HomeMy WebLinkAboutUST PROGRAM CHECKLIST 6-21-2013UNIFIED PROGRAM INSPECTION CHECKLIST
rms. c... ��' ut. us3.,. w.:.....ic...,w..,....i.+::�_w. awl. w�_ u...,... a.., Yw.« u„ Y:..:««. .....u.u,:...:_u..,v..ii..r,... s......,...a.�.. .,. -. <_. ;'..,.
Underground Storage Tank Program
BAKERSFIELD FIRE DEPARTMENT
Prevention Services Division
2101 H Street
Bakersfield, CA 93301
Phone: 661- 326 -3979
Fax: 661 -852 -2171
Facility Name:
Date of Inspection: (' /.Z"O.// 3
SC
Time In: ,�
Time Out:
Address:
Inspected by: Ernie Medina
Rosedale Hwy. Bakersfield, CA. 93308
ICC# 8012428 -Ul
Contact:
Type of Inspection:
Annual Compliance ❑Re- inspection ❑ Complaint
Eric Tallman
Phone:
Permission for Inspection Granted by:
1 -• 1 (24 hr)
Tank ID
#1
#2
#3
Size
20,000
20,000
20,000
Contents
Construction
REG
. REG
PREM
DWF
DWF
DWF
Tank Monitoring: -
DW: Continuous Interstitial Monitoring"
�'
❑ D a Brine /H drostatic ❑ Vacuum /Pressure.
SW: SIR and Line Test every 2 years.
SW: ATG 0.1 annual.
SW: ATG 0.2 monthly.
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
SW: Continuous In -Tank Leak Detection (CITLD).
SW: Tank Gauging.
SW: Vadose /GW Monitoring.
❑
❑
❑
❑
❑
❑
❑
❑
El
❑
El
❑
Other Description:
❑
❑
❑
❑
Piping Monitoring:'
DW Suction: Continuous Interstitial at UDC and Tank Sump.
❑
❑
❑
El
DW Pressurized: Interstiti I at UDC and Turbine Sump and 3.0 gph LLD,
❑ Annual Line Test or Auto- shutdown and Failsafe.
DW VPH Monitoring: Includes lines, sumps, fill pipe, vapor lines, etc.
❑
❑
❑
El
SW Conventional Suction: Triennial 0.1 gph line test., and daily
❑
❑
monitoring.
SW Pressurized: Line 0.1 gph annual or 0.2 gph monthly line test and
❑
D
❑
❑
LLD with Auto - Shutdown.
SW or DW Safe Suction.
SW: Vadose Zone or GW Monitoring.
DW or SW: Gravity Flow Pipe.
Other Description:
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
El
❑
El
- -- ...
�. .--- ' --_
- r,_.....i_i:,..... aM....••..4...+
+hoc Anrcnr'iiv
era
References to the Health and Safety Code, the California code of Keguiauons anu tnt: t..uuc ul Fr-1c, .,,..- ,.y...,... ••••- •rr -
intended to be useful but are not necessarily exhaustive of all legal references that might apply or be relevant to a specific compliance determination.
Laws and regulations are subject to change, so the references contained herein may not be up to date. It is the responsibility of the owner and operator
to know and comply with all applicable legal requirements.
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Facility Name: Date:
Bakersfield Fire Department — Prevention Services Division, 2 101 H Street, Bakersfield, CA 93301 (661) 326 -3979
If in compliance, check the box. Check NA if not applicable.
If a violation, determine if Minor, Class 11, or Class 1, or To
Violations
Be Determined (TBD) if uncertain and will be determined
later.
Pint"
so
rvw
igt
File Review
UST Permit to Operate is current. HSC 25284(a), 25299(a)(1) 25299 (b)(1)
❑
❑ 2
Transfer of permit and/or change of information provided within
30 days of ownership/information changes. HSC 25284(b) (C); T23
X
CCR 2712(d)
YT
UST form information current/correct for facility, including BOE
❑
number. HSC 25286(x)
Fees are paid up-to-date. HSC 25285(c), 25287
11
pir
Monitoring Plan approved for current owner with appropriate
1:1
content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h)
6
Current Emergency Response Plan submitted with appropriate
❑
content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h)
Ik 1 7
Plot Plan/Site Map submitted with appropriate content and
1:1
level of detail. T23 CCR 2632(d), 2634(d), 2641(h), 2711(a)(8)
08
Owner/Operator agreement submitted, if required. HSC 25284(a)(3)
Certification of Compliance and Designated Operator
❑
00'
Certification submitted by current tank owner. T23 CCR 2715
7&1-0
Certificate of Financial Responsibility submitted and is current
❑
for the permit period. HSC 25292.2, 25299.30-25299.34; T23 CCR 2711; 2808.1;
2809-2809.2
11
Monitoring system certification (most recent) conducted within
allowable timeframe (sensors and console). Results submitted
1771
and show all required components with passing results. HSC
25284.1 (a) (4) (c); T23 CCR 2638
/Kj 2
Spill-bucket test results (most recent) conducted within
allowable time frame. Results submitted and indicate a passing
1
F-1
test. HSC 25284.2
13
Leak Detector testing conducted within allowable time frame.
The most recent annual certification submitted and shows
RD
RD
RD
RD
❑
passing results. 40 CFR 280.40(a)(2), 280.43(8)(1)&(2), 280.44(a); HSC 25292(e);
T23 CCR 2638, 2641 6)
>1'4—
Secondary containment testing conducted within allowable
time frame. Most recent testing results submitted and indicate
El
a passing test. HSC 25284. 1(a)(4)(B); T23 CCR 2637(a)
❑15
Pipe and/or tank integrity testing conducted within allowable
time frame. Most recent testing results submitted and indicate
I
passing results. 40 CFR 280.33, 280.40, 280.41, 280.44; T23 CCR 2636(f),
2643(b)(3), (c)(3), (d) (e).
❑16
Repaired tanks/piping are tightness tested within 30 days of
RD
RD
RD
RD
the repair. 40 CFR 280.33; T23 CCR 2661
❑17
ELD test conducted within allowable time frame. Most recent
test results submitted and passing results achieved. T23 CCR
2644.1
❑18
The corrosion protection system is checked by a corrosion
specialist within six months of instal lation/repair and at least
every three years thereafter; results show protection to be
RP
RP
RP
RP
adequate. Impressed current inspected every 60-calendar
days. 40 CFR 280.31, 280.70; T23 CCR 2635(a)(2)
❑19
Tank Lining recertification is current (within 10 years of lining
and every 5 years thereafter) and compliant. 40 CFR280.21(b)(1)(fiJ;
RP
RP
RP
RP
T23 CCR 2663(h)
Bakersfield Fire Department — Prevention Services Division, 2 101 H Street, Bakersfield, CA 93301 (661) 326 -3979
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Facility Name: Date:
"V
Cif
On-Site, Review
This Inspection is being conducted during the annual
monitoring certification. L7 YES NO
The service technician has provided /CC Certification and
IMENE
manufacturers training documentation, and possesses a tank
RP
tester's license or works under a CSLB contractor's license.
RP
,RYES L7 NO
❑
MWWWE
General
El
Tank systems meet current construction standards as required
for type of system. HSC 25288
1
Hazardous substance tanks have secondary containment. 40
CFR 280.42(b); T23 CCR 2631
,M2
Electronic monitoring system has audible and visual alarm in
RD
operating condition. T23 CCR 2632, 2634, 2636
Monitor console programmed appropriately for monitoring
'9s23
option used. T23 CCR 2638, 2643, 2643.1
❑24
Tank systems in temporary closure meet requirements. 40 CFR
280.70, T23 CCR 2670 & 2671
X5
Overfill Prevention mechanism present and operational
according to type: ❑Flapper valve� Audible-visual alarm
❑ball float. ❑ AN alarm and Ball Float 40 CFR 280.20(c)(1)(Y),
280.21(d); T23 CCR 2635(b)(2), 2631Ld2(4)
)426
Spill prevention device is present and functional (in good
condition and drain mechanism operational if applicable). 40 CFR
280.20(c)(1)(0, 280.21(d); T23 CCR 2635(b)(1);2665
'5&7
Piping and piping penetration boots within sumps/UDC are in
good condition. HSC 25288(a), 25292.1
8
All sumps, spill buckets, and UDC's free from debris and liquid.
HSC 25291(e), 25290.1, 25290.2; T23 CCR 2635(b)(1)(C)
A9
Areas around vents appear to be free from signs of liquid
releases. HSC 25288(a), 25290.1, 25290.2, 25295.5
Release Detection methods are present and meet performance
standards. See LG-1 13. 40 CFR 280.40(a)(3)
)931
All sensors are correct for the type of system and operational.
40 CFR 280.40(a)(2), 280.43(g)(1)&(2); HSC 25290.1 e , 25290.2, 25291; T23 CCR 2638
;1<32
All sensors are located in the proper position/location. 40 CFR
280.40(a)(2), 280.43(g)(1)&(2); HSC 25290.1, 25290.2, 25291; T23 CCR 2630(d);
2632(c ; 2641 (q
3
All secondary containment, including UDC shall be equipped
with a continuous monitoring system that either activates an
AN alarm or stops the flow of product at the dispenser when it
detects a leak. T23 CCR 2636 (0(1)
Tank ,'Monitoring ' .'r'
i.
p4nierstitial monitoring conducted properly. 40 CFR 280.40(a)(2),
280.43(g)(I)&(2); T23 CCR 2632 (c) 2 ); 2634(dj(1 )
❑35
❑ VPH monitoring conducted proper) . HIS C 25290.1
7
O SIR
❑36
SIR and Biennial 0.1 gph tank test performed properly. 40 CFR
280.41, 280.43, T23 CCR 2643, 2646.1
❑37
Non-passing SIR monitoring report results are reported and
investJgated properly. 40 CFR 280.4 1 (a), 280.43(h)(1),(2); T23 CCR 2646.1 _J
"V
UZ ® - - ®I5701
RP I RP I RP I RP 11 ❑
EMENE
MENNE
IMENE
RP
RP
RP
RP
❑
MWWWE
El
"MMME
RD
RD
RD
RD
UZ ® - - ®I5701
RP I RP I RP I RP 11 ❑
EMENE
MENNE
IMENE
swans
MWWWE
"MMME
a W
ammm n
ZZ11111111MIIIIII I 0a I
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326-3979
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Facility Name: Date:
O Line Integrity Testing
051 SW pressurized piping: annual 0.1 gph line integrity test or a
monthly 0.2 gph line integrity test is performed properly. 40 CFR
280.4 1, 280.44; T23 CCR 2643(q)(2),(3)
❑52 SW conventional suction system: 0.1 gph line integrity test is
performed every three vears. 40 CFR 280.40, 280.41; T23 CCR 2643(d)
OMMMI
O®® ®I ►-
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
O Automatic Tank Gauging (ATG) / Continuous In -Tank Leak
1504
Detection CITLD
038
ATG or CITLD 0.2 gph monthly test performed properly. 40 CFR
RD
RD
RD
RD
❑
280.43; T23 CCR 2643(b)(1), 2643 b 5
-9
ATG generates a hard copy printout of all data reported
'ST45
including time and date, tank I.D., fuel depth, water depth,
temperature, liquid volume and duration of test. If installed after
❑
1/1/95 printout includes calculated leak rate and leak threshold.
T23 CCR 2643 b 7
❑46
O Manual Tank Gauging (SW tanks </ =1000 gal. ONLY)
RD
RD
RD
RD
❑40
Weekly manual tank gauging performed properly. 40 CFR 280.43;
RD
RD
RD
RD:
T23 CCR 2645
041
Tank Integrity test performed, if necessary. 40 CFR 280.43; T23 CCR
RD
RD
RD
RD
2645
O Vadose Zone and /or Groundwater Monitoring
RD
RD
RD
RD
❑
042
Monitoring system is installed and monitored properly. 40CFR
RD
RD
RD
RD
280.43; T23 CCR 2647 -48
OTank Exemption
043
Tanks /piping meet tank exemption criteria, and weekly visual
)Z4-8
monitoring records are kept up-do-date. HsC 25283.5
PiDe Monitoring
RD
RD
RD
RD
❑
O Line Integrity Testing
051 SW pressurized piping: annual 0.1 gph line integrity test or a
monthly 0.2 gph line integrity test is performed properly. 40 CFR
280.4 1, 280.44; T23 CCR 2643(q)(2),(3)
❑52 SW conventional suction system: 0.1 gph line integrity test is
performed every three vears. 40 CFR 280.40, 280.41; T23 CCR 2643(d)
OMMMI
O®® ®I ►-
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
O Continuous Monitoring System
1504
DW piping (gravity, suction, pressure) in the turbine sump has
continuous monitoring system that activates an audible and
RD
RD
RD
RD
❑
visual alarm or restricts or stops flow at dispenser. T23 CCR
2636( 0(1)
'ST45
DW piping in the UDC is continuously monitored and method
either shuts down the flow of product to the dispenser or
❑
activates an AN alarm. T23 CCR 2636(0(1)
O Line Integrity Testing for Pressurized Piping
❑46
An annual 0.1 gph line integrity test is performed properly.
RD
RD
RD
RD
(Either third party or by Enhanced Line Leak Detection) T23 CCR
2636 4
e 7
In lieu of the annual tightness test for DW pressurized piping,
the monitoring system for all product piping outside the
dispenser is fail -safe and shuts down the pump when a leak is
RD
RD
RD
RD
❑
detected and the monitoring system shuts down the pump or
flow restriction occurs when a leak is detected in the UDC. T23
CCR 2636(0(5)
O Line Leak Detectors (LLD)
)Z4-8
LLD's installed, annually tested, and operational on DW
pressurized piping that detects a 3.0 -gph leak, and restricts or
RD
RD
RD
RD
❑
shuts off flow of product. T23 CCR 2636(0(2)
O DW Emergency Generator Tank
049
LLD activates AN alarm and monitoring system is checked
RD
RD
RD
RD
dail . T23 CCR 2636(1)(2)
❑50
In lieu of LLD, continuous monitoring system of DW emergency
generator tank activates AN alarm, system is checked daily,
,.
and logs are kept. T23 CCR 2636 (0(6)
O Line Integrity Testing
051 SW pressurized piping: annual 0.1 gph line integrity test or a
monthly 0.2 gph line integrity test is performed properly. 40 CFR
280.4 1, 280.44; T23 CCR 2643(q)(2),(3)
❑52 SW conventional suction system: 0.1 gph line integrity test is
performed every three vears. 40 CFR 280.40, 280.41; T23 CCR 2643(d)
OMMMI
O®® ®I ►-
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Facilitv Name: Date:
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326-3979
❑53
SW conventional suction system: inspections conducted for
presence of air in the pipeline. Daily monitoring records are
kept. T23 CCR 2643(d)
❑54
SW gravity flow piping: biennial 0.1 gph integrity test or overfill
tank integrity test is conducted within allowable time frames.
T23 CCR 2643(e)
0 Safe Suction (SS) System
❑55
Piping meets the SS requirements. 40 CFR 280.41; T23 CCR 2636(a)(3)
RD
RD
RD
RD
(A-D)
I
I
* LLD for Pressurized Piping
❑56
LLD's installed, annually tested and operational on SW
pressurized piping. Pump shuts down when a leak occurs and
RD
RD
RD
RD
when the LLD fails or is disconnected. T23 CCR 2666
❑57
LLD's installed, annually tested, and operational on SW
emergency generator systems; LLD is connected to an AN
alarm. 40 CFR 280.40(a) (2), 280.43(g) (1), (2), 280.44(8); T23 CCR 2666
Corrosion Protection
❑58
Metal Tanks and piping components have corrosion protection,
RIP
RP
RP
RP
%:71
or are isolated from the backfill. 40 CFR 280.20, 280.21
❑59
Corrosion protection equipment turned on, functioning properly
RIP
RP
RIP
RP
and provides continuous protection. 40 CFR 280.31(a),(b)(1); T23 CCR
2635
❑60
Cathodic protection system is tested within 6 months of
RP
RP
RP
RIP
installation and then every 3 years. 40 CFR 280.31(a) & (b) (1); T23 CCR
2635(a) Q
❑61
Impressed current systems checked every 60-calendar days
RIP
RP
RP
RP
and records are up-to-date. 40 CFR 280.31(c); T23 CCR 2635(a)(2)
On-site Paperwork
N92
Permit and conditions available on-site. Facility is operated
❑
A
according to permit and conditions. HSC 25293; 25299, T23 CCR 2712(i)
3
Monitoring and response plans are on-site and are the
approved version. T23 CCR 2712(i); 2632,,2634; 2641
%4
r _�
�F*
Site plan depicts current site conditions and has all required
El
elements. T23 CCR 2632(d)
)465
All release detection records for monitoring method are
available, up-to-date, and appropriate for leak detection
RD
RD
RD
RD
❑
method. 40 CFR 280.41, 280.45
1
)66
All monitoring/testing records/documents are available for the
required timeframe. (3 years, 6'/2 years, five years, life of tank) T23 CCR
❑
2712
67
Equipment maintenance records/logs available. T23 CCR 2712(b)
❑
�068
R
Alarm logs/tapes available and appropriate follow-up actions
❑
occurred. T23 CCR 2712(b); 2632,,2634
;90
Visual observation logs available, up-to-date, and appropriate
❑
follow-up actions to problems occurred. T23 CCR 2712(b); 2642
X1_1
Designated UST Operator monthly reports available and
complete. T23 CCR 2715
X1
Employee training records available and training appropriate
and up-to-date. T23 CCR 2715
%972
Suspected or actual unauthorized releases are recorded
and/or reported within allowed timeframes, including non-
RD
RD
RD
RD
❑
passing test results. Leak and Spill Logs available. 40 CFR 280.50,
T23 CCR, 2650, 2652
%673
Financial Responsibility Certificate and mechanisms (CFO
Letter, etc.) on-site and up-to-date. HSC 25292.2, 25299.30-25299.34; T23
11
1
1
E]
IL
L
CCR 2711; T23 2808.1; 2809-2809.2
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326-3979
UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT
Facility Name: Date:
On-Site Observation of Periodic Testing
❑74 Spill-bucket testing conducted appropriately and a passing test 5 :
achieved.
❑75 Secondary Containment testing conducted appropriately and a
Dassina test achieved.
SOC AND RED TAG
a. This facility is in compliance with Release Detection (RD) requirements only. (No
violations in boxes marked RD, but one or more in boxes marked RP.)
b. This facility is in compliance with Release Prevention (RP) requirements only. (No ❑
violations in boxes marked RP, but one or more in boxes marked RD.)
c. This facility is in compliance with BOTH Release Detection (RD) and Release ❑
Prevention (RP) requirements. (No violations in boxes marked RD or RP.)
d. This facility is NOT in compliance with both Release Detection (RD) and Release
Prevention (RP) requirements. (One or more violations marked in (both) boxes RD ❑
and RP.)
A Red Tag was issued to this facility based on the results of this inspection. ❑
Red Tag #
Reason for Red Tag (Choose one):
1. Violation that causes or threatens to cause a liquid release. CCR 2717(a)(1) ❑
2. Violation that impairs the ability of an UST system to detect a leak. CCR 2717(a)(2) ❑
3. Chronic violation or committed by a recalcitrant violator. CCR 2717(a)(3) ❑
Item
# � Inspection Comments:
Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326-3979