Emergency Response & Training Solutions
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1 Emergency Response & Training Solutions EMERGENCY RESPONSE REPORT XPO Logistics-XCL Spill Response-Cargo Incident Non-Hazardous Non-HazMat kemamide EBS Wax Pounds Parma, OH Snow Rd Parma, OH Claim No: Trailer No: Incident Date: April 04, 2017 Closure Date: April 21, 2017 Prepared for Jeff Sexten Manager of Environmental Compliance XPO Logistics-XCL Snow Rd Parma, OH Prepared by Ross Mitchell Project Manager 6001 Cochran Rd. Suite 300 Solon, OH Office Phone Number: Emergency Line: Fax Number:
2 Emergency Response & Training Solutions Table of Contents Site Map Incident Response Report Contractor Narrative Cargo Narrative Photos MSDS Bill of Lading Office Phone Number: Emergency Line: Fax Number:
3 Emergency Response & Training Solutions Site Map Office Phone Number: Emergency Line: Fax Number:
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5 Emergency Response & Training Solutions Incident Response Report Office Phone Number: Emergency Line: Fax Number:
6 Emergency Response and Training Solutions XPO Logistics-XCL Incident Reponse Report ERTS Alert #53108 Client Reference No: Project Manager: Ross Mitchell Intake Information Call to ERTS: Incident Reported by Phone: Location of Incident: 4/4/2017 8:50:00AM Daniel McDonie of (216) Trailer Floor Incident Occurred: April 4, :38 am Unknown? o Initial Incident Description: At 0850 ERTS received a call from Daniel McDonie of XPO Logistics - XCL to report a spill. It was reported that at 0838 hours terminal personnel discovered (1) 2000 pound supersack of non-hazardous product called "Kemamide EBS WAX" damaged inside trailer # due to improper loading from the previous terminal (XCO) resulting in the release of approximately 500 pounds to the trailer floor. ERTS reviewed the SDS with the caller to ensure they are capable of cleaning the release, however based on the powder form of the material it has a high potential for exposure limits to exceed with dust particles in the air during the spill clean up and based on that ERTS dispatched EMS for the spill response, ETA 45 minutes. No storm drains, waterways, or soils were impacted; spills in trailers, containment areas, and concrete docks are not considered reportable. ERTS to generate Titan Entry and upload BOL and SDS to alert. Reported material released name/description: o Hazardous Hazardous Material UN/NA Primary Haz Class Secondary Haz Class Packing Group Qty Released þ Non-Hazardous Non-Hazardous Material Description Qty Released Non-HazMat (Specify Description) kemamide EBS Wax Pounds o Petroleum o Non-Regulated o N/A Incident Category(s): Spill Response-Cargo Incident Truck Number: N/A Trailer Number: Domicile Terminal: XCO Driver Name: N/A Onsite Contact: Daniel McDonie Phone: (216) Reported Impact Medium: Inside Trailer Reported Cause of Incident: Pro Number (no dashes or spaces): Cargo Only Incident (See Cargo Narrative) Container Type : 2000 Pound Supersac Bags Quantity in Container(s): 2000 Pounds Trade Name of Product: kemamide EBS Wax Shipper: PMC Biogenics Inc. Has the release already been cleaned up: Yes Has the release already been cleaned up: Yes Determination Response Date: Terminal Cause of Incident: Responsible Party: April 4, :50 am unknown Other Description: Cleanup Already Complete: Network Vendor Dispatch Contractor(s): Environmental Management Specialists (OH)- LTL Contractor ETA: April 4, :15 am Weather in the Area: 56 degrees and raining
7 Emergency Response and Training Solutions XPO Logistics-XCL Incident Reponse Report ERTS Alert #53108 Client Reference No: Project Manager: Ross Mitchell Regulatory Notifications Fed RQ Exceeded or Potential to Exceed: Tracking No Contact Name Notification Date/Time NCR Notified: SERC Notified: State Env Agency Notified: Other Notified: DOT 5800 or TDG Reportable: State Police Notified: Fire Dept Notified: Incident Requires reporting per Clean Water Act: Confirm Material Released: Size of Impacted Area: Kemamide EBS Wax 3'x3' Contractor Site Accessment Confirmed Amount Released: Pounds Confirmed Medium Impacted: Trailer Floor Specific Area of Release: N/A Post Accessment Shipper (confirmed from BOL): PMC Biogenics Inc. Was the waste taken for disposal by the contractor: No Was the waste staged onsite until the contractor can return to collect and dispose of the waste: No Amount of Waste Generated: (9) 55-gallon steel drums Container Type: 55 Gallon Steel Drums Content of Containers: Kemamide Imapcted Debris (PPE, Cardboard, etc..) Was there any salvaged material: No If Yes, where is the salvaged material: N/A Is Additional Remediation Needed: No Did the Cost Reserve Change: No If Yes, New Reserve: N/A If Yes, Why did the reserve change: N/A Have you entered the incident into Titan with any spill clean-up debris, PPE, or adsorbent mixed together or separately as awaiting pickup, any salvageable product as awaiting disposition, and if no waste was generated as no waste generated: Yes Titan Reference Number: XCL Shipper Notification Reference Number Provided: N/A Disposal Classification(s): NA Remediation
8 Emergency Response & Training Solutions Contractor Narrative Office Phone Number: Emergency Line: Fax Number:
9 IST and ER General Service Summary Updated January 1, 2017 Chronologic Reporting Log Date: 4/4/2017 Job No Client: ERTS/XPO EMS Rep: Steve Sims GPS Latitude: GPS Longitude: Time Notes 0900 CALL FROM DISPATCH 0900 CALLED CREW 0905 CALLED ERTS/PM 0905 LOADED TRAILER 0930 EN ROUTE 0950 ON SCENE 0955 OUT WITH TRAILER # CALLED ERTS DISUSSED PLAN 1005 DONED PPE STARTED CLEAN UP 1115 CALL SHOP FOR MORE DRUMS AND HAD DYLAN GO TO SHOP 1145 PAUL ARRIVED WITH MORE DRUMS 1230 PAUL AT SHOP OFF CLOCK 1245 DYLAN ARRIVED ON SITE 1300 FINISHED DRUMING FREE PROUDCT/ UPDATE ERTS 1310 STARTED TO HEPA VAC FLOOR AND GROUND UNDER TRAILER 1350 FINISHED CLEAN UP / XPO REP NOTIFED 1400 LABLE ALL DRUMS 1415 MOVED TO OS&D ON SITE 1445 CALLED ERTS/PM 1445 OFF SITE TO SHOP 1545 AT SHOP RESTOCK TRAILER 1700 OFF CLOCK Environmental Management Specialists, Inc. 24/7 One Call Dispatch: (Scheduling and Emergency Response)
10 Emergency Response & Training Solutions Cargo Narrative Office Phone Number: Emergency Line: Fax Number:
11 Emergency Response and Training Solutions Cargo Narrative ERTS Alert # Cargo Information Material(s) Involved: Product Name: Container Type: What Failed? : How Did It Fail? : Cause(s) of Failure: Comments: Kemamide EBS Wax Other (describe in comments) 103 Basic Material 309 Punctured 517 Improper Preperation for Transport On 04/4/2017 ERTS was notified that (1) 2000 pound supersack of Kemamide EBS Wax was damaged due to an accidental puncture resulting in the release of approximately 500 pounds of material to the floor of trailer # due to improper loading. Based on the amount spilled and the high potential for dust exposure, ERTS dispatched EMS for the spill response.
12 Summary of Network Contractor Observations Summary of Network Contractor Observations:.Contractor arrived on site and suited in level C hazardous materials suit and began shoveling the spilled material into drums. A total of (9) 55 Gallon steel drums were used to containerize the 2,000 pound supersack of Kemamide EBS Wax. Contractor also vacuumed trailer floor for residual dust material and placed into 1/9 drums. All waste was left at the terminal for terminal personnel to manage.
13 Emergency Response & Training Solutions Photos Office Phone Number: Emergency Line: Fax Number:
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22 Emergency Response & Training Solutions MSDS Office Phone Number: Emergency Line: Fax Number:
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30 Emergency Response & Training Solutions Bill of Lading Office Phone Number: Emergency Line: Fax Number:
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