Title Page

  • Business name

  • Business Address
  • Contact name

  • Business Email

  • Business telephone

  • Conducted on

  • Officer

  • Officer Contact Number

  • Document No.

Assessment Details

  • Premises Type

  • Activity

  • Activity

  • Details

  • Activities of interest

  • Details

Liquid Storage / Spill Management

  • Are Material Data Sheets (MSDS) held on site for all chemicals used?

  • Does the business store any liquids

  • Liquids stored

  • Details

  • Are liquids stored above ground, underground or both?

  • Above ground storage

  • Are all liquids and other potential contaminants stored on sealed ground and in a bunded and undercover area?

  • Details

  • Does the business have sufficient emergency spill control equipment on site.

  • Details

  • Have all staff been adequately trained in emergency spill response procedures?

  • Details

  • Underground storage

  • Is there an underground tank that holds flammable or combustible materials

  • Tank capacity / tank contents / notes

  • Is there an underground chemical storage tank? (E.g. Acid, alkali, spent coolant, radiator wash)

  • Tank capacity / tank contents / notes

Controlled Waste Management

  • Does the business generate or handle any controlled waste?

  • Which controlled wastes

  • Details

  • Number of tyres exceeds 100

  • Number of tyres exceeds 500

  • Amount of waste generated per year

  • Is the business a Licensed Controlled Waste carrier?

  • Licence No.

  • Does the business use a licensed waste contractor to remove any controlled waste

  • Details

  • Controlled waste records kept? (I.e. Receipts or register)

Air Quality Management

  • Measures to prevent dust leaving premises

  • Details

  • Measures to prevent fumes / vapours leaving premises

  • Details

  • Measures to prevent odours leaving premises

  • Does the company repair / refurbish / decommission air conditioners

  • Details

  • How are refrigerant gases managed?

  • Refrigerant Trading Authorisation?

  • Refrigerant Handling Licence

  • Is spray painting carried on at the premises

  • Is it conducted in an approved spray booth

  • Is a gun cleaning station used that captures and recirculates contaminated gun wash?

Waste Water Management

  • Does the business undertake any activities that generate wastewater?

  • Vehicle washing

  • Is treatment adequate?

  • Is disposal appropriate

  • Degreasing

  • Is treatment adequate?

  • Is disposal appropriate

  • Is engine degreasing conduced in a dedicated wash down bay that discharges to an oil separation system?

  • Are quick break and biodegradable degreasers and detergents used where wastewater is directed to an oil separation system.gd

  • Floor washing

  • Is treatment adequate?

  • Is disposal appropriate

  • Parts washing

  • Is treatment adequate?

  • Is disposal appropriate

  • Radiator flushing

  • Is treatment adequate?

  • Is disposal appropriate

  • Heat treatment

  • Is treatment adequate?

  • Is disposal appropriate

  • Metal cooling / cutting

  • Is treatment adequate?

  • Is disposal appropriate

  • Other

  • Details

  • Is treatment adequate?

  • Is disposal appropriate

  • Does the business discharge waste water to Deep sewer Septic tank or Approved apparatus

  • Approval from Water Corp or other relevant body to discharge wastewater to sewer?

  • IW permit number

  • The following devices are fitted

  • Sediment trap

  • Comments

  • Petrol and oil separator

  • Comments

  • Grease trap

  • Comments

  • In summary does business dispose of wastewater appropriately?

  • Are there other (non water) cleaning systems e.g. For small parts?

  • Is waste liquid disposed of appropriately?

Solid Waste Management

  • How does the business dispose of general solid waste?

  • Other details

  • Does the business segregate solid waste items for disposal, recycling or reuse?

  • Cardboard

  • Scrap metal

  • Rags

  • Wood

  • Other

Follow up and actions

Best Practice

  • Is there an environmental management system in place

  • Are independent environmental audits conducted

  • Details

  • Is there an internal incident reporting system

  • Is there an internal complaint reporting system?

  • Is there a documented maintenance procedure?

Summary and Follow up

  • Overall environmental standard

  • Attitude to environmental management

  • Follow up action required

  • Follow visit after or on

  • I have read and understood the contents of this assessment

  • Proprietor / Staff name

  • Officer Name

  • Officer

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.