Title Page

  • Conducted on

  • Prepared by

Cold Feed

  • Motor

  • Bin 1 feeder motor

  • Cold feed lighting

  • Bin 1A Vibro

  • Bin 1A Feeder belt motor

  • LV Cable

  • Bin 2 vibro

  • Cold Feed conveyor isolator

  • Bin 3 vibro motor

  • Bin 4 Vibro motor

  • Bin 5 vibro motor

  • Bin 6 vibro motor

  • Bin 6 feeder belt motor

  • Cold feed E/stop

  • Pull wire/Pull key left side of conveyor

  • Pull wire/Pull key right side of conveyor

  • Cold feed conveyor motor

  • Bin 1 vibro isolator

  • Cold feed E/Stop - Outside guards

  • Cold feed junction box

  • 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

  • Drum junction box

  • Drum drive motor

  • Drum E/Stop

  • Drum inspection light

  • Burner E/Stop

  • Burner motor isolator

  • Burner Motor

  • Fuel pump motor

  • Burner platform E/Stop

  • Rap hopper vibro

  • Rap hopper vibro isolator

  • Rap conveyor Pull key + pull wire

  • Rap conveyor isolator

  • Rap conveyor motor

  • Rap hopper/conveyor lighting

  • 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/Compressor Room

  • Air Con isolator

  • Mixer cabin main panel isolator

  • Mixer cabin RCD sockets x 3

  • Mixer cabin burner panel isolator

  • Mixer cabin lighting

  • Mixer cabin RCD sockets below air con and window

  • Compressor isolator - 1

  • Compressor isolator - 2

  • Switch room lighting

  • Main fan inverter isolator

  • Main fan inverter panel E/Stop

  • Compressor isolator

  • RCD sockets under DB 2

  • Fuel oil pump heater isolator

  • Rotary valve isolator

  • Switch room 415v 32a sockets

  • Bitumen delivery control panel isolator

  • Bitumen tank 1 heater panel

  • Bitumen tank 2 heater panel

  • Trace heating DB isolator

  • DB 2 isolator

  • DB 1 isolator

  • Vulcan burner panel 1 isolator

  • Vulcan burner panel 2 isolator

  • LV cables

  • Plant lighting above switch room

  • MCC/Compressor room lighting

  • 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

  • Screen level E/Stop - 1

  • Screen level E/Stop - 2

  • Screen motor

  • Screen house lighting

  • Tower staircase lighting

  • Mixer room lighting

  • Rap chute vibro motor

  • Mixer motor

  • Mixer motor isolator

  • Mixer room E/Stop

  • Bitumen weigh room lighting

  • Bitumen weigh room hopper vibro

  • Rap chute vibro isolator

  • Rap chute vibro

  • 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

  • Exhaust fan motor

  • Exhaust fan motor E/Stop

  • Baghouse LV cable

  • Baghouse valve 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

Kerosene, Lowtherm, Filler and Bitumen

  • Kerosene tank lighting

  • Kerosene tank alarm isolator - 1

  • Kerosene tank alarm isolator - 2

  • LV Cable

  • Fuel additive dosing controller

  • Kerosene pump motor

  • Kerosene pump heater control panel

  • Waste oil isolator

  • Kerosene shed consumer unit isolator

  • Unknown isolator

  • Kerosene shed lighting

  • Filler silo screw isolator

  • Filler silo screw motor

  • Filler silo rotary valve isolator

  • Filler silo rotary valve motor

  • Low therm panel isolator

  • Low therm panel E/Stop

  • Bitumen tank 1 heating panel isolator

  • Bitumen tank 2 heater panel isolator

  • LV cable

  • Bitumen emergency shower isolator

  • Bitumen tank 2 pump motor isolator

  • Bitumen tank 2 pump motor

  • Bitumen Tank 1 pump motor isolator

  • Bitumen tank 1 pump motor

  • Bitumen tank delivery panel isolator

  • Low therm panel isolator

  • Low therm heat jacket isolator

  • Fibre silo vibro

  • Fibre silo vibro isolator

  • Fibre silo control panel isolator

  • Silo protection panel isolator

  • Bitumen tank 2 level sensor

  • Kerosene tank lighting

  • Kerosene tank isolator - 1

  • Kerosene tank isolator - 2

  • Kerosene tanks LV cable

  • Fuel additive dosing controller

  • Fibre silo vibro isolator

  • Bitumen tanks lighting

  • 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

  • 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.