Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Banlaw FuelTrack AutoID Receiver (Part - BFT 23LS)

  • Check general condition

  • Secured and leak free

  • Free from contamination

  • Dust caps allocated

RTD Temperature Measurement (Part# PS0043)

  • Check general condition

  • Check wiring and terminals are secure

  • Secured and leak free

Banlaw Receiver Banlaw (Part# BRM 23L)

  • Check general condition

  • Secured and leak free

  • Dust caps allocated

  • Free from contamination

  • Record serial number

Banlaw Vent AUS25-A

  • Check general condition

  • Secured and leak free

  • Record serial number

Banlaw Heavy Vehicle Refuelling Nozzle

  • Record serial number / nozzle ID

  • Secured and leak free

  • Inspect nozzle handles

  • Inspect front end of nozzle

  • Inspect dust cap for nozzle

Banlaw Swivel

  • Inspect general condition

  • Secured and leak free

  • Record serial number

Refuelling Hose

  • Inspect general condition of refuelling hose

  • Secured and leak free

Banlaw Break Away Valve

  • Inspect flange and screw joints for leaks

  • Inspect shear bolts

  • Secured and leak free

Banlaw Break Out Point

  • Secured and leak free

  • Inspect conduit and wiring is secure

Actuated Ball Valve

  • Check all operations of actuated ball valve

  • Inspect conduit and wiring is secure

  • Inspect flange and screw joints for leaks

Tank

  • Record serial number

  • Secured and leak free

Banlaw Depot / BOM box

  • Record serial number

  • Check keyboard operations

  • Check wiring

  • Check all terminals ( tight, labeled etc)

  • Check physical appearance (seals door etc)

  • Check screen (contrast)

  • Check lantronix (lights etc)

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

  • Check contrek (temperature, settings etc)

Banlaw FillSafe

  • Inspect general condition

  • Check wiring

Auto ID Swipw Card

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

Emergency Stop Button

  • Check emergency stop button is operational

More

  • As required record additional comments or recommendations

Approvals

  • Performed by

  • Approved by

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.