MIN O TOM FOR Orica Pump Operation

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

TASKS OBSERVED

• Correct PPE is being worn

  YES

  NO

• Driver/operator demonstrates correct pump walk around inspection

  YES

  NO

• Driver/operator establishes supply and delivery capacity

  YES

  NO

• Driver/operator conducts pre-start testing/checking of pump safeties

  YES

  NO

• Driver /operator checks connections and sets valve path to ensure flow prior to starting pumps

  YES

  NO

• Driver/operator conducts pre-start testing/checking of pump safeties

  YES

  NO

• Driver/operator starts pump - establishes flow (confirm explicit understanding of how to check for flow)

  YES

  NO

• 1 to 2 minutes after start - Driver/operator checks and ensures flow

  YES

  NO

• Before pump safeties are reset the driver/operator ensures flow

  YES

  NO

• Driver/operator stops the pump when necessary (valves remain open prior to stopping)

  YES

  NO

• Driver/operator closes and locks valve path

  YES

  NO

• Driver/operator cleans up any spillage as per the site waste management procedure

  YES

  NO

• Location of evacuation point known and indentified

  Yes

  No

  N/A

• Question emergency situation and local procedures

  YES

  NO

SIGNATURES

• Driver/Operator

  Sign

• Assessor

  Sign