Title Page

  • Site conducted

  • Reagent Operator Check Sheet

  • Conducted on

  • Name

Area Safety Inspection

  • Housekeeping / Walkways (free of hazards, obstacles, etc.)

  • Electrical Issues (exposed wires, missing covers, etc.)

  • Equipment Guarding (adequate and secure)

  • Emergency Facilities (eye wash stations, e-lights, etc.)

  • Fire Extinguishers (current month and annual punched, not used nor damaged)

  • Maintenance Notifications / Comments:

  • Operator Signature

  • Supervisor Signature

Reagent Tote Inventories

  • F-549 Tote Inventory (storage)

  • F-549 Tote Inventory (Moly)

  • F-549 24-hour Use

  • Totes Added

  • P-4000 Field Tank Level

  • Flocculant Inventory (bags)

  • 7260 (TK09) Main Tank Level

  • Nitrogen

  • F549 Main (TK39) Tank Level

  • F-549 Day Tank Level

  • 7260 Totes

  • Aero 8989 Totes

Reagent Shift Observations

Start of Shift Operating Information

  • SAG's Running

  • Expected # of Lime Trucks to Deliver

  • Lime BN01 Level

  • Lime BN02 Level

  • Lime Tank TK07 Level

  • Lime Tank TK08 Level

  • Lime Tank TK50 Level

  • # of Lime Trucks that can Fit with Current Silo Inventory

  • Cyanide Main Tank Level

  • 8989 Collector Main Tank Level

  • X237 Main Tank Level

  • Mo120 Moly Collector Main Tank Level

  • NaHS Tank Level

  • 24 hour average NaHS Usage (GPM)

  • NaOH Tank Level

  • Lime Deliveries
  • Truck Arrival Time

  • Detention Reason (if Any)

Slaker 1 Density

  • 6 AM

  • 8 AM

  • 10 AM

  • 12 PM

  • 2 PM

  • 4 PM

Slaker 1 Power Draw (KWA, target is 32)

  • 8 AM

  • 12PM

  • 4PM

  • Grinding Media Added during Shift?

  • Amount Charged:

Slaker 2 Density

  • 6 AM

  • 8 AM

  • 10 AM

  • 12 PM

  • 2 PM

  • 4 PM

Slaker 2 Power Draw (KWA, target is 32)

  • 8 AM

  • 12 PM

  • 4 PM

  • Grinding Media Added during Shift?

  • Amount Charged:

Lime Plant Inspection (pumps, piping, housekeeping, clean operating slaker(s) lime feed chute

  • 6 AM

  • 8 AM

  • 10 AM

  • 12 PM

  • 2 PM

  • 4 PM

  • Maintenance Notifications / Comments

Reagent Off-load Areas Inspection (pumps, piping, housekeeping)

  • 6 AM

  • 8 AM

  • 10 AM

  • 12 PM

  • 2 PM

  • 4 PM

  • Maintenance Notifications / Comments:

Flocculant Plant Inspection

  • 6 AM

  • 8 AM

  • 10 AM

  • 12 PM

  • 2 PM

  • 4 PM

  • Maintenance Notifications / Comments:

  • NaHS / NaOH Water Addition Readings
  • Driver Name

  • Time

  • Gallons of Water Added

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.