Information
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Site address
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Document No.
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Site occupant
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Site location / description
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Date and time if inspection
General Inspection Information
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PoM personnel undertaking inspection
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Non-PoM personnel undertaking inspection
Site Activities
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Site activities
Site activity
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Description of site activity
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Photo of site activity (if notable)
Environmental Documentation
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Does the site have an Environmental Management Plan?
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Indicate availability.
- Sighted
- Hardcopy provided
- Hardcopy requested
- Softcopy provided
- Softcopy requested
- Not available
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Indicate why the EMP is not available.
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Does the site have any current EPA licences?
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Details regarding EPA licence
EPA Licence
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EPA licence type and EPA licence number
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Other relevant licence details
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Have there been environmental incidents on the site since the last documented inspection or past 1-2 years?
Incident
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Description of incident
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Photo of affected area (if visible)
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Has the site been subject to any infringement notices, enforcement actions, fines or prosecutions?
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Description
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Photo of any relevant documentation if available
Site Features
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Buildings (e.g. offices, warehouses, sheds, workshops)
Buildings
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Description of building
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Photo of building (if notable)
Environmental Checks
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Are any dangerous goods and/or fuel stored or transferred on site?
Products
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Description of product
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Are MSDS's available for products stored?
MSDS's
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Are they stored in a designated/signed location?
Storage
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Are all hazardous/dangerous goods labelled?
Labelled
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Is the tenant/operator/site personnel aware of any restrictions on hazardous/dangerous goods storage?
- knowledge of incompatible materials requiring separate storage, is there adequate ventilation?
Storage
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Have any Hazardous/Dangerous goods handling procedures been developed?
Procedures
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Is there adequate spill containment in place?
- evidence of nearby fire extinguisher, spill kit, bunding in good condition?
Spill containment
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Are emergency access routes clear?
Access
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Are fire extinguishes/systems available for use and do you know when was the last inspection/test date?
Fire extinguisher
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Are there any signs of underground infrastructure (e.g. Fill points, vents, gatics etc)?
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Underground infrastructure
Underground infrastructure
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Description
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Photo
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Are there any washbays on site?
Washbay
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Description
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Photo
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Are there any triple interceptor traps or oil water separators on site?
TIT
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Description
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Photo
Separator
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Description
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Photo
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Are plant and equipment used on site?
Plant
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Description (type)
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Where is it maintained?
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How is it fuelled?
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Where is it refuelled (if applicable)?
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Photo
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Equipment
Equipment
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Description (type)
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Where is it maintained?
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How is it fuelled?
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Where is it refuelled (if applicable)?
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Photo
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Is there any visual signs or surface staining as evidence of chemical or fuel spills?
Chemical or fuel spill
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Description
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Photo
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Are there any visual signs of recent excavation or demolition works? (Cross check with LIDAR or survey plans if available)
Filling or excavation
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Description
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Photo
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Is waste managed on site?
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Solid Wastes (receptacle types and locations)
Solid wastes
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Description
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Photo
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Liquid Wastes (receptacle types and locations)
Liquid wastes
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Description
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Photo
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Are any groundwater monitoring wells on site?
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Is maintenance of any observed groundwater monitoring wells required?
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Photo
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Is dust managed appropriately onsite?
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Is noise managed appropriately onsite?
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General site amenity / housekeeping
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Other comments or observations
Comments or observations
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Comments or observations
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Photo
Site Photographs
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Take photographs at all photo points for the site
Photo point
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Photo
Closing
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Are there any follow up items or recommendations?
Follow up item
- Suggestions
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Signature of PoMC personnel
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Signature of non-PoMC personnel (if present)