INFORMATION

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

MANUAL & TRAINING RECORDS

  • Does the vendor have access to the most current copy of the Mesa Airlines, Inc. Fueling Manual #310?

  • Are employees aware of how to access the Mesa Airlines Fuel Manual through the Mesa non-employee Tech Pubs website?

  • Is there at least one certified Train the Trainer for the type of aircraft serviced and is Form S-101F on file? (LMS Certificate)

  • Does each fueler have a form T-009 for the type of aircraft serviced current and on-file?

  • If differences training is marked, does fueler have full (non-differences), current training from another carrier on the type of aircraft serviced? <br>

  • Are training certification records for persons performing equipment and facility inspections current and available for review? <br>

  • Are there any waivers currently on file? (Make copies for reference if applicable) <br>

  • Does fuel vendor have an operations and maintenance manual? <br>

  • Does the vendor have a current copy of the ATA 103?

FUEL RECEIPT RECORDS

  • Do fuel load receipt certification documents meet ASTM D1655 specifications? Are files retained for 12 months or more? <br>

PIPELINE

  • Are the following tests being conducted and recorded at the beginning, mid-point (if over 4 hours) and end of the fuel receipts?

  • Visual appearance in White Bucket

  • API Gravity, corrected to 60 degrees F (15 degrees C)

  • Color Membrane

  • Free Water Detection Test

  • Flash Point (Multi-Product Pipeline deliveries only)

  • Is the API Gravity between 37 degrees C and 51 degrees C? (Ensure there is not a change of less than 1 degree API as shown on the shipping document)

TRANSPORT

  • Are the following tests being conducted and recorded?

  • Visual appearance in White Bucket

  • API Gravity, corrected to 60 degrees F (15 degrees C)

  • Is the API Gravity between 37 degrees C and 51 degrees C? (Ensure there is not a change of less than 1 degree API as shown on the shipping document)

FUEL FACILITY CHECKS

  • Do facility records for persons performing daily, monthly, quarterly and annual inspections have legible signatures, initials or employee identification numbers? <br>

  • Are fuel facility filter change records kept on file for at least 36 months?

  • Are fuel facility tank inspection and cleaning records kept on file indefinitely?

  • Are Daily, Semi-Annual and Annual check records being retained on file for at least 12 months? <br>

DAILY CHECKS

  • Is the general condition of the tank yard being checked?

  • Are security, fire and safety deficiencies being checked?

  • Are fuel leaks being checked?

  • Are storage tank and reclamation tank sumps being performed and is the first sample being recorded? <br>

  • Are there separate sump recordings for each filter vessel?

  • Are filter differential pressures being recorded for each filter vessel and less than 15PSI? <br>

  • Are there separate differential pressure recordings for each filter vessel? <br>

  • Is the condition of hoses, swivels and nozzle covers being checked? <br>

  • Is the condition of static reels, cables and clamps being checked? <br>

  • Are Fire Extinguishers, inspection tags and seals being checked? <br>

MONTHLY CHECKS

  • Are monthly Millipore tests being performed on each filter vessel and are they available? <br>

  • Do Millipore membrane test results ratings meet (ASTM D2276) a 2A (3A wet) or less? <br>

  • Are free water tests being performed? <br>

  • Can the water kit detect 15ppm or less? <br>

  • Are the results 15ppm or less? <br>

  • Is the shelf life inspected to ensure no expired kits are used? (Aqua-Glo & Metrocator kits do not have a shelf life)

  • Are bonding cable continuity tests 25 ohms or less? <br>

  • Are nozzles removed and the screens checked? <br>

  • Are signs and placards being checked? <br>

  • Are the floating suctions checked? <br>

  • Are Fire Extinguishers, inspection tags and seals being checked? <br>

QUARTERLY CHECKS

  • Are the Emergency shutdown systems being operationally checked? <br>

  • Are the water defense systems being operationally checked on filter/separators? <br>

  • Are tank high level controls being checked? <br>

  • Are product reclamation tank interior inspections complied and cleaned as required? <br>

SEMI-ANNUAL CHECKS

  • Are loading and unloading hoses with reusable fittings pressure checked pre API 1540 requirements? <br>

ANNUAL CHECKS

  • Are the storage tank interiors inspections being checked and documents on ATA Form 103.07 or equivalent? <br>

  • Are filter differential pressure gauges being checked?<br>

  • Are filter elements being replaced every 12 months?<br>

  • Are filter separator/heaters being checked?<br>

  • Are tank vents being checked?<br>

  • Is cathodic protection being checked for underground storage tanks?<br>

  • Are line strainers, if installed, being removed and checked?<br>

  • Are filter vessel water defense systems being checked for operation?<br>

FUELING OPERATION OBSERVATION

  • Are fuel trucks backing up guided by ramp, airline, or vendor personnel?

FUEL STORAGE FACILITY WALK-AROUND

  • Is the storage facility secure from public access (Mesa Airlines, Inc. Manual #310)<br>

  • Are all fences and gates in good condition?<br>

  • Are all fence openings in unsecured areas locked when not in use?<br>

  • Are NO SMOKING, FLAMMABLE and JET FUEL or other product signs displayed?<br>

  • Ensure that there are no galvanized, copper alloys, cadmium plated or other materials?<br>

  • Is product identified and color-coded per API 1542 standards?<br>

  • Are flow direction arrows and color-coded bands clearly marked and visible on all piping above ground?<br>

  • Is there an adequate supply of ladders, stands and other related support equipment and in serviceable condition?<br>

  • Is there adequate lighting in the area for night operations?<br>

  • Are filter/separators or full-flow monitors being used for fuel receiving and dispensing?<br>

  • Do filter/separators meet current API Group II Class B Specifications? (API 1581)<br>

  • Do the filter/separators have an automatic water defense system that will either stop fuel flow or alert personnel?<br>

  • Do the filtration vessels have the following:<br>

  • Provisions for eliminating air?

  • Direct reading differential pressure gauges?

  • Manual sump drains?

  • Downsteam & upstream Millipore connections?

  • Pressure relief valves?

  • Placard indicating the month and year of last filter change?

  • Do the filtration vessels nameplate contain all of the following:<br>

  • The ManufactureÂ’s name and address?

  • The serial and unit number?

  • The API classification?

  • The rated capacity fot JET A?

  • The date of manufacture?

  • The number and model numbers of the coalescer and separator elements?

  • The manufactureÂ’s recommended element change pressure differential?

  • Are the filter vessel sumps acceptable?<br>

  • Are tank sumps acceptable?<br>

  • Is there a placard indicating the volume of tank drain piping adjacent to the tank drain valves?<br>

  • Does the fuel storage facility have an operating dead man control for all truck loading operations?<br>

  • Does the fuel storage facility have static ground cables at all truck loading points?<br>

  • Are plumbing, valves and hoses free from leaks and damage?<br>

  • Do loading and unloading fuel hoses/couplings meet API 1529 standards and 10 year service life?<br>

  • Are dust covers installed?<br>

  • Is there a system in place to prevent accidental mixing of fuels?<br>

  • Is the emergency shutoff systems placarded with (NFPA 407):<br>

  • At least 2" letters?

  • Method of operation?

  • At least 7' above grade?

  • Can be read 25' away from rack?

  • Is there unobstructed access to the emergency shutoff valves and switches?<br>

  • Are electrical junctions, boxes and conduits intact, with no expose wiring or frayed connections?<br>

  • Are the fire extinguishers in proper place and unobstructed?<br>

  • Ensure that all inspection tags and seals are intact or the extinguisher must be taken out of service?<br>

  • Are floating suctions working properly?<br>

TANKER TRUCKS AIRCRAFT FUELING EQUIPMENT CHECKS

  • Does the vendor use Tanker Trucks for fueling?

  • If those signing off the appropriate checks use initials, is there a record of each person's name and initials on file?

  • Are the records being kept on file for at least 12 months?

DAILY TANKER EQUIPMENT CHECKS

  • Is the general condition of the fueling vehicle(s) being checked?

  • Are filter sumps being performed and is the first sample being recorded?

  • Are samples taken under pressure?

  • Are the differential pressures being checked and under 15 psi? On filter/separators and 25psi.On full flow monitors?<br>

  • Are the dead man controls being checked?<br>

  • Are brake (safety) interlocks being checked?<br>

  • Is the nozzle fueling pressures being checked and under 40psi (50psi max)?<br>

  • Are hoses, swivels and nozzles being checked?<br>

  • Are the static reels, cables and clamps being checked?<br>

  • Are lift platforms being checked?<br>

  • Are the fire extinguishers being checked?<br>

  • Are surge/waste tanks being checked?<br>

  • Are air tanks being checked?<br>

  • Are tanker trough drains being checked?<br>

  • Are tanker sumps being performed form each tank compartment and is the first sample being recorded?<br>

  • Is tanker bottom loading pre-check controls being checked?<br>

MONTHLY TANKER EQUIPMENT CHECKS

  • Are monthly Millipore tests being performed on each filter or monitor vessel and are they available?<br>

  • Are the results a 2A (3A wet) or less?<br>

  • Are free water test being performed?<br>

  • Can the kit detect 15ppm or less?<br>

  • Are the results 15ppm or less?<br>

  • Is the shelf life inspected on the kit to ensure no expired ones are used? (Aqua-Glo and Metrocator kits do not have an expiration date)<br>

  • Is corrected filter differential pressure being checked for fueling equipment?

  • Is a static system continuity test being performed and is the resistance less than 25 ohms?<br>

  • Are nozzle screens being removed and checked?<br>

  • Are fuel hoses being checked?<br>

  • Are signs and placards being checked?<br>

  • Are meter seals being checked?<br>

  • Are fire extinguishers being checked?<br>

  • Are emergency shutdown systems being checked?<br>

  • Are lift platforms being checked?<br>

  • Are tanker interiors being checked?<br>

  • Are tanker vents and dome covers being checked?<br>

  • Are tank tough drains being checked?<br>

QUARTERLY TANKER EQUIPMENT CHECKS

  • Are vehicle inspections being performed?<br>

  • Are pressure controls being checked?<br>

  • Is the secondary pressure recorded and below 50psi?<br>

  • Are the water defense systems (external checks) being performed?

ANNUAL TANKER EQUIPMENT CHECKS

  • Are the filter elements being replaced (2 years for full-flow monitor elements)?<br>

  • Are all pressure gages (fuel delivery and differential pressure) being checked?<br>

  • Are the meters calibrated for tanker trucks?<br>

  • Are the water defense systems being operationally checked on filter/separators?<br>

TANKER TRUCK-FUELING EQUIPMENT WALK-AROUND

  • Does the vendor use tanker trucks for fueling?

  • Is equipment free from visible fuel leaks?<br>

  • Ensure that there are no galvanized, copper alloys or cadmium plating materials.<br>

  • Are all lights and other electrical equipment functioning properly?<br>

  • Are the windows free of cracks and crazing?<br>

  • Is the exhaust system intact?<br>

  • Are electrical junctions, boxes and conduit intact w/no exposed wiring or frayed connections?<br>

  • Are ladders in good condition?<br>

  • Do the filter/separators meet current API Group II Class C specifications?<br>

  • Do the filter/separators have an automatic water defense system that will stop fuel flow?<br>

  • Do the filtration vessels have the following:<br>

  • Provisions for eliminating air?

  • Direct reading differential pressure gauges?

  • Manual sump drains?

  • Downstream & upstream Millipore connections?

  • Pressure relief valves?

  • Placard indicating the month and year of the last filter change?

  • Do the filtration vessels nameplate contain all of the following:<br>

  • The manufactureÂ’s name and address?

  • The serial and unit number?

  • The API classification?

  • The rated capacity for Jet A?

  • The date of manufacture?

  • The number and model numbers of the coalescer and separator elements?

  • The manufactureÂ’s recommended element change pressure differential? (API 1581)

  • Are the filter vessel sumps acceptable?<br>

  • Are the tank sumps acceptable?<br>

  • Does each tanker truck have an emergency fuel shutoff in addition to a dead man?<br>

  • Do units with a lift platform have an emergency shutoff on the platform in addition to one on the ground level?<br>

  • Is there an emergency shutoff system on each side of the tanker trucks?<br>

  • Are the emergency shutoff systems placarded with at least 2” letters and does the placard indicate the method of operation (NFPA 407)?<br>

  • Does the interlock system function properly or are wheel chocks used?<br>

  • The interlock systems override device, if installed, should be secured in the normal positions with breakaway safety wire and the positions should be placarded.<br>

  • Are tanker trucks equipped with a minimum of two 20-lbs. B/C dry chemical fire extinguishers?<br>

  • Are Fire Extinguisher inspection tags and seals intact? (If not, the extinguisher must be taken out of service)<br>

  • Are the extinguishers mounted on opposite sides of the truck and placarded for location if in enclosed compartments?<br>

  • Do fuel hoses meet API 1529 Standards?<br>

  • Are all nozzle swivels secured by lock-rings or safety wired screws?<br>

  • Are there manual shutoffs ahead of each fuel hose?<br>

  • Are dust covers installed?<br>

  • Are the nozzles equipped with 100 mesh strainers?<br>

  • Is the fueling pressure gauge visible to the operator at all times and at least 4” in diameter?<br>

  • Is the nozzle pressure limited to 40psi?<br>

  • Have the fuel meters been calibrated within one year and are they sealed?<br>

  • Are the bonding cables in good condition and are there bayonet plugs available for the cable and the nozzles?<br>

  • Are the following placards posted:<br>

  • Jet A on each side and rear?

  • FLAMMABLE (3”) on each side and rear?

  • NO SMOKING (3”) on each side and in the cab?

  • Fuel and differential pressure gauges?

  • Filter vessels and tank drains?

  • Are tank interiors clean and made of stainless steel, aluminum or epoxy coated?<br>

  • Do the dome covers have forward mounted hinges?<br>

  • Are dome cover seals intact?<br>

  • Is there a pre-check system working for bottom loading trucks?<br>

  • Are solid wing mats available? (Mesa Airlines, Inc. Manual 310)<br>

HYDRANT SYSTEM CHECKS

  • Does vendor use Hydrant Systems for fueling

  • If those signing off the appropriate checks use initials, is there a record of each person's name and initials on file?

  • Are the records being kept on file for at least 12 months? Filter change records 36 months? <br>

DAILY HYDRANT SYSTEM CHECKS

  • Are pit areas being checked for leaks and cleanliness?<br>

  • Are hydrant pit covers being checked?<br>

  • Are the EFS (emergency fuel shutoff) stations being checked?<br>

MONTHLY HYDRANT SYSTEM CHECKS

  • Are hydrant valve assemblies being checked?<br>

  • Are isolation valve pits being checked?<br>

  • Are low point drains being checked and cleaned of debris?<br>

  • Are the emergency shutdown systems being checked?<br>

QUARTERLY HYDRANT SYSTEM CHECKS

  • Are high point vents being checked?<br>

  • Are surge absorbers being checked?<br>

  • Are leak detection and piping isolation system checks being performed?<br>

ANNUAL HYDRANT SYSTEM CHECKS

  • Is the cathodic protection being checked?<br>

HYDRANT TRUCKS/CARTS AIRCRAFT FUELING EQUIPMENT CHECKS

  • Does vendor use Hydrant Systems for fueling?

HYDRANT TRUCKS/CARTS AIRCRAFT FUELING EQUIPMENT CHECKS

  • If those signing off the appropriate checks use initials, is there a record of each personÂ’s name and initials on file?

  • Are the records being kept on file for at least 12 months?<br>

HYDRANT TRUCKS/CARTS DAILY CHECKS

  • Is the general condition of the fuel vehicles being checked?<br>

  • Are filter sumps being performed under pressure and is the FIRST sample being recorded?

  • Are safety interlock systems verified for proper operation?<br>

  • Are the dead man controls being checked?<br>

  • Is the nozzle fueling pressures being checked and under 40psi (50psi max)?<br>

  • Are hoses, swivels and nozzles being checked?<br>

  • Are the static reels, cables and clamps being checked?<br>

  • Are lift platforms checked for proper operation?<br>

  • Are the fire extinguishers tags and seals being checked?<br>

  • Are surge/waste tanks being checked?<br>

  • Are air tanks being checked?<br>

  • Are refueling truck troughs checked for proper drainage?<br>

HYDRANT TRICKS/CARTS MONTHLY CHECKS

  • Are monthly Millipore tests being performed on each filter or monitor vessel and are they available? (ATA 103.04B)<br>

  • Are the results a 2A (3A wet) or less?<br>

  • Are free water tests being performed?<br>

  • Can the kit detect 15ppm or less?<br>

  • Are the results 15ppm or less?<br>

  • Is the shelf life inspected on the kit to ensure no expired ones are used? (Aqua-Glo and Metrocator kits do not have expiration dates)<br>

  • Is corrected filter differential pressure being checked for fueling equipment?<br>

  • Is a static system continuity test being performed and is the resistance less than 25 ohms?<br>

  • Are nozzle screens being removed and checked?<br>

  • Are fuel hoses being checked?<br>

  • Are signs and placards being checked?<br>

  • Are meter seals being checked?<br>

  • Are fire extinguishers being checked?<br>

  • Are emergency shutdown systems being checked?<br>

HYDRANT TRUCKS/CARTS QUARTERLY CHECKS

  • Are vehicle inspections being performed?<br>

  • Are primary and secondary pressure controls being checked?<br>

  • Are filter separators external water defense system checks being performed?<br>

  • Are internal valve function tests performed for bottom loading or dispensing fuel?<br>

HYDRANT TRUCKS/CARTS SEMI-ANNUAL CHECKS

  • Are refueling hoses with reusable couplings pressure checked to 225psi every six months per API/IP 1540?<br>

HYDRANT TRUCKS/CARTS ANNAUL CHECKS

  • Are the water defense systems being operationally checked on filter/separators?

  • Are all pressure gauges (fuel deliver and differential pressure) checked for accuracy within (+/-) 2psi of full scale in accordance with manufacturerÂ’s procedures?<br>

  • Are the filter elements being replaced (2 years for full flow monitor elements)?<br>

FUELING EQUIPMENT WALK AROUND HYDRANT TRUCKS/CARTS

  • Does vendor use Hydrant System for fueling?

  • Is equipment free from visible fuel leaks?

  • Ensure that there are no galvanized, copper alloys or cadmium plating materials.

  • Are all lights and other electrical equipment functioning properly?

  • Are the windows free of cracks and crazing?

  • Is the exhaust system intact?

  • Are electrical junctions, boxes and conduits intact with no exposed or frayed connections?

  • Are ladders in good condition?

  • Do the filter/separators meet current API Group II Class C specifications?

  • Do filtration vessels have the following:

  • Provisions for eliminating air?

  • Direct reading differential pressure gauges?

  • Manual sump drains?

  • Downstream and upstream Millipore connections?

  • Pressure relief valves?

  • Placard indicating the month and year of last filter change?

  • Do the filtration vessel's nameplate contain the following:

  • The manufacturer's name and address.

  • The serial and unit number.

  • The API classification.

  • The rated capacity for Jet A.

  • The date of manufacture.

  • The number and model numbers of the coalescer and separator elements?

  • The manufacture's recommended element change pressure differential?

  • Are the filter sumps acceptable?

  • Does the deadman function properly?

  • Does each hydrant hydrant cart/truck have an emergency fuel shutoff in addition to a deadman?

  • Does the hydrant cart/truck stop the fuel flow by automatically closing the hydrant pit valve upon activation of the emergency fuel shut off system?

  • Are the emergency shutoff systems placarded with at least 2" letters and does the placard indicate the method of operation?

  • Are the following placards posted:

  • Flammable (3") on each side and rear.

  • No Smoking (3") on each side and in the cab?

  • Fuel and differential pressure gauges?

  • Filter vessels and tank drains?

  • Does the interlock system function properly or are wheel chocks used?

  • The interlock system override device, if installed, should be secured in the normal position with break away safety wire and the position should be placarded.

  • Are hydrant carts/trucks equipped with a minimum of one 20-pound B/C dry chemical fire extinguisher?

  • Ensure that all inspection tags and seals are intact or the extinguisher is taken out of service.

  • Do fuel hoses meet API 1529 standards?

  • Are all nozzle swivels secured by lock rings or safety wire screws?

  • Are there manual shutoff ahead of each fuel hose?

  • Are dust covers installed?

  • Are nozzles equipped with 100 mesh strainers?

  • Is the fueling pressure gauge visible to the operator at all times and at least 4" in diameter?

  • Is the nozzle pressure limited to 40 PSI?

  • Have the fuel meters been calibrated within one year and are they sealed?

  • Are the bonding cables in good condition and are there bayonet plugs available for the cable and the nozzle?

HYDRANT SYSTEM PIT WALK-AROUND

  • Does station use Hydrant Systems for fueling?

  • Are pits free from fuel leaks and trash?

  • Pits are removed from service if the water level is within 12" from the top of the pit valve.

  • Are the hydrant valves and sense plug dust covers in place?

  • Are the hydrant pit covers and hinges in acceptable condition?

  • Inspect the pressure flow charts for abnormal operating conditions. Are they acceptable?

  • Are the emergency shut off stations clearly marked and accessible?

OUTBRIEF & SIGNATURE

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  • Auditor's Signature:

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  • Auditor Comments:

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.