example spcc plan 2002

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SPILL PREVENTIONSPILL PREVENTIONSPILL PREVENTIONSPILL PREVENTION

CONTROLCONTROLCONTROLCONTROL ANDANDANDAND

COUNTERMEASURECOUNTERMEASURECOUNTERMEASURECOUNTERMEASURE PLANPLANPLANPLAN

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SPILL PREVENTION CONTROLSPILL PREVENTION CONTROLSPILL PREVENTION CONTROLSPILL PREVENTION CONTROL ANDANDANDAND

COUNTERMEASURE PLANCOUNTERMEASURE PLANCOUNTERMEASURE PLANCOUNTERMEASURE PLAN FORFORFORFOR

__________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ CompanyCompanyCompanyCompany Designated person accountable for spill prevention _________________________________________________________________

Name & TitleName & TitleName & TitleName & Title

C E R T I F I C A T I O NC E R T I F I C A T I O NC E R T I F I C A T I O NC E R T I F I C A T I O N I hereby certify that I have examined the facility, and being familiar with the provisions of 40 CFR Part 112, attest that this SPCC Plan has been prepared in accordance with good engineering practices and EPA requirements in final rule dated July 17, 2002 ________________________________________ ____ Print Name and Title Signature: Registration Number: ______________________________ DateDateDateDate SSSSealealealeal

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SPILL PREVENTION CONTROL AND COUNTERMEASURESPILL PREVENTION CONTROL AND COUNTERMEASURESPILL PREVENTION CONTROL AND COUNTERMEASURESPILL PREVENTION CONTROL AND COUNTERMEASURE COMPLIANCE INSPECTION PLANCOMPLIANCE INSPECTION PLANCOMPLIANCE INSPECTION PLANCOMPLIANCE INSPECTION PLAN

R E V I E W P A G ER E V I E W P A G ER E V I E W P A G ER E V I E W P A G E

In accordance with 40 CFR PART 112.5 (b) a review and evaluation of this SPCC plan is conducted at least once every five years. As a result of this review and evaluation, _______________________________________ _______________________________________ _______________________________________ _______________________________________ Company Company Company Company will amend the SPCC Plan within six months of the review to include more effective prevention and control technology if: (1) such technology will significantly reduce the likelihood of a spill event from the facility, and (2) if such technology has been field-proven at the time of the review. Any amendment to the SPCC Plan shall be certified by a Professional Engineer within six months after a change in the facility design, construction, operation or maintenance occurs which materially affects the facility’s potential for the discharge of oil into or on the navigable waters of the United States or adjoining shorelines. The plan must be reviewed every five years and if no amendments are made P.E. certification is not required. See review letter to be used in appendix “A”.

REVIEW DATESREVIEW DATESREVIEW DATESREVIEW DATES

YearYearYearYear MonthMonthMonthMonth DayDayDayDay SignatureSignatureSignatureSignature

2007

2012

2017

MANAGEMENT APPROVALMANAGEMENT APPROVALMANAGEMENT APPROVALMANAGEMENT APPROVAL ________________________________________ ________________________________________ ________________________________________ ________________________________________ Company Company Company Company is committed to the prevention of discharges of oil to navigable waters and the environment and maintains the highest standards for spill prevention control and countermeasures through regular review, updating, and implementation of this Spill Prevention Control and Countermeasure Plan for the C-Store Facility. Authorized Representative:Authorized Representative:Authorized Representative:Authorized Representative: ___________________________ ___________________________ ___________________________ ___________________________SignatureSignatureSignatureSignature __________________________ __________________________ __________________________ __________________________ TitleTitleTitleTitle

SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued… This plan is prepared following the sequence specified in 40 CFR Part 112 Section 112.7. At the end of this plan can be found a copy of Subpart A, Sections 112.1 through 112.7. There is also Subpart B, Sections 112.8 through 112.11, which do not apply to this facility. Subpart C does not apply to this facility and Subpart D and F are covered in this plan. This facility is a C-Store and stores gasoline and diesel fuel for sale to the general public. The product is delivered to the facility by transport or bobtail truck. These trucks are driven by CDL certified drivers with HAZMAT certification. No trucks are loaded at this facility. The containers (tanks) store more than 1320 gallons in total. It is reasonable to expect this location could have a discharge from tank failure, piping failure, or over filling of tank. Secondary containment can be achieved. This plan is to be available at the facility as it is staffed more than 4 hours 5 days a week.

Sections:Sections:Sections:Sections: 112.7(a)(3) The physical layout of this facility is as shown on the drawing on page X. Following the drawing there are pictures of the piping (not shown on drawing), containment structure, and tanks. In addition there is a map showing the location of the facility. There are no buried tanks at this location. The tanks are compatible with the product in them. (a)(3)(i)

Tank ID # Tank ID # Tank ID # Tank ID # (see drawing)(see drawing)(see drawing)(see drawing) SizeSizeSizeSize ProductProductProductProduct 1111 2222 3333 4444

(a)(3)(ii) There is no loading of product at this location. Product is removed through approved retail dispensers. All loading of tanks is done by HAZMAT certified drivers. (a)(3)(iii) Secondary containment drainage is via a pipe with a locked valve on it. The key is to be in control of the person responsible for spill prevention. The water is to be drained only when there is no sign of oil on it. If there is a small amount of oil on the water it is to be removed with absorbent pads. These pads are to be disposed of per the manufactures requirements and local regulations. (a)(3)(iv) The facility maintains a supply of absorbent pads, booms and other material to stop or clean up small spills. In the event of a large spill that escapes the secondary containment or is held in the secondary containment a list of environmental contractors is attached to this plan. Attached is a signed certification, assuring that in the event of a spill, qualified personnel are available.

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SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued… (a)(3)(v) All contaminated material that is removed will be handled and disposed of in accordance with State DNR regulations.

(a)(3)(vi) Attached to this plan is a list of contact phone numbers. It contains the person responsible for oil spill prevention at the facility, the National Response Center, cleanup contractors (see (a)(3)(iv) above), EPA Regional Office, State DNR and local police and fire departments. (a)(4) In appendix A there is shown the procedure for reporting a reportable spill. This list should be laminated and a copy posted where it is available to on duty staff. (a)(5)(b) The direction of flow if product should escape from secondary containment is shown on drawing.

FLOW CHARTFLOW CHARTFLOW CHARTFLOW CHART Potential SpillPotential SpillPotential SpillPotential Spill How ContainedHow ContainedHow ContainedHow Contained Volume ReleasedVolume ReleasedVolume ReleasedVolume Released Rate of ReleaseRate of ReleaseRate of ReleaseRate of Release

Complete Failure Of Full Tank Contained in Secondary Largest Tank Instantaneous Partial Failure Of Full Tank Contained in Secondary

Containment 1 Gallon to Full Tank Gradual to

Instantaneous Tank Overfills Containment Contained in Secondary

Containment 1 Gallon to Full Truck Compartment

1 to 120 gpm

Full Truck Potential SpillPotential SpillPotential SpillPotential Spill How ContainedHow ContainedHow ContainedHow Contained ComComComCompartmentpartmentpartmentpartment Rate of ReleaseRate of ReleaseRate of ReleaseRate of Release

Pipe Failure Contained in Secondary Containment

1 Gallon to 1000 Gallons

1 to 50 gpm

Leaking Pipe or Valve Contained in Secondary Containment

Drip to a Few Gallons 05 gpm

Delivery Truck Or Hose Rupture

Contained in Truck Holding Containment

1 To 4000 Gallons Largest Compartment

Gradual to Instantaneous

Hose Leak During Delivery Contained in one of the Secondary Containments

1 to 15 Gallons 1 gpm

Pump Seal Rupture Contained in One of the Secondary Containments

1 To 15 gpm 1 gpm

(a)(5)(c) Prevention Measures ProvidedPrevention Measures ProvidedPrevention Measures ProvidedPrevention Measures Provided The tanks are in secondary containment (see drawing) that has the capacity to hold the volume of the largest tank plus 10%. The capacity is figured as follows: Length X Width X Height X 7.5 gallons per cubic footLength X Width X Height X 7.5 gallons per cubic footLength X Width X Height X 7.5 gallons per cubic footLength X Width X Height X 7.5 gallons per cubic foot minus the volume of any other tank(s) figured at containment height. minus the volume of any other tank(s) figured at containment height. minus the volume of any other tank(s) figured at containment height. minus the volume of any other tank(s) figured at containment height.

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SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…

The owner will keep a supply of absorbent materials such as sand, chat, pads, and booms at the location. The truck secondary containment will be as shown on the drawings.

(a)(5)(e) Inspections, Test, and Records:Inspections, Test, and Records:Inspections, Test, and Records:Inspections, Test, and Records: A visual inspection shall be made daily of tanks, piping, valves, and secondary containment. There is a sample form to be filled out at the end of this Plan. These records and all other records are to be kept 3 years. Per Subpart B, in addition to visual inspection you must test on a regular schedule and whenever you make material repairs. This testing will use one of the following testing methods such as hydrostatic, radiographic, ultrasonic, acoustic emissions, or another system of non-destructive shell testing. Tank inspectors should meet STI or API certification.

(a)(5)(f) Personnel, Training, and Discharge Prevention Procedures:Personnel, Training, and Discharge Prevention Procedures:Personnel, Training, and Discharge Prevention Procedures:Personnel, Training, and Discharge Prevention Procedures:

At a minimum, your oil-handling personnel will be train in the operation and maintenance of equipment to prevent discharges; discharge procedure protocols; applicable pollution control laws, rules and regulations; general facility operations; and the contents of the SPCC Plan.

1. The person accountable for discharge prevention is:

____________________________________________________ Print or type name

2. The person above shall schedule and conduct briefings for personnel once a year.

(a)(5)(g) Security:Security:Security:Security:

1. You must fence the containers (tanks) at a minimum. 2. Drain valve must be locked and key kept by authorized personnel. 3. When facility is closed, electricity to pumps must be turned off. 4. Unloading line must have a check valve, gate valve, and locking cap. 5. Lighting will be as shown on drawing. 6. All piping will be supported so a minimum of abrasion occurs, corrosion is mitigated and

expansion and contraction are allowed.

(a)(5)(h) Truck Unloading Area:Truck Unloading Area:Truck Unloading Area:Truck Unloading Area:

1. Unloading area has secondary containment. 2. Trucks have interlocking brake systems when hoses are connected. 3. Check for leaks on truck before and after unloading.

(a)(5)(i) Field Constructed Tanks:Field Constructed Tanks:Field Constructed Tanks:Field Constructed Tanks:

There are no field constructed tanks at this facility.

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SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION SPILL PREVENTION CONTROL AND COUNTERMEASURE ~ COMPLIANCE INSPECTION PLAN ~ continued…PLAN ~ continued…PLAN ~ continued…PLAN ~ continued…

SUBPART B: SUBPART B: SUBPART B: SUBPART B: All the prevention, control and counter measure requirements of Section 112.8 (a) and (b) and those in (c) through Section 112.8(c)(6) have been addressed in Section 112.7 Section 112.8(c)(7):Section 112.8(c)(7):Section 112.8(c)(7):Section 112.8(c)(7): ! There are no heating coils in these tanks.

112.8(c)(8): ! All tanks have overfill alarms which are tested on a regular bases. The balance of this paragraph has

been addressed in Section 112.7 112.8(d) Facility Pumping: Facility Pumping: Facility Pumping: Facility Pumping: ! The underground piping is buried to allow traffic over it. ! The piping is tested annually. ! The underground piping leads to the retail pump island(s). ! The underground piping is corrosion protected.

! 112.9 through 112.15 do not apply to this retail facility.112.9 through 112.15 do not apply to this retail facility.112.9 through 112.15 do not apply to this retail facility.112.9 through 112.15 do not apply to this retail facility.

This plan needs review every 5 years. A form that can be used for this review follows the plan.

GENERAL OPERATING INFORMATIONGENERAL OPERATING INFORMATIONGENERAL OPERATING INFORMATIONGENERAL OPERATING INFORMATION The information found below may be found elsewhere in the plan. It is listed here to have an easy check off list. ! Before draining the dike check for signs of oil. Clean up all oil. Keep a record of time, date and who did the

inspection. Keep records 3 years. ! Plan to be reviewed every year with employees and every 5 years for changes. See forms in Appendix. ! Personnel Training: ! The truck owner will conduct driver training and driver will be HAZMAT certified. ! Spill reporting will be reviewed yearly. ! Personnel on duty will be trained in how to shut down operation in case of a spill.

! Electricity to pumps will be shut off in non-operating hours. ! All valves will be closed and locked except when getting product. ! Electricity to retail dispensers will be off in non-operating hours. ! Signs with local phone numbers are to posted where they can be seen at all times. ! Sign with the following driver instructions are to be posted where the driver will see them. ! Check inventory before unloading and record on bill of lading. ! Check truck for signs of leaks before unloading. ! Stay at truck shut off valve at all times. ! When unloaded again check truck for sign of leaks. ! Check gage when done and record on bill of lading. ! Close and lock valves. ! Before moving truck be sure hoses are stored.

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APPENDIX ‘A’APPENDIX ‘A’APPENDIX ‘A’APPENDIX ‘A’ THE FOLLOWING SAMPLE FORMS ARE IN THIS APPENDIX:

! SPCC PLAN OWNER’S REVIEW

! SPILL PREVENTION BRIEFING REPORT

! WEEKLY INSPECTION REPORT

! DIKE DRAINAGE REPORT

! MONTHLY INSPECTION REPORT

! INVENTORY RECORD REPORT

! LIST OF OUTSIDE MANPOWER, EQUIPMENT, AND MATERIALS

! TRANSPORT DRIVER DELIVERY REPORT

! EMPLOYEE ACKNOWLEDGMENT These forms or ones with the same basic content will be used to fulfill the requirements of this plan.

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S P C C P L A N O W N E R ’ S R E V I E WS P C C P L A N O W N E R ’ S R E V I E WS P C C P L A N O W N E R ’ S R E V I E WS P C C P L A N O W N E R ’ S R E V I E W As required by 40 CFR, Part 112.5(b), “a review and evaluation of the SPCC Plan at least once every five years from the date such facility becomes subject to this part,” is required of the owner. If major changes to the facility have occurred since the last review the plan must be updated and recertified by a registered Professional Engineer. If no amendment is necessary, the owner should indicate that the SPCC Plan was reviewed and that “No amendment is necessary as per 40 CFR, Part 112.5" Fill out this form to comply. Reviewed on 20 Reviewed by: Name (Type or Print)

Signature: Title: The next review date will be before __________________/ ______/ 20 ____________ *(Max. 5 years) or when a major change is made.

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S P I L L P R E V E N T I O N B R I E F I N G R E P O R TS P I L L P R E V E N T I O N B R I E F I N G R E P O R TS P I L L P R E V E N T I O N B R I E F I N G R E P O R TS P I L L P R E V E N T I O N B R I E F I N G R E P O R T

DATEDATEDATEDATE PERSONNEL ATTENDINGPERSONNEL ATTENDINGPERSONNEL ATTENDINGPERSONNEL ATTENDING TOPICS DISCUSSED AND REMARKSTOPICS DISCUSSED AND REMARKSTOPICS DISCUSSED AND REMARKSTOPICS DISCUSSED AND REMARKS SUPERVISORS SIGNATURESUPERVISORS SIGNATURESUPERVISORS SIGNATURESUPERVISORS SIGNATURE

Spill prevention briefing should be held at least Spill prevention briefing should be held at least Spill prevention briefing should be held at least Spill prevention briefing should be held at least annually and be attended by all facility personnel.annually and be attended by all facility personnel.annually and be attended by all facility personnel.annually and be attended by all facility personnel.

Cover such topics as:Cover such topics as:Cover such topics as:Cover such topics as: ! Spill prevention practicesSpill prevention practicesSpill prevention practicesSpill prevention practices ! Spill reportingSpill reportingSpill reportingSpill reporting ! Containment techniquesContainment techniquesContainment techniquesContainment techniques ! Cleanup techniquesCleanup techniquesCleanup techniquesCleanup techniques ! Facility SPCC PlanFacility SPCC PlanFacility SPCC PlanFacility SPCC Plan ! Applicable Federal and State lawsApplicable Federal and State lawsApplicable Federal and State lawsApplicable Federal and State laws

Then complete the spill prevention briefing report and file with, the SPCC Plan.

W E E K L Y I N S P E C T I O N S H E E TW E E K L Y I N S P E C T I O N S H E E TW E E K L Y I N S P E C T I O N S H E E TW E E K L Y I N S P E C T I O N S H E E T

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W e e k l y I n s p e c t i o n S h e e tW e e k l y I n s p e c t i o n S h e e tW e e k l y I n s p e c t i o n S h e e tW e e k l y I n s p e c t i o n S h e e t Week of: Week of: Week of: Week of: Date Inspected: Date Inspected: Date Inspected: Date Inspected: INSPECTED BY:INSPECTED BY:INSPECTED BY:INSPECTED BY: Signature: Signature: Signature: Signature: Print namePrint namePrint namePrint name EQUIPMENTEQUIPMENTEQUIPMENTEQUIPMENT PRODUCTPRODUCTPRODUCTPRODUCT LEAK?LEAK?LEAK?LEAK?

Y= YESY= YESY= YESY= YES N = NON = NON = NON = NO

IF LEAK, ACTION TAKEN TO CORRECTIF LEAK, ACTION TAKEN TO CORRECTIF LEAK, ACTION TAKEN TO CORRECTIF LEAK, ACTION TAKEN TO CORRECT

PUMPPUMPPUMPPUMP

VALVESVALVESVALVESVALVES

PIPE(S)PIPE(S)PIPE(S)PIPE(S)

FLANGESFLANGESFLANGESFLANGES

VISUAL TANK(S)VISUAL TANK(S)VISUAL TANK(S)VISUAL TANK(S)

HOSESHOSESHOSESHOSES

* This form is filled out weekly for each product This form is filled out weekly for each product This form is filled out weekly for each product This form is filled out weekly for each product

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D I K E D R A I N A G E R E P O R TD I K E D R A I N A G E R E P O R TD I K E D R A I N A G E R E P O R TD I K E D R A I N A G E R E P O R T DATEDATEDATEDATE __________/______/______ TIMETIMETIMETIME _____________________ _____________________ _____________________ _____________________

! OIL DETECTEDOIL DETECTEDOIL DETECTEDOIL DETECTED

! OIL REMOVEDOIL REMOVEDOIL REMOVEDOIL REMOVED

! DIKE CONDITIONDIKE CONDITIONDIKE CONDITIONDIKE CONDITION

INSPECTED BY:INSPECTED BY:INSPECTED BY:INSPECTED BY: StartStartStartStart FinishFinishFinishFinish YesYesYesYes No No No No YesYesYesYes No No No No GoodGoodGoodGood PoorPoorPoorPoor NOTESNOTESNOTESNOTES

Containment (Dike) drainage procedure:

1. Examine the surface of the water to be drained. All hydrocarbons must be removed prior to draining. 2. When the water is free of hydrocarbons, unlock and open the drain valve. 3. Stay at the open valve continuously and monitor the water discharge. 4. Close and lock the drain valve when the water is drained. 5. Complete the dike inspection and drainage report and file with the SPCC Plan.

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MONTHLY PHYSICMONTHLY PHYSICMONTHLY PHYSICMONTHLY PHYSICAL INSPECTIONAL INSPECTIONAL INSPECTIONAL INSPECTION

CHECK FOLLOWINGCHECK FOLLOWINGCHECK FOLLOWINGCHECK FOLLOWING DATEDATEDATEDATE REMARKSREMARKSREMARKSREMARKS INSPECTED BYINSPECTED BYINSPECTED BYINSPECTED BY

Tanks for sign of leaksTanks for sign of leaksTanks for sign of leaksTanks for sign of leaks

Condition of lines & valvesCondition of lines & valvesCondition of lines & valvesCondition of lines & valves

Water in dikeWater in dikeWater in dikeWater in dike

Condition of dikeCondition of dikeCondition of dikeCondition of dike

General plant conditionGeneral plant conditionGeneral plant conditionGeneral plant condition

Good housekeeping lessons chances of leaks!

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DAILY INVENTORY RECORDAILY INVENTORY RECORDAILY INVENTORY RECORDAILY INVENTORY RECORDDDD DATEDATEDATEDATE PRODUCTPRODUCTPRODUCTPRODUCT OPENING OPENING OPENING OPENING

INVENTORYINVENTORYINVENTORYINVENTORY + DELIVERY + DELIVERY + DELIVERY + DELIVERY ---- SALES SALES SALES SALES

CLOSING CLOSING CLOSING CLOSING INVENTORYINVENTORYINVENTORYINVENTORY

CHECK BYCHECK BYCHECK BYCHECK BY

opening inventory plus (+) delivery minus (opening inventory plus (+) delivery minus (opening inventory plus (+) delivery minus (opening inventory plus (+) delivery minus (----) sales equals (=) closing inventory) sales equals (=) closing inventory) sales equals (=) closing inventory) sales equals (=) closing inventory

If there are more than 7 products this chart should be modified or if it is desired to keep inventory by separate tanks this chart can be modified.

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LIST OF OUTSIDE MANPOWER, EQUIPMENT & MATERIALSLIST OF OUTSIDE MANPOWER, EQUIPMENT & MATERIALSLIST OF OUTSIDE MANPOWER, EQUIPMENT & MATERIALSLIST OF OUTSIDE MANPOWER, EQUIPMENT & MATERIALS

NAMENAMENAMENAME PHONE NUMBERPHONE NUMBERPHONE NUMBERPHONE NUMBER TYPE OF SERVICETYPE OF SERVICETYPE OF SERVICETYPE OF SERVICE Police Security

Fire

*Under type of service show excavator, petroleum maintenance, clean up, etc.

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TRANSPORT DRIVER DELIVERY REPORTTRANSPORT DRIVER DELIVERY REPORTTRANSPORT DRIVER DELIVERY REPORTTRANSPORT DRIVER DELIVERY REPORT

Date & Time Product Volume Before

(Inches or Gallons)

Volume After (Inches or Gallons)

Driver

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EMPLOYEE ACKNOWLEDGMENTEMPLOYEE ACKNOWLEDGMENTEMPLOYEE ACKNOWLEDGMENTEMPLOYEE ACKNOWLEDGMENT

I I I I ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________, , , , NameNameNameName----print or typeprint or typeprint or typeprint or type

have read and had explained to me the SPCC Plan for _______________have read and had explained to me the SPCC Plan for _______________have read and had explained to me the SPCC Plan for _______________have read and had explained to me the SPCC Plan for _________________________________________ __________________________ __________________________ __________________________ and am aware what to do in case of a spill and where the plan is kept.and am aware what to do in case of a spill and where the plan is kept.and am aware what to do in case of a spill and where the plan is kept.and am aware what to do in case of a spill and where the plan is kept. ________________________________________________________________________________________________________________________________________________ _______/_____/20_____________/_____/20_____________/_____/20_____________/_____/20______ SignatureSignatureSignatureSignature Month/day/yearMonth/day/yearMonth/day/yearMonth/day/year

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APPENDIX “B”APPENDIX “B”APPENDIX “B”APPENDIX “B” This appendix contains the following:

1. Reporting procedure for leaks, spills and overfills of refined oils.

2. What to say when reporting 1 above to NRC & DNR

3. Follow up spill reporting procedure.

4. Spill history form.

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REPORTING PROCEDURE FORREPORTING PROCEDURE FORREPORTING PROCEDURE FORREPORTING PROCEDURE FOR

LEAKS, SPILLS, AND OVERFILLS OF REFINED OILSLEAKS, SPILLS, AND OVERFILLS OF REFINED OILSLEAKS, SPILLS, AND OVERFILLS OF REFINED OILSLEAKS, SPILLS, AND OVERFILLS OF REFINED OILS The reporting for The Company is to be inserted by the owner following this page. Also a laminated copy of this procedure is posted where all can see and read it. The owner needs to keep this page updated as personnel change, move and change phone numbers and phone companies are changing area codes. REPORT IMMEDIATELY ANY LEAK, SPILL OR OVERFILL TO:REPORT IMMEDIATELY ANY LEAK, SPILL OR OVERFILL TO:REPORT IMMEDIATELY ANY LEAK, SPILL OR OVERFILL TO:REPORT IMMEDIATELY ANY LEAK, SPILL OR OVERFILL TO:

NATIONAL RESPONSE CENTER (NCR) NATIONAL RESPONSE CENTER (NCR) NATIONAL RESPONSE CENTER (NCR) NATIONAL RESPONSE CENTER (NCR) 1111----800800800800----424424424424----8802880288028802 Follow the company guidelines on next page and posted laminated page.

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WHAT TO SAY WWHAT TO SAY WWHAT TO SAY WWHAT TO SAY WHEN REPORTINGHEN REPORTINGHEN REPORTINGHEN REPORTING LEAK, SPILL, OR OVERFILLLEAK, SPILL, OR OVERFILLLEAK, SPILL, OR OVERFILLLEAK, SPILL, OR OVERFILL

TO NCR AND MDNRTO NCR AND MDNRTO NCR AND MDNRTO NCR AND MDNR

ALWAYS TELL THE TRUTH. GIVING FALSE INFORMATION OR ATTEMPTING TO COVER UP IS A CRIMINAL ACT AND SUBJECT

TO SEVERE PENALTIES.

FOLLOW THE EXHIBIT “A” ON NEXT PAGE AND ON THE LAMINATED PAGE POSTED WHERE ALL CAN SEE AND READ.

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FOLLOW UP REPORTINGFOLLOW UP REPORTINGFOLLOW UP REPORTINGFOLLOW UP REPORTING THE HOME OFFICE PEOPLE WILL NEED THE FOLLOWING FROM THE FACILITY:

1. TYPE OF PRODUCT INVOLVED.

2. QUANTITY SPILLED.

3. TYPE OF SPILL.LEAK, OVERFILL, HOSE BREAK.

4. EXACT LOCATION OF SPILL ON PROPERTY, IF NOT DIRECTION OF FLOW.

5. IS PRODUCT CONTAINED IN CONTAINMENT DIKE.

6. THE NEAREST DITCH, CREEK, LAKE OR RIVER.

7. STEPS BEING TAKEN TO COMMENCE THE CLEAN UP.

8. WRITE DOWN WHO YOU CALLED, WHO YOU TALKED TOO, TIME OF CALL AND WHAT WAS SAID. KEEP A WRITTEN RECORD OF EVERYTHING YOU DO.

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APPENDIX “C”APPENDIX “C”APPENDIX “C”APPENDIX “C”

CERTIFICATION OF THE CERTIFICATION OF THE CERTIFICATION OF THE CERTIFICATION OF THE APPLICABILITYAPPLICABILITYAPPLICABILITYAPPLICABILITY

OF THE OF THE OF THE OF THE SUBSTANTIAL HARM SUBSTANTIAL HARM SUBSTANTIAL HARM SUBSTANTIAL HARM

CRITERIACRITERIACRITERIACRITERIA

SUBSTANTIAL HARM CRITERIA CHECKLISTSUBSTANTIAL HARM CRITERIA CHECKLISTSUBSTANTIAL HARM CRITERIA CHECKLISTSUBSTANTIAL HARM CRITERIA CHECKLIST Facility Name: Facility Address: City State 1. Does the facility transfer oil over water and does the facility have a total storage capacity greater than or equal to 42,000

gallons

! Yes Yes Yes Yes ! NoNoNoNo

2. Does the facility have a total storage capacity greater than or equal to 1 million gallons and does the facility lack secondary containment that is sufficiently large to contain the capacity of the largest aboveground oil storage tank plus freeboard to allow for precipitation within any aboveground oil storage tank area.

! YesYesYesYes ! NoNoNoNo

3. Does the facility have a total oil storage capacity greater than or equal to 1 million gallons and is the facility located at distance (as calculated using the formula in Attachment C-lll, Appendix C, 40 CFR 112 or a comparable formula) such that a discharge from the facility could cause injury to fish and wildlife and sensitive environments? For further description of fish and wildlife see Appendices 1, 11, and 111 to DOC/NOAA’s Guidance for Facility and Vessel Response environments (Section 10-, Appendix E, 40CFR 112 for availability) and the applicable Area Contingency plan.


4. Does the facility have a total storage capacity greater than or equal to 1 million gallons and is the facility located at a distance (as calculated using appropriate formula in attachment C-111, Appendix C 40CFR 112 or a comparable formula*) such that a discharge from the facility would shut down a public drinking water intake**?


5. Does the facility have a total capacity greater than or equal to 1 million gallons and has the facility experienced a reportable oil spill in an amount greater than or equal to 10,000 within the last 5 years?


CERTIFICATIONCERTIFICATIONCERTIFICATIONCERTIFICATION I certify under penalty of law that I have personally examined and am familiar with the information submitted in this document and based on my inquiry of those individuals responsible for obtaining this information I believe that the submitted information is true, accurate and complete. Engineer’s Name: _______________________ Signature Date:_________________ From 40 CFR 112 Appendix C, Attachment C-11 * Comparable formula not used.

** For the purposes of 40 CFR 112 , public drinking water intakes are analogous to public water systems as described at 40 CFR 143.2(c).

example spcc plan 2002

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