Title Page

  • Conducted on

  • Prepared by

Cold Feed

  • Vibro 1A

  • Bin 1A Vibro

  • Bin 1A Feeder belt motor

  • Cold feed junction box

  • Pull wire/Pull key left side of conveyor

  • Pull wire/Pull key right side of conveyor

  • Bin 6 vibro motor

  • Bin 6 feeder belt motor

  • Bin 5 vibro motor

  • Bin 4 Vibro motor

  • Bin 3 vibro motor

  • Bin 2 feeder belt motor

  • Cold feed lighting

  • Cold feed conveyor motor

  • Cold feed E/stop - 1, inside guards

  • Cold feed E/stop - 2, outside guards

  • LV Cable

  • Add Asset
  • Asset Type

  • Photo of lighting, location, ID and type

  • Fitted with photocell, PIR or switch

  • In good working order and fit for purpose

  • Photo of isolator and ID for reference

  • Isolator is in good working condition and LOTOTO can be achieved

  • Photo of RCD/RCBO for reference

  • RCD/RCBO is fit for purpose and in good working condition

  • Is quarterly check label in place

  • Photo of socket, ID and voltage for reference

  • Is isolator fit for purpose and in good working condition

  • Can the isolator be locked in the On position

  • Photo of motor, ID and motor plate for reference

  • Is the motor fit for purpose and in good working order

  • Check condition of terminal box

  • Photo of DB/MCCB, ID and fed via for reference

  • Is the DB/MCCB in good working order and fit for purpose

  • Is a lock off and arc flash kit available

  • Are blanks fitted

  • Photo of switchroom/substation for reference

  • Is there a lock off kit, electical safety mat and arcflash kit available

  • Is the electric shock poster, electricity at work act and arc flash assessment visible

  • Is lighting adequate and emergency lighting fitted

  • Photo of cable, ID and location for reference

  • Is LV cable in good condition and fit for purpose

  • Cable clips, earth bonding, tray and fixings in good condition and fit for purpose

  • Photo of E/Stop, ID and location for reference

  • Is E/Stop in good condition, not discoloured, and fit for purpose/enviroment

  • Add media

  • Photo of pull key, pull wire, ID and location for reference

  • Is pull key in good condition and fit for purpose

  • Are the pull wires, pigtails and tensioners suitable for the enviroment?

  • Photo of barrier and location for reference

  • Is the barrier in good condition and fit for purpose

  • Are the barrier and end support fixings present and tight

  • Are the barrier lights functional and the correct colour for the position of the barrier

  • Photo of control panel, ID and fed via for reference

  • Check control panel is in good condition, fit for purpose and is suitable for the enviroment

  • Check the control panel has correct identifiable markings

  • Appliance name

  • Appliance make

  • Appliance Model

  • Appliance ID

  • Check appliance is identifiable, in good condition and fit for purpose

  • Any further issues with appliance

Burner and RAP

  • Burner inspection light

  • Dryer motor

  • Fuel pump motor

  • Dryer E/Stop

  • Burner Motor

  • RAP hopper vibro

  • RAP hopper vibro isolator

  • RAP conveyor pull key and pull wire

  • RAP conveyor motor isolator

  • RAP conveyor motor

  • LV Cable

  • Add Asset
  • Asset Type

  • Photo of lighting, location, ID and type

  • Fitted with photocell, PIR or switch

  • In good working order and fit for purpose

  • Photo of isolator and ID for reference

  • Isolator is in good working condition and LOTOTO can be achieved

  • Photo of RCD/RCBO for reference

  • RCD/RCBO is fit for purpose and in good working condition

  • Is quarterly check label in place

  • Photo of socket, ID and voltage for reference

  • Is isolator fit for purpose and in good working condition

  • Can the isolator be locked in the On position

  • Photo of motor, ID and motor plate for reference

  • Is the motor fit for purpose and in good working order

  • Check condition of terminal box

  • Photo of DB/MCCB, ID and fed via for reference

  • Is the DB/MCCB in good working order and fit for purpose

  • Is a lock off and arc flash kit available

  • Are blanks fitted

  • Photo of switchroom/substation for reference

  • Is there a lock off kit, electical safety mat and arcflash kit available

  • Is the electric shock poster, electricity at work act and arc flash assessment visible

  • Is lighting adequate and emergency lighting fitted

  • Photo of cable, ID and location for reference

  • Is LV cable in good condition and fit for purpose

  • Cable clips, earth bonding, tray and fixings in good condition and fit for purpose

  • Photo of E/Stop, ID and location for reference

  • Is E/Stop in good condition, not discoloured, and fit for purpose/enviroment

  • Add media

  • Photo of pull key, pull wire, ID and location for reference

  • Is pull key in good condition and fit for purpose

  • Are the pull wires, pigtails and tensioners suitable for the enviroment?

  • Photo of barrier and location for reference

  • Is the barrier in good condition and fit for purpose

  • Are the barrier and end support fixings present and tight

  • Are the barrier lights functional and the correct colour for the position of the barrier

  • Photo of control panel, ID and fed via for reference

  • Check control panel is in good condition, fit for purpose and is suitable for the enviroment

  • Check the control panel has correct identifiable markings

  • Appliance name

  • Appliance make

  • Appliance Model

  • Appliance ID

  • Check appliance is identifiable, in good condition and fit for purpose

  • Any further issues with appliance

Control room and MCC

  • Air Con isolator

  • Switch room lighting

  • Bitumen tank heater isolator

  • Compressor room DB isolator

  • Plant 5 Acti Board DB

  • Bitumen tank 5c isolator

  • Bitumen tank 5c isolator

  • Switch room main incoming supply isolator

  • Switch room DB1

  • DB RCD socket

  • 32a 3p + N socket

  • Rotary valves 1 and 2 isolators

  • LV cables

  • Bitumen tank 5a pump start/stop isolator

  • New oil plant isolator

  • Compressor house isolator

  • Main fan isolator

  • DP12 isolator

  • Unidentified isolator

  • LV cable

  • Add Asset
  • Asset Type

  • Photo of lighting, location, ID and type

  • Fitted with photocell, PIR or switch

  • In good working order and fit for purpose

  • Photo of isolator and ID for reference

  • Isolator is in good working condition and LOTOTO can be achieved

  • Photo of RCD/RCBO for reference

  • RCD/RCBO is fit for purpose and in good working condition

  • Is quarterly check label in place

  • Photo of socket, ID and voltage for reference

  • Is isolator fit for purpose and in good working condition

  • Can the isolator be locked in the On position

  • Photo of motor, ID and motor plate for reference

  • Is the motor fit for purpose and in good working order

  • Check condition of terminal box

  • Photo of DB/MCCB, ID and fed via for reference

  • Is the DB/MCCB in good working order and fit for purpose

  • Is a lock off and arc flash kit available

  • Are blanks fitted

  • Photo of switchroom/substation for reference

  • Is there a lock off kit, electical safety mat and arcflash kit available

  • Is the electric shock poster, electricity at work act and arc flash assessment visible

  • Is lighting adequate and emergency lighting fitted

  • Photo of cable, ID and location for reference

  • Is LV cable in good condition and fit for purpose

  • Cable clips, earth bonding, tray and fixings in good condition and fit for purpose

  • Photo of E/Stop, ID and location for reference

  • Is E/Stop in good condition, not discoloured, and fit for purpose/enviroment

  • Add media

  • Photo of pull key, pull wire, ID and location for reference

  • Is pull key in good condition and fit for purpose

  • Are the pull wires, pigtails and tensioners suitable for the enviroment?

  • Photo of barrier and location for reference

  • Is the barrier in good condition and fit for purpose

  • Are the barrier and end support fixings present and tight

  • Are the barrier lights functional and the correct colour for the position of the barrier

  • Photo of control panel, ID and fed via for reference

  • Check control panel is in good condition, fit for purpose and is suitable for the enviroment

  • Check the control panel has correct identifiable markings

  • Appliance name

  • Appliance make

  • Appliance Model

  • Appliance ID

  • Check appliance is identifiable, in good condition and fit for purpose

  • Any further issues with appliance

Main plant tower

  • Hot stone elevator motor

  • Crane isolator

  • Hot stone elevator E/Stop

  • Screen level E/Stop - 1

  • Screen level E/Stop - 2

  • Screen motor

  • Screen house lighting

  • Screen house LV cable

  • Rap feeder vibro isolator

  • Rap feeder vibro's

  • Bitumen weigh room lighting

  • Bitumen weigh room LV cable

  • Mixer room lighting

  • Mixer motor

  • Mixer motor isolator

  • Mixer room E/Stop

  • Mixer room LV cable

  • RAP PSU panel isolator

  • RAP PSU panel E/Stop

  • LV Cable

  • Add Asset
  • Asset Type

  • Photo of lighting, location, ID and type

  • Fitted with photocell, PIR or switch

  • In good working order and fit for purpose

  • Photo of isolator and ID for reference

  • Isolator is in good working condition and LOTOTO can be achieved

  • Photo of RCD/RCBO for reference

  • RCD/RCBO is fit for purpose and in good working condition

  • Is quarterly check label in place

  • Photo of socket, ID and voltage for reference

  • Is isolator fit for purpose and in good working condition

  • Can the isolator be locked in the On position

  • Photo of motor, ID and motor plate for reference

  • Is the motor fit for purpose and in good working order

  • Check condition of terminal box

  • Photo of DB/MCCB, ID and fed via for reference

  • Is the DB/MCCB in good working order and fit for purpose

  • Is a lock off and arc flash kit available

  • Are blanks fitted

  • Photo of switchroom/substation for reference

  • Is there a lock off kit, electical safety mat and arcflash kit available

  • Is the electric shock poster, electricity at work act and arc flash assessment visible

  • Is lighting adequate and emergency lighting fitted

  • Photo of cable, ID and location for reference

  • Is LV cable in good condition and fit for purpose

  • Cable clips, earth bonding, tray and fixings in good condition and fit for purpose

  • Photo of E/Stop, ID and location for reference

  • Is E/Stop in good condition, not discoloured, and fit for purpose/enviroment

  • Add media

  • Photo of pull key, pull wire, ID and location for reference

  • Is pull key in good condition and fit for purpose

  • Are the pull wires, pigtails and tensioners suitable for the enviroment?

  • Photo of barrier and location for reference

  • Is the barrier in good condition and fit for purpose

  • Are the barrier and end support fixings present and tight

  • Are the barrier lights functional and the correct colour for the position of the barrier

  • Photo of control panel, ID and fed via for reference

  • Check control panel is in good condition, fit for purpose and is suitable for the enviroment

  • Check the control panel has correct identifiable markings

  • Appliance name

  • Appliance make

  • Appliance Model

  • Appliance ID

  • Check appliance is identifiable, in good condition and fit for purpose

  • Any further issues with appliance

Baghouse and compressor shed

  • Main fan inverter panel

  • Inverter panel isolator

  • Inverter panel E/Stop

  • Main fan motor local E/Stop

  • Main fan motor

  • 16a BS socket

  • Compressor isolator

  • Compressor shed lighting

  • Compressor E/Stop

  • LV cable

  • Add Asset
  • Asset Type

  • Photo of lighting, location, ID and type

  • Fitted with photocell, PIR or switch

  • In good working order and fit for purpose

  • Photo of isolator and ID for reference

  • Isolator is in good working condition and LOTOTO can be achieved

  • Photo of RCD/RCBO for reference

  • RCD/RCBO is fit for purpose and in good working condition

  • Is quarterly check label in place

  • Photo of socket, ID and voltage for reference

  • Is isolator fit for purpose and in good working condition

  • Can the isolator be locked in the On position

  • Photo of motor, ID and motor plate for reference

  • Is the motor fit for purpose and in good working order

  • Check condition of terminal box

  • Photo of DB/MCCB, ID and fed via for reference

  • Is the DB/MCCB in good working order and fit for purpose

  • Is a lock off and arc flash kit available

  • Are blanks fitted

  • Photo of switchroom/substation for reference

  • Is there a lock off kit, electical safety mat and arcflash kit available

  • Is the electric shock poster, electricity at work act and arc flash assessment visible

  • Is lighting adequate and emergency lighting fitted

  • Photo of cable, ID and location for reference

  • Is LV cable in good condition and fit for purpose

  • Cable clips, earth bonding, tray and fixings in good condition and fit for purpose

  • Photo of E/Stop, ID and location for reference

  • Is E/Stop in good condition, not discoloured, and fit for purpose/enviroment

  • Add media

  • Photo of pull key, pull wire, ID and location for reference

  • Is pull key in good condition and fit for purpose

  • Are the pull wires, pigtails and tensioners suitable for the enviroment?

  • Photo of barrier and location for reference

  • Is the barrier in good condition and fit for purpose

  • Are the barrier and end support fixings present and tight

  • Are the barrier lights functional and the correct colour for the position of the barrier

  • Photo of control panel, ID and fed via for reference

  • Check control panel is in good condition, fit for purpose and is suitable for the enviroment

  • Check the control panel has correct identifiable markings

  • Appliance name

  • Appliance make

  • Appliance Model

  • Appliance ID

  • Check appliance is identifiable, in good condition and fit for purpose

  • Any further issues with appliance

Kerosene, Lowtherm, Filler and Bitumen

  • Fibre silo vibro isolator

  • LV Cable

  • Filler silo screw motor

  • Filler silo rotary valve motor

  • Fibre silo control panel isolator

  • Silo protection panel isolator

  • Low therm isolator

  • Low therm heat jacket isolator

  • Bitumen tank 5a isolator

  • Bitumen Tank 5a pump motor

  • Bitumen tank 5c heating panel isolator

  • Bitumen tank 5c pump motor

  • Bitumen tank 5b pump motor

  • Bitumen tanks lighting

  • Bitumen tank 6b heater panel isolator

  • Fuel oil tank 5 alarm isolator

  • Fuel oil tank 5 level sensor LV cable

  • Gas oil tank 5b level sensor isolator

  • Gas oil tank 5b old level sensor cable

  • Kerosene pump heater control

  • 32a 3p + N socket

  • Oil heater isolator

  • Gas oil pump isolator

  • Lighting and power DB

  • Fuel additive isolator

  • RCD socket 13a

  • Kerosene pump house lights

  • LV cable

  • Add Asset
  • Asset Type

  • Photo of lighting, location, ID and type

  • Fitted with photocell, PIR or switch

  • In good working order and fit for purpose

  • Photo of isolator and ID for reference

  • Isolator is in good working condition and LOTOTO can be achieved

  • Photo of RCD/RCBO for reference

  • RCD/RCBO is fit for purpose and in good working condition

  • Is quarterly check label in place

  • Photo of socket, ID and voltage for reference

  • Is isolator fit for purpose and in good working condition

  • Can the isolator be locked in the On position

  • Photo of motor, ID and motor plate for reference

  • Is the motor fit for purpose and in good working order

  • Check condition of terminal box

  • Photo of DB/MCCB, ID and fed via for reference

  • Is the DB/MCCB in good working order and fit for purpose

  • Is a lock off and arc flash kit available

  • Are blanks fitted

  • Photo of switchroom/substation for reference

  • Is there a lock off kit, electical safety mat and arcflash kit available

  • Is the electric shock poster, electricity at work act and arc flash assessment visible

  • Is lighting adequate and emergency lighting fitted

  • Photo of cable, ID and location for reference

  • Is LV cable in good condition and fit for purpose

  • Cable clips, earth bonding, tray and fixings in good condition and fit for purpose

  • Photo of E/Stop, ID and location for reference

  • Is E/Stop in good condition, not discoloured, and fit for purpose/enviroment

  • Add media

  • Photo of pull key, pull wire, ID and location for reference

  • Is pull key in good condition and fit for purpose

  • Are the pull wires, pigtails and tensioners suitable for the enviroment?

  • Photo of barrier and location for reference

  • Is the barrier in good condition and fit for purpose

  • Are the barrier and end support fixings present and tight

  • Are the barrier lights functional and the correct colour for the position of the barrier

  • Photo of control panel, ID and fed via for reference

  • Check control panel is in good condition, fit for purpose and is suitable for the enviroment

  • Check the control panel has correct identifiable markings

  • Appliance name

  • Appliance make

  • Appliance Model

  • Appliance ID

  • Check appliance is identifiable, in good condition and fit for purpose

  • Any further issues with appliance

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.