Title Page

  • Site conducted

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Add media

undefined

Condition of pumping equipment & surrounding area

  • Fuel hoses are clear of the ground and in good physical condition?

  • Breakaway couplings in good condition and free of corrosion?

  • All pumps within calibration certification period?

  • All pumps are clean and free from physical damage?

  • Bollards are in place and free from physical damage?

  • Hazardous warning/safety signage in place and clearly legible?

Facility boundaries

  • Security fences in good condition?

  • Site entrance(s) and exit(s) are free of visual obstructions?

  • Site perimeter free of obstructions/trip hazards?

Forecourt surface

  • Forecourt free of potholes and cracks?

  • Forecourt clear of fuel spills?

  • Site run-off will mean any spills will flow into site drainage?

Forecourt canopy (or Gull wings)

  • Canopy footings in good condition and free of corrosion?

  • Canopy lights in good condition?

Vent pipes

  • Vent pipes at least 1.5 metres (radius) clear of combustible items?

  • Hazardous warning signage in place on vent pipes?

Underground fuel tanks

  • Fill points correctly marked?

  • Dip points correctly marked?

  • Under the toby plate the fill points are in good condition?

  • All dip sticks present and useable?

  • Safe Fill Levels on dip sticks able to be checked?

  • Enter SFL levels on dip sticks for each fuel tank on-site.

  • Tank truck access to fill points assessed as adequate?

  • Wet stock reconciliation being done on daily basis?

  • Water level in tank monitored and below alarm level?

  • All dip sticks present and useable?

Interceptor pits

  • Interceptor pit located on-site?

  • Location of isolation valve clearly identified?

  • Does the interceptor handle turn?

  • Does the site undertake monthly checks of the interceptor?

  • Interceptor checked within last 12 months?

Major ID Sign

  • Major ID sign positioned away from overhead power cables?

  • Footing of major ID sign secure and free of corrosion?

Emergency response

  • Emergency contact numbers are clearly displayed and legible?

  • Fire extinguisher(s) available and within certification?

  • Suitable spill kit available, appropriately stocked and clearly visible?

  • Emergency plan tested with last 12 months and recorded?

  • Emergency stop button clearly visible or staff know of location?

  • Safety data sheets are available and less than five years old?

Forecourt security cameras

  • Security cameras operational and giving good quality images?

Store and site buildings

  • If present, store building is free from damage and in good physical condition?

  • Doors to office are shut and locked?

  • Restricted access to cashier?

  • CCTV capturing customer image on entry to store?

  • Height strips on door?

  • Instore lighting assessed as adequate?

  • For 24 hr sites, can they operate controlled door access and activate from the cashdesk?

  • For 24 hour sites, does the cash draw operate correctly?

  • IT door handle can be opened from the inside?

Certification and compliance requirements

  • Stationary container tank certificates available and current?

  • HSNO Location certificate available and current?

  • Approved handler's name + contact details known and cetrification current?

  • Electrical certificate of compliance (or revalidation) issued and current?

  • Building Warrant of Fitness current and on display?

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.