9-4762-14 SMALL REMOTE SERVICE STATION SAFETY AUDITS

• PCBU Trading Name:

• Location
  Address

• PCBU Registered Name:

• ABN:

• PCBU's Representative:

• Contact Phone Number:

• Email Address:

• Workers Representative:

• Conducted on

  Date

• Inspection Conducted By:

Manifest Quantities of Hazardous Chemicals

• 1. Is there a manifest quantity of hazardous chemicals on site? WHS Regulation 2011, Schedule 11

  Yes

  No

• Category & Quantity

  Select Category 1 flammable gases (i.e. LPG, Acetylene) in excess of5,000 litres Category 2 flammable liquids (i.e. Petrol, Acetone, Metho) in excess of 2500 litres Category 3 flammable liquids (i.e. Kerosene) in excess of 10,000 litres Category 4 flammable liquids (i.e. Diesel) in excess of 100,000 litres Combined quantity of category 1,2,3 flammable liquids in escess of 10,000 litres

  • Category 1 flammable gases (i.e. LPG, Acetylene) in excess of5,000 litres
  • Category 2 flammable liquids (i.e. Petrol, Acetone, Metho) in excess of 2500 litres
  • Category 3 flammable liquids (i.e. Kerosene) in excess of 10,000 litres
  • Category 4 flammable liquids (i.e. Diesel) in excess of 100,000 litres
  • Combined quantity of category 1,2,3 flammable liquids in escess of 10,000 litres

Manifest of Hazardous Chemicals

• 2. Has the PCBU prepared a manifest? WHS Regulation 2011, Clause 347(1)(a)

  Yes

  No

  Not Applicable

• Action / Notice / Comments

• 2a. Does the manifest contain all the required information? WHS Regulation 2011, Schedule 12. <br>Refer to Appendix 1

  Yes

  No

• Action / Notice / Comments

• Refer to Appendix 1

• 2b. Is the information up to date? (i.e. correct PCBU, fuel quantities, site plan) WHS Regulation 2011, Clause 347 (1)(b)

  Yes

  No

• Action / Notice / Comments

• 2c. Is a copy of the manifest kept in an Emergency Services Information Cabinet (ESIC / Manifest box at or near the service stations entrance OR another position agreed to by Fire & Rescue (FR) NSW? WHS Regulation 2011, Clause 347 (3)(a)

  Yes

  No

• Action / Notice / Comments

• 2d. Is the manifest readily available to emergency services? WHS Regulation 2011, Clause (3)(c)

  Yes

  No

• Action / Notice / Comments

• 2e. Is it fitted with a 003 emergency services lock?<br>

  Yes

  No

• Comments:

Notification to the Regulator

• 3. Has the PCBU notified SafeWork NSW? WHS Regulation 2011, Clause 348

  Yes

  No

• Action / Notice / Comments

• 3a. Does the PCBU have an acknowledgement letter from SafeWork? Refer to Appendix 2<br>

  Yes

  No

• Action / Notice / Comments

• NDG No:

• 3b. Are the acknowledgement letter & manifest consistent? i.e. Same PCBU, fuel quantities, address.<br>

  Yes

  No

• Comments:

• 3c. Is the information in the acknowledgement letter up to date? i.e. Current PCBU, correct fuel quantities.<br><br>

  Yes

  No

• Comment:

• 3d. Is the acknowledgement letter and manifest consistent with the work site?

  Yes

  No

  N/A

• Comment:

Emergency Plans

• 4. Has the PCBU prepared & implemented an emergency plan? WHS Regulation 2011, Clauses 43(1) and 360.

  Yes

  No

• Comments:

• 4a. Does the plan contain the required information? WHS Regulation 2011, Clause 43(1)

  Yes

  No

• Comments:

• 4b. Has a copy of the emergency plan been sent to Fire & Rescue NSW? WHS Regulation 2011, Clause 361(2)

  Yes

  No

• Comments:

• 4c.Does the PCBU have an acknowledgement from Fire & Rescue NSW?

  Yes

  No

  N/A

• 4d. Has Fire & Rescue NSW recommended amendments to emergency plan? WHS Regulation 2011, Clause 361(3)

  Yes

  No

• 4e. Have those recommendations been implemented? WHS Regulation 2011, Clause 361(3)<br>

  Yes

  No

• Comments:

• 4f. Are worker/s trained & / or competent to initiate emergency plan? WHS Regulation 2011, Clause 43(c)<br>

  Yes

  No

• Comments:

• 4g. Are emergency drills carried out? WHS Regulation 2011, Clause 43(b)

  Yes

  No

• Comments:

Hazardous Chemicals Register

• 5. Is there an up to date Hazardous Chemical Register on site? WHS Regulation 2011, Clause 346

  Yes

  No

• Comments:

• 5a. Is it readily accessible? WHS Regulation 2011, Clause 346(2)

  Yes

  No

• Comments:

• 5b. Does the PCBU have all the required Safety Data Sheets? WHS Regulation 2011, Clause 344(1)

  Yes

  No

• Comments:

• 5c. Are they in an easily identifiable & readily accessible location? WHS Regulation 2011, Clause 344(3)

  Yes

  No

• Comments:

• 5d. Are they up to date & in the correct format? WHS Regulation 2011, Clause 330(3) & Schedule 7.

  Yes

  No

• Comments:

• 5e. Have they been reviewed by the PCBU?

  Yes

  No

• Comments:

Consultation at Work

• 6. Does the PCBU have a consultative process in place?

  Yes

  No

• Please provide comment:

First Aid

• 7a. Is the required first aid equipment on site? WHS Regulation 2011, Clause 42(1)<br>

  Yes

  No

• Comments:

• 7b. Is there an adequate number of workers trained to administer first aid? WHS Regulation 2011, Clause 42(2)

  Yes

  No

• Comments:

Workers Compensation & Return to Work

• 8a. Do the PCBU have a Workers Compensation Policy? Workers Compensation Act s155

  Yes

  No

• Comments:

• 8b. Is there an Injury Register on site? WIMWC Act S63

  Yes

  No

• Comments:

• 8c. Does the PCBU have a Return to Work Program? WIMWC Act S52

  Yes

  No

• Comments:

• 8d. Summary of WIMWC Act displayed & policy details available to workers (If you get injured at work poster) WIMWC Act S231 (Refer appendix: 5)<br>

  Yes

  No

• Comments:

• Manifest Checklist only
  WHS Regulation 2011 Clause 347 Manifest of hazardous chemicals
  WHS Regulation 2011 Clause 347(2) A manifest of Schedule, hazardous chemicals must comply with Schedule 12.
  Schedule 12 (7) Manifest - plan of workplace
  

• Does the manifest contain a plan of the workplace?<br>

  Yes

  No

• Is the plan to scale?<br><br>

  Yes

  No

• Does the plan show True North?

  Yes

  No

• Does the plan show location and ID No./code/description of bulk storage areas not in containers (e.g. stockpiles)?

  Yes

  No

• This item is most likely required for a service station.

• Does the plan show location and ID No./code/description of bulk containers (e.g. tanks and vessels)?

  Yes

  No

• Does the plan show location and ID No./code/description of package and Intermediate Bulk Containers (IBC) storage areas?

  Yes

  No

• This item is most likely required for a service station.

• Does the plan show location and ID No./code/description of manufacturing areas?

  Yes

  No

• This item is most likely required for a service station.

• Does the plan show location and ID No./code/description of in transit areas?

  Yes

  No

• This item is most likely required for a service station.

• Does the plan show legend for identification numbers or codes used in the plan?

  Yes

  No

• Does the plan show the main entrance and other entry and exit points to the workplace?

  Yes

  No

• Does the plan show essential site services including fire services or gas supply?

  Yes

  No

• Does the plan show location of isolation points for fuel and power?

  Yes

  No

• Does the plan show location of all drains?

  Yes

  No

• Does the plan show location of the manifest?

  Yes

  No

• Does the plan show description of the nature of the occupancy of adjoining sites or premises?

  Yes

  No

• Advisory Only - Is the plan laminated?

  Yes

  No

• Advisory Only - Is plan A3 in size?

  Yes

  No

• Additional Information:

• Example SafeWork NSW Acknowledgement Letter Page 1 of 3

  

• Example SafeWork NSW Acknowledgement Letter Page 2 of 3

  

• Example SafeWork NSW Acknowledgement Letter Page 3 of 3

  

• Manifest Requirements:
  Clause 347 WHS Regulation 2011 requires a PCBU that has manifest quantity of schedule 11 Hazardous Chemicals on site to prepare a manifest in accordance with schedule 12 & Keep it in a place determined in agreement with the primary emergency service organisation (NSW Fire & Rescue)

• References:
  WHS Regulation 2011:
  Clause 437 Manifest Requirements;
  Schedule 11; and
  Schedule 12

• NSW Fire & Rescue
  1. NSW Fire & Rescue recommend that PCBUs keep a copy of their manifest
  a. in a prominently labeled weather proof red Emergency Services Information Cabinet (ESIC) / Manifest Box (See example)
  b. Fitted with a 003 Emergency Service lock
  c. at or near the sites main entrance/s
  2. If this is done it the manifest is deemed to be kept in a place determined in agreement with the primary emergency service.
  3. However if a PCBU wishes to keep the manifest anywhere else agreement must be sought.
  
  Note this agreement is to Fire & Rescue NSW not the local brigade
  
  

• Example
  Emergency Services Information Cabinet (ESIC) / Manifest Box
  
  

  

• Note: The outer warning placards (WHSR 349)are not required at retail fuel outlets (Service Stations)
  

  

• Any Additional Information:

• References:
  WHS Regulation 2011, Clause 359
  AS/NZS 1851 Routine service of fire protection systems and equipment
  AS 2444 Portable Fire Extinguishers & Fire Blankets Selection & Location
  
  

• 
  

  

• 

• Selection (type & size) & location of fire extinguishers determined by a competent person?<br>

  Yes

  No

• Evidence of routine servicing of fire extinguisher being undertaken by a competent person?<br>

  Yes

  No

• Service records kept on site? WHSR Cl 359(1)(d) Fire protection and firefighting equipment?<br>

  Yes

  No

• Maintenance tags indicate the appropriate services have been undertaken?<br>

  Yes

  No

• Maintenance tags punched within the last 6 months? AS/NZS 1851 (S1.11).<br>

  Yes

  No

• Extinguishers clearly visible from at least 20m?<br>

  Yes

  No

• Extinguishers located in a conspicuous & readily accessible position?<br>

  Yes

  No

• If practicable, extinguishers located along normal travel paths & near exits?<br>

  Yes

  No

• Extinguishers not located in positions where access could present a hazard to potential users?<br>

  Yes

  No

• Extinguisher correctly mounted?<br>

  Yes

  No

• Extinguishers are the correct class & rating?<br>

  Yes

  No

• Operators trained & competent in the selection & use of fire extinguishers ?

  Yes

  No

• Signage, appropriately located, legible, clearly visible?<br>

  Yes

  No

• WHSR 2011, Cl359(1)(c) the fire protection & firefighting equipment is properly installed, tested & maintained?

  Yes

  No

• 

• Spill Kits can incorporate a 003 key to prevent customers using as a rubbish bin.
  Spills kit maybe kept inside however it must be readily accessible & a sign should be erected in the forecourt indicating its location.

• Are spills containment procedures in place? (WHSR Cl 357 (1) <br>

  Yes

  No

• Are those procedures adequate?<br>

  Yes

  No

• Are operators trained & competent in those procedures?<br>

  Yes

  No

• Is there spill containment & clean up equipment available on site? (Cl 357(3)) <br> i.e. spills kit, PPE<br><br>

  Yes

  No

• Is the equipment suitable for containing fuel & oil spills? (hydrocarbon) (Site risks)<br>

  Yes

  No

• Is there sufficient equipment available?<br>

  Yes

  No

• Is the equipment in an easily identifiable & readily accessible position?<br>

  Yes

  No

• Is there sufficient & appropriate signage in place?<br>

  Yes

  No

• Is it suitably located?<br>

  Yes

  No

• Are their provisions is place for the disposal of the waste material?<br>

  Yes

  No

• Are there procedures in place for the replacement of used or damaged equipment ASARP?<br>

  Yes

  No

• Is there sufficient & appropriate PPE available? <br>i.e. safety glasses, face shields, respirators, chemical resistant gloves & boots, high vis vests etc.<br><br>

  Yes

  No

• Is there sufficient equipment in place to isolate the area around a spill?<br>i.e. witches hats, tape, bunting, signage<br><br>

  Yes

  No

• Are shovels, dustpans, brooms, etc used to clean up a spill “non-spark”?<br>

  Yes

  No

• Is there an instruction sheet with spill kit?<br>

  Yes

  No

• Is there equipment to isolate spill area (i.e. witches hats, barriers, tape, signage etc) available?

  Yes

  No

• 

• 

• 

• All operators at least 16 year old? (WHSR 336)<br>

  Yes

  No

• Potential ignition sources controlled (WHSR 355)<br>

  Yes

  No

• ≥ 4m Separation from ignition sources maintained? (WHSR 355)<br>

  Yes

  No

• Mandatory safety sign in place? (WHSR 353)<br>

  Yes

  No

• Signage properly located?<br>

  Yes

  No

• Signage legible?<br>

  Yes

  No

• Remote emergency power cut-off available? <br>

  Yes

  No

• Remote emergency power cut-off suitably located?<br>

  Yes

  No

• Remote emergency power cut off location easily identifiable & readily accessible? <br>

  Yes

  No

• Workers suitably trained & / or supervised?<br>

  Yes

  No

• Min 2 x 9kg AB(E) or 4 x 4.5kg fire extinguisher readily accessible in forecourt? (WHSR 359) <br>

  Yes

  No

• Additional fire extinguisher available if more than two dispensing bays on site? (1 per bay)<br>

  Yes

  No

• Fuel Nozzles (No latching devices attach) only able to be held open by operators hand?<br>

  Yes

  No

• Impact protection in place? (WHSR Cl 358)<br>

  Yes

  No

• Underground tanks & pipework Protected from damage? (WHSR 2011 Cl 358)

  Yes

  No

• Emergency power cut offs on bowsers (Customer fill only)<br>

  Yes

  No

• Hoses not lying on ground (prone to damage & creating trip hazard<br>

  Yes

  No

• Min lighting 50 lux<br>

  Yes

  No

• 

• Potential ignition sources Controlled (WHSR Cl 355)<br>

  Yes

  No

• Separation distance maintained AS 1940 Cl 5.4.4 Exclusion zones for vent outlets ?<br>

  Yes

  No

• Vents away from trafficable areas or protected by bollards or barriers etc.? WHSR Cl 358)<br>

  Yes

  No

• Vent terminal point’s ≥ 4m above ground?<br>

  Yes

  No

• Vent pipes against a wall secured to it?<br>

  Yes

  No

• Underground tank & pipework protected from damage? (WHSR 358)<br>

  Yes

  No

• 

• 

• Fill & dip points clearly identified? Ref: AS 4977-2008 cl 3.2 & figure 3.1<br>

  Yes

  No

• Surface markers within 100mm of fill & dip points<br>

  Yes

  No

• Fill & dip point surface makers color coded in accordance with AS 4977<br>

  Yes

  No

• Fill & dip points readily accessible?<br>

  Yes

  No

• Fill & dip points protected from accidental damage? (WHSR Cl 358)<br>

  Yes

  No

• Fill & dip point’s ≥ 3m from ignition sources? (WHSR Cl 355)<br>

  Yes

  No

• Fill & dip point’s ≥ 2m from openings into buildings?<br>

  Yes

  No

• Underground tank & pipework protected from damage? WHSR 358)<br>

  Yes

  No

• Area around fill & dip points free of debris, water & other potential contaminates?<br>

  Yes

  No

• Fill & dip points sealed to prevent vapor release?<br>

  Yes

  No

• 

• 

• Are safety procedures in place for transferring of bulk fuel from tanker to tanks?<br>

  Yes

  No

• Are those procedures documented?<br>

  Yes

  No

• Are operator/s able to describe those procedures?<br>

  Yes

  No

• Is there a designated area for transferring of bulk fuel from tanker to tanks?<br>

  Yes

  No

• Are potential ignition sources Controlled? WHSR Cl 355 (AS 60079.10.1)<br>

  Yes

  No

• 4m exclusion zone (ignition sources) from tanker discharge point (exclusion zone defined)<br>

  Yes

  No

• 3m exclusion zone (ignition sources) from tank fill point<br>

  Yes

  No

• Is exclusion zone clearly identified? (I.e. demarcation lines, witches hats, signs etc.)<br><br>

  Yes

  No

• Does exclusion zone extend over driveway or a fuel dispensing area?<br><br>

  Yes

  No

• If yes are vehicles & pedestrians not involved in the procedure prevented from entering zone?<br>Note: station needs to be closed or bulk fuel transfers performed out outside operating hours<br><br><br>

  Yes

  No

• Are tankers parked wholly within property during discharge process?<br><br>

  Yes

  No

• Are there systems to prevent tanker movement during discharge process? (i.e. handbrake on)<br><br>

  Yes

  No

• Is tanker able to travel (or be towed) forward to exit site (emergencies)?<br><br>

  Yes

  No

• Is tankers exit path unobstructed at all times during transfer process?<br><br>

  Yes

  No

• Are there procedures in place to ensure no persons remain in tankers cabin during transfer?<br><br>

  Yes

  No

• Is operator/driver able to view discharge & fill points during discharge process?<br><br>

  Yes

  No

• Driver able to stop discharge process if an emergency occurs?<br><br>

  Yes

  No

• Is there adequate fire fighting equipment available during discharge process?<br><br>

  Yes

  No

• Is discharge process monitored to prevent fuel overflow, spillage, or excessive tank pressure?<br><br>

  Yes

  No

• Flexible transfer hoses not running under tanker?<br><br>

  Yes

  No

• Is there a system in place to prevent the buildup or discharge of static electricity?<br><br><br>

  Yes

  No

• References:
  Australian Dangerous Good code Chapter 10 - Transfer Requirements
  AS/NZS AS/NZS 60079.10.1:2009 Explosive atmospheres
  Part 10.1: Classification of areas— Explosive gas atmospheres
  AS 1940 - 2004 the storage and handling of flammable and combustible liquids
  WHSR Cl 355
  
  

• Notes:
  If the exclusion zone extends over the service station driveway or a fuel dispensing area, vehicles must be prohibited from entering that area. The service station may need to be shut down for the duration of the tank filling operation or the tank filling operation carried out outside of normal operating hours.
  The tanker delivery driver and site operator must have a clear understanding of where the exclusion zone extend to and provide adequate barriers (e.g. witches hats) and warning signs for the duration that transfer hoses are connected.
  AS 1940 9.18 BULK TRANSFER
  9.18.1 General requirements
  Safe filling and emptying procedures for tanks and tankers shall be established on the basis of the following requirements:
  (a) A safe filling level that allows for thermal expansion shall be established, and shall not be exceeded.
  (b) Filling and emptying flow-rates for which the tank vents were designed shall not be exceeded.
  (c) Filling shall be monitored and controlled so as to prevent the occurrence of overflow, spillage, or excessive pressure in the tank.
  (d) The recommendations of AS/NZS 1020 and the requirements of the ADG Code shall be observed wherever applicable.
  9.18.2 Control of static electricity
  The requirements of AS/NZS 1020 and AIP CP8, as appropriate, shall be observed when transferring flammable or combustible liquids into any container or tank to control and safely dissipate any static electricity generated during the operation.
  9.18.3 Continuity testing
  Tests shall be carried out at intervals of not more than six months to ensure that earthing and bonding is effective and that the resistance between a vehicle tank and earth is not greater than 1MΩ.
  9.18.4 Restrictions on vehicles in tank vehicle filling facilities
  The following restrictions apply to vehicles in filling facilities handling flammable liquids:
  (a) A tank vehicle shall be positioned at all times so that in an emergency it can be driven or towed straight out without recourse to reversing.
  (b) The tank vehicle should be driven forward into the tank vehicle filling area rather than being backed in. Where the layout makes this impossible, so that reversing is unavoidable, a person shall be stationed to guide the driver while reversing.
  (c) No vehicle, including tank vehicles, shall be maintained or serviced whilst in the tank vehicle filling facility except for the refueling of the vehicle running tank.
  (d) No vehicle, other than a tank vehicle, a vehicle associated with maintenance of the filling facility or an emergency services vehicle, shall be permitted to pass through or stand in a dedicated vehicle filling facility, consisting of two or more filling positions.
  (e) A tanker containing product shall not park or stand in or under a filling facility other than when filling or draining.
  (f) Where a flammable liquid spill occurs at the filling facility while a tank vehicle is standing therein, the vehicle engine shall not be started until the spill has been satisfactorily cleaned up, except in the case of an emergency.
  The requirements of Items (c) and (d) may be varied by the use of a work permit.
  Where a filling facility has been constructed for combustible liquids only and it is separated from a flammable liquid filling facility by more than 15m, the requirements of Items (d), (e) and (f) shall not apply
  
  

• 

• 

• References:
  AS/NZS 3788:2006 Pressure equipment – In-service inspection.
  AS 4343 2014: Pressure equipment – Hazard levels.
  SafeWork Australia Information Sheet “Compressed Air and Air Receiver”
  
  
  
  

Compressor Checks

• Unit away from trafficked area or impact protection in place?<br>

  Yes

  No

• Unit secured against movement?<br>

  Yes

  No

• Unit in an area free of airborne or other contaminants (hazardous chemicals, dust, fumes etc.)<br>

  Yes

  No

• Unit readily accessible?<br>

  Yes

  No

• Air filter/s in place and in good condition?<br>

  Yes

  No

• Pressure gauge undamaged & fully operational? (max pressure clearly marked)<br>

  Yes

  No

• Regulator undamaged & fully operational? (no evidence of tampering)<br>

  Yes

  No

• Safety valve (Pressure relief) undamaged & fully operational? (no evidence of tampering)<br>

  Yes

  No

• Drain valve undamaged & fully operational? (no evidence of tampering)<br>

  Yes

  No

• Air receiver undamaged? (No dents, corrosion, distortion, holes, leaks, stress fractures etc.)<br>

  Yes

  No

• Fan belt/s & pulleys adequately & securely guarded? (If applicable)<br>

  Yes

  No

• All piping & valves in serviceable condition? (no corrosion, distortion, leaks etc.)<br>

  Yes

  No

• Compressed air supply line/s & fittings in good condition & if applicable adequately secured?<br>

  Yes

  No

• Noise issues identified?<br>

  Yes

  No

• Electrical plug & lead in good condition? (tested & tagged/recorded in register)<br>

  Yes

  No

• On/off switch in serviceable condition & easily identified & accessible position?<br>

  Yes

  No

• On/off switch in serviceable condition & easily identified & accessible position?<br>

  Yes

  No

• Evidence of routine maintenance identified? (i.e. completed logbook, service record)<br>

  Yes

  No

• Operation &/or service manual available to workers?<br>

  Yes

  No

• Safety signage in place?<br>

  Yes

  No

Operational Checks: Have the operator turn it on a demonstrate the following:

• Check that it is running smoothly (i.e. no excessive noise or vibration)<br>

  Yes

  No

• Check that pressure gauge is working <br>

  Yes

  No

• Check that units motor cuts out before maximum working pressure is exceeded<br>Note: If max pressure is exceeded This may indicate that regulator has been damaged or tampered with &/or pressure switch is faulty &/ or relief valve is not working correctly<br><br><br>

  Yes

  No

• Check gauge to ensure pressure does not drop whilst unit is not being used <br>Note: If pressure drops &/or motor cuts in this may indicate that the unit is losing air <br>(i.e. leaking valves, hoses, fittings, air receiver etc.)<br><br>

  Yes

  No

• Have operator open relief valve and check that air is escaping through valve & air pressure is <br>dropping<br><br>

  Yes

  No

• Once air receiver is free of compressed air have operator open drain valve & check that valve opens easily & excessive condensation, oil or other contaminants are not released as this may indicate that valve is not routinely opened & the air receiver drained.

  Yes

  No

• Note:
  1. condensation if not removed routinely it will led to corrosion inside the air receiver
  2. Oil inside the air receiver may indicate that there is excessive wear inside the compressor
  Note:
  If safety valve opens before units motor cuts out the pressure switch may be damaged