New Dealer Storage Compliance checklist

• Document Reference: YIM-SM-F001 (01)
  
  

• Created on : 15 October 2016

• Instruction:
  This form contains list of requirement related to safe storage compliance that based on Yara and regulatory standards and shall be completed by the potential/ new dealers prior to appointment. This apply to the cash crop dealers only. The dealers who use Yara’s warehouse for storage are excluded from this assessment.
  The objective is to ensure the dealers storage practices are safe and secure for Yara products. The compliance should be assessed by Yara Sales Personnel.
  
  Completed forms shall be returned to Yara International (M) Sdn Bhd by postage, fax or via electronic mail.
  
  Address:
  Lot 3.02, Level 3, 1 First Avenue, Bandar Utama,
  47800 Petaling Jaya,
  Selangor Darul Ehsan, Malaysia.
  Tel : +603 7726 4181
  Fax: +603 7722 2479
  

• Dealer Premise:

• Address:
  Address

• Dealer's Telephone Number:

• Fax Number:

• Type of Yara product:

• Size of storage area (sf):

Storage Compliance

• Please provide evidence (photo) for the answer with ‘Yes’.

• Fire extinguishers & water source are available.

  Yes

  No

  N/A

• Fire extinguishers are in good condition (i.e. within green zone & bomba cert. available).

  Yes

  No

  N/A

• No flammables (oil, gas, diesel, grease) in the storage area of fertilizer.

  Yes

  No

  N/A

• No combustibles (paper, wood, boxes) in the storage area of fertilizer.<br>* Except the material that used with purpose (pallet, tarpaulin)<br>

  Yes

  No

  N/A

• No farm chemicals (pesticides, herbicides, etc) shall be stored within 5m of fertilizer.

  Yes

  No

  N/A

• The electric equipment & cables are in good condition (no broken equipment, safe joins).

  Yes

  No

  N/A

• The electric panel is kept closed & located away from the fertilizers.

  Yes

  No

  N/A

• Floor is even & fertilizers are elevated from the ground.

  Yes

  No

  N/A

• Fertilizer stacking is stable (maximum 35 bags/ 4 pallets high).

  Yes

  No

  N/A

• Storage building is clean, dry, stable, no water leakage which may contaminate the fertilizer.

  Yes

  No

  N/A

• Storage building is clean, dry, stable, no water leakage which may contaminate the fertilizer.

  Yes

  No

  N/A

• Labelling on the fertilizer is available (product name, hazard label if any).

  Yes

  No

  N/A

• Fertilizers that are stored outdoor are well-sheltered from rain water.<br><br>

  Yes

  No

  N/A

• Download the Safety Data Sheets of fertilizer product from www.yara.com & kept available in the storage area.

  Yes

  No

  N/A

• I have received the brochure ‘Safe Use of Fertilizer’ from Yara, read and understood the information contained in the brochure.

Declaration:

• This form has been completed by:

• Signature of Yara Sales Personnel:

  Sign

• Signature of Dealer:

  Sign

• Date:

  Date

• Company stamp (optional):

  Media

Verifiction (office use only)

• Date Received:

  Date

• Compliance Status:

• Remarks:

• Verified by: Janice Liew (HESQ)