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LITTLETON/ENGLEWOOD WASTEWATER TREATMENT PLANT SPILL PREVENTION, COUNTERMEASURE, CONTROL AND CLEAN-UP DOCUMENT SUBMISSION The Littleton/Englewood Wastewater Treatment Plant (L/EWWTP) requires that all contractors hired to complete work onsite must evaluate whether or not they meet the requirements to develop a project specific Spill Prevention, Countermeasure, Control and Cleanup Plan (Spill Plan). You must read through the criteria listed below to make that determination. IF there is a chance that the type of work you are providing at the plant COULD cause a spill of either process wastewater from the treatment plant or hazardous waste from a liquid you brought to the site to use, you are required to develop a spill plan which will address each of the areas of concern. The definition of a spill at the L/EWWTP is 25 gallons or more of process wastewater and anything over 5 gallons of hazardous substances. If, after careful consideration and thorough evaluation of the below listed criteria, you have determined there is little or no possibility of creating a spill, you may sign below: CRITERIA TO CONSIDER a. Is there a potential that the work you will be conducting could cause a wastewater process spill of 25 gallons or more? yes no b. Is there a potential that liquids you have brought on site to use in your project could have a spill of 5 gallons or more (examples include paint, solvents, etc.)? yes no c. If your answers are no you may sign the below certification and will not be required to develop a Spill Plan. If one or both of your answers is yes you will be required to proceed in this form to develop a Spill Plan. I certify that I have carefully read and evaluated all potential spill scenarios based on the work I will be completing at L/EWWTP. I have determined there is little or no risk which requires a written Spill Plan. Contractor Signature: Title: Date: The Contractor is required to prepare a project-specific Spill Plan prior to starting any contract activity onsite. The purpose of the plan is to protect human health and the environment from spills and releases of both wastewater and hazardous materials (a generic term used to mean dangerous waste, problem waste, petroleum products, and hazardous substances). The submitted documentation must satisfy the L/E WWTP specification standards. December 2015 Page 1 of 5

Contractor Spill Plan Directions: 1. Provide: Project Name or number and any additional background information the Contactor might want to add. 2. Table 1 identifies the name(s), title(s), and contact information for the personnel responsible for implementing and updating the Spill Plan, and for responding to spills. Complete Table 1. Table 1 Responsible Personnel Responsibility Name and Title Contact Information Implementing and Updating Spill Plan (primary contact person) Implementing and Updating Spill Plan (secondary contact person) On-Site Spill Responder On-Site Spill Responder Spill Response Subcontractor if applicable 3. Identify and describe the spill potential. 4. Describe the measures which will be taken to prevent spills from occurring and measures that will be taken to prevent spills from entering storm drains located on site. (For example, installing storm water dikes/dams, providing secondary containment, properly maintaining equipment, staff training, etc.) December 2015 Page 2 of 5

5. Complete Table 2 below to address potential process wastewater spills. Table 2 Spill Response Procedures, Including Actions to be Taken and Equipment to be Used Process area where contract work is being done Assess the Spill Secure the Area, Contain and Eliminate the Spill Source Clean Up Spilled Material Decontaminate Equipment Dispose of Spilled & Contaminated Material 1 Describe potential for spill during contract work Describe how spill might occur and what can be done to prevent the spill Describe your plan for securing the spill to prevent it from going into storm drain Describe the method you will use to clean the area and dispose of the spilled product 6. Complete Table 3 below to address potential hazardous waste spills. Table 3 Spill Response Procedures, Including Actions to be Taken and Equipment to be Used Hazardous Material and Location Assess the Spill Secure the Area, Contain and Eliminate the Spill Source Clean Up Spilled Material Decontaminate Equipment Dispose of Spilled & Contaminated Material 1 Describe potential for spill during contract work Describe how spill might occur and what can be done to prevent the spill Describe your plan for securing the spill to prevent it from going into storm drain Describe the method you will use to clean the area and dispose of the spilled product Notes: 1 Spilled fuel, petroleum product and hazardous materials, contaminated stormwater, contaminated soil and water, and all cleanup supplies shall be transported off site for disposal at a facility approved by CDPHE. No potentially hazardous materials, contaminated soil or water, or cleanup supplies may be discharged to any sanitary sewer without approval of the local sewer authority. Contaminated stormwater will not be discharged to any sanitary sewer without approval of the local sewer authority. Wastewater. Petroleum products, fuel, and hazardous material spills shall be addressed and shall be prevented from reaching storm drains or other discharge points. It is acceptable to combine materials covered by the same response procedures, as long each material is clearly identified. December 2015 Page 3 of 5

7. L/EWWTP Contact numbers if a spill occurs. Include these contacts in your Plan for assistance and reporting purposes. 7.1 The Contractor will immediately inform the Lead Operator: Cell: 303-435-4763 Office: 303-762-2612 7.2 If a spill is caused by a contractor or one of your subcontractors it is your responsibility to call the proper agencies to report the spill. The Contractor will report spills in accordance with the Colorado Water Quality Control Division requirements. Call Colorado Department of Public Health and Environment (CDPHE) 24 hour hot line for emergency spill at 1-877-518-5608. An operator (CDPHE 24 hour hot line) will request information which the Contractor will be required to provide verbally. The Contractor will be required to provide written follow up information within five working days. 7.3 The Contractor also must report to the following people at the L/EWWTP in the order of availability so Littleton/Englewood will be able to contact all downstream users. Mary Gardner, Environmental Compliance Manager 303-762-2605 Jim Tallent, Treatment Manager 303-762-2610 Dennis Stowe, Plant Manager 303-762-2634 John Saturley, Safety Coordinator 303-762-2603 7.4 After all verbal reports have been made, the Contractor must document date, time and agencies notified and email this information to the Environmental Compliance Manager at mgardner@englewoodgov.org. 8. Describe how and when all Project personnel (including subcontractors) shall be trained in spill prevention, containment, and response and the location of spill response kits. December 2015 Page 4 of 5

Spill Plan Training Record Employee Name Employee Signature Date Further Information: 9. Plan Approval I certify that all of the information above to the best of my knowledge and belief contains the necessary equipment, training and response actions necessary to prevent spills from occurring and from entering any storm drains. If a spill should occur, the necessary actions will be taken as outlined in this plan. Executive Officer Name Executive Officer Signature Date Project Manager Name Project Manager Signature Date December 2015 Page 5 of 5