• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Compliant - Completed, no problems found

  • Non-compliant - Completed, problems noted & repairs required

  • Rectified - Completed, problems corrected

  • Incomplete - Unable to perform inspection or additional work to be done.


  • Banlaw Job Number:

  • Order Number:

  • Work started

  • Work completed


  • 01-Power light operational

  • 02-Operation of ZP2R control panel

  • 03- Membrane damaged or worn

  • 04-Conduit entry undamaged

  • 05-Lack of water ingress

  • Add media

  • Add drawing

Actuated ball valve

  • 01-Operation valve via control panel

  • 02-Operation via manual override

  • 03-Check lack of damage

  • 04-Check lack of water ingress

  • Add media

  • Add drawing

Level sensor

  • 01-Check normal operation

  • 02-Check lack of damage

  • 03-Check lack of water ingress

  • Add media

  • Add drawing

Loading arm

  • 01-800 LPM receiver cap attached

  • 02-800 LPM receiver free of damage or leaks

  • 03-1000 LPM receiver cap attached

  • 04-1000 LPM receiver free of damage or leaks

  • 05-Hose clamps tight

  • 06-Hose free of damage or leaks

  • 07-Actuated valve free of damage or leaks

  • 08-Actuator secure to ball valve

  • 09-Pipe mounts free of damage

  • 10-Pipe work free of damage or leaks

  • 11-Tank entry free of leaks

  • 12-Painted parts free of wear or fading

  • Add media

  • Add drawing

Tank vents

  • 01-Vents free of damage or blocking

  • 02-Overflow hose free of damage or kinks

  • 03-Remote filter assembly free of blockage

  • 04-Fuel tank free of damage (e.g. swelling)

  • 05-Level sensor has tight fit & free of leaks

  • Add media

  • Add drawing

Commission system

  • 01-System operates as designed

  • 02-System free of leaks

  • 03-Check pressure gauge & record pressure

  • 04-Confirm overflow hose is expelling air while refueling

  • 05-Overflow hose free of leakage

  • Add media

  • Add drawing

Fuel truck 672

  • 01-Flow rate

  • 02-Correct nozzle type fitted

  • 03-Correct nozzle spring setting

  • 04-Nozzle in good condition

  • 05-Holster, plug etc in good condition

  • Add media

  • Add drawing

Refueling process

  • 01-Operator wipes receiver

  • 02-Nozzle has shut off restrictor (i.e. o-ring)

  • 03-Operator understands the Fillsafe system

  • Add media

  • Add drawing

Issues & remarks

  • Inspection Comments

  • Recommendations


  • Inspected by

  • Inspected by

  • Inspected by

  • Approved by

  • NOTE: All non-compliant results will followed up by Banlaw Service. Work required will be quoted then submitted for review, approval and scheduling.

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