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UNIFIED PROGRAM INSPECTION CHECKLIST
Aboveground Petroleum Storage Tank Program
FACILITY NAME @q
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INSPECTION DATE
INSPECTION TIME
ADDRESS
Prepare an SPCC plan [CFR 112.3]
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
CONSENT TO INSPECT NAME /TITLE
DESCRIPTION
Y
N
N/A
ENTS
Prepare an SPCC plan [CFR 112.3]
Review or amend SPCC plan [CFR 112.5 (a)(d)]
SPCC plan available on site [CFR 112.3(e)]
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Conduct inspections and test in accordance with written procedures [CFR 112.7(e)]
Maintain records of inspections, tests and/or procedures [CFR 112.7(e)]
Records of inspections or tests signed by inspector [CFR 112.7(e)]
N.
DESCRIPTION
YJ
N
N/A
COMMENTS
Self - certification for Tier I or H facility [112.6(a)(1),(b)(1)
Professional engineer certification [CFR 112.3(d) and 11 2.6(b)(4)]
Documentation of 5 year review and evaluation of SPCC plan [CFR 112.5(b)]
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 with location and contents of containers, transfer stations, connecting piping [112.7(a)(3)]
Type of oil and storage capacity for each container [CFR 112.7(a)(3)]
Discharge prevention measures and procedures for routine handling {CFR 112.7(a)(3)]
Countermeasures for discovery, response and clean-up [CFR112.7(a)(3)]
Required contact list and phone numbers [CFR 112.7(a)(3)]
DESCRIPTION
Y
N
N/A
COMMENTS
Provide corrosion protection [CFR I12.8(c)(4)(5), (d)(1)]
Containers compatible with materials stored [CFR 112.8(c)(1)
Implement SPCC plan review changes or amendments within 6 months [CFR 112.5(a)(d)]
Prepare an oil contingency plan or written control /removal commitments [CFR 112.7(d)]
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DESCRIPTION
Y
N
N/A
COMMENTS
Training program [CFR 112.7(f)]
Train personnel in operation and maintenance of equipment [CFR 112.7(f)]
Conduct annuals ill prevention briefings [CFR 112.7(f)(3)]
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DESCRIPTION
YJ
N
N/A
COMMENTS
Meet provisions of conditional exemption [H &S 25270.4.5(b)
Facility security adequate [CFR 112.7(g)]
Clean-up materials readily available CFR 1 12.7 c
Overfill protection procedures or devices in place and operative [CFR 112.8(c)(8)]
Portable /mobile containers positioned to prevent discharge [CFR 1 12.8(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)]
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]
NY HAZARDOUS WASTE ON SITE? ?'a YES ❑ NO Si nature ofReceipt
xplain:
POST INSPECTION INSTRUCTIONS:
• Refer to the back of this inspection report for regulatory citations and corrective actions
• Correct the violation(s) noted above by 17, . fl,
• Within 5 days of correcting all of the violations, sign and return 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)
FD2156b (Rev 9/10)