Pesticide operator

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Vehicles

• Registration number of vehicles

  Yes

  No

  N/A

• Firm name displayed on vehicle and registration number from DOH (50mm height)

  Yes

  No

  N/A

• Drivers compartment isolated from pesticides and fumigants on vehicle

  Yes

  No

  N/A

• Vehicle equipped with lockable storage for pesticide

  Yes

  No

  N/A

• Additional security for 1080 and strychnine

  Yes

  No

  N/A

• Vehicle is well maintained

  Yes

  No

  N/A

• Vehicle equipped with respirator, 2sets of overalls, gloves, boots, goggles

  Yes

  No

  N/A

• Spillage on vehicle can be contained

  Yes

  No

  N/A

• Spillage cloths ( kitty litter)

  Yes

  No

  N/A

• Spill kit or bucket of sand

  Yes

  No

  N/A

• Spraying equipment is free of leaks

  Yes

  No

  N/A

• Spraying equipment is clean, we'll maintained, not old or likely to rupture

  Yes

  No

  N/A

• Back flow prevention device fitted

  Yes

  No

  N/A

• Clean water on vehicle

  Yes

  No

  N/A

• Emulsion tanks labelled Poison

  Yes

  No

  N/A

• Chemical concentrate in original container, correctly labelled

  Yes

  No

  N/A

• Chemical rinsate containers available, correctly labelled

  Yes

  No

  N/A

• MSDS of pesticide on vehicle

  Yes

  No

  N/A

PPE

• Twin cartridge respirator

  Yes

  No

  N/A

• Reserve supply of cartridges (in date)

  Yes

  No

  N/A

• PVC or nitrile chemical resistant gloves

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• PVC boots

  Yes

  No

  N/A

• Two pairs of overalls

  Yes

  No

  N/A

• Washable headwear

  Yes

  No

  N/A

• All PPE stored separate from pesticide

  Yes

  No

  N/A

• First aid kit

  Yes

  No

  N/A

Pesticide store

• Storage of pesticides at premise

  Yes

  No

  N/A

• Store capable of being locked

  Yes

  No

  N/A

• Roof to protect from rain

  Yes

  No

  N/A

• Impervious floor

  Yes

  No

  N/A

• Storage shelving made from impervious material

  Yes

  No

  N/A

• Water available for washing down spillage

  Yes

  No

  N/A

• Situated so that spillage cannot drain into any water supply or water course

  Yes

  No

  N/A

• Away from food storage or preparation areas

  Yes

  No

  N/A

• Adequate ventilation for fire control ( 150mm round ventilation holes)

  Yes

  No

  N/A

• Impervious sump, capable of being cleaned regularly

  Yes

  No

  N/A

• Natural lighting or sealed electrical lighting

  Yes

  No

  N/A

• First aid kit

  Yes

  No

  N/A

• Fire extinguisher within easy access to storage facility

  Yes

  No

  N/A

• Warning signs fitted restricting unauthorised entry, prohibit smoking

  Yes

  No

  N/A

• Dangerous goods Class label displayed

  Yes

  No

  N/A

• Additional storage for 1080 and strychnine to comply with Code of Practice

  Yes

  No

  N/A

• Hand washing sink

  Yes

  No

  N/A

• Showers or washing facilities

  Yes

  No

  N/A

• Laundry facilities

  Yes

  No

  N/A

• Separation of pesticides of different chemical classes

  Yes

  No

  N/A

• Record of pesticide stocks kept

  Yes

  No

  N/A

• Register of employees kept

  Yes

  No

  N/A

• Register of MSDS

  Yes

  No

  N/A

• Emergency plan

  Yes

  No

  N/A

Wash down facilities

• Wipe down of vehicles only

  Yes

  No

  N/A

• Wash down facilities provided

  Yes

  No

  N/A

Rinsate

• Used as a diluent for same class of pesticide

  Yes

  No

  N/A

• Used at site of application

  Yes

  No

  N/A

Disposal of pesticide containers

• Triple rinsed, crushed, land filled

  Yes

  No

  N/A

• Empty containers stockpiled on site

  Yes

  No

  N/A

• Drum Muster collection

  Yes

  No

  N/A

• Used as rinsate containers

  Yes

  No

  N/A

• Other-give detail

  Yes

  No

  N/A

Recommendations

Follow up or next inspection

• Select date

  Date

• Signature Environmental Health Officer

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• Signature: Proprietor

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