Environmental Evaluation 1.1

• Client, Site and/ or Location:

• Date Conducted:

  Date

• Evaluated By:

• Facility Manager:

• Facility Location:
  Address

• Personnel Affiliated; if Applicable:

• Expectations of this audit is to ensure that the facility is operating with in the guidelines of the regulating agencies as well as the specifically assigned permits. The goal of completing this audit is to avoid any potential environmental impacts by enforcing the requirements set forth by Ecoserv and the regulating agencies.

DIVISION DETAILS

• Environmental Services Division – [Check which operation that is applicable]:

  Select Collection Operations Processing Operations Injection Operations NORM Injection Operations Industrial Disposal Facility Operations Permian Basin Operations

  • Collection Operations
  • Processing Operations
  • Injection Operations
  • NORM Injection Operations
  • Industrial Disposal Facility Operations
  • Permian Basin Operations

APPLICABLE REGULATORY

• Environmental Regulatory – [Click on all that apply]:

  Select Railroad Commission of Texas Spill Prevention Control, and Countermeasure Waste Management Operations Plan Louisiana Department of Natural Resources United States Coast Guard Louisiana Department of Environment Quality Texas Department of State Health Services United States Environmental Protection Agency Texas General Land Office

  • Railroad Commission of Texas
  • Spill Prevention Control, and Countermeasure
  • Waste Management Operations Plan
  • Louisiana Department of Natural Resources
  • United States Coast Guard
  • Louisiana Department of Environment Quality
  • Texas Department of State Health Services
  • United States Environmental Protection Agency
  • Texas General Land Office

• Reference Page #1

  

• Reference Page #2

  

• Reference Page #3

  

1.0 DOCUMENT VERIFICATION

• Is there an updated map of the facility

  Compliant

  Non-Compliant

  N/A

• Is there an Emergency Contact listing posted (i.e. Louisiana Emergency Contacts for LA Facilities & Texas Emergency Contacts for TX Facilities)

  Compliant

  Non-Compliant

  N/A

• Is the previous year's Tier II Report available.

  Compliant

  Non-Compliant

  N/A

• Is there an up to date SDS packet for products found on-site

  Compliant

  Non-Compliant

  N/A

• Is the facility permitted/regulated by Louisiana Department of Natural Resources

  Yes

  No

  N/A

• Are the following documents available:<br>- WMOP<br>- UIC 28 Manifest (3 years)<br>- Samples (30 days)<br>- Louisiana Emergency Contacts

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are missing

  Select WMOP UIC 28 Manifest (30) Days Samples (30) Days Louisiana Emergency Contacts

  • WMOP
  • UIC 28 Manifest (30) Days
  • Samples (30) Days
  • Louisiana Emergency Contacts

• Is this facility permitted/regulated by Louisiana Department of Environmental Quality

  Yes

  No

  N/A

• Which of the following are conducted at this facility

  Select Storm water/Sanitary Discharge D-Listed Area (i.e. Hazardous Waste Transfer, NORM Transfer/work, Non E&P Waste Transfer)

  • Storm water/Sanitary Discharge
  • D-Listed Area (i.e. Hazardous Waste Transfer, NORM Transfer/work, Non E&P Waste Transfer)

• Is the Stormwater/Sanitary Discharge Permit available

  Compliant

  Non-Compliant

  N/A

• Select which of the following operations are conducted on the D-Listed Area

  Select Hazardous Waste Transfer/Non E&P Non-Hazardous Waste Transfer NORM contaminated Waste/Equipment Transfer

  • Hazardous Waste Transfer/Non E&P Non-Hazardous Waste Transfer
  • NORM contaminated Waste/Equipment Transfer

• Are the following documents available: <br>- EPA ID Number <br>- D-Listed Area waste log (log of accepted and shipped)<br>- Waste Manifest from D-Listed Area (3 years- Copies)<br>- Training Records ( Advanced & Basic Hazardous Waste, Hazardous Waste Contingency Plan)<br>- LDR Notices (Hazardous waste requirement only)<br>- Regulatory Agency Inspection (EPA/LDEQ)<br>- Internal Facility Inspections (Weekly)<br>- Inspection Log (3 Years)<br>- Copy of Inspection Plan<br>- Emergency Coordinator List<br>- Contingency Plan<br>- List and Locations of Emergency Response Equipment<br>- Evacuation Plan

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select EPA ID Number D-Listed Waste Log (log of accepted and shipped) Waste Manifest (3 years- Copies) LDR Notices (Hazardous Waste Only- copies) Training Records (Advanced & Basic Hazardous Waste, Hazardous Waste Contingency Plan Regulatory Inspection records Internal Facility Inspections (Weekly) Emergency Coordinator List Contingency Plan List and Locations of Emergency Response Equipment Evacuation Plan Inspection Log (3 years) Copy of the Inspection Plan

  • EPA ID Number
  • D-Listed Waste Log (log of accepted and shipped)
  • Waste Manifest (3 years- Copies)
  • LDR Notices (Hazardous Waste Only- copies)
  • Training Records (Advanced & Basic Hazardous Waste, Hazardous Waste Contingency Plan
  • Regulatory Inspection records
  • Internal Facility Inspections (Weekly)
  • Emergency Coordinator List
  • Contingency Plan
  • List and Locations of Emergency Response Equipment
  • Evacuation Plan
  • Inspection Log (3 years)
  • Copy of the Inspection Plan

• Are the following documents available: <br>- NORM Manifest<br>- NORM Training (NORM Worker, RSO)<br>- Records of Transfer<br>- Inventory Log (Accepted, Shipped, Current)<br>- DRC- 3 Posting (CDF)<br>- LDEQ Radiological License (CDF)

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select NORM Manifest NORM Training (NORM Worker, RSO) Records of Transfer Inventory Log (Brought in, shipped, and current) DRC-3 Posting (CDF) LDEQ Radiological License (CDF)

  • NORM Manifest
  • NORM Training (NORM Worker, RSO)
  • Records of Transfer
  • Inventory Log (Brought in, shipped, and current)
  • DRC-3 Posting (CDF)
  • LDEQ Radiological License (CDF)

• Is the facility permitted/regulated by Texas Railroad Commission

  Yes

  No

  N/A

• Is there a permitted pit at this facility?

  Yes

  No

  N/A

• Are the following documents available:<br>- Pit Permit<br>- Pit Inspections

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select Pit Permit Pit Inspections

  • Pit Permit
  • Pit Inspections

• Do disposal operations occur at this facility?

  Yes

  No

  N/A

• Are the following documents available:<br>- Well Permits<br>- H-5 Reports

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select Well Permits H-5 Reports (Most Recent: 1 yr/ 5 yr)

  • Well Permits
  • H-5 Reports (Most Recent: 1 yr/ 5 yr)

• Is the facility permitted/regulated by Texas Commission on Environmental Quality

  Yes

  No

  N/A

• Which of the following does TCEQ regulate at this facility

  Select Stormwater Discharge Waste Processing and Disposal

  • Stormwater Discharge
  • Waste Processing and Disposal

• Are the following documents available:<br>- Permit Application<br>- Facility Permit (Solid Waste Permit)<br>- Well Permits<br>- Waste Analysis Plan<br>- Waste Manifest<br>- Waste Profiles<br>- Scale Certificate<br>- Safety Survey of Waste Management Units (Every day of month)<br>- Waste Analysis Plan <br>- Well Pressure Chart (Every day of month)<br>- Employee Training (SEMS)

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select Permit Application Facility Permit (Solid Waste Permit) Well Permits Waste Analysis Plan Waste Manifest Waste Profiles Scale Certificate Safety Survey of Waste Management Units (Every day of Month) Waste Acceptance Reports Well Pressure Charts (Every day of Month)

  • Permit Application
  • Facility Permit (Solid Waste Permit)
  • Well Permits
  • Waste Analysis Plan
  • Waste Manifest
  • Waste Profiles
  • Scale Certificate
  • Safety Survey of Waste Management Units (Every day of Month)
  • Waste Acceptance Reports
  • Well Pressure Charts (Every day of Month)

• Are the following documents available:<br>- Storm Water MSGP<br>- Storm Water Pollution Prevention Plan (SWPPP)<br> or<br>- No-Exposure Certificate (must have if above two are not available)<br>

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select Stormwater MSGP No-Exposure Certificate Stormwater Pollution Prevention Plan (SWPPP)

  • Stormwater MSGP
  • No-Exposure Certificate
  • Stormwater Pollution Prevention Plan (SWPPP)

• Is the facility permitted/regulated by Texas Department of State Health Services

  Yes

  No

  N/A

• Are the following documents available:<br>- TDSHS License<br>- Quarterly Reports<br>- Dosemitry Badge Reports<br>- Monthly Audits/Surveys<br>- Employee Training (SEMS)<br>- NORM Employee Awareness Posting<br>- Ambient Air Reports<br>- Past TDSHS Audits<br>- Gamma Spec Daily Response Checks (Big Hill only)

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select TDSHS License Quarterly Reports Dosemitry Badge Reports Monthly Audits/Surveys Employee Training Documents (NORM Worker, RSO) NORM Employee Awareness Posting Ambient Air Reports Past TDSHS Audits Gamma Spec Daily Response Check

  • TDSHS License
  • Quarterly Reports
  • Dosemitry Badge Reports
  • Monthly Audits/Surveys
  • Employee Training Documents (NORM Worker, RSO)
  • NORM Employee Awareness Posting
  • Ambient Air Reports
  • Past TDSHS Audits
  • Gamma Spec Daily Response Check

• Is the facility permitted/regulated by United States Coast Guard

  Yes

  No

  N/A

• Are the following documents available:<br>- Facility Operation Manual<br>- Facility Response Plan<br>- Tabletop Drill (3 years)<br>- OSRO Letters (3 years)<br>- Past Inspections<br>- PIC List<br>- PIC Training<br>- Quarterly Phone Drills (3 years)<br>- Declaration of Inspection (DoI)<br>- Transfer Hose Pressure Reports<br>- Site Diagram<br>- Spill Notification List<br>- Hose Log<br>

  Compliant

  Non-Compliant

  N/A

• Which of the following documents are not available

  Select Facility Operations Manual Facility Response Plan Tabletop Drill (3 years) OSRO Letters (3 years) Past Inspections (3 years) PIC List PIC Training Quarterly Phone Drills Declaration of Inspection (DoI) Transfer Hose Pressure Reports Site Diagram Spill Notification List/Emergency Contact List Hose Log

  • Facility Operations Manual
  • Facility Response Plan
  • Tabletop Drill (3 years)
  • OSRO Letters (3 years)
  • Past Inspections (3 years)
  • PIC List
  • PIC Training
  • Quarterly Phone Drills
  • Declaration of Inspection (DoI)
  • Transfer Hose Pressure Reports
  • Site Diagram
  • Spill Notification List/Emergency Contact List
  • Hose Log

• Are all items above up to date.

  Yes

  No

  N/A

• Is the facility permitted/regulated by the Environmental Protection Agency. (i.e. Oil or oily material onsite)

  Yes

  No

  N/A

• Is there an SPCC for the facility.

  Yes

  No

  N/A

• Is employee training up to date

  Compliant

  Non-Compliant

  N/A

• Are permanent ASTs (i.e. Water plant tanks, slurry tanks, waste storage tanks) in compliance with tank inspection program.

  Compliant

  Non-Compliant

  N/A

• Are equipment inspection sheets available.

  Yes

  No

  N/A
Equipment Inspection Sheets

• Were issues that were noted with equipment corrected

  Compliant

  Non-Compliant

  N/A

• Which piece of equipment is there an issue with.

• Coaching Comments and/or Category Recognition:

Sampling/Waste Screening

• Is sampling/waste screening equipment located on site

  Yes

  No

  N/A

• 

• 

• Which of the following sampling equipment can be found on site

  Select Retort Chloride test pH Flashpoint EC/Resistivity Meter Centrifuge LEL- 4 Gas Meters VOC- PID Meters Confirmation Analysis (Drager Tubes) NORM Screening Device (Ludlum Model 3/3000) NORM Confirmatory Device (Ludlum Model 2200) Scales Gamma Spec

  • Retort
  • Chloride test
  • pH
  • Flashpoint
  • EC/Resistivity Meter
  • Centrifuge
  • LEL- 4 Gas Meters
  • VOC- PID Meters
  • Confirmation Analysis (Drager Tubes)
  • NORM Screening Device (Ludlum Model 3/3000)
  • NORM Confirmatory Device (Ludlum Model 2200)
  • Scales
  • Gamma Spec

• Does sampling/screening equipment meet requirements of what the permit/regulatory agency require and what is required from the safety department (Employee Education, Protection, and Exposure Application).

  Compliant

  Non-Compliant

  N/A

• Which of the following required sampling/screening equipment, cannot be found at the site.

  Select Retort Chloride test pH Flashpoint EC/Resistivity Meter Centrifuge LEL- 4 Gas Meters VOC- PID Meters Confirmation Analysis (Drager Tubes) NORM Screening Device (Ludlum Model 3/3000) NORM Confirmatory Device (Ludlum Model 2200) Scales Gamma Spec

  • Retort
  • Chloride test
  • pH
  • Flashpoint
  • EC/Resistivity Meter
  • Centrifuge
  • LEL- 4 Gas Meters
  • VOC- PID Meters
  • Confirmation Analysis (Drager Tubes)
  • NORM Screening Device (Ludlum Model 3/3000)
  • NORM Confirmatory Device (Ludlum Model 2200)
  • Scales
  • Gamma Spec

• Where is the sampling/screening equipment stored

• Is all sampling/screening equipment properly maintained and stored (i.e. properly Calibrated, properly working, properly stored)

  Compliant

  Non-Compliant

  N/A

• Can calibration logs be verified

  Compliant

  Non-Compliant

  N/A

• Are any pieces of equipment being used passed it's calibration date.

  Compliant

  Non-Compliant

  N/A

• Which pieces of equipment are past the calibration date.

  Select Retort Chloride test pH Flashpoint EC/Resistivity Meter Centrifuge LEL- 4 Gas Meters VOC- PID Meters Confirmation Analysis (Drager Tubes) NORM Screening Device (Ludlum Model 3/3000) NORM Confirmatory Device (Ludlum Model 2200) Scales Gamma Spec

  • Retort
  • Chloride test
  • pH
  • Flashpoint
  • EC/Resistivity Meter
  • Centrifuge
  • LEL- 4 Gas Meters
  • VOC- PID Meters
  • Confirmation Analysis (Drager Tubes)
  • NORM Screening Device (Ludlum Model 3/3000)
  • NORM Confirmatory Device (Ludlum Model 2200)
  • Scales
  • Gamma Spec

Demonstration of sampling/screening procedure.

• Who demonstrated sampling/screening procedure; Name and Title.

• Was sampling/screening of waste demonstrated by qualified individual. (i.e. Knowledgeable on Sampling/screening)

  Compliant

  Non-Compliant

  N/A

• Was sampling/screening completed properly

  Compliant

  Non-Compliant

  N/A

• What problems were encountered?

• Add media

  Media

• Was waste properly collected in order to demonstrate a representative sample of the contents being collected. i.e.: homogeneous mixture; top, middle, and bottom.

  Compliant

  Non-Compliant

  N/A

• Which of the following equipment was used for this demonstration.

  Select Retort Chloride test pH Flashpoint EC/Resistivity Meter Centrifuge LEL- 4 Gas Meters VOC- PID Meters Confirmation Analysis (Drager Tubes) NORM Screening Device (Ludlum Model 3/3000) NORM Confirmatory Device (Ludlum Model 2200) Scales Gamma Spec

  • Retort
  • Chloride test
  • pH
  • Flashpoint
  • EC/Resistivity Meter
  • Centrifuge
  • LEL- 4 Gas Meters
  • VOC- PID Meters
  • Confirmation Analysis (Drager Tubes)
  • NORM Screening Device (Ludlum Model 3/3000)
  • NORM Confirmatory Device (Ludlum Model 2200)
  • Scales
  • Gamma Spec

• Was equipment used in sampling/screening demonstration used properly.

  Compliant

  Non-Compliant

  N/A

3.0 Observation

3.1 General Facility

• Is there a Muster Station with proper signage.

  Compliant

  Non-Compliant

  N/A

• Location:

• Is there a smoking area with proper signage.

  Compliant

  Non-Compliant

  N/A

• Location:

• Is there a "Transfer Communication System" used (i.e. Two Way Radio)

  Yes

  No

  N/A

• What type of system is being used

• Is the "Transfer Communication System" being used intrinsically safe (this is noted on the systems)

  Compliant

  Non-Compliant

  N/A

• Does the Facility Manager have the capability of being notified via this form of communication

  Yes

  No

  N/A

3.2 Facility Entrance

• Is there a sign(s) posted at the entrance of the facility

  Compliant

  Non-Compliant

  N/A

• Take picture of entrance- including all sign(s)

  Media

• What is the condition of the sign(s)

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Is there a lockable gate

  Compliant

  Non-Compliant

  N/A

• What is the condition of the gate and lock

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Is there a security fence or a barrier of entry located around the entire facility.

  Compliant

  Non-Compliant

  N/A

• What is the condition of the security fence or barrier of entry

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Add media

  Media

3.3 Facility Housekeeping

• Are there any spills/leaks or signs of spills/leaks. (soil/gravel stains)

  Compliant

  Non-Compliant

  N/A
Spills

• Spill Location/Description:

• Add media

  Media

• Is there permanent/portable Secondary Containment present at this facility

  Yes

  No

  N/A
Secondary Containment

• Location:

• What type of secondary containment is present

  Earthern Berm

  Man-made

• Is containment sufficient for total storage capacity

  Compliant

  Non-Compliant

  N/A

• What is the condition of the secondary containment

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Add media

  Media

• Is there any trash/junk located throughout the facility. (i.e.: Junk piles, trash on ground, overflowing trashcans, empty drums)

  Compliant

  Non-Compliant

  N/A
Trash/Junk

• Location/Description:

• Add media

  Media

• Are there spill kits located throughout the facility (i.e. oil absorbent)

  Yes

  No

  N/A

3.4 Facility Equipment

• Is there a washwater plant at this facility

  Yes

  No

  N/A

• Is the plant in good condition and properly functioning

  Compliant

  Non-Compliant

  N/A

• Are there any odors present

  Compliant

  Non-Compliant

  N/A

• Is there sufficient/adequate containment. Does the containment meet regulatory requirements (i.e.: 100 year flood, if required).

  Yes

  No

  N/A

• Are all AST's in good condition, no signs of age/wear and tear or leaks.

  Compliant

  Non-Compliant

  N/A

• Is there a transfer pit/tank present at this facility.

  Yes

  No

  N/A
Transfer pit/tank

• Is the "Pit Permit Number" posted, if applicable. (Required by RRC)

  Compliant

  Non-Compliant

  N/A

• Does the freeboard meet the requirement found in permit, if applicable.

  Compliant

  Non-Compliant

  N/A

• What is freeboard

• What condition is the truck ramp in, if applicable

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• What is the condition of the pit/tank

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Add media

  Media

• Is there a washrack/ cleaning slab present at this facility (i.e.: area where cleaning jobs occur)

  Yes

  No

  N/A

• What is the condition of the washrack/cleaning slab. (i.e.: cracks, not draining properly, releases outside of area)

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Add media

  Media

• Are there above ground storage tanks (ASTs) present at this facility

  Yes

  No

  N/A
ASTs

• Location/I.D. of ASTs

• What are the contents of the ASTs

• What is the condition of the ASTs

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Is there any signs of leaks or spills around ASTs

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Are there any portable tanks present at this facility (i.e. MPTs, Frac Tanks, Cutting boxes)

  Yes

  No

  N/A
Portable tanks

• Location of portable tanks

• What are the contents of the portable tanks

• Is there any signs of leaks or spills around portable tanks

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Is there mobile equipment present at this facility (i.e. Forklift, Cranes, Excavator)

  Yes

  No

  N/A
Mobile Equipment (i.e. Forklift, Cranes, Excavator)

• Mobile Equipment I.D. (i.e. Forklift, Crane, Excavator)

• Is there any visible signs of faulty, leaking, or damaged parts (i.e. damaged hydraulic hose, oil leak, leaking seal)

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Add media

  Media

• Is there permanent lighting at this facility

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Is work conducted during non-daylight hours

  Compliant

  Non-Compliant

  N/A

• Do the lights put off sufficient illumination

  Compliant

  Non-Compliant

  N/A

• What is the condition of the lighting

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

3.5 Dockside Facility (USCG regulated)

• Is this a dockside facility (USCG regulated)

  Yes

  No

  N/A

• Are there warning signs on the dock

  Compliant

  Non-Compliant

  N/A

• Total number on dock

• Do they face Downstream and Upstream

  Compliant

  Non-Compliant

  N/A

• Do they face Seaward and Landward

  Compliant

  Non-Compliant

  N/A

• Are the signs in good condition

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Are there Fire Extinguishers on the dock

  Compliant

  Non-Compliant

  N/A

• Total number on dock

• Are the extinguishers in good condition

  Compliant

  Non-Compliant

  N/A

• Are the extinguishers fully charged

  Compliant

  Non-Compliant

  N/A

• When were the extinguishers last inspected

  Date

• Is there proper signage indicating location of extinguishers

  Yes

  No

  N/A

• Are the extinguishers properly mounted

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Are there Life Rings on the dock

  Compliant

  Non-Compliant

  N/A

• Total number on the dock

• Is there retrieval rope on all Life Rings

  Compliant

  Non-Compliant

  N/A

• Are the Life Rings mounted properly (i.e. on rack with retrieval rope properly coiled)

  Compliant

  Non-Compliant

  N/A

• Are the Life Rings in good condition

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Are there Work Vest located on the dock

  Compliant

  Non-Compliant

  N/A

• Total number of Work Vest

• Are the Work Vest in good condition.

  Yes

  No

  N/A

3.6 Transfer Hoses/Transfer piping (i.e. Hoses used to transfer waste)

• Are there transfer hoses/Transfer piping present at this facility

  Yes

  No

  N/A
Transfer Hoses

• Hose I.D./Location

Hose Markings

• is there a Hose Marking indicating OIL SERVICE

  Compliant

  Non-Compliant

  N/A

• Is there a Hose Marking stating the "Maximum Allowable Working Pressure" (MAWP)

  Compliant

  Non-Compliant

  N/A

• Is there a Hose Marking idicating the "Hose I.D." (Hose I.D. should match information in hose log book)

  Compliant

  Non-Compliant

  N/A

Hose Defects (i.e. Wear and Tear of hoses)

• Is the hosed mashed

  Compliant

  Non-Compliant

  N/A

• Are there any cuts

  Compliant

  Non-Compliant

  N/A

• Are there any kinks

  Compliant

  Non-Compliant

  N/A

• Does the hose show any signs of peeling/deteriorating

  Compliant

  Non-Compliant

  N/A

Spill Control

• Are all connections properly secured (i.e. Camlocks secured with pins, diapered)

  Compliant

  Non-Compliant

  N/A

• If not being used are ends properly capped (i.e. Camlocks secured with pins, diapered)

  Compliant

  Non-Compliant

  N/A

• Drip pans placed under connections

  Compliant

  Non-Compliant

  N/A

• Is drip pan empty of any fluids and clean

  Compliant

  Non-Compliant

  N/A

• Add media

  Media
Transfer Piping

• Pipe I.D./Location:

• What is condition of the piping

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Do all flanges, have sufficient number of bolts

  Compliant

  Non-Compliant

  N/A

• Are Nuts and Bolts in good condition

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Add media

  Media

3.7 Over the top transfers

• Are over the top transfers being conducted at this facility

  Yes

  No

  N/A

• Does the Transfer Manifold Equipment being used meet the requirements of the SOP "Marine Liquid Bulk Transfer Procedure" Section D

  Compliant

  Non-Compliant

  N/A

• Do the hoses being used meet the requirements of the SOP "Marine Liquid Bulk Transfer Procedure" Section E.

  Compliant

  Non-Compliant

  N/A

• Do the hoses connections being used meet the requirements of the SOP "Marine Liquid Bulk Transfer Procedure" Section F

  Compliant

  Non-Compliant

  N/A

• Does the Grounding/Bonding mechanisms being used meet the requirements of the SOP "Marine Liquid Bulk Transfer Procedure" Section G

  Compliant

  Non-Compliant

  N/A

3.8 Hopper Barges

• Are Hopper Barges present at this facility.

  Yes

  No

  N/A
Hopper Barges

• Barge Name:

• Number of mooring lines

• Condition of lines

  Compliant

  Non-Compliant

  N/A

• Percent loading

  25%

  50%

  75%

  100%

• Is an oil sheen present

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Are the following documents available:<br>- Vessel Response Plan/USCG Letter<br>- Stability Letter<br>- Certification of Financial Responsibility <br>- COI <br>- USCG Documents:<br> o Interim Period to Operate<br> o Security Exemption<br>- Manifest (If in transit/fleet area; or has been transited)<br>

  Compliant

  Non-Compliant

  N/A

• Select which of the following documents can not be found in the barge

  Select Vessel Response Plan/ USCG Letter Stability Letter Certificate of Financial Responsibility (Barge Specific) CoI COD USCG Document: Interim Period to Operate USCG Document: Security Exemption Manifest (If in transit/fleet area; or has been transitted)

  • Vessel Response Plan/ USCG Letter
  • Stability Letter
  • Certificate of Financial Responsibility (Barge Specific)
  • CoI
  • COD
  • USCG Document: Interim Period to Operate
  • USCG Document: Security Exemption
  • Manifest (If in transit/fleet area; or has been transitted)

• Are all documents up to date (i.e. not expired)

  Compliant

  Non-Compliant

  N/A

• If free oil is present, is the oil being skimmed prior to navigation

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Does the oil skimming operations being conducted meet the requirements of the SOP "Marine Liquid Bulk Transfer Procedure" Section J

  Compliant

  Non-Compliant

  N/A

3.9 Disposal Wells

• Are there disposal wells located at this facility

  Yes

  No

  N/A
Disposal Wells

• Well Number:

• Is there a sign located at the well head

  Compliant

  Non-Compliant

  N/A

• Can the following information be found on the well sign:<br>- Operator (Ecoserv)<br>- Lease Name <br>- Lease Number<br>- Well Number<br>- Well Permit Number

  Compliant

  Non-Compliant

  N/A

• Select the following information that can not be found on the well sign

  Select Operator Well Number Lease Number Lease Name Well Permit Number

  • Operator
  • Well Number
  • Lease Number
  • Lease Name
  • Well Permit Number

• Is the sign legible

  Compliant

  Non-Compliant

  N/A

• Is the sign big enough

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Is this well currently being used for disposal

  Yes

  No

  N/A

• Is the well's pressure within the permitted limits set in disposal permit

  Compliant

  Non-Compliant

  N/A

• Is there a pressure gauge on the well head

  Compliant

  Non-Compliant

  N/A

• Is the gauge working

  Compliant

  Non-Compliant

  N/A

• Can the pressure gauge be read

  Compliant

  Non-Compliant

  N/A

• Is there a pressure observation valve on the tubing and for each annulus

  Compliant

  Non-Compliant

  N/A

• Is the wellhead in good condition

  NEEDS IMPROVEMENT

  MEETS EXPECTATIONS

  EXCEEDS EXPECTATIONS

  Non-Applicable

• Was an H-5/MIT completed on this well within the last year, or if applicable (Fannett only) 5 years

  Compliant

  Non-Compliant

  N/A

• Is there any signs of releases around the wellhead

  Compliant

  Non-Compliant

  N/A

3.10 D-Listed Area

• Does this facility have a "D-Listed" Area (i.e. Areas of the dock non-LDNR permitted)

  Yes

  No

  N/A

• Are there items/waste present in the D-Listed area

  Compliant

  Non-Compliant

  N/A

• Do the items found on the Inventory log of the D-listed area match what is located on the site.

  Compliant

  Non-Compliant

  N/A

• Are containers within storage limits (i.e. Hazardous Waste: Manifested Offshore- 10 days/ Classified onshore- 90 days; All other waste: 90 days (Ecoserv Policy)

  Compliant

  Non-Compliant

  N/A
Waste Containers being used

• Are Waste Containers closed

  Compliant

  Non-Compliant

  N/A

• Are containers in good condition

  Compliant

  Non-Compliant

  N/A

• Are containers leaking or show evidence of a leak

  Compliant

  Non-Compliant

  N/A

• If applicable, is the container stored in adequate secondary containment

  Compliant

  Non-Compliant

  N/A

• Are containers marked with accumulation start date (i.e. Date accepted on Ecoserv's facility)

  Compliant

  Non-Compliant

  N/A

• Are containers labeled with contents

  Compliant

  Non-Compliant

  N/A

• If applicable, is the container marked with "Hazardous Waste"

  Compliant

  Non-Compliant

  N/A

• If applicable, are ignitable Hazardous Waste stored >50 feet from the property line

  Compliant

  Non-Compliant

  N/A

• Are containers DOT approved

  Compliant

  Non-Compliant

  N/A

• Is there appropriate aisle space between containers being stored (i.e. Enough room to navigate to each container if necessary)

  Compliant

  Non-Compliant

  N/A

• Is there a water source near by with sufficient flow rate and pressure

  Compliant

  Non-Compliant

  N/A

• What is the source

• Is facility security system adequate to minimize unauthorized entry

  Compliant

  Non-Compliant

  N/A

• Is an Emergency Number Posted

  Compliant

  Non-Compliant

  N/A

• Are "NO SMOKING" signs posed in the area

  Compliant

  Non-Compliant

  N/A

• Is "No Unauthorized Entry" sign posted

  Yes

  No

  N/A

• Is a "Hazardous Waste" sign posted, if applicable (i.e. if hazardous waste is present)

  Compliant

  Non-Compliant

  N/A

• Are signs posted and legible for 25 feet

  Compliant

  Non-Compliant

  N/A

• Are there spill kits located throughout the D-Listed area (i.e. oil absorbent)

  Compliant

  Non-Compliant

  N/A

4.0 COMMENTS

EVALUATOR ACKNOWLEDGMENT

• Name of (PIC) Person In Charge:

• (PIC) Person In Charge Signature:

  Sign

• Name of Reviewer/ Evaluator:

• Evaluator Signature:

  Sign

• Date:

  Date