Ref: 5090.54

 

ENVIRONMENTAL, SAFETY, HEALTH DEFICIENCY REPORT (ESHDR)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

nsible Part f?
ESHDR (saff?cwelomel?) Code 980.7 age/53753:;
Title (summarize the problem with a brief title) I Chemical Hazard Warning Alarms
Event Date Responsible Party Po'c Phone 
Time 2/26/2011 0745 (Superintendent or Randy Corbell 627 4805
Area/Location Building 1109
Other Identifying Number or Comments (if applicable) I

Name Shop/Code Phone

Emnloyee Identifying Deficlencv Craig Henderson Code 106.22 476?7896
ESHDR Prepared By Craig Henderson Code 106.22 476-7896

Occmational Health ESH Process

 

 

 

 

   

  
 

PROBLEM DESCRIPTION: Brief description - Include regulation. requirement violated, and any immediate corrective actions taken.
ALSO INC UDE OTHE ACTIONS REQUIRED IN ORDER TO CLOSE THE ESHDR. Attach additional sheets if necessary.

QPS
LINE ITEM BRIEF PROBLEM DESCRIPTION AND ACTIONS REQUIRED

(1, 2, 3, etc.) CODE

 
 
   

 

Safety and Health: This is a level 3 event.

1 Requirementi 29 CFR 1910.165(d) The employer shall ensure the reliability and adequacy of
employee hazard alarms.

Deficiency Description: The cyanide and chlorine alarms in building 1109 are unreliable in
that the alarms have gone off when no processes were being performed. For example, they
were activated on 2/26/2011 and 3/18/2011.

Immediate Corrective Actions Taken (Ongoing): Ensure all hazardous chemical warning
alarms are treated as treated as if a hazardous condition exists. Contact the manufacture of
the alarms to determine why the alarms are falsely activating. Ensure the alarms are
connected to the fire department dispatch (NESCOM).

Action: Conduct a root cause analysis using page three as a guide. Include a narrative of the
root cause in addition to providing the root cause code. Include immediate and long term
corrective actions to prevent recurrence of discrepancies in your response. Include ESHDR
response with CATS item. If the ESHDR response includes additional action, create a CATS
item and reference the new CATS item number in the ESHDR response.

 

 

 

 

 

 

 

 

      
   
   

    
   
 

   

 

 

Responsible Party

IMPORTANT PLEASE READ - This item will also be input to QPS for informational purposes and Response Due Date (no later
CATS for the purpose of tracking to completion. Please use the ESHDR Response Form for than 15 working days from date
responding to this Item but utilize CATS for closure signatures and requesting an extension if of submittal)
necessary 04/11/2012
Responsible Issuing Party or . OPS Severity Level
designated representative Signature Date (1 or 2)
Review/Concurrence Si nature - Level .
cm, ue Detemma?o? Jeffrey Clzek 03/21/2012 3

POST-RESPONSE ACCEP ANCEIREJECTION and FINAL CLOSU WILL BE OTED IN CATS.

WILL BE:

(1) E-mailed to appropriate parties (follow Distribution List
established).

(2) Entered into QPS and CATS.

5090/258 (Rev. 5-11) (Front)

CATS 2012-02220