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ATTACHMENT B3 <br /> SPCC FIVE YEAR REVIEW AND EVALUATION <br /> I CLV/4IJ ,as the facility representative owner or operator,have reviewed the <br /> Facility SPCC Plan for any technical changes to the Plan that may require an amended plan to be <br /> reviewed and stamped by a Professional Engineer. <br /> Yes No <br /> • Have any new tanks,drums,or totes been added? ❑ �— <br /> • Have any tanks,drums, or totes been removed? ❑ ( <br /> • Have any tanks, drums,or totes been moved to a new location? ❑ <br /> • Has any tank, drum,or tote been repaired? ❑ <br /> • Has any secondary containment changed? ❑ <br /> • Have any overfill devices(gauges,alarms)changed? ❑ <br /> • Has the emergency contingency plan changed? ❑ <br /> • Are there any significant changes to any structures or operations? ❑ J ' <br /> If you checked"Yes" for any of these questions,your Plan may need to be reviewed/amended by a Professional Engineer. <br /> Please contact your KPA representative for assistance. <br /> PLAN AMENDMENT <br /> ❑ I will amend Plan <br /> RNo amendment is needed <br /> I have completed a review and evaluation of this Plan. Name and signature of person authorized to <br /> review Plan: <br /> Signature: <br /> Title: C ���✓ ' <br /> Date: <br /> PLEASE KEEP THIS SIGNED FORM WITH YOUR PE-STAMPED SPCC PLAN AT ALL TIMES <br /> AND STORE BOTH WITHIN THE YELLOW BOX <br /> Tracy Chevrolet SPCC Plan <br /> 08-14 <br />