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UNIFIED PROGRAM INSPECTION CHECKLIST
WMININNUMEM
Aboveground Petroleum Storage Tank r ram
FACILITY NAME ,
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1
INSPECTION DATE
i
INSPECTION TIME
ADDRESS
Prepare an SPCC plan CFR 112.3]
PHbAE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
CONSENT TO INSPECT NAME /TITLE
SFCTIMI 1' Rpcnrric Review' Calitornia Health & Satety Code, 25270
DESCRIPTION
Y
N
N/A
COMMENTS
Prepare an SPCC plan CFR 112.3]
-
Review or amend SPCC plan [CFR 112.5 (a)(d)]
y
SPCC plan available on site [CFR 112.3(e)
A-
h
Conduct inspections and test in accordance with written procedures [CFR 112.7(e)]
AA4,,-tkj,,
Maintain records of inspections, tests and/or procedures [CFR 112.7(e)
Records of inspections or tests signed by inspector [CFR 112.7(e)]
IX
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SF MIM 2' SPCC Plan Elements: Calitornia Health & Satety Code: Z5ZTU.4.5. Z5Z <U.11
DESCRIPTION
Y
N
N/A
COMMENTS
Self- certification for Tier I or 11 facility 112.6(a )(1),(b)(1)]
-
Professional engineer certification [CFR 112.3(d) and 11 2.6(b)(4)
y
Documentation of 5 year review and evaluation of SPCC plan [CFR 112.5(b)]
h
Amendments required within 6 months of changes/certifications [CFR 112.5(a) and 112.6(a)(2), (b)(4)]
Management authorization of resource commitment to implement the SPCC [CFR 112.7 & 112.6(a) ]
Diagram �,ith location and contents of containers, transfer stations, connecting piping [112.7(a)(3)]..,,
, nr.
T e of oil and storage capacity for each container CFR 112.7(a)(3)]a
Discharge prevention measures and procedures for routine handling CFR 112.7(a)(3)
1
ell
Countermeasures for discovery, response and clean-up [CFR112.7(a)(3)]
Required contact list and phone.numbers [CFR 112.7(a)(3)]
'
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CFf'TI(7N q• ronornI CPI- -'- Wanmrampntc' t :;mtnrnm mp_airn & NarP_ry UnCIP_' ZCfZ /U_4.5_ ZnZ /U_5_ ZnZ /U_ 'IZ
DESCRIPTION
Y
N
N/A
COMMENTS
Provide corrosion protection [CFR 112.8(c)(4)(5), (d)(1)]
-
Containers compatible with materials stored [CFR 112.8(c)(1)]
y
Implement SPCC plan review changes or amendments within 6 months CFR 112.5(a)(d)]
S. x
Prepare an oil contingency plan or written control /removal commitments [CFR 112.7(d)]
!@Fr-TIC1N d• GPC('_ Plan Trnininn• C:alifnrnia Health X SatP_tV Cndp_' Z5Z1U_4.5 i FW '',w' ,,3V � 1,�- - e
DESCRIPTION
Y
N
N/A
m... COMMENTS
Training program [CFR 112.7(f)]
-
Train personnel in operation and maintenance of equipment [CFR 112.7(f)
a
Conduct annuals ill prevention briefings [CFR 112.7(f)(3)]
SFf- T11.7N -• Far_ility Incnpntenn, cantnrnia Healtn & 52tetV Code: ZbZIU.4.9
DESCRIPTION
Y
N
N/A
COMMENTS
Meet provisions of conditional exemption [H &S 25270.4.5(b)]
-
Facility security adequate CFR 112.7(g)]
a
Clean-up materials readily available CFR 112.7(c)]
Overfill protection procedures.or devices in place and operative [CFR 112.8(c)(8)
Portable /mobile containers positioned to prevent discharge CFR 112.8(c)(11
Loading / unloading rack drains into containment area CFR 112.7(h)
Provide appropriate containment /diversionary structures to prevent discharge [CFR 112.8(a), 112.7(c)
Secondary containment adequate to contain capacity of largest container + precipitation CFR 112.8(c)]
1
ell
Remove accumulation of oil in secondary containment [CFR 112.8(c)(10)]�
Secondary containment valve(s) closed [CFR 112.8]
'
Implement SPCC plan elements CFR 112.3]
ANY HAZARDOUS WASTE ON SITE? ❑ YES 14 NO jSignatureoffteoi t
Explain:
POST INSPECTION INSTRUCTIONS:
• Refer to the back of this inspection report for re latory citations and corrective actions
• Correct the violation(s) noted above by l
• Within 5 days of correcting all of the violations, sign and retur• A a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
Date
Pink - Prevention Services Copy
White - Business Copy Yellow - Business Copy to be Sent in after return to Compliance
Signature (that all violations have been corrected as noted)
Y
FD2156b (Rev 9/10)