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Clearwater Oil Company, Ltd.

Big Bear Lease No. 2 Production Facility

SAMPLE Spill Prevention, Control, and

Countermeasure (SPCC) Plan

APPENDIX C: Monthly Inspection Checklist

Further description and comments, if needed, should be provided on a separate sheet of paper and attached to this sheet. Any item answered “YES” needs to be promptly reported, repaired, or replaced, as it may result in non-compliance with regulatory requirements. Records are maintained with the SPCC Plan at the Ridgeview field office.

Date: _________________Signature: ____________________________

Yes

No

Description & Comments

(Note tank/equipment ID)

Storage tanks and Separation Equipment

Tank surfaces show signs of leakage

Tanks show signs of damage, rust, or deterioration

Bolts, rivets or seams are damaged

Aboveground tank supports are deteriorated or buckled

Aboveground tank foundations have eroded or settled

Gaskets are leaking

Level gauges or alarms are inoperative

Vents are obstructed

Thief hatch and vent valve does not seal air tight

Containment berm shows discoloration or stains

Berm is breached or eroded or has vegetation

Berm drainage valves are open/broken

Tank area clear of trash and vegetation

Equipment protectors, labels, or signs are missing

Piping/Flowlines and Related Equipment

Valve seals or gaskets are leaking.

Pipelines or supports are damaged or deteriorated.

Buried pipelines are exposed.

Transfer equipment

Loading/unloading lines are damaged or deteriorated.

Connections are not capped or blank-flanged

Secondary containment is damaged or stained

Response Kit Inventory

Discharge response material is missing or damaged or needs replacement

Additional Remarks (attach sheet as needed):

-X-

Version 1.0, 11/28/2005

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