Water Quality - Excel by maclaren1

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									                                                                                            Yes   No   N/A   Comment/Concerns
Georgia
Water Quality

Inventory
       1 Has the facility developed a water balance/flow diagram which details all water
                                                                                                               Please Input
         sources and all discharge locations?
       2 Does the water balance/flow diagram include ALL of the following data:
                a) Sources and quantities of all pollutants which could be present in
                discharges from the facility; and
                b) Flow rates or quantities, documented where possible with meter
                readings, flow charts and/or calculations?
       3 Have the entities which receive water/wastewater discharges been determined
         and documented?
                                                                                                               Please Input


        4 Are discharge points properly and consistently identified on site drawings and
          schematics for emergency in-house and compliance needs?
                                                                                                               Please Input


        5 Have incoming water sources, wastewater and storm water runoffs been
          sampled and analyzed for regulated parameters?                                                       Please Input

        6 Has a schedule which lists the site's pending water pollution control permit
          applications and current permits been prepared?
                                                                                                               Please Input


SWPP Plan
     7 For industrial facilities covered under the state's industrial general permit, did
        they prepare and implement SWPPPs following the EPA guidance document,
                                                                                                               Please Input
        Storm Water Management for Industrial Activities: Developing Pollution
        Prevention Plans and Best Management Practices?
     8 Did the facility operator prepare and implement an SWPPP within 60 days of
        commencing any industrial activity?
                                                                                                               Please Input


        9 For oil and gas facilities, did they prepare and implement an SWPPP within 60
          days of learning about a release of a reportable quantity of oil or hazardous
          substance?                                                                                           Please Input


      10 Does the SWPPP include the following items:
                a) A pollution prevention team that identifies specific individuals
                responsible for developing and assisting in its implementation.
                b) A description of potential sources of pollution.
                c) A facility-specific description of the stormwater management controls
                including good housekeeping practices, preventative maintenance,                               Please Input
                inspections, and spill prevention control and countermeasure (SPCC)
                plans.
                d) Comprehensive site compliance inspections, conducted at least once
                per year by the team leader, with documentation of the results of each
                inspection.
      11 Did permittees conduct annual sampling of their stormwater discharges?
                                                                                                               Please Input

      12 Did the permittee record the date(s) and duration (in hours) of the storm event
         sampled, rainfall measurements, the duration in days between the last
         measurable storm event and the total volume (in gallons) sampled?
Additional Notes:
                                                                                                 Yes   No   N/A   Comment/Concerns
Georgia
Worker and Community Right To Know

EPCRA - Emergency Planning Notification
     1 Have all mixtures or formulations containing one percent or more of an
        extremely hazardous substance been evaluated for notification purposes?                                     Please Input

       2 Was the quantity of each extremely hazardous substance in each mixture
         aggregated to determine whether the amount at the facility exceeds the
         threshold planning quantity?
                                                                                                                    Please Input




       3 Are the contacts at the State Emergency Response Commission and Local
         Emergency Planning Committee known and on file at the facility?

                                                                                                                    Please Input



       4 Did the facility notify all State Emergency Response Commissions with
         jurisdiction over the facility that the facility is subject to the Emergency Planning
         requirements?                                                                                              Please Input


       5 Was the notification submitted prior to May 17, 1987, or within 60 days after the
         facility first became subject to the Emergency Planning requirements?




       6 Has the facility provided the Local Emergency Planning Committee with
         information concerning ALL of the following subjects:
                   a) The information it has requested and which is necessary for
                   developing the local comprehensive emergency response plan; and
                   b) Any relevant changes occurring at the facility?
       7 Has the owner or operator of the facility designated a representative to serve as
         a facility emergency response coordinator?                                                                 Please Input

       8 Did the facility emergency coordinator notify the Local Emergency Planning
         Committee of his appointment before September 17, 1987, or within 30 days
         after the Local Emergency Planning Committee was established, whichever was
         earlier?
       9 Does your facility have an emergency preparedness plan?
                                                                                                                    Please Input

EPCRA - MSDSs
    10 Has the facility emergency coordinator or designee developed and implemented
        BOTH of the following systems:
              a) A system to ensure that all MSDSs are readily available, updated as
              needed and filed with the appropriate authorities; and
                                                                                                                    Please Input
              b) A system to monitor the total inventory of each particular hazardous
              chemical for which an MSDS is required to ensure that he/she is aware
              when the applicable threshold reporting amount is reached?

      11 For all hazardous chemicals stored on-site above the minimum threshold level,
         has the facility submitted EITHER of the following:
                  a) An MSDS for each hazardous chemical; or
                  b) A list of the hazardous chemicals arranged by hazard category,                                 Please Input
                  including the chemical name or common name of each hazardous
                  chemical and any hazardous component of each chemical (except
                  mixtures) as provided on the MSDS?
      12 Has the facility submitted a list of hazardous chemicals or the MSDSs to ALL of
         the following authorities:
                  a) The State Emergency Response Commission;
                  b) The Local Emergency Planning Committee; and
                  c) The fire department with jurisdiction over the facility?
      13 Was the initial submission of MSDSs or list of chemicals completed prior to
         October 17, 1990, or within three months of the date the facility became subject
         to the reporting requirement?
                                                                                                Yes   No   N/A   Comment/Concerns
      14 Does the facility submit a new or revised MSDS for a hazardous chemical within
         three months whenever significant new information is discovered about the
         chemical?



      15 Was an MSDS or a revised list submitted within three months after a threshold
         was exceeded because of EITHER of the following events:
                 a) A new chemical was brought on-site which exceeded the TPQ; or
                 b) A chemical already on-site exceeded the TPQ?
      16 Has the Local Emergency Planning Committee (LEPC) requested an MSDS
                                                                                                                   Please Input
         from the facility to respond to an information request?
      17 Was the requested MSDS provided within 30 days of the request?


      18 Has the facility ever been penalized for failure to comply with the MSDS
                                                                                                                   Please Input
         requirements?
      19 Was the problem corrected that led to the penalty for violations of the MSDS
         requirements?
Inventory Form Reporting - Tier I/Tier II
      20 Has the facility prepared for ALL of the following requests from the fire
         department with jurisdiction over the facility:
                 a) An on-site inspection; and                                                                     Please Input
                 b) An information request, on the specific location of hazardous
                 chemicals at the facility?
      21 Has the facility ever been penalized for failure to comply with the inventory form
                                                                                                                   Please Input
         reporting requirements
      22 Was the problem corrected that led to the penalty for violations of the inventory
         form reporting requirements?


Inventory Form Reporting - Tier I
      23 Has the facility submitted a Tier I inventory form?
                                                                                                                   Please Input

      24 Was the inventory form submitted on or before March 1 of each year following
         the date when the facility became subject to the reporting requirements?




      25 Did the facility send the Tier I inventory form to ALL of the following authorities:

                 a) The State Emergency Response Commission;
                 b) The appropriate Local Emergency Planning Committee; and
                 c) To the fire department that has jurisdiction over the facility?
      26 Did the inventory form contain ALL of the following information:
                 a) The hazardous chemicals categorized according to the health and
                 physical hazards established by the EPA; and
                 b) Facility identification information (owner/operator, emergency
                 contacts, and certification)?
      27 Did the inventory form include ALL of the following information for the preceding
         calendar year:
                 a) The maximum amounts (in ranges) of all hazardous chemicals in each
                 category;
                 b) The average daily amounts (in ranges) of all hazardous chemicals in
                 each category;
                 c) The number of days the hazardous chemicals in each hazard
                 category were on-site; and
                 d) The general location of all hazardous chemicals in each category?
Inventory Form Reporting - Tier II
      28 Has the facility submitted a Tier II inventory form (either voluntarily or by
                                                                                                                   Please Input
         request)?
                                                                                                    Yes   No   N/A   Comment/Concerns
       29 Was the Tier II inventory form submitted by the following deadlines, as
          applicable:
                  a) On March 1 of each year, for submission in place of a Tier I form;
                  and
                  b) Within 30 days of a request by the State Emergency Response
                  Commission, the Local Emergency Planning Committee, or the local fire
                  department?
       30 Did the facility send the Tier II inventory form to ALL of the following authorities:

                  a) The State Emergency Response Commission;
                  b) The appropriate Local Emergency Planning Committee; and
                  c) To the fire department that has jurisdiction over the facility?
       31 Did the Tier II report include ALL of the following data:
                  a) The facility identification (including owner/operator, emergency
                  contacts, and certification);
                  b) The chemical name or common name of all chemicals as provided on
                  the MSDS;
                  c) The chemical properties of all hazardous chemicals listed, including
                  whether the chemical is pure or a mixture, whether it is a solid, a liquid
                  or a gas, and whether it is an extremely hazardous substance;

                   d) The hazard categories for all chemicals;
                   e) The manner in which hazardous chemicals are stored;
                   f) The general location of all hazardous chemicals in each category
                   (which may be claimed confidential and not released to the public); and

               g) Whether an chemical identity is claimed as a trade secret?
    32 Did the Tier II form include ALL of the following information for the preceding
        calendar year:
               a) The maximum amounts (in ranges) of all hazardous chemicals in
               each category;
               b) The average daily amount (in ranges) of all hazardous chemicals in
               each category; and
               c) The number of days the hazardous chemicals in each hazard
               category were on-site?
EPCRA - Hazardous Chemical Reporting - Mixtures
    33 For mixtures of hazardous chemicals, did the facility provide information on the
        submitted MSDS or inventory form using EITHER of the following methods:

                   a) Provide the information on each component in the mixture; or                                     Please Input
                   b) Provide the information on the mixture itself, so long as the reporting
                   of mixtures was the same for both MSDS and inventory form reporting?

       34 If the facility is reporting each component of a mixture which is a hazardous
          chemical, did it multiply the percentage by weight by the mass of the mixture to
                                                                                                                       Please Input
          determine the quantity of the hazardous chemical in the mixture?

      35 If the facility is reporting the mixture itself, did it report the total quantity of the
                                                                                                                       Please Input
         mixture?
      36 To determine whether the reporting threshold for an extremely hazardous
         substances was equaled or exceeded, did the facility aggregate ALL of the
         following quantities:
                  a) The quantity of the extremely hazardous substance present as a                                    Please Input
                  component in all mixtures at the facility; and
                  b) All other quantities of the extremely hazardous substance present at
                  the facility?
      37 If extremely hazardous substances are being reported and are a component of a
         mixture, did the facility report the extremely hazardous substances in EITHER of
         the following ways:
                                                                                                                       Please Input
                  a) The whole mixture, even if the total quantity of the mixture was below
                  its reporting threshold; or
                  b) The extremely hazardous component(s) of the mixture?
Toxic Chemical Release Reporting - Form R
      38 When taking into account the amount of toxic chemicals on-site at the facility,
         did the facility include mixtures containing toxic chemicals or components of
                                                                                                                       Please Input
         trade name products which the owner or operator received from another
         person?
      39 Did the facility complete a toxic chemical release form for each reportable
         chemical and submit it to the EPA Administrator and designated state official on                              Please Input
         or before July 1, 1988 and by July 1 each year thereafter?
                                                                                              Yes   No   N/A   Comment/Concerns
      40 If the facility submits Form Rs separately for each establishment or for each
         group of establishments, does the facility also submit separate reports for all
         other chemicals above the threshold amount at that same establishment or
         group?

                                                                                                                 Please Input




      41 If the facility manufactures or processes a toxic chemical, does it provide the
         required information to customers who must file the toxic chemical release form?                        Please Input

     42 Does the facility provide toxic chemical supplier notification information to
         customers in writing by January 1 of each year, that includes ALL of the
         following information:
                 a) A statement that the mixture or trade name product you supplied
                 contains a toxic chemical(s) subject to the reporting requirements;
                 b) The name and CAS registry number of each toxic chemical you sold;
                 and
                 c) The percent by weight of each toxic chemical in the mixture or trade
                 name product?
Form R - Recordkeeping
     43 Do you retain copies of submitted Form Rs for at least three years?
                                                                                                                 Please Input

      44 Do you retain supporting data and documentation of ALL of the following issues
         for at least three years:
                  a) Determination whether a reporting threshold applies;
                  b) Calculations used to determine the quantity of each toxic chemical
                                                                                                                 Please Input
                  released to the environment or transferred to an off-site location; and

                   c) Calculations of use indications and quantities of each toxic chemical
                   (including dates of manufacturing, processing and use)?
      45 Do you retain ALL of the following records for at least three years:
                   a) Receipts or manifest associated with the transfer of toxic chemicals
                   to off-site locations;
                                                                                                                 Please Input
                   b) Documentation of reported waste treatment methods for each toxic
                   chemical; and
                   c) Development of estimates of any release or off-site transfer?
      46 Does the facility retain all supporting material used to determine whether
         supplier notification was required AND a copy of each supplier notice for at least                      Please Input
         three years from the date of submission?
      47 Are all records associated with toxic chemical release reporting kept at the
         facility which submitted the reports AND at the facility to which they apply?                           Please Input

      48 Are records readily available for EPA inspection?
                                                                                                                 Please Input
      49 If the facility ever received a penalty for a recordkeeping violation, was the
         problem that led to the penalty corrected?                                                              Please Input

Toxic Chemical Release Reporting - Reportable Chemicals
      50 Do any of the following conditions apply to the waste stream:
                a) The stream is a product:
                b) The stream is sent to a boiler or industrial furnace, where it is burned
                as fuel;
                c) The stream is a byproduct, intermediate, or a material that is used at
                the facility for the production of a product; or
                                                                                                                 Please Input
                d) The stream leaves the facility, and one or both of the following apply:

                    1) The stream is transferred to another facility for further processing
                    and is returned to the original facility; or
                    2) The stream is transferred to an intracompany facility for further
                    processing in the production of a product or provision of a service?
                                                                                          Yes   No   N/A   Comment/Concerns
      51 Do ANY of the following circumstances apply to the chemical waste stream:

                 a) The stream contains one or more reportable chemicals that is
                 released into the environment;
                                                                                                             Please Input
                 b) The stream enters a permitted waste treatment device for treatment;
                 and destruction, biological degradation or chemical conversion of the
                 stream occurs; or
                 c) The stream enters a device where all outputs release or dispose?
Pollution Prevention
      52 Is there a procedure in place at the facility which ensures that pollution
         prevention is a consideration in decision-making?
                                                                                                             Please Input



Additional Notes:
                                                                                           Yes   No   N/A   Comment/Concerns
Georgia
Standards Applicable to Generators of Hazardous Waste

Hazardous Waste Determination
      1 Do you have a EPA Hazardous Waste Generator ID number?

                                                                                                              Please Input


        2 Have solid wastes been characterized to determine whether they are
          hazardous?
                                                                                                              Please Input


        3 Does the site determine that wastes are hazardous by any of the following?
                  a) Testing;
                  b) Knowledge of processes: or
                  c) Both testing and knowledge of processes
        4 Are results of waste tests and waste analyses:
                  a) Kept on file at the site for each waste stream; AND
                  b) Retained for at least three years for ALL wastes tested
        5 Are waste analyses up to date?
                                                                                                              Please Input

Pollution Prevention
        6 Does the facility's waste minimization program include ALL of the following:
                  a) Demonstrated top management support;
                  b) The tracking of types and amounts of hazardous wastes and
                  hazardous waste constituents, including the rates and dates they are
                  generated;
                  c) A system for determining the true costs associated with hazardous
                  waste management and cleanup, including future liabilities;                                 Please Input

                  d) Looking at a process to see where materials can be prevented from
                  becoming a waste minimization opportunities might be;
                  e) A cost allocation system, which identifies those activities which
                  generate hazardous waste;
                  f) Periodic review?
LQG - Manifest - General Requirements
       7 Does the LQG use hazardous waste manifest forms?


                                                                                                              Please Input



       8 Is ALL of the following identifying information provided in the LQG facility's
         manifests;
                 a) The generators name, mailing address, and telephone number;
                 b) The generators EPA Identification Number;
                 c) The transporter's name and EPA Identification Number;
                 d) The TSDF's name, address, and EPA Identification Number; and
                 e) The waste description required by DOT (proper shipping name,
                 hazard class and ID number)?
       9 Is EACH of the following true of the LQG facility's manifest
                 a) The manifests contain the signed generator's certification; and
                 b) Copies of manifests are retained for at least three years from the
                 date the waste was accepted b the initial transporter?
      10 Did the owner/operator of the LQG facility receive signed copies of ALL
         manifests from transporters and/or TSDFs within 35 days of the shipment?                             Please Input

      11 For any manifest not returned within 35 days, was the transporter and/or TSDFs
         immediately contacted?
      12 If a signed manifest was not received from the transporter and/or TSDF within
         45 days, were BOTH of the following actions taken:
                  a) An Exception Report was sent to EPA;
                  b) Copies of Exemption Reports were retained for at least three years?
                                                                                            Yes   No   N/A   Comment/Concerns
Acquisition of Manifests
     13 If the consignment state for the shipment is NJ, are you using the Department
          supplied manifest?
                                                                                                               Please Input


Pre-Transport Requirements - Marking
      14 Has each container of 110 gallons or less used in transportation been marked
         with the following words and information:
               HAZARDOUS WASTE--Federal Law Prohibits Improper Disposal. If
               found, contact the nearest police or public safety authority or the U.S.
                                                                                                               Please Input
               Environmental Protection Agency or the New Jersey Department of
               Environmental Protection.
               Generator's Name and Address________________________
               State Manifest Document Number___________________________
Recordkeeping and Reporting
      15 Are manifests being kept for three years as well as a signed copy from the
         owner or operator of the designated facility which received the waste.                                Please Input

LQG - Reporting - Biennial Report
      16 Has a Biennial Report been prepared, and does it detail the LQG facility's
         hazardous waste activities?                                                                           Please Input

      17 Are ALL of these Biennial Reporting requirements followed:
                a) One copy of the report is submitted to EPA by March 1 of every even-
                numbered year;
                b) Biennial Reports are completed using EPA Form 8700-13A (or
                required State form); and
                c) Copies of the Biennial Reports are retained for at least three years?
      18 Does the Biennial Report include ALL of the following:
                  a) The EPA Identification Number, name, and address of the generator
                  b) The calendar year covered by the report
                  c) The name, EPA Identification Number, and address for each TSDF
                  in the U.S. to which HW was shipped during the year;
                  d) The name and EPA Identification Number of each transporter used
                  to transport HW during the year;
                  e) A description, EPA hazardous waste number, DOT hazardous class,
                  and quantity of each hazardous wasted shipped off-site to a TSDF
                  within the U.S.;
                  f) The certification signed by the generator or authorized
                  representative?
      19 Is the biennial report sent to DEQ by March 1 of each even-numbered year on
         the federal Form 8700-13A/B?                                                                          Please Input

LQG - Off-Site Transport
      20 When offering hazardous waste for off-site transport, does the LQG ensure that
         ALL of the following TSDF and waste hauler conditions are met:
                 a) Manifested hazardous wastes are shipped to properly permitted
                 TSDF;
                 b) Each TSDF to which manifested HW is being shipped has an EPA
                 Identification Number;                                                                        Please Input
                 c) Manifested hazardous wastes are transported only by waste haulers
                 that have EPA Identification Numbers;
                 d) There are records of the names of each hauler who transported
                 manifested hazardous waste and the waste hauled by each (this
                 information would be included on the facilities manifests)?
      21 Are ALL of the following true for vehicles which are used to transport shipments
         of manifested hazardous wastes:
                 a) The vehicles are placarded according to DOT regulations;                                   Please Input
                 b) Outgoing trucks are inspected to verify proper placarding before they
                 leave the facility?
LQG - Accumulation Time
      22 Does the owner/operator of the LQG facility assure that the following on-site
         HW accumulation time limits are met:
                 a) HW is accumulated for no more than 90 days; and/or
                                                                                                               Please Input
                 b) When the 90-day time limit is exceeded, the generator obtains an
                 extension from the regulating authority and removes the waste before
                 the extension expires?
                                                                                                Yes   No   N/A   Comment/Concerns
LQG - On-Site Accumulation - Training
      23 Does the owner/operator of the LQG facility assure that employees, whose work
         may associate them with hazardous waste accumulation areas, receive on-the-
                                                                                                                   Please Input
         job or classroom training about the facility they work in and their job
         responsibilities?
      24 Are ALL of the following training requirements met:
                   a) All facility personnel who handle hazardous waste in any manner,
                   participated in an initial training course related to their management of
                   hazardous waste within six months of beginning employment;
                   b) Each facility employee participated in an annual review of his or her
                   training;
                   c) The initial training and annual review was directed by a person
                   trained in hazardous waste management?
      25 Are personnel assigned in hazardous waste storage areas generally familiar
         with ALL of the following:
                   a) Facility start up procedures;
                   b) The normal operation of the facility;
                   c) Facility shut down procedures;
                   d) Communications or alarm systems;
                   e) The facility contingency plan;
                   f) Emergency shut down procedures;
                   g) A description of controls;
                   h) The fail safe features of the systems?
      26 Are personnel assigned in hazardous waste storage areas generally familiar
         with ALL of the following:
                   a) Operating problems;
                   b) Flow controls;
                   c) Monitoring;
                   d) Documentation;
                   e) Site operating procedures;
                   f) Maintenance requirements;
                   g) Equipment safety;
                   h) Personnel safety;
      27 Are documents containing ALL of the following information maintained at the
         facility:
                   a) Records of each current employees training;
                   b) Records of former employee training, for at least three years after
                   they leave
                   c) Job title, written job description and name of employee for each
                   position related to hazardous waste management;
                   d) Written description of type and amount of training (including
                   continual training) that will be given to person filling a hazardous waste
                   management position?
      28 Did employees with duties and responsibilities including emergency response,
         chemical operations, or hazardous substance processing receive additional
         training in:
                   a) Safety equipment and procedures used in the cleanup and removal
                   of a specific hazardous substance;
                   b) Standard operating procedures, including a detailed review of the
                   hazardous substance material safety data sheets, the safe handling
                                                                                                                   Please Input
                   practices for the hazardous substance, and the application of standard
                   operating procedures to actual conditions;
                   c) Emergency procedures regarding fires, leaks, and discharges;
                   d) Equipment familiarization;
                   e) Operating data collection and entry;
                   f) Equipment start-up and shutdown;
                   g) Control and adjustment of operating conditions.
On-site Accumulation - On-site Accumulation - Preparedness and Prevention
      29 Are ALL employees thoroughly familiar with proper waste handling and
         emergency procedures which are relevant to their responsibilities as follows:
                                                                                                                   Please Input
                a) During normal facility operations;
                b) During emergencies?
      30 Does the owner/operator operate and maintain the LQG facility so as to
         minimize the possibility of fire, explosion, and an unplanned release of                                  Please Input
         hazardous waste constituents?
                                                                                                Yes   No   N/A   Comment/Concerns
      31 Do potential hazards associated with the waste handled in the LQG facility
         require ANY of the following equipment to ensure safety from fire, explosion or
         unplanned releases of waste;
                 a) Internal communications or alarm system;                                                       Please Input
                 b) Telephone or two-way radio to summon outside help;
                 c) Fire extinguishers and other fire control equipment; and/or
                 d) Water at adequate volume and pressure?
      32 Is the necessary safety equipment provided as follows;
                 a) Present and available for use;
                 b) Maintained properly;
                 c) Tested periodically?
      33 Whenever HW is being handled, is immediate access to communications and
         alarm systems assured as follows;
                 a) All personnel involved have immediate access to an internal alarm or
                 emergency communication device; and
                 b) When only one employee is on the premises working with hazardous
                 waste, the employee has immediate access to a telephone or two-way
                 radio?
      34 Has the fact that no safety equipment is necessary been demonstrated?




      35 Is sufficient aisle space maintained for the unobstructed movement of
         personnel, fire, spill response and other emergency equipment?
                                                                                                                   Please Input


      36 Has the owner/operator attempted to make arrangements with local authorities
         to familiarized them with their HW operations that include information about the
         following:
                                                                                                                   Please Input
                  a) The facility;
                  b) The hazardous waste handled there; and
                  c) The facility's emergency procedures?
LQG - On-site Accumulation - Contingency Plan/Emergency Response
      37 Does the LQG facility have a contingency plan that is designed to minimize
         hazards to health or the environment from fires, explosions or unplanned                                  Please Input
         releases of hazardous waste?
      38 Does the contingency plan include all of the following information:
                  a) The actions facility personnel must take in response to an
                  emergency situation (such as a fire or HW release)
                  b) The arrangements with local or emergency response teams;
                  c) A list of ALL required pieces of emergency equipment, their locations
                  and capabilities; and
                  d) A facility evacuation plan?
      39 Have copies of the contingency plan been sent to local police and fire
         departments, hospitals and state and local emergency response teams AND
         maintained at the facility?


      40 Is the contingency plan reviewed and immediately amended whenever ANY of
         the following circumstances arise:
                  a) Applicable regulations are revised;
                  b) The plan fails in an emergency;
                  c) The HW accumulation area or associated processes change in a
                  way that materially increases the potential for an emergency situation or
                  changes the response necessary in an emergency;
                  d) The list of emergency coordinates changes; or
                  e) The list of emergency equipment changes?
      41 Are ALL of the following emergency coordinator requirements being met:
                  a) The contingency plan list names, addresses and phone numbers
                  (home and office) of people qualified to act as emergency coordinator;
                                                                                                                   Please Input
                  b) Other possible coordinators are listed in the order they will serve as
                  alternates; and
                  c) At all times, an emergency coordinator is o the premises or on call?
      42 Has the on-site accumulation area had an imminent or actual hazardous waste
         emergency situation (i.e. spill, sudden release, leak, explosion, or ignition of any                      Please Input
         hazardous waste)?
      43 During the imminent or actual emergency situation, did the emergency
         coordinator (or the designee) immediately complete ALL of the following actions:
                                                                                               Yes   No   N/A   Comment/Concerns
                 a) Activate internal facility alarms or communication systems, to notify
                 all facility personnel; and
                 b) Notify appropriate State and local agencies with designated
                 response roles if their help is needed?
      44 In response to a release, fire or explosion, did the emergency coordinator take
         ALL of the following action:
                 a) Determined the character, exact source, amount, and a real extent of
                 any released material;
                 b) Assessed possible hazards (direct and indirect) to human health or
                 the environment that could result from the release, fire or explosion;
                  c) Where human health was threatened, notified local authorities and
                  the EPA (where applicable)
                  d) During an emergency, took reasonable measures to ensure that
                  fires, explosions, and releases would not occur, recur, or spread; and
                  e) After an emergency, provided for proper cleanup, storage, treatment
                  or disposal of waste or contaminated materials and equipment?
      45 If the owner/operator had to implement the contingency plan, was the following
         information recorded and reported:
                  a) A note was made in the operating record of the time, date, and
                  details of the incident; and
                  b) Within 15 days after the incident, a written report of the incident was
                  submitted to the Regional Administrator?
LQG - On-site Accumulation - Containers
      46 Is the container storage area inspected weekly?

                                                                                                                  Please Input


      47 Are the container storage area inspections:
                 a) Recorded; and
                 b) Maintained for at least three years?
      48 Does the inspection record for the container storage area include ALL of the
         following:
                 a) The date and time of inspection;
                 b) The name of the inspector;
                 c) The observations of the inspector;
                 d) The date and nature of remedial actions, if any remedial actions
                 were required?
      49 Are ALL of the following true of containers kept in an on-site accumulation area:

                  a) The containers are in good condition;
                  b) The containers shows no signs of leakage, spillage, rust, bulges, or
                  other damage;
                  c) Each container is labeled or marked clearly with the words,
                  "Hazardous Waste";
                  d) The containers are clearly marked with the date accumulation began;                          Please Input

                  e) The containers are kept closed except when waste is added or
                  removed;
                  f) The containers and/or their linings are compatible with the waste
                  stored in them; and
                  g) The containers are handled and stored properly so they won't
                  rupture or leak?
      50 If a container is found to be in poor condition or leaking, are EITHER of the
         following steps taken:
                  a) The entire container is transferred to one in good condition;                                Please Input
                  b) The contents of the original container are transferred to one in good
                  condition?
      51 Are containers holding ignitable or reactive waste located at least 50 feet from
         the facility's property line                                                                             Please Input
                                                                                            Yes   No   N/A   Comment/Concerns
      52 Are hazardous wastes stored in containers in ANY of the following ways:
                  a) Incompatible wastes, or incompatible wastes and materials are
                  placed in the same container;
                  b) Hazardous wastes are placed in an unwashed container that
                  previously held an incompatible waste or material; or                                        Please Input
                  c) Containers holding compatible hazardous wastes or materials are
                  stored near other containers, piles, open tanks, or surface
                  impoundments that contain wastes with which the container waste may
                  not be compatible?
      53 Where incompatible wastes or materials are stored in the same container, or
         stored in unwashed container that previously held incompatible wastes, are the
         wastes and materials managed as incompatible wastes, or incompatible wastes
         and materials in compliance with 40 CFR 265.17(b)?
      54 Where containers holding compatible hazardous wastes or materials are stored
         near other containers, piles, open tanks, or surface impoundments that contain
         wastes with which the container waste may not be compatible, are those
         containers separated from the other materials or protected from them by means
         of a dike, berm, wall, or other device?
      55 Does the owner/operator have any containers or inner liners which they wish to
                                                                                                               Please Input
         render "empty"?
      56 Are the following containers considered "empty" when they meet the following
         standards:
                  a) A compressed gas container when the pressure in the container
                  approaches atmospheric pressure;
                  b) For acutely hazardous waste containers, the inner liners prevent
                                                                                                               Please Input
                  contact with the container, OR the containers are cleaned with solvent
                  or other appropriate methods;
                  c) For all other waste containers, when the wastes are removed using
                  standard industry methods, OR the percent weight of remaining waste
                  are reduced to the mandated levels.
On-site Accumulation - Air Emission Standards
      57 Does the facility manage any hazardous waste with organic concentrations of at
         least 10 ppmv that is associated with process vents?
                                                                                                               Please Input


      58 Does the owner/operator maintain documentation of compliance under the CAA
                                                                                                               Please Input
         as part of the facility's operating record?
LQG - On-site Accumulation - Drip Pads
      59 Are there written procedures to ensure that all wastes are removed from the drip
         pad and associated collection system at least once every 90 days?                                     Please Input

      60 Are records kept concerning the removal of the containers, which identify:
                 a) The quantity of waste removed from the drip pad and the sump or
                                                                                                               Please Input
                 collection system; and
                 b) The date and time of each removal?
      61 In order to use drip pads or containment buildings as accumulation units without
         obtaining a RCRA TSDF Permit or Interim status, has the generator complied
         with ALL of the following requirements for Large Quantity Generators (LQGs):

                 a) Personnel training requirements of 40 CFR 265.16;
                 b) Contingency plan requirements of 40 CFR 265, Subpart D (40 CFR
                                                                                                               Please Input
                 265.50-56);
                 c) Closure requirements of 40 CFR 265.111 and 265.114;
                 d) On-site accumulation limits (without a permit or interim status) to a
                 maximum of 90 days; and
                 e) The standards for drip pads (40 CFR 265, Subpart W), and/or
                 containment buildings (40 CFR 265, Subpart DD)?
      62 Are records kept concerning the removal of hazardous waste from drip pads
         and containment buildings, which identify:
                 a) A description of procedures which ensures all wastes are removed
                 from the drip pad and associated collection system at least once every
                 90 days;
                 b) The quantity of waste removed from the drip pad and the sump or
                 collection system; and
                 c) The date and time of each removal?
                                                                                           Yes   No   N/A   Comment/Concerns
On-site Accumulation - Containment Buildings
      63 For containment buildings, does the LQG maintain EITHER of the following at
         the facility:
                  a) Written procedures to ensure each waste remains in the unit for no
                  more than 90 days, written procedures for waste generation and
                                                                                                              Please Input
                  management which are consistent with the 90-day storage limit, and
                  documentation that the procedures are implemented; or
                  b) Records which document that containment building is emptied at
                  least once every 90 days?
On-site Accumulation - Closure of Accumulation Sites
      64 Was the facility closed in a manner that minimized the need for further
         maintenance?
                                                                                                              Please Input


      65 Was the facility closed in a manner that minimizes, or eliminates post-closure
         escape of ALL of the following to the ground, surface waters, or to the
         atmosphere:
                 a) Hazardous waste;
                                                                                                              Please Input
                 b) Hazardous constituents;
                 c) Leachate;
                 d) Contaminated runoff; or
                 e) Waste decomposition products?
      66 During closure were ALL of the following properly disposed of or
         decontaminated:
                 a) All contaminated equipment;                                                               Please Input
                 b) All contaminated structures; and
                 c) All contaminated soil?
Universal Waste - Lamps
      67 Does the facility manage waste mercury-containing lamps in a way that
         prevents a release of any waste mercury-containing lamps or a component of a
         waste mercury-containing lamp to the environment, and as follows:
                 a) Accumulate no more than 12,000 waste mercury-containing lamps at
                 any time.
                 b) Accumulate no more than 5,000 kilograms total of universal waste
                 and waste mercury-containing lamps, calculated collectively, at any
                 time.
                 c) Waste mercury-containing lamps that show evidence of leakage,
                 spillage, or damage must be contained in a container that is closed,
                 structurally sound, and compatible with the contents of the waste
                 mercury-containing lamps and that lacks evidence of leakage, spillage,
                 or damage that could cause leakage.                                                          Please Input
                 d) Unbroken waste mercury-containing lamps must be transported in
                 containers or in containers secured on pallets to prevent leakage,
                 spillage, or damage. The lamps should not be secured with any filler,
                 structure, or adhesive material inside the container unless required by
                 the destination facility.
                 e) The facility or vehicle in which broken or unbroken waste mercury-
                 containing lamps are placed must be closed, structurally sound, and
                 compatible with the lamp and lack evidence of leakage, spillage, or
                 damage that could cause leakage.
                 f) Containers containing waste mercury-containing lamps must be
                 labeled or marked clearly with the words "Waste Mercury-Containing
                 Lamps" or "Used Waste Mercury-Containing Lamps."?
      68 Does the facility generate universal waste lamps?

                                                                                                              Please Input


      69 Are universal waste lamps contained in packages or containers as follows:
                  a) Containers and packages are structurally sound;
                  b) Containers and packages are compatible with the contents of the
                  lamps                                                                                       Please Input
                  c) Containers and packages are adequate to prevent leakage and
                  breakage under reasonably foreseeable conditions; and
                  d) Containers and packages show no sign of leakage?
      70 Have any universal waste lamps appeared to be leaking, spilling, or damaged
         so that they might leak?                                                                             Please Input
                                                                                                Yes   No   N/A   Comment/Concerns
      71 Was the lamp which was leaking, spilling or damaged moved to a container that
         meets ALL of the following requirements:
                  a) The container is closed;
                  b) The container is structurally sound;
                  c) The container is compatible with the battery; and
                  d) The container lacks evidence of leakage, spillage, or damage that
                  could allow for leakage, spillage or damage?
      72 Is EACH universal waste package or container which holds a lamp labeled or
         marked clearly with AT LEAST ONE of the following:
                  a) The words "Universal Waste Lamp(s)"; or                                                       Please Input
                  b) The words "Waste Lamp(s)"; or
                  c) The words "Used Lamp(s)"?
Universal Waste - Accumulation Time Limits
      73 Is universal waste accumulated for longer than one year from the date the
                                                                                                                   Please Input
         universal waste was generated or received from another handler?
      74 Is universal waste accumulated longer than one year only to gather sufficient
         quantities to facilitate recovery, treatment or disposal?



      75 Is the handler able to prove how long the universal waste has been
         accumulating?                                                                                             Please Input

Universal Waste - Off-site Transport
      76 Does the universal waste handler always send or take universal waste to one of
         the following:
                  a) Another universal waste handler;                                                              Please Input
                  b) A destination facility; or
                  c) A foreign destination?
      77 Does the universal waste handler itself take waste off-site?                                              Please Input
      78 Where a universal waste handler sends or takes universal waste off-site, have
         they compiled with the regulations for universal waste transporters (40 CFR
         273, Subpart D)?
      79 For universal wastes being transported off-site that meet the DOT's definition of
         "hazardous material, are they packaged, labeled, marked and placarded                                     Please Input
         according to DOT regulations before shipment?
      80 Does the handler ever send a shipment of universal waste to another handler?
                                                                                                                   Please Input
      81 Whenever the handler has sent a universal waste shipment to another handler,
         has the receiving handler always agreed to receive the shipment?

      82 Has a universal waste shipment sent by the handler ever been rejected by the
                                                                                                                   Please Input
         receiving handler or destination facility?
      83 As the originating handler of a rejected shipment, did the facility do either of the
         following:
                 a) Take the universal waste back; or
                 b) Agree to a destination facility with the receiving handler?
Universal Waste - Small Handler
      84 Does the small quantity handler provide training which includes a description of
         proper handling and emergency procedures appropriate to the types of                                      Please Input
         universal waste handled at the facility?
Used Oil
      85 Does the facility dispose of any hazardous used oils?                                                     Please Input
      86 Are hazardous used oils disposed of according to hazardous waste
         requirements of 40 CFR 260 through 40 CFR 265, 40 CFR 268, 40 CFR 270,
         and 40 CFR 124?
      87 Does the facility dispose of used oils that are not hazardous wastes and cannot
                                                                                                                   Please Input
         be recycled?
      88 Are non-hazardous used oils disposed of according to the requirements of 40
         CFR 257 and 40 CFR 258?
Used Oil - Generation, Collection, Aggregation
     89 Does the facility generate used oil that may have been mixed with hazardous
                                                                                                                   Please Input
          waste?
     90 Is 40 CFR 279.10(b) referenced for making the determination whether mixtures
          of used oil and hazardous waste are subject to hazardous waste regulations?

      91 Has there been a release of used oil from a facility after the effective date of the
                                                                                                                   Please Input
         used oil management program?
                                                                                              Yes   No   N/A   Comment/Concerns
      92 Upon detection of a release, did the generator perform ALL of the following
         cleanup steps:
                 a) Stop the release;
                 b) Contain the released used oil;
                 c) Clean up and manage properly the released used oil and other
                 materials; and
                 d) Repair or replace any leaking used oil storage containers or tanks
                 prior to returning them to service
      93 Is used oil shipped off-site from the facility?
                                                                                                                 Please Input
     94 Does the generator, collection center or aggregation point ship used oil off-site
          exclusively with transporters who have EPA Identification Numbers?
Used Oil - Storage
     95 Do generators who store used oil comply with ALL applicable requirements,
          listed below, whether or not the used oil exhibits any of the characteristics of
          hazardous waste:
                   a) Spill Prevention Countermeasures requirements, 40 CFR 112 (see                             Please Input
                   the SPILL PREVENTION - FEDERAL module); or
                   b) Underground Storage Tank standards, 40 CFR 280 (see the
                   STORAGE TANKS - FEDERAL module)?
     96 Is used oil stored only in ANY of the following storage units:
                   a) Tanks;
                                                                                                                 Please Input
                   b) Containers; or
                   c) Units subject to regulation as a permitted or interim status TSDF?
     97 Are all containers, aboveground tanks, and fill pipes which are used to store and
          transfer used oil:
                   a) In good condition, with no severe rusting, no structural defects and                       Please Input
                   no signs of deterioration;
                   b) Not leaking?
     98 Are all containers and aboveground tanks which are used to store used oil
                                                                                                                 Please Input
          labeled or marked clearly with the works "used oil"?
     99 Do you have a Professional Engineer signed Spill Prevention, Countermeasure,
          Control Plan?
                                                                                                                 Please Input


Used Oil - Transport/Transfer
     100 Has there been a release of used oil from the facility after the effective date of
                                                                                                                 Please Input
          the used oil management program?
     101 Upon detection of a release, were the following cleanup steps performed:
                 a) Stop the release:
                 b) Contain the released used oil;
                 c) Clean up and manage properly the released used oil and other
                 materials; and
                 d) Repair or replace any leaking used oil storage containers or tanks
                 prior to returning them to service?
Additional Notes
                                                                                             Yes   No   N/A   Comment/Concerns
Georgia
Air Quality Standards

Fugitive Dust
       1 For owners and operators whose operations result in fugitive dust, did they take
         preventive steps to ensure that dust does not become airborne by the following:

               a) Use water or chemicals for dust control.
               b) Apply asphalt, water, or dust suppression chemicals to dirt roads and
               stockpiled materials.                                                                            Please Input
               c) Install hoods, fans, or fabric filters to enclose and vent materials
               handling operations.
               d) Use appropriate containment measures while sandblasting.
               e) Cover open transport vehicles while in motion.
               f) Remove dirt or other spills from roads?
     2 Does fugitive dust from the following sources exceed 20 percent opacity:
               a) Demolition and construction operations
               b) Grading of roads
               c) Clearing of land
               d) Dirt roads                                                                                    Please Input
               e) Stockpiles
               f) Materials handling operations
               g) Sandblasting
               h) Open-bodied transport vehicles?
NESHAPs
     3 Are procedures in place to ensure that substances collected as a result of efforts
       to control hazardous pollutants are properly disposed of in accordance with the
       RCRA requirements?                                                                                       Please Input


       4 Was the acceptable ambient concentration data determined using toxicity data
         from the following sources:
                 a) Integrated Risk Information System (IRIS).
                 b) Occupational Health and Safety Administration time weighted
                 averages and ceiling permissible exposure limit standards.
                                                                                                                Please Input
                 c) Threshold limit values (TLV).
                 d) National Institute for Occupational Safety and Health recommended
                 standards.
                 e) Other sources of toxicity data, such as Material Safety Data Sheets?

Risk Management Program
      5 For all covered processes, has the stationary source complied with the Risk
        Management Program requirements by the latest of the following dates:

                  a) June 21, 1999;
                                                                                                                Please Input
                  b) 3 years after the date on which a regulated substance is first listed
                  under 40 CFR.130; or
                  c) the date on which a regulated substance is first present above a
                  threshold quantity in a process?
       6 Are all records supporting the implementation of the RMP maintained for 5
         years?
                                                                                                                Please Input


Risk Management Program - Response Program
      7 Has an emergency response program been developed and implemented?
                                                                                                                Please Input

       8 Does the emergency response program include an emergency response plan
         kept at the stationary source?
                                                                                                                Please Input


       9 Is the emergency response plan coordinated with the community emergency
         response plan that has been developed under the comprehensive emergency
         response plan requirements (42 U.S.C. 11003)?                                                          Please Input
                                                                                              Yes   No   N/A   Comment/Concerns
      10 Does the emergency response plan include AT LEAST ALL of the following
         items:
                a) Procedures for informing the public and local emergency response
                agencies about accidental releases;
                                                                                                                 Please Input
                b) Documentation of proper first-aid and emergency medical treatment
                necessary to treat accidental human exposures; and
                c) Procedures and measures for emergency response after an
                accidental release of a regulated substance?
      11 Does the emergency response program also include ALL of the following
         elements:
                a) Procedures for the use of emergency response equipment and for its
                inspection, testing, and maintenance;
                                                                                                                 Please Input
                b) Training for all employees in relevant procedures; and
                c) Procedures to review and update, as appropriate, the emergency
                response plan to reflect changes at the stationary source and ensure
                that employees are informed of changes?
Risk Management Program - Risk Management Plan
      12 Has the owner submitted a single Risk Management Plan (RMP) for all covered
         processes?                                                                                              Please Input

      13 Was the RMP submitted no later than the latest of the following dates:
                 a) June 21, 1999;
                 b) Three years after the date on which a regulated substance is first
                 listed under 40 CFR 68.130; or
                 c) The date on which a regulated substance is first present above a
                 threshold quantity in a process?
      14 Is the RMP made available to the public?
                                                                                                                 Please Input

      15 Does the RMP include an executive summary that provides a brief description of
         all the following:
                  a) The accidental release prevention and emergency response policies
                  at the stationary source
                  b) The stationary source and regulated substances handled
                  c) The worst-case release scenario(s) and the alternative release
                  scenario(s), including administrative controls and mitigation measures to                      Please Input
                  limit the distances for each reported scenario
                  d) The general accidental release prevention program and chemical-
                  specific prevention steps
                  e) The 5-year accident history
                  f) The emergency response program
                  g) Planned changes to improve safety
Risk Management Program - Program 3 Prevention Program
      16 Has a management system been developed to oversee the implementation of
         the Risk Management Program?
                                                                                                                 Please Input


      17 Have individuals been identified who are responsible for the development,
         implementation, and integration of the Risk Management Program?
                                                                                                                 Please Input


      18 Has a written plan of action been developed for the implementation of the
         employee participation required by the Risk Management Program?
                                                                                                                 Please Input


Risk Management Program - Program 3 - Training
      19 Are all employees, either presently involved in an operating process or about to
         be assigned to a new process, trained in an overview of the process and in the
         operating procedures?
                                                                                                                 Please Input
                                                                                              Yes   No   N/A   Comment/Concerns
      20 Does the training emphasize ALL of the following aspects of the employee's
         tasks:
                a) Specific safety and health hazards;                                                           Please Input
                b) Emergency operations; and
                c) Safe work practices?
      21 For employees already involved in operating a process on June 21, 1999, has
         the owner or operator certified in writing that the employee has the required
         knowledge, skills, and abilities necessary for safely carrying out operating                            Please Input
         procedures?
      22 Is refresher training for each employee involved in a process provided AT
         LEAST every three years?

                                                                                                                 Please Input



      23 Is a training record which contains ALL of the following information prepared for
         employees involved in operating a process:
                  a) The identity of each employee;
                                                                                                                 Please Input
                  b) The date of his/her training; and
                  c) The means used to verify that the employee understood the training?

Risk Management Program - Program 3 - Process Hazard Analysis
      24 Has an initial process hazard analysis been completed for all processes covered
         by this standard?
                                                                                                                 Please Input


      25 Were the initial process hazard analyses conducted on or before June 21,
         1999?
                                                                                                                 Please Input


      26 Was each process hazard analysis appropriate to the complexity of the
         process?
                                                                                                                 Please Input


      27 Did each process hazard analysis identify, evaluate, and control the hazards
         involved in the process?

                                                                                                                 Please Input



      28 Have the initial process hazard analyses and the priority order for performing the
         process hazard analyses been documented?
                                                                                                                 Please Input


      29 In determining and documenting the priority order for conducting process
         hazards analyses, were ALL of the following considerations taken into account:

                a) The extent of the process hazards;
                                                                                                                 Please Input
                b) The number of potentially affected employees; c) The age of the
                process; and d) The operating history of the process?
                c) The age of the process; and
                d) The operating history of the process?
      30 Does the employer consult with employees and their representatives concerning
         the conduct and development of process hazard analyses and other elements of
         process safety?                                                                                         Please Input


      31 Do employees have access to process hazard analyses?

                                                                                                                 Please Input
                                                                                               Yes   No   N/A   Comment/Concerns
      32 To evaluate the hazards of each process being analyzed, was at least ONE of
         the following methodologies used:
                  a) What-If;
                  b) Checklist;
                  c) What-If/Checklist;                                                                           Please Input
                  d) Hazard and Operability Study (HAZOP);
                  e) Failure Mode and Effects Analysis (FMEA);
                  f) Fault Tree Analysis; or
                  g) An appropriate equivalent methodology?
      33 Does each process hazard analysis address ALL of the following considerations:

                 a) The hazards of the process;
                 b) The identification of any previous incident which had a likely potential
                 for catastrophic consequences;
                 c) The engineering and administrative controls applicable to the hazards
                 and their interrelationships;                                                                    Please Input
                 d) The consequences of failure of engineering and administrative
                 controls;
                 e) Stationary source siting;
                 f) The human factors; and
                 g) A qualitative evaluation of the possible safety and health effects on
                 employees in the event of control failure?
      34 Does each process hazard analysis team consist of members with expertise in
         engineering and process operations, with one member having experience with
         the process being evaluated, AND one member knowledgeable in the                                         Please Input
         methodology being used?

      35 After completing a process hazard analysis, does the owner or operator take
         ALL of the following actions:
                 a) Establishes a system to address the team's findings and
                 recommendations;
                 b) Resolves the recommendations in a timely manner and documents
                 the resolution;
                 c) Documents what actions are to be taken and completes actions as                               Please Input
                 soon as possible;
                 d) Develops a written schedule of when the actions are to be completed;

                 e) Communicates the actions to operating, maintenance, and other
                 employees who are assigned to work in the process and who may be
                 affected by the recommendations or actions?
      36 Is each process hazard analysis updated and revalidated at least every five
         years?
                                                                                                                  Please Input


      37 Are all process hazards analyses, their updates, revalidations, and documented
         resolutions to recommendations retained for the life of the process?
                                                                                                                  Please Input


Risk Management Program - Program 3 - Process Safety Information
      38 Prior to conducting any process hazard analysis, has a compilation of written
         process safety information been completed?                                                               Please Input

      39 Does the process safety information include information pertaining to ALL of the
         following items:
                 a) The hazards of the regulated substances used or produced;
                 b) The technology of the process; and
                 c) The equipment in the process?
      40 Does the process safety information include ALL of the following data pertaining
         to the hazards of the regulated substances used or produced:
                 a) Toxicity information;
                 b) Permissible exposure limits;
                 c) Physical data;
                 d) Reactivity data;
                 e) Corrosivity data;
                 f) Thermal and chemical stability data; and
                 g) Hazardous effects of inadvertent mixing of different materials that
                 could occur?
                                                                                             Yes   No   N/A   Comment/Concerns
      41 Does the process safety information include ALL of the following information
         pertaining to the technology of the process:
                  a) A block flow diagram or simplified process flow diagram;
                  b) Process chemistry;
                  c) Maximum intended inventory;
                  d) Safe upper and lower limits for such items as temperature, pressures,
                  flows or compositions; and
                  e) An evaluation of the consequences of deviations?
      42 Does the process safety information include ALL of the following information
         pertaining to the equipment in the process:
                  a) Materials of construction;
                  b) Piping and instrument diagrams (P&IDs);
                  c) Electrical classification;
                  d) Relief system design and design basis;
                  e) Ventilation system design;
                  f) Design codes and standards employed;
                  g) Material and energy balances for processes built after June 21, 1999;
                  and
                  h) Safety systems such as interlocks, detection, or suppression
                  systems?
      43 Is the process safety information updated whenever a change occurs to process
         chemicals, technology, equipment, or procedures or a change occurs to the
         stationary source that affects a covered process?



      44 Has the owner or operator documented that equipment complies with
         recognized and generally accepted good engineering practices?                                          Please Input

      45 Is there documentation for equipment designed using codes, standards, or
         practices that are no longer in use, stating that the equipment is designed,
         maintained, inspected, tested, and operating in a safe manner?
                                                                                                                Please Input




Risk Management Program - Program 3 - Operating Procedures
      46 Have written operating procedures been developed that provide instructions for
         safely conducting activities involved in each process covered by the Risk                              Please Input
         Management Program standard?
      47 Do the operating procedures provide step-by-step instructions for ALL of the
         following operating phases:
                 a) Initial startup;
                 b) Normal operations;
                 c) Temporary operations;
                 d) Emergency shutdown including the conditions under which shut-down
                 is required and the assignment of responsibility to ensure that shutdown
                 is executed in a safe and timely manner;
                 e) Emergency operations;
                 f) Normal shutdown; and
                 g) Startup following a turnaround or after an emergency shutdown?
      48 Do the operating procedures address safe operating limits including ALL of the
         following elements:
                 a) The consequences of deviation from the operating limits; and
                 b) The steps required to correct or avoid deviation?
      49 Do the operating procedures address safety and health considerations including
         ALL of the following concerns:
                 a) The properties of and hazards presented by the chemicals used in the
                 process;
                 b) The precautions necessary to prevent exposure, including
                 engineering controls, administrative controls, and personal protective
                 equipment;
                 c) The control measures to be taken if physical contact or airborne
                 exposure occurs;
                 d) Quality control for raw materials and control of hazardous chemical
                 inventory levels; and
                 e) Any special or unique hazards?
                                                                                             Yes   No   N/A   Comment/Concerns
      50 Do the operating procedures include safety systems and their functions?




      51 Are the operating procedures easily accessible to employees working on or
         maintaining a process?




      52 Are the operating procedures reviewed often enough to ensure that they reflect
         current operating practice?




      53 Are the operating procedures updated whenever a change occurs to process
         chemicals, technology, equipment, or procedures or a change occurs to the
         stationary source that affects a covered process?


      54 Are the operating procedures certified annually to verify that they are current
         and accurate?



      55 Are safe work practices developed and implemented for employees and
         contractor employees for the control of hazards during operations such as
         lockout/tagout, confined space entry, opening process equipment or piping, and
                                                                                                                Please Input
         for control over entry into the facility by support personnel?


Risk Management Program - Program 3 - Change Control
      56 Are written procedures established and implemented to manage changes to
         process chemicals, technology, equipment, and procedures, and changes to
                                                                                                                Please Input
         facilities that affect a covered process (excluding "replacements in kind")?

      57 Are ALL of the following considerations addressed in the procedures for
         managing change:
                a) The technical basis for the proposed change;
                b) The impact of the change on safety and health;
                c) Modifications to operating procedures;
                d) Necessary time period for the change; and
                e) Authorization requirements for the proposed change?
      58 Are employees involved in operating a process and maintenance and contract
         employees whose jobs may be affected by a change informed of, and trained in,
                                                                                                                Please Input
         the change prior to startup of the process or affected part of the process?

Risk Management Program - Program 3 - Incident Investigation
      59 Is each incident which resulted in, or could have resulted in, a catastrophic
                                                                                                                Please Input
         release of a regulated substance in the workplace investigated?
      60 Was each incident investigation initiated within 48 hours of the incident?

      61 Did the investigation team consist of AT LEAST ONE person knowledgeable in
         the process involved, including a contract employee, if the incident involved the
         work of the contractor, and other persons knowledgeable and experienced to
         investigate and analyze the incident?
      62 When the investigation of the incident was completed, was a report prepared
         which contained ALL of the following information:
                 a) Date of the incident;
                 b) Date the investigation began;
                 c) A description of the incident;
                 d) The factors that contributed to the incident; and
                 e) Any recommendations resulting from the investigation?
      63 Is a system in place to promptly address and resolve all the findings of the
         incident investigation?
                                                                                              Yes   No   N/A   Comment/Concerns
      64 Are all resolutions and corrective actions documented?

      65 Have all people whose job tasks are relevant to the incident findings reviewed
         the investigation report?



      66 Are incident investigation reports retained for at least five years?



Risk Management Program - Program 3 - Contractors
      67 Does the facility employer evaluate information regarding a contract employer's
         safety performance and programs?

                                                                                                                 Please Input




      68 Are the known potential fire, explosion, or toxic release hazards related to each
         contractor's work and process conveyed by the facility employer?
                                                                                                                 Please Input


      69 Do contractors receive an appropriate explanation from the facility employer of
         applicable provisions of the emergency response plan?

                                                                                                                 Please Input



      70 Are appropriate safe work practices developed and implemented by the facility
         employer which cover the entrance, presence, and exit of contract employees
         and employers?                                                                                          Please Input


      71 Is each contract owner or operator's performance periodically evaluated by the
         facility employer for compliance with contract employer responsibility
         requirements?
                                                                                                                 Please Input



      72 Does the facility employer verify that the contract owner or operator has
         adequately trained the contract employees to safely perform his or her assigned
         job?

      73 Does the facility employer verify that each contract employee is aware of the
         potential fire, explosion, or toxic release hazards associated with his or her job
         and the applicable provisions of the emergency action plan?




      74 Does the facility employer verify that the contract owner or operator has
         documented that each contract employee has received and understood the
         required training?



      75 Does the facility employer verify that the training documentation for each
         contract employee include ALL of the following information:
                 a) The identity of the employee;
                                                                                                                 Please Input
                 b) The date of training; and
                 c) The means used to verify the employee's understanding of the
                 training?
      76 Does the facility employer verify that each contract employee follows all of the
         safe work practices and safety rules of the stationary source?
                                                                                              Yes   No   N/A   Comment/Concerns
      77 Is the facility employer advised of any unique hazards presented or found by the
         contract employer?




Risk Management Program - Program 3 - Compliance Audits
      78 Does the facility conduct compliance audits to verify that the procedures and
         practices developed under the Program 3 Prevention Program (40 CFR 68,                                  Please Input
         Subpart D) are adequate and are being followed?
      79 Has compliance with the Program 3 Prevention Program requirements been
         evaluated AT LEAST every three years?




      80 Was the compliance audit conducted by AT LEAST ONE person knowledgeable
         in the process?




      81 Has a report of the findings been developed for each compliance audit for the
         Risk Management Program?




      82 Have responses to each finding in the compliance audit and corrections to
         deficiencies been documented?




      83 Have the two most recent audit reports been retained?




Risk Management Program - Registration
      84 Is a single, completed registration form covering all regulated substances
         handled in all covered processes included in the RMP?
                                                                                                                 Please Input


      85 Does the registration include ALL of the following data:
                a) Stationary source name, street, city, county, state, zip code, latitude
                and longitude, method for obtaining latitude and longitude, and
                description of location that latitude and longitude represent;
                b) The stationary source Dun and Bradstreet number;
                c) Name and Dun and Bradstreet number of the corporate parent
                company;
                d) The name, telephone number, and mailing address of the owner or
                operator;
                e) The name and title of the person or position with overall responsibility
                for RMP elements and implementation; and
                f) The name, title, telephone number, and 24-hour telephone number of
                the emergency contact?
      86 Does the registration include all the following for each covered process:
                a) Name and CAS number of each regulated substance held above the
                threshold quantity in the process
                b) The maximum quantity of each regulated substance or mixture in the
                process in pounds to 2 significant digits
                c) NAICS code that corresponds to the process
                d) Program level of the process
                                                                                                Yes   No   N/A   Comment/Concerns
      87 Does the registration include all the following:
                   a) Stationary source EPA identifier
                   b) Number of full-time employees at the source
                   c) Whether source is subject to OSHA standard for Process Safety
                   Management (29 CFR 1910.119)
                   d) Whether source is subject to the hazardous substance release
                   standards (40 CFR 355)
                   e) Title V operating permit number (if applicable)
                   f) Date of the last safety inspection of the stationary source by a
                   Federal, state, or local government agency and the identity of the
                   inspecting entity
      88 If a stationary source is no longer subject to the Risk Management Program, is a
         revised registration submitted to EPA within six months indicating that the
         source is no longer covered?
Risk Management Program - Revisions and Updates
      89 Is the RMP revised and updated as follows:
                   a) Within 5 years of initial submission or most recent update
                   b) No later than 3 years after a newly regulated substance is first listed
                   by EPA
                   c) No later than the date on which a new regulated substance is first
                   present in an already covered process above a threshold quantity
                   d) No later than the date on which a regulated substance is first present
                                                                                                                   Please Input
                   above a threshold quantity in a new process
                   e) Within 6 months of a change that requires a revised process hazard
                   analysis or hazard review
                   f) Within 6 months of a changes that requires a revised offsite
                   consequence analysis (40 CFR 68.36)
                   g) Within 6 months of a change that alters the Program level that
                   applied to any covered process
      90 Has the implementing agency issued a preliminary written determination of
         necessary revisions to the RMP?                                                                           Please Input

      91 Has the owner or operator of the stationary source sent a written response to
         the implementing agency making ONE of the following statements:
                 a) The revisions will be implemented in accordance with the timetable
                 specified by the implementing agency; or
                 b) The owner or operator rejects the revisions, and includes an
                 explanation of the basis for rejection?
      92 Was the written response sent to the implementing agency within 90 days of the
         issue of the preliminary written determination?


      93 Does the public have access to all preliminary determinations and responses?



      94 Has the implementing agency issued a final written determination of revisions to
         the RMP?
                                                                                                                   Please Input


      95 Within 30 days of the final determination, was the RMP revised and submitted?



      96 Does the public have access to all final determinations?
                                                                                             Yes   No   N/A   Comment/Concerns
Risk Management Program - Program 1 Requirements
      97 For each Program 3 process, is ALL of the following information provided in the
         RMP:
                a) The five- or six-digit NAICS code that most closely corresponds to the
                process;
                b) The name(s) of the substances(s) covered;
                c) The date of the most recent review or revision of the safety
                information;
                d) The date of the most recent review or revision of operating
                                                                                                                Please Input
                procedures;
                e) The date of the most recent review or revision of maintenance
                procedures and the date of the most recent equipment inspection or test
                and the equipment inspected or tested;
                f) The date of the most recent change that triggered management of
                change procedures and the date of the most recent review or revision of
                management of change procedures; and
                g) The date of the most recent pre-startup review?
Risk Management Program - Program 3 Requirements
      98 For each Program 3 process, is ALL of the following information provided in the
         RMP:
                a) The date of completion of the most recent process hazard review or
                update and the technique used;
                b) The expected date of completion of any changes resulting from the
                process hazard review;                                                                          Please Input
                c) Major hazards identified;
                d) Process controls in use;
                e) Mitigation systems in use;
                f) Monitoring and detection systems in use; and
                g) Changes since the last process hazard review?
      99 For each Program 3 process, is ALL of the following information provided in the
         RMP:
                a) The date of the most recent review or revision of training programs;
                                                                                                                Please Input
                b) The type of training provided (classroom, classroom plus on the job,
                on the job); and
                c) The type of competency testing used?
     100 For each Program 3 process, is ALL of the following information provided in the
         RMP:
                a) The date of the most recent compliance audit and the expected date
                of completion of any changes resulting from the compliance audit;

                 c) The date of the most recent incident investigation and the expected
                 date of completion of any changes resulting from the investigation;
                                                                                                                Please Input
                  d) The date of the most recent review or revision of employee
                  participation plans;
                  e) The date of the most recent review or revision of hot work permit
                  procedures;
                  f) The date of the most recent review or revision of contractor safety
                  procedures; and
                  g) The date of the most recent evaluation of contractor safety
                  performance?
     101 For all Program 3 processes, are all of the following scenarios included in the
         RMP:
                  a) One worst-case release scenario to represent all regulated toxic
                  substances held above the threshold quantity;
                  b) One alternative release scenario to represent all regulated toxic
                                                                                                                Please Input
                  substances held above the threshold quantity;
                  c) One worst-case release scenario to represent all flammable regulated
                  substances held above the threshold quantity; and
                  d) One alternative release scenario to represent all flammable regulated
                  substances held above the threshold quantity?
     102 Does the RMP include a certification that, to the best of the signer's knowledge,
         information, and belief formed after reasonable inquiry, the information
         submitted is true, accurate, and complete?                                                             Please Input
                                                                                             Yes   No   N/A   Comment/Concerns
Risk Management Program - Off-Site Consequence Analysis
     103 Are the following parameters used for analyses of offsite consequences:
                  a) Toxic endpoints and endpoints for flammables, including explosion,
                  radiant heat/exposure time, and lower flammability limit;
                  b) Wind speed/atmospheric stability class;
                  c Ambient temperature/humidity;                                                               Please Input
                  d) Height of the release;
                  e) Surface roughness;
                  f) Dense or neutrally buoyant gases; and
                  g) Temperature of the released substance?
     104 When defining offsite impacts, is population estimated within a circle having its
         center at the point of release and its radius determined by the distance from the
         point of release to the endpoint?                                                                      Please Input


     105 Is the population estimated to two significant digits?

                                                                                                                Please Input


     106 Is the presence of ANY of the following establishments within the circle noted in
         the RMP:
                  a) Schools;
                  b) Hospitals;                                                                                 Please Input
                  c) Prisons;
                  d) Parks and recreational areas; and
                  e) Major commercial, office, or industrial buildings?
     107 Are any environmental receptors within the circle also listed in the RMP?

                                                                                                                Please Input


     108 Are ALL of the following records maintained by the owner or operator:
                 a) Documentation of the estimated quantity released, release rate, and
                 duration of release;
                                                                                                                Please Input
                 b) Methodology used to determine the distance to the endpoints; and
                 c) Data used to estimate population and environmental receptors
                 potentially affected?
     109 Are the offsite consequence analyses reviewed and updated at least once every
         five years?

                                                                                                                Please Input



     110 Is a revised offsite consequence analysis completed within six months of any
         change in processes, quantities stored or handled, or any other aspect of the
         stationary source that may be expected to increase or decrease the distance to                         Please Input
         the endpoint by a factor of two or more?

Risk Management Program - Worst-Case Release Scenario - All Processes
     111 For substances in a vessel or pipe, is the greatest amount of substance held in
         a single vessel or in a pipe used as the worst-case release quantity?
                                                                                                                Please Input



     112 For each worst-case release scenario, are the parameters defined in 40 CFR
         68.22 used to determine the distance to the endpoints?

                                                                                                                Please Input




     113 Are any passive mitigation systems considered in the analysis of worst-case
         release scenarios?
                                                                                                                Please Input
                                                                                            Yes   No   N/A   Comment/Concerns
     114 Are all passive mitigation systems considered in the analysis of worst-case
         release scenarios capable of withstanding the release event and remain
         functioning as intended?




     115 Are all of the following records maintained regarding worst-case release
         scenarios:
                  a) Description of the vessel or pipeline and substance chosen for
                  scenario
                  b) Assumptions used, including administrative controls and passive
                                                                                                               Please Input
                  mitigation assumed to limit the release quantity
                  c) Anticipated effect of the controls and mitigation on the release
                  quantity and rate
                  d) Parameters used
                  e) Rationale for the selection of assumptions and parameters
     116 For each release scenario, is all of the following information submitted in the
         RMP:
                  a) Chemical name
                  b) Percentage weight of the chemical in a liquid mixture (toxics only)
                  c) Physical state (toxics only)
                  d) Basis of results (name of model if used)                                                  Please Input
                  e) Scenario (explosion, fire, toxic gas release, or liquid spill and
                  vaporization)
                  f) Quantity released in pounds
                  g) Release rate
                  h) Release duration
     117 For each release scenario, is all of the following information submitted in the
         RMP:
                  a) Wind speed and atmospheric stability class (toxics only)
                  b) Topography (toxics only)                                                                  Please Input
                  c) Distance to endpoint
                  d) Public and environmental receptors within the distance
                  e) Passive mitigation considered
Risk Management Program - Worst-Case Release Scenario - Toxic Substances
     118 Are any worst-case release scenarios developed for regulated toxic substances
         that are gases at ambient temperature and handled as a gas or as a liquid under
         pressure?                                                                                             Please Input



     119 Unless passive mitigation systems are in place, is it assumed in the worst-case
         release scenario for each regulated toxic substance that the release rate is the
         total quantity divided by ten?




     120 Are any worst-case release scenarios developed for regulated toxic gases that
         are handled as refrigerated liquids at ambient pressure and also meet ONE of
         the following conditions:
                  a) The released substance is not contained by passive mitigation                             Please Input
                  systems; or
                  b) The released substance is contained by passive mitigation systems in
                  a pool with a depth of one centimeter or less?
     121 For these regulated toxic substances, is it assumed in the worst-case release
         scenario that the quantity in the vessel or pipe is released as a gas over ten
         minutes?
                                                                                                Yes   No   N/A   Comment/Concerns
     122 Are any worst-case release scenarios developed for regulated toxic gases that
         are handled as refrigerated liquids at ambient pressure and are contained by
         passive mitigation systems in a pool with a depth greater than one centimeter?
                                                                                                                   Please Input



     123 For these regulated toxic substances, is it assumed in the worst-case release
         scenario that the quantity in the vessel or pipe is released instantaneously to
         form a liquid pool?




     124 Is the release rate of the regulated toxic substance calculated at the boiling point
         of the substance?
     125 Are any worst-case release scenarios developed for regulated toxic substances
         that are liquids at ambient temperature?                                                                  Please Input
     126 For these regulated toxic substances, is it assumed in the worst-case release
         scenario that the quantity in the vessel or pipe is released instantaneously to
         form a liquid pool?
     127 Is ONE of the following determinations of surface area used to calculate the
         volatilization rate of the liquid pool:
                  a) The surface area is determined by assuming that the liquid spreads to
                  a pool one centimeter deep where passive mitigation systems are not in
                  place; or
                  b) The known surface area of the contained liquid is used where passive
                  mitigation systems are in place?
     128 If the surface area where the release would occur is not smooth, are the actual
         surface characteristics taken into account when developing a worst-case
         scenario?
     129 Does the volatilization rate of the liquid take into account ALL of the following
         conditions:
                  a) The highest daily maximum temperature over the past three years;
                  b) The substance temperature; and
                  c) The concentration of the toxic substance if the liquid spilled is a
                  mixture or solution?
     130 Is the release rate of the regulated toxic substance to the air determined from
         the volatilization rate of the liquid pool?


Risk Management Program - Worst-Case Release Scenario - Flammable Substances
     131 For all regulated flammable substances, is it assumed that the quantity of the
         substance vaporizes, resulting in a vapor cloud explosion?                                                Please Input

     132 For regulated flammable substance models based on TNT-equivalent methods,
         is a yield factor of 10% of the available energy released in the explosion used to                        Please Input
         determine the distance to the explosion endpoint?
     133 Are any worst-case release scenarios developed for regulated flammable
         substances that are gases at ambient temperature and handled as a gas or as a
         liquid under pressure?
                                                                                                                   Please Input



     134 In the worst-case release scenario for each regulated flammable substance, are
         BOTH of the following assumptions made:
                  a) The quantity in the vessel or pipe is released as a gas over ten
                  minutes; and
                  b) The total quantity is involved in the vapor cloud explosion?
     135 Are any worst-case release scenarios developed for regulated flammable gases
         that are handled as refrigerated liquids at ambient pressure and also meet ONE
         of the following conditions:
                  a) The released substance is not contained by passive mitigation                                 Please Input
                  systems; or
                  b) The released substance is contained by passive mitigation systems in
                  a pool with a depth of one centimeter or less?
     136 In the worst-case release scenario for each regulated flammable gas, are BOTH
         of the following assumptions made:
                  a) The total quantity of the substance is released as a gas in ten
                  minutes; and
                                                                                               Yes   No   N/A   Comment/Concerns
                b) The total quantity of the substance will be involved in the vapor cloud
                explosion?
     137 Are any worst-case release scenarios developed for regulated flammable
         substances that are handled as refrigerated liquids at ambient pressure and are
         contained by passive mitigation systems in a pool with a depth greater than one
         centimeter?                                                                                              Please Input




     138 In the worst-case release scenario for each regulated flammable substance, is it
         assumed that the quantity which becomes vapor in the first ten minutes of
         release is involved in the vapor cloud explosion?




     139 Is the volatilization rate (release rate) for each regulated flammable substance
         calculated at the boiling point of the substance and at the conditions specified in
         40 CFR 68.25(d)?




     140 Are any worst-case release scenarios developed for regulated flammable gases
         that are normally liquids at ambient temperature?                                                        Please Input

     141 In the worst-case release scenario for each regulated flammable substance, are
         BOTH of the following assumptions made:
                 a) The entire quantity of the substance in the vessel or pipe is spilled
                 instantaneously to form a liquid pool; and
                 b) The quantity which becomes vapor in the first ten minutes is involved
                 in the vapor cloud explosion?
     142 For any flammable liquids at temperatures below their atmospheric boiling point,
         is the volatilization rate calculated at the conditions specified in 40 CFR
         68.25(d)?




Risk Management Program - Worst-Case Release Scenario - Program 1 Processes
     143 For all Program 1 processes, is one worst-case release scenario included in the
         RMP?
                                                                                                                  Please Input


Risk Management Program - Worst-Case Release Scenario - Program 2 and 3 Processes
     144 For each Program 2 and Program 3 process, does the owner or operator report
         in the RMP one worst-case release scenario estimated to create the greatest
         distance in any direction to an endpoint resulting from the accidental release of a
         regulated toxic substance?
                                                                                                                  Please Input




     145 For each Program 2 and Program 3 process, does the owner or operator report
         in the RMP one worst-case release scenario estimated to create the greatest
         distance in any direction to an endpoint resulting from the accidental release of a
         regulated flammable substance?
                                                                                                                  Please Input
                                                                                               Yes   No   N/A   Comment/Concerns
     146 For each Program 2 or Program 3 process, does the owner or operator report in
         the RMP additional worst-case release scenarios if worst-case releases from
         other covered processes potentially affect public receptors different from those
         affected in the scenarios developed under 40 CFR 68.25(a)(b)(i) and (ii)?
                                                                                                                  Please Input




Risk Management Program - Alternative Release Scenario
     147 For each regulated toxic substance held in a process, is AT LEAST ONE
         alternative release scenario identified and analyzed that meets BOTH of the
         following conditions:
                  a) The scenario is more likely to occur than the worst-case release                             Please Input
                  scenario under 40 CFR 68.25; and
                  b) The scenario will reach an endpoint offsite, unless no such scenario
                  exists?
     148 Is AT LEAST ONE alternative release scenario that represents all flammable
         substances held in covered processes identified and analyzed that meets BOTH
         of the following conditions:
                  a) The scenario is more likely to occur than the worst-case release                             Please Input
                  scenario under 40 CFR 68.25; and
                  b) The scenario will reach an endpoint offsite, unless no such scenario
                  exists?
     149 For each alternative release scenario, are the parameters defined in 40 CFR
         68.22 used to determine the distance to the endpoints?                                                   Please Input

     150 Do the alternative release scenarios include AT LEAST the following, as
         applicable:
                  a) Transfer hose releases due to splits or sudden hose uncoupling;
                  b) Process piping releases from failures at flanges, joints, welds, valves
                  and valve seals, and drains or bleeds;
                  c) Process vessel or pump releases due to cracks, seal failure, or drain,                       Please Input
                  bleed, or plug failure;
                  d) Vessel overfilling and spill, or overpressurization and venting through
                  relief valves or rupture disks; and
                  e) Shipping container mishandling and breakage or puncturing leading to
                  a spill?
     151 Are all active and passive mitigation systems considered for the alternative
         release scenarios capable of withstanding the release event of the scenario and
         functioning as intended?                                                                                 Please Input


     152 Are BOTH of the following factors considered when selecting alternative release
         scenarios:
                a) The five-year accident history provided required under 40 CFR 68.42;
                                                                                                                  Please Input
                and
                b) The failure scenario identified under 40 CFR 68.50 for Program 2
                processes and under 40 CFR 68.67 for Program 3 processes?
     153 Are ALL of the following records maintained for all alternative release scenarios:

                 a) A description of the scenarios identified;
                 b) Assumptions used, including any administrative controls and passive
                 mitigation assumed to limit the release quantity;                                                Please Input
                 c) The anticipated effect of the controls and mitigation on the release
                 quantity and rate;
                 d) Parameters used; and
                 e) The rationale for selection of assumptions and parameters?
                                                                                              Yes   No   N/A   Comment/Concerns
     154 For each alternative release scenario, is ALL of the following information
         submitted in the RMP:
                  a) Chemical name;
                  b) Percentage weight of the chemical in a liquid mixture (toxics only);
                  c) Physical state (toxics only);
                  d) Basis of results (give model name if used);                                                 Please Input
                  e) Scenario (explosion, fire, toxic gas release, or liquid spill and
                  vaporization);
                  f) Quantity released in pounds;
                  g) Release rate; and
                  h) Release duration?
     155 For each alternative release scenario, is ALL of the following information
         submitted in the RMP:
                  a) Wind speed and atmospheric stability class (toxics only);
                  b) Topography (toxics only);
                                                                                                                 Please Input
                  c) Distance to endpoint;
                  d) Public and environmental receptors within the distance;
                  e) Passive mitigation considered; and
                  f) Active mitigation considered?
Risk Management Program - RMP - Five-Year Accident History
     156 Is a five-year accident history submitted with the RMP?
                                                                                                                 Please Input

     157 Does the five-year accident history include ALL of the following accidental
         releases from covered processes:
                  a) Accidental releases that resulted in death, injuries, or significant
                  property damage on site; and
                  b) Accidental releases that resulted in known offsite deaths, injuries,
                  evacuations, sheltering in place, property damage, or environmental
                  damage?
     158 For EACH accidental release included in the five-year accident history, is ALL of
         the following information reported:
                  a) Date, time, and approximate duration of the release;
                  b) Chemical(s) released;
                  c) Estimated quantity released in pounds and, for mixtures containing
                  regulated toxic substances, percentage concentration by weight of the
                  released regulated toxic substances in the liquid mixture;

                  d) Five- or six-digit NAICS code that most closely corresponds to the
                  process;
                  e) The type of release event and its source; and
                  f) Weather conditions, if known?
     159 For EACH accidental release included in the five-year accident history, is ALL of
         the following information reported:
                  a) On-site impacts;
                  b) Known offsite impacts;
                  c) Initiating event and contributing factors, if known;
                  d) Whether offsite responders were notified, if known; and
                  e) Operational or process changes that resulted from investigation of the
                  release?
     160 Are all numerical estimates in the five-year accident history provided to two
         significant digits?
Risk Management Program - Emergency Response - Program 1 Processes
     161 Have all response actions at the facility been coordinated with local emergency
         planning and response agencies?
                                                                                                                 Please Input
                                                                                          Yes   No   N/A   Comment/Concerns
Risk Management Program - Emergency Response - Program 2 and 3 Processes
     162 Is ALL of the following information provided in the RMP:
                 a) Whether the facility has a written emergency response plan;
                 b) Whether the emergency response plan includes specific actions to be
                 taken in response to an accidental release of a regulated substance;

                 c) Whether the emergency response plan includes procedures for
                 informing the public and local agencies responsible for responding to                       Please Input
                 accidental releases;
                 d) Whether the plan includes information on emergency health care;
                 e) The date of the most recent review or update of the emergency
                 response plan; and
                 f) The date of the most recent emergency response training for
                 employees?
     163 In the RMP, does the owner or operator provide the name and telephone
         number of the local agency with which emergency response activities and the
         emergency response plan are coordinated?

                                                                                                             Please Input




     164 In the RMP, does the owner or operator list other Federal or state emergency
         plan requirements to which the stationary source is subject?

                                                                                                             Please Input




Additional Notes:
                                                                                               Yes   No   N/A   Comment/Concerns
Georgia
Standards Applicable to Transport of Hazardous Materials

Administration - Emergency Response Information
      1 Does the facility provide Emergency Response Information for transported
        hazardous materials?                                                                                      Please Input

       2 Is emergency response information immediately available to all of the following:

                 a) Facility personnel, for use at all times when a hazardous material is
                 present; and                                                                                     Please Input
                 b) Federal, state, or local government agencies that respond to an
                 incident involving a hazardous material, or are conducting an
                 investigation which involves a hazardous material?
       3 Is the emergency response information presented in AT LEAST ONE of the
         following ways:
                 a) On a shipping paper:
                 b) In a document that includes both the technical name and basic
                 description of the hazardous material, and the emergency response
                                                                                                                  Please Input
                 information (such as a MSDS); or
                 c) In a document (such as an emergency response guidance document)
                 that cross-references the description of the hazardous material on the
                 shipping paper with the emergency response information contained in
                 the document?
       4 Does the facility's emergency response information include:
                 a) The basic description and technical name of the hazardous material;

                 b) The immediate hazards of health;
                 c) The risks of fire or explosion;
                 d) The immediate precautions to be taken in the event of an accident or                          Please Input
                 incident;
                 e) The immediate methods for handling fires;
                 f) The initial methods for handling spills or leaks in the absence of fire;
                 and
                 g) The preliminary first aid measures?
       5 Is the emergency response information:
                 a) Printed legibly in English; and
                                                                                                                  Please Input
                 b) Available for use away from the package containing the hazardous
                 material?
       6 For each shipment of hazardous materials, is an emergency response telephone
         number provided?
                                                                                                                  Please Input

       7 Is the emergency response telephone number entered on shipping papers in
         one of the following locations
                 a) Immediately following the description of each hazardous material; or

                  b) If the telephone number applies to all the hazardous materials on the
                  shipping paper, in one, clearly visible, and identified location?
       8 Is the phone which receives emergency response telephone calls monitored at
         all times that hazardous material are in transit?



       9 Does the emergency response telephone number provide the required access to
         someone who:
                 a) Is knowledgeable of the hazards and characteristics of the hazardous
                 material being shipped; and
                 b) Has comprehensive emergency response and accident mitigation
                 information for the material?
      10 Do you report any release of a hazardous substance in a quantity equal to or
         greater than its reportable quantity to the U.S. Coast Guard National Response
         Center as soon as the release occurs?                                                                    Please Input


Administration - Training
     11 Does the facility have a training program for employees who work with or near
        hazardous materials?                                                                                      Please Input
                                                                                             Yes   No   N/A   Comment/Concerns
      12 Have all employees who have ANY responsibility for preparing hazardous
         materials for shipment received the necessary training on regulation
         requirements?                                                                                          Please Input


      13 Is training of all new hazmat employees completed within 90 days after
                                                                                                                Please Input
         employment began?
      14 When a hazmat employee's job function changes, is the appropriate training for
                                                                                                                Please Input
         the new job function completed within 90 days?
      15 Is the proper training/retraining given to hazmat employees at least once every
                                                                                                                Please Input
         three years?
      16 Are all incompletely trained hazmat employees under the supervision of a
         properly trained hazmat employee?                                                                      Please Input

      17 Have all hazmat employees received:
                 a) General awareness/familiarization training;
                                                                                                                Please Input
                 b) Function-specific training; AND
                 c) Safety training?
      18 Are hazmat employees tested by the hazmat employer on the required training
         subjects?                                                                                              Please Input

      19 Are both of the following TRUE about the maintenance of training records:
                 a) Records of the previous three years training for each hazmat
                 employee are kept by the hazmat employer; AND                                                  Please Input
                 b) The training records are retained until 90 days after the date the
                 hazmat employee no longer serves in such a capacity?
      20 Do the training records include:
                 a) The hazmat employee's name;
                 b) The most recent date the hazmat employee completed training;
                 c) A description, copy, or the location of the training materials used to
                                                                                                                Please Input
                 meet the training requirements;
                 d) The name and address of the person providing the training; AND
                 e) A certification that the hazmat employee has been trained and tested?

Administration - Registration
     21 Has the facility submitted a registration statement to the DOT?
                                                                                                                Please Input

     22 Did the facility meet ALL of the following registration requirements:
                 a) The registration statement was submitted on DOT Form F 5800.2;
                 b) The statement was submitted to the DOT before the registration
                 deadline; and
                 c) The annual fee was paid?
     23 Are ALL of the following documents maintained at the facility's principal place of
        business for a period of three years from the issue date of the Certificate of
        Registration:
                 a) The Certificate of Registration; and
                 b) A copy of the registration statement?
     24 If hazardous materials are transported by motor carrier, is a copy of the current
        Certificate of Registration or another document bearing the registration number
                                                                                                                Please Input
        identified as the "U.S. DOT Hazmat Reg. No." carried on board each truck and
        truck tractor?
Highway Transport - Loading/Unloading
     25 Are the following loading and unloading practices implemented at the facility:

                  a) Packages containing hazardous material are secured against
                  movement within the loaded vehicle before it is allowed to leave the
                  shipper's property;
                  b) Smoking is prohibited on or about any vehicle during loading or
                                                                                                                Please Input
                  unloading of any explosive, flammable liquid, flammable solid, oxidizing
                  material, or flammable compressed gas;
                  c) The handbrake or airbrake is triggered on motor vehicles while
                  loading or unloading hazardous materials; and
                  d) Only tools that could not adversely affect packages, containers, or
                  their closures are used?
      26 Is the facility in compliance with the modal segregation requirements?
                                                                                                                Please Input
                                                                                               Yes   No   N/A   Comment/Concerns
      27 Are the following fork-lift requirements met whenever fork lifts are used for
         loading and unloading hazardous materials:
                 a) The rear wheels or motor vehicle are chocked at all times; and                                Please Input
                 b) Only trained and authorized operators are allowed to utilize fork lifts?

Highway Transport - Portable Tanks/Cargo
     28 Is a "qualified" person, who meets all of the following requirements, in
        attendance during the loading and unloading of cargo tanks containing
        hazardous material:
                a) Is alert and located within 25 feet of the cargo tank and delivery hose
                                                                                                                  Please Input
                with an unobstructed view:
                b) Is aware of the nature of the hazardous materials;
                c) Has been instructed on emergency procedures; and
                d) Is authorized and has the means to move the cargo tank?
     29 Are tanks containing a residue of a hazardous material handled in the same
        manner as are full tanks?                                                                                 Please Input

Highway Transport - Hazardous Materials Table
     30 Is the Hazardous Materials Table reviewed prior to shipping each hazardous
        material to determine:
                a) If materials originating at the site are hazardous;
                b) The proper shipping name from column 2;
                c) The hazard class or division of the material from column 3:                                    Please Input
                d) The identification number of the material (UN or NA number) from
                column 4;
                e) The packing group(s) assigned to a material from column 5; and
                f) The label(s) to be applied to packages from column 6?
     31 Unless excepted, when a mixture or solution containing a hazardous material is
        not specifically listed in the Table, is it described using the proper shipping name
                                                                                                                  Please Input
        of the hazardous material with the qualifying word "mixture" or "solution"?

      32 When a mixture or solution containing two or more hazardous materials in the
         same hazard class is not identified in the Table by a specific description, is the
                                                                                                                  Please Input
         mixture or solution described using the most appropriate general shipping
         description (e.g., "Flammable liquid, n.o.s")?
      33 Is the Hazardous Materials Table reviewed prior to shipping each hazardous
         material to determine:
                 a) Packaging requirements for non-bulk and bulk packagings from
                 columns 8b, 8c, and references cited therein;                                                    Please Input
                 b) Exceptions to packaging requirements from column 8a in addition to
                 those specified in subpart A of part 173; AND
                 c) Special provisions from column 7?
      34 Is the Appendix to the Hazardous Materials Table reviewed for each hazardous
         material to determent if the material is also listed as a hazardous substance?                           Please Input

      35 Is the facility in compliance with the classification and hazardous communication
         requirements in Parts 172 and 173 (Regulations for the use of the Hazardous
                                                                                                                  Please Input
         Materials Table and for Communications) not previously in effect?

Highway Transport - Shipping Papers
     36 Does the facility use shipping papers for hazardous materials shipped from the
        site?                                                                                                     Please Input

      37 Are hazardous material identified on shipping papers by using at least one of the
         following methods:
                 a) Hazardous materials entered first;
                                                                                                                  Please Input
                 b) Hazardous materials entered in a contrasting color; or
                 c) Hazardous materials identified by the entry of an "X" in a column
                 captioned "HM"?
      38 Do ALL hazardous materials descriptions on the shipping papers have the
         following characteristics:
                 a) Legible;
                                                                                                                  Please Input
                 b) In English;
                 c) Free of any code or abbreviations; and
                 d) Include an emergency response telephone number?
                                                                                             Yes   No   N/A   Comment/Concerns
      39 Are ALL of the following elements of the basic shipping description of a
         hazardous material included on shipping papers and entered in the following
         sequence:
                  a) Proper shipping name;                                                                      Please Input
                  b) Hazard class;
                  c) Identification number; and
                  d) Packing group, if any?
      40 Is the basic description on shipping papers free of unauthorized interruptions of
         the required sequence of elements, i.e., proper shipping name, hazard class,                           Please Input
         etc.?
      41 Is the total quantity, by weight (or as otherwise appropriate), of each hazardous
         material on a shipping paper entered before and/or after the basic description?                        Please Input

      42 Is all additional information placed AFTER the basic shipping description?

                                                                                                                Please Input


      43 Are hazardous material shipping descriptions entered on shipping papers
         without abbreviations, except for those specifically authorized by the                                 Please Input
         regulations?
      44 Are ALL shipments of hazardous materials (not including hazardous wastes)
         shipped under ONE of the following conditions:
                 a) In a cargo tank supplied by the carrier;
                 b) By the shipper as a private carrier except for a hazardous material                         Please Input
                 that is to be reshipped or transferred from one carrier to another; or
                 c) For the return of an empty tank car which previously contained a
                 hazardous material and which ahs not been cleaned or purged?
      45 Is an acceptable, legibly signed, shipper's certification statement shown on each
         shipping paper for shipments of hazardous materials?


      46 Are hazardous wastes offered for highway transportation from the facility?                             Please Input
      47 Is an acceptable, legibly signed, shipper's certification statements shown on
         each shipping paper for shipments of hazardous wastes?


Highway Transport - Shipping Papers - Specific Substances
     48 If the proper shipping name is "n.o.s.: or other generic description, is the name
        of the compound or constituent causing a material to be hazardous entered in                            Please Input
        association with the shipping description?
     49 If a hazardous material is a mixture of two or more hazardous materials, are the
        technical names of at least two components most predominately contributing to
                                                                                                                Please Input
        the hazards of the mixture or solution entered on the shipping paper?

      50 If the proper shipping name of a hazardous substance does not identify the
         hazardous substance by name, is the name of the hazardous substance shown                              Please Input
         in parentheses in association with the basic description?
      51 Are the shipments containing a hazardous substance described on the shipping
         paper by use of the letters "RQ" either before or after the basic shipping                             Please Input
         description?
      52 Are shipments of hazardous materials in limited quantities described on the
         shipping paper by use of the words "Limited Quantity" or the abbreviation "LTD                         Please Input
         QTY"?
      53 If empty packagings (drums) are shipped by common carrier, are they properly
         described on the shipping papers as a hazardous material or as a RESIDUE?                              Please Input

      54 Has all hazardous waste, which had been offered, transported, or delivered,
         been accompanied with an EPA hazardous waste manifest, prepared in
         accordance with 40 CFR 262 (EPA regulations for hazardous waste generators),                           Please Input
         and signed, carried, and given as required in 49 CFR 172.205 (hazardous waste
         manifest requirements)?
      55 If a package contains an elevated temperature material and this fact is not
         disclosed in the shipping name (for example, when the words "Molten" or
                                                                                                                Please Input
         "Elevated temperature" are part of the shipping name), does the shipping paper
         include the word "HOT" immediately preceding the shipping name?
      56 If a package contains a poison, and this fact is not disclosed in the shipping
         name or class entry, does the shipping paper include the word "Poison" or                              Please Input
         "Toxic"?
                                                                                                Yes   No   N/A   Comment/Concerns
Highway Transport - Shipping Papers - Poisonous by Inhalation Materials
     57 For materials which are poisonous by inhalation, are the words "Poison-
        Inhalation Hazard" or "Toxic-Inhalation Hazard" and the proper Hazard Zone
                                                                                                                   Please Input
        included on the shipping paper immediately following the shipping description?

Highway Transport - Marking
     58 Are packages/containers of hazardous materials marked prior to being offered to
        a carrier for transport?                                                                                   Please Input

      59 Are all non-bulk packages of hazardous materials marked with the proper
                                                                                                                   Please Input
         shipping name and the appropriate UN or NA identification number?
      60 Are combination packages of liquid hazardous materials legibly marked with
         package orientation markings that consist of two arrows pointing upwards with a                           Please Input
         line under them?
      61 Are packages of hazardous substances marked "RQ" in association with the
                                                                                                                   Please Input
         proper shipping name?
      62 Are all package markings:
                  a) Durable, in English, and unobscured by labels or attachments;
                  b) Printed on or affixed to the surface of the package, or on a label, tag
                  or sign;                                                                                         Please Input
                  c) Displayed on a background of sharply contrasting color; AND
                  d) Located away from other markings (such as advertising) that could
                  substantially reduce their effectiveness?
      63 Are all non-bulk packages of hazardous material marked with the name and
                                                                                                                   Please Input
         address of the consignee or consignor?
      64 Is the marked proper shipping name without any abbreviations, except "W" for
         "with" or "W/O" for "without" in descriptions of ammunition, or "ORM" for "Other                          Please Input
         Regulated Material"?
      65 If the marked proper shipping name of a hazardous substance does not identify
         the hazardous substance by name, is the name of the hazardous substance
                                                                                                                   Please Input
         marked on the package, in parentheses, in association with the basic
         description?
      66 If a package is re-used to transport materials other than the material it originally
         contained, are the original markings removed or changed to identify the material                          Please Input
         it now contains?
      67 Are portable tanks containing hazardous materials shipped from the facility?
                                                                                                                   Please Input
      68 Is the proper shipping name of the material marked on two opposite sides of the
         portable tank?


     69 If the portable tank has a capacity of less than 1,000 gallons, is the identification
        number marked on two opposite sides of the tank in association with the proper
        shipping name?
     70 If the portable tank has a capacity of 1,000 gallons or more, is the identification
        number marked on each side and each end of the tank?
Highway Transport - Marking - Poisonous by Inhalation Materials
     71 Is the facility in compliance with the marking requirements for materials that are
        poisonous by inhalation?
                                                                                                                   Please Input


Highway Transport - Labeling
     72 Does the site use warning labels, required by the DOT, for shipments of
        hazardous materials?                                                                                       Please Input

      73 Are the labels in accordance with the DOT size and color specifications?
                                                                                                                   Please Input

      74 Is column (6) of the Hazardous Materials Table consulted to ensure that the
         proper labels are applied to packages?                                                                    Please Input

      75 Are DOT warning labels placed only on packages that contain the hazard
         represented by the label?                                                                                 Please Input

      76 When a mixed or consolidated packages of hazardous material are shipped, is a
         label placed on the outside of the package for each hazard class in the mixture
         or consolidation?                                                                                         Please Input
                                                                                                Yes   No   N/A   Comment/Concerns
      77 When two or more labels are required on a package, are they displayed or
         affixed next to each other?                                                                               Please Input

      78 When the package is of a size or shape that does not allow normal labeling, are
         labels displayed on tags affixed to packages?                                                             Please Input

      79 Are additional labeling requirements adhered to, when applicable?
                                                                                                                   Please Input

Highway Transport - Placarding
     80 Does the facility use placards required by the DOT to indicate the hazards of the
        material shipped?                                                                                          Please Input

      81 Do the placards meet the DOT size and color specifications?
                                                                                                                   Please Input

      82 Whenever a shipment requires placarding of the vehicle, does the shipper
         provide the required number of the proper placards to the carrier?
                                                                                                                   Please Input

      83 Do placards furnished to carriers represent the hazard of the materials offered
         to, and to be transported by, the carrier?                                                                Please Input

      84 Are placards provided for:
                 a) Any quantity of Table 1 hazardous material; and
                                                                                                                   Please Input
                 b) Table 2 hazardous materials when 1,001 pounds or more are offered
                 to the carrier at one time?
      85 Are freight containers and aircraft unit load devices, packaged with the capacity
         of 640 cubic feet or more, placarded the same as are motor vehicles?                                      Please Input

      86 Are freight containers and aircraft unit load devices, which are packaged with
         less than 640 cubic feet capacity, placarded/labeled with one placard and two                             Please Input
         warning labels?
Placarding - Poisonous by Inhalation
      87 Is the facility in compliance with the placarding and hazard communication
         requirements for materials poisonous by inhalation under 49 CFR 172, Subpart
         F (Placarding)                                                                                            Please Input


Highway Transport - Placarding - Bulk Packaging
     88 Are placards affixed to each transported bulk packaging that contains hazardous
        materials?                                                                                                 Please Input

     89 Does each bulk packaging that is required to be placarded when it contains a
        hazardous material remain placarded until ONE of the following occurs:
                a) It is sufficiently cleaned of residue and purged of vapors to remove all
                                                                                                                   Please Input
                potential hazards; or
                b) It is refilled with a different material, so that any remaining residue is
                no longer hazardous?
Highway Transport - Placarding - Mode-specific Requirements
     90 Is the Placard Substitution Table from 49 CFR 171.14(b) being used as a
        guideline for current placarding practices?                                                                Please Input

Highway Transport - Packaging
     91 Are materials that have more than one hazard class or division, and that are not
        specifically listed in the Hazardous Materials Table, classed according to the                             Please Input
        highest applicable hazard class?
     92 For each material to be packaged for transportation, is the Hazardous Materials
        Table consulted to determine:
                a) The packing group in column 5 corresponding to the proper shipping
                name and hazard class for that material?
                                                                                                                   Please Input
                b) The applicable packaging specification section of 49 CFR 173 under
                column 8b or 8c; and
                c) Any special provisions or exceptions to specific packaging
                requirements under columns 7 and 8a?
                                                                                              Yes   No   N/A   Comment/Concerns
      93 Is the Hazardous Materials Table AND 49 CFR 173.21 checked to see if a
         material or packaging for shipment is forbidden by the mode of transport
                                                                                                                 Please Input
         selected?

      94 Are the packaging specifications for each hazardous material obtained from the
         applicable sections of the transportation regulations 49 CFR Part 173?                                  Please Input

      95 Are all hazardous material packagings prescribed or permitted in the specified
         packaging section (Column 8 of the Hazardous Materials Table), OR otherwise
         authorized for hazardous materials shipment?                                                            Please Input


      96 If containers are reused, are they refurbished to meet the requirements of new
         containers?                                                                                             Please Input

      97 Are REUSED paper, plastic, film, or textile packagings utilized for the transport
         of hazardous materials?                                                                                 Please Input

      98 Are packages of hazardous materials prepared so that ALL of the following are
         TRUE for normal transportation conditions:
                a) There will be no significant release of the hazardous materials to the
                environment;
                b) The effectiveness of the packaging will not be substantially reduced;
                                                                                                                 Please Input
                and
                c) There will be no mixture of gases or vapors in the package which
                could, through any credible spontaneous increase of heat or pressure, or
                through an explosion, significantly reduce the effectiveness of the
                packaging?
      99 Does the facility ensure that packagings are compatible with their lading
         (contents)?                                                                                             Please Input

     100 Are packaging closures checked to ensure they are both designed and closed,
         so that under transportation conditions no release to the environment occur?                            Please Input

     101 Does this facility ship any packages that require venting?                                              Please Input
     102 For packages that require venting, are the provisions under 49 CFR 273.24(g)
         consulted to ensure that venting is permissible?
    103 Is sufficient head space left in liquid-containing packagings to ensure that
        neither leakage nor permanent distortion of the packaging will occur during                              Please Input
        normal transportation conditions?
Highway Transport - Packaging - Non-bulk Packaging
    104 For combination packages containing liquid hazardous materials, are the
        closures on inner packages upright?                                                                      Please Input

     105 Does the facility consider the nature and thickness of the outer packaging to
         ensure that friction occurring during transportation will not generate enough heat                      Please Input
         to dangerously alter the chemical stability of the package?
     106 Is cushioning material within the package:
                 a) Placed so as to prevent breakage and leakage;
                 b) Placed to prevent movement within the package;
                 c) Incapable of reacting dangerously with the contents of the inner                             Please Input
                 packagings; and
                 d) Incapable of having its protective properties weakened in the event
                 of leakage?
     107 Are nails, staples, and other metallic devices secured so that they won't protrude
         from the outer packaging and damage inner packagings or receptacles?                                    Please Input

     108 Are filling limitations of non-bulk packages in compliance with the provisions of
         49 CFR 173.24a(b)?                                                                                      Please Input

     109 Do any outer non-bulk packagings contain more than one hazardous material?
                                                                                                                 Please Input
     110 Do the non-bulk packaging with more than one hazardous material conform to
         the provisions contained in 49 CFR 173.24(c)(1)?
     111 Does the facility ship hazardous liquids in receptacles:                                                Please Input
     112 Do liquids completely fill receptacles at a temperature of 55 degrees Celsius
         (131 degrees Fahrenheit) or less?
                                                                                                Yes   No   N/A   Comment/Concerns
Railroad Transport - Loading/Unloading
     113 Are pre-trip inspections performed on ALL of the following rail cars:
                 a) All rail tank cars; and
                                                                                                                   Please Input
                 b) Other rail cars that will be used for transporting hazardous materials?

     114 Is each rail car containing hazardous material inspected, at ground level, for ALL
         of the following conditions:
                  a) Required markings;
                  b) Required labels;
                  c) Required placards;
                  d) Leakage; and
                  e) Securement of closures?
     115 Are packages containing hazardous materials loaded in such a was to prevent
         the packages from changing positions, falling to the floor, or sliding into each                          Please Input
         other during normal transportation?
     116 Are procedures in place that ensure compliance with segregation and separation
         requirements for hazardous materials in rail cars?
                                                                                                                   Please Input


     117 Are wheel stops used to prevent railroad cars from moving during loading and
         unloading operations?                                                                                     Please Input

     118 Are derail and/or bumper blocks provided on spur railroad tracks in accordance
         with OSHA regulations?                                                                                    Please Input

Railroad Transport - Hazardous Materials Table
     119 Is the Hazardous Materials Table reviewed prior to shipping each hazardous
         material to determine:
                 a) If materials originating at the site are hazardous;
                 b) The proper shipping name from column 2;
                 c) The hazard class or division of the material from column 3:                                    Please Input
                 d) The identification number of the material (UN or NA number) from
                 column 4;
                 e) The packing group(s) assigned to a material from column 5; and
                 f) The label(s) to be applied to packages from column 6?
     120 Unless excepted, when a mixture or solution containing a hazardous material is
         not specifically listed in the Table, is it described using the proper shipping name
                                                                                                                   Please Input
         of the hazardous material with the qualifying word "mixture" or "solution"?

     121 When a mixture or solution containing two or more hazardous materials in the
         same hazard class is not identified in the Table by a specific description, is the
                                                                                                                   Please Input
         mixture or solution described using the most appropriate general shipping
         description (e.g., "Flammable liquid, n.o.s")?
     122 Is the Hazardous Materials Table reviewed prior to shipping each hazardous
         material to determine:
                 a) Packaging requirements for non-bulk and bulk packagings from
                 columns 8b, 8c, and references cited therein;                                                     Please Input
                 b) Exceptions to packaging requirements from column 8a in addition to
                 those specified in subpart A of part 173; AND
                 c) Special provisions from column 7?
     123 Is the Appendix to the Hazardous Materials Table reviewed for each hazardous
         material to determent if the material is also listed as a hazardous substance?                            Please Input

     124 Is the facility in compliance with the classification and hazardous communication
         requirements in Parts 172 and 173 (Regulations for the use of the Hazardous
                                                                                                                   Please Input
         Materials Table and for Communications) not previously in effect?

Railroad Transport - Tank Cars - Unloading
     125 Are tank cars containing hazardous materials unloaded by reliable and properly
         trained individuals?                                                                                      Please Input
                                                                                                 Yes   No   N/A   Comment/Concerns
     126 Do the unloading personnel:
                a) Set brakes and block wheel on tank cars during unloading;
                b) Place caution signs on the track or tank car to warn approaching
                persons that the car is being unloaded;
                c) Use caution signs made of metal or other comparable material;
                                                                                                                    Please Input
                d) Check to ensure caution signs contain the required warning;
                e) Check to ensure letters on the caution signs the required size; and

                  f) Check to ensure letters on caution signs are white on a blue
                  background?
     127 Is the tank car safely relieved of all interior pressure BEFORE the manhole
         cover or outlet cap is removed?                                                                            Please Input

     128 Are ALL of the following actions taken immediately after a tank car is unloaded:

                a) Unloading connections are disconnected; and                                                      Please Input
                b) All valves and closures are made tight by the use of a bar, wrench or
                other suitable tool?
     129 Are tank cars attended by the unloader throughout the entire period of
         unloading, and until the car is disconnected from an unloading device?
                                                                                                                    Please Input

Railroad Transport - Mode-specific Requirements
     130 For hazardous materials shipped by rail, do the shipping papers contain the
         following notations, when applicable:
                 a) The reporting mark and number for hazardous materials shipped in
                 rail cars, freight containers, transport vehicles or portable tanks that
                 display a reporting mark and number;
                 b) For each Class DOT-113 tank car containing a flammable gas, the
                 notations "DOT-113," and "DO NOT HUMP OR CUT OFF CAR WHILE
                                                                                                                    Please Input
                 IN MOTION";
                 c) For a tank car that contains only the residue of a hazardous material,
                 the notation "RESIDUE: Last Contained ***," followed by the basic
                 description of the hazardous material last contained in the tank car; and

                d) For shipments of elevated temperature materials, an appropriate
                notation such as "MAXIMUM OPERATING SPEED 15 MPH."?
     131 Are tank cars that contain a hazardous material marked in the following manner:

                 a) With the identification number specified for the material on each side
                 and each end of the tank; and                                                                      Please Input
                 b) With the material's proper shipping name (or authorized common
                 name) on each side of the tank for materials listed at 49 CFR
                 172.330(a)(1)(ii)?
Railroad Transport - Placarding - Mode-specific Requirements
     132 Are procedures in place to ensure that required placards are affixed to the rail
         car before it is tendered to the rail carrier?
                                                                                                                    Please Input



     133 Are special provisions for placarding made whenever the following hazardous
         materials are transported:
                 a) Division 1.1 and 1.2 explosive materials - requires a white square
                 background
                 b) Material classed in Division 2.3 Hazard Zone A or 6.1 Packing Group
                 I Hazard Zone A which require POISON GAS or POISON placards
                 affixed to the rail car, including tank cars containing only a residue of the
                 material - requires a white square background;                                                     Please Input
                 c) Class DOT 113 tank cars used to transport a Division 2.1 (flammable
                 gas) material, including tank cars containing only a residue of the
                 material - requires a white square background; and
                 d) Each rail car containing Division 1.1 or 1.2 (explosive) ammunition
                 which also meets the definition of a material poisonous by inhalation -
                 placarded EXPLOSIVES 1.1 or EXPLOSIVES 1.2 and POISON GAS or
                 POISON INHALATION HAZARD?
     134 Is each placard on a rail car readily visible from the direction it faces, except
         from the direction of another rail car to which the car is coupled?                                        Please Input

Additional Information:
                                                                                                 Yes   No   N/A   Comment/Concerns
Georgia
Spills

General SPCC Plan Guidelines
      1 Does a single aboveground storage capacity exceed 660 gallons; or the total
         capacity exceed 1,320 gallons; or the underground storage capacity exceed                                  Please Input
         42,000 gallons?
      2 Does the facility have a Spill Prevention Control and Countermeasure Plan
         (SPCC Plan) prepared in writing?                                                                           Please Input

       3 Does the SPCC Plan meet BOTH of the following requirements:
                 a) Follows the sequence outlined in 40 CFR 112.7; and
                 b) Includes a discussion of the facility's conformance with the
                 appropriate guidelines listed in 40 CFR 112.7?
       4 Was the facility's SPCC Plan:
                 a) Prepared during the first six months of facility operation or within six
                 months of the effective date of the SPCC plan regulations (March 26,
                 1976) whichever is later;
                 b) Implemented no later than one year after the facility commenced
                 operation; and
                 c) Reviewed and certified by a Registered Professional Engineer?
       5 Does the SPCC plan have the full approval of management at a level with
         authority to commit the necessary resources?
       6 Does the site have a designated person who is responsible for implementation
         of the SPCC Plan and reports to line management?



       7 Is a complete copy of the SPCC plan maintained at facilities that are attended at
         least eight hours per day OR if the facility is not so attended, at the nearest field
         office?
       8 Is the SPCC Plan reviewed, updated, and if necessary, amended by a
         registered engineer for ANY of the following circumstances:
                  a) Every three years;
                  b) If a change in facility design, construction, operation, or maintenance
                  affects the facility's potential to discharge a hazardous substance;

                  c) If more effective prevention and control technology has been
                  demonstrated and field-proven to significantly reduce the likelihood of a
                  spill event; or
                  d) As the result of a spill event(s)?
       9 Are all required amendments or changes to the SPCC Plan implemented no
         later than six months after the event(s) that triggered the amendments?


      10 Does the SPCC plan contain a description of the physical plant that includes all
         of the following:
                  a) A facility diagram with the location and contents of all tanks marked;
                b) Unit-by-unit storage capacity;
                c) Type and quantity of oil stored;
                d) Estimates of quantity of oil potentially discharged:
                e) Possible spill pathways; and
                f) Spill controls such as secondary containment, equipment and
                procedures for control of a discharge?
      11 Does the SPCC plan contain a contact list and phone numbers for:
                a) The facility response coordinator;
                b) The National Response coordinator;
                c) Cleanup contractors:
                d) Fire departments;
                e) The Local Emergency Planning Committee;
                f) The State Emergency Planning Committee:
                g) Downstream water suppliers?
                                                                                               Yes   No   N/A   Comment/Concerns
12 Is documentations in the Plan sufficient to enable the reporter of a discharge to
   provide the following information:
           a) The address and phone number of the facility;
           b) The names of individuals and organizations who have been notified;

             c) The spill date, time and material spilled;
             d) Estimates of the total quantity spilled, and the total quantity spilled
             into navigable water;
             e) The source and cause of the spill and a description of the effected
             medium;
             f) Any damages or injuries caused by the spill;
             g) Actions being used to stop, remove and mitigate the discharge; and

          h) Whether an evacuation might be necessary?
13 Does the SPCC Plan (and/or the incident log where applicable):
          a) Include a written description of each spill, corrective action taken, and
          plans for preventing recurrence; and
          b) Examine each possible scenario for equipment failure and predict the
          direction, rate of flow, and the quantities of hazardous substance that
          could be discharged?
14 Does the SPCC plan contain procedures for the following;
          a) Spill prevention, including routine handling of products (loading,
          unloading, facility transfers);
          b) Spill countermeasures for spill discovery, response and cleanup; and

            c) Disposal of recovered materials in accordance with applicable legal
            requirements?
15 Is a complete copy of the SPCC plan maintained at facilities that are attended at
   least eight hours per day OR if the facility is not so attended, at the nearest field                          Please Input
   office?
16 Does the SPCC Plan meet ALL of the following requirements:
            a) Is prepared in accordance with good engineering practices;
            b) Has the full approval of management at a level with authority to
            commit the necessary resources:
            c) Includes separate discussion paragraphs for additional facilities or
            procedures, methods, or equipment not yet fully operational, including a                              Please Input
            separate explanation of the details of installation and operational start-up

             d) Follows the sequence outlined in 40 CFR 112.7; and
             e) Includes a discussion of the facility's conformance with the
             appropriate guidelines listed in 40 CFR 112.7?
17   Does the SPCC Plan include both of the following, as applicable:
             a) For facilities which have experienced one or more spill events within
             twelve months prior to the effective date of 40 CFR 112 (March 26,
             1976), a written description of each such spill, corrective action taken
             and plans for preventing recurrence; and                                                             Please Input
             b) Where experience indicates a reasonable potential for equipment
             failure, a prediction of the direction, rate of flow, and total quantity of oil
             which could be discharged from the facility as a result of each major type
             of failure?
18   Has the facility had a reportable spill event which required review and/or
                                                                                                                  Please Input
     amendment of the SPCC plan?
19   If any hazardous substance(s) is discharged into the environment in an
     amount(s) greater than the reportable quantity(s) (as listed in 40 CFR 302, Table
                                                                                                                  Please Input
     302.4), is there a written procedure to assure that the proper authorities are
     immediately notified?
20   Are the procedures a part of a hazardous substance SPCC Plan?


21 Is a current copy of the procedures available at the site?
                                                                                                  Yes   No   N/A   Comment/Concerns
    22 Within 60 days of any reportable spill event, was a report submitted to the EPA
        Regional Administrator and the state water pollution control agency that included
        all of the following:
                 a) The name and location of the site, name of the owner/operator, and
                 date of initial facility operation;
                 b) Maximum facility storage or handling capacity and normal daily
                 throughput;
                 c) A description of the facility including maps and flow diagrams;                                  Please Input
                 d) A copy of the SPCC plan;
                 e) Cause(s) of the spill including a failure analysis of the system in
                 which the failure occurred;
                 f) Corrective actions and/or countermeasures taken;
                 g) Preventative measures taken to prevent recurrence; and
                 h) Such other information as the Regional Administrator requires
                 pertinent to the plan or spill event?
    23 Is the SPCC plan reviewed, updated, and if necessary, amended and certified
        by a Registered Professional Engineer under ALL of the following
        circumstances:
                 a) Every three years;
                 b) If a change in facility design, construction, operation, or maintenance
                                                                                                                     Please Input
                 affects the facility's potential to discharge oil;
                 c) If more effective prevention and control technology has been
                 demonstrated and field-proven to significantly reduce the likelihood of a
                 spill event; or
                 d) If required by the Regional Administrator?
    24 Are all required amendments or changes made to the SPCC Plan and fully
                                                                                                                     Please Input
        implemented within the appropriate time period?
SPCC Plan - Containment/Diversionary Structures
    25 Have appropriate containment and/or diversionary structures been provided at
        the facility to prevent discharged oil from reaching a navigable water course,
        including AT LEAST ONE of the following systems or its equivalents:

                 a) Sufficiently impervious dikes, berms, or retaining walls;
                 b) Curbing;
                 c) Culverts, gutters, or other drainage systems;                                                    Please Input
                 d) Weirs, booms, or similar barriers;
                 e) Spill diversion ponds;
                 f) Retention ponds;
                 g) Sorbent materials;
                 h) Curbing, drip pans (for offshore facilities); or
                 I) Sumps and collection systems (for offshore facilities)?
    26 When installation of containment or diversionary structures is impracticable, has
        the facility submitted the following information to EPA:
                 a) A clear demonstration of the impracticability;
                 b) An oil contingency plan; and
                 c) A written commitment of personnel, material and equipment required
                 to expeditiously remove harmful quantities of discharged oil
    27 If installation of containment or diversionary structures is impractible, is:
                 a) Tank integrity testing conducted every five years; and
                 b) Valve and piping leak/integrity testing conducted every year?
SPCC Plan - Onshore Facility Drainage
    28 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for onshore non-production facility drainage (40                              Please Input
        CFR 112.7(e)(1))?
    29 Is plant drainage engineered as follows:
                 a) Drainage from diked storage areas is retrained by manual, open-and-
                 closed valves or other positive means to present a spill or other
                 excessive leakage of oil into the drainage system or inplant effluent
                 treatment system except where plan systems are designed to handle
                                                                                                                     Please Input
                 such leakage, OR is emptied by manually activated pumps or ejectors;
                 and
                 b) Drainage from undiked areas, if possible, flows into ponds, lagoons
                 or catchment basins designed to retain oil or return it to the facility?

      30 If plant drainage is not engineered as specified in 40 CFR 112.7(e)(1)(I) through
         (III), is the final discharge of all in-plant ditches equipped with a diversion system
         that could, in the event of an uncontrolled spill, return the oil to the plant?
                                                                                               Yes   No   N/A   Comment/Concerns
      31 If drainage waters are treated in more than one treatment unit, are the following
         methods used to move the water:
                  a) Natural hydraulic flow; and                                                                  Please Input
                  b) If pump transfer is needed, tow "lift" pumps with at least one of the
                  pumps permanently installed when the treatment is continuous?
      32 If the facility is in a location subject to flooding, does the SPCC Plan provide
         additional protection for events that may occur during the floods?                                       Please Input

SPCC Plan - Onshore Bulk Storage Tanks
    33 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for onshore non-production facility bulk storage                           Please Input
        tanks (40 CFR 112.7(e)(2))?
    34 Does the SPCC Plan cover spill prevention and containment procedures for bulk
        storage tanks?
                                                                                                                  Please Input


      35 Do tanks used for the storage of oil meet ALL of the following conditions:
                 a) Material and construction is compatible with the material stored and
                 conditions of storage (i.e. pressure and temperature)
                 b) Adequate secondary containment (e.g. dike, containment curb, pit,
                 drainage trench) is provided for the entire contents of the largest singe
                 tank (plus sufficient freeboard for precipitation);                                              Please Input
                 c) Provisions meeting the requirements of 40 CFR 112.7 (e)(2)(III)(A)
                 through (D) are made for the drainage of rainwater;
                 d) Corrosion protection is provided for a new underground metallic
                 storage tanks and they are subjected to regular pressure testing; and
                 e) Corrosion protection is provided for partially buried metallic tanks?
      36 Are aboveground tanks, including tank supports and foundations, being tested
         using techniques such as hydrostatic testing, visual inspection, or non-                                 Please Input
         destructive shell thickness testing?
      37 Is the outside of each aboveground tank frequently checked for signs of
         deterioration, leaks which might cause a spill, or accumulation of oil inside diked                      Please Input
         areas?
      38 To control leakage through defective internal heating coils, are the following
         factors applied, as appropriate:
                 a) The stream return or exhaust lines from internal heating coils which
                 discharge into an open water course are monitored for contamination, or
                                                                                                                  Please Input
                 passed through a settling tank, skimmer, or other separation or retention
                 system; and
                 b) The feasibility of installing an external heating system is considered?

      39 Are tanks equipped with fail-safe engineering for overfill protection, including
         one or more of the following devices:
                a) High liquid level alarms with audible or visual signal at a constantly
                manned surveillance station;
                b) High liquid level pump cutoff devices set to stop flow at a
                predetermined tank content level;                                                                 Please Input
                c) Direct audible or code signal communication between the tank
                gauger and the pumping station; or
                d) A fast response system for determining the liquid level of each bulk
                storage tank such as digital computers, telepulse, or direct vision
                gauges or their equivalent?
      40 Are tanks that fail leak testing taken out of service, repaired or replaced?
                                                                                                                  Please Input

      41 Are liquid levels sensing devices tested regularly?                                                      Please Input
      42 Are plant effluent disposal facilities observed frequently enough to detect system
                                                                                                                  Please Input
         problems that could lead to an oil spill?
      43 Are hazardous substance leaks from tank seams, gaskets, rivets and bolts
         corrected promptly (including removal of hazardous substances or hazardous
                                                                                                                  Please Input
         substance contaminated material within 72 hours from the time the spill event
         occurs)?
      44 Are all mobile or portable storage tanks equipped with secondary containment
         and positioned to prevent discharges?                                                                    Please Input

      45 Does the facility have field-constructed aboveground storage tanks that have
                                                                                                                  Please Input
         undergone repair, alteration or change in service?
                                                                                             Yes   No   N/A   Comment/Concerns
    46 Were the following activities conducted when the repairs, alterations or changes
        to a field-constructed aboveground tank occurred:
                 a) They were conducted in accordance with Section 3 of Tank
                 Inspection, Repair, Alteration and Reconstruction, 1991 (API Standard
                 653); and
                 b) The tank was evaluated for risk of failure due to brittle fracture?
SPCC Plan - Transfer/Pumping Operations
    47 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for onshore non-production transfer/pumping                              Please Input
        operations (40 CFR 112.7(e)(3))?
    48 Does the site have any buried piping installations?                                                      Please Input
    49 Does the underground piping have protective wrapping, coating, and cathodic
        protection?
    50 Are ALL of the following true for buried piping installations:
                 a) The installations comply with relevant requirements in Technical
                 Standards and Corrective Action Requirements for Underground
                 Storage Tanks (40 CFR 280);
                 b) The installations are tested for leaks annually OR monitored monthly;
                 and
                 c) Records of testing are maintained for five years?
    51 If a pipeline is not in service, is the terminal connection at the transfer point
                                                                                                                Please Input
        capped or blank - flaged and marked as to origin?
    52 Are pipe supports designed to minimize abrasion and corrosion, and allow for
        expansion and contraction?
                                                                                                                Please Input


    53 Does the site have any aboveground valves and pipelines?                                                 Please Input
    54 Are the following true for each aboveground piping installation:
                a) Aboveground valves and pipelines are inspected regularly;
                b) The general condition of flange joints, expansion joints, valve glands
                and bodies, catch pans, pipe supports, locking of valves an metal
                surfaces are assessed regularly; and
                c) In areas where facility drainage is such that a piping failure might
                lead to a spill event, periodic pressure testing of piping is conducted?
    55 Are drivers entering an area with aboveground piping warned verbally or by
        appropriate signs to be sure that the vehicle, because of its size, will not
        endanger aboveground piping?
SPCC Plan - Loading/Unloading
    56 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for facility bulk loading and unloading (40 CFR                          Please Input
        112.7(e)(4))?
    57 Do the facility's tank car and truck loading and unloading procedures meet the
        minimum requirements established by the Department of Transportation (DOT)?                             Please Input

      58 Does the drainage from each rack area flow into a catchment basin or treatment
         facility designed to handle spills?                                                                    Please Input

      59 In these rack areas, is a quick drainage system used, with a containment system
         designed to hold at least the maximum capacity of any single compartment of an
         tank car or truck loaded or unloaded in the area?

    60 Do the tank car and truck loading and unloading procedures incorporate BOTH
        of the following work practices:
                 a) An interlocked warning light, warning signs or physical barrier system
                 are provided to prevent vehicular departure before transfer lines are                          Please Input
                 disconnected; and
                 b) The lowermost drain and all outlets of each tank car or truck are
                 checked for leakage prior to its filling and departure?
SPCC Plan - Onshore Facility Drainage
    61 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for onshore oil production facility drainage (40                         Please Input
        CFR 112.7(e)(5)(ii))?
    62 Are facility drainage systems designed to ensure that:
                 a) Dikes (or equivalent) at tank batteries and central treating stations
                 where an accidental discharge of oil would have a reasonable possibility
                 of reaching navigable waters have drains that are closed and sealed
                                                                                                                Please Input
                 except when rainwater is drained;
                 b) Field drainage ditches, and oil traps, sumps or skimmers are
                 inspected at regularly scheduled intervals for accumulation of oil; and
                 c) Accumulated oil is removed?
                                                                                                 Yes   No   N/A   Comment/Concerns
     63 Are facility drainage systems designed for the following situations:
                a) Discharged oil is prevented from reaching navigable waters in the
                event of equipment failure or human error; and                                                      Please Input
                b) In locations subject to flooding, provision is made for additional
                protection during floods?
Tank Equipment Standards
     64 If a major facility has an AST total storage capacity of 20,000 gallons or more of
        hazardous substance other than petroleum or petroleum products is an                                        Please Input
        adequate secondary containment system in place?
SPCC Plan - Inspections and Records
     65 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for inspections and records (40 CFR 112.7(e)(8))?                            Please Input

    66 Are all inspections and tests required by the SPCC plan conducted in
        accordance with written procedures developed by the owner/operator or certified                             Please Input
        engineer?
    67 Are the written procedures and records of inspections:
                a) Signed by the supervisor or inspector; and                                                       Please Input
                b) Maintained as part of the SPCC Plan for a three-year period?
SPCC Plan - Security
    68 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for security (40 CFR 112.7(e)(9))?                                           Please Input

    69 Does the facility provide ALL of the following security measures:
                a) The facility is fenced and entrance gates are locked when the facility
                is not in production
                b) All valves that allow outflow of product have security systems and
                remain closed when not in operation;
                c) All pump starter controls are accessible only to authorized personnel                            Please Input
                or are locked in the "off" position when not in operation;
                d) The loading/unloading connections of piping shall be capped or blank-
                flanged when not in service; and
                d) Facility lighting is adequate for discovery of spills and prevention of
                vandalism?
SPCC Plan - Training
    70 Does the SPCC plan include a complete discussion of the facility's conformance
        with the applicable guidelines for personnel, training, and spill prevention                                Please Input
        procedures (40 CFR 112.7(e)(10))?
    71 Are all oil-handling personnel provided with instruction in the following subjects:

                 a) Operation and maintenance of equipment to prevent oil discharges;                               Please Input

                 b) Applicable pollution control laws, rules, and regulations?
      72 Does the site have a designated person who is accountable for oil spill
                                                                                                                    Please Input
         prevention and reports to line management?
      73 Do operating personnel attend spill prevention briefing sessions to discuss spill
         events, equipment malfunctions, and precautionary measures?                                                Please Input

      74 Are the spill prevention briefing sessions conducted frequently enough to assure
         adequate understanding of the SPCC Plan?
      75 Are all personnel involved in oil-handling activities trained in ALL of the following
         subjects:
                  a) Equipment operation and maintenance;
                                                                                                                    Please Input
                  b) General facility operations;
                  c) Discharge prevention regulations; and
                  d) Contents of the SPCC Plan?
      76 Is training conducted according to the following schedules:
                  a) All employees receive eight hours of training within one year of the
                  effective date of this final rule and four hours training in subsequent
                  years;
                                                                                                                    Please Input
                  b) New employees receive eight hours training within their first week of
                  employment; and
                  c) All personnel participate in unaccounted drills at least once a year?

      77 Does the facility have a hazardous substance spill response team?                                          Please Input
      78 Does the hazardous substance spill response team conduct and document
         routine drills and training?
Spill Prevention - Oil Release
       79 Were the number of spills or discharges of oil or other petroleum products
                                                                                                                    Please Input
          documented in the last 12 months?
                                                                                                    Yes   No   N/A   Comment/Concerns
       80 For each spill or discharge, was ALL of the following information provided:
                  a) The date and time of the incident;
                                                                                                                       Please Input
                  b) The identity of the specific material spilled/discharged; and
                  c) The estimated quantity of the spilled/discharged material?
       81 For each spill or discharge, did the person in charge, or a person designated to
          report spills, determine whether or not any outside entities (e.g. federal, state
                                                                                                                       Please Input
          and local officials, emergency response teams) needed to be notified?

       82 For each spill or discharge, was the elapsed time between discovery and the
          notification determination documented?
       83 For each spill or discharge, were the appropriate authorities notified immediately
          after the discovery of the spill or discharge?
       84 For each spill or discharge, was the cause of the release documented?                                        Please Input
       85 For any spill or discharge, was any material (regardless of quantity) released to:

                   a) Surface water or other waters of the United States;
                                                                                                                       Please Input
                   b) Groundwater;
                   c) Air; or
                   d) Ground?
Spill Prevention - Reporting
       86 If any spill or discharge caused or contributed to a violation of an NPDES permit,
          was the violation reported in accordance with procedures set forth in the NPDES                              Please Input
          permit?
       87 If any spill or discharge endangered public health or the environment, was it
          reported by telephone within 24 hours to the EPA (or the state if the state has                              Please Input
          enforcement authority) and by written notice within five days?
       88 If required by the EPA, was a written report for any spill or discharge submitted,
          and did each report include ALL of the following:
                   a) A description of the noncompliance and its cause;
                   b) There period of noncompliance, including dates and times;                                        Please Input
                   c) The anticipated amount of time to correct the noncompliance; and
                   d) Steps taken to reduce, eliminate, and prevent recurrence of the
                   noncompliance?
       89 Were any recommended preventive measures implemented?
                                                                                                                       Please Input
       90 If a follow-up written report for any spill or discharge was required by another
                                                                                                                       Please Input
          agency other than the EPA, was the report submitted?
Spill Prevention - Remedial Action
       91 Was remedial action taken for each spill or discharge or oil, and did remedial
          action(s):
                    a) Control the source of the spill(s) or discharge(s), prevent further spills
                    or discharges, and halt or slow the spread of the spils(s) or                                      Please Input
                    discharges(s); and
                    b) Include mechanical or manual methods to recover spilled or
                    discharged petroleum from the water or adjoining shorelines?
       92 If chemical agents were included in any remedial action, were they used:
                    a) In accordance with National Contingency Plan (NCP); and
                                                                                                                       Please Input
                    b) With the permission of the Federal on-scene coordinator or a state
                    representative?
       93 For each spill or discharge did remedial action comply with:
                    a) Guidelines established in Coast Guard regulations (33 CFR 153) and
                    the National Contingency Plan (40 CFR 300); and                                                    Please Input
                    b) All state and local requirements for recovering oil and contaminated
                    materials?
       94 For each spill or discharge, were the long-term remedial actions taken
                                                                                                                       Please Input
          documented?
Spill Prevention - Hazardous Substance Release
       95 Were the number of spills or discharges of hazardous substances documented
                                                                                                                       Please Input
          in the last 12 months?
       96 For each spill or release, were ALL of the following documented:
                    a) The date and time of the incident;
                    b) The identity of thee specific material spilled/discharged; and                                  Please Input
                    c) The estimated quantity of the spilled/discharged material; and
                    d) The location of the spill?
       97 For each spill, was it documented if the spill equaled or exceeded the reportable
                                                                                                                       Please Input
          quantity for that material?
       98 For each spill, did the person in charge of the facility or the person designated to
                                                                                                                       Please Input
          report spills notify the appropriate authorities immediately?
       99 For each spill, was it documented whether any agencies other than the National
          Response Center were notified by the person designated to report spills, and/or                              Please Input
          by the National Response Center?
                                                                                               Yes   No   N/A   Comment/Concerns
     100 Were any substance(s) released in a spill defined as hazardous under the Clean
                                                                                                                  Please Input
         Water Act (CWA)?
     101 For ALL substances released during the spill which exceeded a reportable
         quantity under the Clean Water Act, did the person in charge of the facility or the
         person designated to report spills immediately notify ONE of the following
         entities in descending order of priority:
                  a) The National Response Center;
                  b) The On-scene Coordinator as designated in the Regional
                  Contingency Plan;
                  c) The Officer-in-Charge at any vicinity Coast Guard unit; or
                  d) The Commander of the Coast Guard District?
     102 Were any substance(s) released in a spill defined as hazardous substance(s)
                                                                                                                  Please Input
         under Superfund (CERCLA)?
     103 Did the person in charge or the person designated to report spill immediately
         notify the National Response Center by telephone?
     104 If an agency required a follow-up written report for any spill or release, was that
         report submitted by the deadline?
     105 For each spill or discharge, was material released:
                  a) Into waters of the United States; or
                  b) Into or onto the ground where it could affect either ground or surface
                  water?
     106 For any spill or discharge, were remedial actions recommended by any
                                                                                                                  Please Input
         regulatory agency(s)?
     107 Were all recommended remedial actions taken?
Spill Prevention - Reportable Quantity
      108 For each spill or release did the Emergency Coordinator (or his/her designee) do
          ALL of the following:
                  a) Activate facility alarms or communication systems;
                  b) Notify the Community Emergency Coordinator of the Local                                      Please Input
                  Emergency Planning Committee;
                  c) Notify the State Emergency Response Commission; and
                  d) Notify the National Response Center?
      109 For each spill or release did the Emergency Coordinator (or his/her designee)
          determine whether the release:
                  a) Could threaten human health or the environment outside the facility;
                                                                                                                  Please Input
                  b) Required immediate notice to the Community Emergency Coordinator
                  of the Local Emergency Planning Committee; and
                  c) Triggered the facility's hazardous waste contingency plan, and if so
                  notify the EPA Regional Administrator?
Spill Prevention - No Reportable Quantity
      110 For any release of one pound or more of a hazardous substance that is not on
          EPA's list of extremely hazardous substances and for which there is no
          reportable quantity that occurred ON or AFTER 4/30/88, did the Emergency
          Coordinator (or his/her designee) notify BOTH of the following:                                         Please Input
                  a) The Community Emergency Coordinator for the Local Emergency
                  Planning Committee; and
                  b) The State Emergency Response Commission?
      111 Did the notice indicate ALL of the following:
                  a) The chemical name of any substance released;
                  b) That the substance was not on the EPA list of Extremely Hazardous
                  Substances;
                  c) The quantity of the substance released (estimate);
                  d) The time and duration of the release;
                  e) The name and telephone number of a contact person at the facility;

                  f) The environmental media into which the release occurred;
                  g) Health risks that could be triggered by the release and the
                  appropriate medical treatment and/or advice; and
                  h) Proper precautions to be followed during and after the release?
Spill Prevention - Extremely Hazardous Substance
      112 For each spill or release was a notice of the release given to ALL of the
          following officials:
                  a) The Community Emergency Coordinator;                                                         Please Input
                  b) State Emergency Response Commission; and
                  c) The National Response Center?
                                                                                               Yes   No   N/A   Comment/Concerns
     113 For each spill or release, did the notice of release indicate ALL of the following:

                  a) The chemical name of hazardous substance released;
                  b) Whether the substance was on the EPA list of Extremely Hazardous
                  Substances;
                  c) The estimated quantity of the extremely hazardous substance;
                  d) The time and duration of the release;
                                                                                                                  Please Input
                  e) The name and telephone number of a contact person at the facility;

                f) The environmental media into which the release occurred;
                g) Any known or anticipated health risks that could be triggered by the
                release and appropriate medical treatment advice; and
                h) Recommendations on precautions to be followed during and after the
                release?
Additional Notes:

								
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