Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

Checklist

Other

  • Fire Department Tour for all manned and non-manned locations

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  • Observation

  • Corrected By and Date Corrected:

  • Green Forklift Tag

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  • Observation

  • Corrected By and Date Corrected:

  • Correct 3 drug testing forms

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  • Observation

  • Corrected By and Date Corrected:

  • SPCC Binder—plan and inspections are current

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  • Observation

  • Corrected By and Date Corrected:

  • Fire Department Tour for all manned and non-manned locations

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  • Observation

  • Corrected By and Date Corrected:

  • High Vis vests for all application equipment and vehicles

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  • Observation

  • Corrected By and Date Corrected:

  • First Aid Kits for all application equipment and vehicles

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  • Observation

  • Corrected By and Date Corrected:

  • Padlocks (regular or long)

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  • Observation

  • Corrected By and Date Corrected:

  • Safety Glasses. (Regular or over the glasses)

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  • Observation

  • Corrected By and Date Corrected:

  • Correct emergency sign name and number (contact Ted Scheidel)

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  • Observation

  • Corrected By and Date Corrected:

  • Set of 4 decals for LP cylinder cage and 500/1000 gallon LP tank

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  • Observation

  • Corrected By and Date Corrected:

  • No Smoking decals on all equipment and buildings

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  • Observation

  • Corrected By and Date Corrected:

Company Use Fuel Tanks

  • Correct and readable decals

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  • Observation

  • Corrected By and Date Corrected:

  • Grounding Rod (contact Mike Helmold with questions)

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  • Observation

  • Corrected By and Date Corrected:

  • Gasoline vent extension (contact Mike Helmold with questions)

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  • Observation

  • Corrected By and Date Corrected:

  • Interstitial float at a glance (text Mike Klahsen 319-269-6569)

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  • Observation

  • Corrected By and Date Corrected:

  • Glass replacement for gasoline at a glance

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  • Observation

  • Corrected By and Date Corrected:

  • There are not any leaks

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  • Observation

  • Corrected By and Date Corrected:

  • Adequate crash protection (contact Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

  • Located water finding paste and stick

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  • Observation

  • Corrected By and Date Corrected:

  • Fire extinguisher hung and inspected

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  • Observation

  • Corrected By and Date Corrected:

  • Padlock on nozzle area or power is locked off

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  • Observation

  • Corrected By and Date Corrected:

  • Fill port has a locking cap (text Mike Klahsen)

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  • Observation

  • Corrected By and Date Corrected:

  • Is there a safe step to fill the tank and read the meter (Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

Petro Bulk Plant

  • There are not any leaking valves (contact Mike Helmold with questions)

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  • Observation

  • Corrected By and Date Corrected:

  • Gasoline piping extension at loading rack (contact Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

  • Signs/Decals at transport unload

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  • Observation

  • Corrected By and Date Corrected:

  • Plugs for transport unload coupling

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  • Observation

  • Corrected By and Date Corrected:

  • Fire extinguisher hung and inspected

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  • Observation

  • Corrected By and Date Corrected:

  • Grounding Rod (contact Mike Helmold with questions)

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Confined space decals on manway covers

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  • Observation

  • Corrected By and Date Corrected:

  • Valves shut at the tank and the fence is locked

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  • Observation

  • Corrected By and Date Corrected:

NH3 Storage Tanks

  • Piping painted white

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  • Observation

  • Corrected By and Date Corrected:

  • Valves painted orange and yellow

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  • Observation

  • Corrected By and Date Corrected:

  • Bulkhead painted green

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  • Observation

  • Corrected By and Date Corrected:

  • Bulkhead Anhydrous Ammonia and 1005 sign (Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

  • Relief valve and hydrostatic caps

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  • Observation

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  • ESV signs

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  • Observation

  • Corrected By and Date Corrected:

  • Correct and readable decals

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  • Observation

  • Corrected By and Date Corrected:

  • There are not any leaks

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  • Observation

  • Corrected By and Date Corrected:

  • Adequate crash protection (contact Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

  • 6 sided guard (contact Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

  • 3 valves under tank and 2 transport valves are locked

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  • Observation

  • Corrected By and Date Corrected:

  • Valve box on riser is locked.

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  • Observation

  • Corrected By and Date Corrected:

  • Uses heater for fresh water tank during winter months

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  • Observation

  • Corrected By and Date Corrected:

LP Storage Tanks

  • Piping painted white

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  • Observation

  • Corrected By and Date Corrected:

  • Valves painted red and white

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  • Observation

  • Corrected By and Date Corrected:

  • Bulkhead painted red

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  • Observation

  • Corrected By and Date Corrected:

  • Bulkhead Propane and 1075 sign (Mike Helmold)

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  • Observation

  • Corrected By and Date Corrected:

  • Relief valve and hydrostatic caps

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  • Observation

  • Corrected By and Date Corrected:

  • ESV signs

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Correct and readable decals

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • There are not any leaks

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Adequate crash protection (contact Mike Helmold)

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • 6 sided guard (contact Mike Helmold)

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Fire extinguishers hung and inspected

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  • Observation

  • Corrected By and Date Corrected:

  • All valves are shut and locked or fence is locked

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  • Observation

  • Corrected By and Date Corrected:

Dry Fertilizer Building

  • Correct signs/decals on bins

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  • Observation

  • Corrected By and Date Corrected:

  • Fire extinguishers hung and inspected

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  • Observation

  • Corrected By and Date Corrected:

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