HSEQ Checklist

• Customer name

• Document No.

• Location
  Address

• Conducted on

  Date

• HSEQ checklist done by:

  Select Hugo Adendorff Hayley Holesgrove Nadia Thomas Johann Le Roux

  • Hugo Adendorff
  • Hayley Holesgrove
  • Nadia Thomas
  • Johann Le Roux

Above Ground Tanks

• Are above ground tanks positioned with a minimum safety distance of:<br><br>- 3.0 Meters from the edge of the tank to a boundary ,buildings ,drains or any combustible materials<br>- For tanks with a capacity greater than 45 000 liters and less than 80 000 liters ,the safety distance becomes 6 meters

  Yes

  No

  N/A

• Are tanks correctly marked with : Tank Number ,capacity,product?

  Yes

  No

  N/A

• Are there fixed ladders on the tanks & are they in good condition?

  Yes

  No

  N/A

• Is the filler position safe?

  Yes

  No

  N/A

• Are the Dip & Filler caps in place ,sealed and locked?

  Yes

  No

  N/A

• Is there any evidence of spills or overfills at the tank or filler point?

  Yes

  No

  N/A

• Report into IHSE🚨

• Are the tanks in good condition ,free of rust and painted?

  Yes

  No

  N/A

• Comments:

Under Ground Tanks

• Are tanks identified with: Tank number,capacity,product?

  Yes

  No

  N/A

• Are the correct delivery couplings installed?

  Yes

  No

  N/A

• Is the filler manholes sealed to prevent spills leaking out?

  Yes

  No

  N/A

• Are the filler point manholes clean & free of product?

  Yes

  No

  N/A

• Report into IHSE🚨

• Are the filler & dip caps securely fitted and locked at all times?

  Yes

  No

  N/A

• Is there any evidence of spills or overfills at the filler points?

  Yes

  No

  N/A

• Report into IHSE🚨

• Are vent pipes at least 3.5m above ground level and at least 600mm above a building roof if positioned against a building?

  Yes

  No

  N/A

• Is there any signs of fuel running out of the vents?

  Yes

  No

  N/A

• Report into IHSE🚨

• Comments:

BTF Tanks

• Are there more than 2 btf's used at the commercial site?

  Yes

  No

  N/A

• Are there fixed ladders on the btf's & are they in good condition?

  Yes

  No

  N/A

• Are the tanks in good condition : free of rust and painted?

  Yes

  No

  N/A

• Are tanks identified with: Tank Number;capacity;Product?

  Yes

  No

  N/A

• Is there any evidence of spills or overfills at the tank or filler point?

  Yes

  No

  N/A

• Report into IHSE🚨

• Comments:

Bunds

• Are all above ground installations bunded?

  Yes

  No

  N/A

• Are all bund walls constructed of brickwork: plastered & in good condition?

  Yes

  No

  N/A

• Does the site have a concreted bund floor?

  Yes

  No

  N/A

• Bund wall valve operational: kept closed and locked?

  Yes

  No

  N/A

• Correct safety signage visible at the tank area?

  Yes

  No

  N/A

• Are the inside of the bunded areas clean with no rags: debris or other flammable material?

  Yes

  No

  N/A

• Comments:

Pumps & Pipelines

• Are the correct decals displayed on the pumps?

  Yes

  No

  N/A

• Any signs of leaks on pumps or piping?

  Yes

  No

  N/A

• Is the correct safety signage displayed(No smoking,Cell Phones,Naked Flames)?

  Yes

  No

  N/A

• Are aboveground pipelines painted and colour-coded?

  Yes

  No

  N/A

• Is the Emergency STOP identified & accessible?

  Yes

  No

  N/A

• Is the pump secured to a concrete base?

  Yes

  No

  N/A

• Is there spill retention at the pump/fuel dispensing area?

  Yes

  No

  N/A

• Comments:

Environmental

• Has the site experienced spills or leaks?

  Yes

  No

  N/A

• If Engen's responsibility ,have they been entered in IHSE?

  Yes

  No

  N/A

• EINC # .....

• Is there a seperator on site & is it maintained?

  Yes

  No

  N/A

• Does the site have a good stock control system, with records available?

  Yes

  No

  N/A

• Comments:

Electrical

• Visually check for loose wires at pump/dispenser?

  Yes

  No

  N/A

• Is the electrical distribution board correctly marked?

  Yes

  No

  N/A

• Is the emergency Stop clearly identified & tested regularly?

  Yes

  No

  N/A

• Comments:

Emergency Response

• Does the site have emergency response plans in place,including spill contingency plans?

  Yes

  No

  N/A

• Are portable fire extinguishers provided for use at the bunded areas?

  Yes

  No

  N/A

• Are there fire extinguishers available at the pump/dispenser areas?

  Yes

  No

  N/A

• Are the fire extinguishers serviced and well maintained?

  Yes

  No

  N/A

• Has all staff been trained how to handle a fuel spill?

  Yes

  No

  N/A

• Is sand or spill absorbent (spill kits) available on site?

  Yes

  No

  N/A

• Are copies of MSDS for each product available on the site?

  Yes

  No

  N/A

• Comments:

General

• Does the site have a Valid Flammable Substance Storage License avalable?

  Yes

  No

  N/A

• Doc No:

• Add media

  Media

• Does the site manager understand Engen's work permit system?

  Yes

  No

  N/A

• Are there any signs of leaks and/or spills on the site?

  Yes

  No

  N/A

• Does the operator check regularly for water in the tanks&have records of results?

  Yes

  No

  N/A

• Are the areas around the tanks ; bunds or dispensing areas free from weeds; grass or flammable material?

  Yes

  No

  N/A

• Are the signs that the ug tanks are filled from the dip pipe instead of the correct filler point?

  Yes

  No

  N/A

• Do you have recent photos of the complete installation & surrounding areas?

  Yes

  No

  N/A

• Is the customer using wooden dipsticks - (Aluminum dipsticks to be removed)

  Yes

  No

  N/A

• Comments:

Follow up by Regional Sales Manager

• Corrective action required by item

  Select Above ground Tanks Underground Tanks Btf's Bunds Pumps & Pipelines Environmental Electrical Emergency Resonse General

  • Above ground Tanks
  • Underground Tanks
  • Btf's
  • Bunds
  • Pumps & Pipelines
  • Environmental
  • Electrical
  • Emergency Resonse
  • General

• Corrective action by whom?

  Select Salesperson Engineer Customer Regional Salesperson Other

  • Salesperson
  • Engineer
  • Customer
  • Regional Salesperson
  • Other

• Corrective action done by when?

  Date

• What corrective action need to be done?

• Signature by Salesperson:

  Sign

• Signature by customer confirming items discussed:

  Sign

• Signature by Regional Sales Manager:

  Sign

• Picture of site:

  Media