Title Page

  • Site conducted

  • Conducted on

  • Prepared by

End of Day

  • Did you produce asphalt today?

  • What was your target loadout time?

  • Did you meet your target?

  • What was your actual loadout time and why was it late?

  • How many plant breakdown events occurred (enter 0 if you had none)?

  • What part of the plant broke down?

  • How many hours was the plant down?

  • Breakdown 1- What part of the plant broke down?

  • Breakdown 1- How many hours was the plant down?

  • Breakdown 2- What part of the plant broke down?

  • Breakdown 2- How many hours was the plant down?

  • Breakdown 1- What part of the plant broke down?

  • Breakdown 1- How many hours was the plant down?

  • Breakdown 2- What part of the plant broke down?

  • Breakdown 2- How many hours was the plant down?

  • Breakdown 3- What part of the plant broke down?

  • Breakdown 3- How many hours was the plant down?

  • Are your silos empty, clean, and free of buildup?

  • Did you schedule any planned maintenance items?

  • Do you have any current IT related issues?

  • Do you currently have help desk tickets open regarding your issues?

  • Do you need help escalating this issue to get it solved in a timely manner?

  • Does any crew member have an innovation/best practice to submit?

SAFETY AND ENVIRONMENTAL:

  • Ground areas, walkways, catwalks, platforms clean?

  • Plant area clean and kept free of material buildup under belts, screws, bins, etc?

  • Tool room, break room, and parts areas cleaned and organized?

  • Were LOTO and confined space entry logs filled out as needed?

  • Is all guarding in place on all components that are not currently locked out?

  • Were baghouse maintenance and containment logs filled out as needed?

HOT OIL HEATER:

  • Heater oil is at adequate level?

  • Pumps and couplings free of leaks?

  • Temperature set and maintaining properly?

  • Is hot oil callout system in place and working properly?

AIR COMPRESSOR:

  • Oil level is adequate and tank and water traps drained as needed?

  • All gauges and safety valves working properly and all lubrication performed as needed?

BAGHOUSE:

  • Stack, ductwork, and all seals in proper condition to prevent leaks and/or ambient air infiltration?

  • Bearings properly greased throughout the day?

  • Visual opacity inspection shows baghouse operating properly?

ALL CONVEYORS & SCALE BELTS:

  • All conveyor belts in adequate condition (tension, splicing, and tracking)?

  • All skirtboards, rollers, and scrapers installed and in proper working order?

  • Weigh bridge rollers free of debris?

DRIER:

  • Trunions and drive chain properly tracking and lubricated?

  • Drum seals installed and in proper working condition?

SHAKER DECKS:

  • Shaker is free from unusual noises and leaks?

  • Screens and springs are in proper working condition?

BURNER:

  • No loose linkages or mounting bolts?

  • Fuel system free of leaks and at proper gas pressure or RFO viscosity?

TANK FARM:

  • All strainers checked and cleaned as needed?

  • All pumps and tanks free of leaks?

SLAT/SILOS/TRAVERSE

  • All bearings (drives AND idlers) lubricated as needed and in proper working condition?

  • Batchers operating properly?

  • Silo safety switches and loadout cameras working properly?

Lime Mixer

  • Belts and bearings in proper working condition?

  • Buildup inside of mixer removed as needed to ensure proper mixer operation?

Other

  • Are there any other items you need to report?

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.