Description taken from TSBC website:
An ammonia release on May 26, 2022, at an ice making facility in the Mount Paul Industrial Park located on Tḱemlúps te Secwépemc reserve in Kamloops led to a significant amount of ammonia being released into the surrounding area, resulting in one fatality, multiple exposures, a local evacuation, and the temporary shutdown of nearby businesses.
Our investigation found the primary cause of the incident was a failure to remove ammonia from the refrigeration system ahead of its disassembly. The investigation concluded that the ammonia release occurred when a ball valve holding back pressurized ammonia for the entire system was opened, however those working on the disassembly understood the system to have been previously emptied.
Several contributing factors led to this incident, including miscommunication, staffing changes, and failing to involve a licensed refrigeration contractor to conduct a complete assessment for the presence of ammonia.
Based on our findings of this investigation, we are sharing our learnings and recommendations to prevent a similar occurrence.
View Full Report or go to TSBC.com report page.