MIN O BOT FOR Chlorine Site Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

REQUIREMENTS

• Is there any delivery instructions or a specific delivery window

  Yes

  No

  N/A

• Site access adequate for a semi trailer

  Yes

  No

  N/A

• Is there a designated loading zone

  Yes

  No

  N/A

• Is the loading zone clearly labelled, including DG and safety signage

  Yes

  No

  N/A

• Are the chlorine drums/cylinders stored on a sealed surface

  Yes

  No

  N/A

• Are the chlorine drums/cylinders stored in a secure area

  Yes

  No

  N/A

• Does the site have lifting equipment to unload drums and cylinders in crates

  Yes

  No

  N/A

• If there is no site lifting equipment is there enough room for the forklift to manouver safely

  Yes

  No

  N/A

• Is there any emergency equipment available to contain an accidental release of chlorine gas on site

  Yes

  No

  N/A

• Does the driver need to complete a site specific induction

  Yes

  No

  N/A

• Is the driver made aware of the site evacuation plan and muster points on each visit

  Yes

  No

  N/A

• INSPECTED BY

  Sign