COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

�J Facility Name: Facility Address: FRP ID No.: NI Applicability of Substantial Harm Criteria Does the facility transfer oil over -water' to or from vessels and does the facility have a total oil storage capacity greater than or equal to 4 2,000 gallons? Yes FNo] Does the facility have a total oil storage capacity greater than or equal to 1 million gallons and, within any storage area, does the facility lack secondary containment2 that is sufficiently large to contain the capacity of the largest aboveground oil storage tank plus sufficient freeboard to allow for precipitation? -7] Yes FNo Does the facility have a total oil storage capacity greater than or equal to 1 million gallons and is the facility located at a distance Z (as calculated using the appropriate formula in Appendix C or a comparable formula) such that a discharge from the acility could cause injury to fish and wildlife and sensitive environmentsZ? Yes F`9 Does the facility have a otal oil storage capacity greater than or equal to 1 million gallons and is the facility located at a distance (as alculated using the appropriate formula in Appendix C or a comparable formula) such that discharge from the facility would shutdown a public drinking water intakeZ? 'i'es Does the facility have a tal oil storage capacity ty [greler than or equal to 1 million gallons and has the facility experienced a reportable Oil spillZ in an amount greater than or equal to 10,000 gallons within the last 5 years? Yes 71 CERTIFICATION I certify under p nalty of law that I have personally examined and am familiar with the information submitted in this document, and that based on my inquiry of those individuals responsible for obtaining information, I believe that the submitted information is true, accurate, and complete. - - - r---�- -Z,4-- /I - -- -- - - - -- _ _ - -- -- - Sigrlatu#e Date Field Name (Please type or print) Title: ' Explanations of the above -referenced terms can be found in Appendix C to this part. If a comparable formula to the ones contained in Attachment C -III is use I to establish the appropriate distance to fish and wildlife and sensitive environments or public drinking water intakes, documentation of the reliability and analytical soundness of the formula must be attached to this form. z For further description df fish and wildlife and sensitive environments, see Appendices 1, II, and III to DOC/NOAA's "Guidance for Facility and Vessel Res once Plans: Fish and Wildlife and Sensitive Environments" (59 FR 14713, March 29, 1994) and the applicable ACP.