Petroleum Audit Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Information

• Site Name and Address

• Telephone No:

• Photograph of Site

  Media

• Email:

• Type of Site

  Retail Petrol Filling Station

  Workplace

  Farm

• No of Staff Employed

• Ownership

  Company Owned

  Dealer Operated

  Independant

• No of Competent Persons (For Assisted Deliveries)

• Type of Operation

  Attended Self Service

  Attended Service

  Unattended Service

  Delivery Terminal(s)

1.0. Administrative Records and Procedures

• 1.1. Current Petroleum Licence and Conditions available?<br>PCA Section 1

  Yes

  No

  N/A

• 1.2. Expiry date shown?

  Yes

  No

  N/A

• 1.3. Are there special or additional conditions of Licence? PCA Section 2

  Yes

  No

  N/A

• 1.4. Are staff aware of Conditions of Licence? DSEAR Regs 11

  Yes

  No

  N/A

• 1.5. Are there any current site plans available? DSEAR Reg 5, ACoP L136 Control and Mitigation

  Yes

  No

  N/A

• 1.6. Is there a current tank to pump diagram? Best Practice

  Yes

  No

  N/A

• 1.7. No of tanks

• No of Petrol tanks

• No of Diesel tanks

• No of other fuel tanks

• 1.8. Is there an Electrical Test Certificate that covers the hazardous areas? DSEAR Reg 5; Electricity at Work Regs 1989

  Yes

  No

  N/A

• 1.9. Is there current Hazardous Waste Transfer Notes or Certificate available? Licence Conditions; DSEAR Reg 5; ACoP L137 Safe Maintenance

  Yes

  No

  N/A

• 1.10. Does the Operator maintain a Site Register? Best Practice

  Yes

  No

  N/A

• 1.11. Are wet stock records maintained with delivery certificates? Licensing Conditions; DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 1.12. Is there any evidence of gains or losses? Licensing Conditions; DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 1.13. Is there a record of Maintenance visits? DSEAR Reg 5, ACoP L137 Safe Maintenance

  Yes

  No

  N/A

• 1.14. Is there a Site Operating Manual kept? DSEAR Reg 9

  Yes

  No

  N/A

• 1.15. Are there any Staff Training Records? DSEAR Reg 9

  Yes

  No

  N/A

• 1.16 Are training manuals available and up to date? <br>DSEAR Reg 9

  Yes

  No

  N/A

• 1.17. Is there a HS(G) 146 Risk Assessment.<br>Good Practice

  Yes

  No

  N/A

• 1.18. Is there a risk assessment in accordance with DSEAR?<br>DSEAR Reg 5, ACoP L138 General Requirements<br>

  Yes

  No

  N/A

• 1.19. Does the DSEAR Risk Assessment include Tanker Deliveries?<br>DSEAR Reg 5 ACoP L133 Tanker Deliveries

  Yes

  No

  N/A

• 1.20. Is there a competent Person in charge of the site?<br>Licensing Condition; DSEAR Reg 5 & 8<br>

  Yes

  No

  N/A

• 1.21. Has the site installed Stage 2 Vapour Recovery?<br>PPC Regs (Permit Requirements)

  Yes

  No

  N/A

• 1.22. Is there test and installation documentation on site?<br>PPC Regs (Permit Requirements)

  Yes

  No

  N/A

• 1.23. Does the site operate Statistical Inventory Reconciliation?<br>Licensing Conditions; DSEAR Reg 5; ACoP 136 Controls<br>

  Yes

  No

  N/A

• 1.24. Does the site have an Emergency Action/Response Plan?<br>DSEAR Reg 8

  Yes

  No

  N/A

• 1.25. Are there safety procedures in place to protect employees against a Dangerous Substance? (Eg Safety Data Sheets and PPE)<br>DSEAR Reg 8

  Yes

  No

  N/A

• 1.26. Is there a first aid kit on site?<br>DSEAR Reg 8

  Yes

  No

  N/A

• 1.27. Are there records of maintenance of fire fighting equipment?<br>Licensing Condition

  Yes

  No

  N/A

• 1.28. Is there an Accident/Incident Book held on site?<br>DSEAR Reg 8

  Yes

  No

  N/A

• 1.29. Is there a Pollution Response or Restoration Plan in place?<br>DSEAR Reg 8

  Yes

  No

  N/A

• 1.30. Has there been any fire, explosion, leak or spillage on site?<br>Licensing Condition

  Yes

  No

  N/A

• 1.31. Has any request been made to disclose information held on file?<br>Freedom of Information Act 2003

  Yes

  No

  N/A

2.0 Storage Tanks, Vents and Vapour Recovery

• 2.1 Types of tanks known?

  Yes

  No

  N/A

• 2.2. Is there any record of any tank tests?

  Yes

  No

  N/A

• 2.3. Are there discontinued tanks on site?

  Yes

  No

  N/A

• 2.4. Have they been made either permanently or temporarily safe?

  Yes

  No

  N/A

• 2.5. Are there any above ground tanks?

  Yes

  No

  N/A

• 2.6. Are they bunded and free from debris?

  Yes

  No

  N/A

• 2.7. Are there any LPG storage vessels on site?

  Yes

  No

  N/A

• 2.8. Do LPG vessels appear in good condition, free from corrosion?

  Yes

  No

  N/A

• 2.9. Are LPG vessels in a secure compound, and protected against impact collision?

  Yes

  No

  N/A

• 2.10 Method of tank filling satisfactory?

  Yes

  No

  N/A

• 2.11 Off set or Direct Fill

• 2.12. Are tanks tagged and labelled?

  Yes

  No

  N/A

• 2.13. Are fill pipes securely locked?

  Yes

  No

  N/A

• 2.14. Is a dedicated tanker stand provided?

  Yes

  No

  N/A

• 2.15. Is the tanker stand satisfactory, with dedicated drainage?

  Yes

  No

  N/A

• 2.16. Gauge measurement (or dipsticks) system working?

  Yes

  No

  N/A

• 2.17. Are tank chambers free from surplus water?

  Yes

  No

  N/A

• 2.18. Is all visible pipe/cable ducts sealed in manhole chambers?

  Yes

  No

  N/A

• 2.19. Is all visible pipe work free from excess corrosion and sound?D

  Yes

  No

  N/A

• 2.20. Are manhole lifting key(s) available?

  Yes

  No

  N/A

• 2.21. Are manhole chambers and covers in good condition?

  Yes

  No

  N/A

• 2.22. Are vents and vapour recovery lines secure and free from damage?

  Yes

  No

  N/A

• 2.23. Is there any opening within 1.5 metres with vapour recovery or within 3 metres for natural venting?

  Yes

  No

  N/A

• 2.24. Is vapour pipe work manifolded?

  Yes

  No

  N/A

• 2.25. Are all vent lines tagged and labelled?

  Yes

  No

  N/A

• 2.26. Has a vapour recovery permit been issued?

  Yes

  No

  N/A

• 2.27. Is vapour recovery warning and indication tags provided?

  Yes

  No

  N/A

• 2.28. Is there evidence of any test on the vapour recovery system?

  Yes

  No

  N/A

• 2.29. Has any maintenance taken place on the vapour recovery installation?

  Yes

  No

  N/A

• 2.30. Is stage 2 vapour recovery fitted and monitored and working?

  Yes

  No

  N/A

• 2.31. Is any dedicated tanker stand lighting working?

  Yes

  No

  N/A

• 2.32. Is there an unassisted delivery cabinet provided for the tanker driver?

  Yes

  No

  N/A

• 2.33. Is the phone, print out, high level alarm, spillage control and fire extinguisher provided and working?

  Yes

  No

  N/A

• 2.34. Emergency switch provided in the cabinet?

  Yes

  No

  N/A

• 2.35. Has the the number of drop lines been specified? Sign "Maximum number of tanker compartments to be unloaded simultaneously is x"

  Yes

  No

  N/A

• 2.36. Does the driver check the ullage space before dropping?

  Yes

  No

  N/A

3.0 Pumps/Dispensers and Electrical Aspects

• Make and Model of Pumps

• No of Pump Islands

• 3.1. Are all pumps numbered clearly?

  Yes

  No

  N/A

• 3.2. Do all automatic nozzle shut offs operate?

  Yes

  No

  N/A

• 3.3. Are all deliver hoses in good condition and free from leaks?

  Yes

  No

  N/A

• 3.4. Are all joints/couplings free from any signs of wear and leaks?

  Yes

  No

  N/A

• 3.5. Have all trigger latches been removed?

  Yes

  No

  N/A

• 3.6. Are dispenser housings ventilated properly?<br>DSEAR Reg 5, ACoP L134 Design of Plant and Equipment

  Yes

  No

  N/A

• 3.7. Are there any cavities at the base of the pumps (Old types)<br>DSEAR Reg 5, ACoP L134 Design of Plant and Equipment

  Yes

  No

  N/A

• 3.8 Are check valves (Suction System) fitted?<br>DSEAR Reg 5, ACoP L134 Design of Plant and Equipment

  Yes

  No

  N/A

• 3.9. Is a sump system (Pressure System) fitted?<br>DSEAR Reg 5, ACoP L134 Design of Plant and Equipment

  Yes

  No

  N/A

• 3.10. Are lead seals in position on metering devices?<br>DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 3.11. Are pump operating instructions clearly displayed?<br>DSEAR Reg 5

  Yes

  No

  N/A

• 3.12. Are fuel grades marked clearly?<br>DSEAR Reg 5f

  Yes

  No

  N/A

• 3.13. Does all electrical wiring appear free from damage?<br>Electriciety at Work Regulations 1989

  Yes

  No

  N/A

• 3.14. Are there any obvious signs of leakage?<br>eLicensing Condition; DSEAR Reg 5

  Yes

  No

  N/A

• 3.15. Are all dispensers secure on their mountings?<br>DSEAR Reg 5

  Yes

  No

  N/A

• 3.16. Are spillage control facilities provided for?<br>Licensing Conditions; DSEAR Reg 5

  Yes

  No

  N/A

• 3.17. Are diesel/LPG dispensers in good order?<br>DSEAR Reg 5

  Yes

  No

  N/A

• 3.18. Is visibility an issue over the dispensing area?<br>DSEAR Reg 5, ACoP L134 Design of Plant and Equipment

  Yes

  No

  N/A

• 3.19. Are vehicle parking arrangements satisfactory?<br>DSEAR Reg 5

  Yes

  No

  N/A

• 3.20. Type of earthing known?<br>Electricity at Work Regulations 1989

  Yes

  No

  N/A

• 3.21. Are all electrical ducts sealed where they enter the building?<br>DSEAR Reg 5

  Yes

  No

  N/A

• 3.22. Can any uncertified electrical equipment equipment be brought into the hazardous area?<br>Licensing Condition; DSEAR Regs 5 & 7; Schedule 3

  Yes

  No

  N/A

• 3.23. If a CCTV is installed as part of the safety arrangements for dispensing, is it working adequately?<br>Licensing Condition; DSEAR Reg 5

  Yes

  No

  N/A

• 3.24. Is the public address system working and sufficiently audible against all background noise?<br>DSEAR Regs 5 & 8

  Yes

  No

  N/A

• 3.25. Is there an emergency isolation switch under the Console?<br>DSEAR Reg 8

  Yes

  No

  N/A

• 3.26. Is there an emergency isolation switch on the fascia of any building suitably marked?<br>DSEAR Reg 8

  Yes

  No

  N/A

• 3.27. Are signs provided for all emergency switches?<br>DSEAR Reg 5 and Schedule 3

  Yes

  No

  N/A

• 3.28. Are all lights and switchgear that are not protected, outside of the hazardous areas?<br>DSEAR Reg 6

  Yes

  No

  N/A

• 3.29. If fitted, are all canopy lights working?<br>DSEAR Reg 6

  Yes

  No

  N/A

4.0 Fire Safety, Signage and Drainage

• 4.1. Are Fire Safety and Warning signs provided and legible?<br>DSEAR Regulation 8

  Yes

  No

  N/A

• 4.2. Is an interceptor or separator provided?<br>Licensing Condition; DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 4.3. Vent for separator in good order?

  Yes

  No

  N/A

• 4.4. Water act Consent?

  Yes

  No

  N/A

• 4.5. Are the existing arrangements capable of taking up to 9,000 litres of product?<br>Licensing Condition; DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 4.6. Is the drainage system clear of debris and surplus product?<br>Licensing Condition; DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 4.7. Are all storm drains clear of debris and fuel? (Surface Water)<br>DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 4.8. Is there drainage at the entrance/exit /tanker stand?<br>DSEAR Reg 5, ACoP L136 Controls

  Yes

  No

  N/A

• 4.9. Are LPG cylinders stored outside on the forecourt? If so are they secure?<br>DSEAR Reg 5

  Yes

  No

  N/A

• 4.10. Are all fire extinguishers checked and serviced at least once per year?<br>Licensing Condition; DSEAR Reg 5, RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.11. Are the types of extinguishers appropriate to the risk?<br>Licensing cCondition; DSEAR Reg 8; RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.12. Is there a written fire procedure displayed or known?<br>Licensing Condition; DSEAR L136 Controls; RR FIre Safety Order 2005

  Yes

  No

  N/A

• 4.13. Has all staff been trained in fire procedures and evacuation?<br>DSEAR Reg 11; RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.14. Are fire exits clear from obstructions?<br>DSEAR Reg 8; RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.15. Is the standard of housekeeping satisfactory?<br>DDSEAR Reg 5; RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.16. Are all panic bolts and escape door devices working?<br>DSEAR Reg 8; RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.17. Is emergency lighting installed? If so has it been tested within the last 6 months?<br>RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.18. Is a fire detection and alarm system installed? If so, is it tested each week?<br>RR Fire Safety Order 2005

  Yes

  No

  N/A

• 4.19. Are all promotional signs sited so not causing anobstruction?<br>DSEAR Regulation 6

  Yes

  No

  N/A

Actions to be Taken

• Action to be taken

  Select No Action - Site is Satisfactory Recommendations to be made Contraventions Found - Letterr to be issued Contraventions Found - Improvement Notice Required Dangerous Conditions Found - Prohibition Notice Required Item Found not under PLA remit but notification needed

  • No Action - Site is Satisfactory
  • Recommendations to be made
  • Contraventions Found - Letterr to be issued
  • Contraventions Found - Improvement Notice Required
  • Dangerous Conditions Found - Prohibition Notice Required
  • Item Found not under PLA remit but notification needed

Details required to:

• Details required to:

  Select Fire Authority Environmental Health Trading Standards Building Control Health and Safety Executive Environment Agency No referral required

  • Fire Authority
  • Environmental Health
  • Trading Standards
  • Building Control
  • Health and Safety Executive
  • Environment Agency
  • No referral required

• Signed:

  Sign