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BAKERSFIELD FIRE DEPT.
s ..... . K s F: , �. „ Prevention Services
F/ RE 2101 H Street
�R� Bakersfield, CA 93301
UNIFIED PROGRAM INSPECTION CHECKLIST Tel.: (661)326 -3979
Fax: (661) 852 -2171
Aboveground Petroleum Storage Tank Program
FACILITY NAME
Y
INS.PE7TION DATE,
INSPECTION TIME
ADDRESS
t�
PHONE NO.
NO OF EMPLOYEES
FACILITY CONTACT
BUSINESS ID NUMBER
CONSENT TO INSPECT NAME/TITLE
SECTION 1: Records Review: California Health & Safety Code; 25270
DESCRIPTION
Y
N
N/A
COMMENTS
an SPCC -plan [CFR 112.3.]
-Prepare
or amend SPCC plan [CFR 112.5 (a)(d)]
-Review
SPCC plan available on site [CFR 112.3(e)]
Conduct inspections and test in accordance with written procedures [CFR 112.7(e) ]
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Maintain records of inspections, tests and/or procedures [CFR 112.7(e)]
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Records of inspections or tests signed b inspector [CFR 112.7(e)]
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DESCRIPTION
Y
N
N/A
COMMENTS
Self - certification for Tier I or II facility [112.6(a)(1),(b)(1)
Professional engineer certification [CFR 112.3(d) and 112.6(b)(4 )]
of 5 year review and evaluation of SPCC plan [CFR 112.5(b)]
-Documentation
Amendments required within 6 months of changes/certifications [CFR 112.5(a) and 112.6(a)(2), (b)(4)]
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Management authorization of resource commitment to implement the SPCC [CFR 112.7 & 11 2.6(a)
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Diagram with location and contents of containers, transfer stations, connecting piping [112.7(a)(3)]
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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)]
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Required contact list and hone numbers [CFR 112.7(a)(3)]
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DESCRIPTION
Y
N
N/A
COMMENTS
corrosion protection [CFR 112.8(c)(4)(5), (d)(1)]
-Provide
- compatible with materials stored CFR 112.8(c)(1)]
-Containers
Im lement SPCC lan review chan es or amendments within 6 mo nth s [CFR 112.5(a)(d)]
Prepare an oil contingency plan or written control /removal commitments [CFR 112.7(d)]
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DESCRIPTION
YJ
N
N/A
COMMENTS
program [CFR 112.7(f)]
-Training
Train personnel in operation and maintenance of equipment [CFR 112.7(f)
Conduct annuals ill prevention briefmgs [CFR 112.7(f)(3)
SECTION 5: Facility Inspection: calitornla Maim & Srtet c;oae; z5zru.4.5
DESCRIPTION Y N N/A COMMENTS
Meet provisions of conditional exemption
ANY HAZARDOUS WASTE ON SITE? 'CI)YES ❑ NO ISignature ofReceipt
Explain:_-
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POST INSPECTION INSTRUCTIONS:
• Refer to the back of this inspection report for regulatory citations and corrective actions
• Correct the violation(s) noted above by x . / Signature (that all violations have been corrected as noted)
• 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
White - Business Copy Yellow - Business Copy to be Sent in after return to Compliance Pink - Prevention Services Copy FD2156b (Rev 9/10)
[H &S 25270.4.5(b)
Facty security ade uate [CFR 112.70
Clean-up materials readily available CFR 112.7 (c)
Overfill protection procedures or devices in place and operative [CFR 112.8(c)(8)]
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Portable /mobile containers positioned to prevent discharge [CFR .112.8(c)(11)
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Loadin / 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 112.31
ANY HAZARDOUS WASTE ON SITE? 'CI)YES ❑ NO ISignature ofReceipt
Explain:_-
�y /p t n,
'y..
3 4A. .4,i L F pr. -,• "w� ^`^ ,. t:. 2�: �ij�t• is+" .,.,
POST INSPECTION INSTRUCTIONS:
• Refer to the back of this inspection report for regulatory citations and corrective actions
• Correct the violation(s) noted above by x . / Signature (that all violations have been corrected as noted)
• 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
White - Business Copy Yellow - Business Copy to be Sent in after return to Compliance Pink - Prevention Services Copy FD2156b (Rev 9/10)