PSE Field Fleet Facility Onsite Assessment Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

EFR and GFR Parts Cabinet

• Perform visible inspection of parts cabinet including a brief assessment of the available items. The items are headlights, Marker Lights, Wiper Blades, Tire checking equipment, Shop towels, Washer fluid, engine oil and coolant, spotlight bulbs

  Yes

  No

  N/A

DVIR Books

• Meet with EFR or GFR supervisor or the person responsible of overseeing who ensures 90 days of DVIR records are readily available

  Yes

  No

  N/A

Parked Equipment

• Check overall condition of spare EFR and GFR equipment that's parked in the yard

  Yes

  No

  N/A

• Check and see if the trickle charger and extension cord are present and working

  Yes

  No

  N/A

Bulk Fueling Station

• Check overall condition of bulk fueling tanks, Document any potential defects or leaks

  Safe

  At Risk

  N/A

• Check overall condition of the fuel dispensers and nozzles, check condition of fuel hoses

  Safe

  At Risk

  N/A

• Check location of emergency fuel shutoff reporting if area is obstructed by any objects that would impede emergency access

  Yes

  No

  N/A

• Check emergency fuel shutoff signage at fuel dispensers

  Yes

  No

  N/A

• Check and record date last fuel pump preventative maintenance was performed

  Yes

  No

  N/A

Propane Fueling Station

• Check overall condition of the above ground propane fuel tank, document any tank deformities or signs of exterior rust

  Safe

  At Risk

  N/A

• Check location of propane emergency shutoff

  Yes

  No

  N/A

• Check for nearby electrical sources that may create a potential spark in the event of a significant propane tank leak that would result in an explosion

  Safe

  At Risk

  N/A

• Check and document if possible when the last professional inspection was completed by the propane fueling station provider

  Yes

  No

  N/A

Check Mobile Mechanic Work Area

• Is the mechanic work area free from potential hazards that could result in personal injury?

  Safe

  At Risk

  N/A

• Is the mechanics work area readily available and free from obstruction?

  Safe

  At Risk

  N/A

• Check bulk engine oil storage location, document if any oil drums are not on secondary oil containment

  Safe

  At Risk

  N/A

• Check bulk waste oil collection site, Document any signs of excess engine oil on asphalt surfaces

  Safe

  At Risk

  N/A

Signatures

• Comments

  Yes

  No

  N/A

• Do any Items require immediate attention?

  Yes

  No

  N/A

• PSE Employee who performed inspection

  Sign