Title Page

  • Site conducted

  • Conducted on

  • Inspected by


  • Housekeeping

  • Vegetation Control

  • Fencing

  • Fencing Condition

  • Total Number of Gates

  • Gates Locked

  • Emergency Exits

  • Emergency Exit Signs

  • No Trespassing Signs

  • Perimeter Pipeline Signs

  • Comments

Signs, Placards, Labels

  • ET Sign with Emergency Number

  • Station Name

  • Hard Hat Required

  • Eye Protection Required

  • Hearing Protection Required

  • FR Clothing Required

  • No Smoking

  • H2S Sign (50 PPM or Higher)

  • Authorized Personnel Only

  • Driving Plan

  • No Cell Phone or Camera Usage

  • Danger High Voltage

  • ARC Flash on High Voltage Panel

  • Voltage Labels on all Electrical Panels

  • Windsock

  • Pigging Procedures

  • Comments


  • Staircases and Catwalks in need of repair

  • Ground System available for trucks

  • Loadline fittings condition satisfactory

  • Loading Procedures

  • Proper Labeling and Identification

  • No Smoking Signs

  • Tanks atleast 100' from fired vessels

  • Confined Space Signs - Permit Required

  • Methanol Tanks properly grounded

  • Comments

Stairways, Catwalks, and Ladders

  • Fixed ladders over 24' equipped with fall arrest

  • Signs posted where harness required

  • Platforms have gates at ladder openings

  • Ladders and platforms in good condition

  • Handrails and Toeboards in place

  • Oil spills near ladders/stairs

  • Portable Ladders in good condition

  • Comments

Fire Prevention / Protection

  • Adequate number of Fire Extinguishers

  • Monthly Inspections Current

  • Annual Inspections Current

  • Hydro Test Dates Current

  • Approved Containers used for flammable/combustable liquids

  • Proper signage for Fire Extinguishers

  • Comments

Final Comments

  • Final Comments

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.