HSE and Customer Experience Audit

• Conducted on

  Date

• Prepared by

• RD Number

• Site Name

• Site Manager Name

• Site Manager Contact Number

• Site Manager Signature

  Sign
• Location
  Address

• Upload the complete picture of site

  Media

Forecourt

• Security & Safety signage is present & visible for customers (stickers)

  Yes

  No

  N/A

• Pictures of Safety signages

  Media

• Fire extinguishers placed near dispenser

  Yes

  No

  N/A

• Picture of Fire extinguishers near dispenser

  Media

• There are no electrical connection near dispenser & fueling area

  Yes

  No

  N/A

• Picture of electrical connection near dispenser & fueling area

  Media

• Staff prompt customers to turn engine off before fueling?

  Yes

  No

  N/A

• There is no visible leakage of fuels from dispensers

  Yes

  No

  N/A

• There is no any issue in canopy water leakage?

  Yes

  No

  N/A

• There is no any any unsafe hanging items from the canopy?

  Yes

  No

  N/A

• Complete forecourt picture

  Media

Emergency Response

• Is the Safety Organization chart available and displayed visibly?

  Yes

  No

  N/A

• Picture of safety organization chart

  Media

• Does the staff know their responsibilities for the day?

  Yes

  No

  N/A

• ESD Button Working (One or two buttons to cut Electrical Supply of entire site)?

  Yes

  No

  N/A

• Does the staff know designated Assembly Point?

  Yes

  No

  N/A

• Does the Site staff conduct ERP drill? Check written record

  Yes

  No

  N/A

• Emergency Contact Numbers Displayed & Visible?

  Yes

  No

  N/A

• Picture of Emergency contact numbers

  Media

• Are there sufficient number of FE present on site? (2 per tank, 1 per dispenser, 1 per DB (CO2), 1 per Generator, 1 per each NFR)

  Yes

  No

  N/A

• Are all FE Valid? (not expired)

  Yes

  No

  N/A

• Picture of expired FEs

  Media

• Are FE accessible that is not on high or rusted hooks?

  Yes

  No

  N/A

• Is the First Kit Aid available and accessible i.e. it is not in a locked space; not fixed to the wall.

  Yes

  No

  N/A

• Picture of First aid kit

  Media

Decantation

• No Electrical Connection within 10ft of Decantation Area?

  Yes

  No

  N/A

• Dip Caps are available for all tanks? Mark "No" even if one dip cap is missing.

  Yes

  No

  N/A

• Dip Caps are secured and fit completely? Mark "No" even if one dip cap is loose.

  Yes

  No

  N/A

• Picture of Dip caps

  Media

• Is Earthing Point Present?

  Yes

  No

  N/A

• Is Earthing Point Clean & not painted on?

  Yes

  No

  N/A

• Picture of earthing point

  Media

• Decantation Area Clean?

  Yes

  No

  N/A

• Decantation Area Tanks Labelled with Fuel Grade & Capacity?

  Yes

  No

  N/A

• Spill Containment Area Present at decantation point?

  Yes

  No

  N/A

• Picture of decantation area

  Media

• All necessary signage in place? ( Precautionary Measures, No Smoking, Switch off Mobile)

  Yes

  No

  N/A

• Earth Bonding Cable Available on site?

  Yes

  No

  N/A

• Is 50 kg foam trolley available near decantation area?

  Yes

  No

  N/A

• Is 50 kg trolley is Valid not Expired

  Yes

  No

  N/A

• Sufficient and valid fire extinguishers/sand buckets present on the site?

  Yes

  No

  N/A

• Picture of FEs and sand buckets

  Media

• Staff is wearing all PPE?

  Yes

  No

  N/A

• Decantation Area is safe ( no naked wiring, electric connect nearby)

  Yes

  No

  N/A

• Area around the decantation point is well-lit.

  Yes

  No

  N/A

Electric Safety

• There is no naked wiring on the entire site? Check DB room, decantation area, NFR facilities

  Yes

  No

  N/A

• There is no flammable substances near an electrical connection for example spilled oil or clothes/mattresses in DB room

  Yes

  No

  N/A

• Rubber Pad Placed in DB Room?

  Yes

  No

  N/A

• Picture of DB room

  Media

Cash Safety

• Is the cash room locked while counting?

  Yes

  No

  N/A

• Does the cashier adhere to 25K cash limit? Check on-ground with the cashier.

  Yes

  No

  N/A

Site Security

• Are CCTV cameras available and functional?

  Yes

  No

  N/A

• At least 7 days backup available?

  Yes

  No

  N/A

• Picture of CCTV camera with 7 days backup

  Media

• Do the CCTV cameras sufficiently cover the site particularly the decantation and fuelling area? Mention in notes areas not covered.

  Yes

  No

  N/A

• Security guard deployed on site ?

  Yes

  No

  N/A

• How many guards are deployed

• Picture of guard

  Media

Tuck Shop

• Tuck shop available at site?

  Yes

  No

  N/A

• Was the Shop premises free from any observable naked wiring?

  Yes

  No

  N/A

• Fire extinguishers available in Shop?

  Yes

  No

  N/A

• Fire extinguisher is valid?

  Yes

  No

  N/A

• Picture of Tuck shop

  Media

Car Wash

• Car Wash available at site?

  Yes

  No

  N/A

• Bollard Present in Car Wash?

  Yes

  No

  N/A

• Picture of Car Wash

  Media

Oil Change

• Oil Change available at Site?

  Yes

  No

  N/A

• Bollard installed in oil change?

  Yes

  No

  N/A

• Valid Fire Extinguisher available in Oil Change

  Yes

  No

  N/A

• Picture of Oil Change

  Media

Tyre Shop

• Tyre shop available at site?

  Yes

  No

  N/A

• Valid Fire Extinguisher available in tyre shop

  Yes

  No

  N/A

• Is the water for tyres being changed regularly?

  Yes

  No

  N/A

• Picture of Tyre shop

  Media

Entrance & Exit

• Entrance & Exit Area is clean - free of litter & spills?

  Yes

  No

  N/A

• Are the surrounding areas of the site, including roads and approaches, clean and well-maintained?

  Yes

  No

  N/A

• Picture of Entrance-Exit and Surrounding Areas

  Media

• Landscaping area/green belt is clean, green and well maintained?

  Yes

  No

  N/A

• Picture of Landscape area

  Media

• Pylon is clean and functional

  Yes

  No

  N/A

• Picture of Pylon

  Media

• Site is looking clean and bright?

  Yes

  No

  N/A

• All canopy branding is working & functional (Fascia and bar)?

  Yes

  No

  N/A

• Picture of canopy branding

  Media

• Is there no waste dumped around the premises, and are big bags used for proper waste management?

  Yes

  No

  N/A

Forecourt

• Forecourt Area is generally clean & free of litter, spills or water collection?

  Yes

  No

  N/A

• Forecourt Picture

  Media

• All lights work & are switched on when dark? (ask staff or check CCTV footage of night)

  Yes

  No

  N/A

• Under Canopy Area is Clean and undamaged?

  Yes

  No

  N/A

• Picture of under canopy area

  Media

• All Signage on Site is Clean and undamaged?

  Yes

  No

  N/A

• Picture of singages

  Media

• All Fuel Dispensers are clean and functional?

  Yes

  No

  N/A

• Pictures of all dispensers

  Media

• Nozzle jackets are in good condition & clean?

  Yes

  No

  N/A

• Pictures of Nozzle jackets

  Media

• All forecourt staff are wearing complete uniforms?

  Yes

  No

  N/A

• All forecourt staff are wearing name badges?

  Yes

  No

  N/A

• All forecourt staff are wearing Safety shoes?

  Yes

  No

  N/A

• Picture of staff

  Media

• Staff greet the customer? Show zero and final meter?

  Yes

  No

  N/A

• Wiper bucket & Wiper is available on site?

  Yes

  No

  N/A

• Picture of Wiper bucket

  Media

• Is there enough staff working on the site?

  Yes

  No

  N/A

NFR

• NFR Available at stie?

  Yes

  No

  N/A

• Name of the available NFRs

• Pictures of the NFR

  Media

• NFR area is clean

  Yes

  No

  N/A

• NFR Staff are wearing the complete uniform?

  Yes

  No

  N/A

• NFR Staff are wearing the name badges?

  Yes

  No

  N/A

• NFR staff are wearing shoes?

  Yes

  No

  N/A

• NFR Staff Picture

  Media

• Price lists are displayed for the customers

  Yes

  No

  N/A

Toilets

• Customer Toilets present on site?

  Yes

  No

  N/A

• Toilets Area is clean & tidy?

  Yes

  No

  N/A

• Toilets are clean from the inside?

  Yes

  No

  N/A

• Toilets are stocked with soap & tissues/towel.

  Yes

  No

  N/A

• All equipment inside toilets are functional (no water leaking & toilet is usable)?

  Yes

  No

  N/A

• Are toiletries, tissues, and other essential items of good quality?

  Yes

  No

  N/A

• Toilet Pictures (inside and outside)

  Media

Site Manager/Staff Feedback

• Feedback by staff

• Observations by trainer

• Any other pictures

  Media