Title Page

  • Site Name:

  • Address ID:

  • Physical Address / GPS Coordinates:
  • Assessor Name:

  • Company:

  • Conducted on

General - Building and Site

  • Does the site have a combined diesel storage of 100kL or above?

  • Are there tanks onsite that have been out of use and/or out of service for more than 24 months?

  • Are there tanks onsite that have been out of use and/or service for more than 12 months?

  • Is the site secure with access to diesel storage infrastructure restricted from the public (e.g. site fencing)

  • Comment

  • Photo

  • Are there any sensitive receptors adjacent to the site (e.g. schools, nursing homes, parks, farms, waterways etc.)

  • Comment

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  • Are there any major potential contributors to contamination within the immediate vicinity (e.g. landfills, quarry, mines, other industrial activities)

  • Comment

  • Photo

  • Are current tested fire extinguishers readily available in close proximity to the diesel storage area(s) and diesel refuelling point.

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  • Are there adequate spill response materials provided at the site:<br>- onsite and readily identifiable;<br>- adequately stocked, and not contaminated with general waste items;<br>- fixed with a breakable lock (e.g zip tie) or is inspected routinely;<br>- appropriate to the nature/ quantity of substances onsite; and<br>- accessible in the vicinity of the diesel storage areas and/or refuelling point.<br>

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  • Comment

  • A Hazchem placard is located on the outside of the building at the entrance to the workplace<br>Note: Applicable for all sites where 10 000L or more diesel is stored (total across the system).

  • Photo

  • Comment

  • Sample placard

    actual Hazchem.PNG

Diesel Re-Fuelling Area

  • Inspection Check

  • Is there suitable space and infrastructure for safe refuelling of the diesel tanks:<br>- There is a suitable distance between the re-fuelling point and sensitive receptors (stormwater drains, vegetation, members of public); and<br>- Diesel re-fuelling points are adequately marked and, locked (or otherwise inaccessible to the general public).

  • Comment

  • Photo

  • Is the refuelling area is sealed with effective measures to contain spills (describe).

  • Comment

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  • Gauges, fill level monitoring and/or fuel dips are accessible to the fill point and correctly indicate tank capacity and current level(s).

  • Comment

  • Photo

  • Are there any tank overfill protection devices and/or local high level alarms fitted and functional. Record overfill protection type.

  • Comment

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  • Hosepipes, couplings, fittings and nozzles are free of damage and corrosion (no discoloration, delamination, swelling or disintegration etc.).

  • Comment

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  • Are there any signs of leaks or spills in the re-fuelling area.<br>Note the source of any leaks. Initiate a HIRO to report any significant leaks / spills evident..

  • Comment

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Tanks and Secondary Containment

    Tank Details
  • Tank Number:

  • Date of Install (if indicated)

  • Tank / Surround Photos (each side where practicable)

  • Status

  • Date Decommissioned

  • Comment:

  • Tank Usage

  • Tank Location

  • AST / UST

  • Is the tank protected by a Cathodic Protection system?

  • Describe

  • Photo

  • Are there any tank well or groundwater monitoring wells. Record number, any photograph each well showing location and any identifying labels / numbers

  • Comment

  • Photo

  • Measure and record the current groundwater level. Is this below the depth of the tank bottom?

  • Comment

  • Photo

  • Tank Construction

  • Describe

  • For tanks where the capacity exceeds 10 000L:<br>- A COMBUSTIBLE LIQUID placard is located on the external surface of the tank or adjacent to the tank (for tanks located inside, one placard is sufficient if multiple tanks are in the immediate vicinity).<br>- Information placards are in good condition and clearly visible from normal approaches

  • Photo

  • Comment

  • Sample placard

    Combustible Liquid.PNG
  • Are there any other chemicals stored in the immediate vicinity of the diesel storage location (i.e. other flammable liquids, gas bottles, chlorine, etc.). List any other chemicals within the vicinity / bund.

  • Comment

  • Photo

  • Is the tank and associated pipelines adequately protected from vehicle or other sources of mechanical damage (e.g. located away from hoist operating areas)

  • Comment

  • Photo

  • Is the tank and associated pipelines/ fittings free of visible signs of diesel leakage.

  • Comment

  • Photo

  • Are the tank, tank protection, piping, foundation, drainage, supports, platforms and safety equipment free from signs of deterioration or damage (e.g. cracks, corrosion or areas of wear).

  • Comment

  • Photo

  • Are there any sections of diesel transfer piping that are underground.

  • Comment

  • Photo

  • Is this tank standalone or a Day Tank supplied from a Bulk Tank?

  • Is there a secondary spill containment system that can contain 110% of the capacity of the largest tank; Provide comment on the type of spill containment and its integrity.

  • Comment

  • Photo

  • Are there secondary containment arrangements to capture spills from pipelines / fittings connected to the tank (provide comment on the type of spill containment and its integrity).

  • Comment

  • Photo

  • Are there secondary containment arrangements to capture spills from the generator (provide comment on the type of spill containment and its integrity).

  • Comment

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  • Are there a secondary spill containment systems that:<br>- can contain any leaks from the Day tank;<br>- can contain any overflow from the tank in the event of overfill protection failure and/or failure of the diesel transfer / supply piping / systems.<br>Provide comment on the type of spill containment and its capacity. In the absence of an internal leak detection / transfer trip system, spill containment for diesel handling / transfer systems needs be sized to contain 110% of the capacity of all interconnected tanks.

  • Comment

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  • Are there secondary containment arrangements to capture spills from the Transfer Pump and any associated leak points (provide comment on the type of spill containment and its integrity).

  • Comment

  • Photo

  • Are there secondary containment arrangements to capture spills from the generator (provide comment on the type of spill containment and its integrity).

  • Comment

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  • Does the Diesel Transfer Pump control system appear to be working (i.e. pump not running continuously).

  • Comment

  • Are any secondary spill containment systems:<br>- free of water / debris / or other items which may impact on capacity; and<br>- free from cracks, corrosion or other potential leak points; <br>- constructed from material impervious to diesel (e.g. not bitumen); and<br>- are any drain / release valves closed.

  • Comment

  • Photo

  • Are there any instrumented leak detection systems for the Tank / System? If so select type:

  • Describe

  • What controls are provided to protect against overfilling?

  • Describe

  • Photo

  • Is the current diesel level within acceptable limits (i.e current volume is within 20-90% of total capacity).

  • Comment

  • Is the diesel free from water (water disclosing paste check)

  • Comment

Ancillary Equipment Details

  • Record the following system information for an instrumented Leak Detection and Tank Level systems

  • Add system
  • System Name

  • Make

  • Model

  • Date of Install

  • Tank(s) Serviced

  • Trip Function

  • Describe

  • Upload record of Ancillary Equipment Details

Photographic Checklist

  • The site environs and external tank surrounds

  • Above Ground Tanks
  • Different angles to capture each side of tank (to the extent practicable).

  • Tank pipe connections

  • Tank inspection port

  • Below Ground Tanks
  • The Tank Connection Access pit (opened)

  • Refueling point (if separate)

  • The vent line, including any potential isolation points.

  • Corrosion Protection System (if located)

  • Transfer Pumps

  • Pipe lines , fittings, nozzles & jointing

  • Bunding / containment systems

  • Fire Extinguishers / Spill Response equipment

  • Placards / Hazchem signs

  • Any visual signs of contaminated ground

  • Any Tank Well or Groundwater monitoring bores

  • The generator(s)

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