U.S. CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD INVESTIGATION REPORT CHEMICAL SPILL CONTAMINATES PUBLIC WATER SUPPLY IN CHARLESTON, WEST VIRGINIA OVER 300 MEMBERS OF THE PUBLIC SOUGHT MEDICAL TREATMENT FOR POTENTIAL EXPOSURE THE SPILL RESTRICTED WATER USE FOR NEARLY 300,000 RESIDENTS FREEDOM INDUSTRIES, INC. CHARLESTON, WV JANUARY 9, 2014 KEY ISSUES: • TANKSUPERSEDED INSPECTIONS AND MAINTENANCE • RISK COMMUNICATION • PUBLIC WATER SYSTEMS SAFETY AND RISK ASSESSMENT • TOXICOLOGICAL INFORMATION REPORT NO. 2014-01-I-WV SEPTEMBER 2016 Freedom Industries, Inc. Investigation Report Board Vote September 2016 [This page intentionally left blank.] SUPERSEDED ii Freedom Industries, Inc. Investigation Report Board Vote September 2016 Table of Contents 1.0 EXECUTIVE SUMMARY ............................................................................................................... 1 Incident Description .................................................................................................................................. 1 Consequences ............................................................................................................................................ 1 Key Findings ............................................................................................................................................. 3 Lessons Learned ........................................................................................................................................ 4 Recommendations ..................................................................................................................................... 6 2.0 FACTUAL INFORMATION ........................................................................................................... 7 2.1 Incident Description ............................................................................................................................ 7 2.1.1 Leak Discovery ............................................................................................................................ 7 2.1.2 Leak Response ............................................................................................................................. 7 2.1.3 Consequences ............................................................................................................................. 10 2.2 Freedom Industries ............................................................................................................................ 11 2.2.1 Site History ................................................................................................................................ 12 2.2.2 Chemical Storage ....................................................................................................................... 15 2.2.3 Post-Incident Freedom Developments ....................................................................................... 19 2.2.4 Proximity to Water Treatment Intake and Transmission Main .................................................. 22 2.3 West Virginia American Water ......................................................................................................... 24 2.3.1 Kanawha Valley Treatment Plant .............................................................................................. 25 3.0 TECHNICAL ANALYSIS ............................................................................................................. 27 3.1. Tank Failure Analysis ...................................................................................................................... 28 3.1.1 Tank Entry and Visual Inspection .............................................................................................. 28 3.1.2 Pitting Corrosion ........................................................................................................................ 30 3.1.3 Corrosion Rate Analysis ............................................................................................................ 32 3.1.4 Polyvinyl Acetate Material ........................................................................................................ 33 3.1.5 Tank Integrity and Inspections ................................................................................................... 35 3.1.6 American Petroleum Institute Standards on AST Leaks ............................................................ 38 3.1.7 Frost Heave Effect, Flow and Leak Scenario ............................................................................. 39 3.2 MCHM Leak to the Elk River ........................................................................................................... 40 3.2.1 SiteSUPERSEDED Geotechnical Analysis ........................................................................................................ 41 3.2.2 Secondary Spill Containment ..................................................................................................... 44 3.2.3 Culvert ........................................................................................................................................ 46 4.0 PUBLIC HEALTH CONSEQUENCE ANALYSIS ...................................................................... 49 4.1 Water Supply Contamination and Testing ........................................................................................ 50 4.2 Reported Symptoms after Drinking Water Exposure ....................................................................... 51 4.3 Using Available Toxicological Information to Determine Acceptable MCHM Levels ................... 53 iii Freedom Industries, Inc. Investigation Report Board Vote September 2016 4.4 Deficient Crisis and Risk Communication ........................................................................................ 56 4.4.1 Public Distrust of Drinking Water Safety .................................................................................. 60 4.5 Prior Chemical Release Incidents Investigated by CSB ................................................................... 61 4.6 AW and WVAW Response to Water Contamination ....................................................................... 63 4.6.1 American Water Works Company, Inc. ..................................................................................... 63 4.6.2 Use of Boil Water and Do Not Use Notices .............................................................................. 65 4.6.3 WVAW’s Monitoring and Testing Process ............................................................................... 66 4.6.4 AW and WVAW Emergency Preparedness and Response ........................................................ 68 4.7 American Water Works Association ................................................................................................. 73 5.0 REGULATORY ANALYSIS ......................................................................................................... 74 5.1 Regulatory Summary of MCHM and PPH, stripped......................................................................... 74 5.2 Regulation of Aboveground Storage Tanks ...................................................................................... 75 5.2.1 Groundwater Protection Rule ..................................................................................................... 76 5.2.2 West Virginia’s Aboveground Storage Tank Act ...................................................................... 77 5.3 Clean Water Act .......................................................................................................................... 86 5.3.1 National Pollutant Discharge Elimination System Program ...................................................... 86 5.4 Safe Drinking Water Act................................................................................................................... 89 5.4.1 Source Water Assessment Program ........................................................................................... 89 5.5 Emergency Planning ......................................................................................................................... 92 5.5.1 Emergency Planning and Community Right-to-Know Act ....................................................... 93 5.5.2 Emergency Planning in West Virginia ....................................................................................... 95 5.6 Chemical Regulation under the Toxic Substances Control Act ........................................................ 98 5.6.1 TSCA Prior to 2016 ................................................................................................................... 98 5.6.2 Frank R. Lautenberg Chemical Safety for the 21st Century Act ............................................. 102 5.7 Occupational Safety and Health Administration ............................................................................. 104 5.7.1 OSHA’s Hazard Communication Standard ............................................................................. 105 5.7.2 Flammable and Combustible Liquids under 29 C.F.R. § 1910.106 ......................................... 108 6.0 KEY FINDINGS ........................................................................................................................... 109 7.0 LESSONS LEARNED .................................................................................................................. 111 8.0 RECOMMENDATIONS .............................................................................................................