Health & Safety SGN 2019

• Conducted on

  Date

• Prepared by

• Location
  Address

Forecourt

• Adequate Lighting

  Yes

  No

  N/A

• Fire Extinguishers & Buckets

  Yes

  No

  N/A

• Clean and in date with pin in place

  Yes

  No

  N/A

• Emergency Cut off switch clearly labelled and accessable

  Yes

  No

  N/A

• Tannoy System working

  Yes

  No

  N/A

• Pump islands clean, Metal grating in place, Bollards, Hoops

  Yes

  No

  N/A

• Below ground fill points free of excess water

  Yes

  No

  N/A

• Grade labels clean and clear

  Yes

  No

  N/A

• Tanks locked, vapour recovery locked

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Relevent Manhole lifting key available

  Yes

  No

  N/A

• Fuel caps chained to fill pipe

  Yes

  No

  N/A

• DCD box if applicable all working - Phone, Fire Extinguisher in date, printer working

  Yes

  No

  N/A

• Adequate cones available

  Yes

  No

  N/A

• All vent pipes correctly tagged

  Yes

  No

  N/A

• Vent Stack signs in place

  Yes

  No

  N/A

• Maximum height sign in place, any damage

  Yes

  No

  N/A

• Statutory signs in place - CCTV in operation, Trading times, No Smoking, Notice to customers to leave quietly if applicable

  Yes

  No

  N/A

• Calor Gas empty canisters not stored outside the cage

  Yes

  No

  N/A

• LPG Checklist/Operating/Emergency procedures in place

  Yes

  No

  N/A

• LPG Compound clean and tidy no overgrown weeds/shurbs - Fire extinguishers in compound + emergency stop + Signage

  Yes

  No

  N/A

• Aco drains clean and not blocked and bolted down

  Yes

  No

  N/A

• Any potholes damage to forecourt any trip hazards

  Yes

  No

  N/A

Shop

• Electric door lock working - Main Door

  Yes

  No

  N/A

• All gangways clear of trip hazards & DDA access

  Yes

  No

  N/A

• Fire exit signs in place above main door

  Yes

  No

  N/A

• Fire exit signs in place above back door if applicable

  Yes

  No

  N/A

• Fire Action notice on display by main door and back door if applicable

  Yes

  No

  N/A

• Fire extinguishers available 1 X Dry Powder, 1 X CO2, in date and pin in place

  Yes

  No

  N/A

• All marked with fire point label

  Yes

  No

  N/A

• Note the date of fire drill

  Date

• Statutory signs in place - CCTV in operation, No smoking, Allergien information available

  Yes

  No

  N/A

• Digi locks/electronic locks working on doors leading to secure areas

  Yes

  No

  N/A

• Site telephone working and available

  Yes

  No

  N/A

• Floor clear of trailing and damaged extension leads

  Yes

  No

  N/A

• Electricity cupboard free from visible damage and clear of no stored items

  Yes

  No

  N/A

• Smoke detector working

  Yes

  No

  N/A

• All shelves properly secured & sot overloaded

  Yes

  No

  N/A

• All perishible food items off the floor

  Yes

  No

  N/A

• Are all steps/staircases in good condition, no defects

  Yes

  No

  N/A

• Secure area signage displayed

  Yes

  No

  N/A

• Emergency flipchart displayed with contact list

  Yes

  No

  N/A

• Premises licence part A filled in safe

  Yes

  No

  N/A

• Premises licence part B on display

  Yes

  No

  N/A

• DPS authorisation sheet filled in and signed by all staff

  Yes

  No

  N/A

• DPS name and address are the same on both premises and personal licence

  Yes

  No

  N/A

• SGN Operating Procedures Folder available

  Yes

  No

  N/A

Work Equipment

• Wet floor sign available and clean

  Yes

  No

  N/A

• Safety torch available

  Yes

  No

  N/A

• Safety knife available

  Yes

  No

  N/A

• Goggles available

  Yes

  No

  N/A

• Papersuit available

  Yes

  No

  N/A

• 2 X Hi Viz jackets available

  Yes

  No

  N/A

• Step ladders in good condition - Rubber Feet, Top platform

  Yes

  No

  N/A

• Kickstool in good condition - Rubber base,

  Yes

  No

  N/A

• Veeder root checked - Print Out - No Water identified - No Alarms

  Yes

  No

  N/A

• Wet Stock filed & Saved on S: Drive - Fairbanks

  Yes

  No

  N/A

• First aid location notice on display

  Yes

  No

  N/A

• First aid box fully stocked

  Yes

  No

  N/A

• Site Register

  Yes

  No

  N/A

• Petroleum Storage Certificate available

  Yes

  No

  N/A

• Interceptor cleaning certificate available

  Yes

  No

  N/A

• Vapour Recovery Annually/or 3 Yearly maintenaince certificate present

  Yes

  No

  N/A

• Vapour Recovery Fault Log available

  Yes

  No

  N/A

• Electrical test certificate available

  Yes

  No

  N/A

• Pat test completed

  Yes

  No

  N/A

• Fire extinguisher certificate available

  Yes

  No

  N/A

• Asbestos register available

  Yes

  No

  N/A

• LPG Inspection up to date

  Yes

  No

  N/A

• DESER action plan available

  Yes

  No

  N/A

• Notice Board

  Yes

  No

  N/A

• Health & Safety poster on display

  Yes

  No

  N/A

• Emergency Contact list on display

  Yes

  No

  N/A

• Insurance SGN

  Yes

  No

  N/A

• Insurance Retailer

  Yes

  No

  N/A

Health & Safety Group Policy

• Petroleum Storage licence

  Yes

  No

  N/A

• Tank to pump layout

  Yes

  No

  N/A

• Lone working policy

  Yes

  No

  N/A

• Data protection policy

  Yes

  No

  N/A

• Competent person register

  Yes

  No

  N/A

• Dps authoristion form

  Yes

  No

  N/A

• Hazardous zone drawing

  Yes

  No

  N/A

• Probe calibration displayed and updated

  Yes

  No

  N/A

• Nozzle News signed and displayed

  Yes

  No

  N/A