CVA Anhydrous Ammonia Fertilizer Inspection

• Audit Title

• Conducted on

  Date

• Prepared by

• Personnel

Safety Observations

• PLANT INSPECTED BEFORE USE

  Yes

  No

  N/A

• PROPER EMERGENCY WATER DURING LOADING (size of tanks, placement of tanks, full of clean water, not frozen)

  Yes

  No

  N/A

• PROPER PPE (available and in use)

  Yes

  No

  N/A

• WHEEL BLOCKS USED

  Yes

  No

  N/A

• PROPER HANDLING OF HOSES & END VALVES (including properly holding valves by body and parking of hose end valves)

  Yes

  No

  N/A

• PROPER LOADING PROCEDURES USED (valve sequence, bleeding, monitoring tanks with fixed level 85% gauge, etc)

  Yes

  No

  N/A

• NURSE TANKS NOT FILLED OVER 85%.

  Yes

  No

  N/A

• EMERGENCY WATER FILLED ON NURSE TANKS (prior to delivery)

  Yes

  No

  N/A

• ONLY AUTHORIZED PERSONS in ammonia transfer areas.

  Yes

  No

  N/A

• OTHER CONDITIONS or OBSERVATIONS

  Yes

  No

  N/A

INSPECTION / MAINTENANCE RECORDS

• INSPECTION AND MAINTENANCE RECORDS for bulk plant?

  Yes

  No

  N/A

• INSPECTION AND MAINTENANCE RECORDS for nurse tanks.

  Yes

  No

  N/A

BULK PLANT STORAGE AREAS

• AREA FREE OF CLUTTER OR RUBBISH?

  Safe

  At Risk

  N/A

• EMERGENCY WATER (Near Bulkhead for transport drivers - proper size, full, clean, not frozen)

  Safe

  At Risk

  N/A

• FREE OF LEAKS

  Safe

  At Risk

  N/A

• BULKHEAD STRUCTURES compliant

  Safe

  At Risk

  N/A

• BACK CHECK VALVES or EMERGENCY SHUT OFF VALVES at bulkheads.

  Safe

  At Risk

  N/A

• EMERGENCY PULL CABLES PROPERLY RUN?

  Safe

  At Risk

  N/A

• BLEED OFF SYSTEM at bulkhead (valves, hoses, tanks)

  Safe

  At Risk

  N/A

• HYDROSTATIC RELEIF VALVES in liquid piping.

  Safe

  At Risk

  N/A

• HAND VALVES properly positioned and in safe condition.

  Safe

  At Risk

  N/A

• EXCESS FLOW VALVES IN TANKS

  Safe

  At Risk

  N/A

• PIPING (condition, flex sections at bulkhead, and proper support)

  Safe

  At Risk

  N/A

• VAPOR RELIEF VALVES are changed out every 5 years and are directed upward, away from any obstructions, and covered with weatherproof caps?

  Safe

  At Risk

  N/A

• PIERS SUPPORTING TANKS (structurally sound and a corrosion barrier the width of the saddle is to prevent contact between the tank and the pier).

  Safe

  At Risk

  N/A

• TANKS PAINT (condition)

  Safe

  At Risk

  N/A

• TANK MARKINGS (proper signage and condition)

  Safe

  At Risk

  N/A

• VALVES AND PIPING PAINTED (red for liquid and yellow for vapor)

  Safe

  At Risk

  N/A

• ELECTRICAL (in good condition and protected from damage by weather).

  Safe

  At Risk

  N/A

• TRAFFIC BARRIERS in place to protect tanks and plumbing.

  Safe

  At Risk

  N/A

• FREE OF of COMBUSTIBLE ITEMS (such as dry grass or weeds under tanks and piping)

  Safe

  At Risk

  N/A

• EMERGENCY CONTACT SIGNAGE

  Safe

  At Risk

  N/A

• SECURITY (valves and electrical)

  Safe

  At Risk

  N/A

• OTHER CONDITIONS

  Safe

  At Risk

  N/A

LOADOUT STANDS

• AREA FREE OF CLUTTER OR RUBBISH?

  Safe

  At Risk

  N/A

• WATER TANKS FOR LOADING PLATFORMS

  Safe

  At Risk

  N/A

• FREE OF LEAKS

  Safe

  At Risk

  N/A

• LOADING PLATFORMS (design, steps, handrails, standing platforms, paint, general condition)

  Safe

  At Risk

  N/A

• HAND VALVES (placement and condition)

  Safe

  At Risk

  N/A

• PIPING

  Safe

  At Risk

  N/A

• PUMP SWITCHES

  Safe

  At Risk

  N/A

• HOSES

  Safe

  At Risk

  N/A

• HOSE END VALVES

  Safe

  At Risk

  N/A

• HYDROSTATIC PROTECTION for piping and hoses at loading platforms.

  Safe

  At Risk

  N/A

• PULL AWAY DEVICES

  Safe

  At Risk

  N/A

• WIND SOCKS

  Safe

  At Risk

  N/A

• SECURITY (hose end valves at loading platforms)

  Safe

  At Risk

  N/A

• OTHER CONDITIONS

  Safe

  At Risk

  N/A

Nurse Tank Inspections

• Nurse tanks are free of leaks?

  Safe

  At Risk

  N/A

• Each nurse tank is equipped with an emergency water tank in good condition?

  Safe

  At Risk

  N/A

• All nurse tanks are maintained in safe condition including running gear, tires, tanks, valves, and plumbing?

  Safe

  At Risk

  N/A

• Tandem tanks are properly plumbed?

  Safe

  At Risk

  N/A

• Two safety chains installed on each nurse tank.

  Safe

  At Risk

  N/A

• Nurse tanks PAINT (tank and valves)

  Safe

  At Risk

  N/A

• Nurse tanks display proper decals, warning labels, and DOT placards?

  Safe

  At Risk

  N/A

• SMV placards displayed on back?

  Safe

  At Risk

  N/A

• OTHER CONDITIONS

  Safe

  At Risk

  N/A

SIGNATURES

• Inspector

  Sign

• Plant Supervisor

  Sign