Allied Monthly - PM Checklist

• Site conducted

  Select

• Client / Site

• Job Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Expectations of using this PM online survey form :
  1. All urgent works to be communicated directly to Katrina.
  2. All sections are to be completed fully and comments are descriptive.
  3. Photographs must be taken, full site, individual assets and any identified issues.
  4. Complete an audit per asset.

• Take photo of site as a whole

  Media

• Are any internal leaks present? <br>i.e. weeping joints and/or product present in dispenser sump.

  Yes

  No

  N/A

• Comments

• Is the base securely fastened to the pump island or forecourt?

  Yes

  No

  N/A

• Are the panels securely fastened and free from damage and corrosion?

  Yes

  No

  N/A

• Are the hoses in good condition?<br>i.e. no cracking, abrasion, flattening etc.

  Yes

  No

  N/A

• Are all hoses up off the ground? <br>i.e. not lying on the ground and in danger of being run over.

  Yes

  No

  N/A

• Are the hose boom swivels free and moving? Is the hose boom rope in good condition?

  Yes

  No

  N/A

• Are all hose connections tight and leak free?

  Yes

  No

  N/A

• Are breakaway couplings in a good condition?

  Yes

  No

  N/A

• Nozzle - are there any leaks present?

  Yes

  No

  N/A

• What is required?

  Select Repaired on site: Not repaired and ordered parts:

  • Repaired on site:
  • Not repaired and ordered parts:

• Are all swivels in good condition?

  Yes

  No

  N/A

• Are all spouts in good condition?

  Yes

  No

  N/A

• Check Allied-Blue nozzle and test operations.<br>Confirm magnet working, signage and flaps present and secured.

  Yes

  No

  N/A

• Confirm all pump panels are clean

  Yes

  No

  N/A

• Are the spill kits on site free of rubbish and are complete?

  Yes

  No

  N/A

• TMU expiry date

  Date

• Are the harnesses and lanyards are in good condition

  Yes

  No

  N/A

• Take down their expiry / test date please

• Are colour coded ID's present?

  Yes

  No

  N/A

• Has the dip, fill point and vent been checked?

  Yes

  No

  N/A

• Is there water present in the tank?

  Yes

  No

  N/A

• 91 Petrol (if present) :

  Media

• 95 Petrol (if present):

  Media

• Diesel:

  Media

• Is there any visible indication of Diesel Bug or heavy particles in motor spirits? <br>(NOTE: If water is present ONLY and you are removing it otherwise time involved is to high)

  Yes

  No

  N/A

• 91 Petrol (if present):

  Media

• 95 Petrol (if present):

  Media

• Diesel:

  Media

Monitoring Well (if present)

• Please carry out a visual or bail a sample if water is present - A photo is required and a detailed observation.

• Is the dipstick worn or damaged?

  Yes

  No

  N/A

• Is water or fuel present in the fill points?

  Yes

  No

  N/A

• Is transfer / delivery connections and hose in good condition? Please provide expiry date.

  Yes

  No

  N/A

• Does it have a product ID?

  Yes

  No

  N/A

• Record product ID

• What size and length is the hose?

• Are all the toby/manway covers in place? Are they free from damage, seating properly and seals functioning?

  Yes

  No

  N/A

• Comments

• Are all drains and sumps clear of debris? Are they functional?

  Yes

  No

  N/A

• Where grating is present, is it secure? <br>i.e. correctly seated and all bolts right

  Yes

  No

  N/A

• Are separators systems free of fuel?

  Yes

  No

  N/A

• Where an interceptor shut off exists does it operate correctly?

  Yes

  No

  N/A

• Comments

• Is an ATG fitted?

  Yes

  No

  N/A

• Is it in good condition and operational?

  Yes

  No

  N/A

• Check the OPT paper levels and paper jams and carry out test receipt transaction

  Yes

  No

  N/A

Card Reader

• Check and Clean Card Reader

• How many card cleaners were used:

• Please note any loose lids, grates and damaged surfaces. Check and confirm operation of MID/lights, canopy lights and yard lights if possible.

  Yes

  No

  N/A

• Are the correct COVID - 19 QR code signs in place?

  Yes

  No

  N/A

• Are the QR codes mounted on canopy poles and/or front of OPT and/or OPT shelter (not in zone 1 or zone 2 or on front or sides of dispensers)

  Yes

  No

  N/A

• Are the QR codes damaged and unreadable?

  Yes

  No

  N/A

• Photo of QR code

  Media

• Advise if there are any issues or if they need replaced.

• Additional Repairs Required

• Add media

  Media

• Add signature

  Sign