pase 4 .l Precautions to prevent heat stress will include worldrest cycle$ so that rest periods are taken before excessive fatigue occurs, and regular intake of water to replace what is lost from sweating. Work/rest cyctes will be esteblished based on monitoring the heart rate (pulse) of each individual worker. Rest breaks will be long enough to reduce the heart rate (HR) to at rest levels. Heat stress due to water loss can be prevented. To prevent dehydration, water intake musi approximate sweat loss. Water intat<e guidelines are as follcnrus: 1. The sense of thirst is not an adequate regulator of water replacement needs during heat exposure. Therefore, vuiatermust be replaced ai presoibed intervals. 2. Before work begins, drink two 8-ounce glasses of water. 3. Dudng each rest period, drink at leasttwo 8-ounce glasses of water. 4. Drink cool. plain watsr. An adequale supply of potable water and drinking cups will be readily available, such as in a support vehicle, io provide water durlng resting periods. 5. Adding salt to water ls not recomrnended. However, other flulds, in addition to water, could include dilute fruit juies and electro$te replacement drinl€ diluted 3;1 with waFr. Do !g use salt tablets. Although normalworldng hours are expected, additional rest periods may be necessary when heat siress haard is high. Based upon worker monitoring, environmental corlditions, and the judgment of the SSO, the duration and frequency of rest periods will vary. Additionally, at eny time field team ntembers recognize the signs or symptoms of heat stress, they will notifu the $$O immediately so that the appropriate measures can be taken. Heat stress. if not prevented, results in heat stress illnesses. Two criticalillnesses, if not recognized and treated iminediately, can become life ttneatening. These are heat exhaustion and heat stroke. Heat exhaustion will resutt if the prevention measuies described above are not implemented. lgnoring the signs and symptoms of heat exhaustion may lead to the development of heat stroke. Heat stroke is an immediate, life-threatening condition that results because the body'e heat regulating mechanisrns shut down, and the body cannot cool itself sufffciently. As heat is excessively stored in the body, brain damage can result causing permanent disability or death, l .J IJ SITE HEALTH & SAFETY PLAN foT ATOLL HOLDINGS, LLC < 1150 Laurel Ln, San Luis Obispo, Ca (3401 > Project No. 2018-27 Page 6 l l I.l -, i ) l l J I Ij I I _l l "J 4.2.5 Heat Exhaustion The signs and symptoms of heat exhaustion are headache; dizziness: naus€a; weakness; fainting; profuse sweating; loss of appetite; approximate normal body temperature; dilated pupils; weak and rapid pulse; shallow and rapid breathing; possible cramps in abdomen and extremities; difficult walking; co.ol And,sw.eatv Skin.B-ale to qraY_gglod$q. Finst aid for heat exhaustion is as follovtts: 1 - lmrnediately remove the victim to the support area, or if you are the victim, proceed to the support area. 2. Decontaminate, if practical, before entering supportarea. 3. Start cooling. but be careful not to cause a chill ti.e., rest in the shade and epply a wet towel to lhe forehead: open up and/or remove clothing as much as praclical, especially chemical-resistantclothing.) 4. Drink cool water slowlv, but only if conscious, not ln shock. 5. lf vomiting, and/or ihe signs and symptoms aie not tessening within an hour, calt for emergency help and/or transportthe victim to the emergencry room, 6. lt is lit<ely that a heat exhaustion victim wilt be unable to work for the remainder of the day. 7. Do not send someone who has experienced heat illness home unsupervised as delayed reactions that require medical assistance may occur. 4.2.6 Heat Stroke tSun Stroke) The signs and symptoms of heat stroke are hol. dry gkin to,the-tgt{ch: ,red.dish coloring: body temperature >105 F: no sweating; mental confusion; deep, rapid breathing that sounds like snqring progressing to shallow, weak breaihing; headache; dizziness; nausea; vomiting; weakness; dry mouth; convulsions, muscular twitching, sudden collapse; possible unconsciousness- First aid for heat stroke is as follows: 1. lmmediatety remove the victim to the support area; prior to entBting the support area, relnove and dispose of the vlctim's chemical-reslstant clothing. 2. ' Cool the victirn rapidly using whatever means are available, including: shade: opening up and/or removing clothing; soaking dothing/skin with wat$ and fanning: placing the victim in vehicle using air conditioning on max,mufn, 3. Do not give drinking rvater to the victim. 4. Treat for shock, if needed. s- Transport the victim to lhE emergency room or cellfor emergency help; no exceptions for heat stroP.e victim. 4.2.7 Cold Stress Cold stress will be a potential hazard during the field activities when the air temperature at the site is below 4O degrees F. lf winds are blowing at 5 mph or greater and/orthe weather is damp or wet, , cold stress is even more of a potential hazard. 't SITE HEALTH & SAFETY PLAN for AT0LL HOLDINGS, LLC < 1150 Laurel Ln, San Luis 0bispo, Ca (3401 > Project Nq. ?018-27 Paae 6 Precautions will be taken to prevent cold stress including wearlng cold-protective clothing appropriate forthe level of cold and physical activity, changing underclothing if it becomes wet, and establishing a work and warm regimen. Cold protective clothing will include layering of garments and use of gloves and hats. The warming breaks $hould be iaken in a warm locaUon, if at all possible, including improvising a wind break shelter at the site. During warming breaks, warm sweet beverages and soups should be consumed to provide calories and fluids. Drinking coffee or other caffeinated beverages is not recommended. S.O PERSCINAL PROTECTIVE EQUIFIUENT Based on the hazard analysis for this projeci, the following personal protective equipment (PPE) will be required and used. Changes to these specified items of PPE will not be made without the approval of the site safety officer. The minimum required level of per$onal protection on the site at all times is Level D. Level D consists of hard hat with goggles, ANSI approved safety glasses, and steel-toed boots. lf Level C protection is required, it will consist of Level D protection, plus Tyvek@ coveralls, nitrile gloves and liners (taped at the wrist), chemical resistant boots, and half- or full-face mask air purifying respirator with high efficiency particulate filter cartridges. Eye glasses must be AN$l approved (safety glasses). lf at any time throughout the course of this job there io a potential for increased exposure to the personnel, the appropriate upgrade of personal protective equipment will be required. 6.0 MEDIGAL SURVEILLANCE RESUIREMENTS Medical surveillance is csnducted as a routine program which meets the requirements of 29 CFR 1910.140(0. Medical surveillance examinations are provided at regular intervals to monitor the health status of the participating staff. The intervals are: baseline examination on initial assignment to hazardous materials field operations; annual examination for participants in the prOgram; exit examinations to close out the medical records upon employee termination or is reassigned ftom hazardous material$ aotivities; and when periodic examination is required for specific projects and to evaluate an injury or hazardous chemicalsxposure. It is not anticipated that special tests or examinations will be required for staff involved in this project. However, all workers must be eware of the signs and symptoms of potential chemical exposure and heat and cold stress. j SITE HEALTH & SAFETY PLAN for AT0LL H0LDINGS, LLC < 1'150 Laurel Ln, San Luis 0bisp<i, Ca (3401 > Project No. 2018-27 Page 7 I l 7.0 SITE CONTROL MEASURES The potential chemical and physical hazards have been identified in this SHSP; however, should site-specific or unexpected conditions arise, the SSO will stop all work at the site and the Prime Contractor will be notified. Work will not be completed until the SHSP has been revised or re- evaluated, accordingly An exclusion zone will be established around the active work area. Access to the work area will be limited to those persons having a direct involvement with the field activities. The SSO will establish the general limits of the work area and will be responsible for site control. Prior to beginning field activities, the SSO shall determine the wind'direction, and position any support, eating, or break areas upwind of thework area. Equipmentwill be placed upwind of the worke/s location whenever possible. Safe work practices to be employed during the entire progress of field work are asfollows: 1. Set up, assemble, and check out all equipment fur integrity and proper funiiion before entering the restric{ed work area and priorto Starting work ac*fuities. 2. Do not use faulty or susped equipment. 3. Use only new and intact pruteclire dothing. Ghange the suit, gloves, etc. if they tear 4. Do not use hands to wipe sweat away ftom face. Use a clean towel or paper towels. 5. Practice contamination avoidance at alltimes. 6. Do not smoke, eat, drink or apply cosmetics while in the work area(s). 7. Wash hands, face, and arms as soon as possible upon o<iting ftom the wo* area(s), and prior to taking rest breaks, lunch break, and leaving the site atthe end of the work day' 8. Check in and outwith the SSO upon anival and departure 9. Perbrm deontamination procedures as required bythis SHSP. 10. Notiff the SSO immectiately if there is an accident that causes an injury or illness. 8.0 EMERGENCY PROCEDURE$ ln the event of an emergency during construction activities, the SSO will direct the course of action. A first-aid kit and fire extinguisher will be supplied by the SSO and will be kept within the work area. A fire extinguisher will also be supplled by the $ubcontractor and will be kept within easy access of the work area while field work is conduc-ted. Emergency telephone numbers to be used to call for assistance are listed below. A copy of this list will be posted in the work area. The nearest easily accessible hospital to the site is S'ierra Vista Regional Medical Center, 1010 Murray Ave, San Ldis Obispo, CA 93405 SITE HEALTH & SAFETY PLAN for AT0LL H0LDINGS, LLC < 1150 Laurel Ln, San Luis Obispo, Ca (3401 > Project No. 2018*27 Paqe I Fioure 3 is a Route to Hospital Plan showi nq the location of the su b.i site and t he hosoital. Emergency TelepFrone Numbers . Fire, Police, Paramedics Sierra Vista Regional Medical lllilliams Excavation Center 911 (805) s46-7600 (sse) 978-5163 9.8 CCNFINED SPACE EI{TR''f During the field drilling operaiions, there will be @ entry ifito a confined space for any reason. Therefore, confine-d space entry procedures $rill not b6 required. In tlre event eonfined space entlr is required, the worl< will not continue until the SHSP has been modified and proper confined space entry procedures ate developed and implemented- ts.0 o0cuiltENTATtBNt The implernentaiion of the SHSP must be documented to assure ernployee participatton and protection. ln addition, the regulator requirements must be met for record keeping on training, medical surueillance, injuries and illnesses, expogure rnonitoring, health risk information, and respiraior frt-tests- l.l l -t ij SITE'HEALTH & SAFETY PLAN for AT0LL HOLDINGS, LLC < 1150. Laurel Ln, San Luis 0bispo, Ca (3401 > Project Ne. 201&-27 I I -t HOSPITAL ROUTE MAP IIj Ij I i-t IJ I IJ IJ _i I I I I-t II I I I I I t t I I I I I I I Bing Maps - Directions, trip planning, traffic cameras & more SITE HEALTH & SAFETY PLAN for ATOLL HOLDINGS, LLC < 1:150. Laurel Ln, San Luis 0bispo, Ca (3401 Page I of 2 > Project No. 2018-21 LL min,3.0 mi Light traffic (10 min without traffic) Via CA-227, Santa Barbara St [1 bing maps A LL50 Laurel Ln, San Luis Obispo, CA 93401 B Sierra Vista Regional Medical Center, 10L0 Murray Ave, San Luis Obispo, CA 93405, United States Figure: 3.0 Hospital Route Map A 1150 Laurel Ln, San Luis Obispo, CA 93401 f 1. Depart Laurel Ln toward Orcutt Rd 0.1mi L1. Arrive on the right The last intersection is Murray St B Sierra Vista Regional Medical Center IJ .l P 2. Turn right onto Orcutt Rd 0.4 mi Turn right onlo CA-227 / Broad St Chevron on the corner 0.7 miP3. n 4. Turn right onto Santa Barbara St 0.4 mi f 5. Keep straight onto Osos St 0.4 ml n 6. Turn right onto Marsh St 0.1mi q 7. Turn left onto Santa Rosa St 0.4 mi f g. , Keep straight onto CA-1 0.4 mi P 9. Turn right onto MurraY St 210 ft, q 10. Turn left onto road 394ft h1ps://www.bing.com/maps/?FORM:MSNMAP&toWww:1&redig:D59CE4138808459... 8l2ll20l8 Bing Maps - Directions, trip planning, traffic carneras & more SITE HEALTH & SAFETY PLAN for ATOLL H0LDINGS, LLC < 1150. Laurel Ln, San Luis Obispo, Ca (340i Rqlond doothlu tlvd ilhdfel Cants {l Ln, San cA 93401 - Page 2ol2 > Project No. 2018-27 '%; * t I .. -s -o** & * ; '.s. { @ s.ns s 4ji --1id !eing II *in.&r A 1150 Laurel Ln, San Luis Obispo, CA 93401 'r %fu (lq. m00 ted 1kn @2018 HERE $d* St B sierra Vista Regional Medical Center, 101... Pot/t <Mc taole iniwfrity ^dotd'1* I g o5 J * 6 b Mitch.l E Fe$ilt thid at $dt \"*f o^ttq -94 "f"+q a L r*i rnlsRd ,c* HERF bohs ,%o bting I 20t8 Uiffioft Gdpffirbn @ 20tB dlgHERE These directions are subject to the Microsoft@ Seryice Agreement and are lor informational purposes only. No guarantee is made regarding their completeness or accuracy. Construction prcjects, traffic, or other events may cause actual conditions to differ from these results. Map and traffic data @ 2018 HERE ' t*"#oo*un* J I J J J https://www.bing.com/maps/?FORM:MsNMAP&toWww:1&redig:Ds9CE4138808459... 8l2Il20l8 r l Ij SITE HEALTH & SAFETY PLAN for AT0LL HOLDINGS, LLC < 1150. Laurel Ln, San Luis 0bispo, Ca (3401 > Prciject Nc. 2018-27 I l (S H&SP)APPROUED BY: l l *,] l I I ."'-,| I t t --I i T I T I I I I I I I t I I I -ll SITE HEALTH & SAFFTY pLAN for ATOLL HOLDINGS, LLC < 1'150. Laurel Ln, San Luis Ob.ispo, Ca (3401 > Project No. 2A18-27 ,!" t1 1 il i Page 9 -l li SIGIIATURES Site Health e y Plan Approved By: si . Jim tlf'llians Oate:Atx.* l.A,2otb I i {, ,. I ll a 1 1 : I ] I ,l Title: Project ltanager/project Safety 0fficar ContracEor and $uhCllntrqctor Aqre€Elgnts 1 cont,ractor certifies that-the folloring personnel to be employed bn the subject groject have met the folloning requirenents of the OSHA Hazar{ous .tlaste Operator Standard (29 CFR 1910" tA0) and other appl icable OSHA standards 2. contractor certifies that in. addition to meetlng OsltA rEguirements, it has received a copy of this Site Health A. Safety Plan and rlll €nsure that its employees are informed and lllll comply rith both OSHA requirements and the guidelines in "this Site Healtfr & Safety Plan. 3. Contractor further certifies that it has read and understends and wl]] comply r+ith all provisions of this Health & Safety Plan and vill not hold Stateside Excavation, Inc. responslble or liable for any injury or health problems that may arlse._l l --1 I > Project Ng. 2018-27SITE HIALTH & SAFETY PLAN for ATOLL H0LDINGS, LLC < 1'150 Laurel Ln, San Luis 0bispo, Ca (3401 S I GNATU RES TO 5A F'ETV P !-AN I I I -II -I I I T I I I I I I I I I I I SITE HEALTH & SAFfrY PLAN for AT0LL HOLDINGS, LLC < 11'50. Laurel Ln, San Luis Obispo, Ca (3401 > Project No. 20rc-27 Pa$ 10 Gontractor Psrsonnel Sub-Contaetor Personnel T rai ni ng/Csrti f i cati on./ Hgdlcal Exaninatlan t\Vttsr*ru,j{ot -t {-l*z-t^roggq s - *-- - 11^ Date -)ln D\L\.tA;r"J il*-Nar s7s[D] t# nlzr\te slulie 'ilifriteMrr T-Jt0 q-D+ Agene.y _sr Conpany(\ o{1a+Lqf Dlbls,e, /o.*rnn I *-sr H 7 na"l$."rrs ?/bjzE qhiltYffi M,!6 I-i 'l .J i .J 'l -i 't J -r. I I I 't I -t I SITE HEALTH & SAFETY PLAN for AT0LL HOLDINGS, LLC < 1'150 Laurel Ln; San Luis Obispo, Ga (3401 > Project Nq. 2A18-27 sArETv_. _co, uPtrallgg ro,Rlt$ I I I I I I I -J I tj I JJ I -i IJ t J I I I I-t I T I I I I I I I t t I I I I I l i '-1 ii li 11 11 -t 1: -L !i li ! I I: SITE HEALTH & SAFETY PLAN for ATOLL H0LDINGS, -LLC < I Ln, San Luis Obispo, Ca (3401 > Project No. 2A18-27 ffiFq?ffi'rtffi ilrwru}Sffi 244 L Prirncebn avs Fesno, Galifornia 93,?04@ c*, @rrlc gu4m XNJTIRY ANF ILrfiESg giIEVMrrgCl{ FROGEAE4. g'm'n .r** /b!b-32.qrl$Hff nflEEffiNc BEF$SF t1 SUFERTTf;SRS GSITUR.dL $)e$rs hnyMms SrF!fi E&FTF@!-8rydtocttncEr . GMrhDtS. . ecGBttl5ltdEsErcftrrE@ o SfrFrSN8il$X t Sitc Arqiccr Eo \ Datc l'rs :time Con&ucdBy n A+t/ Nanre tPlmseFrirn) Co"Conductor .L .u ' St8lg@E&lllt terulrrcl-t Title \ lt\rol _ Namo (PlcpucPnhr) CxfP.o or+ JPuunisrr Tillctlo.rr cil C RL,$er(tsuLw,.-\ ' ^csidcnto AnaI $ubjcds Dbcwcd sff8affiH{f 4 \b A? +KA{J'. AttcndcdBy ttudqrslfftrc OrnenArfl 1 a gr{OGt'<F FhnRtsrc \rlO I I.J ,1 1 -l r$e rcvwc eiile for dcilailcd coqaegrb or rwomaca&tiEsg ..5 -T t: -T ji SITE H EALllf & SAFETY PLAN for AT0LL HOLDINGS, LLC < :1.50. Lau I Ln, San Luis Obispo, Ca (340j > Project No. ?A18-27 t li 0Fr@ffir4ffi nx@ffirsl}ff 2C4 E Frirncebn aua keslo, e€fi,trnta gs70r ffialEiscartr$rm.dl cR @Flrrra*ilJFtfi -t li ! :: i1 t: ) t, XNJTIR" AT'TS $ff{E$g M T}RSGR./LE{ {rrFs 1 Ii tl sttPEIr\ry$sRS GB1tffi,6L ${J$n$rs AdyMeffis sffin$Hffi $d.F$rr nnrfETItrc REP{}Br J. Jsb #t8. ?.? qdElqfllitrrfiaEtE'gEdtrfl !oF&eE:. a QWEdtlq,lEE o c'E&f&E*dEt sfct{$s - 'nfrcrd-ahvrllt I Sr$EtaaGeedlu .&)r( eaa&z|a=nientac Sits Datc 2$\g-:t'inreBicn CendrrclcdBy Name (Plcarcfrinr)Title C€onducru llianc {PlcascPriirr}TIIIc Assidcnts AnrI Sr$jmrs DfuWd , Lgll AttcndcdBy Fqlq*rarmc (glrrbcnrfrt) I ,T I -l l _t .I l _) Dcr J*t. Jtr0$, gKtAyJ,n\rT. rg16 rxc rErrE[Be eiaie for dclailcd cmmqots or rccffimasdrlfuo, SITE .HEALTH & SAFETY PLAN for AT0LL H0LDINGS, LLC < 150.Laurel Ln, San Luis 0bispo, Ca (3401 > Project No. 2018-?7 ffit5qzgr-fffi ilt@?Pr{mg 244 E Prflnaetun ave. Fesno. C€ftbrnia 9trt04ereimaer$dmsdn cA @trrrc*gt4{0- IN.}TIRY AND ILrfiESg g,hE\rSr$SJ{ PROGRAE{ grrst t1 #=JtlBslrs seryMeeESns SUFERTf,$ORS cgftffiat $fi.TETr RIEErM{G RESOR" Job#[s]-z?0 ryErltocFl6rE:. a e$fn!&tlerAlg! o etE&rFll@EtlEtlrrht& s enc'llgnEldE e SESdEtStEr?&tsl r +rt|l'rF.il&tftdc r't! I t' -T lrl: -l t: j -f l ll li J1 n L1 J1 h 1i l1 t': li I tl ': ji I i l i ! .l I I 1 .,1 j .,1 I _l l I 1 I-/ IJ Sitcprojca ffiB$ABS[ffr CondrrctcdIIy Co€onductm &.u, Namc (PlcansFrint)Title Narnc (PlcarcPn-irt)Tillc Aad SubjccrsDiNomcd AttCndcdBy rfnr.tcrlrrltulc (E@G'DiEf) N\".K Vl r.ltfta. tJJv gr?lcrtFFkFEc a \ rrn rsrgrse giih fordetailcd macab orrcaomncsdstims -? lr -"t! t1 ti l1tI SITE H EALTH & SAFETY PLAN for ATOLL H0LDINGS, LLC < 1 50.I Ln, San Luis Obispo, Ca (3401 > Project No, 2A18-?7 of$qaar4ffi nx@atrssfr 244 L Frflncebn aua kemo. C€fbrntA9ffil4@ct c0F,!r.Lc.tn4{m I li L ti Ii i1 ll 1 ii I 'l ] INJTIRY AND TXS,TTESS g'iqE\rmr$Er{ FROGRLE{ fi'In"F? Sits gqicct ffir€0*$Hffifr t1 .sAIgrF nffiEtNeffiPSKr suPEfiirfis8es GET{mAT!t JSn$rT8 Aery@gs o"rlcCt', t5,:ors CondrrctcdBy tJ Co€ondrctw AttcndedBy nq1ojlerne,o! ggd*.-rr iJ(bti Name (PleaseFrint)Title Narne {flcarePa'irr)TIIIe AcEidcnb Aart $ubjccrs Disomrd \?s o\a sF eN(x,n\l(ls ..,\p .rob #. aO tS-Tl .rdft*sa@Fd8Eli|lttofe!€ a Wrsdlltuc$ o eEEEfilassdEEd*ruue@ ! SE4qdqql?t?A,llr o SrglR@q@di|r \F Ult{$gcs Clt.v L.s :finre t q.3 t gs1rlqt*RlEnfi.rc a.m. I ) .l ,i 'l J uss rEvBrEe eiile for denaitcd cmE-Grrb orrDcomEdtfoss I l --F ll J; -I l 1 50. SITE HEALJ{ & SAFETY PLAN for ATOLL H0LDINGS, LLc <> Project No. 2018-?7 0FFr@ffir4ffi ffi@ryr.mffi .244ePrflncsfisn**W G' c6lruc'*uiNF I Ln, $an Luis Obispo, Ca (3401 ji ii ", l: ] IT{JTIRY ATTF $J,NE$g M FREGSJLRg {ff['F] ;"bfFlSL$:ZI_ .srtSEEf ffiTTHGnFFCfgr i1 K $IJFErllli-i$SR$ GISI{SR,AL Jse$rs AqM@?es ft dq€dglGr!8e,@rd$r*of-.e o Wsdibtlctt o (!lEtrttlSs@dctlsthrE € e@Igaurdr5 $itc Aro3ca \\ ffiff$ffiffir o lroU@ds? ) j I j Dxc Conductcdl[' Narnc, tPlcassPri$t)Title Co€onductsr lfamc {PlealsPriilr}Tille *ccialcilts Affl Subjc+tsDiNoEsd tsc Attemlcd3y Frq,rqclrituaa ts#*+ V .rl gs{ihg|tBAhFrlrr '1 J 'l -J nsc rsrre$e giile for ddailed roomqc$b qr{cmnapodstims --1,] lr "T SITE HEALT! & SAFETY PLAN for ATOLL HOLDINGS, LLC <> Project No. 7A18-27 150 I Ln, lan Luis Obispo, Ca (3401 0FFF%A?r4ffi iltr@'aT"ffiffi 244EFrftrcebn**ffi GAGF{rUa*H4{OA li Tl 11 lr Itll il t: Il: Ji 1 .1 t XN.}TIRY AITD $JJTESS M T}ROGRAEE {ff['F] Joblf .SAfiE:JI:F MEE-f,INC REF$Br {1 tI tI SUFERrriff}RS GEI{MdL JSBSXTS AeryMeEffnEs q$.aq-'EtfEEfylFG.d@'ttoFEg.{i'E a q&t@!q{,Eg3 o 9fEffrils@,E{Ettrulr& e ela'!}SGurslt Sitcp,rq-ccr 'l I . ,sl$ItnGdb!@t'g Datc :tinrc___ :a.BL__ItJrL Narnc (Ple{scPrint)Title tilame {FlcarsPriirr}Tille Aesialcnts AnrI Srfijmte Disc@cd ConftrstcdBy CoConductsr ffir€Eessffiff 'l "l =J .+ 'l =,j I -i AttcndcdBy rbtq*rlqbru tgdnea go1ilagltF FigtFitcrr us. xsnrrroe eirlc for dc*ailcd mnerrb qr rcgotnmd.stiong I I I I SITE HEALTH & SAFETY PLAN for AT0LL H0LDINGS, LLC < 'l'1:50.Laurel Ln, San Luis Obispo, Ca (3401 >>> EIIID 0F PLAN <<< > PFoJeit No. 2018-27 't I I I ]..- l I I J J J J , I I I I-I t I I I I I I I I I I I I I I -t I I I -SITE HEALTH & sAFETy purN for AT0LL HOLDINGS, LLc < 1'150.Laurel Ln, San Luis Obispo, Ca (3401 > Projdct No, ?A$-?7 ildUrs I -'l I J .J .J J .SITE HEALTH & SAFETY pLAN for ATOLL HOLDINGS, LLC < 1'150. Laurel Ln, San Luis 0bispo, Ca (3401 > Projdct No. ?Arc-?7 HdUls :: I I I I I SITE HEALTH & SAFETY PLAN for AT0LL H0LDINGS, LLC < 'l'1'50. Laurel Ln, San Lui-s 0bispo, Ca (3401 > Project No. 2018-27 -t I it f:.:-q 'l t I 'tIt-3 t l.rtt ':1I t- i.-t ! a t I I f ,s i t F .l t! l.I , 1::r*-:.a .-.#t'l- AVOID ACClDEilTs . 'TilI FAI,TI.AT HOf,II ON Oil ilIE HIEHSAY, AIF CAUTED 3Y IIIGrlltunE o] SoffiE ltlDtvlDuAl ro Fottow gtffpt"E AilD FUI|DA- TNEilTAI, SAFETT RUI.ES ON PTECAUilONI. FOT IHIS IEATOil:notr. AcclDEtfTS cAl{ tE ?REVENTED By *ECOOl$Zl}tO r}lE nEAr CAI'SE A}ID DOING SOIilETHING ABOUT II BEFORE THE AGCIDEHT occuRs- ill {tt I -i I .i iJ IJ L