Environment Contact Inspection

• Inspection area

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Inspection team

Wash pads

• Any leaks or water loss evident?

  Not applicable

  OK

  At Risk

• Evidence of spills or leaks?

  Not applicable

  OK

  At Risk

• Are pumps in good working order?

  Not applicable

  OK

  At Risk

• Sumps/pads well maintained?

  Not applicable

  OK

  At Risk

• Drains free flowing and free of rubbish/vegetation?

  Not applicable

  OK

  At Risk

• Sediment levels kept at a minimum?

  Not applicable

  OK

  At Risk

• Is overall house keeping ok?

  Not applicable

  OK

  At Risk

Refuelling facilities

• Evidence of spills or leaks?

  Not applicable

  OK

  At Risk

• Are pumps in good working order?

  Not applicable

  OK

  At Risk

• Sumps/pads well maintained?

  Not applicable

  OK

  At Risk

• Drains free flowing and free of rubbish/vegetation?

  Not applicable

  OK

  At Risk

• Sediment levels kept at a minimum?

  Not applicable

  OK

  At Risk

• Is overall house keeping ok?

  Not applicable

  OK

  At Risk

Oily water separator and ponds

• Are pond gates locked?

  Not applicable

  OK

  At Risk

• Equipment operating effectively?

  Not applicable

  OK

  At Risk

• Pond levels acceptable?

  Not applicable

  OK

  At Risk

• Detergent evident in clean water pond?

  Not applicable

  OK

  At Risk

• Ponds free of rubbish/vegetation?

  Not applicable

  OK

  At Risk

• Has sampling been conducted as per licence conditions?

  Not applicable

  OK

  At Risk

• Is overall house keeping ok?

  Not applicable

  OK

  At Risk

• Fauna egress matting ok?

  Not applicable

  OK

  At Risk

Bulk fuel facility

• Evidence of spills or leaks?

  Not applicable

  OK

  At Risk

• Are pumps in good working order?

  Not applicable

  OK

  At Risk

• Facility bunding free flowing and free of rubbish/vegetation?

  Not applicable

  OK

  At Risk

• Sediment levels kept at a minimum?

  Not applicable

  OK

  At Risk

• Is overall house keeping ok?

  Not applicable

  OK

  At Risk

Summary of actions

• Summary of actions raised

Sign off

• Environmental advisor sign off

  Sign

• Area supervisor/superintendent

  Sign