Environmental Audit

• Document No.

• Location Name:

• Business Unit Number:

• Location
  Address

• Telephone Number:

• Fax Number:

• General Manager:

• Operations Manager:

• Local Safety Officer:

• Conducted on

  Date

• Prepared by

• Personnel

Facility Function:

• Describe Site Use:

• Is this facility shared with another company?

  Yes

  No

  N/A

• If shared, what is the name if the business?

• What is the nature of this their business?

• Does EMSC own or lease this facility?

  Own

  Lease

• How long has AMR been on site?

• If leased, is a copy of the lease documented on site?

  Yes

  No

  N/A

• Lease renewal date?

Uninterrupted Power Supply / Generators

• Does this site have a UPS?

  Yes

  No

  N/A

• Back-up battery system?<br>(If yes, see battery tab)

  Yes

  No

  N/A

• Does this site have a back up generator?

  Yes

  No

  N/A

• Generator fuel type:

  Diesel

  Unleaded

  Liquid Propane

  Natural Gas

• Does generator require any local license or certificate?

  Yes

  No

  N/A

Site Walk and General Housekeeping

• 1. Is the maintenance shop clean and tidy?

  Yes

  No

  N/A

• 2. Are spills cleaned up promptly?

  Yes

  No

  N/A

• 3. Is there an adequate supply of clean absorbent?

  Yes

  No

  N/A

• 4. Is the Environmental policy posted on the wall in a general access area?

  Yes

  No

  N/A

• 5. Are there any hazardous, regulated, or banned wastes in the garbage?

  Yes

  No

  N/A

• 6. Is the facility fenced?

  Yes

  No

  N/A

• 7. Are there scrap vehicle parts, tanks, drums, etc dumped on property?

  Yes

  No

  N/A

• 8. Is litter controlled on property?

  Yes

  No

  N/A

• 9. Are there any drains emptying into ditches surrounding the property?

  Yes

  No

  N/A

• 10. Are the drains clear of rubbish and debris?

  Yes

  No

  N/A

• 11. Are there signs of oil or petroleum discharge around drains?

  Yes

  No

  N/A

• 12. Is there evidence of any of the following on site?

• 12.1 Oil Staining?

  Yes

  No

  N/A

• 12.2 Stressed Vegetation?

  Yes

  No

  N/A

• 12.3 Strong Odors?

  Yes

  No

  N/A

• 13. Is the site under snow cover at time of site walk?

  Yes

  No

  N/A

• 14. Are dumpsters closed or covered?

  Yes

  No

  N/A

• Action Required:

Underground Storage Tanks

• Are underground storage tanks used at this site?

  Yes

  No

  N/A

• Tank 1:

• Material of construction:

  Steel

  Pastic

  Fiberglass

  Other

• Tank is:

  Single Wall

  Double Wall

• Capacity in Gallons:

• Tank contents:

• The tank contents are:

  Active

  Inactive

• Does tank have Cathodic Protection?

  Yes

  No

  N/A

• Has Cathodic protection been tested in past 3 years?

  Yes

  No

  N/A

• Does tank have interstitial monitoring?<br>(Double wall only)

  Yes

  No

  N/A

• Is there a monitoring well? (Some states require ground well sensors)

  Yes

  No

  N/A

• Is there is a well, is there monitoring data?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Does tank have overfill protection?

  Yes

  No

  N/A

• Pipe is:

  Pressure

  Suction

• Pipe construction material:

  Steel

  Pastic

  Fiberglass

  Other

• Pipe wall is:

  Single Wall

  Double Wall

• Does pressurized pipe have leak detection?

  Yes

  No

  N/A

• Are daily inventory records okay?

  Yes

  No

  N/A

• Are monthly reconciliation okay?

  Yes

  No

  N/A

• Does tank have Auto Gauging?

  Yes

  No

  N/A

• Is dipstick in good condition?

  Yes

  No

  N/A

• Date tank was last tested:

  Date

• Is tank tight? (Should be every year, required by law at least every 3 years)

  Yes

  No

  N/A

• Is a permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Action Required:

• Tank 2:

• Material of construction:

  Steel

  Pastic

  Fiberglass

  Other

• Tank is:

  Single Wall

  Double Wall

• Capacity in Gallons:

• Tank contents:

• The tank contents are:

  Active

  Inactive

• Does tank have Cathodic Protection?

  Yes

  No

  N/A

• Has Cathodic protection been tested in past 3 years?

  Yes

  No

  N/A

• Does tank have interstitial monitoring?<br>(Double wall only)

  Yes

  No

  N/A

• Is there a monitoring well? (Some states require ground well sensors)

  Yes

  No

  N/A

• Is there is a well, is there monitoring data?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Does tank have overfill protection?

  Yes

  No

  N/A

• Pipe is:

  Pressure

  Suction

• Pipe construction material:

  Steel

  Pastic

  Fiberglass

  Other

• Pipe wall is:

  Single Wall

  Double Wall

• Does pressurized pipe have leak detection?

  Yes

  No

  N/A

• Are daily inventory records okay?

  Yes

  No

  N/A

• Are monthly reconciliation okay?

  Yes

  No

  N/A

• Does tank have Auto Gauging?

  Yes

  No

  N/A

• Is dipstick in good condition?

  Yes

  No

  N/A

• Date tank was last tested:

  Date

• Is tank tight? (Should be every year, required by law at least every 3 years)

  Yes

  No

  N/A

• Is a permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Action Required:

• Tank 3:

• Material of construction:

  Steel

  Pastic

  Fiberglass

  Other

• Tank is:

  Single Wall

  Double Wall

• Capacity in Gallons:

• Tank contents:

• The tank contents are:

  Active

  Inactive

• Does tank have Cathodic Protection?

  Yes

  No

  N/A

• Has Cathodic protection been tested in past 3 years?

  Yes

  No

  N/A

• Does tank have interstitial monitoring?<br>(Double wall only)

  Yes

  No

  N/A

• Is there a monitoring well? (Some states require ground well sensors)

  Yes

  No

  N/A

• Is there is a well, is there monitoring data?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Does tank have overfill protection?

  Yes

  No

  N/A

• Pipe is:

  Pressure

  Suction

• Pipe construction material:

  Steel

  Pastic

  Fiberglass

  Other

• Pipe wall is:

  Single Wall

  Double Wall

• Does pressurized pipe have leak detection?

  Yes

  No

  N/A

• Are daily inventory records okay?

  Yes

  No

  N/A

• Are monthly reconciliation okay?

  Yes

  No

  N/A

• Does tank have Auto Gauging?

  Yes

  No

  N/A

• Is dipstick in good condition?

  Yes

  No

  N/A

• Date tank was last tested:

  Date

• Is tank tight? (Should be every year, required by law at least every 3 years)

  Yes

  No

  N/A

• Is a permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Action Required:

• Tank 4:

• Material of construction:

  Steel

  Pastic

  Fiberglass

  Other

• Tank is:

  Single Wall

  Double Wall

• Capacity in Gallons:

• Tank contents:

• The tank contents are:

  Active

  Inactive

• Does tank have Cathodic Protection?

  Yes

  No

  N/A

• Has Cathodic protection been tested in past 3 years?

  Yes

  No

  N/A

• Does tank have interstitial monitoring?<br>(Double wall only)

  Yes

  No

  N/A

• Is there a monitoring well? (Some states require ground well sensors)

  Yes

  No

  N/A

• Is there is a well, is there monitoring data?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Does tank have overfill protection?

  Yes

  No

  N/A

• Pipe is:

  Pressure

  Suction

• Pipe construction material:

  Steel

  Pastic

  Fiberglass

  Other

• Pipe wall is:

  Single Wall

  Double Wall

• Does pressurized pipe have leak detection?

  Yes

  No

  N/A

• Are daily inventory records okay?

  Yes

  No

  N/A

• Are monthly reconciliation okay?

  Yes

  No

  N/A

• Does tank have Auto Gauging?

  Yes

  No

  N/A

• Is dipstick in good condition?

  Yes

  No

  N/A

• Date tank was last tested:

  Date

• Is tank tight? (Should be every year, required by law at least every 3 years)

  Yes

  No

  N/A

• Is a permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Is permit posted near tank?

  Yes

  No

  N/A

• Is tank in compliance?

  Yes

  No

  N/A

• Action Required:

• Action Required:

Above Ground Storage Tanks:

• Tank 1:

  Yes

  No

  N/A

• Tank capacity in gallons:

• Tank contents:

  Gas

  Diesel

  Oil

  Other

• Is tank labeled correctly?

  Yes

  No

  N/A

• Year of construction:

• Location:

  Indoors

  Outdoors

• Tank configuration:

• Cube:

• Vertical

• Horizontal

• Drum:

• Vertical

• Horizontal

• Is permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is tank in compliance with local, state, and federal regulations as well as AMR Policy?

  Yes

  No

  N/A

• Is tank skid mounted?

  Yes

  No

  N/A

• Does tank have rain protection?

  Yes

  No

  N/A

• Is outdoor AST electrically grounded?

  Yes

  No

  N/A

• Does tank have automatic inventory controls?

  Yes

  No

  N/A

• Does tank have overfill protection at dispensing point?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Is tank double wall construction?<br>(Is yes skip dike)

  Yes

  No

  N/A

• Is tank diked?

  Yes

  No

  N/A

• Dike floor construction:

  Steel

  Asphalt

  Concrete

  Dirt

  Other

• Is dike drain closed?

  Yes

  No

  N/A

• Is dike empty?

  Yes

  No

  N/A

• Is there more than 1320 gallons of total Petro products stored in above ground tanks?<br>(If yes, need to comply with Sarah Tier II requirements)

  Yes

  No

  N/A

• If yes, is a spill Control & Countermeasure plan required? <br>(Only is petroleum exceeds 1320 gallons, and stored outdoors)

  Yes

  No

  N/A

• If SPCC plan required, is there a written plan in place?

  Yes

  No

  N/A

• Has plan been certified by management / signed by GM?

  Yes

  No

  N/A

• Certified by professional engineer?

  Yes

  No

  N/A

• Notification / Emergency contact list?

  Yes

  No

  N/A

• Inspection report on file?

  Yes

  No

  N/A

• Significant changes to SPCC plan?

  Yes

  No

  N/A

• Spill greater than 10 gallons within last year?

  Yes

  No

  N/A

• If plan has been implemented for more than 3 years, has the last review been done within the past 3 years?

  Yes

  No

  N/A

• Is the facility in compliance with the SPCC plan?

  Yes

  No

  N/A

• Action Required:

• Tank 2:

  Yes

  No

  N/A

• Tank capacity in gallons:

• Tank contents:

  Gas

  Diesel

  Oil

  Other

• Is tank labeled correctly?

  Yes

  No

  N/A

• Year of construction:

• Location:

  Indoors

  Outdoors

• Tank configuration:

• Cube:

• Vertical

• Horizontal

• Drum:

• Vertical

• Horizontal

• Is permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is tank in compliance with local, state, and federal regulations as well as AMR Policy?

  Yes

  No

  N/A

• Is tank skid mounted?

  Yes

  No

  N/A

• Does tank have rain protection?

  Yes

  No

  N/A

• Is outdoor AST electrically grounded?

  Yes

  No

  N/A

• Does tank have automatic inventory controls?

  Yes

  No

  N/A

• Does tank have overfill protection at dispensing point?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Is tank double wall construction?<br>(Is yes skip dike)

  Yes

  No

  N/A

• Is tank diked?

  Yes

  No

  N/A

• Dike floor construction:

  Steel

  Asphalt

  Concrete

  Dirt

  Other

• Is dike drain closed?

  Yes

  No

  N/A

• Is dike empty?

  Yes

  No

  N/A

• Is there more than 1320 gallons of total Petro products stored in above ground tanks?<br>(If yes, need to comply with Sarah Tier II requirements)

  Yes

  No

  N/A

• If yes, is a spill Control & Countermeasure plan required? <br>(Only is petroleum exceeds 1320 gallons, and stored outdoors)

  Yes

  No

  N/A

• If SPCC plan required, is there a written plan in place?

  Yes

  No

  N/A

• Has plan been certified by management / signed by GM?

  Yes

  No

  N/A

• Certified by professional engineer?

  Yes

  No

  N/A

• Notification / Emergency contact list?

  Yes

  No

  N/A

• Inspection report on file?

  Yes

  No

  N/A

• Significant changes to SPCC plan?

  Yes

  No

  N/A

• Spill greater than 10 gallons within last year?

  Yes

  No

  N/A

• If plan has been implemented for more than 3 years, has the last review been done within the past 3 years?

  Yes

  No

  N/A

• Is the facility in compliance with the SPCC plan?

  Yes

  No

  N/A

• Action Required:

• Tank 3:

  Yes

  No

  N/A

• Tank capacity in gallons:

• Tank contents:

  Gas

  Diesel

  Oil

  Other

• Is tank labeled correctly?

  Yes

  No

  N/A

• Year of construction:

• Location:

  Indoors

  Outdoors

• Tank configuration:

• Cube:

• Vertical

• Horizontal

• Drum:

• Vertical

• Horizontal

• Is permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is tank in compliance with local, state, and federal regulations as well as AMR Policy?

  Yes

  No

  N/A

• Is tank skid mounted?

  Yes

  No

  N/A

• Does tank have rain protection?

  Yes

  No

  N/A

• Is outdoor AST electrically grounded?

  Yes

  No

  N/A

• Does tank have automatic inventory controls?

  Yes

  No

  N/A

• Does tank have overfill protection at dispensing point?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Is tank double wall construction?<br>(Is yes skip dike)

  Yes

  No

  N/A

• Is tank diked?

  Yes

  No

  N/A

• Dike floor construction:

  Steel

  Asphalt

  Concrete

  Dirt

  Other

• Is dike drain closed?

  Yes

  No

  N/A

• Is dike empty?

  Yes

  No

  N/A

• Is there more than 1320 gallons of total Petro products stored in above ground tanks?<br>(If yes, need to comply with Sarah Tier II requirements)

  Yes

  No

  N/A

• If yes, is a spill Control & Countermeasure plan required? <br>(Only is petroleum exceeds 1320 gallons, and stored outdoors)

  Yes

  No

  N/A

• If SPCC plan required, is there a written plan in place?

  Yes

  No

  N/A

• Has plan been certified by management / signed by GM?

  Yes

  No

  N/A

• Certified by professional engineer?

  Yes

  No

  N/A

• Notification / Emergency contact list?

  Yes

  No

  N/A

• Inspection report on file?

  Yes

  No

  N/A

• Significant changes to SPCC plan?

  Yes

  No

  N/A

• Spill greater than 10 gallons within last year?

  Yes

  No

  N/A

• If plan has been implemented for more than 3 years, has the last review been done within the past 3 years?

  Yes

  No

  N/A

• Is the facility in compliance with the SPCC plan?

  Yes

  No

  N/A

• Action Required:

• Tank 4:

  Yes

  No

  N/A

• Tank capacity in gallons:

• Tank contents:

  Gas

  Diesel

  Oil

  Other

• Is tank labeled correctly?

  Yes

  No

  N/A

• Year of construction:

• Location:

  Indoors

  Outdoors

• Tank configuration:

• Cube:

• Vertical

• Horizontal

• Drum:

• Vertical

• Horizontal

• Is permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is tank in compliance with local, state, and federal regulations as well as AMR Policy?

  Yes

  No

  N/A

• Is tank skid mounted?

  Yes

  No

  N/A

• Does tank have rain protection?

  Yes

  No

  N/A

• Is outdoor AST electrically grounded?

  Yes

  No

  N/A

• Does tank have automatic inventory controls?

  Yes

  No

  N/A

• Does tank have overfill protection at dispensing point?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Is tank double wall construction?<br>(Is yes skip dike)

  Yes

  No

  N/A

• Is tank diked?

  Yes

  No

  N/A

• Dike floor construction:

  Steel

  Asphalt

  Concrete

  Dirt

  Other

• Is dike drain closed?

  Yes

  No

  N/A

• Is dike empty?

  Yes

  No

  N/A

• Is there more than 1320 gallons of total Petro products stored in above ground tanks?<br>(If yes, need to comply with Sarah Tier II requirements)

  Yes

  No

  N/A

• If yes, is a spill Control & Countermeasure plan required? <br>(Only is petroleum exceeds 1320 gallons, and stored outdoors)

  Yes

  No

  N/A

• If SPCC plan required, is there a written plan in place?

  Yes

  No

  N/A

• Has plan been certified by management / signed by GM?

  Yes

  No

  N/A

• Certified by professional engineer?

  Yes

  No

  N/A

• Notification / Emergency contact list?

  Yes

  No

  N/A

• Inspection report on file?

  Yes

  No

  N/A

• Significant changes to SPCC plan?

  Yes

  No

  N/A

• Spill greater than 10 gallons within last year?

  Yes

  No

  N/A

• If plan has been implemented for more than 3 years, has the last review been done within the past 3 years?

  Yes

  No

  N/A

• Is the facility in compliance with the SPCC plan?

  Yes

  No

  N/A

• Action Required:

• Tank 5:

  Yes

  No

  N/A

• Tank capacity in gallons:

• Tank contents:

  Gas

  Diesel

  Oil

  Other

• Is tank labeled correctly?

  Yes

  No

  N/A

• Year of construction:

• Location:

  Indoors

  Outdoors

• Tank configuration:

• Cube:

• Vertical

• Horizontal

• Drum:

• Vertical

• Horizontal

• Is permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is tank in compliance with local, state, and federal regulations as well as AMR Policy?

  Yes

  No

  N/A

• Is tank skid mounted?

  Yes

  No

  N/A

• Does tank have rain protection?

  Yes

  No

  N/A

• Is outdoor AST electrically grounded?

  Yes

  No

  N/A

• Does tank have automatic inventory controls?

  Yes

  No

  N/A

• Does tank have overfill protection at dispensing point?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Is tank double wall construction?<br>(Is yes skip dike)

  Yes

  No

  N/A

• Is tank diked?

  Yes

  No

  N/A

• Dike floor construction:

  Steel

  Asphalt

  Concrete

  Dirt

  Other

• Is dike drain closed?

  Yes

  No

  N/A

• Is dike empty?

  Yes

  No

  N/A

• Is there more than 1320 gallons of total Petro products stored in above ground tanks?<br>(If yes, need to comply with Sarah Tier II requirements)

  Yes

  No

  N/A

• If yes, is a spill Control & Countermeasure plan required? <br>(Only is petroleum exceeds 1320 gallons, and stored outdoors)

  Yes

  No

  N/A

• If SPCC plan required, is there a written plan in place?

  Yes

  No

  N/A

• Has plan been certified by management / signed by GM?

  Yes

  No

  N/A

• Certified by professional engineer?

  Yes

  No

  N/A

• Notification / Emergency contact list?

  Yes

  No

  N/A

• Inspection report on file?

  Yes

  No

  N/A

• Significant changes to SPCC plan?

  Yes

  No

  N/A

• Spill greater than 10 gallons within last year?

  Yes

  No

  N/A

• If plan has been implemented for more than 3 years, has the last review been done within the past 3 years?

  Yes

  No

  N/A

• Is the facility in compliance with the SPCC plan?

  Yes

  No

  N/A

• Action Required:

• Tank 6:

  Yes

  No

  N/A

• Tank capacity in gallons:

• Tank contents:

  Gas

  Diesel

  Oil

  Other

• Is tank labeled correctly?

  Yes

  No

  N/A

• Year of construction:

• Location:

  Indoors

  Outdoors

• Tank configuration:

• Cube:

• Vertical

• Horizontal

• Drum:

• Vertical

• Horizontal

• Is permit required for tank?

  Yes

  No

  N/A

• If yes, is tank permitted?

  Yes

  No

  N/A

• Is tank in compliance with local, state, and federal regulations as well as AMR Policy?

  Yes

  No

  N/A

• Is tank skid mounted?

  Yes

  No

  N/A

• Does tank have rain protection?

  Yes

  No

  N/A

• Is outdoor AST electrically grounded?

  Yes

  No

  N/A

• Does tank have automatic inventory controls?

  Yes

  No

  N/A

• Does tank have overfill protection at dispensing point?

  Yes

  No

  N/A

• Does tank have spill containment?

  Yes

  No

  N/A

• Is tank double wall construction?<br>(Is yes skip dike)

  Yes

  No

  N/A

• Is tank diked?

  Yes

  No

  N/A

• Dike floor construction:

  Steel

  Asphalt

  Concrete

  Dirt

  Other

• Is dike drain closed?

  Yes

  No

  N/A

• Is dike empty?

  Yes

  No

  N/A

• Is there more than 1320 gallons of total Petro products stored in above ground tanks?<br>(If yes, need to comply with Sarah Tier II requirements)

  Yes

  No

  N/A

• If yes, is a spill Control & Countermeasure plan required? <br>(Only is petroleum exceeds 1320 gallons, and stored outdoors)

  Yes

  No

  N/A

• If SPCC plan required, is there a written plan in place?

  Yes

  No

  N/A

• Has plan been certified by management / signed by GM?

  Yes

  No

  N/A

• Certified by professional engineer?

  Yes

  No

  N/A

• Notification / Emergency contact list?

  Yes

  No

  N/A

• Inspection report on file?

  Yes

  No

  N/A

• Significant changes to SPCC plan?

  Yes

  No

  N/A

• Spill greater than 10 gallons within last year?

  Yes

  No

  N/A

• If plan has been implemented for more than 3 years, has the last review been done within the past 3 years?

  Yes

  No

  N/A

• Is the facility in compliance with the SPCC plan?

  Yes

  No

  N/A

• Action Required: