Information

  • Site address
  • Document No.

  • Site occupant

  • Site location / description

  • Date and time if inspection

General Inspection Information

  • PoM personnel undertaking inspection

  • Non-PoM personnel undertaking inspection

Site Activities

  • Site activities

  • Site activity
  • Description of site activity

  • Photo of site activity (if notable)

Environmental Documentation

  • Does the site have an Environmental Management Plan?

  • Indicate availability.

  • Indicate why the EMP is not available.

  • Does the site have any current EPA licences?

  • Details regarding EPA licence

  • EPA Licence
  • EPA licence type and EPA licence number

  • Other relevant licence details

  • Have there been environmental incidents on the site since the last documented inspection or past 1-2 years?

  • Incident
  • Description of incident

  • Photo of affected area (if visible)

  • Has the site been subject to any infringement notices, enforcement actions, fines or prosecutions?

  • Description

  • Photo of any relevant documentation if available

Site Features

  • Buildings (e.g. offices, warehouses, sheds, workshops)

  • Buildings
  • Description of building

  • Photo of building (if notable)

Environmental Checks

  • Are any dangerous goods and/or fuel stored or transferred on site?

  • Products
  • Description of product

  • Are MSDS's available for products stored?

  • MSDS's
  • Are they stored in a designated/signed location?

  • Storage
  • Are all hazardous/dangerous goods labelled?

  • Labelled
  • 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
  • Have any Hazardous/Dangerous goods handling procedures been developed?

  • Procedures
  • Is there adequate spill containment in place?
    - evidence of nearby fire extinguisher, spill kit, bunding in good condition?

  • Spill containment
  • Are emergency access routes clear?

  • Access
  • Are fire extinguishes/systems available for use and do you know when was the last inspection/test date?

  • Fire extinguisher
  • Are there any signs of underground infrastructure (e.g. Fill points, vents, gatics etc)?

  • Underground infrastructure

  • Underground infrastructure
  • Description

  • Photo

  • Are there any washbays on site?

  • Washbay
  • Description

  • Photo

  • Are there any triple interceptor traps or oil water separators on site?

  • TIT
  • Description

  • Photo

  • Separator
  • Description

  • Photo

  • Are plant and equipment used on site?

  • Plant
  • Description (type)

  • Where is it maintained?

  • How is it fuelled?

  • Where is it refuelled (if applicable)?

  • Photo

  • Equipment

  • Equipment
  • Description (type)

  • Where is it maintained?

  • How is it fuelled?

  • Where is it refuelled (if applicable)?

  • Photo

  • Is there any visual signs or surface staining as evidence of chemical or fuel spills?

  • Chemical or fuel spill
  • Description

  • Photo

  • Are there any visual signs of recent excavation or demolition works? (Cross check with LIDAR or survey plans if available)

  • Filling or excavation
  • Description

  • Photo

  • Is waste managed on site?

  • Solid Wastes (receptacle types and locations)

  • Solid wastes
  • Description

  • Photo

  • Liquid Wastes (receptacle types and locations)

  • Liquid wastes
  • Description

  • Photo

  • Are any groundwater monitoring wells on site?

  • Is maintenance of any observed groundwater monitoring wells required?

  • Photo

  • Is dust managed appropriately onsite?

  • Is noise managed appropriately onsite?

  • General site amenity / housekeeping

  • Use slider to rate general site amenity / housekeeping Where: 0: Low (e.g. Suggested area of improvement for all areas) 5. Average (e.g. some areas of suggested improvement but generally ok) 10: High (e.g No suggested areas for improvement)

  • Other comments or observations

  • Comments or observations
  • Comments or observations

  • Photo

Site Photographs

  • Take photographs at all photo points for the site

  • Photo point
  • Photo

Closing

  • Are there any follow up items or recommendations?

  • Follow up item
  • Suggestions
  • Signature of PoMC personnel

  • Signature of non-PoMC personnel (if present)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.