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ATTACHMENT D: TIER II QUALIFIED FACILITY CHECKLIST TIER 11 QUALIFIED FACILITY PLAN REQUIREMENTS—40 CFR 112.6(b) 112.6(b)(1) Pian Certification; Owner/operator certified in the Plan that: DYes DNo (i) He or she is famiii ar with the requirements of 40 CFR part 112 El Yes DNo DNA (ii) He or she has visited and examined the facility's QYes DNo DNA (iii) The Plan has been prepared in accordance with accepted and sound industry practices and DYes QNo DNA standards and with the requirements of this part (iv) Procedures for required inspections and testing have been established QYes DNo DNA (v) He or she will fully implement the Plan DYes El No DNA (vi) The facility meets the qualification criteria set forth under§112.3(g)(2) QYes [:]No DNA (vii) The Plan does not deviate from any requirements as allowed by§§112.7(a)(2) and 112.7(d), DYes [:]No DNA except as described under§112.6(b)(3)(i)or(ii) (viii) The Plan and individual(s) responsible for implementing the Plan have the full approval of QYes DNo DNA management and the facility owner or operator bas committed the necessary resources to fully implement the Plan. 112.6(b)(2) Technical Amendments: The owner/operator self-certified the Plan's technical amendments QYes 0 No ONA for a change in facility design, construction, operation, or maintenance that affected potential for a§112.1(b)discharge If YES • Certification of technical amendments is in accordance with the self-certification DYes D No DNA provisions of§112.6 b 1 . (i) A PE certified a portion of the Plan(i.e., Plan is informally referred to as a hybrid Plan) [7]Yes QNo DNA If YES The PE also certified technical amendments that affect the PE certified portion of the ©Yes D No DNA Plan as required under§112.6 b 4 ii (ii) The aggregate aboveground oil storage capacity increased to more than 10,000 U.S. gallons DYes ®No DNA as a result of the chanple If YES The facility no longer meets the Tier It qualiFying because it exceeds 10,000 U S. gallons in aggregate aboveground storage capacity. The - The ownerloperator prepared and implemented a Plan within 6 months following the change QYes No ©NA and had it certified by a PE under§112.3(d) 112.6(b)(3) Plan Deviations: Does the Plan include environmentally equivalent alternative methods or DYes No DNA impracticability determinations for secondary containment? If YES Identify the alternatives in the hybrid Pian: • Environmental equivalent alternative method(s) allowed under§112.7(a)(2); QYes D Nc DNA • Impracticability determination under§112.7(d) DYes QNo DNA 112.6(b)(4) . For each environmentally equivalent measure,the Plan is accompanied by a written E]Yes DNo DNA statement by the PE that describes:the reason for nonconformance,the alternative measure, and how it offers equivalent environmental protection in accordance with §112.7(a)(2); • For each secondary containment impracticability determination, the Plan explains the []Yes [:]No DNA reason for the impracticability determination and provides the alternative measures to secondary containment required in§112,7(d) AND (i) PE certifies in the Plan that: (A) Helshe is familiar with the requirements of 40 CFR Part 112 DYes D No DNA (B) He/she or a representative agent has visited and examined the facility DYes D No DNA (C) The alternative method of environmental equivalence in accordance with§112.7(a)(2)or the DYes F-1No DNA determination of impracticability and alternative measures in accordance with§112.7(d) is consistent with good engineering practice, including consideration of applicable industry standards, and with the requirements of 40 CFR Part 112. Comments: "Note that only the person certifying the Plan can make the site visit Onshore Facilities(Excluding Oil Production) Page D-9 of 2 June 2014