Applegreen Operation Sites Safety Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

Documentation

• Is there a fire assembly sign displayed and is it in a suitable location?

  Yes

  No

  N/A

• Do store staff know where the emergency isolation switch is in case of a fire?

  Yes

  No

  N/A

• Has a PDSP and PSCS been appointed in writing for this project?

  Yes

  No

  N/A

• Has the Applegreen Permit to Work Form been completed and signed off by the operatives on site and the Store Manager?

  Yes

  No

  N/A

• Is there Risk assessments and method statements on site for all works taking place?

  Yes

  No

  N/A

• Have the risk assessments and method statements been reviewed by Fiontar Safety?

  Yes

  No

  N/A

• Is there a lock out tag out in operation at the time of inspection and is this suitable?

  Yes

  No

  N/A

• Is all electrical and mechanical isolations documented?

  Yes

  No

  N/A

• Does the site have an evacuation procedure and is this communicated with contractors on site?

  Yes

  No

  N/A

• Is there a sign in book?

  Yes

  No

  N/A

• Is the sign in book being used at time of inspection?

  Yes

  No

  N/A

• Is there Certification for all plant and equipment being used on site?

  Yes

  No

  N/A

• Is there daily checks of plant and equipment?

  Yes

  No

  N/A

• Is there examples of specific training for operatives such as fire training for working around fuel lines?

  Yes

  No

  N/A

Physical Safety

• Is there any exposed openings?

  Safe

  At Risk

  N/A

• Are works areas suitably segregated off from the public

  Yes

  No

  N/A

• Is there signage in place warning of the dangers?

  Yes

  No

  N/A

• Is traffic being managed safely at time of inspection?

  Safe

  At Risk

  N/A

• Is there a suitable number of fire extinguishers available on site?

  Safe

  At Risk

  N/A

• Are the fire extinguishers Carbon Dioxide or Foam? (Water is strictly forbidden)

  Yes

  No

  N/A

• Is there appropriate segregation between pumps being worked on and live pumps?

  Safe

  At Risk

  N/A

• Is there evidence of any spillages of flammable liquids?

  Safe

  At Risk

  N/A

• Is appropriate PPE being worn by all operatives?

  Yes

  No

  N/A

• Is plant and equipment being used safely without risk to the public?

  Safe

  At Risk

  N/A

• Are operatives using mobile phone on the forecourt?

  Yes

  No

  N/A

• Is there risk of plant and equipment damaging the structure of the building and canopy?

  Safe

  At Risk

  N/A

• Is material and equipment being stored safely and neatly?

  Yes

  No

  N/A

• Is there any other safety concerns on site?

  Safe

  At Risk

  N/A

• Site Manager

• Add signature

  Sign

• Person conducting the inspection

• Add signature

  Sign