Inspection Detail

Inspection: 316817410 - West County Wastewater District

Inspection Information - Office: High Hazard Unit - Central

Investigation Summary

At approximately 7:40 a.m., on May 8, 2013, Employee #1, a Senior Maintenance Technician of West County Wastewater, sustained chemical burns to his hands, legs and eyes while attempting to connect a flange to a three inch Sodium Hypochlorite line. On the day of the incident, Employee #1 was tasked by Employee #2, his supervisor, to attach a bypass line to the low-point drain of Sodium Hypochlorite Tank #1. The manufacturer of the tank was Snyder Industries; composition of the tank was black high density linear polyethylene (HDLPE) resin. Tank dimensions were 143 inches (11 feet, 11 inches) in diameter by 177 inches (14 feet, 11 inches) in height with a capacity of 10,500 gallons. At approximately 7:40 a.m., Employee #1 began to install the flange using a bolt pattern of upper left bolt followed by the lower right bolt and then lower left followed by upper right. No torque was to be applied during the bolting sequence. Upon finishing the last bolt (upper right), Employee #1 heard a cracking noise and the valve with all the fittings attached broke off at the tank. After the valve and fittings broke off, the tank began spraying Sodium Hypochlorite. Employee #1 immediately began running to the containment dike exit stairs located near the backside of Sodium Hypochlorite tank #2 and exited the containment dike. After exiting the containment dike, Employee #1 entered the Chemical & Dewatering Building to use the sink located in the restroom for rinsing the Sodium Hypochlorite off of himself. The Chemical & Dewatering Building entrance is located in close proximity to the exit stairs of the Sodium Hypochlorite tank dike, but the restroom in the Chemical & Dewatering Building did not have a safety shower or eyewash. After briefly rinsing himself in the sink of the Chemical & Dewatering Building, Employee #1 exited the building, got onto the roadway and began making his way to the lab. While on the roadway Employee #1 was met by Employee #3. Employee #3 and Employee #4 had just finished a task and Employee #3 walking past the maintenance shop when he heard a scream for help. Employee #3 began walking toward the scream and saw Employee #1 with his shirt off, Employee #3 asked Employee #1 what happened, and Employee #1 responded that he felt like he was on fire. Employee #3 then led Employee #1 to the administrative building and helped Employee #1 enter the safety shower/eye wash located in the lab. Employee #1 stripped off his clothing, entered and activated the safety shower/eye wash and remained under the safety shower for 15 minutes. At approximately 7:49 a.m., Employee #4 ran into the operations room and notified Employee #5 to call 911. Emergency medical services arrived on site several minutes later, provided initial first aid and transported Employee #1 to Kaiser Hospital in Richmond for further treatment. Upon further examination, Employee #1 was transported to UC Davis Medical Center for advanced burn treatment. Employee #1 suffered chemical burns to 22 percent total body surface area (TBSA), to include both corneas. The torque specification stamped on the valve flange was 25 foot pounds and Employee #1 was not using any type of device to measure/monitor the torque while tightening the bolts on the flange.

Keywords: BURN