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The provisions contained in this appendix are not mandatory unless specifically referenced in the adopting ordinance or legislation of the jurisdiction.
(see Example Format in Figure 1).
  1. Fill out items and sign the declaration.
  2. Part A of this section is required to be updated and submitted annually, or within 30 days of a process or management change.
(see Example Format in Figure 2).
  1. Provide a site plan on 81/2-inch by 11-inch (215 mm by 279 mm) paper, showing the locations of all buildings, structures, outdoor chemical control or storage and use areas, parking lots, internal roads, storm and sanitary sewers, wells and adjacent property uses. Indicate the approximate scale, northern direction and date the drawing was completed.
(see Example Format in Figure 3).
  1. Provide a floor plan of each building identified on the site plan as containing hazardous materials on 81/2-inch by 11-inch (215 mm by 279 mm) paper, identifying the northern direction and showing the location of each storage and use area.
  2. Identify storage and use areas, including hazard waste storage areas.
  3. Show the following:
    1. 3.1. Accesses to each storage and use area.
    2. 3.2. Location of emergency equipment.
    3. 3.3. Location where liaison will meet emergency responders.
    4. 3.4. Facility evacuation meeting point locations.
    5. 3.5. The general purpose of other areas within the building.
    6. 3.6. Location of all aboveground and underground tanks to include sumps, vaults, below-grade treatment systems, piping, etc.
    7. 3.7. Hazard classes in each area.
    8. 3.8. Locations of all Group H occupancies, control areas, and exterior storage and use areas.
    9. 3.9. Emergency exits.
  1. HMIS Summary Report (see Example Format in Figure 4).
    1. 1.1. Complete a summary report for each control area and Group H occupancy.
    2. 1.2. The storage summary report includes the HMIS Inventory Report amounts in storage, use-closed and use-open conditions.
    3. 1.3. Provide separate summary reports for storage, use-closed and use-open conditions.
    4. 1.4. IBC/IFC Hazard Class.
    5. 1.5. Inventory Amount [Solid (lb), Liquid (gal), Gas (cu ft, gal or lbs)].
    6. 1.6. IBC/IFC Maximum Allowable Quantity per control area (MAQ). (If applicable, double MAQ for sprinkler protection and/or storage in cabinets. For wholesale and retail sales occupancies, go to Tables 5003.11.1 and 5704.3.4.1 of the International Fire Code for MAQs.)
  2. HMIS Inventory Report (see Example Format in Figure 5).
    1. 2.1. Complete an inventory report by listing products by location.
    2. 2.2. Product Name.
    3. 2.3. Components. (For mixtures specify percentages of major components if available.)
    4. 2.4. Chemical Abstract Service (CAS) Number. (For mixtures list CAS Numbers of major components if available.)
    5. 2.5. Location. (Identify the control area or, if it is a Group H occupancy, provide the classification, such as H-2 or H-3.)
    6. 2.6. Container with a capacity of greater than 55 gallons (208 L). (If product container, vessel or tank could exceed 55 gallons, indicate yes in column.)
    7. 2.7. Hazard Classification. (List applicable classifications for each product.)
    8. 2.8. Stored. (Amount of product in storage conditions.)
    9. 2.9. Closed. (Amount of product in use-closed systems.)
    10. 2.10. Open. (Amount of product in use-open systems.)
Facilities that have prepared, filed and submitted a Tier II Inventory Report required by the U.S. Environmental Protection Agency (USEPA) or required by a state that has secured USEPA approval for a similar form shall be deemed to have complied with this section.
  1. Emergency Notification. (See Example Format in Figure 6.)
  2. Where OSHA or state regulations require a facility to have either an Emergency Action Plan (EAP) or an Emergency Response Plan (ERP), the EAP or ERP shall be included as part of the HMMP.
ICC IBC—18 International Building Code H102.1
FIGURE 1
HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION I: FACILITY DESCRIPTION


FIGURE 2
HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION I: FACILITY DESCRIPTION


FIGURE 3
HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION I: FACILITY DESCRIPTION PART C—FACILITY MAP


FIGURE 4
SECTION II—HAZARDOUS MATERIALS INVENTORY STATEMENT (HMIS) SUMMARY REPORTa (Storageb Conditions)c
IBC/IFC HAZARD CLASS HAZARD CLASS INVENTORY AMOUNT IBC/IFC MAXIMUM ALLOWABLE QUANTITYd
  (Abbrev) Solid (lb) Liquid (gal) Gas (cu ft, gal, lb) Solid (lb) Liquid (gal) Gas (cu ft, gal, lb)
Combustible C2   5     120  
  C3A         330  
  C3B   6     13,200  
               
Combustible Fiber Loose/Baled            
Cryogenics, Flammable Cryo-Flam         45  
Cryogenic, Oxidizing Cryo-OX         45  
               
Flammable Gas FLG            
(Gaseous)       150     1,000
(Liquefied)           30  
               
Flammable Liquid F1A         30  
  F1B & F1C   5     120  
Combination (1A, 1B, 1C)   5     120  
               
Flammable Solid FLS       125    
               
Organic Peroxide OPU       0    
  OP1       5    
  OP2       50    
  OP3       125    
  OP4       NL    
  OP5       NL    
               
Oxidizer OX4       0    
  OX3       10    
  OX2       250    
  OX1       4,000    
  1. Complete a summary report for each control area and Group H occupancy.
  2. Storage = storage + use-closed + use-open systems.
  3. Separate reports are required for use-closed and use-open systems.
  4. Include increases for sprinklers or storage in cabinets, if applicable.
(This is an example; add additional hazard classes as needed.)



FIGURE 5
SECTION II — HAZARDOUS MATERIALS INVENTORY STATEMENT (HMIS) INVENTORY REPORT(Sort Products Alphabetically by Location of Product and then Alphabetically by Product Name)
  1. Identify the control area or, if it is a Group H occupancy, provide the classification, such as H-2, H-3, etc.
  2. If the product container, vessel or tank could exceed 55 gallons, indicate yes in the column.
  3. Specify percentages of main components if available.
  4. In cubic feet, gallons or pounds.
(This is an example; add additional hazard classes as needed.)


FIGURE 6
HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: EMERGENCY PLAN