Title Page

  • Site conducted

  • Site / Business name

  • Conducted on

  • Inspecting officer

Site Details

Business & Contacts

  • Site / Business name

  • Site address
  • Person Responsible name

  • Person Responsible phone

  • Person Responsible email

  • Site owner name

  • Site owner phone

  • Site owner email

  • Nature of lease / responsibility for site & UPSS

  • Provide details

UPSS Operation

  • Does an Exemption Order apply?

  • Provide details:

  • Total annual fuel sales (litres)

  • Is the site located in a Vapour Recovery Region?<br>https://www.epa.nsw.gov.au/your-environment/air/reducing-motor-vehicle-emissions/vapour-recovery-service-stations

  • Is there a Vapour Recovery System in place?

  • VR1

  • VR2

  • VR1 = captures vapour from storage tanks when a tanker delivers petrol to the service station
    VR2 = captures vapour at the bowser while a motorist refuels

  • All UPSS operators inside the Vapour Recovery Regions must have a system installed.

  • Tank information available?

  • If a tank contains multiple compartments, record each compartment as a separate tank.

  • Tank
  • Year tank was commissioned

  • Construction material(s)

  • Product contained

  • Volume (litres)

  • Operational status

  • Provide details

  • All UPSS operators are required to have this information available.

SECTION A: Fuel System Operation Plan (FSOP) or equivalent

  • Does the site have an FSOP?

  • Location

  • The FSOP is required to be located onsite.

  • Does the FSOP exist as separate documents?

  • What format is the FSOP in?

Fuel System Operation Plan (FSOP) - Contents

  • Does the FSOP contain business and contact details?

  • The FSOP must have this element.

  • Does the FSOP contain site security and access information?

  • The FSOP must have this element.

  • Does the FSOP have contact details for the Person Responsible for the UPSS?

  • The FSOP must have this element.

  • Does the FSOP indicate modification and monitoring records and their locations?

  • The FSOP must have this element.

  • Does the FSOP contain design standards / industry specifications?

  • The FSOP must have this element.

  • Does the FSOP contain details of the Loss Monitoring System?

  • The FSOP must have this element.

  • Are loss monitoring reports included in the FSOP?

  • The FSOP must have this element.

  • Does the FSOP contain an Incident Management Procedure?

  • The FSOP must have this element.

  • Does the FSOP contain details of the maintenance schedule?

  • The FSOP must have this element.

  • Does the FSOP contain plans / 'as-built' drawings of each UPSS?

  • The FSOP must have this element.

  • Does the FSOP contain details of employee induction and incident management training?

  • The FSOP must have this element.

  • All UPSS operators are required to have an FSOP.

SECTION B: Loss Monitoring System

  • Is there a Loss Monitoring System in place?

  • All UPSS operators must have a Loss Monitoring System in place.

  • What type of Loss Monitoring System is it ?

  • Provide details

  • Are loss monitoring reports generated at least monthly?

  • All UPSS operators are required to generate loss monitoring reports at least monthly.

  • Is the Loss Monitoring System certified to detect a release of 0.76 L/hr of fuel?

  • All Loss Monitoring Systems must meet this requirement.

  • Does the Loss Monitoring System cover all tanks?

  • The Loss Monitoring System must cover all installed tanks.

  • Are discrepancies in litres delivered vs. litres sold investigated?

  • All discrepancies must have evidence of further investigation as soon they are as identified.

SECTION C: Leak Detection System

  • Is there a Leak Detection System in place?

  • What type of Leak Detection System is it?

Groundwater wells

  • Number of wells installed

  • Is the installation report accessible onsite?

  • The groundwater well installation report must be accessible.

  • Is the testing procedure accessible onsite?

  • The Leak Detection System testing procedure must be accessible.

  • Are groundwater monitoring results accessible onsite?

  • The groundwater well monitoring results must be accessible.

  • Are the groundwater wells tested every 6 months?

  • Groundwater wells must be tested every 6 months.

Alternative system

  • Provide details

  • Is the system designed by a duly qualified person?

  • Alternative Leak Detection Systems must be designed by a duly qualified person.

  • Is the testing procedure accessible onsite?

  • The Leak Detection System testing procedure must be accessible.

  • All UPPS operators must have a Leak Detection System in place.

SECTION D: Incident Management Procedure

  • Is the Incident Management Procedure outlined in the Fuel System Operation Plan in place?

  • All UPSS operators must have an Incident Management Procedure in place.

  • Is an incidents log kept in the Fuel System Operation Plan?

  • An incidents log must be kept in the Fuel System Operation Plan

  • Are there steps in the Incident Management Procedure to mitigate spills / leaks?

  • Incident Management Procedure must outline steps to mitigate spills and leaks.

SECTION E: Maintenance schedule

  • Is there a schedule in place showing system maintenance? Such as fill points, sump pumps, gauges, sensors and other UPSS system and measuring instruments.

  • Contains maintenance actions?

  • This maintenance schedule must have this element.

  • Contains frequency of maintenance?

  • This maintenance schedule must have this element.

  • Contains location of maintenance records

  • This maintenance schedule must have this element.

  • All UPSS operators are required to have a maintenance schedule in place.

Comments, areas for action / improvement

  • undefined

Other environmental management issues

  • This page contains industry best practices, but are not requirements. See Practice Note: Managing run-off from service station forecourts
    https://www.epa.nsw.gov.au/-/media/epa/corporate-site/resources/contaminated-land/19p1681-practice-note-managing-run-off-from-service-station-forecourts.pdf?la=en&hash=9F0379C61DBE440562881E23D707BE7F3732DA70

SECTION F: Forecourt design operation and maintenance

  • Are stormwater drains free of pollution?

  • Are stormwater drains protected from spills?

  • Is the forecourt area sealed and free from cracks?

  • Does the forecourt area have a canopy with overhang?

  • Is the forecourt area bunded for collecting surface runoff?

  • Is there an oil / water separator? (or alternative)

  • Is the oil / water separator appropriately maintained?

  • Is there a trade waste agreement / permit?

  • Is wastewater discharged to the sewer?

  • Is wastewater treated prior to discharge?

  • What alternative discharge option is used?

  • Provide details

  • Is waste stored in a way to prevent a pollution incident?

  • Are licensed waste contractors used, or are planned to be used to dispose of spill and leak waste?

SECTION G: Spill response and chemical storage

  • Is a spill kit present, accessible, and adequately stocked?

  • Is the spill kit regularly checked and refilled?

  • Are sweep / vacuum / absorbent materials used to clean small spills and surface areas?

  • Is there an up-to-date register of chemicals used and stored on the site?

  • Are there relevant Material Safety Data Sheets on the site?

  • Are employees aware of who to contact in the event of a spill?

  • Are employees trained in spill clean up procedures?

Comments, areas for action / improvement

  • undefined

Inspection Outcome

  • Inspection Outcome

  • Enforcement Action

  • Name of Person Interviewed

  • Signature of Person Interviewed

  • Name of Authorised Officer

  • Signature of Authorised Officer

  • Inspection completion time

Information Page

  • Links to EPA Website/Legislation

  • https://www.epa.nsw.gov.au/your-environment/contaminated-land/upss

  • https://www.epa.nsw.gov.au/your-environment/contaminated-land/upss/resources-for-implementing-upss

  • https://www.epa.nsw.gov.au/-/media/epa/corporate-site/resources/clm/19p2015-fact-sheet-5-upss-obligations.pdf?la=en&hash=BCBE6980100A6B07B6DE9F504D9B9A07BDC18583

  • https://www.epa.nsw.gov.au/your-environment/contaminated-land/upss/fuel-system-operation-plans

  • https://legislation.nsw.gov.au/view/html/inforce/current/act-1997-140#sec.60

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