Document pBO9Za3gXMedmdgpO6vX5ZBZw

U.S. Environmental Protection Agency Region 4 61 Forsyth Street Atlanta, GA 30303 Emergency Planning and Community Right-to-Know Act (EPCRA) Inspection Report Company Name Monogram Assembled Foods Lead Inspector Name Bethany Terpin Inspection Team Members_ Jordan Noles, Chet Gala SIC/NAICS 311991 Inspection Date 7/28/2022 _ 1. Record names and titles of the facility representatives participating in the inspection. Name/Title Evan Ingersoll /EHS Manager Phone: (615) 229-1841 Name/Title Willie Gordon /Plant Manager Phone: (803) 439-6816 2. Obtain exact name and address of the facility being inspected, as well as any Parent Company information. Facility Name: Monogram Assembled Foods Address: 1655 Old Columbia Road, Dickson, Tennessee 37055 County: Dickson Owner/Operator/Parent Company (Name, Address, Phone): Monogram Food Solutions 530 Oak Court Drive Suite 400 Memphis, TN 38117 901-685-7167 How long owned/operated, recent sale of facility (date)? November 2021 3. Obtain/review facility description. a. Officers' names and titles: Willie Gordon /Plant Manager b. Incorporation date and location: c. Other facilities owned by the company: d. Number of employees: 350 e. Annual Corporate Sales: f. Process Description and Process Diagrams: Monogram Assembled Foods is a facility that uses anhydrous ammonia as a refrigerant to manufacture packaged frozen food products. The facility has a maximum of 27,099 pounds of anhydrous ammonia on site. g. Jurisdictional Fire Department: Dickson County Fire Department Inspection Identifier: B.T.EPCRA 7/28/2022 Page 1 of 3 4. Compliance Review by Statute: Section 312 a. Obtained chemical inventory list Y N N/A b. View purchase records (where applicable) Y N N/A c. Tier II reports to SERC, LEPC, fire dept (Haz. Chem 10,000 lbs)? Y N N/A d. Tier II reports to SERC, LEPC, fire dept (EHSs 500 lbs or TPQ)? Y N N/A e. Reviewed documentation of maximum daily amounts stored? Y N N/A f. Reviewed MSDSs? Y N N/A g. Reviewed documentation of submissions? Y N N/A h. Has each report from the past 3 years been submitted by March 1? Y N N/A Section 313 i. Form R/A to State and EPA for Toxic Chemicals: Manufactured, Processed 25,000lbs, Otherwise Used 10,000 lbs Y N N/A j. Obtained list of 313 chemicals MPOU at the facility Y N N/A k. Obtained documentation of submissions? Y N N/A l. Has each report from the past 3 years been submitted by July 1? Y N N/A Additional Observations: Inspection Identifier: B.T.EPCRA 7/28/2022 Page 2 of 3 Report Prepared By: Name (Printed): Bethany Terpin Title: Signature: Inspector Digitally signed by BETHANY BETHANY TERPIN TERPIN Date: 2022.09.19 10:22:54 -04'00' Report Authorized By: Name (Printed): Jason Dressler Title: Signature: Chief, North Air Enforcement Section Digitally signed by JASON JASON DRESSLER DRESSLER Date: 2022.09.19 14:01:19 -04'00' Inspection Identifier: B.T.EPCRA 7/28/2022 Page 3 of 3