Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Sign In Sheets

  • Are sign in sheets available and filled out for PSM employee training element

Roof

Valve Stations

  • Add media

  • Gauges in place and working properly

  • Defrost pressure between 65-70 PSI

  • Valve stems clean and lubricated

  • Valve stems exercised regularly

  • Pipe plugs in place

  • No evidence of leaks

  • Electrical boxes and conduit in good condition

  • Select from range

Crossovers

  • Add media

  • Crossovers in place and in good condition

  • Select from range

Pipe Condition

  • Add media

  • Piping in good condition

  • Select from range

Insulation / Pipe Saddles

  • Add media

  • Insulation in condition

  • Pipe saddles in place at pipe stands

  • Select from range

Pipe Labels

  • Add media

  • Proper pipe labels being used and in place

  • Pipe labels in good condition

  • Select from range

Pipe Stands

  • Add media

  • Pipe stands in place and properly supporting pipes

  • Select from range

Rain Cover On Relief Line

  • Add media

  • Rain cover in place on relief line to prevent contamination

  • Select from range

Vent Line Sensor

  • Add media

  • Vent line sensor in place and 15 feet above working surface

  • Select from range

Exhaust System

  • Add media

  • Exhaust system operates when ammonia is detected

  • Exhaust system meets IIAR2-2008 standards

  • Fan belts in good condition

  • Fan blades in good condition

  • Intake dampers working properly

  • Exhaust fans can be started manually from outside the engine room

  • Select from range

Condenser

  • Add media

  • Fans in good condition

  • Fan belts in good condition

  • Fan blades in good condition

  • Bearings in good condition

  • Piping in good condition

  • Paint on piping in good condition

  • Tubes in good condition - check for corrosion and scaling

  • Nozzles have good water pressure and coverage over tubes

  • Drift eliminators in place and in good condition

  • Water sump clean and free of debris

  • Water pumps running properly with no leaks

  • Relief valves removed from condensers

  • Structural steel in good condition

  • Electrical conduit and junction boxes in good condition

  • Water treatment in place and effective

  • Valves in good working condition

  • Access to valves and nozzles easily accessible

  • Select from range

Purger

  • Add media

  • Equipment clean and bubbler easy to see through

  • Insulation in place and in good condition

  • Purger operation working properly

  • Purger cycle counts recorded

DHU

  • Add media

  • Valves in good working condition

  • Sensors in place and working properly

  • Filters in place and not clogged

  • Belts in good working order

  • Desiccant wheel in good working condition

  • Equipment operating properly

  • Select from range

Machine Room

Glycol Loop

  • Add media

  • Heat exchanger working properly

  • Relief valves in place and in compliance

  • Glycol pump working and in good condition

  • Glycol temperature between 40-50 degrees

  • Glycol flow is appropriate

  • Glycol liquid level is appropriate

  • Glycol valves in good condition

  • Glycol temperature probes working properly

  • Select from range

HVAC

  • Add media

  • Heat exchanger working properly

  • Relief valves in place and in compliance

  • Pump in good working order

  • Temperature set properly

  • Glycol flow is acceptable

  • Valves in good working order

  • Temperature probes working properly

  • Select from range

Condenser Pumps

  • Add media

  • Condenser pumps working properly with no leaks

  • Select from range

Cross Connection Regulator

  • Add media

  • Cross connection regulator set properly and working

  • Select from range

Compressors - Screw

  • Add media

  • Name plate legible

  • Relief valves in place and in compliance

  • Gauges in place and in good working condition

  • Economizer working properly

  • Set points set up properly

  • Guards in place

  • Filter pressure within acceptable limits

  • Operating limits are good

  • Anchors and grouting in good condition

  • Safety switches in place and working properly

  • Oil quality and changing is based on oil sampling analysis

  • Sensors reading accurately

  • Equipment is clean

  • Equipment is operating properly

  • No oil leaks are evident

  • Valves are in good shape and working properly

  • Starters are in good condition and working properly

  • Select from range

Compressor - Reciprocating

  • Add media

  • Name plate legible

  • Relief valves in place and in compliance

  • Gauges in place and in good working condition

  • Economizer working properly

  • Set points set up properly

  • Guards in place

  • Filter pressure within acceptable limits

  • Operating limits are good

  • Anchors and grouting in good condition

  • Safety switches in place and working properly

  • Oil quality and changing is based on oil sampling analysis

  • Sensors reading accurately

  • Equipment is clean

  • Equipment is operating properly

  • No oil leaks are evident

  • Valves are in good shape and working properly

  • Starters are in good condition and working properly

  • Select from range

Vessels

  • Add media

  • Name plate / ASME stamp legible

  • Level controls working properly

  • Bulls eyes in good condition

  • Oil pots in good condition

  • Insulation in place and in good condition

  • Feed valves working properly

  • Safety float cut outs working properly

  • Relief valves in place and in compliance

  • Vessel is in good condition

  • Piping in good condition

  • Equipment is clean

  • Valves in good working condition

  • Electrical conduit and junction boxes are in good condition

  • Equipment is operating properly

  • Select from range

Oil Recovery System

  • Add media

  • Oil recovery system in good condition and working properly

  • Select from range

Floors

  • Add media

  • Floors in good condition

  • Select from range

Walls

  • Add media

  • Walls are in good condition

  • Select from range

Electrical / Panels

  • Add media

  • Electrical panels are in good condition and doors closed

  • No open holes are in panel, especially the top

  • If filters are in panel filter is clean and fits opening properly

  • Select from range

Spare Parts

  • Add media

  • Spare parts are in Maximo and on cycle counts

  • Select from range

Clutter / Unauthorized Material

  • Add media

  • No unauthorized storage in a machine room. Only refrigeration equipment and parts allowed

  • Select from range

Ladders

  • Add media

  • Ladders are designated for machine room

  • Select from range

Labels

  • Add media

  • Pipe and equipment labels are in place and meet IIAR standards

  • Select from range

Pipes

  • Add media

  • Pipes are in good condition and painted

  • Select from range

Insulation / Pipe Saddles

  • Add media

  • Insulation is in good condition and pipe saddles in place

  • Select from range

High Pressure Reciever

  • Add media

  • High pressure receiver is in good condition

  • Select from range

Ammonia Dispersion Tank

  • Add media

  • Dispersion tank is in good condition with no leaks

  • Select from range

Transfer Hose

  • Add media

  • Transfer hose is suitable and certification date is not expired

  • Select from range

Ammonia Level

  • Add media

  • Ammonia level within acceptable range

  • Select from range

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.