Title Page

  • Audit Title

  • Client / Site

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Safety

  • 1. Have all employees required to handle, transfer, transport, or otherwise work with ammonia been trained to understand the properties of ammonia, to become competent in safe operating practices, and to take appropriate actions in the event of a leak or emergency?<br>CGA G-2.1-2014 3.1

  • Comments

  • 2. Is refresher training completed at least every 3 years?<br>CGA G-2.1-2014 3.1

  • Comments

  • 3. Do all employees making, breaking or testing any ammonia connection, transferring ammonia, or performing maintenance or repair on an ammonia system under pressure wear protective gloves and chemical splash goggles? Note: A full face shield may be worn over goggles; however a face shield shall not be worn as a substitute for goggles.<br>CGA G-2.1-2014 3.2

  • Comments

  • 4. Do all employees making, breaking or testing any ammonia connection and transferring ammonia do so in accordance with written operating procedures?<br>CGA G-2.1-2014 3.2

  • Comments

  • 5. Do only employees trained for and designated to handle emergencies attempt to stop leaks? Note: If yes a minimum of Technician Level 24 Hour HAZWOPER Training (29 CFR 1910.120) would be required, otherwise N/A.<br>CGA G-2.1-2014 3.3.1

  • Comments

  • 6. In emergencies, is respiratory equipment of a type suitable for ammonia worn? Note: Must have if doing emergency response mentioned in #5.<br>CGA G-2.1-2014 3.3.1

  • Comments

  • 7. Has release recognition, prevention, notification, coordination of response actions, and evacuation and/or shelter in place protections been preplanned with local emergency planners and/or responders?<br>CGA G-2.1-2014 3.3.2

  • Comments

  • 8. Has the SERC, LEPC, and local fire department been notified that the facility has a threshold quantity (500 lbs.) of an extremely hazards substance and has a facility coordinator been identified?<br>CGA G-2.1-2014 3.3.3.2

  • Comments

  • 9. Is the following equipment for employee protection and first aid purposes available at the storage facility?<br>• One pair of protective gloves impervious to ammonia for each of the maximum number of employees that may be storing, handling, transferring or otherwise working with anhydrous ammonia at the same time plus at least one spare.<br>• Chemical splash goggles or chemical splash goggles with a full face shield worn over the goggles for each of the maximum number of employees that may be storing, handling, transferring or otherwise working with anhydrous ammonia at the same time plus at least one spare.<br>• One pair of protective boots impervious to ammonia<br>• One protective slicker and/or protective pants and jacket, all impervious to ammonia.<br>• Easily accessible emergency shower and a plumbed eyewash unit or at least 150 gals of clean water in an open top container. <br>o Emergency water should be available at each transfer location with no obstacles in the way to travel. <br>o Distance to emergency water should not exceed 10 seconds of travel time or 100 ft.<br>CGA G-2.1-2014 3.4

  • Comments

Container and Appurtenances

  • 1. For relocated/reinstalled storage vessels, is the storage tank designed according to code for pressure vessels by:<br>• Being registered with the National Board, or<br>• Having available an ASME manufacturer’s data report, or<br>• Being subject to testing.<br>Note: This question applies only to those tanks relocated/reinstalled after the implementation of the PSM (place N/A for initial PHA).<br>CGA G-2.1-2014 5.1.1.1

  • Comments

  • 2. Is the minimum design pressure of the storage tank(s) 250 psi?<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.1.1.2

  • Comments

  • 3. Has storage tank(s), without a legible data plate that is not replaceable, been inspected and tested to determine the following information:<br>• Wall thickness container shell and heads<br>• Water capacity<br>• Outside surface area.<br>Note: Tanks must be removed from service by the year 2030.<br>CGA G-2.1-2014 5.4.3

  • Comments

  • 4. Are all repairs or alterations to pressure containing parts of a storage tank or nurse tank performed by a firm that holds a valid R-stamp certification? <br>Note: Storage tanks and nurse tanks must have a legible data plate in order to be repaired or altered.<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.2.4

  • Comments

  • 5. Are container storage areas accessible to emergency vehicles?<br>​Note: Also applies to nurse tanks CGA G-2.1-2014 5.3.5

  • Comments

  • 6. Are areas within 10 ft. of a storage container maintained clear of dry grass and weeds and other combustible materials?<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.3.6

  • Comments

  • 7. Are all appurtenances fabricated from materials suitable for anhydrous ammonia?<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.6.1

  • Comments

  • 8. Do all connections to the container (except connections for pressure relief devices, thermometer wells, liquid level gauging, or connections with No. 54 drill orifice or those plugged) have a shutoff valve located as close to the container as possible?<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.5.3

  • Comments

  • 9. Does each filling connection container opening have a positive shutoff valve in conjunction with either an approved internal backpressure check valve or an approved internal excess flow valve as appropriate?<br>Quick opening (1/4 turn) valves are not recommended.<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.5.11

  • Comments

  • 10. Does each vapor connection have a positive shutoff valve together with an approved internal excess flow valve? <br>Quick opening (1/4 turn) valves are not recommended.<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.5.11

  • Comments

  • 11. Does the piping used meet at least ASTM A53, Grade B seamless or electric resistance welded pipe?<br>CGA G-2.1-2014 5.6.4

  • Comments

  • 12. Is all welded or welded and flanged piping at least Schedule 40?<br>CGA G-2.1-2014 5.6.4

  • Comments

  • 13. Is all threaded piping at least Schedule 80?<br>CGA G-2.1-2014 5.6.4

  • Comments

  • 14. Is all piping supported in accordance with good engineering practices and are provisions made to expansion, contraction, impact, vibration and settling?<br>CGA G-2.1-2014 5.6.3

  • Comments

  • 15. Do all metal, flexible connections have double braided construction and a minimum working pressure of 350 psi?<br>CGA G-2.1-2014 5.6.5

  • Comments

  • 16. After assembly, is all piping and fittings pressure tested and proved free of leaks?<br>CGA G-2.1-2014 5.6.8

  • Comments

  • 17. Is all underground piping evaluated at a minimum of every 5 years to ensure leak-tightness?<br>CGA G-2.1-2014 5.6.8

  • Comments

  • 18. Are all hoses subject to container pressure designed for a minimum working pressure of 350 psi and a minimum burst pressure of 1750 psi?<br>CGA G-2.1-2014 5.7.3

  • Comments

  • 19. Are hose assemblies when made up (modified or assembled at location) capable of withstanding a test pressure of 525 psi?<br>CGA G-2.1-2014 5.7.3

  • Comments

  • 20. Are all hoses marked with the following information?<br>• Anhydrous Ammonia<br>• XXX psig (Maximum Working Pressure)<br>• Manufactures Name or Trademark<br>• Year of Manufacture<br>CGA G-2.1-2014 5.7.6

  • Comments

  • 21. Are hoses inspected before each use for possible weakness as specified below?<br>• Cuts or nicks<br>• Deterioration<br>• Blistering<br>• Bulges, flat spots, or kinks<br>• Coupling damage or slippage<br>• Markings<br>• Leaks<br>• Maximum service period<br>CGA G-2.1-2014 5.7.7

  • Comments

  • 22. Are hose inspections documented seasonally for possible weakness as specified in the previous question?<br>CGA G-2.1-2014 5.7.9

  • Comments

  • 23. Are hoses pressure tested at least annually? Note: Does not apply to hose used to fill implements of husbandry (i.e. nurse tank).<br>CGA G-2.1-2014 5.7.10

  • Comments

  • 24. Are hoses immediately removed from service when failing an inspection or when they have reached their maximum service period?<br>CGA G-2.1-2014 5.7.11

  • Comments

  • 25. Is every container provided with one or more pressure relief valves which comply with the following?<br>• Relief valves are installed in a manifold so they can be replaced while the container remains pressurized. [NOTE: Shut-off valves are prohibited between the pressure relief valve and the container]<br>• The discharge is vented away from the container, upward and unobstructed to the atmosphere<br>• Precautions have been taken to insure that the rate of flow of the pressure relief valve is not restricted by piping or connections on either the upstream or downstream side of the pressure relief valve [Vent pipes, if used must not be smaller in size than the relief valve outlet]<br>• Pressure relief valves must have suitable rain caps, which allow free discharge of the vapor and prevent entrance of water.<br>• Relief valves are designed to drain possible accumulation of condensation.<br>• Pressure relief valves are constructed with a setting sealing device and the device intact and free of damage with no evidence that the spring tension device has moved since being set by the manufacturer<br>• The pressure relief valves are plainly and permanently marked as follows:<br>o With the letters “AA” or the symbol “NH3”:<br>o The pressure in psig at which the valve is set to start-to-discharge;<br>o The rate of discharge in cubic feet per minute:<br>o Year of manufacture; and<br>• The manufacturer’s name and catalog number.<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.8

  • Comments

  • 26. Is every pressure relief device subject to a systematic, periodic, visual external inspection at least annually to determine that it is free of evidence of tampering, damage, corrosion, or foreign matter that might prevent proper operation; free of leakage; has a properly installed rain cap; and has an open weep hole to permit moisture to escape?<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.8.14

  • Comments

  • 27. Is a hydrostatic relief valve installed in each section of piping (including hose) in which liquid ammonia can be isolated between shutoff valves to relieve pressure that could develop from the trapped liquid?<br>CGA G-2.1-2014 5.8.12

  • Comments

  • 28. Are pressure relief devices replaced by the date specified by the manufacturer of the device? Note: If no date is specified, the pressure relief device shall be replaced no later than 5 years following the date of manufacture.<br>Note: Also applies to nurse tanks CGA G-2.1-2014 5.8.16

  • Comments

Transfer of Liquids

  • 1. Does at least one qualified operator experienced in the procedures monitor the transfer of ammonia from the time the connections are first made until they are finally disconnected?<br>CGA G-2.1-2014 5.10.2

  • Comments

  • 2. Except for pneumatic testing, are containers only pressured with ammonia vapor? Note: Upon discovery, air or other system inerts shall be promptly purged from containers using accepted documented practices.<br>CGA G-2.1-2014 5.10.3

  • Comments

  • 3. Are pumps used for transferring ammonia recommended and labeled for ammonia service by the manufacturer?<br>CGA G-2.1-2014 5.10.6

  • Comments

  • 4. Are positive displacement pumps equipped with a pressure actuated bypass valve on the discharge side of the pump?<br>CGA G-2.1-2014 5.10.6.1

  • Comments

  • 5. Is a 0 to 400 psi working pressure gauge designed for ammonia service installed on the discharge side of the pump before the bypass valve line?<br>CGA G-2.1-2014 5.10.6.2

  • Comments

  • 6. Are shutoff valves installed as close to practical to the pump connections?<br>CGA G-2.1-2014 5.10.6.3

  • Comments

  • 7. Are compressors used for transferring ammonia recommended and labeled for ammonia service by the manufacturer?<br>CGA G-2.1-2014 5.10.7

  • Comments

  • 8. Are compressors designed for at least 250 psi working pressure?<br>CGA G-2.1-2014 5.10.7.1

  • Comments

  • 9. Are shutoff valves installed as close to practical to the compressor connections?<br>CGA G-2.1-2014 5.10.7.2

  • Comments

  • 10. Is a pressure relief valve, large enough to discharge the full capacity of the compressor, connected to the discharge side before any shutoff valve?<br>CGA G-2.1-2014 5.10.7.3

  • Comments

  • 11. Is there an adequate means, such as a drainable liquid trap provided on the compressor suction to minimize the entry of liquid into the compressor?<br>CGA G-2.1-2014 5.10.7.5

  • Comments

  • 12. Does the stationary storage tank location have an approved emergency shutoff valve(s) or backflow check valves installed in the liquid and vapor piping of the transfer system within 5 lineal ft. or other reasonable distance of where the hose is attached to the fixed piping?<br>CGA G-2.1-2014 5.10.8.1

  • Comments

  • 13. Are the above emergency shutoff valve(s) or backpressure check valves protected from any possible pull-away-while-connected incident between the mobile container and the transfer station so any break from a pull will occur on the hose side of the connection while retaining intact the valves and piping on the plant side of the connection?<br>Note: Pull-away-while-connected protection may be accomplished by:<br>• Concrete or steel bulkheads strong enough not to break or be uprooted<br>• Approved breakaway devices or<br>• Use of shear fittings designed to conform to good engineering practices<br>CGA G-2.1-2014 5.10.8.1

  • Comments

  • 14. Does the emergency shutoff valve incorporate a reliable actuation system that will close all of the emergency valves on the first attempt from a remote location in the event of an emergency or testing?<br>CGA G-2.1-2014 5.10.8.1

  • Comments

  • 15. Do meters used for the measurement of liquid anhydrous ammonia meet the following requirements:<br>• Recommended and labeled for ammonia service by manufacturer;<br>• Designed with a minimum working pressure of 250 psi; and<br>• Incorporates a device the will prevent the inadvertent measurement of vapor.<br>CGA G-2.1-2014 5.10.9

  • Comments

  • 16. Is each container equipped with an approved liquid level gauging device?<br>• Either a liquid level gauge indicating the maximum level to which the container may be filled with liquid anhydrous ammonia at temperatures between 20oF and 100oF; OR<br>• Gauging devices that require bleeding of the product to the atmosphere such as the rotary tube, or fixed dip tube.<br>CGA G-2.1-2014 5.11.2

  • Comments

  • 17. Do aboveground containers have a reflective surface (i.e. painted white) maintained in a good condition?<br>CGA G-2.1-2014 5.12

  • Comments

Systems using Stationary, Pier-Mounted, or Skid-Mounted above ground storage

  • 1. Is each storage tank equipped with a working pressure gauge graduated from 0 to 400 psi designed for ammonia service?<br>CGA G-2.1-2014 6.2

  • Comments

  • 2. Is the storage container provided with either:<br>• Reinforced footings and foundations; or<br>• Structural steel supports and foundations,<br>which maintain the lowest point of the tank not less than 18 inches above the ground?<br>CGA G-2.1-2014 6.4.1

  • Comments

  • 3. Do saddle supports extend over at least one third (1/3) of the circumference of the shell of the tank.<br>CGA G-2.1-2014 6.4.2

  • Comments

  • 4. Is there a suitable means to prevent corrosion on the portion of the container in contact with the foundation or saddles?<br>CGA G-2.1-2014 6.4.2

  • Comments

  • 5. Are the saddles, foundation and corrosion protection in good condition?<br>CGA G-2.1-2014 6.4.2

  • Comments

  • 6. Is each container or group of containers marked on at least two sides, which are visible, with the words, ANHYDROUS AMMONIA, or CAUTION – AMMONIA (letters not less than 3.9” high in sharply contrasting colors)?<br>CGA G-2.1-2014 6.6.1

  • Comments

  • 7. Is each container or group of containers conspicuously marked with a hazard warning label complying with 29 CFR 1910.1200?<br>CGA G-2.1-2014 6.6.2

  • Comments

  • 8. Are containers and appurtenances located or protected by suitable barriers to avoid damage by trucks or other vehicles?<br>CGA G-2.1-2014 6.7.1

  • Comments

  • 9. Are shutoff valves on storage tanks openings kept closed and protected by suitable means against tampering or theft of product when the installation is unattended?<br>Note: Examples of suitable means could include valve locks, remote surveillance, security systems, fencing, lighting, motion detectors, alarms, or chemical additives that render the ammonia unusable or undesirable for illicit use. One means of protection is usually not adequate.<br>CGA G-2.1-2014 6.7.1

  • Comments

  • 10. Is there a legible sign displayed on the premises at which a storage tank is located that is readily visible to emergency response personnel with lettering not less the 2 inches in height, stating the following:<br>• Phrase “EMERGENCY INFORMATION”;<br>• Name of facility;<br>• Name or title of at least two responsible persons<br>• Area code and telephone number(s) of each person listed; and<br>• Phrase “the 911 address is” and the appropriate 911 address?<br>CGA G-2.1-2014 6.8

  • Comments

Facility Siting

  • 1. Are there safe exit routes for accessibility and emergencies?

  • Comments

  • 2. Has equipment been adequately spaced and located to safely permit anticipated maintenance and hot work?

  • Comments

  • 3. Is the motor control center (MCC) located so that it is easily accessible to operators?

  • Comments

  • 4. Are circuit breakers labeled, easy to identify, properly guard live parts, and protected from physical damage?<br>1910.303(e)(f)(g), 305(b)

  • Comments

  • 5. Are fixed stairways constructed to OSHA standards to elevated work platforms?<br>1910.27 & 24

  • Comments

  • 6. Are fire extinguishers readily accessible, properly mounted, and serviced?<br>1910.157(c)(1)

  • Comments

  • 7. Are administrative building located away from inventories of highly hazardous chemicals?

  • Comments

  • 8. Are administrative building located away from release points of highly hazardous chemicals?

  • Comments

  • 9. Are access roads for emergency vehicles free of the possibility of being blocked by trains, highway congestion, spotting of rail cars, etc.?

  • Comments

  • 10. Are access roads well engineered to avoid sharp curves?

  • Comments

  • 11. Are traffic signs provided?

  • Comments

  • 12. Is a system in place to notify neighboring units, facilities, and residents if a release occurs?

  • Comments

  • 13. Are there detection systems and/or alarms in place to assist in warning neighboring units, facilities, and residents if a release occurs?

  • Comments

  • 14. Do neighbors know how to respond when notified of a release?

  • Comments

  • 15. Do they know how to shelter in place or when to evacuate?

  • Comments

  • 16. Are there adequate controls to ensure that electrically qualified equipment is replaced with equipment of equal or higher classification?

  • Comments

  • 17. On installations with multiple tanks, are the elevations of your storage tanks arranged to prevent unintentional overfilling? Note: 85% fill lines need to be at same elevation.

  • Comments

  • 18. Is there secure anchorage or adequate pier height to protect against container floatation whenever high flood waters can occur?<br>CGA G-2.1-2014 6.4.3

  • Comments

  • 19. Are there adequate controls (e.g. hot work permit, lockout/tagout) on repair and construction activities, including work by contractor personnel?

  • Comments

  • 20. Are procedures in place to restrict nonessential or untrained personnel from entering areas deemed to be hazardous?

  • Comments

  • 21. Are evacuation plans (from building, etc.) adequate and accessible to personnel?

  • Comments

  • 22. Are evacuation drills routinely conducted?

  • Comments

Human Factors

  • 1. Are working areas generally clean?

  • Comments

  • 2. Is emergency equipment accessible without presenting a further hazard to personnel?

  • Comments

  • 3. Is communication equipment adequate and easily accessible?

  • Comments

  • 4. Is access to all controls adequate?

  • Comments

  • 5. Can operators/maintenance workers safely perform all required routine/emergency actions, considering the physical arrangement of equipment?

  • Comments

  • 6. Are emergency shutoff valves or shutoff devices easily accessible?

  • Comments

  • 7. Is all important equipment legibly, accurately and unambiguously labeled?

  • Comments

  • 8. Has responsibility for maintaining and updating labels been assigned?

  • Comments

  • 9. Do written operating procedures exist for all operating phases (normal operations, temporary operations, etc.)?

  • Comments

  • 10. Are safe operating limits documented, providing consequences of deviation from limits and actions to take when deviations occur?

  • Comments

  • 11. Are procedures current (i.e., are they revised when changes occur)?

  • Comments

  • 12. Do operators believe that the procedure format and language are easy to follow and understand?

  • Comments

  • 13. Are the procedures accurate (i.e., do they reflect the way in which the work is actually performed)?

  • Comments

  • 14. Is responsibility assigned for updating the procedures, distributing revisions of the procedure, and ensuring that workers are using current revisions of the procedures?

  • Comments

  • 15. Are temporary notes or instructions incorporated into revisions of written operating procedures as soon as practical?

  • Comments

  • 16. Do procedures address the personal protective equipment required when performing routine and/or non-routine tasks?

  • Comments

  • 17. Are new employees trained in the hazards of the processes?

  • Comments

  • 18. Do operators and maintenance workers receive adequate training in safely performing their assigned tasks before they are allowed to work without direct supervision?

  • Comments

  • 19. Does training for operator and maintenance workers include training in appropriate emergency response?

  • Comments

  • 20. When changes are made, are workers trained in the new operation, including an explanation of why the change was made and how worker safety can be affected by the change?

  • Comments

  • 21. Are operators and maintenance workers trained to request assistance when they believe they need it to safely perform a task?

  • Comments

  • 22. Are operators and maintenance workers trained to report near misses as part of the incident investigation program?

  • Comments

  • 23. Are operators trained to shut down the process when in doubt about whether it can continue to operate safely?

  • Comments

Incidents

  • 1. Is all equipment installed according to manufacturer’s recommendations?

  • Comments

  • 2. Is there a rack to “hang-up” NH3 hoses on elevated platform to minimize tripping hazard?

  • Comments

  • 3. Is there an effective means to fill double nurse tanks so employees do not climb on tanks or throw hoses over the top of a tank?

  • Comments

  • 4. If wheel-valves on NH3 hoses, are employees trained to avoid accidental NH3 release by never handle the hose using the wheel valve, or drag on surface so wheel-valve unintentionally opens?

  • Comments

  • 5. Is there an adequate bleed-off system (recommend 200 gallons or more), with procedure to change on regular basis and avoid contact?

  • Comments

  • 6. Are employees training to understand NH3 pressure build-up in hoses and equipment that is shut-off or disconnected?

  • Comments

  • 7. Are employees training to properly connect and disconnect NH3 hoses to avoid exposure?

  • Comments

  • 8. Do all emergency valves remain closed except during periods of operation?

  • Comments

  • 9. On storage tanks not equipped with internal control valves, is there an emergency shut-off valve located on the line feeding the pump within 3 feet of the manual valve of the storage tank?

  • Comments

Team Completing PHA

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