Mark V, Inc.

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Emergency Response Data Sheet (ERDS)

Electronic Form Instructions

 

 

 

 

Prepared for:

 

Operating Engineers National Hazmat Program

International Union of Operating Engineers

International Environmental Technology and Training Center

1293 Airport Road

Beaver, WV  25813

 

304.253.8674

Website:  http://www.iuoeiettc.org

 

 

 

 

 

 

Prepared by:

 

Peter Paul Howell, PE

Mark V, Inc.

23 Edgewood Drive

Hurricane, WV  25526

 

304.757.3997

e-mail:  howell@citynet.net

Website:  http://www.markfive.com

 

 

 

March 22, 1999


 

Emergency Response Data Sheet

Electronic Form Instructions

 

1)      Guidance on how to develop an ERDS is provided in the Emergency Response Data Sheet Protocol, which is available at:  http://www.iuoeiettc.org .  The development methodology is the same for a hard copy as for an electronic copy. 

2)      Download or copy this template to:  C:\MSOffice\Templates\Other Documents.

3)      Open MS Word and on the File menu, select New, and select the tab Office 95 Templates.

4)      Scroll through the displayed templates and select Emergency Response Data Sheet Form, select the Create New Document button, and press OK.  The ERDS form will appear on the monitor.

5)      Save the document using a unique name at this time, and periodically as the form is completed.

6)      The electronic form is a protected Microsoft Word Template.  When a document is protected, data can be entered into a form field, but no other modifications to the form can be made.  On-line help is also only available when the document is protected.  In a conventional protected form;  if the document is unprotected and then reprotected, all data entered into the form fields is deleted.  This form has been modified to permit reprotecting the form without loosing data..  It is recommended that the form be left in the protected state except as note below.

7)      Each data field is indicated by      .  To enter data, just select the field (by clicking on it), and start typing.  There are no limits to the amount of text that can be entered into each field. 

8)      Help on what information should be placed in the field can be obtained by selecting the field, and then pressing the F1 key.  The amount of text that can be placed in a help box is limited.  Therefore in some cases it was necessary to insert multiple data fields just so all of the help information could be provided.

9)      Sections 4 and 12 require a drawing.  These drawings can be attached in the appropriate places after printing the ERDS.  If desired, pictures can be inserted into these pages so that the document is fully electronic and retains all of the advantages of an electronic document.  In order to allow this insertion, Sections 4 and 12 are not protected.

a)      To insert a drawing made using one of the graphics drawing programs or one that has been scanned:

i)        Place the cursor in the ERDS document where the drawing to be inserted.

ii)       From the Insert menu, select Picture, then From File

iii)     Select the Browse button and then navigate to the file that contains the drawing.

iv)     Select the drawing and press the Insert button.

b)      If the drawing is in AutoCAD R13 or higher; Word does not have the capability to import it this way.  Instead:

i)        Open the AutoCAD drawing.

ii)       Select the window that contains the material to be copied.

iii)     Select Copy View on the Edit menu to place this drawing on the clipboard

iv)     Open the ERDS form and place the cursor at the desired insertion point.

v)      Select Paste Special from the Edit menu

vi)     Select Picture (Enhanced Metafile), and OK

10)  Once the picture has been copied to the ERDS form, it can be dragged to the desired size.

11)  When data has been entered into all of the fields in the form, proceed to the next step.

12)  Save the document.

13)  Open the Forms toolbar by selecting View, Toolbars, and checking Forms.  The padlock button will be depressed indicating that the document is protected.  Unprotect the document by pressing the Padlock button.

14)  Using the View menu and Headings Toolbar,  Insert the name and address of the company preparing the ERDS and Logo (if desired) in the heading for the first page.  Then insert the name of the technology in the header for the second page.

15)  On the Forms toolbar, press the button with an “a” in the center surrounded by hash marks.  This will eliminate the shading around the form fields and make the document easier to read.

16)  Perform a Spell-Check.

17)  Reprotect the document by pressing the Padlock button on the Forms toolbar.

18)  When the form has been completed, us Save As to save this document using a unique name, in the directory that you select.  The template will remain in its original directory and can be used again for another application.. 

19)  Open the ERDS document.  Delete the instruction pages, including the section break.  This will allow the page numbering to be correct and prevent the instructions from being printed or viewed.

20)  Protect the document before distributing it by:  select SaveAs from the File menu, then select Options.  Enter a password (BE SURE TO WRITE THE PASSWORD DOWN.  IF YOU FORGET THE PASSWORD, YOU WILL NEVER BE ABLE TO UNPROTECT THE FORM TO UPDATE IT), in the Password To Modify Box, and click OK.

21)  The document is now ready to be printed or electronically distributed.


 

 

Emergency Response Data Sheet

     

 

Section 1:  Technology Identity

Manufacturer Information

Manufacturer’s Name and Address

asdf

Primary Emergency Contact:

     

Information Contact:

     

Secondary Emergency Contact:

     

Operator Information

Operator’s Name and Address

     

Primary Emergency Contact:

     

Information Contact:

     

Secondary Emergency Contact:

     

Other Names for Technology:

     

ERDS Prepared by:

     

Origination Date:       

Revision Date:       

Revision Number:       

 

 

 

 


 

 


 

Section 2:  Site Information

Facility Information

Facility where technology is deployed:

 

     

Primary Emergency Entrance Gate:

 

     

Secondary Emergency Entrance Gate:

 

     

Facility’s Primary Emergency Contact:

 

     

Facility’s Secondary Emergency Contact:

 

     

Facility’s Environmental Contact:

 

     

Facility’s Medical Contact

 

     

Operator information

Operator’s Primary Emergency Contact:

 

     

Operator’s Secondary Emergency Contact:

 

     

 


 

 


 

Section 3:  Emergency Actions

                                 

 

 

Section 4:  First Aid

                   

 

 

Section 5:  Process Description

            

 


 

 

Section 6:  Plot Plan

            


 

 

 

Section 7:  Fire and Explosion Data

Fire and Explosion Hazards:

            

Small Fires:

     

Large Fires:

            

Extinguishing Media:

     

Special Fire Fighting Procedures:

     

Flammability Data:     

Material

LEL, %

UEL, %

Flash Point, °F

Auto Ignition, °F

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

 

 

Section 8:  Personal Protective Equipment

Normal Operation

     

Emergency Requirements

     

 

 

Section 9:  Chemical Dangers

Health Hazards:

            

Hazardous materials used by the technology:

     

Hazardous materials that are present at the remediation site:

     

Hazardous materials that may be generated by the technology:

     

Properties of hazardous materials:

     


 

 

Personal Hazard Data:             

Material

Identification Number

ERPG-1

ERPG-2

ERPG-3

PEL (ppm)

NFPA

Registry

CAS

ICSC

UN

(mg/m3)

(ppm)

(mg/m3)

(ppm)

(mg/m3)

(ppm)

TWA

STEL

IDLH

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     


 

 

Section 10:  Physical Dangers

Hazardous Operating Conditions:

     

Hazardous Equipment:

     

Hazardous Effects of Natural Occurrences:

     

Proximity to Other Hazards:

            

 

 

Section 11:  Monitoring Requirements
Medical Monitoring

Hazardous Materials to be Monitored:

     

Methodology to be used:

     

Monitoring results feedback:

            

Indications of Overexposure:

     

Area Monitoring

Hazardous Materials to be Monitored:

     

Methodology to be used:

     

Monitoring results feedback:

     

Indications of Overexposure:

     

 

 

Section 12:  Spill and Leak Procedures

PPE Requirements:

     

Actions to take:

            

Containment Requirements:

     

Neutralization Requirements:

     

Waste Handling Requirements:

     

Waste Labeling Requirements:

     

Waste Disposal Requirements:

     

 

 

Section 13:  Decontamination Requirements:

Emergency Response Personnel Decontamination

PPE Requirements for Decontamination Personnel:

     

Location for Decontamination:

     

Decontamination Procedures:

     

Containment Methodology:

     

Waste Handling:

     

Technology and Emergency Response Equipment Decontamination

PPE Requirements for Decontamination Personnel:

     

Location for Decontamination:

     

Decontamination Procedures:

     

Containment Methodology:

     

Waste Handling:

     

Accident Victim Decontamination

PPE Requirements for Decontamination Personnel:

     

Location for Decontamination:

     

Decontamination Procedures:

     

Containment Methodology:

     

Waste Handling:

     


 

 

Section 14:  Technology Diagram