Text For Citation: 01 Item/Group: 002B Hazard:

29 CFR 1910.119(l)(1):29 CFR 1910.119(l)(1): The employer did not establish and implement written procedures to manage changes to process chemicals, technology, equipment, and procedures; and, changes to facilities that affect a covered process: At the facility located at 3019 Scanlan Avenue, Salina, Kansas, the employer had not implemented the management of change program to address changes to the ammonia refrigeration system that can result in hazards associated with operating ammonia refrigeration equipment such as, but not limited to the following: (a) The employer did not have any documentation for the perimeter fencing being placed around the outside ammonia refrigeration equipment. (b) The employer did not have any documentation for the electronic badging system being installed for the ammonia refrigeration equipment. (c) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9A-N) valve HV04. (d) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9A-N) valve HV05. (e) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9B-N) valve HV04. (f) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9B-N) valve HV05. (g) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9A-S) valve HV04. (h) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9A-S) valve HV05. (i) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9B-S) valve HV04. (j) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9B-S) valve HV05. (k) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9C-S) valve HV04. (l) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9C-S) valve HV05. (m) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9D-S) valve HV04. (n) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9D-S) valve HV05. (o) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9E-S) valve HV04. (p) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9E-S) valve HV05. (q) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9F-S) valve HV04. (r) The employer did not have any documentation for the cable used to lock open Evaporative Condenser (EC9F-S) valve HV05. Employees engaged in operating, inspecting, testing, and maintaining activities in the ammonia refrigeration system at the facility were exposed to catastrophic release of ammonia which results in asphyxiation, explosion and flash fire leading to death and injury.