EPA RMP GDC and EPCRA citations @ meat processing, cooking, packaging, and storage facility (NH3 & $132K)

This posting includes some very interesting citations issued by EPA (not OSHA).  For example, EPA took issue with using “pink ribbons” on valves being used in an energy isolation for contractors installing a piece of equipment – rather than LOTO locks or tags!  This “ribbon” idea is still fairly prevalent in the refrigeration industry still today, as evident by recent discussions in some social media refrigeration forums.  Take note, even EPA knows “pink ribbons” (or any color ribbon for that matter) tied to valves being used for energy control is NOT an acceptable means of LOTO!  The other aspect of this case is the fact that it was a General Duty Clause (GDC) case, but EPA pulled out all the stops and many of these citations are the type that would be issued to a process that exceeds the RMP threshold(s) (e.g. 10,000 pounds for NH3); although this process had only 6,275 pounds.  Heck EPA even referenced the newest editions of IIAR 2 and ASHRAE 15 for a process that was built well before their publication.  A table is provided with all the citations and referenced RAGAGEPS for SAFTENG members.  I should also point out that EPA used NFPA codes, State Fire Codes, OSHA stds, and several NH3 refrigeration RAGAGEPS in their citations.

Respondent owns and operates a meat processing, cooking, packaging, and storage facility in Massachusetts. Respondent failed to accurately report ammonia and sulfuric acid in lead acid batteries in its 2013 Tier II filing required under Section 312 of EPCRA, at 40 C.F.R. Part 370. Taking into account the relevant statutory penalty criteria and such matters as justice may require, Complainant has determined that it is fair and proper that Respondent pay a total civil penalty in the amount of one hundred thirty-two thousand, one hundred eighty-three dollars ($132,183) to resolve the violations alleged in this matter.

Pursuant to Section 112(r)(1) of the CAA, owners and operators of stationary sources producing, processing, handling, or storing substances listed pursuant to Section 112(r)(3) of the CAA, or any other extremely hazardous substance, have a general duty, in the same manner and to the same extent as Section 654 of Title 29, to:

  1. identify hazards that may result from accidental releases of such substances, using appropriate hazard assessment techniques;
  2. design and maintain a safe facility, taking such steps as are necessary to prevent releases; and
  3. minimize the consequences of accidental releases that do occur

This section of the CAA is referred to as the “General Duty Clause.”

The extremely hazardous substances listed pursuant to Section 112(r)(3) include, among others, anhydrous ammonia.

Emergency Planning and Community Right-to-Know Act

In accordance with Section 312(a) of EPCRA, owners and operators of facilities that are required to prepare or have available material safety data sheet (“MSDS”) for hazardous chemicals under the Occupational Safety and Health Act (“OSHA”) (“hazardous chemicals” or “hazardous chemicals under OSHA”) must prepare and submit an emergency and hazardous chemical inventory form (“Tier I” or “Tier II” form) to the state emergency response commission (“SERC”), the local emergency planning committee (“LEPC”), and local fire department. Tier I or Tier II forms must be submitted annually on or before March 1 and are required to contain chemical inventory information with respect to the preceding calendar year.

The regulations promulgated pursuant to Section 312 of EPCRA, 42 U.S.C. §11022, are found at 40 C.F.R. Part 370.

The Commonwealth of Massachusetts requires facilities subject to EPCRA Section 312 to submit “Tier II” forms containing chemical-specific information, rather than “Tier I” forms containing aggregate information by hazard category. See SERC Policy Position (Updated 12/17/98), currently available at
http://www.mass.gov/eopss/docs/mema/resources/serc/serc-policy-position.pdf 

 

GENERAL ALLEGATIONS

Respondent’s facility is located in a mixed industrial/residential neighborhood. The Facility is within a quarter mile of residences, schools, churches, and a park, and is less than one mile from the state-designated Area of Critical Environmental Concern, the Saugus River, Broad Sound, and three towns.

Respondent uses anhydrous ammonia in a refrigeration system in a series of interconnected pipes and vessels at the Facility (“Process” or “System”).

On July 17, 2014, EPA inspectors visited the Facility (the “Inspection”) to assess Respondent’s compliance with Section 112(r) of the CAA and with Sections 302-312 of EPCRA.

In light of the potential hazards posed by the mishandling of anhydrous ammonia, industry trade associations have issued standards outlining the recognized and generally accepted good engineering practices (“RAGAGEP”) in the ammonia refrigeration industry. In collaboration with the American National Standards Institute, the International Institute of Ammonia Refrigeration (“IIAR”) has issued (and updates) “Standard 2: Equipment, Design, and Installation of Closed-Circuit Ammonia Mechanical Refrigerating Systems,” along with other applicable standards and guidance. Also in collaboration with the American National Standards Institute, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (“ASHRAE”) has issued (and updates) “Standard 15: Safety Standard for Refrigeration Systems.”

These standards are consistently relied upon by refrigeration experts and are sometimes incorporated into state building and mechanical codes.

The Process is a “closed-loop” refrigeration system, with components and piping in interconnected areas both inside and outside of the main building. The Process includes:

  1. large freezer storage rooms and
  2. two ammonia refrigeration engine rooms denoted by Respondent as “West Side” and “East Side.”
  3. A refrigeration high pressure receiver for the West Side system is located outside at ground level on the northwest side of the building.

During the Inspection and in follow-up communications from Respondent, EPA requested and received certain documentation pertaining to the Process and to the Facility’s Tier II reporting. Documents provided included:

  1. the Facility’s Reporting Year (RY) 2012 Tier II Report;
  2. RY 2013 Tier II Report;  
  3. piping and instrumentation diagrams (P&IDs);
  4. a list of the number of fork trucks and forklifts;
  5. an inventory of the ammonia in the refrigeration system;
  6. the ammonia system hazards analysis, dated 12/19/2013; and
  7. an Emergency Action Plan (“EAP”)

On September 23, 2015, EPA sent a “Notice of Potential Violation of Clean Air Act 112(r)- General Duty Clause and Emergency Planning Community Right-to-Know
Act” (“Notice”) to Respondent. Respondent provided its response to the Notice on October 26 and November 16, 2015.

EPA found that the Inspection and EPA’s review of submitted information revealed some potentially dangerous conditions relating to the Process at the time of the
Inspection in 2014, including:

  1. the EAP was missing several items including lists of key emergency response personnel and contact information, emergency call numbers for the National Response Center, Local Emergency Planning Committee, 911, and other required local and state emergency response agencies. The EAP was also missing chemical inventory and location information, evacuation and muster points, and specific actions to take in the case of emergency scenarios such as severe weather;
  2. a significant amount of the refrigeration piping in the facility was not labeled for contents, relative pressure, physical state, and direction of flow;
  3. none of the main shut-off, or king, valves on the East Side and West Side refrigeration systems were identified with a prominent sign having letters sufficiently large enough to be read;
  4. West Side refrigeration system high-pressure receiver, visual liquid level indicator and associated piping were located at ground level in an area accessible by vehicles and were not protected against physical damage;
  5. none of the doors entering the refrigeration system machinery rooms or any other locations containing significant quantities of ammonia contained National Fire Protection Association (NFPA) placards, ammonia warning signs, or emergency instructions;
  6. none of the doors entering the East Site or West Side refrigeration rooms contained an audible or visual alarm indicating the presence of ammonia vapors in the room;
  7. no remote controls were present immediately outside the East Side or West Side refrigeration system machinery room primary entrances for the purpose of shutting down the equipment or starting ventilation fans in an emergency. The controls for the East Side machinery room were located on the first floor, which is up a flight of stairs and through another door. The emergency shutdown switch for the West Side machinery room equipment was in the maintenance shop, but the maintenance shop was not isolated from the machinery room in the event of an ammonia release. The West Side machinery room ventilation system remote control was located inside the machinery room;
  8. ammonia detection systems had not been maintained and calibrated per industry standards (i.e. annually or as otherwise recommended by the manufacturer). The Manning Systems GM-4000 ammonia detection system panels for the East Side and West Side refrigeration systems each indicated an ammonia reading on one of the detectors (East Side detector measured 1 ppm and West Side detector measured approximately 8 or 80 ppm). In addition, the West Side detection system panel indicated a “Fault” on Channel 3. Facility representatives believed the panel had a bad board inside. Both of the East Side machinery room gas detectors had a calibration due date of March 2012 on the detector label;
  9. multiple vessel pressure relief valves (PRVs) on the East Side refrigeration system had not been tested or replaced within five years of installation. The East Side high pressure receiver (HPR) and accumulator pressure vessels had dual PRVs on each vessel. The replacement dates on the tags for the HPR and accumulator were March 2012 and February 2012, respectively;
  10. a large piece of spare machinery was obstructing the access doorway between the East Side machinery room and the narrow adjacent room housing vacuum pumps and other equipment. The obstruction limited access to refrigeration system components and egress from the machinery room;
  11. East Side and West Side machinery rooms were not sealed to prevent the release of ammonia to other locations. The East Side machinery room contained gaps in the walls around air ductwork, piping channels, and electrical conduit and one section of wall was open into the adjoining sprinkler room. The West Side machinery room contained two doorways with no doors present and one door that contains large air gaps;
  12. Facility did not have a legible, permanent sign easily accessible in either of the ammonia refrigeration system machinery rooms displaying the following information:
    1. name and address of the installer,
    2. the refrigerant number and the amount of refrigerant in the system,
    3. the lubricant identity and amount, and
    4. the field test pressure(s) applied;
  13. all air intake and exhaust ducts for the East Side machinery room were located in or near the ceiling of the room. The air circulation pattern in the room may not have allowed adequate ventilation of lower elevations in the room near the machinery and may have short-circuited the air flow;
  14. West Side machinery room did not contain an air intake that would guarantee fresh air enters the room. Intake air was drawn through the maintenance room, chemical storage room and other interior spaces since the machinery room was not sealed from the rest of the building;
  15. exhaust fan for the West Side machinery room drew air from the machinery room and surrounding rooms (i.e. chemical storage and maintenance shop) since there were no doors separating the adjoining rooms from the machinery room. Thus, the exhaust fan did not serve the machinery room exclusively;
  16. PRV on the West Side condenser in operation discharged approximately 5 to 6 feet above the walkway platform on the condenser, which is too low;
  17. combustible material, including wooden pallets and cardboard boxes were stored in the machinery rooms;
  18. contractors were performing hot work without a hot work permit while cutting and grinding on metal piping during the installation of a new condenser on the West Side refrigeration system;
  19. Facility did not implement proper lockout/ragout (LO/TO) procedures during installation of the new West Side refrigeration condenser. The power controller switch did not contain a tag or lock to ensure the power to the condenser could not be energized. In addition, the Facility was not sure if the main breaker was deenergized in the basement electrical room. The contractor performing the work closed isolating valves and marked those valves with pink ribbon. The valves were not identified in any other way as being isolating valves and no LO/TO roster was available;
  20. building contained one windsock affixed to the platform of the West Side refrigeration system. The windsock was not higher than the top of the condenser, was lower than other roof grades of the building and could not be visibly seen from locations around the perimeter of the building. This presented an exposure hazard to employees, emergency responders, and the public if they were unable to determine the wind direction;
  21. there was no eyewash or body shower units located in or near either the East Side or the West Side machinery rooms;
  22. neither the East Side nor the West Side machinery rooms were equipped with self-closing, tight-fitting doors equipped with panic-type hardware;
  23. electrical extension cord was lying in a pool of water in the narrow room adjacent to the East Side machinery room and extending under the door into the meat processing room, presenting an electrical hazard;

As of January 31, 2016, Respondent provided information on how it addressed the conditions identified above.

EPA identified from the Inspection and EPA’s review of submitted Tier II information that Respondent:

  1. Failed to make an applicability determination and did not report sulfuric acid (CAS # 7664-93-9)) from lead-acid batteries on their Reporting Year (“RY”) 2013 Tier II report. Subsequent information from Respondent documented that there were over 500 pounds of sulfuric acid at the Facility. The threshold reporting quantity for sulfuric acid is 500 pounds;
  2. Under-reported the average and maximum inventory of anhydrous ammonia stored at the Facility in Respondent’s RY2013 Tier II report. Respondent reported a maximum quantity of 3,000 pounds in 2013. Subsequent information from Respondent documented that there were at least 6,275 pounds of ammonia at the Facility. The threshold reporting quantity for ammonia is 500 pounds.

Accordingly, based on the conditions at the Facility, Complainant alleges the following violations of Section 112(r) of the CAA, 42 U.S.C. § 7412(r) and Section 312 of EPCRA, 42 U.S.C. § 11022, and its implementing regulations at 40 C.F.R. Part 370. Respondent neither admits nor denies the allegations.

Count 1: Failure to Comply with Clean Air Act 112{r)(l) General Duty Clause Requirements to Design and Maintain a Safe Facility

Pursuant to the General Duty Clause, Section 112(r)(1) of the CAA, owners and operators of stationary sources producing, processing, handling, or storing extremely hazardous substances have a general duty – to, in the same manner, and to the same extent as Section 654 of Title 29, design and maintain a safe facility, taking such steps as are necessary to prevent releases.

The recommended industry practice and standard of care for designing and maintaining a safe facility with an ammonia refrigeration system of the same size and type as Respondent’s System is to base design considerations upon applicable design codes, federal and state regulations, and industry guidelines to prevent releases or minimize their impacts as well as to develop and implement standard operating procedures, maintenance programs, personnel training programs, management of change practices, incident investigation procedures, self-audits, and preventative maintenance programs. IIAR, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), and others have developed standards and guidelines for this purpose, such as the IIAR Bulletins, American National Standards Institute (ANSI)/IIAR Standard 2, the IIAR Ammonia Refrigeration Management (ARM) Program, and ANSI/ASHRAE Standard 15. See also EPA’s General Duty Clause Guidance, Section 2.3.2 and National Fire Protection Association 1, Fire Code, Section 53.

Respondent failed in its general duty to design and maintain the Facility as a safe facility, taking such steps as were necessary to prevent a release of an extremely hazardous substance, in at least the respects listed in Paragraph’s (b), (c), (d), (e), (t), (g), (h), (i), (j), (l), (m), (n), (o), (r), and (w), above.

By failing to comply the CAA Section 112(r) General Duty Clause requirements to design and maintain a safe facility Respondent violated Section 112(r)(1) of the CAA, 42 U.S.C. § 7412(r)(1).

Count 2: Failure to Comply with Clean Air Act 112(r)(1) General Duty Clause Requirements to Minimize the Consequences of Accidental Releases that do occur

Industry standards and guidelines for minimizing the consequence of an accidental release from ammonia refrigeration systems are found, among other things, in the IIAR ARM Program, ANSI/UAR Standard 2, ANSI/ ASHRAE Standard 15, IIAR bulletins, and other materials (including updates and revisions) consistently relied upon by refrigeration experts. They include design and maintenance measures to minimize the severity and duration of releases that do occur, such as, among other things, standards for vapor detection, alarms, equipment and door labeling, emergency shut-off switches, ventilation, keeping combustible materials and electrical hazards away from ammonia, safe oil drain systems, tight construction of machinery rooms; designing safe pressure relief valves and associated piping; reducing obstructions for responders; and having emergency eyewash stations and showers.

In addition, EPA’s General Duty Clause Guidance discusses the standard of care for emergency response planning at facilities that have extremely hazardous substances, such as anhydrous ammonia. The recommended industry practice and standard of care for emergency planning at ammonia refrigeration systems of this size is to inter alia, design and implement an emergency response plan that specifically addresses release scenarios developed from hazard analyses and facility-based knowledge; identifies emergency response equipment and its whereabouts, includes communication with and involvement of emergency planning and response officials (e.g., the Local Emergency Response Planning Committee); incorporates accident training for employees; and involves conducting periodic exercises to ensure that the plan is adequate to address emergency scenarios. EPA’s GDC Guidance at 16-18. IIAR, ANSI, ASHRAE, and other organizations have developed standards and guidelines for this purpose, including, among other things, ANSI/IIAR Standard 2, the IIAR ARM Program (2005), and ANSI/ASHRAE Standard 15. For example, Section 7 of IIAR’s ARM Program for smaller ammonia refrigeration systems provides that refrigeration facilities should develop an up-to-date, facility specific emergency response plan that accurately describes the facility and the potentially affected population. Such a plan should include, among other items, types of evacuation; evacuation procedures and routes; procedures for employees who remain to maintain critical operations; procedures for accounting for evacuated employees; any employee’s rescue and medical duties; and means for reporting emergencies. An adequate emergency response program should also identify procedures for responding to an ammonia release, including shutting the system down; starting emergency ventilation; and coordinating with relevant off-site emergency responders. IIAR’s ARM Program, Section 7.

By failing to comply the CAA Section 112(r) General Duty Clause requirements to minimize harm Respondent violated Section 112(r)(1) of the CAA.

 

Count 3: Failure to Adequately Account for Ammonia and Failure to Include Sulfuric Acid on Tier 2 Report for Reporting Year 2013

In the Facility’s RY2013 Tier II report, Respondent failed to make an applicability determination and did not report sulfuric acid (CAS # 7664-93-9)) from lead-acid batteries that exceeded the 500-pound reportable quantity;

In the Facility’s RY2013 Tier II report, Respondent under-reported the average and maximum inventory of anhydrous ammonia stored at the Facility. Respondent reported a maximum quantity of 3,000 pounds, although the subsequent information provided by Respondent documented more than twice that much was actually present.

Respondent’s failure to adequately account for ammonia and failure to include sulfuric acid on its Tier 2 Report for Reporting Year 2013 was in violation of Section 312 of EPCRA and 40 C.F.R. Part 370.

 

Taking into account the relevant statutory penalty criteria, the facts described above, Respondent’s Consent Agreement and Final Order cooperation in coming in to compliance and such other circumstances as justice may require, EPA has determined that it is fair and proper to assess a civil penalty of $132,183 for the violations alleged in this matter. Of this amount, $117,094 is attributable to the CAA violations and $15,089 is attributable to the EPCRA violation.

 

Attachment 1

Table of General Duty Clause Violations

EPA inspectors found several dangerous conditions at the Facility, listed in the table below, which gave rise to violations of the General Duty Clause. Many of these conditions indicate that the Facility was not following industry standards of care that are common in the ammonia refrigeration industry.

The chart cites to the versions of the industry standards and guidance in effect at the time of EPA’s Inspection in July, 2014.

Dangerous Condition GDC Violation How Condition Could Lead Examples of Industry to an Accidental Release or Exacerbate Consequences of a Release Standards of Care

The Emergency Action Plan (EAP) is missing several items including lists of key emergency response personal and contact information, emergency call number numbers for the  National Response Center, Local Emergency Planning Committee, 911, and other required county and state emergency response agencies.

The EAP is also missing chemical inventory and location information, evacuation and muster points, and specific actions to take in the case of emergency scenarios such as severe weather.

Failure to minimize the consequences of accidental releases which do occur.

Increases likelihood that a dangerous situation will not be recognized in time to prevent a release.

 

Increases likelihood that any response to such a release will be less efficient and effective because the scenario was unanticipated and the response unplanned.

 

Increased risk to emergency responders and increased potential for off-site impact.

IIAR Ammonia Refrigeration Management (ARM) Program (2005), Section 7

A significant amount of the refrigeration piping in the facility was not labeled for contents, pressure, physical state, and direction of flow.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Makes it more difficult to: properly maintain system, operate correct valves, warn workers and emergency responders about hazards posed by system, reduce risk of human error in operating

the system, and respond quickly in the event of a release.

ANSI/ ASHRAE 15 (2013), Section 11.2.2

 

ANSI/IIAR 2-2008 (Add. B), Section 10.6

 

IIAR Bulletin No. 109, Section 4.7.6

 

IIAR Bulletin No. 114

None of the main shut-off, or king, valves on the East Side and West Side refrigeration systems were identified with a prominent sign having letters sufficiently large enough to be read.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

The king valve can be used to quickly shut off flow of ammonia from the ammonia receiver to the rest of the system.  

Any impediment to its use can lengthen the time of a release, endangering workers, emergency responders, and people off-site.

NFPA 1 (2012), Sections 53.2.4.2

 

ANSI/ ASHRAE 15 (2013), Section 11.2.2.a.

 

IIAR Bulletin No.109, Section 4.10

The West Side refrigeration system high-pressure receiver, visual liquid level indicator, and associated piping are located at ground level in an area accessible by vehicles and are not protected against physical damage.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

The West Side refrigeration system high-pressure receiver, visual liquid level indicator, and associated piping were located such that they could be inadvertently damaged or struck, risking release of ammonia.

ANSI/ ASHRAE 15 (2013) Sections 9.11.2 and 11.1

 

ANSI/IIAR 2-2008 (Add. B), Section 12.1.1

 

IIAR Bulletin No. 109, Section 4.6.1 and Section 7 Inspection

Checklists

None of the doors entering the

refrigeration system machinery

rooms or any other locations

containing significant quantities of ammonia contained NFPA placards, ammonia warning signs, or emergency instructions.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Proper signage provides critical information to those who are maintaining a system or responding to a release.

NFPA 1 (2012), Sections 53.2.4.1

 

ANSI/ ASHRAE 15 (2013), Sections 8.11.8, 11.2.4, 11. 7

 

ANSI/IIAR 2-2008 (Add. B), Sections 13.1.2.4, 13.1.10.4, App.L

None of the doors entering the East Side or West Side refrigeration rooms contain an audible or visual alarm indicating the presence of ammonia in the room.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Alarms provide an early warning that a release is taking place, enabling quick response and protecting workers, emergency responders, and the public from a larger release.

NFPA 1 (2012), Section 53.2.3.1.2

 

ANSI/ASHRAE 15 (2013), Section 8.11.2.1

 

ANSI/IIAR 2-2008 (Add. B), Section 13.2.1.2

No remote controls were present immediately outside the East Side or West Side refrigeration system machinery room primary entrances for the purpose of shutting down the equipment or starting ventilation fans in an emergency.

The controls for the East Side machinery room are located on the first floor which is up a flight of stairs and through another

door.

 

The emergency shutdown switch for the West Side machinery room equipment is in the maintenance shop, but the maintenance shop is not isolated from the machinery room in the event of an ammonia release.

 

The West Side machinery room ventilation system remote control is located inside the machinery room.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Creates risk of harm to workers and emergency responders who cannot quickly shut down or properly ventilate machinery room without entering it, which room could have dangerous levels of vapors.

The delay could also contribute to a longer ammonia release time, exacerbating risks to workers, emergency responders, and people off-site.

NFPA 1 (2012), Section 53.2.3.3.1, 53.2.3.4.5

 

ANSI/ASHRAE-15 (2013), Section 8.12.i.

 

ANSI/IIAR 2-2008 (Add. B), Sections 13.1.13.2, 13.3.11

The ammonia detection systems have not been maintained and calibrated per industry standards (i.e., annually).

 

The Manning Systems GM-4000 ammonia detection system panels for the East Side and West Side refrigeration systems each indicated an ammonia reading on one of the detectors (East Side detector measured 1 ppm and West Side detector measured approximately 8 or 80 ppm).

 

In addition, the West Side detection system panel indicated a “Fault” on Channel 3. Facility representatives believed the panel had a bad board inside.

 

Both of the East Side machinery room gas detectors had a calibration due date of March 2012 on the detector label.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Lack of detector maintenance and calibration can create risk that ammonia releases are not properly detected and managed, which can endanger employees and potentially result in a larger release.

NFPA 1 (2012), Sections 53.3.2.2

 

ANSI/ASHRAE-15 (2013), Section 11.6.3

 

ANSI/IIAR 2-2008 (Add. B), Section 13.2.5

Multiple vessel pressure relief valves (PRVs) on the East Side refrigeration system have not been tested or replaced within five years of installation.

 

The East Side high pressure receiver (HPR) and accumulator pressure vessels had dual PRVs on each vessel.

 

The replacement dates on the tags for accidental releases HPR and accumulator were March which do occur.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Pressure relief valves should be replaced or recalibrated every five years to ensure that they will function properly.

 

Old pressure relief valves could release ammonia at the normal operating pressure at any time because the spring inside the relief could be weakened due to age.

ANSI/ASHRAE-15 (2013), Sections 10.1.1 and 10.2

 

IIAR Bulletin 109, Section 4.9.7

 

IIAR Bulletin 110, Section 6.5.4

A large piece of spare machinery was obstructing the access doorway between the East Side machinery room and the narrow adjacent room housing vacuum pumps and other equipment.

 

The obstruction limits access to refrigeration system components and egress from the machinery room.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Makes it very difficult to access machinery for proper preventative maintenance, risking an ammonia release from improperly-maintained equipment. Likewise, emergency responders

would have a hard time accessing equipment, which could increase the duration of a release.

ANSI/ASHRAE-15 (2013), Sections 8.3, 9.12.1

 

ANSI/IIAR 2-2008 (Add. B), Section 13.1.2.2

The East Side and West Side machinery rooms are not sealed to prevent the release of ammonia to other locations.

 

The East Side machinery room contains gaps in the walls around air ductwork, piping channels, and electrical conduit and one section of wall is open into the adjoining sprinkler room.

 

The West Side machinery room contains two doorways with no doors present and one door that contained large air gaps.

Failure to minimize the consequences of accidental releases which do occur. Allows release of ammonia inside the machinery rooms to spread to other parts of the building, putting employees and responders at risk.

ANSI/ASHRAE-15 (2013), Sections 8.11.2, 8.11.7, and 8.12.b, 8.12.f

 

ANSI/IIAR 2-2008 (Add.B), Sections 13.1.1.3, 13.1.1.6, 13.1.5.2, 13.1.10.1 and 13.1.10.2

The facility did not have a legible, permanent sign easily accessible in either of the ammonia refrigeration system machinery rooms displaying the following information:

a) Name and address of the installer

b) The refrigerant number and the Failure to minimize the amount of refrigerant in the system consequences of

c) The lubricant identity and amount

d) The field test pressure(s) applied which

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Information provides critical information to those who are maintaining system and respond to releases.

NFPA 1 (2012), Section 53.2.4.1

 

ANSI/ ASHRAE 15 (2013), Section 11.2.1

 

IIAR Bulletin No. 109, Section 4.10.4

All air intake and exhaust ducts for the East Side machinery room are located in or near the ceiling of the room.

The air circulation pattern in the room may not allow ventilation of lower elevations in the room near the machinery and may short circuit the air flow.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Without adequate ventilation, vapors are more likely to build up to levels that are significant inhalation and dermal hazards or that risk causing fire or explosion.

ANSI/IIAR 2-2008 (Add. B) Section  13.3.3.2

 

ANSI/ASHRAE-15 (2013), Section 8.11.4

The West Side machinery room does not contain an air intake that will guarantee fresh air enters the room.

 

Intake air is drawn through the maintenance room, chemical storage room and other interior spaces since the machinery room is not sealed from the rest of the building.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Without adequate ventilation, vapors are more likely to build up to levels that are significant inhalation and dermal hazards or that risk causing fire or explosion.

ANSI/ ASHRAE 15 (2013), Section 8.11. 7

 

ANSI/IIAR 2-2008 (Add. B) Sections 13.1.1.6, 13.3.3

The exhaust fan for the West Side machinery room draws air from the machinery room and surrounding rooms (i.e., chemical storage and maintenance shop) since there are no doors separating the adjoining rooms from the machinery room. Thus, the exhaust fan does not serve the consequences of machinery room exclusively.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Without adequate ventilation, vapors are more likely to build up to levels that are significant inhalation and dermal hazards or that risk causing fire or explosion.

 

Allows release of ammonia inside the machinery room to spread to other parts of the building, putting employees and responders at risk.

ANSI/ ASHRAE 15 (2013), Section 8.11.4

 

ANSI/IIAR 2-2008 (Add. B) Section 13.3.4.3

The PRVs on the West Side condenser in operation discharged approximately 5 to 6 feet above the walkway platform on the condenser.

Failure to minimize the consequences of accidental releases which do occur.

Improperly placed discharge reliefs can result in ammonia being sprayed on people during a release, further exacerbating the

consequences of a release.

ANSI/IIAR 2-2014, Section 15.5.1.3
Combustible materials including wooden pallets and cardboard boxes were stored in the machinery rooms. Failure to minimize the consequences of accidental releases which do occur. Exacerbates risk of fire or explosion. Ammonia is flammable at certain concentrations.

ANSI/IIAR 2-2008 (Add. B), Section 13.1.3.1

 

NFPA 1 (2012), Section 53.3.1.3.1

Facility contractors were performing hot work without a hot work permit while cutting and grinding on metal piping during the installation of a new condenser on the West Side refrigeration system.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

Improper procedures for conducting hot work exacerbates risk of fire or explosion. Ammonia is flammable at certain concentrations.

527 Code of Massachusetts Regulations (CMR) 39.00

 

29 C.F.R. 1910.252

 

NFPA 1 (2012), Section 1.12

 

IIAR Bulletin No. 110, Section 5.2.2

There were no eye wash or body shower units located in or near either the East Side or the West Side machinery rooms. Failure to minimize the consequences of accidental releases which do occur. Lack of eye wash or body shower units poses a risk to workers and emergency responders in the event of an ammonia release.

ANSI/IIAR 2-2008 (Add. B), Section 13.1.6

 

IIAR Bulletin No. 109, Section 4.10.10

Neither the East Side nor the West Side machinery room has a door self-closing, tight-fitting doors equipped with panic-type hardware. Failure to minimize the consequences of accidental releases which do occur. In the event of an ammonia release inside either of the machinery rooms, the failure to have a tight-fitting and self- closing door risks the spread of ammonia vapors outside the room.

ANSI/IIAR 2-2008 (Add. B), Section 13.1.10.3

 

ANSI/ASHRAE-15 (2013), Section 8.12.d.

An electrical extension cord was lying in a pool of water in the narrow room adjacent to the East Side machinery room and extending under the door into the meat processing room, presenting an electrical hazard.

Failure to design and maintain a safe facility taking such steps as are necessary to prevent releases.

 

Failure to minimize the consequences of accidental releases which do occur.

Exacerbates risk of electrocution, fire or explosion. Ammonia is

flammable at certain concentrations.

NFPA 1 (2012), Section 11.1.7

 

ATTACHMENT 2 – LIST OF MINIMUM SAFETY MEASURES

Identifying Hazards

  • Hazard Addressed: Releases or safety deficiencies that stem from a failure to identify hazards in design/operation of system
    • Facility has completed a process hazard analysis or review.
    • For systems that employ hot gas defrost, the process hazard analysis/review includes an analysis of, and identifies, the engineering and administrative controls for the hazards associated with the potential of vapor propelled liquid slugs and condensation-induced hydraulic shock events.

Operating Activities:

  • Hazard Addressed: High risk of release from operating or maintenance activity
    • System has self-closing/quick closing valves on oil pots.
    • Facility has written procedures for maintenance and operation activities.
    • Only authorized persons have access to machinery room and the ability to alter safety settings on equipment.
    • Written procedures are in place for proper use and care of personal protective equipment.
    • If respirators are used, facilities know the location of their respirators, and they are inspected and maintained per manufacturer or industry standards.
    • All changes to automation systems (programmable logic controls and/or supervisory control and data acquisition systems) if present, are subject to management of change procedures.

Maintenance/Mechanical Integrity:

  • Hazard Addressed: Leaks/releases from maintenance neglect
    • A preventative maintenance program is in place to, among other things, detect and control corrosion, deteriorated vapor barriers, ice buildup, and pipe hammering, and to inspect integrity of equipment/pipe supports.
    • All piping system openings except the relief header are plugged or capped, or valve is locked.
    • Equipment, piping, and emergency shutdown valves are labeled for easy identification, and pressure vessels have legible, accessible nameplates.
    • All atmospheric pressure relief valves have been replaced in the last five years with visible confirmation of accessible pressure relief valves [note -replacement every five years is the general rule but there are two other options in IIAR Bulletin 110, 6.6.3].

Machinery Room and System Design

  • Hazard Addressed: Inability to isolate and properly vent releases
    • The System(s) has/have emergency shut-off and ventilation switches outside each machinery room.
    • The machinery room(s) has/have functional, tested, ventilation. Air inlets are positioned to avoid recirculation of exhaust air and ensure sufficient inlet air to replace exhausted air.
  • Hazard Addressed: Releases from backpressure and overpressure
    • Documentation exists to show that pressure relief valves that have a common discharge header have adequately sized piping to prevent excessive backpressure on relief valves, or if built prior to 2000, have adequate diameter based on the sum of the relief valve cross sectional areas.
    • The facility has engineering controls in place to protect equipment and piping against overpressure due to hydrostatic expansion of trapped liquid refrigerant. Administrative controls are acceptable where hydrostatic overpressure can occur only during maintenance operations.

Emergency Actions

  • Hazard Addressed: Inability to regain control and reduce release impact
    • Critical shutoff valves are accessible, and a schematic is in place to show responders where to access them.
    • Eyewash station(s) and safety shower(s) is/are present and functional.
    • Emergency response communication has occurred or has been attempted with the Local Emergency Planning Committee and local responders.
    • The facility has an emergency action or response plan.
    • EPCRA Tier II reporting is up to date.

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