Title Page

  • Facility

  • Conducted on

  • Prepared by

  • Location

PSSR

Location and layout

Site Conditions

  • Drainage

  • Flood control/protection

  • Prevailing wind

  • Air or water pollution exposures

  • Other site conditions requiring attention

  • Soil protection in storage, materials handling & process areas

Nearby operations

  • Hazards from

  • Hazards to

Traffic

  • Vehicular/railroad/pedestrian

  • Clearances, hazards

  • Adequacy of traffic signs

Security

  • Special requirements imposed by new facility

Storage and handling of chemicals

  • Buried pipes, tanks or chemical sewer

  • Leak detection and containment

Above ground storage tanks

  • Adequate secondary containment provided

  • Operating and maintenance access adequate and safe

  • Adequate and accessible manways

  • Unobstructed pressure/vacuum relief vents

  • Manifolding of vents reviewed

  • Documented vent sizing basis (process safety manuals)

  • Winterization (including instrument connections)

  • Adequate lighting

  • Labeling, placarding of hazards

  • Other installation details

  • Flammable and combustible liquids

  • Tank placement and spacing adequate

  • Steel supports requiring fireproofing

  • Flammable liquid breather vents provided with flame arrestors or conservation vents

  • No flame arrestors on emergency relief vents

  • Safe vent discharge locations

  • Vapor-space ignitions hazards

  • Corporate recommended/approved fire protection systems in place

  • Flammable gases or liquefied flammable gasses

  • Corporate recommended/approved fire protection systems in place

Bulk dry chemicals

  • Dust explosion potential addressed

Tanks truck and railcar unloading and loading stations

  • Spill containment and safe impounding

  • Access platform safety

  • Lighting adequate

  • Grounding cables

  • Fixed unloading pump and backflow preventer

  • Emergency stop button location

  • Connections lockable and closed

  • Placarding of hazards

  • Remotely operated emergency stop valve for vehicles carrying hazardous materials

  • Fusible-link fire valve on vehicles with bottom unloading of flammable

  • Portable fire extinguisher at ground level or flammable

  • Safety shower and eyewash units

  • Recommended fire protection systems in place

  • Electrical

Process

General workplace

  • Safe operator access

  • Building exits marked

  • Lighting adequate

  • Safety shower and eyewash units

  • • Accessible

  • • Located on each deck

  • • Located in control room

  • Portable fire extinguishers

  • • Accessible

  • • Located on each deck

  • • Located in control room

Human Factors

  • Labeling of equipment, piping, critical valves, field instruments, switches

  • Location of field instruments

  • Sampling points

  • Operator task safety

  • Operator task ergonomics

  • Opportunities for operator error

  • Non-routine tasks

  • Chemical Exposure Hazards

  • Potential exposures

  • Engineering controls adequate

  • Building ventilation/fresh air intakes

  • Toxic gas monitors, alarms

  • Protective equipment location

  • Placarding

Process Piping

  • Construction appropriate for duty

  • Materials quality assurance (including flange bolts), if critical, during construction

  • Workmanship (for example, no short flange bolts)

  • Routing satisfactory

  • Adequately supported and guided

  • Allowance for thermal expansion/no references

  • No small diameter connections vulnerable to breakage/failure

  • Expansion bellows properly installed/piping not able to move sideways/bellowed

  • Undamaged during installation

  • Flexible piping connectors correctly installed/undamaged (for example, kinked) during installation

  • Necessary drains provided

  • Hazardous outlets plugged closed

  • Thermal (hydrostatic) pressure relief (including heat-traced sections)

  • Sight glasses and gauge glasses

  • External corrosion protection

  • Freeze protection

  • Insulation adequate for personal protection

  • Protective flange covers

  • Approved hoses and hose and connectors (no improvisations)

Process Vents

  • Flammable liquid breather vents provided with flame arrestors or conservation vents

  • Telltale pressure gauge or other indicator provided between rupture disc and relief valve where a disc is installed below a relief valve

  • Discharge piping from emergency pressure relief devices unrestricted by 90 degree ells,

  • Excessive length or flame arrestors

  • Provisions such as drain holes to prevent accumulation of rainwater in discharge piping

  • Discharge piping adequately supported to withstand reactive forces of pressure venting

  • Safe vent discharge locations

  • Manifolding of vents reviewed

  • Vent sizing basis; documentation

Ductwork

  • Cleanouts

Heat Exchangers, Jackets

  • Vent, drains

  • Thermal (hydrostatic) pressure relief

  • Maintenance access (tube bundle)

Machinery

  • Guarding

  • Local emergency stop button

  • Emergency lubrication of critical machinery

  • Maintenance provisions

  • Local exhaust ventilation required for shaft seals

Pumps

  • Backflow prevention

  • Connecting piping adequately supported to limit forces on casings

  • Seal spray protection

  • Isolation for maintenance

  • Preparation for maintenance (drain and vent provided)

Containment

  • Spill containment

  • Fire water runoff

Process Controls/Control Room

  • Control room inherent safety (vs. process hazards)

  • Ventilation

  • Emergency lighting

  • Fire protection

  • Field wiring security

  • System cable security

  • Power supply

  • Operator interface(s)

  • Alarm systems

  • Emergency shutdown

  • Communications - normal and emergency

  • Software access/security

  • Software back-up

Utilities Water Supply

  • No municipal /potable water connections to the process

Steam Boilers and Distribution

  • Feedwater treatment chemicals handling

  • Gas piping routing

  • Combustion controls

  • High and low drum water level alarms provided

  • Bypass around Feedwater regulator accessible from operating level and located where

  • Drum level gauge glass can be seen

  • Two independent low water level trips provided for unattended boilers

  • Dual safety relief valves in service

  • Relief discharge piping adequately supported and drained

  • Non-return valve on steam outlet

  • Distribution piping – see Process piping

  • Condensate drainage adequate

Compressed Air Systems

  • Non-lubricated construction or non-flammable synthetic lubricants used for compressor

  • Discharge pressures above 100 psig

Electrical

  • Transformer location

  • Motor control center(s)

Standby Emergency Utility Systems

  • Review provisions to satisfy proceeds safety requirements

Waste Handling/Treatment

  • Inspect new facilities in the same manner as process facilities

Warehouse

  • Flammable and combustible liquids

  • Forklifts and Motorized Hand Trucks

  • Traffic safety

  • Non combustible fuel

  • Recommended Fire-Protection Systems in Place

Maintenance Area and Shop

  • General

  • Local exhaust ventilation provided for welding

Locker Room and Lunch Room

  • Adequate space

  • Provisions to protect contamination of food by chemicals

Process Safety General

  • Employee Participation Statement

  • Process Safety Information

  • Review of highly hazardous chemicals (HHC) and MSDSs

  • Block flow diagram

  • Maximum inventories

  • Operating limits

  • Equipment Information

  • P&IDs

  • Process Hazard Analysis (PHA) report(s)

  • All PHA action items completed

  • Training plan

  • Contractor work rules

  • Pre-Startup Safety Review plan

  • Mechanical Integrity plan

  • List of critical equipment

  • Testing program with schedule

  • Hot Work Permit System

  • Site Management of Change Procedure

  • Incident Investigation Plan

  • Emergency Action Plan (EAP)

  • Facility EAP written

  • Are new chemical or process hazards or risks such that changes to existing EAP are required?

  • Do new facilities create any new transportation emergency response needs and are such needs in place? (Chemtrec update)

  • Audit Schedule

Operating Instructions

  • Operating instructions clear and easily understood

  • Instructions adequate (complete)

  • Material hazards adequately covered for raw materials, catalysts, intermediates,

Products and by-products

  • Health hazards and permissible exposure levels (PELs)

  • Physical hazards

  • Handling precautions and safe handling procedures including Personal

  • Protective equipment (PPE) requirements

  • Corrective respiratory protection specified

Process hazards adequately described

  • Thermal hazards

  • Any other hazards

  • Tabulation of process alarms, interlocks (both safety & non-safety) and trips included

  • Alarm and trip settings given

  • Specific instruction included, or reference made to separate instructions, for

  • • Unloading and loading of bulk materials

  • • Step-by-step process procedures provided for each operating phase including:

  • • Initial start-up

  • • Normal start-up

  • • Normal operation

  • • Normal shutdown

  • • Emergency operations including emergency shutdown

  • • Start-up following emergency shutdown

  • • Start-up following a turnaround

  • • Non-routine procedures (for example. equipment clean-out, equipment preparation for maintenance)

  • • Auxiliary equipment operation

  • Operating limits clearly defined in step-by-step procedures

  • Control ranges/limits specified

  • Consequences of deviations given

  • Responses to deviations/abnormal conditions specified

  • Safe hold points specified

  • PPE caution statements incorporated in step-by step procedures

  • Use of checklists as appropriate

  • Up-to-date

  • All pages show revision number and date

  • Reviewed for correctness

  • Approved / signed by Department Manager

Responsible Care

Community Awareness and Emergency Response

  • Communications training for key employees

  • Education of employees on EAP, safety, health, and environmental

  • Education of community on new process or change

  • Outreach to educate responders, government officials, EAP

  • Assessment of potential risks to employees from accidents

  • Communication of emergency planning information to LEPC

  • Facility tours for emergency responders

Process Safety

  • Current, complete documentation of process design and operating parameters

  • Current, complete documentation of hazards of materials and process

  • Use of site management of change procedure

  • Use of site incident investigation procedure

  • Documented sound engineering practices consistent with recognized codes and standards

  • Mechanical integrity program implemented for new unit or process change

  • E#mployee Health and Safety

  • Medical surveillance program tailored to meet needs of new process or change

  • Personnel change to Central Safety Committee needed

Pollution Prevention

  • A quantitative inventory of wastes generated and releases to air, water and land

  • Education of employees and public about the inventory and impact evaluation

  • Documentation that waste generation is not increased by, or is minimized in, the change or new process

  • Documentation that waste and release prevention objectives were included the design of the new modified process & products

Distribution

  • Review and training of distribution hazards with distributors

  • Review of transportation routing to minimized potential risks

  • Review with corporate transportation department

Industrial Hygiene

  • New substances

  • Health care

  • Toxicity data available

  • Accident treatment plan

  • Need for change in periodic medical exam

  • Occupational hygiene

  • Inventory of possible sources of exposure

  • Inventory means to restrict exposure

  • Methods available to monitor exposure

  • Suitable personal protection equipment available

  • Hearing Conservation

  • Noise level monitoring needed/arranged for new operations

  • Engineering and administrative controls adequate

  • Permissible exposure limits for chemical substances

  • Appropriate exposure monitoring and evaluation arranged to determine compliance with applicable PELs

  • PELs for mixtures applied when two or more hazardous substances present

  • Engineering and administrative controls adequate

Local exhaust ventilation systems

  • Performance of local exhaust ventilation systems

  • Local exhaust ventilation systems placed on inspection and maintenance program

Control of chemical substances posing a potential occupational mutagenic or carcinogenic risk

  • Are materials used having control levels A, B, C, or D?

  • • In the plant

  • • In the laboratory

Hazard Communication Program

  • Location inventory of chemicals updated

  • Hazardous materials identified in accordance with definitions

  • MSDSs on file and available to all employees

  • Chemical containers labeled (or alternate means of label information provided)

  • Piping labeled

  • Training

Respiratory protection

  • Review/confirm conformance with Corporate Industrial Hygiene Program

  • Respirator selection in accordance with selection charts and specified in writing

  • Pressure-demand SCBAs

  • Emergency “escape only” respirators

  • User medical clearance

  • Facial hair policy

  • Initial issues verified by supervision

  • Fit testing

  • Replacement of cartridges and canisters

  • Inspection and maintenance

  • Breathing air tested/tagged

  • Training

  • Smoking policy established

Laboratory Control

  • Process Laboratory Support Plan communicated

  • Staffing adequate

  • Laboratory facilities adequate

  • General

  • • Emergency exits marked

  • • Emergency lighting

  • • Safety shower & eyewash

  • • Fire protection

  • Laboratory equipment

  • • Suitable and adequate

  • • Maintenance provisions needed

  • • Storage and handling of chemicals

  • Reagent storage

  • • Segregation adequate (oxidizers, acids)

  • • Flammable liquid storage

  • • Refrigerator for flammables explosion-proof

  • Sample storage

  • • Sample and waste disposal

  • Compressed gases

  • • Cylinder location safe (for example, away from heat sources)

  • • Quantities limited to immediate requirements

  • • Separation of flammable and oxidizers

  • • Toxic gas use limited to small cylinders

  • • Local exhaust ventilation for toxic gases

  • • SCBAs available for toxic gases

  • • Personnel trained in SCBA use as needed

  • Laboratory procedures

  • • Analytical procedures written and verified

  • • Sampling procedures included

  • • PPE requirements specified

  • • Training completed

  • • Industrial hygiene

Maintenance

  • Necessary maintenance information in place

  • Design drawings: for example as-built P&IDs, electrical schematics, isometric piping drawing

  • Piping specifications

  • Equipment purchase orders

  • Equipment manuals

  • Vendor prints

  • Initial inspection and test results

  • Resources adequate

  • Needs communicated

  • Plant personnel

  • Contract maintenance (arrangements completed)

  • Shop facilities

  • Specialized requirements

  • Requirements defined

  • Skills available

  • Equipment available

  • Procedures developed

  • Training completed

  • Certificate obtained and documented

  • Maintenance management

  • Service contracts arranged

  • Maintenance management system in place

  • Spare parts

  • Requirements defined by maintenance department

  • Procurement complete

  • Start-up needs on hand

  • Storage security

  • Quality assurance program in place for critical equipment

  • Materials of construction/quality of maintenance materials and parts

  • Workmanship

  • Preventive maintenance/mechanical integrity program developed

  • • Machinery

  • • Boilers and pressure vessels

  • • Critical equipment, vessels, piping, check valves, expansion bellows, flexible piping connectors, hoses defined

  • • Critical equipment inspection and test methods and frequencies defined

  • • Conservation vents, flame arrestors, PSEs, PSVs inspection and test methods and frequencies

  • • Critical instruments defined

  • • Proof-testing frequency

  • • Proof-testing procedures, validity

  • • Maintenance of combustion safety controls on direct-fired equipment

  • • Inspection and testing acceptance criteria developed and documented

Training

Operations and Maintenance

  • Initial qualifications of personnel (knowledge and skills)

  • Training program content vs. needs

  • Safety orientation for new employees

  • General safety training

  • Job-specific training

  • Basic knowledge and skills

  • Specialized knowledge and skills

  • General process knowledge

  • Material hazards, MSDSs

  • Process hazards

  • Process procedures

  • Operating limits

  • Consequences of deviations

  • Responses to deviations/abnormal conditions

  • Emergency procedures

  • Field training

  • Location of:

  • • Emergency equipment, showers, alarms

  • • Fire-fighting equipment

  • • Leak/spill prevention

  • Reporting, mitigation

  • Emergency drills

  • Compliance with OSHA 1910.120 for hazardous waste operations

  • New emergency response training requirements

  • Measurement of training

  • Effectiveness/certification (when applicable)

  • Formal documentation of training

  • Team assessment of training effectiveness

Commissioning

Commissioning plan and schedule

  • Detailed, step-by-step plan written

  • Plan adequately reviewed

  • Responsibilities clearly defined and understood

  • Plant verification of any equipment and systems check-out done by contractor

  • Construction inspection by plant

  • Confirm line-by-line conformity to P&IDs verified by plant, including:

  • Materials of construction

  • Location of instrument elements/connections

  • Orifice plate specifications and orientation

  • Ranges of local PIs and TIs

  • All local TIs have thermowells

  • Identifies and relief pressure of PSEs & PSVs

  • Actuated valve failure modes

  • Equipment internals

Vessels and piping

  • Stress relieving done and documented as required

  • Field radiography done and documented as required

  • Pressure/Leak testing done and documented

  • Cleaned and flushed (instruments, control valves, check valves protected)

  • Special commissioning requirements (such as chemical cleaning, passivating, or testing)

  • Vents and pressure relief valves

  • Shipping supports removed from conservation vents

  • Relief pressure of PSVs verified by test

Fire protection systems

  • Fire water systems inspection and commissioned

  • Fire water pump acceptance test(s) completed and witnessed

  • Other non-water fire protection system acceptance test(s) completed and witnessed (for example, CO2 or dry chemical

  • New fire protection signaling systems and alarms commissioned

  • Copies of completed test forms forwarded to insurance carrier and Corporate Risk Department

  • New fire protection equipment, signaling systems and alarms placed on regular inspection and testing programs

Electrical grounding

  • Resistance of building and equipment and grounding systems measured <5 ohms

  • Resistance to ground of all piping sections carrying flammable liquids and combustible powders measured <5 ohms

Ventilation systems

  • Ventilation systems balanced

  • Performance of local exhaust ventilation systems checked for conformance

Machinery

  • Alignment checked

  • Absence of excessive forces on pump casings and other equipment from connected piping

  • Pre-startup screens installed in pump suctions

  • Agitator impeller security

  • Lubrication systems functional

  • Cooling systems functional

  • Seal flush systems functional

  • Rotation checked

  • Vibration measurements

  • Performance tests

  • Other baseline data collection

Instruments and control systems

  • Program software checked

  • Instrument loop sheet index available

  • Pneumatic lines blown clean

  • Loop checking done and documented

  • Instrument calibrations done and documented review methods

  • Alarm and trip points set and documented

  • Interlocks (both safety & non-safety) tested

  • Digital control system review and tests

  • Combustion safety controls on direct-fired equipment

  • Equipment inspection, adjustment and testing documented

  • Punch list

  • Review status

  • Daily update

  • Priorities with respect to start-up acceptable

Water batching

  • Plan developed

Start-up

  • Start-up plan and schedule

  • Written and reviewed

  • Procedures for initial start-up specifically covered in the operating

  • Instruction manual or under separate cover

  • Reviewed and approved if separate

  • Raw materials supply

  • Technical support

  • Adequate

  • Lines and limits of authority clear

  • Maintenance support

  • Industrial hygiene monitoring

  • Equipment monitoring

  • Performance measurements and tests

Regulatory Compliance

  • New Substances

  • • Review of toxicity to environment

  • • Persistency in the environment

  • • Prevention of exposure to environment

  • • Destruction of substance when necessary

  • Toxic Substances Control Act (TSCA)

  • • Project reviewed for any new requirements which might be imposed on the plant location under TSCA

  • Transportation

  • • New transport operations adequately reviewed for compliance with all applicable DOT (or equivalent) regulations

  • Emissions

  • • Operating permits obtained as directed by the site or corporate environmental departments

  • Effluents

  • • New operations covered within the present NPDES permit or a new permit has been obtained

  • Hazardous wastes

  • • Determined whether particular wastes qualify as hazardous wastes under federal, state and/or local laws and regulations

  • • On-site storage, treatment and/or disposal of hazardous wastes

  • • Reviewed for compliance with applicable laws and regulations, documentation?

  • • Off-site transportation and disposal of hazardous wastes reviewed with waste coordinator, documentation?

  • PCBs

  • • Review equipment for PCB hazardous properties

Supplementary Checklist for New Plant Sites

  • Plant Security

  • Access

  • Fencing

  • Visitor controls

  • Vehicle controls

  • Restrictions posted

  • Communications

  • Normal

  • Emergency back-up

  • Safety program

  • • Accountability

  • • Program conformance with Corporate Safety Standards

  • • Conformance with group safety standards

  • • First aid and emergency medical response

  • • Location procedures written

  • • Training conducted

  • • Industrial hygiene program

  • • Accountability

  • • Program conformance with Corporate Industrial Hygiene Standards

  • Fire protection organization

  • • Location organization

  • • Level of protection established in accordance with insurance requirement and Corporate Risk Department

  • • Training conducted in accordance with standard

  • • Equipment provided in accordance with standard

  • Municipal fire department (or equivalent)

  • • Response time and capabilities consistent with location needs and fire protection organization

  • • Liaison established

  • • Familiarization

  • • Drills

  • Process Safety Management

  • • Location coordinator appointed

  • • Program

  • • Training conducted

Completion

  • Comments/Recommendations

  • Safe and ready for commissioning/startup?

  • Engineering

  • Safety

  • Quality

  • Operations

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.