B100

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Banlaw FuelTrack AutoID Receiver (Part - BFT 23LS)

• Check general condition

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

• Free from contamination

  Yes

  No

  N/A

• Dust caps allocated

  Yes

  No

  N/A

RTD Temperature Measurement (Part# PS0043)

• Check general condition

  Yes

  No

  N/A

• Check wiring and terminals are secure

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

Banlaw Receiver Banlaw (Part# BRM 23L)

• Check general condition

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

• Dust caps allocated

  Yes

  No

  N/A

• Free from contamination

  Yes

  No

  N/A

• Record serial number

  Yes

  No

  N/A

Banlaw Vent AUS25-A

• Check general condition

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

• Record serial number

  Yes

  No

  N/A

Banlaw Heavy Vehicle Refuelling Nozzle

• Record serial number / nozzle ID

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

• Inspect nozzle handles

  Yes

  No

  N/A

• Inspect front end of nozzle

  Yes

  No

  N/A

• Inspect dust cap for nozzle

  Yes

  No

  N/A

Banlaw Swivel

• Inspect general condition

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

• Record serial number

  Yes

  No

  N/A

Refuelling Hose

• Inspect general condition of refuelling hose

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

Banlaw Break Away Valve

• Inspect flange and screw joints for leaks

  Yes

  No

  N/A

• Inspect shear bolts

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

Banlaw Break Out Point

• Secured and leak free

  Yes

  No

  N/A

• Inspect conduit and wiring is secure

  Yes

  No

  N/A

Actuated Ball Valve

• Check all operations of actuated ball valve

  Yes

  No

  N/A

• Inspect conduit and wiring is secure

  Yes

  No

  N/A

• Inspect flange and screw joints for leaks

  Yes

  No

  N/A

Tank

• Record serial number

  Yes

  No

  N/A

• Secured and leak free

  Yes

  No

  N/A

Banlaw Depot / BOM box

• Record serial number

  Yes

  No

  N/A

• Check keyboard operations

  Yes

  No

  N/A

• Check wiring

  Yes

  No

  N/A

• Check all terminals ( tight, labeled etc)

  Yes

  No

  N/A

• Check physical appearance (seals door etc)

  Yes

  No

  N/A

• Check screen (contrast)

  Yes

  No

  N/A

• Check lantronix (lights etc)

  Yes

  No

  N/A

• Inspect mother board (lights, terminals, reset etc)

  Yes

  No

  N/A

• Check contrek (temperature, settings etc)

  Yes

  No

  N/A

Banlaw FillSafe

• Inspect general condition

  Yes

  No

  N/A

• Check wiring

  Yes

  No

  N/A

Auto ID Swipw Card

• Check operations (enable nozzle, valve opens, auto ID's etc)

  Yes

  No

  N/A

Emergency Stop Button

• Check emergency stop button is operational

  Yes

  No

  N/A

More

• As required record additional comments or recommendations

Approvals

• Performed by

  Sign

• Approved by

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