ENVIRONMENTAL  MANAGEMENT
       PROGRAM  REVIEW
DEPARTMENT OF VETERANS AFFAIRS
 OLIN E. TEAGUE VETERANS CENTER
         TEMPLE, TEXAS
            PREPARED BY
 U.S. ENVIRONMENTAL PROTECTION AGENCY
             REGION 6
FEDERAL FACILITIES COMPLIANCE PROGRAM
         SEPTEMBER 1994

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      ENVIRONMENTAL MANAGEMENT
                          *
               PROGRAM REVIEW

                     FOR THE

    DEPARTMENT OF VETERANS AFFAIRS

                 OLINE. TEAGUE

               VETERANS CENTER
                                   \
                 TEMPLE, TEXAS
                      September 1994
               U.S. Environmental Protection Agency
           Federal Assistance Section, Federal Activities Branch
                 Environmental Services Division
                             *.'''•• s    P
                      1445 Ross Avenue
                    Dallas, Texas 75202-2733
Prepared Bv:  J W^X^^ZS    Date:
             James T. High^nd>P-E.
             EnvironmentalvEnEMieer

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                                 CONTENTS

                           REPORT ON REVIEW OF
                 ENVIRONMENTAL MANAGEMENT PROGRAM
                    OLIN E. TEAGUE VETERANS' CENTER
EXECUTIVE SUMMARY	  i

I.     BACKGROUND AND GENERAL INFORMATION  	  1
      A.    Background and Purpose of Site Visit  	  1
      B.    General Facility Information	2
      C.    Scope of the Review	2

II.    FINDINGS	  3
      A.    Organization and Environmental Management Program (EMP)	  3
            1.     Organizational Structure, Agency and OTVC	  3
            2.     EMP Applicability, Basis and Support  	    4
            3.     Basic Goals and Objectives of the OTVC EMP	  4
            4.     Communication to Facility Personnel	  5
            5.     Public Information and Community Perception of the OTVC
                  EMP  	  5
            6.     NEPA Involvement	  5

      B.    Resources and Training	  5
            1.     Environmental Staffing	  5
            2.     Staff Training	  5
            3.     Facilities and Equipment	  6
            4.     Funding Resources	  6
            5.     Staff Performance Evaluation  	  6

      C.    Environmental Management Program (EMP) Implementation	  6
            1.     Knowledge of Executive Orders, OMB Circulars	  6
            2.     Use of the A-106 Process to Address Needs	  7
            3.     Knowledge  of  Environmental  Laws,  Regulations   and
                  Regulators	  7
            4.     Environmental Auditing and Self-Monitoring  	  7
            5.     Identification and Correction of Violations	  7
            6.     Tracking Compliance, Permits, Reporting Requirements	  8
            7.     Reported Compliance Status, Open Enforcement Actions	  8
            8.     Environmental Restoration  	  8
            9.     Pollution Prevention, Waste Reduction	  8
            10.    Protection of Natural and Cultural Resources	  9
            11.    Applications of New and/or Innovative Technologies	  9

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III.   CONCLUSIONS AND RECOMMENDATIONS	  9
      A.    Environmental Management Program (EMP) And Organization 	  9
           1.    Conclusions . '[.•:.':,,,.•--.	  9
           2.    Recommendations  . .	   10
           *                                                             '
      B.    EMP Resources and Training	   11
        ..  * 1.   . Conclusions	   11
           2.    Recpmmen'datioris  	-.	   11

      C.    EMP Implementation	 . '. . .   12
           1.    Conclusions . .	>. .	   12
           2.    Recommendations	 . . .	   12
APPENDICES^
      I.    VA Organization Charts

      II.    Olio E. Teague Veterans' Center Organization Charts

      III.   Olin E. Teague Veterans' Center Memoranda

      IV.   Acronyms Used in the Report

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EXECUTIVE SUMMARY

The Environmental Management Program (EMP) Review concept was developed by the
Federal Facilities Compliance Program (FFCP) in EPA Region 6 as a means of expanding
our outreach'efforts and enhancing communication and coordination between Region 6 and
other Federal agencies. In FY 1993, the FFCP staff chose to concentrate the EMP review
efforts on minor Federal facilities (FF), particularly those of Civilian  Federal Agencies
(agencies other than the Departments of Defense and Energy). In addition to enhancing
cross-communication and coordination, the purpose of the EMP  review is to assess the
overall health  of  the facility's environmental  management program and  to  provide
recommendations to  the facility  and its  parent  agency for their consideration.  We
emphasize  to  the  facility from the  outset that our review visit is not a  compliance
enforcement inspection and that the EPA representative is not looking at the facility to
determine compliance status.

The Department of Veterans Affairs (VA) Olin E, Teague Veterans' Center  (OTVC) in
Temple, Texas was chosen for an EMP review visit during FY94. This facility  is a 1,000+
bed general medical, surgical and psychiatric hospital, domiciliary and nursing home for
military service veterans. In addition to providing health care for veterans, OTVC activities
include health care education and research and, in a national emergency, support of the
Department of Defense.  Besides the medical  and health care facilities,   OTVC has
laboratories, vehicles and service shops (plumbing, carpentry, electrical, etc.). These varied
operations  and  activities generate  or  involve  handling of  domestic and industrial
wastewaters, hazardous  and  other solid  wastes, air pollutants and toxic and hazardous
substances subject to the environmental laws and regulations administered by the EPA. The
OTVC has no environmental management office (EMO) or full-time environmental staff.

The EMP review consisted primarily of on-site discussions and observations and generally
covered the areas of:

o      Organization (facility and parent agency) and the facility's existing EMP.

o      Facility resources and environmental training of personnel.

o      Implementation of the existing EMP.

o      Current environmental restoration and pollution prevention activities and  compliance
       status.
Review findings and  recommendations are divided into three major categories:   1)
Organization and  EMP; 2)  Resources and  Training;  and 3)  EMP  Implementation.
Environmental restoration, pollution prevention and compliance status are included under
EMP implementation.  Review findings and other observations are those of the EPA

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representative conducting  the  review, and the recommendations presented reflect his
judgement. The recommendations are offered for consideration by the OTVC and the VA
and are summarized below:

ORGANIZATION AND ENVIRONMENTAL MANAGEMENT PROGRAM

o     Consider OTVC reorganization to separate environmental coordination from health
      and safety, putting environmental program  responsibility  under  a full-time
      Environmental  Coordinator.   Changes  would demonstrate higher  priority for
      environmental issues, reduce competition for budget dollars, facilitate expansion of
      the total EMP and increase environmental awareness and support.

o     VA Headquarters should  review its  organization,  environmental responsibility
      assignments and budget to ensure that environmental matters  are given proper
      priority and support.

o     Expand scope, change name of Waste Management Committee, make it a focal point
      for addressing  and resolving all  environmental compliance  issues,  information
      dissemination and health and safety related coordination.

o     Consider developing a Center strategic plan for environmental,  safety and health
      compliance  to consolidate guidance, make necessary revisions,  provide a formal
      statement of the Center's EMP and address all areas of environmental concern and
      roles of OTVC services and programs.

o     Ensure that basic environmental awareness training is available and mandatory for
      all OTVC employees.

o     Institute a public relations program to  keep  local community  aware of OTVC
      environmental activities, plans and issues.
EMP RESOURCES AND TRAINING

o     Provide full-time Environmental Coordinator and staff assistance to satisfy immediate
      program needs.

o     Include  management indicators in  recommended Environmental  Coordinator's
      performance standards.

o     Assess current environmental  training for Center personnel, especially that for
      hazardous waste/materials handling and spill response.  Ensure that all appropriate
      employees are included and necessary refresher training is available.
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o     Increase EMP  funding to  cover recommended additional resources.  Recurring
      operations-type activities funds should be reflected in VA O&M budget.
EMP IMPLEMENTATION

o     Continue VA plans under way to implement an effective environmental auditing
      program,either internal external audits, or a combination of both.

o     Assess all OTVC operations to identify additional pollution prevention and waste
      reduction opportunities.

o     Assess OTVC operations also for potential opportunities for applying or testing of
      innovative technologies  with potential  application to current  or future OTVC or
      other VA operations.
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      REPORT ON ENVIRONMENTAL MANAGEMENT PROGRAM REVIEW
                 AT VA OLIN E. TEAGUE VETERANS' CENTER
I.     BACKGROUND AND GENERAL INFORMATION

      A.   x Background and Purpose of Site Visit

On September 13, 1994, a representative  of Region 6, U.S. Environmental Protection
Agency, James T. Highland, visited the Olin E. Teague Veterans'Center (OTVC or Center)
to review and evaluate the total environmental management program (EMP) at that facility.
The visit was a part of  the Region 6  Federal Facilities (FF) technical assistance and
outreach initiative and not an enforcement inspection visit to determine compliance status.
OTVC management personnel were so  informed both prior to and during the visit.  The
visit was informal and consultative  in nature,  and no part of this report should be
interpreted as a formal finding of actual compliance status.

OTVC personnel involved in the visit in-briefing or contacted during the visit included:

      Mr. Jerry B. Boyd, OTVC Director

      Mr. Edgar Tucker, Associate OTVC Director

      Mr. Theodore A. Martin, Chief, Environmental Management Service (EMS)

      Mr. Randy Blodgett, Chief, Engineering Service (ES)

      Mr. David Vick, Assistant Chief, Engineering Service (ES)

      Mr. Nate Wilson, Safety and Occupational Health Specialist (ES)

      Ms. Myra Winfield, Industrial Hygienist and OTVC Environmental Coordinator (ES)
Ms. Marilyn Waggoner, Regional Industrial Hygienist, VA Regional Division Office, Grand
Prairie, Texas, attended as an observer of the review visit and also participated in the visit
interviews.  An informal out-briefing of the visit was provided to Messrs. Blodgett and
Wilson and Ms. Winfield.

Information  and data obtained during  the review visit, and in subsequent telephone
communications with OTVC personnel, were examined, along with personal observations
made during the visit, and the following evaluation report prepared.  Review conclusions
and  recommendations for either improving or  expanding  the  existing environmental
management program are presented at the end of this report.

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      B.     General Facility Information

The Olin E. Teague Veterans' Center (OTVC) is a large general medical and psychiatric
service hospital and resident patient care complex of the Department of Veterans Affairs
(VA).  The OTVC complex occupies approximately 184 acres of urban land located in the
southern edge of Temple, Texas.  The complex consists of 68 buildings with a total of
almost 1.4 million square feet of floor  area.  Current resident patient population totals
approximately 640, and hospital employees number about 1,600. Outpatient visits average
about 20,000 per month.

The primary mission of the  OTVC includes patients health care, food and lodging, health
care training and research,  logistics, and service support for the Center.  These OTVC
activities generate or involve handling of domestic wastewaters, hazardous, infectious and
other solid wastes, air pollutants and toxic and hazardous substances subject to the various
environmental laws and regulations administered by the EPA.  Domestic and pre-treated
wastewaters are discharged to the  local municipal sewers.  The Center water supply is
obtained from the City of Temple, and the only treatment provided by OTVC is softening
for boiler water at the steam plant.  The Center  does have underground storage tanks
(UST), but no longer has a PCB involvement and is  not involved in any environmental
restoration  activities.  Therefore, OTVC does not have a significant involvement with
NPDES, SDWA, CERCLA or TSCA.  It does, however, have some involvement with CAA,
RCRA, UST and NEPA.   This facility has  a pathological incinerator  having a State
operating permit,  which classifies the  OTVC as a  Class A source under the State
Implementation Plan and therefore a major  air emissions source. It is currently listed as
a RCRA hazardous waste  conditionally exempt small quantity generator,  maintains  a
number of  underground fuel storage tanks,  and has NEPA activity currently underway.
These activities are discussed further in  later parts of this report.
      C.     Scope of the Review

In the OTVC environmental management program (EMP) review, I surveyed the OTVC
organization VA hierarchy; OTVC environmental program goals, objectives, resources, staff
and training; upper management awareness and support; communication mechanisms and
employee awareness.  I also explored the facility's needs, plans and activities in the three
areas of installation  or  site  restoration, environmental compliance  (including NEPA
involvement), and pollution prevention, as well as protection or enhancement of natural
resources and use or testing of new or innovative technologies.  Findings are presented in
Section  II under three main headings; Environmental Management Program (EMP) and
Organization, EMP Resources and Training, and EMP Implementation. Conclusions and
recommendations for improving or expanding the OTVC EMP are given in Section III.
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II.    FINDINGS

      A.    Organization and Environmental Management Program (EMP)

           • 1.     Organizational Structure. Agency and OTVC - The OTVC is one of
171 medical centers nationwide under the Department of Veterans Affairs (VA). These
centers are divided between four VA regions, and the OTVC is one of 42 centers in VA
Region 3. The VA is Headquartered in Washington, DC, and the OTVC Director reports
directly to VA Headquarters through the Under Secretary for Health, Veterans Health
Administration. Environmental program guidance and technical assistance is provided to
the medical centers by an Environmental Engineering Division located in an Operations
office under the same Under Secretary.  This organization is shown in Appendix I in the
back of this report.

The OTVC hierarchy is the Center Director, Center Associate Director and the Chief of
the Engineering Service. The designated Environmental Coordinator for the Center, and
most of the environmental compliance responsibilities and involved staff are located in the
Engineering Service. However, there is also an Environmental Management Service which
has responsibility for control of medical and solid waste, pest control and recycling.  The
Environmental Coordinator is primarily occupied as an industrial hygienist and only spends
a small  percent  of her tune on  environmental matters.  She  also has two  layers of
management between her and the Center Director.  OTVC  organization charts  and
pertinent responsibilities for this hierarchy are also included as report Appendices III and
IV, respectively.

The Center also has a Waste Management Committee to coordinate the Center's Hazardous
Waste Management (HWM) Plan.  This Committee is chaired by the Chemist, Pathology
and Laboratory Medicine Service and meets at the call of the Chairperson but not less than
quarterly.  Duties of the Committee include 1) review regulations and waste classifications
to determine hazardous classification, 2) review waste handling procedures of all Services,
and 3) review  each Service's training to determine  effectiveness.  Members of the Waste
Management Committee are:

      Chief, Environmental Management Service
      Chief, Anatomic Pathology Section
      Safety and Occupational Health Specialist
      Chief, Pharmacy Service or designee
      Industrial Hygienist
      Associate Chief of Staff for Research and Development or designee
      Chief, Acquisition and Materiel Management Service or designee
      Radiation Safety Officer
      Infection Control Nurse
      AFGE Union representative
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The hospital services also have sub committees advising the Waste Management Committee
on  their particular areas.  The OTVC Hazardous Waste Management Plan includes
guidance for handling and disposal  of infectious wastes, waste gases, radioactive waste,
hazardous chemical waste, and  antineoplastic (chemotherapy medication) waste.   The
OTVC HWM Coordinator is also the designated OTVC Environmental Coordinator.

           % 2.     EMP  Applicability. Basis and Support - The mission,  facilities and
varied operations at the OTVC are sufficient to make an EMP applicable to this facility.
Ms. Winfield, Mr. Wilson and Mr. Blodgett initially questioned the need for an EMP, but
after our discussion of the Center's  environmental responsibilities, they agreed with this
assessment.  Their current  "environmental program" is almost totally focused on hazardous
waste and hazardous materials (Hazmat) handling and disposal, with other environmental
areas ah" but ignored.  With the exception of documents on HWM, Hazmat management
and emergency and spill procedures, OTVC policy and procedural guidance documents
observed deal primarily with industrial hygiene, health and safety.

Winfield, Wilson and Blodgett said the primary basis for their current environmental activity
is guidance generated locally by the OTVC. Excerpts from this guidance, showing purpose
and responsibility assignments, are included in Appendix III of this report. OTVC guidance
is supplemented by guidance the OTVC receives from VA Headquarters Environmental
Engineering Division regarding environmental compliance and issues, safety and health and
industrial hygiene. The latter guidance, however, is described as limited.  Other sources
impacting on their EMP activities include Federal and State regulations, local ordinances,
guidance from the American Hospital Association and other hospital industry organizations
and information on new processes, state-of-the-art equipment, etc.

Two key indicators of agency and upper management support for environmental issues and
management programs are policy directives and funding.  OTVC representatives perceive
that upper level (VA Headquarters) support is beginning to improve in  the issuance of
policy guidance, but total support for environmental issues is still hindered by an inadequate
budget  and staffing.   They  feel that  too  little resources are  left over for proper
environmental management after their patient care mission is served. Hospitals are not
being given staffing and other resources necessary for a viable EMP. They believe, however,
that more support from Congress (personnel ceilings and money) would result in more EMP
support to the hospitals from the VA.  Inadequate EMP support is also reflected at the
Center  level, with an  inadequate budget and personnel ceiling for an environmental
management staff. Part of the support problem is attributed to the competition for funds
between environmental issues and other facility planning issues.

             3.     Basic  Goals and Objectives of the OTVC  EMP  -  The  current
environmental focus at OTVC is on management and/or disposal  of hazardous wastes and
materials,  spill prevention, emergency response and recyling used materials. The major
emphasis is on personnel safety and health and industrial hygiene rather than compliance
and pollution prevention.  With the exception of employee safety  and health concerns, the

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OTVC does't appear to have defined environmental program goals and objectives relating
to environmental cleanup and restoration, compliance with regulations and  Executive
Orders, risk assessment and adverse  environmental  impacts, pollution prevention and
protection of natural resources.
           *
            4.     Communication to Facility Personnel  -  Safety,  Health,  industrial
hygiene and environmental management initiatives at the OTVC are currently conveyed to
facility personnel through OTVC and VA memoranda, OTVC committee and subcommittee
meetings,  VA policy statements,  Service  Hotlines, hazardous and medical waste and
chemicals  handling training, accreditation  regulations  from the Joint Commission on
Accreditation of Healthcare Organizations, regular OTVC briefings  on various levels,
Center Partnership Council (with employees union), weekly newsletter and new employee
orientations and annual reviews.

            5.     Public Information and Community Perception of the QTVC EMP -
The OTVC currently has no organized public relations program on environmental issues,
and staff interviewed say they doubt if the community is aware whether they have an EMP
or not. The Center has apparently been perceived by  the  community as doing well
environmentally, probably due to a history lacking  in apparent environmental problems.
Little, if any public perception of their EMP has been vocalized or presented in the local
news media.
            6.     NEPA Involvement -  OTVC recently had a NEPA involvement in
connection with a new hospital wing  for which construction  is to begin in 1995.   An
Environmental Assessment was conducted and a Finding of No Significant Impact issued.
      B.     Resources and Training

             1.     Environmental Staffing - There is currently no one assigned full time
to environmental management program at the OTVC. Even the designated Environmental
Coordinator, Myra Winfield, spends most of her time at the duties of an industrial hygienist
and only about ten percent with environmental management activities. In addition to her
OTVC responsibilities, she also has the same responsibilities for the Marlin, Texas Hospital.
There are other personnel, located  in the various hospital services, who are also involved
part time with hazardous wastes and materials handling in their respective services and the
training required.  There are really no centralized environmental management responsibility
or sufficient dedicated resources to carry out a viable EMP at the OTVC.

             2.     Staff  Training  -    The  OTVC  representatives report  that staff
development  training opportunities are  available  but are mostly off-site.  Environmental
training also has to compete with other  mission-oriented training for limited travel funds.
Opportunities availabe include annual  safety conferences at  the  regional  level, ongoing
health  and safety training, and  some  environmental training,  at the Little  Rock, AR
Engineering Training Center,  EPA  annual  conferences, annual refresher training  on

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handling of hazardous wastes and materials, initial orientation of new employees, and
annual refresher training given by the various hospital services that touch on environmental
areas.  This training is only minimally adequate for management of a viable environmental
program.
            *
             3.    Facilities and Equipment - Housing, space and data management, other
office, laboratory and vehicular equipment needed for an environmental program currently
and in  the near future appear to be available at the OTVC. These areas would have to be
reassessed after centralizing the environmental management responsibilities and necessary
resources.

             4.    Funding Resources - The OTVC does not designate funds specifically
for environmental  management activities, but funds for such activities conducted come
primarily out of the budgets for the Engineering and Environmental Management Services.
Except for dedicated staff salaries and travel funds for training, funds for current activities
have generally been  adequate.   The OTVC Director does have authority to delegate
monetary resources and personnel to the area of environmental management, but these
resources must  compete  with  the higher priority patient  care  mission.    OTVC
representatives report that  annual VA Headquarters'  budgets  also have not adequately
addressed environmental program needs.

             5.    Staff Performance Evaluation - The Environmental Coordinator, Ms.
Winfield,  does not have performance standards by which to evaluate her performance
relative to environmental management.  The exact basis  of her performance evaluation
appears unclear. This situation likely exists for other  staff personnel engaged in  related
environmental activities, at least as far as those activities are concerned. In light of the lack
of a designated environmental staff, staff turnover has obviously not been a problem at the
OTVC. The main environmental staff problem at OTVC appears  to be the lack of staff.
      C.     Environmental Management Program (EMP) Implementation

             1.     Knowledge of Executive Orders. OMB Circulars - None of the OTVC
staff appear to have a working knowledge of and familiarity with Presidential Executive
Order 12088 concerning  Federal  facilities compliance  with  environmental laws and
regulations and with Office of Management and Budget (OMB) Circulars A-ll and A-106.
Circular A-ll is the OMB guidance for preparing and submitting annual budgets, and
Circular A-106 is the implementing document for fulfilling the intent of Executive Order
12088. They did demonstrate a better awareness and knowledge of Executive Order  12856
regarding pollution prevention, toxic chemical and waste reporting, and emergency planning
requirements under the Pollution Prevention Act of 1990 and the Emergency Planning and
Community Right-to-Know Act of 1986.  Their  awareness of EO 12856 was apparently
obtained from information received through agency guidance and recent EPA conferences
and workshops.

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            2.     Use of the A-106 Process to Address Needs - OTVC apparently has
not been a ready participant in this comprehensive process for identifying environmental
needs and obtaining  resources to implement solutions.   In the  A-106 process,  the
Environmental Coordinator prepares required VA documentation for A-106 projects to
meet identified needs. This documentation is forwarded through the OTVC management
and agency ckain to VA Headquarters for agency review, project prioritization and inclusion
in the agency A-106 Plan. The agency Plan is forwarded to EPA for review, evaluation and
priority recommendation to OMB for inclusion in the President's budget request.

The OTVC Environmental Coordinator has been preparing some project documentation,
but had not made the connection with the A-106 process. A-106 funding has been received
in recent years for some asbestos and UST removal projects, and all currently identified
needs at OTVC are apparently covered by projects in the agency A-106 Plan. Asbestos and
UST projects funding received, however, may have been in  response to actual or potential
hazardous conditions or enforcement actions and may  not necessarily demonstrate a high
priority for environmental issues.

            3.     Knowledge of Environmental Laws. Regulations and Regulators - The
Environmental Coordinator demonstrates a fair knowledge  of environmental  laws  and
regulations applicable to  the  OTVC.   She admits  the  need for additional training.
Comprehensive knowledge  of  requirements specific to OTVC  (permits,  reporting
requirements, monitoring, registration, etc.) is limited among the balance of the OTVC staff.
Those with a need to know are periodically  advised through agency orders, OTVC memos
and instructions, staff briefings, the OTVC newsletter and training opportunities.   Ms.
Winfield  says she  is knowledgeable  of  the  Texas  Natural  Resource  Conservation
Commission organization, but admits to a limited knowledge of EPA, at both the regional
and national levels.  She asked for us to send her information to help her know where to
go in  EPA for assistance with environmental laws and  regulations.

            4.     Environmental Auditing and Self-Monitoring - The OTVC does not
have  an audit or  self-monitoring program  in place, according to Ms. Winfield and  Mr.
Wilson.  They informed me that VA Headquarters is setting  up an audit program to include
both internal and external audits. They said the agency audit program guidance is expected
to emphasize the need for frequent and regular audits at VA facilities.

            5.     Identification  and Correction of  Violations  -  The OTVC depends
largely on its  operating  staff and/or  the  Safety Committee to  identify environmental
problems,  potential problems or  violations.    That   Committee  normally assigns
responsibilities for response actions, depending on the types of actions required.   If the
problem  or violation concerns  hazardous waste (HW) or  hazardous materials  (HM)
handling, the Environmental Coordinator usually initiates the correction. Corrective actions
involving construction, or in areas outside HW and HM management, usually go through
the Engineering Service.  The OTVC Safety Committee follows up on health and  safety

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problems. Problems/violations cited by regulatory agencies would normally receive higher
priority for correction than those identified internally. Time taken for correction depends
on urgency of the correction and sometimes requires interim emergency action.

The OTVC-Memorandum for Emergency  and Spill  Procedures  indicates  emergency
response to hazardous materials spills or other releases will be handled by OTVC personnel,
and Ms.  Winfield is the designated Spill Control Coordinator.  However, she and Mr.
Wilson stated that the OTVC does not have on-site emergency response capability and
relies on local emergency agencies for  assistance.  Required reports to  either local, State
or Federal agencies are filed by the Spill Control Coordinator.

            6.     Tracking Compliance, Permits, Reporting Requirements - The OTVC
has no apparent formal system  for logging permit requirements and to  keep track of due
dates for reports required.  There is also no formal system currently to track violations,
enforcement actions and follow up actions.

            7.     Reported  Compliance Status.  Open  Enforcement  Actions  -  As
previously stated, this facility has monitoring  and regulatory involvements with several
environmental statutes, including CAA, RCRA, UST and NEPA. The recent Presidential
Executive Order 12856 also will place additional requirements on the Center to comply with
all provisions of the Emergency Planning and Community Right-to-Know Act (EPCRA) and
the Pollution Prevention Act (PPA) in connection with the control of releases and emissions
from toxic and hazardous chemicals.  OTVC appears to be complying currently with CAA,
RCRA, UST and NEPA requirements, and is taking steps to meet the  EPCRA and PPA
requirements, for which compliance benchmark deadlines began coming due in December
1993. No open enforcement actions were identified.

            8.     Environmental Restoration -  OTVC has no CERCLA sites  on  the
National Priority List (NPL) and, as a RCRA generator  only, is not required to  have a
RCRA permit.  No potential hazardous waste sites have been identified by OTVC that
would require cleanup or other restoration action under CERCLA.

            9.     Pollution Prevention. Waste Reduction - Current pollution prevention
or waste reduction activities at OTVC  are limited to recycling of office  paper, corrugated
and other paper boxes and products,  aluminum, plastic and glass.  Guidance  for this
program is included in OTVC Memorandum No. 137-9. OTVC personnel report that not
much is being done by the VA in the way of waste minimization or product substitution,
either at the OTVC or in the agency. Some chemical substitutions, such as cleaning agents,
have been done primarily for safety reasons. A hospital accreditation group, the College
of American Pathology, also requires the hospital labs to have a waste minization program.

OTVC has not been involved in the EPA's voluntary "33/50" Program to  reduce releases of
17 priority chemicals by 33% by 1993 and 50%  by 1995.  However, as stated in paragraph
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C.I. above, OTVC is now required by Executive Order 12856 to seek to reduce by 50%
their emissions of toxic  chemicals or pollutants by  1999, as well as comply  with  all
requirements of the Pollution Prevention Act.  These requirements will likely necessitate
a more aggressive pollution prevention/waste reduction program at OTVC.

             10.    Protection of Natural and Cultural Resources - OTVC personnel report
that the only^work being done at OTVC in the areas of protection of endangered species,
wetlands, natural or cultural resources, or mitigation bank activities is  that which may be
connected with NEPA activities when planning major changes or additions to OTVC
facilities and/or operations.

             11.    Applications of New and/or Innovative Technologies - No new and/or
innovative technologies are being tested, implemented  or currently planned at the OTVC,
according to OTVC personnel questioned.
III.   CONCLUSIONS AND RECOMMENDATIONS

      A.    Environmental Management Program (EMP) And Organization

            1.     Conclusions - Our observations indicate that the OTVC currently does
not have a true Environmental Management Program  (EMP), and  a well-defined  and
empowered EMP is desirable for this facility. The OTVC mission, operations and facilities
necessitate an EMP focused on environmental compliance, pollution prevention, cleanup
and restoration, risk assessment, adverse environmental impacts and protection of natural
resources. Personnel health, safety and industrial hygiene issues are  related but are not
necessarily a part of an EMP.  Communication among OTVC staff appears to be good,
although lacking in some environmental management areas.  It appears  also that some
changes in the OTVC organization and priorities would further help the EMP to meet
facility needs, be better defined and supported at all management levels, and widen the
scope of communications on environmental matters among all interested and responsible
parties.

It also appears that funding, a key indicator of agency support for environmental issues and
management programs, is missing both at the facility and Headquarters levels.  Support
from the VA Headquarters Environmental Engineering Division has been improving in the
matter of agency policy directives and technical guidance, but because they must compete
with funds for the patient care mission, funding allocations for environmental management
personnel and programs are inadequate.  This results in the medical centers not being given
staffing and other resources necessary for a viable EMP and having  to utilize  staff with
other responsibilities and priorities to provide token attention to environmental issues.
                                      -9-

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             2.     Recommendations

                   a.     Consider organization  changes at  OTVC level  to separate
coordination  of  environmental matters from health,  safety and industrial hygiene and
medical matters. We suggest that environmental coordination responsibility be placed with,
and appropriate funding be provided for, a full-time Environmental Coordinator who may
or may  not* need  other  full-time  staff to carry out an  appropriate  EMP.    These
responsibilities  would  include  coordination of  all  Center  activities to comply with
environmental legislation and executive orders administered by the EPA.  They would
include some responsibilities now located in the Engineering Service, as well as recycling
and solid waste management responsibility now located in the Environmental Management
Service.  These  changes would demonstrate a higher priority for environmental  issues,
reduce competition between environmental  and other facility planning issues for budget
dollars, facilitate expansion of the total EMP to meet OTVC needs and increase facility-
wide  environmental  awareness  and  support.   The  Coordinator's  "Environmental
Coordination Office" can be located in either the Engineering Service or the Environmental
Management Service, but placing it in the'former would appear to require less relocation
of responsibilities.

                   b.     VA Headquarters should review  the priority and resultant
guidance and support being given to environmental matters at their field installations and
make necessary adjustments in organization, responsibility assignments and/or budgeting to
correct real or perceived shortcomings described above.  This would also ensure that the
agency is giving environmental matters the priority mandated in Executive Order 12088 and
the various environmental laws.

                   c.     Expand the scope of the Waste Management Committee (may
want to change the name, too) to go beyond hazardous waste management and make it a
focal point for addressing and resolution of all environmental compliance issues, increasing
employee environmental awareness through information dissemination, and coordinating
environmental, health and safety related compliance.

                   d.     Consider the  development of an  OTVC  strategic plan  for
environmental, safety and health  compliance, through the Committee recommended in 2c.
Such  a plan would consolidate guidance  currently contained in  the  various  Center
memorandums, with revisions necessitated  by  the reorganization of  the environmental
coordination responsibility suggested in 2a. It should also contain a formal statement of the
goals and objectives of the OTVC EMP and address all areas of environmental concern and
roles  of all OTVC  services and  programs.  Total effectiveness of the OTVC EMP will
depend on cooperation by all parties contributing to waste and other pollutant discharges
and emissions at the Center.
                                      - 10-

-------
                   e.     Continue overall communication on environmental matters at
OTVC by ensuring that basic environmental awareness training is available and mandatory
for all OTVC employees.  Recommendations on specialized training for certain employees
are included below under "EMP RESOURCES AND TRAINING".
                   f.     Institute a public relations program to keep the local community
  waic of OTxVC environmental activities, plans and issues. Such a program is necessary for
  complete environmental communications program for the OTVC.
aware
      B.     EMP Resources and Training

             1.     Conclusions - Our observations and reviews of information received on
environmental management resources and training lead us to conclude that there is a need
for additional dedicated personnel and monetary resources to meet current and anticipated
OTVC needs to keep up and comply with  the growing number of environmental laws,
regulations and executive orders.  Current part-time staff and monetary resources applied
to environmental compliance  are too little to manage an effective EMP and maintain a
proactive approach to potential environmental problems.  Their primary responsibilities
compete for their time and normally are given higher priority. Current facilities, equipment
and space appear adequate to meet current projected and anticipated future program needs.
Some aditional technical and environmental awareness training may be needed for the
Environmental Coordinator and part-time staff assisting the Coordinator, particularly in the
areas of multi-media compliance, toxic  substances inventory, reporting and emergency
release  response,  pollution  prevention,  waste reduction,  risk   assessment,  adverse
environmental impacts and natural resources protection.  Identified personnel and training
needs will reqire increased funding for the EMP.

             2.     Recommendations

                   a.     Provide a full-time Environmental Coordinator to oversee the
Center EMP.  Additional technician-type assistance may also be required to carry out a
propoer EMP,  especially if the  Coordinator is to be responsible also for the Marlin
Hospital. If readily available, technician-type assistance to the Coordinator may be provided
from other Center offices or programs. However, if current work load prevents this sharing
of personnel  resources,  consider adding at least one full-time  technician  to  assist the
Coordinator and preclude the use of "leaner" personnel part-time.

                   b.     Include management indicators in the performance  standards
for the Environmental Coordinator.
                                      - 11-

-------
                   c.     Assess all current environmental management training for
Center personnel, especially training for hazardous waste and material handling and spill
response, and expand as necessary to ensure all appropriate Center personnel are included.
Provide refresher training as necessary to maintain competence.

                   d.     Increase EMP funding to cover the recommended additional
resources, as*well as any needed environmental projects identified by the EMP. Funds for
recurring operations-type activities should be reflected in the VA O&M budget.
      C.     EMP Implementation

             1.     Conclusions - Since there is currently no real EMP at the OTVC, it is
difficult to evaluate implementation of any EMP elements present. Some elements of a
good EMP have been implemented, but other elements were found to be either non-existent
or only  minimally implemented. Basic environmental awareness  and capability of staff
personnel currently involved in  environmental matters is lacking in some environmental
areas, and the  current program in place to  maintain a level of  staff  competence and
knowledge needs to be expanded (see the recommendation in B.2.c above). Environmental
awareness of upper management also could  be unproved, as could that of the general
OTVC employee.   Goals  and objectives need to be  set for an appropriate EMP, and
dedicated environmental staff, other resources, training, communication mechanisms and
EMP support improved where necessary to properly implement it.

Procedures for identifying and correcting violations and tracking compliance and reporting
requirements at the Center also need improvement, and a good environmental auditing
program put into place by the VA.  Reported compliance with environmental laws and
regulations and NEPA compliance also  appear to be in good shape at OTVC.  Although
no clean up or environmental restoration needs have been identified, a further look into this
environmental area, at possible former spill and/or disposal sites, may be in order to confirm
that no  needs exist. Some pollution prevention and waste  reduction activities  have been
begun, but additional pollution prevention opportunities,  as well as new or  innovative
technologies application opportunities may  also exist.

             2.     Recommendations - Recommendations for increasing environmental
staff, other EMP resources, technical training and EMP support are  included under III.B.2.
above.  Other  recommendations for general employee awareness  training and public
information communications are included above under III.A.2. Recommendations relative
to other needs mentioned above in this Section are as  follows:

                   a.     Continue agency plans  already under  way to implement an
effective environmental auditing program, either internal or external audits or a combination
of both.
                                      - 12-

-------
                   b.     Conduct an  assessment of all OTVC  operations to identify
additional pollution prevention and waste elimination or reduction opportunities.  These
opportunities may be crucial to toxic  chemical and  pollutant reductions required by
Executive Order 12856.   In consideration of potential funds limitations in the future,
additional action on these opportunities can be on an as-needed or as-desired basis.

            *       c.     Assess OTVC operations also for potential opportunities for
applying or testing of innovative technologies which may have current or future application
to OTVC or other VA facilities and operations.
                                       - 13-

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APPENDICES


      I.     VA Organization Charts
           *

            A.    Department of Veterans Affairs, Headquarters
           %
            B.    Under Sec. for Health, Veterans Health Administration


            C.    ACMD for Operations, Envir. Engineering Division



      II.    Olin E. Teague Veterans Center Organization Charts


            A.    Center Organization


            B.    Engineering Service Organization



      III.   OTVC Memoranda


            A. Recycling Program


            B. Hazardous Material Management Program


            C. Safety, Occupational Health and Fire Protection, Rules and Regulations


            D. Hazardous Waste Management Plan


            E. Environmental Sampling and the Industrial Hygiene Program


            F. Emergency and Spill Procedures



      IV.   Acronyms Used in the Report
                                     - 14-

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                                   Department  of  Veterans  Affairs
                               Inspector General
                                 Chairman,
                          Board ol Contract Appeals
                                 Director,
                      Office of Small and Dlsadvantaged
                            Business Utilization
           _L
     Assistant Secretary
  lor Finance and Information |
    Resources Management
   Deputy Assistant
 Secretary lor Budget
   Deputy Assistant
 Secretary for Financial
     Management
   Deputy Assistant
Secretary for Information
Resources Management
                                                                    Secretary
                                                                Deputy Secretary
                                  Under Secretary for Health,
                                Veterans Health Administration
                                     171 Medical Centers



General Counsel

Chairman.
Board ol Veterans' Appeals

Speclal-Asslslanl to the Secretary
lor Veterans Service Organizations
Liaison
                                                Under Secretary lor Benefits,
                                              Veterans Benefits Administration
                                                   . SB Regional Ollices
                                                                                       Director,
                                                                               National Cemetery System
                                                                                 114 National Cemeteries
     -L
Assistant Secretary
  lor Policy and
    Planning
 Aaslslanl Secretary
lor Human Resourcea
 and Administration
  Assistant Secretary
    for Public and
Intergovernmental Affairs
                                                      _L
Assistant Secretary
  tor Acquisition
  and Facilities
•
Deputy Assistant
Secretary tor Policy

r

Deputy Assistant 1
Secretary lor Planning 1 —

Director,
National Center lor Veteran
Analysis and Statistics
V

Deputy Assistant I
Secretary lor Equal 1 —
Opportunity 1

Deputy Assistant I
Secretary lor Human I—-
Resources Management 1

Deputy Asslslsnl 1
Secretary lor 1— J
Administration 1







Deputy Asslslsnl
Secretary lor —
Public Attain

Deputy Assistant 1
Secretary lor 1—
Intergovernmental Attain!


                                                                                                                L
                                                       _L
Assistant Secretary
 for Congressional
     Affairs
                                                                        Deputy Assistant
                                                                         Secretary for
                                                                     Acquisition and Material |
                                                                         Management
                                                                        Deputy Assistant
                                                                      Secretary lor Security
                                                                      and Law Enforcement
                                                                           Director,
                                                                           Veterans
                                                                        Canteen Service
                                                             J
                                                             }
                                                                       Deputy Assistant
                                                                         Secretary lor
                                                                     Congressional Liaison
                                                  Deputy Assistant
                                                    Secretary tor
                                                  Legislative Allaire

-------
           ORGANIZATIONAL CHART 2: VHA OSH RESPONSIBILITIES
                                          (CHAPTER 2, SECTION 6)
                                             Under Secretary for Health (10)
                                                      VHAOSH
                                                      Official
         ACMO lor
         Quality
         Management
         416)
                       ACMO
                       ConttMction
                       Manafement I08f
JCA
            TOli
                                                                    Managing
                                                                    VHAOSH
                                                                    Program
ACMD
for Operations 1131
                        Office of Program
                        IftenagflmeiH (081
                                                            L
                                                                     VHAOSH
                                                                                        Patten
                                                                                        Safety
                                                                                                                 1
                                                                                                       ACMO far Ctinotol
                                                    Director*
                                             (131-134)
s
hd

O
H
X
H
                      Resident tnglneer*
Facility Responslblltles
  Employee Health
  Radiation Safety Olltcor
  Inlaotlon Control Officer
  Chief, Human Resources Management
  Chief, Acquisition and Materiel Monngomnnt
  Chief, Engineering Service
  Chlof, Environmental Management Servian
                                             Sfto

PEป/



raH.
                              FaoRlty
                              DfreclBrc
                                                                                                         I
                                                            Olractor
                                                            OlS
                                                         II11AI
                                                            nCo
                                                                                                        InfectlonControl
Attoclclfl
Dfrectort


FซcMyOSN
CamaiHKa
                             Facility Safety
                             and Haalth
                             Oflteert
         Engineering Management
         and Fletd SuppoH (138)
                                                                                         DABHO
                                                                                         Ua4aon (13IC6)

-------
                                                                     Environmental Engineering
                                                                          Division (138C4)
                                   22-J
                        I
        I  "^
PM4
                      (13BC8)
5
TJ
W
Z
D
H
X
o
                                                                            John G. Staudt, P.E.
                                                                                 Chief
                                                                              (202) 233-7197
Rita Pittlllo
Industrial Hygienist
DASHO Liaison
(202) 233-7220

John Kordalski, P.E.
Environmental Enginer
(202) 233-3729
                                                                                 Environmental
                                                                      Engineering Division Do?
                                                • Manages VACO environmental
                                                 technology and compliance program.
                                                • Reviews environmental issues facing
                                                 VA.
                                                • Develops policy and program guidance.
                                                • Provides technical assistance to the
                                                 Regions and VAMCs.
                                                • Liaisons with EPA and other federal
                                                 agencies on environmental issues.
                                                • Interacts with DASHO, EMS, A&MM,
                                                 OGC, NCS and others.
                                                • VHA program manager for Regional
                                                 Industrial Hygiene programs.
                                                • VACO contact for VAMCs on
                                                 environmental issues.

-------
                                          ORGANIZATION CHART


                               OLIN E. TEAGUE VETERANS' CENTER, TEMPLE, TEXAS
                                                 DIRECTOR
           ASSOCIATE DIRECTOR
ง
M
a
a
H
x

H
    _L
PROSTHETIC  i

 SENSORY AIDS

  SERVICE
\
ITION 1
EL MOT
VICE


1
CANTEEN
SERVICE



CHAPLAIN
SERVICE

1 1
PETtC
VICE

1
NMENTAL
3EMENT
WICE



DOMICILIARY
OPERATIONS

1
FISCAL
SERVICE

1 1
VL ADMIN
WICE

PERSONNEL
SERVICE




ENGINEERING
SERVICE



INFO RESOURCES
MOT SERVICE



PHARMACY
SERVICE





VOLUNTARY


 SERVICE








ACOS/AMBULATORY
CARE

ACOS/EXTENDED
CARE

ACO8/RE3EARCH 4
DEVELOPMENT

ACOS

/EDUCATION


ALLIED HEALTH
EDUCATION








LIBRARY
SERVICE

MEDICAL MEDIA
PRODUCTION








AUDIOLOQY/SPEECH
PATHOLOGY




MEDICAL
SERVICE



PSYCHIATRY
SERVICE



RECREATION
THERAPY
SERVICE




SOCIAL WORK
SERVICE
CHIEF OF STAFF









DENTAL
SERVICE



NUCLEAR MEDICINE
SERVICE



PSYCHOLOGY
SERVICE



REHABILITATION
MEDICINE SERVICE



SURGICAL
SERVICE






LABORATORY
SERVICE


NURSING
SERVICE


RADIOLOGY
SERVICE


8OPC-AUSTIN
/, /
     SEPTEMBER 10. 1192
                                                                           APPROVED:

-------
                                                 QB8UUZATIOIM. CHART
                                                 BtGIHEERHlS SgyiCE	
                                           01 in E. league Veteran*' Center
                                                 teaple. Teas 7K04
                                                  OH-ICE OF IE UUEF
                                     1 Chief
                                     1 Asst Qiief
                                     1 Secretary/Steno
                                     1 Attainting Tedi/Typing
                                                             4708
                                                             4694
                                                             4812
                                     GS-801-14
                                     GS-801-13
                                     6S-31B-06
                                     65-525-05
        1.0
        1.0
        1.0
        1.0
1 Chief
1 Engin Tecft
1
1
1
1
I
1
I
                DESIGN SEOTOH
                         4997
                         5157
Constractton Inspector  4968
Interior Designer       5889
Progran Asst/Typing     4879
Architect               5075
Adiitect               5840
General  Eogin           6097
Progran Clerk (OA)      5148
GS-SQS-13
GS-8Q2-OS
GS-30S-07
GS-1008-10
GS-303-06
ss-aos-ii
                               GS-801-U
                               GS-303-Q4*"
            rCanpletion of Bed Replacement
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
  'Pro jectj  •(Term Appt/HTE 2/21/96)
             OPERAnOHS SECTIOH
 1 Chief                    4315  VS-4701-L3 1.0
 1 Engineering TedJ         4710  GS^02-06  1.0
 1 A/C Emrtp Opcr Fran      5713  W-5U5-09 1.0
 5 A/C Equip Oper           4Z98A NC-5415-1I 5.0
 4 A/C Equip (teen           SIZ7A U6-5306-10 4.0
 5 Blr Plant Qpor           4095A WG-540^U 5.0
 1 Blr P!*nt Oper Fran      3956  US-540Z-09 1.0
 1 Maint/Qpe  Fnn          929  US-4701-08 1.0
 1 Eng &nrip Oper           4702  W-571&-08 1.0
 3 Tractor Oper             4103A NE^705-06 3.0
 3 Gardener                 4I10A W-aX)3-06 3.0
 1 Gardener                 5*17  K-5003-04 1.0
 I fetor Yell Oper           S370A K-5703MJ6 Z.O
 I tetor Yrt Oper           4S19A U&4703^5 2.0
 1 Hater Yeh Oper           SB37  W6-5703-06  ^
 1 Gardener  •              6720  V5-SKQ-07 1.0
   * (Tegp prontiofi NTE 11/94)
Full Tfoe 	 I
Part Tiae .....
Total tatn 	 {
9.0
1.0
KJ.S
         SAFETT ARD IRSPECTTOU SECilUB       '
1 Safety Specialist       4827  GS^n8-U  l.C
1 Safety Specialist       6105  GS-018-07  1.0
1 Industrial Bygienlst    6009  6S-ฎ0-12  1.0
                                                                             BIOHEOICAL EQUIPMEVT REPAIR SECTIOH
                                        1 Supv 5itBEd Eng
                                        1 Supv Bfcaed ฃ09 Teen
                                        2 Blaaedical Eng Tecb
                                        2 Bionedical Eng Teen
                                        1 Btaedical Eng Tecs
                                        2 nectrmric Tceft
                                        2 Electronic Teen
                         6142  6S-S58-I2
                         4313  GS-S02.11
                         6T19A GS-802-10
                         5S68A GS-8B-Q9
                         5077  GS-802-10
                         449GA GS-K6-09
                         8107A GS-ffiS-10
l.C
1.C
2.C
2.C
l.C
2*C
2.C
                                        1 Chief
                                        1 Engineering Tech
                                        1 Kaint Controller
                                        1 (taint (ten Fran
                                        1 Plaster
                                        I Painter LOT
                                        4 Painter
                                        2 Pipe Pitta*
                                        2 Pinter


                                        1 Naint ten Fran
                                        4 Electrician
                                        2 Industrial Equip
                                        1 AatoHftdl
                                        3 Kaint Mecn
                                        3 Kaint Been
                                                                                       Kanager 5353
                                                                                               4902
                                                                                               4105
                                                                                               4130
                                                                                       Necb
                        SECTION
                         5131  65-801-12  l.C
                         5909  GS-802-OS  l.C
                               6S-1601-07 i.C
                               HS-4749-10 1.C
                               M6-3605-09 l.C
                          __   H.-4102-Ofl 1^
                         4121A iG-4102mB 4.C
                         4059A HG-4204-10 2.C
                         SS32A K-420M9 2-C
                         5320A H6-4607ซQ9 2.C
                         5620  (C-4607-001.
                         4801  HS-4749-10 1.
                         4222A W-2S05-10 4.
                         4I23A yC-5352-10 2.
                         4115 K&-5B23-10 I.
                         S60SA ME-4749-10 3J
                         600SA VC-4749-09 3.C
REOMOD APPBOVAU
                                      RECOMEED APPROVAL:
                                                                                 APPROVED:
RAB3ALL J. BUibfcU'
Cnief,  Engineering Service
                                                Resonrce CoBilttBe
                                                Oirector
                                        QrtBS   NOV  I 8  1993
                                                                                JBRTB.'
                                                                                Director
                                                                                 on*:
                                                                                       HOV1S1393
                                                                                   APPENDIX II.B

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                                                                 --
                          DEPARTMENT OF VETERANS AFFAIRS
                         Olin E.  Teague  Veterans'  Center           MA
                              Temple, Texas  76504     U,  l\  10 ^ ^

 MEMORANDUM
 HO.  137-9'                                                       Mav 28,  1991

                               RECYCLING  PROGRAM



 -2ffi-S-^^^^


 -^Tor:^
 participate in recycling efforts.   Recycling will  reduce energy  usage?  tne
 amount o  waste going to our landfills,  save natural  resources such as  trees
 reduce the consumption of important minerals used  in  producing plastics  a^in,-
 and glass, and lead to reduction  in our  disposal costs.   Olin E    Teague Veter-n".
 Center encourages recycling and promoting  responsible management of w!ste
 through education and direct action.                                waste
3.  DEFINITIONS:


                -To treat
                                                  ปt.ri.ls. making them


    b.   Recyclable-Materials  such as, but not  limited to, bond paper, computer
paper,  cardboard,  aluminum,  plastic, glass, etc., containing properties that
allow them ro be processed  for  reuse.

4.  RESPONSIBILITY;


    a.   A successful  recycling  program requires the support and assistance
of all  staff.


    b.   The Recycling Committee is comprised of representatives from Acquisition
and Materiel Management, Engineering, and Building Management Services (BMS)    Th*
Committee is responsible for establishing procedures, monitoring center recycling
efforts,  and recommending changes in the program.


    c.   The BMS  representative  is the Recycling Program Coordinator with responsi
bility  for coordinating center-wide recycling efforts.

    d.   Service  chiefs will designate an interested individual to serve as
a service coordinator for this  program.  Service coordinators will be responsible
for developing program support  at service meetings, channeling new ideas to
the Recycling Committee, and reporting any problems with center recycling
efforts.


    e.   BMS will ensure that appropriately labeled containers will be provided
for use in our collection effort.  Collection of paper will include typing paper
and computer paper (mixed together is alright) at the site of generation.  BMS
will coordinate  the collection  of full containers of recyclable material and
transfer to appropriate storage area.
                                                            APPENDIX III.A

-------
    f.  Services and sections generating waste cardboard will  be  responsible
for breaking down boxes (flattening them) so they can  be transported  easily
and stacked in the least amount of space practical.  Staples do not have to
be removed from cardboard boxes.
       •    \  •  " '

5.  PROCEDURE:

    a.- Specific procedures  for collection  of  recyclables  in  each service
will  be established  by  the service coordinator and  the Recycling  Committee.

    b	When individual service efforts  involve significant levels of a recyclr
material  that  is  relative  to^€Katr~se'rvi-ce~oh-ly ~ a -service-level -staridard_operat:
procedure (SOP) will be (prepared  outlining  collection procedures.

6.   REFERENCE;   None.

 7.   RESCISSION;   None.
 p          j
 \J3
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                         DEPARTMENT OF VETERANS AFFAIRS
                        01 in E. Teague Veterans' Center

MEMORANDUM
NO.  138-4                                                      October 5, 1992

                     HAZARDOUS MATERIAL MANAGEMENT PROGRAM


1.  PURPOSE:   To establish a program for educating employees in the hazards
associated with chemicals and other hazardous materials used throughout the
Center; to collect data on chemicals used in the Center; to assist in proper
selection and safe handling, storage, and use of hazardous materials; and to
assign responsibility for hazardous material management at this Center.

2.  POLICY:  To contribute a safe and healthful work place for all employees by
ensuring every reasonable precaution against accidental exposure to toxic
substcinu."., or hazardous chemicals.  A master file of material safety data sheets
(MSDS) will be maintained in the safety office.  A file of the applicable MSDS
will be maintained in the immediate work area of those hazardous materials
utili/ed.  This program incorporates the objectives of OSHA Standard 1910.1200,
Haz.ird Conmiunication, and VA Directive 00-86-21, Hazardous Chemicals.

3.  RESPONSIBILITY:

    a.  The Industrial Hygienist  is designated  as the Hazardous Material Officer
and will be responsible for establishing, implementing, and administering the
Hazardous Material Program.  The Hazardous Material Officer will be the
techn-ical advisor on matters relating to any hazardous material and has been
granted the authority to make  a decision on the disposition of hazardous
material received without an MSDS.

    b.  The Industrial Hygienist  is responsible for the day-to-day compliance
with this program.   This will  be accomplished  through visual observation,
interviews, and review of records.

    c.  Service chiefs are  responsible  for  hazardous material management
(including any research,  record keeping, etc.)  within their  service.   They  will
appoint,  in writing, a service-level  hazardous  material coordinator  and
alternate, provide the Safety/Industrial Hygienist Office  with a copy  of  the
letters of appointment, and ensure  appointees  receive training provided  by  the
Safety/Industrial Hygienist Office.

    d.   Service-level coordinators  are  responsible for  all  tasks  involving
hazardous  materials  within  the service.

4.  PROCEDURE;

    a.   The  Safety/Industrial  Hygienist Office will  provide and  document
training  of  service-level  coordinators  to  enable  them to  fulfill  their
responsibilities  as  assigned  in  this memorandum.

                                                               APPENDIX III.B

-------
    b.   The service-level coordinators will:

    (1)  Train all personnel in the safe use, handling, end storage of hazardous
materials.   Training will include deta::s of CSHA.Stann.ird 1910.1200,
such as:  physical and health hazards, proper jse of p .rsonal protective
equ Dment,  physical detection methods of hazardous chemicals  (e.g., odors,
visibility, etc.), emergency procedures in case of accidental overexposure,
method to determine hazards by reading labels and location and use of MSDS.
Personnel will be trained at the time of initial assignment and .whenever a new
product  is introduced into the work area, and training will be updated annually.
Documentation of this training will be kept on file  in the individual service
with a copy forwarded to the Safety/Industrial Hygienist Office for the master
file.                                                            ...

     (2)  Ensure that MSDS are located in the  immediate work area  and  are easily
identifiable  (in a book or folder marked Material Safety Data Sheets  or MSDS  in
large  bright  letters) and readily accessible.

     (3)  Ensure all containers are properly  labeled  as to content and hazards.
(Include containers of small amounts  transferred  from  bulk containers.)

     (4)  At the beginning of each fiscal year:

     (a)  Compile?  a  complete  list/inventory  of chemicals  and  other hazardous
rn.iLcr-i.il1..  I  isi.  amounts on  hand .uul  estimate annual usage.   Keep one copy
within the service  and furnish  a copy to  the Safety/Industrial  Hygienist  Office.

     (b)  Remove  any chemicals  that  are  obsolete or  no longer needed  and  turn
 them over  to  the  Industrial  Hygienist for  disposal.

     (c)  Go through the  MSDS folder and remove obsolete  MSDS.  Maintain  a
 separate file of  the obsolete  MSDS.

     c.  Services  will  ensure all  appropriate IFCAP  transactions contain  the
 words  "HAZARDOUS:   MATERIAL SAFETY DATA SHEET REQUIRED."  The services  must
 obtain the MSDS  for each hazardous material it purchases before the material  is
 used.

     d.  The  Purchasing Agent will  place "HAZARDOUS:  MATERIAL SAFETY DATA SHEET
 REQUIRED"  in  bold letters in the description of each line item of the purchase
 order when a  material is identified as hazardous.

     e.  Acquisition and Materiel Management  Service (A&MMS)  will deliver
 hazardous materials to the using service only  if a  MSDS has  been obtained from
 the supplier.  If adequate MSDS is not supplied  as  required, the Chief, A&MMS
 must  immediately notify the Industrial Hygienist.   The  Industrial Hygienist must
 either  grant an exception allowing the hazardous material(s) to  be moved  to the
 requesting individuals for proper storage or recommend  to the Chief, A&MMS that
 the material(s) be rejected and returned to  the  vendor.  When granting an
 exception, the Industrial Hygienist  shall  notify the  union,  the  contracting
 officer,  and the employees  affected.   The  contracting officer  is responsible  for

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contacting the supplier within 72 hours after an exception is granted to obtain
the MSDS.  On a quarterly basis, the Industrial Hygienist shall submit a list of
exceptions that were granted through the Director to the Regional Director.
This list will' include the name of the material, its purchase order number, date
of purchase,  quantity, vendor, and the name and phone number of the contracting
officer.      \
5.  REFERENCE:
Aucjust
1985.
G,  1987;
Accreditation
OSHA Standard
Manual for Hospitals, 1992; VA Directive 00-86-21
1910.1200, November 25,  1983; and 29 CFR 1960,
6.  RESCISSION:  Memorandum 138-4, 1990.
JERRYl'B. BOYD
Director
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                  DEPARTMENT  OF VETERANS  AFFAIRS
                  Olin E. Teague Veterans' Center

MEMORANDUM*                                          June 2, 1993
NO. 138-5
          \
         SAFETY. OCCUPATIONAL HEALTH.  AND FIRE PROTECTION
                       RULES AND REGULATIONS

l.  PURPOSE:  To establish policy, responsibility, and procedure
for a health, safety, and fire protection program at this Center.

2.  POLICY:   To prevent accidents and  injuries,  including
occupational disease, to persons under Department of Veterans
Affairs  (VA) control and for  the protection of VA property against
loss by  fire or other accidental damage.

3.  RESPONSIBILITY:

    a.   The Chief, Engineering Service is assigned staff
responsibility for the safety and fire protection program to
assure safety of hospital, nursing care center,  and Domiciliary
patients, beneficiaries, visitors, employees,  and for the
protection of VA property.  Each service  chief,  supervisor, and
employee must be constantly observant  for hazards or potential
hazards.

    b.   The  Safety and Occupational  Health  Specialist is
responsible  for conducting training  sessions;  obtaining training
aids; coordinating and conducting fire and  safety inspections;
fire drills; assisting management in a determined effort to detect
and meet Occupational Safety  and Health Administration  (OSHA) ,  VA,
National Fire Protection Association (NFPA),.  and Joint Commission
on Accreditation of  Healthcare Organizations  (JCAHO) safety and
fire protection standards; paperwork management of  the fire and
safety program; etc.

    c.   Each service is  responsible  for the development of a
Service  Safety Plan.  The plan must  be submitted annually  to  the
Safety Committee  for approval in  accordance with the  schedule as
 set  forth by Attachment  B.   The plan must include,  at a minimum, a
 :cifety training program;  training program on  equipment  related to
patient  care;  service safety inspection program; incident
 ireporting;  and  safety policies and  procedures inherent  for each
 service:

 4.  PROCEDURE:  The attached contents  outline procedures  and work
rtvstl.ods  regarding major program elements.

 5.  REFERENCES:   VHS&RA Supplement,  MP-3, Part III; VHS&RA
 Supplement,  MP-l,  Chapter 2,  Section B;  OSHA Regulations;  NCRP
 Report No.  33;  NFPA-101, 1991; and Accreditation Manual for
 Hospitals,  1993,  JCAHO,  Chicago,  Illinois.

                                                    APPENDIX  III.C

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6.   RESCISSION:
through 3 .
                 Memorandum No. 138-5, 1990, and Supplements 1
                                             EDWIN A.  SAMMER, M.D
                                             Chief of  Staff
Attachments:   4

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                  DEPARTMENT OF VETERANS AFFAIRS
                  Olin E.  Teague Veterans'  Center

MEMORANDUM                                            May 19,  1994
NO. 138-8

                  HAZARDOUS WASTE MANAGEMENT PLAN

1.  PURPOSE:  To establish policy, responsibility, and procedure to
establish, implement, monitor,  and document evidence  of an ongoing
program for the management of hazardous wastes.

2.  POLICY:

    a.  To ensure there is minimal risk to patients,  personnel,
visitors, and the community environment by waste created within the
confines of the Olin E. Teague Veterans' Center and its  facilities,
including the Austin Satellite Outpatient Clinic  (SOPC).

    b.  To develop a systom that addresses the identification,
handling, storing, using, and disposing of hazardous  wastes and
materials from the point of entry into the Center, through use and
hazardous waste, from generation to final disposal  (cradle to
grave).

    c.  To develop a system for safely managing hazardous wastes
after  identification.

    d.  To ensure the policies and procedures  related to the
various hazardous wastes are reviewed,  revised, and approved,  at
least  annually, by the appropriate committee(s).

    e.  To  enhance adequate supervision of Center personnel.

    f.  To  enhance coordination and communication among services,
sections,  and committees of the Center.

3. RESPONSIBILITY:

    a.  Director  has final authority  and  responsibility for the
 assurance of  a comprehensive,  flexible, and integrated hazardous
waste management  program.  Director  is  responsible  for ensuring the
 hazardous waste management program is compatible with Federal,
 State, and local requirements.

     b.  Director delegates  specific  responsibility to each service
 chief for the hazardous wastes generated in their service area(s).

     c.  Director delegates overall coordination for  the hazardous
 waste management program to the Waste Management Committee, which
 reports directly to the Safety Committee, concerning all hazardous
 waste management matters.  Director delegates authority and
 accountability for the hazardous waste management program to the
 Safety Committee.
                                                         APPENDIX  III.D

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    d.   Safety Committee is responsible for reviewing ail policies
and procedures relating to the operation of the hazardous waste
management program and for annually evaluating the effectiveness of
the program.  Safety Committee is responsible for reporting its
findings and recommendations to the Clinical Executive Board and to
the Director through minutes or separate reports.

    e.  Hazardous Waste Management Chairperson is responsible for
ensuring the annual review of all policies and procedures related
to the management of hazardous wastes and for informing the
service (s) of the results of these reviews.   Chairperson is
responsible for maintaining a file of all reports submitted.

    f .  Management of  infectious wastes are the  responsibility  of
the Infection Control  Committee.  The wastes will be handled and
disposed  of in compliance with all relevant Federal, State, and
local  regulations .

    g.  Waste gases are  the responsibility of tha Anesthesiology
Section,  Surgical  Service, and Supply,  Processing and  Distribution
Section,  Acquisition  and Materiel Management  Service  (A&MMS) , who
have  written  procedures  for the  disposal  of their waste gases.

    h.   Radioactive wastes are the  responsibility of the Radiation
 Safety Officer and are disposed  of  in accordance with  the Nuclear
Regulatory Commission rules and  regulations.

     i.  Responsibility for disposing of chemical wastes rests
 with Engineering Service,  in accordance with all applicable
 regulations as set forth by all  governing agencies.

     j .  Disposal of antineoplastic wastes is the joint
 responsibility of Pharmacy,  Nursing, Environmental Management,  and
 Engineering Services.

     k.  Industrial Hygienist, Engineering Service,  has been
 designated as the Hazardous Waste Management Coordinator.  Chief,
 Engineering Service,   as Center Safety Officer,  is designated as
 alternate Hazardous waste Management Coordinator.
  4.  EMFDRrFMRNT ;  Hazardous Waste Management Committee will be
  responsible for enforcement of this plan.  The principal
  ingredients of enforcement of this plan will be:

     a.   Service policies  and procedures reviewed,  revised, and
  approved annually.

     b.   A Hazardous waste Management  Committee to provide liaison
  between the staff,  administration,  and outside agencies and
  coordinate enforcement with other appropriate or allied committees,
  etc .

      c.   Review and evaluation of individual case reports of
  incidents or accidents.

                                   2

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    d.   Systematic follow-up to ensure compliance with the
different segments of the plan annually.

    e.   A rep*ort summarizing the four ingredients of enforcement
shall be submitted to the Safety Committee annually.
5.  TABFT.TNft:  An adhesive label with the words  "HAZARDOUS WASTE"
will be affixed to all containers of hazardous waste.
Identification of the contents, physical and health haz^.. ซ  , and
the accumulation start date will be written on the labe_.
Appropriate  labels can be obtained from the Safety Office.

6.  ACCUMULATION TTMES ;  Environmental  Protection Agency (EPA)
regulations  prohibit  storage of hazardous waste  on-site for more
than  180 days.  Such  wastes must be  turned over  to the Hazardous
Waste Management Coordinator in a timely manner  to facilitate
proper  disposal within the allotted  timeframe.   A Material Safety
Data  Sheet  (MSDS) must also accompany any  chemical waste.

7 .   SPTT.T.  ppnrKDTTOES-. Spill procedures are  addressed in attached
Chapters 2  through  6  for each  specific category of hazardous waste.

 8.   SEEEBEUCE:   AS  stated in  each Chapter.

 9.   PEsrTSSTQN:   Memorandum No.  138-8, dated February 28, 1993.
            iYD


 Attachments

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                             CHAPTER 1


                    WASTE MANAGEMENT
1.  PTTRPQSE>  To establish membership of the Waste Management
Committee.
        _ \
2.  iDEMTiFTrATiQM :   Committee will coordinate the Center's
Hazardous waste Management Plan.

    a.  The follows :g programs will be monitored and evaluated by
this Committee:

     (1)   Identification of waste handling  options.

     (2)   Development  cf procedures  for  waste handling.

     (3)   Proper classification and description of  wastes.

     (4)   waste handling procedures are developed by each service.

     (5)   Education is provided for all persons who may be exposed
 to potential danger in connection with waste handling.

     (6)  A waste management plan is written.

     b.  Duties of the Committee include:

      (1)  Review regulations and classifications of wastes for
  determination of hazardous classification.

      (2)  Review service  waste handling procedures.

      (3)  Review training by  each  service to determine
  effectiveness.

  3.  N^KTTNG :   Committee will meet at the call of the Chairperson
  but not less than quarterly.

  4.  MINUTES:  Minutes will be recorded, published, and distributed
  to all Committee members and to the Safety Committee.

  5.
       Chairman:  Chemist,  Pathology and Laboratory Medicine Service

       Members :   Chief ,  Environmental Management Service
                 Chief,  Anatomic Pathology Section
                 Safety and Occupational Health Specialist
                 Chief,  Pharmacy Service or Designee
                 Industrial Hygienist
                 ACOS for Research or Designee
                 Chief, Acquisition and Materiel Management Service
                 or designee
                 Radiation Safety Officer
                 Infection Control Nurse
                 AFGE Representative

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                  DEPARTMENT OF VETERANS AFFAIRS
                  Olin E. Teague Veterans'  Center

MEMORANDUM                                         June  2,  1993
NO. 138-10

     ENVIRONMENTAL SAMPLING AND THE INDUSTRIAL HYGIENE PROGRAM

1.  PURPOSE:  To establish policy/ responsibility, and procedure
for an Industrial Hygiene Program as a part of the VA Occupational
Safety and Health Program.  The following programs are covered in
this memorandum.

    a.  Respiratory Protection, Chapter l.

    b.  Hearing Conservation, Chapter 2.

    c.  Ethylene Oxide, Chapter 3.

    d.  Formaldehyde, Chapter 4.

    e.  Mercury, Chapter 5.

    f.  Waste Anesthetic Gases, Chapter 6.

    g.  Lead and Other Metals, Chapter 7.

    h.  Asbestos, Chapter 8.

    i.  Confined Space Entry, Chapter 9.

 2.  POLICY:  To develop an  industrial hygiene program and sampling
 plan  to monitor chemical contaminants, biological agents,  and
 physical  agents in the work place on a routine basis.  This policy
 will  be in  compliance with  appropriate laws,  rules,  and
 regulations.

 3.  RESPONSIBILITY:

    a.  The Director is  responsible for overall administration of
 the Industrial  Hygiene and  Environmental Sampling  Program.

    b.  The Industrial Hygienist  will  establish, analyze,
 schedule, and interpret  results  from the Environmental  Sampling
 Program.

     c.   Service chiefs are  responsible for the Industrial Hygiene
 Program as it relates to their employees  as outlined in the
 attached Chapters.

     d.   Employee Health is  responsible for the Industrial Hygiene
 Program as outlined in the attached Chapters.

 4.  PROCEDURE:  The attached contents outline procedures for

                                                      APPENDIX III.E

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environmental sampling and other industrial hygiene program
requirements.

5.  REFERENCES:   MP-3, Part III; Occupational Safety and Health
Administration (OSHA) Regulations; National Institute for
Occupational Safety and Health  (NIOSH);  and Veterans Health
Administration (VHA) Directives.

6.  RESSissiQM:   Memorandum No. 138-10,  1989, and Supplement 1.
JERRYtB. BOYD
Director
     - j
Attachments: 6

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                                                        /  5  <-
                   DEPARTMENT OF VETERANS AFFAIRS
                  Olin  E. Teague Veterans'  Center

MEMORANDUM
NO. 138-14.                                            May 27, 1993

                   EMERGENCY AND SPILL PROCEDURES
          %

1.  PURPOSE:  To establish policy, responsibility, and procedure
for containment and cleanup of hazardous chemical  spills.

2.  POLICY:  To prevent ac~idents, injuries, and  illnesses by
implementing proper cleanup of hazardous chemical  spills and
subsequent disposal.

3.  RESPONSIBILITY:

    a.  The Industrial Hygienist is responsible for.providing
proper guidance in Spill Control procedures and will be designated
the Spill Control Coordinator.  The Safety and Occupational Health
Specialist will serve as Alternate Spill Control  Coordinator.

    b.  All employees are responsible for knowing who to contact  in
case  of a spill of hazardous chemicals and  in knowing their first
line  of responsibility.

4.  PROCEDURE:

    a.  The attached contents outline spill policies for:

     (1)  Mercury

     (2)  Cytotoxic drugs

     (3)  Radioactive materials

     (4)  Formaldehyde

     (5)  Ethylene oxide

    b.   Spills  of any other nature will  be  contained and cleaned up
 on an individual basis  as outlined by the Spill Control
 Coordinator.

 5.  REFERENCE:  MP-3, Part  III;  Occupational Safety and Health
 Administration  (OSHA) Regulations; and Accreditation Manual for
 Hospitals,  1993, Joint  Commission on Accreditation of  Healthcare
 Organizations (JCAHO),  Chicago,  Illinois.
                                                 APPENDIX III.F

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6.  RESCISSION:  Memorandum No.  138-14, 1989
                //
JERRY /ET. BC
Di/reetor .
Kttachments :  5


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                               APPENDIX IV
                     ACRONYMS USED IN THE REPORT
ACMD
ACOS
A-106
CAA
CERCLA

CFC
EMP
EPA
EPCRA
FF
NEPA
NPDES

NPL
O&M
OTVC
PCB
PPA
RCRA
SDWA
SPCC

TSCA
VA
VAMC
VHA
Associate Chief Medical Director
Associate Chief of Staff
Office of Management and Budget Circular A-106
Clean Air Act
Comprehensive Environmental Response, Compensation
      and Liability Act (Superfund)
Chlorofluorocarbons (CAA)
Environmental Management Program
Environmental Protection Agency
Emergency Planning and Community Right-to-Know Act
Federal Facilities
National Environmental Policy Act
National Pollutant Discharge Elimination System
      (Clean Water Act, Section 402)
National Priority List (CERCLA)
Operation  and Maintenance
Olin E. Teague Veterans Center
Polychlorinated Biphenyls (TSCA)
Pollution Prevention Act
Resource Conservation and Recovery Act
Safe Drinking Water Act
Spill Prevention, Control and Countermeasures
      (Clean Water Act, Section 311)
Toxic Substances Control Act
Department of Veterans Affairs
Veterans Affairs Medical Center
Veterans Health Adnonistration

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