·0~ ·:m, - defense logistics agency · a tj•lcl-1'1' storage ... fire protection...
TRANSCRIPT
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and locEMion of Depot or F aci!ity 2 . Nameaoo 3. Sorial No. tf DlA-SM -HWAD Type of Quarltrly loSpt'ctiun uf' Mercury Storiagf'. A n·.ias
Hawthorne. NV Cotnmodity 4. ID NO. D A, LAST 6 Type of
A tj•lcl-1'1' Storage
T B. THIS and Specffic Warehouse klcatioo: Warehouse, /10 ·0~ E ·:M,_,::/ Depot Area Open Storage Area
7. NAME ANO TITLE OF PERSON RE$PON${BLE FOR MATEfillAL -rA. TEL. NO. OR CODE. 78. EXT
Robert Mathias, DLA Strat"'"ic Materials Su,-rvisor 330) 623-0267 H" INSPECTION AREA ~Ond~!t, £ ,:p.\lj!AIIO(llll'•• 1~M""") YES
8. STORAGE A. Storage facilities Are of the Type Prescnbed in the $t01"8qe Manual X 8 $1orage F8Cllllies Are Mainlained in GOOd Order X
9. MAlER!Al A. Materlal ls Stored In the Manner Prescribed in the Stot- Manual X 8 . Ma~erial Is free of Deterioration. ln!es1s1ion, Contamination. Commingling, M19ra!lon and Eros!oo X
10. RECORDS A. Depo1 Manager Confirmed thal al entries have been POSled NJA B, Depot Postings are LaslRR No. Date OSRNo Dated NJA
l1 UNIT$ Quantity lnclica:ed In Item 14h rellecis ESS Postiol) N\d 8Qtte$ with actual and/or computed cot.nt X
12. SE.C~ITY ANO Security and Fire Protection are being p,o,,.,ded in acoordance witl\ Qualdy Assvranoe aM X
FIRE PROTECTION Ma~erials Inspection Handbook and S10tage Manual Requirements
13. CONT AlNERS. A. Ma:erial is Stored in Proper Containers (Check ody if appUcable) X PILES. OR 8 . All Containers, Pies anc:llor Unl!S Are Mark.ed as Pre$Cl'ibed in the StoraQo Manual X OTHER UNITS C. Condition of Con.ta!nets (Give exact number in Class Ill under femarks) I {1} CLASS I I12)CI.ASS II (3)CLASS Ill
NIA N/A N/A 14 DESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
TOTl<L Nt.l'.eER OF UNIT'S
PRO- T)'P!l f'ili:f.. ~"'' WlOTH LENGTH HEIGIT DIAM· n, WEIGHT OF UNIT ,,.,.. " ;_ TOTAL WEIGHT GRAM i'9)le,.,,,*-. )
• , . OLA/$111. ·-
15 REMARKS
C d. •. ETER (1) GROSS (2) NET ,. 29• 20· NIA NIA " 15'l
T O!alPaOet.s
t,:l
,,3 "'1/
(R,1 ......... "1 (ctl,Wa~ 'I" ~ tonh,t!ed Ill "g,JIClo,ior t:~ r,sl)«b,.,ot ~l.;MleCI ~~IS .)rd$!O ... t.k:il~·. arid lldel'iCKlr,ckl,s;
11,1t r11111ld.,(IMIIIO ~-'1• ....,"-,... toro:i~~o,ca,_,n !hi$ ti<><*)
See Attac.hed Sheet fo r other pertinent information.
NET WEIGHT
POUNDS
5'7 ~ ""''
NIA
NO
Actual count of Rash could not be verified, thus no drums were opened at the limo of Inspection, Orum count was verif ied and matched planograph.
Jerome 505 Mercury Vapor testing conducted by the undersigned.
Total Inventory o f Mercury fla.sks are contained w ith in steel drums with no evidence or leaking.
16 RECOMMENDATIONS
NONE
11. rnsm1eur10N
16, NAME OF INSPECTOR (Type ot Pfint)
ev-l.~
OLA/SM/Chief (E)
OLA/SM/PM CiJ OLA/SMIH\11/AO Man r ® SOC EnWOnmerrtaf DIV
[email protected] iti#cn [email protected]
rnben .m.=ithla~ dl.=i.mi1 0 OTHER 18 8 . DATE OF SIGNATURE
07
I .oc~ticxr Hawfflornc, k'-,t\7
Oarcof I uspectioo: 7 - 13 - 1'1" hl:;pccrn, : G;·t ,>te t Gl,4.5
f'indlnE,.~: - \ -Y\11\Q\\A "1$
MERCURY STORAGE FACILITY
0•1::.E'~;::!:/d..~;;::~~"""""'""""_...,.. ___ _,!!INSPE¢TION REPORT FACILITY 10, >!WAD 110-52
D D
B D D
CR1flCALOEFICfENCfE6 :=-A
A1 SAFETY INSTORAGE
A2 EVIDENCE OF LEAKING
A3 Hk3H VAPOR CONCEITTRA TION LEVEL
A4 PACKAGING
A6 MARKINGS
A6 STORAGE CONFIGURATION
O A01 MISSING/INCORRECT FIREANDIORCHEMtCAl SYMBOLS
O AD2 DAMAGED OR DEFECTIVE CONTAINM ENT CURBS
D A03 GEO-MEMBRANE FLOOR DAMA.GEO. RIPPED. TORN OR UNSERVICEABLE D A04 LOOSEJBROKEN DOCK BUMPERS POSING A SIGNIFICANT HAZARD O Aos CRACKS IN WALLS EXCEED1NG 114" IN Vv'IDTH
D AD6 WAREHOUSE F'OUNDA TION/STEPS. EV10ENCE OF OETERIORAn ON
BA07 HOLESIN THEROOF
A08 CO.i FIRE SUPRESSION SYSTEM SHOWS EVlOENCE OF CORROSION, INTRUSION OR IS PHYSICALLY DAMAGED
D D
8 D
MAJOR DEFICIENCIES • B
81 PORTABLE OOCK (If present)
B2 RECOROSMJSIAATCH
S3 ITEML0CATlON MISMATCH
84 INVENTORY RECORD CARO MISMATCH/INCOMPLETE. UNAUTHORIZED QTY ADJUSTM ENT
as HOUSEKEEPING
FACILITIES MAJOR CEFlCtENCI.ES • BO I MINOR OEFIClENCI ES • CO
D B01 DOORS ANO/OR WINDOWS ARE NOT Vv'ORKING PROPERLY ANO CANNOT BE SECURED
O eo2 BROKEN LIGHTING WITHIN THE SJTE. SPECIFY GRto LOCATION
D 803 VENTILATION REGISTERS ARE CLOSED. BROKEN ANOfOR INOPERABLE
Oe04 WINDSOCK POLES ARE NOT 1N Pl.ACE AND WIND SOCK.SA RE NOT V'IORKING PROPERLY
O co1 DOOR DEFECTS • Minng grourd, ffl~t'Ol:&n(l()Of' l'!ooks,. ttollmldoll'Tlllgtldf mi,, i'IQ
D l'lir"Qe8, C8Mot~1~m•d.'chifi:eti11~ ~ l $0'$8m
CO2 EXCESSIVE VEGETATION
BC03 INCORRECT LOCK OR NON-FUNCTIONING LOCK
C04 EVIDENCE OF RAT INFESTATION I.E., NESTS, OROPP1NG-S
[XJ NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADDITIONAL SPACE IS REQUIRED
OLA StGNATUREJDATE
OZHC 63S-E REV< 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name aocs Location of Depot or F&el!lty 2. Nomeaoo 3. Serial No. tf
DLA-SM-HWAD Type of Quarterly lnspcctiuu of '.\ltrcury Stonge Arc1:11s
Hawthorne. NV Commodity 4. IONO.
0 A.LAST 6. Type of
A <l-t.l-11 s,.._ T B. THIS and Specific WarehOuse k)eatlon: Warehouse: /I 0-lo(,, E "1-l'~-17 oepo1 Area Oocn St0tage Area:
7. NAME ANO TITLE OF PERSON RESPONSIBLE FOR MATERIAL t · TEL NO OR CODE 78 EXT
Robert Mathias. DLA Strateaic Materials Su""rvisor 330\ 623-0267 WA
INSPECTION AREA !CIIO:k,,...,~ Exvlllli• rwu,.lro lN1$~ ) YES
8 . STORAGE A. Storage Facili1ies Ale of the Ty"'" Prescribed in the StoraQe Ma,'W,811 X
8. StorllHlc Facilit!e, Ne Maintained in Good Ol'der X
9 MATERIAL •• Materiel Is Stored In the Manner Prescribed in tM Storage Manual X
B. Material Is Free of Deterioratioo, lnfes1ation, Contamination. Commingling, Migration and Erosion X
10. RECORDS A. Oep)I Manager Confirmed that all etittles have been Pos100 NIA 8 . Depot PO$til'IOS are· Last RR No. Date OSRNo Da~ed NIA
11. UNITS Ouatttityindica1ed in Item 14h reflects E.8S Posting and agrees with actual and/or ccmpu1ed count X
12. SECURITY AND Security and Fire Protection are being provided in accordat\Ge ~,h Quality Assurance and X
FIRE PROTECTION Materials ln,we,ct.ion HMdbOOk and Stor- Ae Manual Reqooement.s
13. CONTAINERS, A. Material is Sto,ed in Pt'O;l)er Containers (Check only if applicable) X
PllES. OR 8. A.II Container, .• Pile$ Md,'Or Units Are Marited as Prescribed In !he Storage Manual X
OTHER UNITS C. Condition of Con'lainers (Give exaci number in Class Ill undet remark$) I ( 1) CLASS I 1(2}ClASS II (3)CLASS Ill NIA N/A NIA
14 OESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
1'0TAL NUMSCFt Ol' I.NTII
PRO- , ~~ IPil$.~-. WIDTH LENGTH HEIGHT DIA,-. g .. 'WEIGHT OF UNIT ,,.,.,_.s n. i . TOT AL WEIGHT
GRAM il'IQOl, t<.i~~-)
,. • . ..,.., C,,,m
15, REMARKS
C. d. •. ETER (1) GROSS (2) NET
r. 29" 20- NIA NIA "lo~
TotalPallet& ,a
'l.'\IDlMI
{ll,,..i""'&llodlol a ~O:l)fl~le(l!.1e1'.0n~~l'lt'd ln 11~, (1,11 "'"'i,lt<f~ tll $CO(:'i J:,IOO tl'olll::11.)'!$ ~ ~~,:! h11:1lbt<$' . 1:llll.l ifd,:,I\~ ·!~ ,~ <jN l lf'IOa~ gu\Oe IIU!I0:1'5..., ~ d'1Mk in llri8Utld(j
Sec Attached Sheet for other pertinent informotion.
NET WEIGHT
POUNDS
' . "1 o.iq,,:; .
NIA
NO
Actual count of f lasks could not be verified, thus no drum s were opened at the time of inspection, Drum count was 1/erified and mat ch ed planograph.
J erome> SOS Mercury Vapor testing conduc-t od by the undersigned.
Total Inventory of Mercury flas ks are contained w i thin s teel drums w ith no evido,, co of loaking.
16. RECOMMENDAT.ONS
NONE
17. DISTRIBUTION OLA/SMICi.ef !El ¢har1es [email protected]
DLAISMll'M !El '3$00,[email protected]
CUISMIHWAD Mar\ager !lll , .............. m""thias®dla.mil
SOC Envif'Oflmental DIV (iii 0 OTHER
18. NAME OF INSPECTOR (Type or Print) '8.\ SIGNAT~IE 168. DATE OF SIGNATU<E
,~-l-uL'.,~ ' -. ,
o,J ,~} r, ~ ; I u- wX-. ~ OlAH F00M30 This is a computer-generated form or or'"""-'•.,.m 30 =88
D D
B B
A1 SAFE1Y IN STORAGE
A2 EVIDENCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION LEVEL
MPACKAGING
AS MARKINGS
A6 STORAGE CONFIGURATION
Q A ex MISSING/INCORRECT FIRE A ND/OR C HEMtCAL SYMBOLS
O AO:i? DAMA GEO OR DEFECTIVE CONT Al NM ENT CURBS
D A03 GEt.>.MEMBRANE FLOOR DAMAGED. RIPPED. TORN OR UNSERVIC EABLE D A04 LOOSE/BROKEN DOCK BUMPER$ POSING A SIGNIFICANT HAZA.RO D AD6 CRACKS IN WALLS EXCEEDING 1/4'" IN WIDTH
D A06 WARE.HOUSE FOUNDATION/STEPS 4 EVIDENCE OF DETERIORATION
BA07 HOLESIN THE ROOF
A,08 CO, FIR.E SUPRE,SSION SYSTEM SHOW$ EVIDENCE OF CORROSION. INTRUSION OR IS PHYS!CAll Y DAW.GED
D D
B D
MAJOR DEFICIENCIES= 8
B1 PORTABLE DOCK {If present)
82 RECORD$ MISMATCH
83 ITEM LOCA n oN MJSMATCH
84 INVENTORY RECORD CARD Ml$MATCH/INCOMPLET E, UNAUTHORIZED QTY ADJUSTMENT
85 HOUSEKEEPING
FACIUTiES
FACILITY ID: HWAD 110-66
MAJOR DEFICIENCIES= 80/ MINOR DEFICIENCIES= CO
D B01 DOORS AN DIOR WINDOWS ARE NOT VVORKJNG PROPERLY ANOCANNOT8ESECUREO
O eoz BROKEN LIGHTING w-rH1N TH E s1T E . sPec1FY GR10 LOCATION
D 803 VENTILATION REGISTERS ARE CLOSED. 8 ROKENANOIOR.INOPERABLE
Os04 WINDSOCK POLES ARE NOT IN PLACEANDWINOSOCKS ARE NOT WORKING PROPERLY Oc01 DOOR DEFECTS • M1"'no O!t'Un<l mi,11111~ ~ hOOk:$, orokM'<lafl.'1:11,"d{ rnlSSlrq hin;es.c:.:innot~le:ei1~.r,m~'ICnl&Cl'Mrl$ Oco.2 EXCESS1VEVEGETATION
O cD3 1NCORRECTLOCKORNON-FuNcn oN1NG LOCK
0 cD4 EV1DENCE OF RAT 1NFESTAT10N 1.E .• NESTS. DROPPINGS
@ NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADDITIONAL SPACE IS REQUIRED
/'7 OLA StGNAT\JRE/OATE
DZHC 63S-E Rl;V 4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and Loc..nion of Depot or F -1eilily 2. Name and 3. Serl;lll No. '-I
DLA-SM-HWAD T,,,. of Quarce.r ly l11spteliOn u( Mercury Storage Areas Hawthorne, NV Commodity 4. 10 NO.
D A LAS:/ 6. TypeOC
A i-iiu ';-, 5'0-T 8 THIS 00d Specific Warehou$& l~n: Wa,ehOUff: 1/() -J 7 E
,,,.,,;;.,r, Depot Ate::, Open Stor;igc Arc.i:
7. NA.ME Afll) TrTLE OF PERSON RESPONSIBLE FOR MA TERlAL 17A Ta. NO. OR CODE 7B. E:XT Robert Malhias. DLA Stratenic Materials Sunervisor (330) 623--0267 "" INSPECTION AREA {Cl\e'l:k :in4 OCffCI."'», Exp~,i ncs;:itM~ W4'Ql'IU'!o) YES 8. STORAGE A. Storar1e Fi'*Cili6es Arr; of the T"-Prescribed in the Storane Manual X
8. Storage Facilities Ate Maintained in Good Order X 9. MATERlAL A M3tetl8' ls $1«ed In the MMMr Prescribed in the Storage Manual X
8 . Material Is Free ol Deterioration, lnfests!ion, Contamination, Commingling, Mlaraoon a~ EtoSioo X 10 RECORDS A. Qel)(ll M&f\89er Confirmed that all entries have been Posted N/A
8 . OeDot Postinos ate: Last RR No. Dole OSRNo ~ed NIA 11. UNITS Quarr.ity indica!ed in Item 14h reflee1s E8S Postl~ and aorees with actual and!or oompu1cd oount X
12. SECL.RITY AND Security and fire Protection ara being pro'lided in acoordance with Qualtly Asst.1ranoe Md X
FIRE PROTECTION Malerials ln:spection Handbook and Sta-age Manual Requirements 13. CONTAINERS. A Material is Stored in Proper Containers (Cheek ¢dy if applicable) X
PILES, OR B All Containers. Piles andtor Units Are Marked as Prescribed in the S10rage MMual X OTHER UNITS C Condition ot Con!aine<s (Gille exact number in Class Ill under remarks) I (1) CLASS I 112\CU.SS II (3)CLASS Ill
NIA NIA NIA 14 OESCRIPTtON OF CONTAINER$ PILE$ OR OTHER UNITS
1'0T,.LM.t,,18Ellt OF UNITS
PRO- Tlfl'I {Plko,c,u.-. W IDTH LENGTH HEIGHT DIAM- l"I, WEIGHT OF UNIT R .... • i. TOTAL WEIGHT
GRAM l"9M, e.lle«1q •. • """'" C,.,,m
15 REMARKS
C. d. e. ETER (I) GROSS (2) NET
f
29" 20· NIA NIA
T otalPallets .,, I/ r,1.JC>~
fw,,~ 11t QI~ C1)f('Clri111$ Cl'-'C*rr. c«'l'*>C<l 111 •tilJdO IOI" N IMpi:id!OI\ ol s;l(ld(p;llfld """!tlW!i \ltll,I ~ be,tb,J", lll'ICI II d~~
11•• ,.,.,, .... r;..-11111 ~ .. 1,,9',ltcl,, l'lllffltleir$fl\O«lfflC(,e~ OC".)ltc lll!N:i !)~
See Attached Shee.t for other pertinent informatio11.
NET WEIGHT
POUNDS
,204 '" '
NIA
NO
Actual count of flasks could not be verified, thus no drums were opened at th& Um& of inspection, Orum count was verified and matched planograph.
Jerome 505 Mercury Vapor tosling conducted by th& undersigned.
Total Inventory of Mercury flasks are contained within steel drums with no evicfenco of leaking.
16. RECOMMENDATtONS
NONE
17 OISTR18UTION OLA/SM/Chief
OLA/SM/PM
OLAl$M/HVVAO Managet
0 OTHER 18 NAME Of INSPECTOR (Type or Prinl) 18 S. OATE Of SIGNATURE
07 I 88
Darooflusp«,;011: Q7 ½u} 11 Lu~pCC(Of: .. 6 .. u~_.,_ .. b.i.d:Pa...,r-_)L,;~~'1----
\Y/hsc / l/ ()-l 7
Rern;u-k~ ------- ----------------------------------------
DATE: 01 / 1 ? } I 7 MERCURY STORAGE FACILITY
INSPECTION REPORT fACIUlYIO: HWAO 1 10 -77
I cRmcAt.OEFtciE.NaES=A
D D
B D 0
At SAFETY IN STORAGE
A2 EVIDENCE OF LEAKING
Al HIGH VAPOR CONCENTRATION LEVEL
A4 PACKAGING
A5 MARKINGS
AS STORAGE CONFIGURATION
O AD1 MISSING/INCORRECT FIRE AND/OR CHEMICAL SYMBOLS
D A02 DAMAGED OR DEFECTIVE CONTAINMENT CURBS
0 A03 GEO-MEMBRANE FLOOR CA.MAGED, RIPPED. TORN OR UNSERVICEABLE D A04 LOOSEfBROKEN DOCK BUMPERS POSING A SIGNIFICANT HAZARD D A06 CRACKS IN WALLS EXCEEOlNG 114" IN V"10TH
O AJ>6 WAREHOUSE FOUNDATION/STEPS- EVIDENCE OF DETERIORATION
BA07 HOLES INTHE ROOF
ADS CO; FlRE SUPRESSION SYSTEM SHOWS EVIDENCE OF CORROSION, INTRUStON OR IS PHY$1CALL Y DAMAGED
D D
B D
"i''il•i;l•l#iHMU31ffi: 81 PORT ABLE DOCK (11 present)
82 RECORDS MISMATCH
83 1TEMLOCAT10N MJ$MATCH
04 INVENTORY RECORD CARD M ISMATCH/INCOMPLETE, UNAUTHORIZED QTY ADJUSTMENT
B5 HOUSEKEEPING
FAOUTiES MAJOR DEACI.ENCIES-= BO I MINOR DEFICIENCIES= CD
Oso1 DOORSANDtOR WINDOWS ARE NOTVVORKINGPROPERLY ANOCANNOTBESECURED
Oao2 BROKEN LIGHTING WITHIN THE SITE - SPECIFY GRID LOCATION
0eo3 VE.NTILA TION REGISTERS ARE CLOSED. BROKEN ANO/OR INOPERABLE
OsD4 WlNDSOCK POLESARE NOT IN PlACEANO \NINO SOCKS ARE NOT WORKING PROPERLY O co, DOOR DEFECTS -Mi~)9fOllr.d, mMio~~ndOOfflOOf($. Ol'Qkcdll¥n;;gca/ n11::~
D lir'ICIEIS, C8MOt cl008$$/ml$$11'1{1fd:l:n;:igedklt:~1! ~l~$
CO2 EXCESSIVE VEGETATION
BC03 INCORRECT LOCK OR NON-FUNCTIONING LOCK
CD4 EV10ENCEOF RAT INFESTATION I.E., NESTS, OROPPtNGS
tel: NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF AOOITIONALSPACE IS REQUIRED
DLA StGNA TU RE/DATE
DZHC 63S·E REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and Location or Depol oc Faciliiy 2 . Name and 3. Serial No."'-/
DLA-SM-HWAD Type of Quarftrly ln~pecti<1n or~1ertury Stonge Are111s
Hawthorne, NV Commodity 4.IDNO.
D A~ST 6. Type Of
A '·- 'r $ [<)(age
T B. j',';.J and Specific WarehOuse k)Ca:ion: Warehouse: !IQ-] ~ E 07 , ,,. l)epol Area Open Stor;);)e Area:
7. NAME ANO TITLE OF PERSON RESPONSIBLE FOR MATERIAL l::A TEL. NO. OR CODE 78. EXT
Robert Ma11lias, DLA Strateaic Materials Supervisor 330\ 623-0267 WA
INSPECTION AREA (CIIMd(Wd~. Ex~n~-~~) YES
8 STORAGE A. St-e Facibt!es Are ot the Tvr,e Pre$Crttied In the Storaae MM!.*31 X
•• Storage Faciitiet Are Ma!mained in Good Order X
9. MATERIAL A Material Is Stored In the Manner Pre&eribcd i.n the Storage Manual X
B. Material Is Free of Oetltlior.iion. lnfeS1ation. Contamin.tUon. Commingli- , Minration and Erosion X
10. RECORDS A DeJ)Ol Man-r Confirmed ll'lal at entries haw been Posted NIA
8 . Oepot Posti:nns are: Last RR No. 03,e OSRNo Oa:ed NIA
11. UNITS Quantity indicated in Item t4h refleCI$ EBS Posting and aQ:rees with actual and/or oom-~ec:1 oount X
12. SECURITY AND Scc.un1y and Fi.re Pro:eclion are being provided in sccon:lallee W11h Quality Assurance and X
FIRE PROTECTION Material $ tMpeaioo Handbook and Stonige Manual Requirements
13. CONTAINER$, A. Matcritil is Stored ln Proper Containers (Check only if applicable:) X B. All Containers, Pies and!or Units Are Marked ~ Ptescribecl in the Stora~e MAAoo! X PILES, OR
OTHER u,urs C Condition of Contaitlert; (Give exact number in Class Ill under remarks) I (1) CLASS I 1(2)CtASS II (3)CLASS Ill NIA NIA NIA
14 DESCRIPTIONOFCONTAJNERS Pl.ES OROTHERUNITS
PRO- IW,, O'¾,.ao--..._
GAAM 91:gQl.~olt;)
,. ,. OLA/SIii o-
15. REMARKS
TOTALNIJMMaR OF\.NTII
W IDTH LENGTH HEIGHT DIAM- 9. WEIGHT OF UN1T Ri,J,;$ "·
C. • •. ETER (1) GROSS (2) NET
'· 29'" 20· WA NIA
T Olal Pallets
= " u-n ,
{RC'flew~l (llll')'III 1111f11111ollilf11 f!llfdillol\$ con:;llne,o111, ·~foo.lh., - ,~ er ::.l:Oelq:f',eO ~lits 11!'011h,11? '"/lilill11$.", ;nd IIC!ell~
~re iound,. \J"• lhft~11»gu1C1e nu~ 11td~dlil"" In tN~ t10CkJ
See Attached Sheet for other pertinent information.
; TOTAL WE:IGHT NET WEIGHT
POUNDS
-, -., I u,,
NIA
NO
Actual count of flasks could not be verified, thus no drums were opened at the time of inspection, Orum count was verifiod and matched planograph.
Jerome 505 Mercury Vapor testing conducted by the undersigned.
Total Inventory of Mercury flasks am contained within steel drums with no evidence of leaking.
t6. RE.COMMENDATIONS
HONE
17. OISTRlBUTION OlAJSM!Chicf llD ¢har1es..harde .mil
DLA/SM/PM llD jason.boy dla.ml
Dt.AJ'SMll·fWAD Man;,ge, llD ro~rt.mathia I .mil
soc EtMronmeotal orv D OTHER
18.. NAME OF INSPECTOR (Type O< Print) 18 8 DATE Of SIGNATURE
OLAHFORM30
l .oc;llioo: Hawd1ome. NV
Dltc of lnspcconol: 71/ / 72} / 7 lnspw<>t: G , / /';itl- /,.._ )
Whse/ If C:, -1 i
Vim.lingi;: ------------------------------
OATE Q7 ' /,2/ 12 MERCURY STORAGE FACILITY
INSPECTION REPORT FACILITYID: HWAD 110-78 j cRmCAL OEFtc1E.NC1ES • A
D D
B D D
A1 SAFETY IN STORAGE
A2. EVIDENCE OF LE.A.KING
A3 HIGH VAPOR CONCENTRATION LEVEL
A4 PACKAGING
AS MARKINGS
A6 STORAGE CONFIGURATION
D AO, MISSING/INCORRECT FIRE ANO/OR CH EMICAL SYMBOl.S D A02 DAMAGED OR DEFECTIVE CONTAINMENT CURBS
D A03 GE0-MEMBRANE FLOOR DAMAGED. RJPPEO. TORN OR UNSERVICEABLE D A04 LOOSE/BROKEN DOCK BUMPERS POSING A SIGNIFICANT HAZARD D ADS CRACKS IN WALLS EXCEEDING 1/4 .. IN W10TH
D A06 WAREHOUSEF0UNOATION/$TEP$ • EVIDENCE OF DETERIORATION
BAD7 HOLES INTHE ROOF
A08 COJ FIRE SUPRESSION SYSTEM $ HO'V\!$ EVIDENCE OF CORROSION, INTRUSION OR IS PHYSICALLY DAMAGED
D D
B D
M!H;IU##i31#fi3iiii: 81 PORT ABLE DOCK {If present)
82 RECOROSMISMATCH
83 ITEM LOCATION MISMATCH
a,, INVENTORY RECORD CARO MlSMATCHIINCOMPLETE, UNAUTHORIZED QTY ADJUSTMENT
86 HOV$EKEEPING
FACIUTtES MAJOR OEFICIENC1ES = 80 11\i!NOR OEFlCIENCtES ,:,c CO
O so1 DOORS AND/OR VVINDOWS ARE NOT WORKING PROPERLY AND CANNOT BE SECURED
Oeo2 BROKEN LtGHTING WITH1N THES1TE - SPECIFY G RID LOCATION
O eo3 VENTILATION REGISTERS ARE CLOSED. BROKEN ANO/OR INOPERABLE
O e04 WIND socK POLES ARE NOT 1N PLACE AND WIND socKS ARE NOT WORKING PROPERLY Oc01 DOOR DEFECTS • Mis:si\O ~na. ~ OOO(hoo!($, ~IC:Gn'(l&mage(lf m1&&11"9 henQes. c :imot .x:cc:!iW'liSS1~ai;;~,ve vent seri&eM O c02 e:xcEss1VEVEGETATION
BCb3 INCORRECT LOCK OR NON-FUNCTIONING LOCK
C04 EVIDENCE OF RAT INFESTATION I.E •• NESTS, DROPPINGS
~ NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVER SE IF AODITIONALSPA CE IS REQUIRED
01 Io I DATE OLA StGNATUREJDATE
OZHC 635-E REV 4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and Location of Depot or F 8Cllity 2 . Nomeaoo 3~No.q
DLA-SM-HWAO Typeot Quarte rly I ns pt(tion o f Mt-r tury Ston\j::t Ar~itS Hawthorne, NV Commodity 4.10 NO.
D A'fS~/ 6. Type of
A ..J /7 I• S,orage
T 8. ;r,1!, sod Specific Warehouse loeauon Wa,ehoYH: J ID- ~ 1 E ,q, r oepo1 Area Open Storage Alea:
7 NAME ANO TITLE OF PERSON RESPONSIBLE FOR MATERIAL 17A. TEL. NO. OR COOE 78. EXT Robert Mathias. DLA S1ra1eaic Materials Suoervisar (330\ 823-0267 ""' INSPECTION AREA (ChOdlaf'd~ e:.,~n~,_~) YES 8 . STORAGE A. Scorage Facili1ies Are ol the Type PreSCtlbed in the Storage Manual X
8. Scorage Faclli11es Ale Maintained in Good Ofder X 9 . MATERIAL A. Metenal Is Stored In the Manner Pfei5eribed in thf:l Storaae Manual X
8. Male.rial Is Free OI OeterioratiOn, lnf~on. Con1amina1ion, Commingling. Migra:ion and Etoston X 10 Rl:COROS A Depol Manager COnfitmed that all entries have been Posted N/A
a , Oepot Postings ate: L;Ut RR No. Date OSR No oa,eo NIA 11. UNITS Quantity indic:ated in Item t4h reflects EBS Posting and agrees with aClual MdlOI' OOtnputed count X
12. SECURJTY AND $ecur1Ty and Fire Protection are being provided in accordance with Quality Assurance a.ni:, X
FIRE PROTECTION Ma1ensls lnspec1ion Hand000k and St0taoe Manual R..,,uiremcn1s
13. CONTAINERS, A. M&1erial Is $Cored in Proper Containers {Check """t" if applicable) X PILE$, OR B, All con1ane1$, Pies and/or Units Ale Marked as Prescribed in lfle Storage Manu.-1 X OT>£R UNITS C. COndilion Of Comainers (Give exad number in Class Ill under remark.$) I (1)CLASS 1 (2)Cl.ASS II (3)CLASS m
N/A N/A N/A 14 DESCRIPTION OF CONTAINERS PILES OR OTHER UNIT$
IOTALNUP.'8ER
OF UNITS PRO- Typ,:(.Ne, (.l"A, WIDTH LENGTH HEIGHT OIAM- IA, 1/l'EIGHT OF UNIT .FJMts ._ L TOTAl WEIGHT GRAM lr.,gol.O>alt«c,,)
' • DI.MM °"'m
15, REMARKS
C. d . • ETER (1) GROSS (2) NET , . 29" 20" NIA NIA
TotalPat1e1s _..,, ,_
~-o• Oll'ler ~0,CC.IICSIIOM OOl'llli....., . 'O<'dli 1(11 lh,. ;..,~(M'l~f~leid ~.a:t,n::,!~ .)n:;I 1b:lr.>pa 1~·. ardll~()od;
111erwn:l,9fYCIIIC~llla~-.,nl,llf$111>\t~111c:e,,1.c1et.1:11• •n !111:1 ~
Sec Attached Sheet for other pertinent information.
NET WEIGHT POUNDS
. t 701 vu
NIA
NO
Actual count of flasks could not be veri fied, thu& no drums were opened at the time o f Inspection, Orum count was verified and matched planograph.
Jerome 505 Mercury Vapor testing conducted by the undersigned.
Total Inventory of Mercury flasks arc contained within s teel d rums with no evidence of leaking.
16. RECOMM.Er«lATIONS
NCNE
17 OISTRl8'JTION
18. NAME OF INSPECTOR (Type rx Prinl)
DLA/SM/Chief
DLA/SM/PM
OLA/SMIHWAD Manager fXl
SOC Enwonmentd DIV
chatles harder~dla.mil
Jssoo b0'fl\'I a.mil
ro-hert.mathi I .ml! D OTHER 18 8, DATE~ SIGNATURE
L,vc.-.1lloo: I fawthomc:, NV
Dare of lnspe<tion 9~ [ ~1 /) lu$J>cXIOf: G~ J f::tlf ,
WhsoJ} lb-67
l·11>dtng,,i.:
DATE: Ol /1? l 11 MERCURY STORAGE FACILITY
INSPECTION REPORT FACILITYIO: HWAO 110-87
I CRfHCA.LOEfiCtENCiES=A
D D D D
B
A1 SAFETY IN STORAGE
A2 EVIDENCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION LEVEL
M PACKAGING
AS MARKINGS
A6 STORAGE CONFIGURATION
D AD1 MISSING/INCORRECT FIRE ANO/OR CHEMICAL SYMBOLS O A02 OAMti.GEO OR DEFECTIVE CONTAINMENT CURBS
O A03 G EO-MEMBRANE FLOOR DAMAGED. RIPP ED, TORN OR UNSERVICEABLE
O AD-4 LOOSE/BROKEN OOCK BUMPERS POSING A StGNIFICANT HAZARD O Aos CRACKS 1N WA1.LS exceeo1NG 11,i1" 1N WIDTH
D A.06 WAREHOUSE FOUNDATION/STEP$ , EVIDENCE OF DETERIORATION
B AD7 HOLES IN THE ROOF
A08 CO) FIRE SUPRESSION SYSTEM SHOWS EV10E.NCE OF CORROSION, INTRUSION OR IS PHYSICALLY DAMAGED
D D
8 D
M!i•l;J-i#iiilMl3iffi: 8 1 PORTABLEOOCK(lfp,esent)
!12 RECORDSMI SMATCH
83 ITEM LOCATION MISMATCH
B4 INVENTORY RECORD CARD MISMATCH/INCOMPLETE, UNAUTHORIZED QTY ADJUSTMENT
86 HOUSEKEEPING
FACILITIES MAJOR DEFICIENCIES = BO I MINOR DEFICIENCIES = CO
D 801 DOORS ANO/OR WINOOWS ARE NOT WORKING PROPERLY ANDCANNOTBESECUREO
Oao2 BROKEN l.lGHTINGwTHINTHE srrE. SPECIFY GRro LOCATION
D B03 VENTILATION REGISTERSARECLOSEO. BROKEN AND/OR INOPERABLE
D 804 \/VIND SOCK POLES ARE NOT IN PLACE ANO 'MNO SOC-KS ARE NOT 'IA'ORKING PROPERLY O c01 DOOR DEFECTS • M~ ga.,nO. rrj5~ (IQ()( hOOk.$, t)f'O!((IM;l;lll'liQIXI/ ffllUI~
D tlince,9,. C8MOl ~ i&$1~agcdfclefec:11¥e vent 'fClMM
CO2 EXCESSIVE VEGETATION
8Ctl3. INCORRECT LOCK OR NON-FUNCTIONING LOCK
C04 EVIDENCE OF RAT INFESTATION t ~ . NESTS. DROPPINGS
re NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADDIT10NAL SPACE IS REQUIRED
DLA S tGNATURE.IOATE
REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and L~ion Of oepo1 or Facility 2 . Name and 3. Serial No t./
DLA-SM-HWAD Type of Quar terly Jnspectio11 or Me1·cury Storage Areas
Hawthorne, NV Commodl!y 4. IDNO. • 0
~~~}11 S. TypeOC
A s,.._ Wa,ehouse: J/()- ';5$ T B. T ;';J,, and Specific wareoouse location:
E rfl. Deoot Ares Open St.Of-- Area:
7. NAME ANO TITLE bF PERSON RESPONSlBLE FOR Mi\TERIAL tA, TEL NO. OR CODE 78. EXT
Robert Mathias, DLA Strat-ic MateriaJs Su ...... rvisor 330\ 623-0267 ""' INSPECTION AREA fCtOIC,.$,11<1 ~. Exnu1nc,eg~tve ~~) YES
8. STORAGE A. Stomge Facilities Ate of the Tvoe Prescflbe<I 1n the Storage Manual X
B. Storane Facilities Ale Maintained in Good Order X
9. MATERIAL A. Matenal Is Stored tn the Manner Ptescflbed in the Stor&De Manual X
B Matenal Is Free oi Deterioration. lnfe,tabOO, Contamination. Commingling, Mt9ta11on and Erosion X
10 RECORDS A. Oel)()l Man=er Confirmed that all entries hsve been Pos1ad N/A B. Depol Postings are: LastRR No. De:e OSRNo Dated NIA
11 UNITS QuMtily lncicated in Item 14h reflects EBS Posting and agrees "'1th actual andtor ¢0(l'lputed COU"U X
12. SECURITY AND Security and Fire Protection are being pro'vidad Wl accordance witn Qualny Assurance and X
FIRE PROTECTK)N Malarias 1mi:,eet1on Han0boOk and Stor....,e Manual ReQuiremerus
13. CONTAINERS. A. Material i& Stored in Proper ~ ainers (Check only if a......iicable) X 8 . All containers, Piles andfOt" lnt& Are Marked 3$ Prescribed in the Stor~- Manual X PILES.OR
OTHERUNrT$ C. Condi1ion or Conlainers (Gwe exact number in Class m uooer remari<s) I (1) CLASS 11(2) CLASS ll (3) Cl.ASS Ill
N/A NIA N/A
14 DESCRIPTION ()F CONTAINERS PILES OR OTHER UNITS
PRO- T)'PIIQ"te, u~.
GRAM 1.-q,:t. ~oc,,: .. )
• ' Ol,MSM ·-
15. REMARKS
1'0T,t,l t#..lo!8ER ()fUNIT&
WIDTH LENGTH HEIGHT DIAM· g. !/\'EIGHT OF UNIT Fl,._,, JI
c. d. •. ETER (1) GROSS (2) NET
I.
29" 20" NIA NIA
T0lalPallets ...-rr: "f~XI )
(Re .. _ _.~ ilpj'lfllf)IIMt Qu,ll,l;l!Ort!i Clln!Uloed WI '9',11(1~ to, It!,:, """l~olt.1"~IC<I ~"IS llr.:i SW'*__,,..,..., '..wl !fddil$Ctr,cl,:r',
;i,1~ ,,,,..md. /j'lt IJIO ~.Jlc~~ nu~ 1n:lwms:ll:,h:1dlr(li'lil ln tf'1il:. ~
See Attached Sheet for other pertinent information.
;. TOTAL VVEiGHT NET W'E.IGHT
POUNDS
71,,...,<L, )
N/A
NO
Actual count of f lasks cou ld not be verified, thus no d rums were opened at the t ime of lnspoction, Orum count was verified and matched p lanograph.
Jerome sos Mercury Vapor testing conduct9d by the u ndersigned .
Tot.al Inventory of Mercury flasks are contained with in steel drums with no evidence of leaking.
16 RECOMMENDATIONS
17 DISTRIBUTION
18. NAME OF INSPECTOR (Type or Print)
OLA/SM/Cmsf (gJ
OLA/SM/PM IXl OLAJSMIH\IVAD Manager
SOC Envfronmental Of\/
che:tr!es N [email protected] jasoo,[email protected]
rohert.maithias d1 II 0 OTHER 168, OATE OF SIGNATURE
07
D D
B 8
A1 SAFETYINST0RAGE
A2 EVIDENCE OF LEAKl'1G
A3 H IGH VAPOR CONCENTRATION LEVEL
A4 PACKAGING
AS MARKINGS
AS STORAGE CONF IGURATION
O A01 MISSING/INCORRECT FIRE AND/OR CHEMICAL SYMSOlS
D A02 DM1AGED OR DEFECTIVE CONTAINMENT CURBS
D J\03 GEO-MEMS RANE FLOOR DAMAGED. RIPPED , TORN OR U NSERVICEABLE O A.04 LOOSE.IBROKEN DOCK BUMPERS POSING A SIGNIFICANT HAZARD D A06 CRACKS IN WALLS EXCEEDING 1/4" IN \NIOTH
O ADG WAREHOUSE FOUNDATION/ST EPS · EV1DENCE 0FOETERIORAT100
BA07 HOLES IN THE ROOF
ADS CO, FIRE SUPRESSION SYSTEM SHOW$ EVIDENCE OF CORROSION. INTRUSION OR IS PHYSICALLY DAMA.GEO
D D
B D
MAJOR DEFICIENCIES= 8
81 PORTABLE DOCK (tf present)
82 RECORDS MISMATCH
83 IT EMLOCATION MISMATCH
B4 INVENTORY RECORD CARO MISMATCH/INCOMPLETE. UNAUTHORIZED QTY ADJUSTM ENT
S5 HOUSEKEE.PING
FAC!Lmes
fACIUTYIO: HWAO 110-88
~IAJOR DEFIClENCIES = SD I MINOR DEFICIENCIES • CO
0 001 DOORS ANO/OR WINDOWS ARE NOT WORKING PROPERLY ANDCANN0T8ESECUREO
O ao2 BROKEN LIGHTING WITHIN THE sir e. SPECIFY GRID LOCATION
O eo3 VENTILATION REGISTERS ARE CLOSED, BROKEN ANO/OR INOPERABLE
Oa04 WIND SOCK POLES ARE NOT IN PLACE AND VIIIND SOCKS ARE NOT 'WORKING PROPERLY
O co1 DOOR DEFECTS · MiSUlg l)'Ol.l'td, miss~brciu:1"1 dXir /wxlt$, Of'OQMi&m~ ~'"9 hnij~ unnO( ~i~m~i:dtd~Ne\ler,. J.OT.cni; O c02 EXCESSIVE VEGETATION
D C03 INCORRECT LOCK OR. NON-FUNCTIONING LOCK
DC04 EVIDENCE OF RAT INFESTATION 1.£ . NESTS. DROPPINGS
IJ:J NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF AOOfflONAL SPACE IS REQUIRED
DLA SIGNATURE/DATE'
OZHC 635-£ REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1 Name and Location a Depot or Faci!lty 2. Nam<>and 3. Serial No1
DLA-SM-HWAD Typc ol Q11arrtrly lJUpttliun of!\lcrcury Stor-age Artas Hawthorne, NV Commoditv , . IDNO.
D ~,,'tr 6. Type of
A ,ilt, S1orage
110:~ T 8 . ~r,~ and Specific warehouse location: Warehouse:
E 01 ,· Depoe Area Oi:,eti Stor,_.e Area: 7 NAME ANO TITLE OF PERSON RESPON$JBLE FOR MATERIAL 1;A TEL NO. OR CODE 7B. EXT Robert Mathias, DLA Stral=ic Materials SU""MSOf 330\ 623-0267 .....
ll'ISPECTION AREA ~k iln.:I (Qffll)il::111. Et,i*iitl n,i,g11(v,, IIIIIPOll$4'~J YES S. STORAGE A $1()(~ f-'c:ilities Are of the Type P,eseribed in the Storage Manual X
B. Storaoe Faciities Are Main!a!ned In Good Order X 9. MATERIAL A. Material 15 Stored In the Manner Prescribed in the S1orage Manual X
8. Material Is Free Of De!eriora~ion. Infestation, Contamination. Comm1nglin9, Mig~ ion and Erosion X 10. RECORDS A. Depot Manage< Confirmed tna! &!I entn:es ha-..e been Posted N/A
B. Depot Posting$ arc: Las1 RR No. Oate OSRNo Dsled N/A 11. UNITS Ouan!itv indicated in Item 14h reflects EB$ Postina and agrees with actual &"dfor oomputed oount X
12. SECURITY ANO S~urlty and Fire Protection are being provided in acoordance with Qua'rty Assurance and X
FIRE PROTECTION , Ma:erials Inspection Handboolt and S,orage Manu.'11 Reouiremonts 13. CONTAINERS. A. Material is Stored i.n Proper Containers (Check only if applicable) X
PLES,DR B. Al ContainC1$. Piles andtor Unils Are Matked as Prescnbed in the S10rooe Manual X OTHER UNfTS C. Condition of Containers (Q've eJCaC:t number in Class Ill uooe, remarks) I (1} Cl.ASS I (<2) CLASS II (3) CLASS Ill
NIA NIA N/A 14. OESCRIPTIONOFCONTAINERS PILES OROTHERUNITS
PRO· f )'Pll~I~, - .
GRAM "~~*-.J
• ' OU.ISM 0...
15.REMA~S
fO'lAL NIJMl!ER
YJIOTH LENGTH HEIGHT , .......
DIAM- g. WEtGHT OF UNIT Fl',UJ(S II
C. •• •. ETER 11) GROSS (2) NET f.
29· 2<)'" N/A NIA
T ocalPaue1s -~_,1 ... --x (Rav1M¥a1 (lllw11P1l"oc,,1llle 110X'$!)01Y.i wit:1~ Iii '9-'dli to, lhl i-.:i~ol,ioekP1e<1 ~ ,:i,i,11l; aoo .i1111111" ~. 11M1tC1C11C1enekn
af• rn11!ll1, Olwl '"" 8Pll'IIP!I~ ~ numt,e,'I, and coll"IJ*lt.:i ~ m 1i. ~
See Attached Sheet for other pertinent information.
i. TOTAL WEIGHT
NET WEIGHT
POUNDS
I II.,..,._,, l'i
NIA
NO
Actual count of flasks could not be verified, thus no drums were opened at the time of in.spoction, Drum count was verified and matched planograph.
Jerome 505 Mercury Vapor tos.Ung conducted by the undersigned.
Total Inventory of Mercury flasks are contained within steel drums with no evidence of leaking.
16 RECOMMENDATIONS
17. DISTRlBUTION DlAJSM/Chlel IE) char1es..hard....-:dla.mil DLA/SM/PM IE) j;ason.boyn1oo@(la.mil DLNSMIH'WAO Man~r !XI robert.m at hl;:i("'-~~, ... m i' SOC E11vironment.al DIV ll!l 0 OTHER
18 NAME OF INSPECTOR (Type or Print) ~1~ ht/ ~+ett'-t I) )\ 1~;0r;;J;;TURE
OlAH l--0HM30 .) This is a oompu1er-geoouHUd form of OLAH form
D D
B D D
A.1 SAFETY IN STORAGE
A2 EVIDENCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION LEVEL
A4 PACKAGING
AS MARKINGS
A5 STORAGE CONFIGURATION
O A01 MISSINGIJNCOR.RECT FIRE ANO/OR CHEMICAL SYMBOLS
D A02 DAMAGED OR DEFECTIVE CONTAINMENT CURBS
D A03 GEO-MEMBRANE FLOOR DAMAGED. RIPPED. TORN OR UNSERVICEABLE
O A0-11 LOOSE/BROKEN DOCK BUMPERS POStNGA SIGNIFICANT HAZARD D A06 CRACK$ IN WALL.$ EXCEEDING 11•· IN WIOTI1
O A06 WAREHOUSE FOUNDATION/STEPS- EV10ENCE OF DETERIORATION
BAOJ HOLESINTHEROOF
A08 COi FIRE SUPRESSION SYSTEM SHOWS EVIDENCE Of CORROSION, INTRUSION OR IS PHYStCALL Y DAMAGED
MAJOR OEFICIENCIES = B
0 81 PORTABLE DOCK {If present)
D-82RECORD$ MISMATCH
DD 63ITEMLOCATION MJSMATCH
84 INVENTORY RECORD CARO
MISMATCH/INCOMPLETE, UNAVTHORIZEDOTY ADJUSTMENT
D 85 HOUSEKEEPING
FACILffiES
FACILITY 10: HWAQ 110-89
MAJOR OEFICIENCIES = 801 MINOR DEFICIENCIES= CO
O a01 oooRSANDIORWINDOWSARE NOTVVORKING PROPERLY ANOCANNOTBESECUREO
O ao2 BROKEN LIGHTING WITHIN THE SITE . SPECIFY GRID LOCATION
Oso3 VENTILATION REGISTERS ARE CLOSED, BROKEN AND/OR INOPERABLE
D804 WINO SOCK POLES ARE NOT IN PLACE AND \/VINO SOCKS ARE NOT WORKING PROPERLY
DCOl DOOR DEFECTS • ti,bs:11119 9'Ql,l"l(I, ml5&l'l~lbt01<.et1 0:)0( l'IOOks, tin:it:erJdam-?-:)$41 !M$1no l'i"IQM. esnmx ac:ccs~•l'l!>'08man8CVC1~--. ~ s Deo2 EXCESSIVE VEGETATION
BC03 INCORRECT LOCK OR NON-FUNCTIONING LOCK
C04 EVIDENCE OF RAT INFESTATION I.E.. NESTS. DROPPINGS
~ NO DEFICIENCIES NOTED
COMMENT S CONTINUE ON REVERSE IF AODfflONAL SPACE IS REQUIRED
O? I DLA SIGNA TUROOATE
OZHC 63S·E REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name ttnd Loe.atioo of Depot or F.x:ilily 2. Name and 3.ScrialNo~
DLA-SM-HWAD Typeof (Juartc.r ly lnspectio11 or Mtreury Storage Arr.a.,; Hawthorne, NV Commodity 4. IDNO.
D &-lcyf;,, 6, Type Of
A Storage
T B.;/;fJ and Specffic Warehouse location: Ware-house: l[Q- [,< E .,., , r o,,e.poi Arca Open StQI' ___ Area:
7 NAME ANO TITLE Of PERSON RESPONSIStE FOR MATERIAL 1;A. TEL NO. OR oooe 78. EXT Robert Mathias. DLA Sttateoic Materials Su,,..rvisor 330, 623-0267 .-.,A
INSPECTION AREA (Owldl t fld ~ ,u:t,.,t~. E-.tan nogo,ve t ~ po!Y;C5) YES 8. STORAGE A Storage Fadlil!es Are of the T- Presaibed in the S,orage Manual X
B. S1or.111C1e Faciities Are Maintained in Good Oteler X 9 MATERIAL A. Matorial Is Stored In the Manner PreS<:ribed in the Storage Manual X B. Materiel Is Free of DetetlOtatiOtl, lnfe:station, Contamination. Commingling, Mlgtation illnd Erosion X 10. RECORDS A. Depot Manager Confirmed I.NI all entrie$ have been Posted N/A
8 . Depot Postings are: LaSi RR No. Date OSR I«> Dated NIA 11. Lf.JITS Qvan11ty lndlcated lo ftem 14h reflects EBS Posting and agrees with a~I andfoc comnt.r1.ed count X
12, SECURITY ANO Security and Fire Protection are being provided in accordance with Quality Assurance~ X
FIRE PROTECTION Mateflals IM f)ection Handbook and Storage Manual Requirement$ 13. CONTAfNERS, A Material is Stored in Proper Concainen (Cl'ledl. only if applicable) X
PILES. OR 8. All Containers. ?ties 81ld/or Uflits Ari: Marked as Prescribed in the Storage Manual X OTHER UNITS C. Condition of Container! (Give exad number in Class Ill under remark$) I (1) CLASS I 1(21CI.ASS II (3)CLASS Ill
N/A N/A N/A 14 DESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
PRO, T~ IJ>,li,, ~..,e,
GRAM lns,q,l.bole CO:..,)
• b
OU,OM 0 , 11m
15 REMARKS
TOTAL f.U'eER
WIDTH LENGTH HEIGHT OF UNITS
DIAM- lg, WEIGHT OF UNIT .A .... ,, ..
C. d . • ETER (1) GROSS (21 NET
I 29" 20" NIA NIA
ToUlfP3Uet$ ~,, __ ~!(,
lfle*W ~-~OOl'l)pll• q,~ - 1,111111 1n ·g.,i,ot-Jef lf'.,e n:.~ot:r.'!Oelq::illlll nWlllll,ot. ,,,d ,tot'(le &.tol~-. :.-io 11ocsdi:nc~
11re 1~ ghelhfJ'3001'l)Ol'l-(IIIOl» n111l'C);o,,. ~1:1.1~~1n1~llloc:1>
See Attached Sheet for other pertinent information.
t. TOTAL WEIGHT
NET WEIGHT
POUNDS
-~ 7r,.UXI)
NIA
NO
Actual count of flask$ could not be verified, thus no drums wore opened at the time o f inspection, Orum count was verified and matched p lenograph.
Jerome 505 Mercury Vapor testing conducted by the undersigned.
Total Inventory of Mercury flasks arc contained within steel drums w ith no evidonce of leaking.
16. RECOMMENDATIONS
""'"
17. DISTRIBUTION OLA/SM/Chief (EJ Charles harderlRldla.mil OLA/SM/PM CXJ [email protected]
OLA/SM/HWAO Manai:ier CXJ robert.mathia:s&rldld.m ll SOC Environmental DIV IX! 0 OTHER
18 NAME OF INSPECTOR (Type or ?tint)
,P.,.-) /'J -Ilk< OlAl1 FORM 30 I
18A, SIG IU T •~i:... 18 a DATE OF SJGNATURE
~~ A 07 /1 -z., J,, This Is a oomputcr.generat.8CI form Of OLAH form~t~--~ __ ;;i_;t-----L>"-'-11-'-'-LI-'-<'-----------
MERCURY STORAGE FACILITY DAT'!';.;' ~a!fa!:al~d,;;f;;;;;;;... ________ _!!INSPECTION REPORT FACILilYID: HWAO 110-92
D D B D D
A1 SAFETY IN STORAGE
A2 EVIDENCE OF LEAKJNG
A3 HIGH VAPOR CONCENTRATION LEVEl
,A.4 PACKAGING
A5 MARKINGS
A6 STORAGE CONFIGURATION
D AD1 MISSING/INCORRECT FIRE ANO/OR CHEMICAL SYMBOLS
D A02 DAMAGED OR DEFECTIVE CONTAINMENT CURBS
D A03 GEO-MEMBRANE FLOOR DAMAGED. RIPPED, TORN OR U NSERVICEABLE O A04 LOOSE/BROt<EN DOCK BUMPERS POSING A 8'GNIFICANT HAZARD D A05 CRACKS IN WALLS EXCEEDING 1/4" IN \NIDTH
D AD6 WAREHOUSE FOUNDATION/STEPS. EV10ENCE OF OETERIORATION
BA07 HOLES IN THE ROOF
A08 C(½ FIRE SUPRESSION SYSTEM SHOWS EVIDENCE OF CORROSION. INTRUSION OR IS PHYSICALLY DAMAGED
D D D D
D
MAJOR OERCIENCIES = 8
81 PORTABLE DOCK (If preseM)
82 RECORDS MISMATCH
83 ITEM LOCATION MISMATCH
94 INVENTORY RECORO CARD MISMATCH/INCOMPLETE, UNAUTHORIZEOOTY ADJUSTMENT
8$ HOUSEKEEPING
FACILITIES MAJOR DEFICIENCIES • BO f MINOR OEflCIENCIES = CO
Oso1 DOORS ANO/OR WINDOWS ARE NOT WORKING PROP ERL v AND CANNOT BE SECURED
Oso2 BROKEN LIGHTING WITHIN THE s 1TE. SPECIFY GR 10 LOCATION
Oso3 VENTILATION REGISTERS ARE CLOSED, BROKEN ANO/OR INOPERABLE
Osoc WINO SOCK. POLES ARE NOT 1N PLACE AND WNO socKSARE NOT '11\IQRKING PROPERLY
O co1 DOOR DEFECTS · Misamg Q"OSK1. ffl!H~cn d0cf noc:t:s. ()f'Ot.iMlamaQ(i(II mM!no
D iw'IQlf'!,, ~!11101: ac:o:ssJm'"!l9dll/Tl.ot;Jcdf(l~N$ Y$f'II ~$
CO2 EXCESSIVE VEGETAT ION
Ocoa INCORRECT LOCK. OR NON·FUNCTIONJNG LOCK
DC04 EVIDENCE OF RAT INFESTATION I.E .. NESTS. DROPPINGS
Ja;1 NOOEFICIENCIESNOTEO
COMMENTS CONTINUE ON R.EVERSE IF ADDITIONAL SPACE IS REQUIRED
DlA SJGNATURE/OATE
OZHC 63S•E REV-4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and Location or Depot or Facili.1y 2. Name and 3. Serial No.'-/
OLA-SM-HWAO Typeol Qusu-l t d y J,1.speclion of \.ftrt.ury Stora.it Areu
Hawthorne, NV Commocfily 4. IDNO. .
0 A~j) 6. Type of
A d I /7 Storage Warehouse: / /Q :1 ) T 8 . HI~) and ~fie Warehouse location:
E .,, IJ /" Ottl)OI Area Open Storage Area:
7. NAME AND TITl.E OF PERSON RESPONS!SLE FOR MATERIAL 1:A. TEL. NO. OR CODE 78 EXT
Robert Mathias, DLA Strateaic Materials Suoeivisor 330) 623-0267 ~-INSPECTION AREA ~,rid wn,cit,,t, E.oP'1i"nli.l(lod"11r.1pol'$~ YES
8. STORAGE A . Sier=-- Facifrties Are Of the Type Preson.bed in the S!oraae Manual X B. Storage Facilities Arc Maintained in GOOd Order X
•• MATERIAL />, . Ma:erial Is S.ored In the Manner Pm aibed In the $1orage Manual X B Mtt.erial Is Free of Deterioration. lnicstation. Cont.amina~n, Comm1nging, Migretion and Erosion X
10. RECORDS A Depol Ma,.._...., Confirmed that a1 entriei have been Posted N/A a . oei,ot Postings are: Las1 RR No. Dale OSRNo Oa'\ed N/A
11 UNITS Quantity indlcaled in Item 14h ,eflects EBS Postino and oorees with actual andlOf computed oount X
12. SECURITY ANO secun1y and Fire Pro:ection are being provided in aoco<d.aoce v.ith Quality Assurance aod X
FIRE PROTECTION Ma1enals Inspection Handbook ancs StOf'''"'e Manual Requftements
13 CONTAINERS, A. Material 1$ $10fed In Proper Conlainers (Check only if apnlicable) X Pl.ES, OR 8. All Cot\1a!nen, Plies and.'or units Are Mafted as Prescribed in the Stora!)E! Manual; X OTHER UNITS C,. Condition of Con1ain8'1S (Give exact numbef in ClaH Ill under remark.a) I (1) Ct.ASS' 1(2) CLASS II (l ) CLASS 111
NIA NIA N/A 14 DESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
TOTAL Nt.M'J~ OfUNITS
PRO- Typt f'ilol ear,._, WlOTH LENGTH HEIGHT OIAM· g. WEtGHT OF UNIT Rull,._ fl t TOTAL W'E.IGHT
GRAM !npc(. .,. 11!,C, )
,. • ....... .,, .
15. REMARKS
C. d. •. ETER (1) GROSS (2) NET
f
2t·· 20" NIA NIA
Tota1Pallots -11
(RIMewilll 00'..et OPPJOC)fll!W ql,IMl)QnOf, wnhinll'd in 'Ql,jicie '- 11141, iMpoellon Of ~tplb<I rnetet\01$ O!l(l'S!Olll90 fltoll"'"". ~ o! dlll68/ICNilll
arc IOl¥d, gr,e Iii. IIPlffl;llllllllkl 11 .... m;i,tbol," ""° ~ Oll!al$ In II'& Uoc:I)
See At!Jlched Sheet for other pertinent information,
NET WEICHT
POUNOS
N/A
NO
'
Actual count of flasks could not be verified, thus no drums were opened at the time of inspection, Orum count was verif ied and matched planograph,
Jerome 505 Mercury Vapor testing conducted by the undersigned.
Total Inventory of Mercury f laskS are contained within steel drums with no evidence of leaking.
16. RECOMMENOATIONS
17. DISTRIBUTION DLAISM/Chief
OLA/SM/PM OLA/SMIHWAD Man SOC En'llronmental OIV 0 OTHER
18, NAME OF INSPECTOR (Type ot Print) 18 B. DATE OF $1GNAT1.JR.E·
v "'
1.,-.c:arion: Hawthorne. >JV
o.,c or 10,pc<rion: ~ p~)1
1~) J ] 1r,$pcc-mr: ~G,.L, .. , ... 1_ ,.,;:i~-¼-.u,. .. ;.z:i... ... "~;;:::;.;~:.-,...-
Wl,sc/
D D
B B
A1 SAFETY IN STORAGE
A2 EVIDENCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION LEVEL
A4 PACKAGING
AS MARKINGS
A6 STORAGE CONFIGURATION
O A01 M1ss1NG11NCORRECT FIRE AND/OR CHEMICAL SYMBOLS
O = DAMAGED OR DEFECTIVE CONTAINMENT CURBS
D A03 GEO-MEMBRANE FLOOR DAMAGED, RIPPED. TORN OR UNSERVICEABLE DAD< LOOSE/BROKEN OOCK BUMPERS POSING A SIGNIFICANT HAZARD O Aos CRACKS 1N WALLS excee o1NG 114" 1N VVIDTH
D A06 WAREHOUSE FOUNOATIONISTEPS ·EVIDENCE OF DETERIORATION
BAUT HOLES INTHEROOF
A.08 CD.? FIRE SUPRE$$10N SYSTEM SHOWS EVIDENCE OF CORROSION, INTRUSION OR IS PHVSICAll Y DAMAGED
D D
B D
MAJOR DEFtCIENCIE'S = 8
B1 PORTABLE DOCK (If present}
82 RECORDS M1$MA TCH
B3 ITEM L0CATIONMISMATCH
94 INVEITTORY RECORD CARO MISMATCHl'INCOMPLETE. UNAUTHORIZED QTY ADJUSTMENT
B6 HOUSEKEEPING
FACILITIES
FACIUTYIO: HWAO 110-93
MAJOR 0EFICIENC1ES = BO f MINOR OERCIENCIES =- CO
Oso1 DOORS ANO/OR WINDOWS ARE NOTV,.ORKING PROPERLY ANO CANNOT BE SECURED
D B02 BROKEN LIGHTING WITHIN THE SITE • SPEC1FY GRID LOCATION
0eD3 VENTILATION REG1$TERSARE CLOSED. BROKEN ANO/OR INOPERABLE
0004 WINDSOCK POLES ARE NOT 1N PLACE ANDWINosocKSARE NOT WORKING PROPERLY
O c01 DOOR OEFECTS • lli»rl!)9rount1, miSsin!>\Ho~n dca' hcdts bn:t,:n,l(l,11n89&0{ ,ni~ lli1~ s . t:lrnof .ll!)C(l5tJ!!l$finO{(JM'l~~t! VO'!! Krec:N
O co2 e xcesS1VEVEGETAT10N
O coo INCORRECT LOCK OR NON-FUNCT10 NrNG LOCK
0 c04 EVIDENCE OF RAT INFESTATION I.E., NESTS. DROPPINGS m NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADDmoNA.L SPACE IS REQUIRED
OLA SIGNATURE/DATE
OZHC 635-E REV4 6/ 2014
NOTIFICATION OF STOCKPILE INSPECTION 1. Name and Location of Depot or F:icmty 2. Nameancs 3 Sc!\01 No, 4
DLA-SM-HWAO Type o( Quarttrly fos1>ettioll of Mt rcury Storagt Arus Hawthorne. NV Commodity • . IDNO. '
D A. LAS~, • . Type of
A ,.;.ia/ Ston)ge
Warehouse 11 Q .?f ~ T 8. T ~/,
and Specilie w areh0t1$e IOcallon:
E 0., Ii Depot Area Open Storaoc Area:
7. NA.ME ANO TITLE OF PERSON RESPONSIBLE FOR MATERIAL l~A TEL NO OR CODE 78. EXT
Robert Mathias. DLA Strateqic Materials Suoervisor 3301 623-0267 ""' INSPECTION AREA (C'*lo: 111111 ~ Ex~rn Mlllllh'O m..~> YES
8 STORAGE A. Stor.-.oe Fac:Hltles Ale ot the Type Prescribed in the Storage Manual X B. Storot'le Facilities Ale Maintlined in Good Ordet X
9 MATERIAL A. Matcttial l$ St«ed In the Manner Pfescrlbe<I In the Storage Manual X a. Material Is Free of Oe:teriora5on, Infestation. Coniamination. comm,oo1ing. Miorauon and e,oslon X
10. RECORDS A. Depot Manager Confirmed that all entries have been Posted NIA B. OePol Po$1ings are: Last RR No Oate OSR No Dated NIA
11. u ,urs Quantity indicated II\ tlem 14h re1!ects EB$ Posting and agrees with actual andfor oompLYled oount X
12 SECORITY AND Securi1y and Fire Protection aro being provided in aocoroaoce ~tl'I Ooo!ity A$$ur.lncc and X
FIRE PROTECTION Matelials tns;pection HandbOok atid Storage Manual ReqLJreme.rrts
13. CONTAINERS. A. Mate.Aall it StOf'ecJ in Pn»et COnt,inefS (Cheek only If appllcatlle) X Ptl.ES, OR 8. AH Con1aincrs, Piles andlor Units Arc Mark~ a& Prescribed in the $1¢taQe MQnu~ X OTHER UNITS c. Condition of Containers {Give exact number in Class ti) under , emaits) I (1) ClASS ll(ZICLASS II (3) CLASS Ill
NIA N/A NIA 14 DESCRIPTION OF CONTAINERS. P'tLES. 00 OTHER UNITS
PRO- T ~ (Pil,, Q:sM.
GRAM ll'll!el. wl,;, t« -l
' • . .....,... ... ~
15. REMARKS
TOTAL /IM,IEIER OF UHOS
WIDTH LENGTH HEIGHT O!AM- g. WEIGHT OF UNIT lilms 11.
C • • ETER (1) GROSS (2) NET ,. 29" 20- NIA NIA
TO(a!Pallets
'"'' ,_ '-f 'l '7.A
~ -di~ IJIIC)•OP,IM ' I'~ woh,11,:,d in '9"i6,;,b hi.$~ O,-.~lid !~Mllllill iol'l(f(i!Q. 6.ril~ld~,-, lldel'\6 11/ICW;
II!,;, (t.lU"ld. 11"• IIIM llfl()ff)(>l'IMw lJ•Q 1111nt.,,>j ..-.:I ~ dliHll .. 111 Ilic. Ul)(j;')
See Attached She.et for other pertinent information.
i . TOTAL 'h'EIGHT
NET WEIGHT POUNDS
/ I f- /~KI J
NIA
NO
Actual count of flasks could not be vetified, th us no drums were opened at th9 tlm9 of Inspection, Oruin count was verified and matched planograph.
Jerome 505 Mercury Vapor testing conducted by the undersig ned.
Total Inventory of Mercury flasks are contained within steel drums with no evidence of leaking.
16. RECOMMENDATIONS
17 0 1$TRIBl!TION DLAISM/Chief Iii [email protected]
OlAISMIPM 1B) jason tioyntonl?l!dla ml
Ol.A/SMl1-f!NAO Manaaer 1B) ro'--Art.m ;ithl;isai)d la .mil
SOC Environmental OfV l!I D OTHER
18. NAME OF INSPECTOR (Type or Print) 1 811.. S .JGN.t.TIJli E
: : ~ T~;r,G;TURE t;1"I SteJli-..\ ~ 'J' ' lA ~ -OlAH FORM 30 J This is a oomputer-generated form of OLA , 88 .
Loc:uion: I lawthocnc,. NV
Dltc o r 10,p<'Cli~n e, tf:1/ 17 lnspcctor: G I J S j t 1
Findinp,i;:
R('matks:
D Al SAFETY IN STORAGE
D A2 EVlOENCE OF LEAKING
D A3 HIGH VAPOR CONCENTRATION LEVEL
D A4 PACKAGING
D AS IMRKJNGS
D A6 STORAGECONFIGURATION
D AD1 MISSING/INCORRECT FIRE ANO/OR CHEMICAL SYMBOLS D A0'2 DAMAGED OR DEFECTIVE CONTAINMENT CURSS
D A03 GEO-MEMBRANE FLOOR DAMAGED, RIPPED. TORN OR UNSERVICEABLE O A04 LOOSE/BROKEN OOCK BUMPERS POSING A StGNIFlCANT HAZARD
D AOS CRACK$ IN WALLS EXCEEDING 114" IN \MOTH
D A06 WAREHOUSE FOUNOATIONtSTEPS . EVIDENCE OF OETERJORA TION
BAO'! HOLES IN THE ROOF
AO$ COz FIRE SUPRESSION SYSTEM SHOW$ EVIDENCE OF CORROSION, INTRUSION OR IS PHYS!CALL Y DAMAGED
D D
B D
MAJOR DEFICIENCIES= 8
B 1 PORT ABLE DOCK (If p'8sent)
82 RECORDS MISMATCH
83 1TEMLOCATION M1$MATCH
04 INVENTORY RECORD CARD MISMA TCH11NCOM.PLETE. UNAUTHORl,Z.EO QTY ADJUSTMENT
85 HOUSEKEEPING
FACILITIES
fAOUlYIO: HWAO 110-94
MAJOR DEFICIENCIES= 80 / MINOR DEFICIENCIES= CO
O so1 DOORS ANDIOA. WINDOWS ARE NOT WORKING PROP ERL v ANDCANNOTBE SECUREO
D 002 BROKEN LIGHTING WITHIN THE SITE. SPECIFY GRID LOCATION
Oeoo VENTILATION REGtSTERSARE CLOSED. BROKEN ANO/OR INOPERABLE
D 8 04 \/VIND SOCK POLES ARE NOT IN PLACE AND VIANO SOCKS ARE NOT \J\'ORKJNG PROP£RL Y
O co1 DOOR OEfEClS ·M1~grtiul'IO. m1~cidooc-t'IOOka, bl'O~M1Simag8G'mtu1rq
D fli'IC...S. ¢8nno1 ~~1N}td:irnllgecWefect1Ye V\Vlt :;ctCCn':11
CO2 EXCESSIVE VEGETATION
DC03 INCORRECT LOCK OR NON-FUNCTIONING LOCK
DC04 EVIDENCE Of RAT INFESTATION I.E .• NESTS. DROPPINGS re NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADOfTIONAL SPACE IS REQUIRED
OLA SlGNATUREJOATE
DZI--IC 635-E REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. N3me Md l.oea!loo OI De-pol or ~aci!lty 2 Name and 3. $etlOI NOA.f
DLA-SM-HWAO Type Of Q1J:trte-1•1y luspecdon of~ler<'ury Stonj!c Arc~s Hawthorne, NV CommOdl'ly 4. IDNO.
D A~ ~S::J,-. 6. Type of
A NJ ' Storage
wa,.houH: / /{z :9,) T 6 1 l~ I ..• and $peafic Warehouse IOcatioo
E ~, ., Oc-potArca Open Stor-- - Arca: 7. NAME ANO rn LE OF PERSON RESPONSIBLE FOR MATERIAL f A. TEL NO OR oooe 78. EXT Robert Mathias, DLA Strat..,.,ic Materials Suoervisor 3301 623-0267 ...
INSPECTION AREA ~lllldc:.;ollPl!~ E~noo,iY• tl0$00nw:.) YES 8. STORAGE A. Storage Facilities Are of the Type Prescribed in the sr~e Manual X
8. Slorai)e Facilrbes Are Maintained in Good Order X 9. W\TERIAL A. Material Is Stored In the Msnner Prescribed in tl-.e SI""""""" M"nual X
8. M<1tcrit1l ls Free of Octonorauon. 1nres1at1on, Contam6n811on, COf'l'lmlnglif\g, Migration 8nd Er0Sion X 10 RECORDS A. OeP(ll Manager COnfifmed that all entriss have been Pos1ed N/A
8. Depot POSUl'IQ$ a,e: LastRR No. Oa:e OSRNo oateo N/A 11. UNITS Ouantilv indicated in ti.em 14h reflects EBS Posting and agrees with actual andfor c:omputed count X
12. SECURITY AND Sec:urity and Fire PfOtection are being provided in aocordance with Quality As.wrance and X
FIRE PROTECTION Mstelia!s Inspection HaldbOok Md Storaoe Manual R ...... W'Elments
13 CONTAINERS, A. M,tet\31 i:S S10f'ed in Prooer Containers (Check onlv if """'"licable\ X Pl.ES. OR 8 All CMtainers, Piles and/or Units Are Marted as Prescnbed in the Storage Manual X OTHER UNITS C. CM<ition of Containers (Give exact number in Class ID under rem81'1<s) I (1) ctASS 11(2) CLASS II (3) CLASS Ill
NIA NIA NIA 1 "4 DESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
PRO- f',(l*(File.C-,
GRAM illtl(ll bolo,-C.C )
,. • OLA/SM Orum
15. REMARKS
TOTALNJMSER O,CNTS
WIDTH LENGTH HEJGHT DIAM- • 'WEIGHT OF UNIT ~.Sts II.
C d e. ETER (1) GROSS (2) NET f
29" 20" NIA NIA
T otstP.anet$
~L <-l" )(J]
0-,,-1-111 (llhfllr fW1¢flllifloo 1111~ OQflh,,,.,u "'"911(1" tor t,e.1r,,sl)(!CtlonQI $!0ek~too ~~ .ino ~tor• l;lcliJ~·. 111'dlf~llfo
or. tounci, ~11111 ~illll(l!Jidli,.:od ... 1ondc:,11111A,!., ... m llta!J ~
See AUached Sheet for other pertinent information.
I TOTAL WEIGHT NET WEIGHT
POU"1DS
77/Y.l'KI J
NIA
NO
Actual count of f lasks could not be verified, thus no drum5 were opened at the time of inspection, Orum count was verified and matched planograph.
Jerome 505 Morcury Vapor testing conduct8d by the unde/'$igned.
To tal Inventory of Mercury flasks are contained within steel drum5 with no evidence of leak ing.
16. RECOMMENDATIONS
17. DISTRIBUTION 01.AJSM/Chief OLA/SM/PM IXI
OLA/SMIHWAO Manage< l&I l-'t.m il SOC Environmental DIV a OTHER
·18. NAME OF INSPECTOR (Type or Print) 18 S. DATE OF SIGNATURE
Ol 15 8
D D
B D D
A1 SAFETY IN STORAGE
A2 EVl0£NCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION LEVEL
A4 PACKAGING
Ml MARKINGS
AS STORAGE CONFIGURATION
O A01 MISSING/INCORRECT FIREANOIOR CHEMICAL SYMBOLS
D A02 DAMAGED OR DEFECTIVE CONTAJNMENT CURBS
O AD3 GEO-MEMBRANE FLOOROAMAGEO. RJPPEO, TORN OR UNSERVICEABLE D A04 LOOSE/BROKEN DOCK BUMPERS POSING A SIGNIFICANT HAZA.RO D A05 CRACKS IN WALLS EXCEEDING 1/4~ IN WIDTH
O AD6WAREHOUSEFOUNOATION/STEPS-EV10ENCE OF DETERIORATION
BA07 HOLES IN THE ROOF
AOS ~ FIRE SUPRESSION SYSTEM SHOWS
EVIDENCE OF CORROSION. INTRUSION OR IS PHYSICALLY DAMAGED
0 0
B 0
MAJOR OEFICIENCIFS-=- 8
B1 PORTABLE DOCK {If present)
82 RECORD$ MISMATCH
BJ ITEM LOCATION MISMATCH
54 INVENTORY RECORD CARO MISMATCH/INCOMPLET E, UNAUTHORIZED QTY ADJUSTMENT
85 HOUSEKEEPING
FACILITIES
FACILITYIO:::"H::W"A"'0'-.;,11.:.0:..·..:9.:.5
MAJOR DEFlClENCIES .r BDJ MINOR DEFICIENCIES= CO
D 801 COORS ANO/OR VIAN DOWS ARE NOT VJORKING PROPERLY ANOCANNOTSESECUREO
Oeo2 BROKEN LJGHTlNG Vvl'THIN THE SITE . SPECIFY GRID LOCATION
0803 VENTILATION REGISTERS ARE CLOSED. BROKEN ANO/OR INOPERABLE
Oe04 \NINO SOCK POLES ARE NOT tN PLACE ANO WINO socKSAR.E NOT 'NORKING PROPER\. Y
Oco1 DOOR DEFECTS - M15$11'1Q l1'0U'li:J. mi~ door hooks, brok$Ml.lmececv rn~r~ lli'lCM. C:.mol ao:.eMfml$$ino,'(18m&g8<V!JeieetNe vll!lll 50'CCI\S
O coz excess1veveGETAr10N
BCOJ INCORRECT LOCK OR NON-FUNCTIONING LOCK
C04 EVIDENCE OF RAT INFESTATION I.E., NESTS, DROPPINGS .w NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADDITIONAL SPACE IS REQUIRED
OLA S IGNATUREIOATE
DZHC 6.3S-E REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1 Narne and Locatson ot Depo1 or Facility 2. Nameand 3.. Sens! No . .J../
OLA-SM-HWAO Typeot Quarttrly IOSJ>tction of Merc11ry Storage Areas
Hawthorne, NV Commodity 4. IONO. . D A.u ~l/, 6, Type of
A ">'-I I /" s1or39e w .. .-•• ,., 1/b--ql, T B. I ;';;r; .lnd Specific Warehouse localioo:
e !fl. I Otr .. Arel> Open Storage Area: 7 fllAME ANO TITLE OF PERSON RESPON$tBLE FOR MATERIAL l~A. TEL NO OR CODE 78. EXi Robert Mathias, OLA Strateaic Materials Su""'rvisor (330) 623-0267 ""
IN$PECTtON AREA tc~.-l~ fxpl,:,,n~,,17,0ij,~~> YES 8. STORAGE A Storage Facilities Are of the r-Pre:scrit>ed in the $1orage MaooS X
8 Ston~ge Facilities Ate Maintained W'I Good Ordc-.r X
•• MATERtAL A Ma!el'ial ts Stored In the Manner Prescribed in the Stor.t!)e M8r'lual X B Ma-le,rial Is Free al Oe1eri0f81ion. Infestation. Contaminaition. CommJngling, Migration and Etoeion X
10 RECORDS A. Depot Manage, Contlrmed th8! all emoes have been Postad NIA 8. Depot Postings are: LasLRRNo Date OSRNo oateo NIA
11 UNITS Ouarrtiw indie3tcd in Item 14h reflect$ EB$ PoS'!lng and agrees with actual anclfor cornouted count X
12 SECURITY AND SflC\lrity and F'tte Pr01ecbon are being provided in eoc:ordance 'Mth Quality A5Suraocc and X
FIRE PROTECTION Materials lns-aion Handbook and Stooage fl.'Anual Requirement1
13 CONTAINERS. A. Material i, Siore<:1 in P<0per containers (Check only It appl!cable) X PILES. OR B. Al Contairu::1'$. Pile, and/or Unil$Ate Mat'll.ed as Prescnbed in the S1oraoe Manual X OTHER UNITS C Condition of Con!ainers (Gi\/'8 exac1 number 1n Class Ill under remark$) I {1) CLASS I 1{2)ClASS u (3)CLASSIII
N/A N/A N/A 14 DESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
PRO- T)'lllt f'iloo, •oo&e
GRAM ,..,..,._ h""' .. ic ) . .. ou,s• ·-
1S. REMARKS
TOTAL NUM!lfR Of'UN!TS
WlOTH LENGTH HEIGHT DIAM- g VVEtGHT OF UNIT A',Ub fl.
C. d. •. ETER (1) GROSS (2) NET
f. ,... 20" NIA NIA
T 01a1 Pallet1 --, ,,
" J
~~ 1"*1111 o11,,,, 11~111.:i(IUfflfOtlf; cotU!nooln ~A,s.,:ic rormc in-..peaen oi ~ltd"""'""~_,~ (111;>1t,,io,• ' " "' ,11,.fidoooW:Mo
•11 '°""'-'· 911111r.11pp,opr1,1t.t 91Jdo nutt)Cl'!o 4l1CI ~ Clel:lls 1n ~ ~
Sec Attached Sheet for other pertinent inform:ltion.
i. TOTAL WEIGHT
NET WEIGHT
POUNDS
. '-" 1 r"'\l' l
NIA
NO
Actual count of flasks could not be verif ied, thus no drums were opened at the time of inspection, Drum count was verified and matched planograph.
Jerome 505 Mercury Vapor testing conducted by the undersigned.
To tal Inventory of Mercury flasks are contained within steel drums wfth no evidence of leaking.
16. RECOMMENDATIONS
17 01$TRIBUTION Ol.Al'SMIChief (El
OLA/SM/PM IE [email protected] OLAISMIHWAO Mana er IE robert.mathiat d!a,mil SOC Environmental DIV D OT!-IER
18. NAME OF INSPECTOR (Type or Print) 18 8 . DATE OF SIGNATURE
I .c)(;Hioo: Hawthonie., NV
Dare of lnsp<.-ct~>n: Or// fy/ J luspt·ctoc G \ / ft&r (._ ~
Findinw-:
Remarks::
1
1--, MERCURY STORAGE FACILITY
OAT;;E:~::::;1=-:/::;;"5;::;l:~;::;;:; /i====--,---__.!!INSPECTION REPORT FACILITYIO: HWAO 110-96
D D
B D D
CRlncAL OE'FiCiENCfES =-A
A 1 SAFETYINSTORAGE
A2 EVIDENCE OF LEAKING
AZ HIGHVAPORCONCENTRATION LEVEL
A4 PACKAGING
AJ MAAKINGS
A6 STORAGE CONFIGURATION
O A.01 MISSINGlll'4CORRECT FIREANOJOR CHEMICAL SYMBOLS
O A02 OAMAGEO OR DEFECTIVE CONTAINM ENT CU RBS
O A03 GEO-MEMBRANE FLOOR DAMAGED. RIPPED. TORN OR UNSERVICEABLE
O A!).4 LOOSE/BROKEN OOCK BUMPERS POSING A SIGNIFICANT HAZARD O ADs CRACKS 1N WALLS exceeo1NG 114 " 1N WIDTH
D A.06 WAREHOUSE FOUNOA TION/STEPS ~ EVIDENCE OF DETERIORATION
B A07 HOLES IN THE ROOF
A08 COi FIRE SUPRESSION SYSTEM SHOW$ E'\.1DENCE OF CORROSION. INTRUSION OR IS PHYSICALLY DAMAGED
D D D D
D
MAJOR OEFICfFNCIF.S = B
B1 PORTABLE DOCK (If .,..,en!) 82 RECORDS MISMATCH
83 ITEMLOCATIONMlSMATCH
B4 INVENTORY RECORD CARD MISl'MTCHnllfCOMPLETC:, UNA.UTHORtZEOOTY AOJUS™ ENT
BS HOUSEKEEPING
FAClLITIE.S MAJOR DEFICIENCIES= 80 I MINOR DEFICIENCIES= CD
Os01 DOORSAND/ORWINOOWSARE NOT WORKING PROPERLY ANOCANNOTBESECUREO
Oso2 BROKEN LIGHTING \AKTHIN THE SITE . SPECIFY GRID LOCATION
Osoo VENTILATION REGISTERS ARE CLOSED. BROKEN AN DIOR INOPERABLE
D B04 VVINO SOCK POLES ARE NOT IN PLACE AND VIANO SOCKS ARE NOT V.'ORKJNG PROPERl Y .
O co1 ODOR DEFECTS · Mlwng l)"CU!lO, m,::~ 000< r'lOOk.t. f)(Ci($~m.i9cdl' ffllUI~ n1n;cs. umcr1 ~ 1r.11~mll{l,:,,dA,e,~ vVlt i;ac,cr,:1,
O co2 EXCESSIVE VEGETATION
8Ct)3 INCORRECTt OCK OR NON-FUNCTIONING LOCK
COC EVIDENCE OF RAT INFESTATION t E.. NESTS. OROPPING,S
~ NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF AOOITIONAL SPACE IS REQUIRED
o, I E OLA StGNA TUREIOATE
REV4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1. N;;ame .and Loc:a:ioo of Depot 0< Facility 2. Name and 3. Serial No.q
DLA-SM-HWAD Type of Quarr.rrly lni.pc:ction uf Mc-reury SIOrflge Areas
Hawthorne, NV Commoditu 4.1D NO. . D ':;q'f,~lt· 6. Type of
A S!Of"l)e
Warehouse: / J Cr 'i / T 0·:E~I. and Specific Warehouse location:
E ..,., Ir De$'.)()! Area 0 ....,n Slor---.... Area:
7. NAME AND TITLE OF PERSON RESPO.'IS!BlE FOR MATERIAL 1;A. TEL NO. OR CODE 78.EX.T
Robert Mathias, OLA Sb'at"""ic Materials Su ....... rvisor 330) 623-0267 '"" INSPECTION AREA (Ctw,,::t 1!11(1 (.)1)11,pl:lr~ Etnwn riog w,,: ,c,..QOn-~) YES
8. STORAGE A. Storaoe Filleilities Are or the Type Prescribed in the Storaoe M4:llnu31 X B Storage F acilitie& Arc "taintai"led in GOOd Order X
9, MATERlAL A. Malerial l& Stored In the Manner Pre$cribed In the S1orage Manual X B. Mal.enal ts Free of Deteri01'8.:ion. lnfe:&tation. CM.1am1ns~ion, Comtring!ing. Miora:ion and Erosion X
10 RECORDS A.. OcpOt Manager Confirmed that a!I entries have been Posted N/A B. DGl)Ot Posli11gs are: Last RR No. o ... OSRNo o .... NIA
11. UNIT$ Ouantitv indie.:lted tn tlem 1£h refteas EBS Postil"IQ and a~rte:$ with actual 3ndlor computed coon1 X
12. SECURITY AND S80Jrity at'W:I Fire Prolection are being provided in aocordanee With Quality Assurance and X
FIRE PROTECTKlN M.rtcricllli Inspection Handbook and Storaoo Manual Requirements
13. CONTAINERS, A. Malerlsl is Scored in Proper Containers {Cfleek only t1 applicablel X e . All Containers. Plies ardfor lki'ts Ate Marked as P,esaibed l.n the St.ors~ Manual X PILES. OR
OTHER UNITS C. Condi1iotl of Contaners (Give exact number in Cl-8$S Ill ut1der remarks) I (1) CLASS ~ (2) CLASS II (3) ClASS III
NIA NIA NIA 14 OESC~ IPTIONOFCONTAINERS PILES OROTHERUNITS
PRO- Typ,11fi,,,<11M.
GRAM in,JOl. ~ 11~.)
• ' ........ ·-
15 REMARKS
iOTM.MA'.11.JU\ OF UNITS
WIDTH LENGTH HEIGHT DIAM- o, WEIGHT OF UNIT ,,..., ~ C. d e. ETER (1) GROSS (2) NET ,.
29" 20" NIA NIA
TotalPaU8t& ~-.i ,,. '-1'1 I I<
tR"°'1"""1lllolhool llf¥)1'1)!1)f!~~quc,:.11:1n~cort~ne<11n ·ooo• fo< 1/111 ""'-~ nf1,to¢~ m.:itcnllt. ;:,!'JO~~ lllQl!Ullt" . 1'11U ,..-,,r.(J-1611
;:,ie to.md, Sf"~ ,,,.11ppm~ 9u.» nunc.c~ ~ ~ 6'111llliil i" .. ,tik'.ldt)
See Attached Sheet for other pertinent information,
i TOTAL WEIGHT NET \f\!EIGHT
POUNOS
-, /I ' J _,,, l\..
N/A
NO
Actual count of flasks could not be verified, thus no drums were opened at the time of inspection. Orum count was verified and matchod planograph.
Jerome 506 Mercury Vapor testing conducted by the undersigned.
Total Inventory of Mercury flask& are contained within steel d rum& with no evidence of leaking.
16. RECOMMENOA. TIONS
17. OtSTRIBUTION OLAfSM/Chicf ll!l charles.harder@dl3 mil
OLA/SMIPM ll!l iason.-1onm:.11a.mil
OLA/SMIH'WAO Man""""'r Ii) robe- -~·hJ-#""'dla.mil
SOC EnWonmerrtal DIV IE) 0 OTHER
18. NAME OF INSPECTOR (Type or Priri) W\.Sl ~AAE 18 8 . DATE OF SIGNATURE
t-, ,-/ &tetl1-., '!/:',, 07 / I ::t,J I 7 OLAH F0R:M30 I This is a oomputer-generntoa tonn of UI.AH 4 ecaa
,._, 3 / I MERCURY STORAGE FACILITY OAT1;E:~~' bJ,;. 1 ;;/~~;;;:;aa;,,,.,===",-,---____!INSPECTION REPORT FA.CIU 1YIO: HWAO 110•97
D D
B D D
CR.I TIC AL OEflCtENCIES w A
A.1 SAFETY IN STORAGE
A2 EVIDENCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION l.EVEL
A4 PACKAGING
A5 MARKINGS
A&STOAAGE CONFIGUAATION
D A.01 MISSING/INCORRECT FIRE ANO/OR CHEMICAL SYMBOLS
D A02 DAMAGED OR DEFECTIVE CONTAINMENT CURBS
O A03 GEO-MEMBRANE FLOOR DAMAGED, RIPPED, TORN OR UNSERVICEABLE D AOC LOOSE/SROKEN DOCK BUMPERS POSING A $1GNJFICANT HAZARD
D AOS CRACKS IN WAU$ EXCEEDING 1/,4" JN \IVIOTH
O A06 WAREHOUSE FOUNOAT10Nf$TEPS - EV10ENCE OF OETERIORA TION
BAO, HOLES IN THE ROOF
A08 CO, FIRE SUPRESSION SYSTEM SHOWS EVIDENCE Of CORROSIQH, INTRUSION OR IS PHYSJCALL Y DAMAGED
D D
B D
MAJOR OEfJClENCIES = B
81 PORTABLE DOCK (If pr$$8nt)
82 RECORDS MISMATCH
83 IT EM LOCATION MlSMA TCH
84 INVENTORY RECORD CARO MISMATCH/INCOMPLETE., UNAUTHORIZED QTY ADJUSTMENT
B6 HOUSEKEEPING
FACILITIES MAJOR DEFICIENCIES ,. BO I MINOR DEFICIENCIES"' CO
0 801 OOORSANOJORWINOOWSARE NOTV\IORKING PROPERLY ANOCANNOT 8ESECUREO
Oso2 BROKEN LIGHTING WITHIN THE SITE . SPECIFY GRI0 LOCATION
Oso3 VENTILATION REGISTERS ARE CLOSED. BROKEN ANO/OR INOPERABLE
Os04 WINO SOCK POLES ARE NOT 1N PLACE AND \II/IND soc.KS ARE NOT WORKING PROPERLY
O co1 OOOR DEFECTS . Misa,ng GJOU'ld-. m+ss~,cn (bQ( l'IOOk8, t>t'Ol~r*k!m.:igc-QI l'flM/"9
~ cann« ~:1i"l,'c!ilm~ 1;(11(l~ '-'ec'l seteetlS 0 cm EXCESSIVE VEGETATION
D COJ INCORRECT LOCK OR NON-FUNCTIONING LOCK
DC04 EVIDENCE OF RAT INFESTATION I E.. NESTS. DROPPINGS
~ NO DEFICIENCIES NOTED
COMMENTS CONTINUE ON REVERSE IF ADDfTIONA.L SPACE IS REQUIRED
17 OLA SIGNATURE/DATE
DZHC 635-E REV 4 6/2014
NOTIFICATION OF STOCKPILE INSPECTION 1 N;ame on,ct Loe:ltiOn OI Depot or Facitlty 2. Nameand 3 . Senal No.~
DLA-SM-HWAD Typeot Quart('rly l1iSpt>tlfon of Mercury Stora~,: Areas Hawthorne, NV Commoditv 4 IONO.
D d{/,~T/Ji 6. Type of
A Storage Wa,ehouse: JI(? ·1£ T s.;,r;;111 and Speoflc warehouse loce1lon:
E Q.......-d Area Opon S1or- Area:
7 NAME ANO TITLE Of PERSON RESPONSIBLE FOR MATERIAL 1:A. TEL NO. OR CODE 78.EXT
Robert Mathias, DLA Strategic Materials Supervisor 330)623-0267 N'A
INSPECTION AREA (Cbedt: ano conwiO!t . E~ nooatYt n,soo...-.cs.) YES
8. STORAGE A. S,Of'alle Fac:iities Are 01 tne Type Presonbed u, the S,orage Manual X B. St01'81ge Fac:Wtles A re Maintained in Good Order X
9 MATERIAL A. Material Is Stored In the Manner Prescribed i.n the Storacw, Manual X B. Materiel Is Free of Oe!erioretion. Infestation, Corrtanine'lion, ComminQIWlg, Migration end Erosion X
10 RECOl<OS A . Depot Manager Confirmed that all entries have been Posted NIA B oe,po1 Pos!lngs are. LastRR No, oa,e 0$RNo Dated NIA
11 UNITS Quantity lncbted in Item 14h relte(;ts EBS POSllfl9 and agrees wtth actual and/or computed count X
12. SECURITY AND Security and Fire Protoction arc being provided in accordanoc witA Quality A$SUI anco and X
FIRE PROTECTION Ma:erials lnsoection Handboolt and Stor-Manual Requirements
13 CONTAINERS. A Material is Stored in Proper Containers (Check only if applicable) X PILES. OR B. All Containers, Pies and/or Units Are Marked as Prescribed in the Storaoe Manual X OTHER UNITS C Condition of Con1ainers (Give exed number in Class Ill under remarks) I ( 1) CLASS I 1{2) CLASS II (3) CLASSIII
NIA N/A NIA 14 DESCRIPTION OF CONTAINERS PILES OR OTHER UNITS
PRO. Tvoe(l"lle.~.
GRAM ~ll*Ck .. t
• , . . ...,.. ·-
15. REMARKS
TOTM. NlM:lf.R Of' UNIT$
WIDTH LENGTH HEIGHT DIAM· Q. WEIGHT OF UNIT Fr•• "· C. d. •. ETER (1) GROSS (2) NET ,.
29• 20· NIA NIA
Toca!Paflets
:-4/ ,/
~--«lwf IIPP'll~ q~wrri11nod1n "g,.,ICle kirlhel'll:ll)e(110n ot ~~ llllitenfls 1111d ~lo"* ~1~ ·.~ IIOC!loenc
""' 11""""' (l;.w "'*'Pl'.lm~u•• nvml "''" ...., OO<f""°"" C,,,C4m ll• tillll:*)
See Attached Sheet for other pertinent information.
i . TOTAL WEIGHT NET WEIGHT
POUNDS
J/\,( ,A~L
NIA
NO
ActuaJ count of flasks could not be verified, thus no drums woro opened at the time of Inspection, Orum count was vertfled and matched planograph.
Jerome 505 Mercury Vapor testing conducted by the undersigned.
Total Inventory of Mercury f laskS ar& contained within steel drums with no evidence o f leaking.
16. RECOMMENDATIONS
NONE
17. DISTRIBUTION OLA/SM/Chief Iii) chatles.hatder@l<IIJ mil OLA/SM/PM IE) [email protected]
OLAISMIHWAO Manager ll!l fobert.m.1thiasm'ld!a.mil SOC En'llironmental DIV ll!l D OTHER
18 NAME OF INSPECTOR (Type or Print) 18A. S.!..i.t'° TU~ , ,aa DATE Of S!GNA.TURE
I-. , , / M/> 11 j, 11., ' !I.
n,) c?->J l t 1rQ-'"- '(/ J \ OLAH FORM30 I This is a computeriJenerated form of OLAH .,
8 -
J ,e,carjon: Hawtbonte, NV
l.);ncofln,p«t;.,,,, o,/r5)t 2 Jnspc:c:mr. ()~( ~fi;ft'l..$
(
Whse/
Rcma,1.s:
D D
B D D
A1 SAFETY IN STORAGE
A2 EVIDENCE OF LEAKING
A3 HIGH VAPOR CONCENTRATION LEVEL
AA PACKAGING
AS MARKING$
AG STORAGE CONFIGURATION
O AO'I MISSINGltNC~RECT FIRE ANO/OR CHEMICAL SYMBOLS
D A02 DAMAGED OR DEFECTIVE CONTAJNMENT CURBS
D AOO GEO-MEMBRANE FLOOR DAMAGED. RIPPED. TORN OR UNSERVICEABLE D AD4 LOOSE/BROKEN DOCK BUMPERS POStNG A SIGNIFICANT HAZARD 0 A06 CR.ACK.$ IN WALLS EXCEEDING 1/4• IN \NIOTH
D AD6 WAREHOUSE FOUNOA TION/STEPS. E'vlOENC E OF DETERIORATION
BA07 HOLES IN THE ROOF
AD8 C~ FIRE SUPRESSION SYSTEM $HOWS EVIDENCE OF CORROSION. INTRUSION 0A IS PHYStCALL Y DAMAGED
D D
B D
MAJOR DEFICIENCIES ia B
81 PORTABLE DOCK (If present)
82 RECORDS MISMATCH
83 ITEM LOCATION M ISMATCH
&4 INVENTORY RECORD CARO
MISMATCH/INCOMPLETE. UNA.UTHORIZED QTY ADJUSTMEITT
B5 HOUSEKEEPING
FACllffiES
f ACILITYID: HWAQ 110-98
MAJOR OEACfENCIES: BO I MINOR OEFICIENCJES = CO
D 801 DOORS AND/OR WINDOWS A RE NOT VI/ORKING PROPERLY ANOCANNOTBESECUREO
D 802 BROK.EN LIGHTING 1MTHIN THE SITE • SPECIFY GRID LOCATION
Oeo3 VENTILATION REGISTERS ARE CLOSED. BROKEN ANO/OR INoPERA.8LE
Osoc WIND SOCK. POLES ARE NOT IN PLACE AND VVIND SOCKS A RE NOT WORKING PROPERLY
O co1 DOOR DEFECTS • M15$1no Qro.l'ld. misa~Ok«I cbt.'f liocks. bro1i:~M1.1~ mi6$1no tinges. ~M;Jt ~i6eino'<l8!'1\3gli!dfcfe'ba~'e Yenl so,:cr,5
O co2 excessive VEGETATION
D C03 INCORRECT LOCK OR NON~FVNCTIONING LOCK
DC04 EV10ENCEOF RAT INFESTATION IE,, NESTS. DROPPINGS
~ NODEFICtEl'fC.IESNOTEO
COMMENTS CONTINUE ON REVERSE IF ADDITIONAL SPACE IS REQUIRED
-, OLA SIGNATURE/DATE
DZHC 635-E REV4 6/2014