Title Page
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Conducted on
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Prepared by
Fueling Station
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Fire extinguishers are accessible and fully charged?
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Emergency shut of switch is accessible and sign is intact?
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No smoking signs are visible and easily identifiable?
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Both gas and diesel pump handles are locked and in place?
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Notify mechanics
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Both gas and diesel hoses are intact, free of cracks, and wear marks?
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Notify mechanics
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Windshield washer handle and fluid are present and filled?
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Spill kit is present, free of debris and filled?
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Notify mechanics
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All spill clean up material is cleaned up?
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Notify mechanics
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Area is free of all trash and debris?
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Clean it up
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All tank caps are in place and are intact/free of breaks or cracks?
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Notify mechanics
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All tanks are free of cracks or other damage that would lead to spillage?
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Are the fueling areas free of spills that could cause slips, trips or falls?
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Has action been taken to mitigate spills in fueling area?
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Is fuel storage tank free of the presence of water?
- Yes
- No
- N/A
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Are all pipe connections free of leakage?
Conclusion
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Was anything found defective
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What was defective
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Can it be fixed in a quick manner?