Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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0.1 JSA - Risk assessment to include use of iauditor
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0.2 For Audit Queries Please Call Brookfield Johnson Controls on (1800 351 235)
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Site Photo
1.0 Site Details
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1.1 Site Details
- ARMIDALE COLES EXPRESS B502
- BALACLAVA COLES EXPRESS B767
- BASS HILL COLES EXPRESS A580
- BATEHAVEN COLES EXPRESS B540
- BAULKHAM HILLS COLES EXPRESS B428
- BELMONT (SOUTH) COLES EXPRESS A684
- BELMONT MAUDE COLES EXPRESS B501
- BERKSHIRE PARK COLES EXPRESS B949
- BLACKTOWN COLES EXPRESS A131
- BONDI JUNCTION COLES EXPRESS A320
- BOWRAL COLES EXPRESS A111
- BROOKVALE COLES EXPRESS A486
- BURNS BAY COLES EXPRESS A446
- CABRAMATTA WEST COLES EXPRESS B994
- CAMDEN COLES EXPRESS B996
- CAPTAIN COOK BRIDGE COLES EXPRE A015
- CARLTON COLES EXPRESS A081
- CHATSWOOD COLES EXPRESS A441
- COLYTON COLES EXPRESS B800
- CORRIMAL COLES EXPRESS B498
- DOONSIDE COLES EXPRESS A003
- DRUMMOYNE NORTH COLES EXPRESS A115
- DUNDAS COLES EXPRESS A296
- DURAL COLES EXPRESS B986
- EASTERN CREEK COLES EXPRESS B677
- ENFIELD COLES EXPRESS B950
- ERINA COLES EXPRESS B726
- FORESTVILLE COLES EXPRESS A468
- FORSTER COLES EXPRESS A236
- GOROKAN COLES EXPRESS B699
- GOULBURN COLES EXPRESS A114
- GREEN VALLEY COLES EXPRESS A341
- GREYSTANES COLES EXPRESS B406
- HEXHAM COLES EXPRESS B547
- HUNTERS HILL COLES EXPRESS B442
- JAMISONTOWN COLES EXPRESS B786
- KILLARNEY VALE COLES EPXRESS A139
- KINGSFORD COLES EXPRESS A342
- KIRRAWEE COLES EXPRESS A103
- LIVERPOOL COLES EXPRESS A157
- MARSFIELD COLES EXPRESS B999
- MERRYLANDS COLES EXPRESS A271
- MOUNT ANNAN COLES EXPRESS A212
- NARELLAN COLES EXPRESS A259
- NARRABEEN COLES EXPRESS A493
- NEUTRAL BAY COLES EXPRESS A470
- NORTH RYDE WICKS COLES EXPRESS A421
- NORTHMEAD COLES EXPRESS A287
- PADSTOW COLES EXPRESS A117
- PENNANT HILLS EAST COLES EXP A074
- PENNANT HILLS WEST COLES EXP A425
- PORT MACQUARIE COLES EXPRESS B492
- PYMBLE COLES EXPRESS A436
- RANDWICK ALISON RD COLES EXPRESS A3
- RANDWICK FRENCHMANS COLES EXP A328
- ROBERTS ROAD EAST COLES EXP A262
- ROBERTS ROAD WEST COLES EXPRESS A234
- ST CLAIR COLES EXPRESS B617
- ST HELENS PARK COLES EXPRESS A121
- STANMORE COLES EXPRESS A400
- TAMWORTH COLES EXPRESS A709
- TAMWORTH WEST COLES EXPRESS B259
- TAREE COLES EXPRESS A518
- TAREN POINT COLES EXPRESS A073
- TERRIGAL COLES EXPRESS A646
- THORNLEIGH COLES EXPRESS A427
- UMINA COLES EXPRESS A644
- WAHROONGA COLES EXPRESS A432
- WALLSEND EAST COLES EXPRESS A695
- WALLSEND WEST COLES EXPRESS A438
- WATERLOO COLES EXPRESS A205
- WEST RYDE COLES EXPRESS A403
- WOLLONGONG COLES EXPRESS A058
- WOY WOY COLES EXPRESS B710
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BJC completing in conjunction with other works on site -
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1.2 Site Drawing
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Notes:
2.0 HSSE
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2.1 Require risk assessment of site
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2.2 Work within Overhead Electrical Assets Restriction?
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2.3 Are Viva Permits required?
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2.4 Is Traffic management required for project?
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2.5 If a scissor lift is required is there a suitable area for it to be located?
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2.6 If a scissor lift is required will it be entering the hazardous zone?
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Photo:
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Notes:
3.0 Site Products
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3.1 Products available on site are:
- 1. E10
- 2. Diesel
- 3. ULP95
- 4. VPOWER
- 5. AUTOGAS
- 6. ULP91
- 7.N/A
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Site Photo:
4.0 Price board SI Sign Details
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4.1 Number of Priceboards on Site?
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
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Priceboard SI Sign Details
SI Sign
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4.1 Height of Priceboard/SI Sign
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4.2 Price board Configuration
- A = (7m) 2 medium 3 small
- B = (7m) 4 Medium
- C = (7m) 1 medium 3 small
- D = (7m) 3 Medium
- E = (5m) 4 Medium
- F = (5m) 1 Medium 3 Small
- G = (3m) 3 Small
- H = (3m) 4 small
- I = (3m) 2 small
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4.2.1 List Priceboard Products (top to bottom)
- 1. E10
- 2. Diesel
- 3. ULP95
- 4. VPOWER
- 5. AUTOGAS
- 6. ULP91
- 7.N/A
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4.3 What is the condition of priceboard?
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Notes:
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Price board Photo(s)
5.0 Pumps/Dispenser
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5.1 Quantity of pumps to change?
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
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Add Details of pumps
pump
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5.1.10 Condition of pump?
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Add media
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5.1.1 Pump Number?
- Pump 1
- Pump 2
- Pump 3
- Pump 4
- Pump 5
- Pump 6
- Pump 7
- Pump 8
- Pump 9
- Pump 10
- Pump 11
- Pump 12
- Pump 13
- Pump 14
- Pump 15
- Pump 16
- Pump 17
- Pump 18
- Pump 19
- Pump 20
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5.1.2 Pump Type?
- Ceepec
- Compac
- Electroline
- Eline-MK4
- Enterprise
- HPMPP
- LLMPP
- MPP
- Multipec
- Pacesetter
- SK700-2
- SK700
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5.1.3 What is the pump model number?
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5.1.4 What is the serial number?
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5.1.3 Is this pump included in conversion project?
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5.1.5 Hoses per dispenser?
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
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5.1.6 Products on dispenser (List Left to Right)
- 1. E10
- 2. Diesel
- 3. ULP95
- 4. VPOWER
- 5. AUTOGAS
- 6. ULP91
- 7.N/A
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5.1.7 Number of splash guards to replace?
- E10 x 1
- E10 x 2
- E10 x 3
- E10 x 4
- E10 x 5
- E10 x 6
- E10 x 7
- E10 x 8
- Diesel x 1
- Diesel x 2
- Diesel x 3
- Diesel x 4
- Diesel x 5
- Diesel x 6
- Diesel x 7
- Diesel x 8
- ULP95 x 1
- ULP95 x 2
- ULP95 x 3
- ULP95 x 4
- ULP95 x 5
- ULP95 x 6
- ULP95 x 7
- ULP95 x 8
- VPOWER x 1
- VPOWER x 2
- VPOWER x 3
- VPOWER x 4
- VPOWER x 5
- VPOWER x 6
- VPOWER x 7
- VPOWER x 8
- ULP91 x 1
- ULP91 x 2
- ULP91 x 3
- ULP91 x 4
- ULP91 x 5
- ULP91 x 6
- ULP91 x 7
- ULP91 x 8
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5.1.8 Confirm number of nozzles to be changed?
- E10 x 1
- E10 x 2
- E10 x 3
- E10 x 4
- E10 x 5
- E10 x 6
- E10 x 7
- E10 x 8
- Diesel x 1
- Diesel x 2
- Diesel x 3
- Diesel x 4
- Diesel x 5
- Diesel x 6
- Diesel x 7
- Diesel x 8
- ULP95 x 1
- ULP95 x 2
- ULP95 x 3
- ULP95 x 4
- ULP95 x 5
- ULP95 x 6
- ULP95 x 7
- ULP95 x 8
- VPOWER x 1
- VPOWER x 2
- VPOWER x 3
- VPOWER x 4
- VPOWER x 5
- VPOWER x 6
- VPOWER x 7
- VPOWER x 8
- ULP91 x 1
- ULP91 x 2
- ULP91 x 3
- ULP91 x 4
- ULP91 x 5
- ULP91 x 6
- ULP91 x 7
- ULP91 x 8
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5.1.9 What Style of Boot?
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Notes
6.0 Existing Pump Signage to change
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6.1 Grade Decals – QTY to replace, Pump and Dial face for site project?
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- NA
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6.2 Quality Fuels Mogas Range sticker - QTY to replace for site project?
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- NA
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Pump Decal Photo(s)
7.0 Leader boards
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7.1 Style of Leader-board (2 different styles, refer to guide)
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Add media
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7.2 Quantity Leaderboards to change
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- NA
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7.2 Add details of leaderboars
Leaderboards
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7.3 Current Order of Product on Leaderboard (Top to Bottom)
- 1. E10
- 2. Diesel
- 3. ULP95
- 4. VPOWER
- 5. AUTOGAS
- 6. ULP91
- 7.N/A
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7.4 What is the condition of the leaderboard?
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Leaderboard Photos
8.0 Tanks
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8.1.1 Confirm number of tanks to change
- T01 - E10
- T02 - E10
- T03 - E10
- T04 - E10
- T05 - E10
- T06 - E10
- T07 - E10
- T01 - DSL
- T02 - DSL
- T03 - DSL
- T04 - DSL
- T05 - DSL
- T06 - DSL
- T07 - DSL
- T08 - DSL
- T09 - DSL
- T10 - DSL
- T01 - ULP95
- T02 - ULP95
- T03 - ULP95
- T04 - ULP95
- T05 - ULP95
- T06 - ULP95
- T07 - ULP95
- T01 - VPOWER
- T02 - VPOWER
- T03 - VPOWER
- T04 - VPOWER
- T05 - VPOWER
- T06 - VPOWER
- T07 - VPOWER
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Tank Details
Tank
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What is the condition of tank asset?
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8.1.2 Tank Number
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- NA
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8.1.3 Tank Product
- 1. E10
- 2. Diesel
- 3. ULP95
- 4. VPOWER
- 5. AUTOGAS
- 6. ULP91
- 7.N/A
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8.1.4 Is this tank part of conversion project?
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8.1.5 Is this a system Tank?
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8.1.6 If a system tank, what tank number is the linked tank?
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- NA
9.0 Dip/Fill Markers
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9.1 Number of Fill Markers to change
- E10 x 1
- E10 x 2
- E10 x 3
- E10 x 4
- E10 x 5
- E10 x 6
- E10 x 7
- E10 x 8
- Diesel x 1
- Diesel x 2
- Diesel x 3
- Diesel x 4
- Diesel x 5
- Diesel x 6
- Diesel x 7
- Diesel x 8
- ULP95 x 1
- ULP95 x 2
- ULP95 x 3
- ULP95 x 4
- ULP95 x 5
- ULP95 x 6
- ULP95 x 7
- ULP95 x 8
- VPOWER x 1
- VPOWER x 2
- VPOWER x 3
- VPOWER x 4
- VPOWER x 5
- VPOWER x 6
- VPOWER x 7
- VPOWER x 8
- ULP91 x 1
- ULP91 x 2
- ULP91 x 3
- ULP91 x 4
- ULP91 x 5
- ULP91 x 6
- ULP91 x 7
- ULP91 x 8
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Fill Marker Photo(s)
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9.2 Number of Dip markers to change
- E10 x 1
- E10 x 2
- E10 x 3
- E10 x 4
- E10 x 5
- E10 x 6
- E10 x 7
- E10 x 8
- Diesel x 1
- Diesel x 2
- Diesel x 3
- Diesel x 4
- Diesel x 5
- Diesel x 6
- Diesel x 7
- Diesel x 8
- ULP95 x 1
- ULP95 x 2
- ULP95 x 3
- ULP95 x 4
- ULP95 x 5
- ULP95 x 6
- ULP95 x 7
- ULP95 x 8
- VPOWER x 1
- VPOWER x 2
- VPOWER x 3
- VPOWER x 4
- VPOWER x 5
- VPOWER x 6
- VPOWER x 7
- VPOWER x 8
- ULP91 x 1
- ULP91 x 2
- ULP91 x 3
- ULP91 x 4
- ULP91 x 5
- ULP91 x 6
- ULP91 x 7
- ULP91 x 8
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Dip Marker Photo(s)
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9.3 Fill Box Markers Inside Fillbox? (Include number to order in 9.2)
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Fill Box Photo (Only if possible in regards WPCG to site hazards map)
10.0 Location of Pumps/Dispensers & Product on each - Mud Map
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10.1 Location of each pump/product (Drawing)?
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10.1.2 Location of each pump/product (Photo of marked up plan)?
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Comments:
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Select date
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Signed: