Bradtom - Site Safety and Asset Condition Assessment

• Document No.

• Client

  Enviro One Services

• Audit Title

  PCB Board Change Out and Asset Condition Assessment

• Conducted on

  Date

• Conducted By

  Bradtom

• Location

SWMS, Work Environment and Conditions

• Environment inspected for hazards and controls put in place to manage hazards - slips, trips and falls, uneven ground, dogs, cats, etc?

  Yes

  No

  N/A

• SWMS Available and Understood?

  Yes

  No

  N/A

Systems/Standards/Procedures

• Competence for task?

  Yes

  No

  N/A

• Perform Lock Out, Tag Out and confirm circuit is isolated and safe to work on.

  Safe

  At Risk

  N/A

Site Location and Condition Assessment

• Where is control box located on the property?

  Front Yard

  Back Yard

• Is screen panel display in good condition?

  Yes

  No

  N/A

• Is alarm board type 1 and needs replacing? If NO proceed to Site Task Completion Section below

  Yes

  No

  N/A

• Is integrated circuit chip inserted correctly? ie notch must be on left hand side.

  Yes

  No

  N/A

• DIP switch position - UP UP DOWN (UUD)

  Yes

  No

  N/A

• Voltage reading from screen panel display

• Amperage reading from screen panel display

Site Task Completion

• Alarm board type on site departure, type 1, 2, or 3

  Board Type 1

  Board Type 2

  Board Type 3

• Board Type Photo

  Media

• Conduct de isolation of energy to power board and site left in safe condition?

  Yes

  No

  N/A