SGN Health & Safety Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

• 1. Answer all the questions provided below.
  2. Add photos and notes by clicking on the paperclip icon, if applicable.
  3. To add a Corrective Action click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date. (Please include the Next Steps, Name of Person and When will the action take place.)
  4. Complete audit by providing digital signature.
  5. Share your report by exporting as PDF, Word, Excel or Web Link.

• Add location
  Address

• Select date

  Date

Forecourt

• Boundary walls and fences in good condition with no damage visible?

  Yes

  No

  N/A

• Merchandise store outside is kept tidy and stacked safely?

  Yes

  No

  N/A

• Forecourt surface in good condition with no slip/trip hazard or damage?

  Yes

  No

  N/A

• Number of dry powder fire extinguishers ( minimum 2)

  Yes

  No

  N/A

• Date of last inspection ( within 12 months)

  Yes

  No

  N/A

• Fire buckets at least 3/4 full with dry sand and lids

  Yes

  No

  N/A

• Emergency Cut Off switch clearly labelled and accessible?

  Yes

  No

  N/A

• Tannoy system working correctly?

  Yes

  No

  N/A

• Hoses and nozzles free from wear or cracking (retractable hoses must be PULLED<br>OUT and checked)?<br><br>

  Yes

  No

  N/A

• Pump islands, kerbs and bollards in good condition?

  Yes

  No

  N/A

• All metal gratings in place, clear of debris and with securing bolts present?

  Yes

  No

  N/A

• Below ground fillpoints free from WATER / rubbish with no evidence of illegal tank<br>entry? <br>

  Yes

  No

  N/A

• Delivery manhole chamber surround free from build up of dust / muck?

  Yes

  No

  N/A

• Lifting key available (if required)?

  Yes

  No

  N/A

• Floodlights and canopy lights working?

  Yes

  No

  N/A

• Tank labels VISIBLE with text CLEARLY READABLE?

  Yes

  No

  N/A

• Tank, offset fill and vapour recovery padlocks fitted and locked?

  Yes

  No

  N/A

• Fill pipe caps chained to the fill pipe?

  Yes

  No

  N/A

• Emergency Equipment Cabinet phone working (check for dial tone)?

  Yes

  No

  N/A

• Emergency Equipment Cabinet phone working (check for dial tone)?

  Yes

  No

  N/A

• Adequate forecourt cones available?

  Yes

  No

  N/A

• All LPG cylinders are stored within a locked cage?

  Yes

  No

  N/A

• Compound tidy and free from damage, LPG checklist up to date (refer to OnSite -<br>H&S/LPG Bulk Fuel - for guidance)? <br>

  Yes

  No

  N/A

• All bins are locked?

  Yes

  No

  N/A

• Clean and tidy, with no overgrown shrubbery or weeds visible?

  Yes

  No

  N/A

• Locks working and alarmed when closed?

  Yes

  No

  N/A

• Canopy heights marked clearly on all approaches?

  Yes

  No

  N/A

• All vent pipes correctly tagged?

  Yes

  No

  N/A

• Stanchion warning sign (No Smoking / Switch off Engines, etc)?

  Yes

  No

  N/A

• Correct grade stickers on all dispensers?

  Yes

  No

  N/A

Shop Floor/POS

• Electronic door lock (shunt lock) working where fitted?

  Yes

  No

  N/A

• Digi locks / electronic lock working on doors leading to secure area / storeroom?

  Yes

  No

  N/A

• Emergency phone working (dial tone audible) and available to staff?

  Yes

  No

  N/A

• “Wet Floor” sign is available and clean?

  Yes

  No

  N/A

• Floor clear of trailing or damaged extension leads ?

  Yes

  No

  N/A

• Safety torch (Usually YELLOW or ORANGE) available and working?

  Yes

  No

  N/A

• Safety knife undamaged, available and being used?

  Yes

  No

  N/A

• Clear of boxes and other obstructions (check the door opens easily)?

  Yes

  No

  N/A

• Clearly marked with “Running Man” sign and leads to a place of safety?

  Yes

  No

  N/A

• Secured ONLY by push bar and glass bolt when site open (signage in place)?

  Yes

  No

  N/A

• Minimum one DRY POWDER, one CARBON DIOXIDE CO2. How many in total?

  Yes

  No

  N/A

• All locations marked with red “Fire Point” label?

  Yes

  No

  N/A

• All locations noted on Emergency Flip chart?

  Yes

  No

  N/A

• Fully charged with safety pin in place?

  Yes

  No

  N/A

• Note the date of last inspection DATE

  Yes

  No

  N/A

• Note the date of your last emergency drill DATE

  Yes

  No

  N/A

• Probe Thermometer available and working ?

  Yes

  No

  N/A

• Electricity cupboard free from visible damage and containing NO stored items (mops, buckets etc)?

  Yes

  No

  N/A

• Smoke Detector working (press “TEST” button to check)?

  Yes

  No

  N/A

• PPE 2 x Hi Viz tabard / jacket available (minimum) and in good order?

  Yes

  No

  N/A

• Gloves & goggles available and in good order?

  Yes

  No

  N/A

• All shelves properly secured?

  Yes

  No

  N/A

• Goods are all stacked correctly (part cases on top) with no shelves overloaded?

  Yes

  No

  N/A

• All perishable food items stored off the floor?

  Yes

  No

  N/A

• Are there steps / staircases in the secure area, leading to storerooms / offices /<br>other areas etc ?<br><br>

  Yes

  No

  N/A

• Are all steps / stairways in good condition with no defects (no loose tread, no<br>broken edges etc) ?<br><br>

  Yes

  No

  N/A

• Are all steps / stairways fitted with a secure handrail on one side ?

  Yes

  No

  N/A

• Secure area signage displayed?

  Yes

  No

  N/A

• Emergency Flipchart displayed?

  Yes

  No

  N/A

• Emergency Flip chart Section 1 (Contacts) up to date?

  Yes

  No

  N/A

• Emergency Flip chart Section 8 (Fire) up to date?

  Yes

  No

  N/A

Age Restricted sales

• No ID No Sale Refusals Register up to date and correctly signed off?

  Yes

  No

  N/A

• No ID No Sale 'Challenges Made' log up to date and correctly signed out?

  Yes

  No

  N/A

• Challenge 25 Badges worn by all staff on duty?

  Yes

  No

  N/A

• Certified copy of the Premises Licence Act 2003 - Part A retained in safe?

  Yes

  No

  N/A

• Copy of the Premises Licence Summary - Part B displayed adjacent to the alcohol<br>section?<br><br>Proprietor Address and Licensing Hours Letter displayed where possible?

  Yes

  No

  N/A

• DPS Authorisation Sheet Filed in Alcohol Manual and SIGNED BY ALL STAFF?

  Yes

  No

  N/A

• DPS name and address are THE SAME on both Premises and Personal Licence?

  Yes

  No

  N/A

• Individual staff training records up to date ?

  Yes

  No

  N/A

• Alcohol Licensing manual available and fully up to date?

  Yes

  No

  N/A

• Legal required signage displayed as per 'Age Restricted Signage' template?

  Yes

  No

  N/A

• No ID No Sale Underage Laws and Maximum Penalties Laminate (yellow sheet)?

  Yes

  No

  N/A

• No ID No Sale Valid I.D. Laminate (yellow sheet)?

  Yes

  No

  N/A

Work Equipment

• Top handrail securely attached and undamaged?

  Yes

  No

  N/A

• Steps secure, with no damaged treads?

  Yes

  No

  N/A

• Stepladders top platform secure and undamaged? locks in place

  Yes

  No

  N/A

• Rubber feet in place and in good condition?

  Yes

  No

  N/A

• Kickstool - Castors undamaged / unit moves correctly?

  Yes

  No

  N/A

• No broken / sharp edges?No broken / sharp edges?

  Yes

  No

  N/A

Bake off/Hot food

• Hand held temperature probe available?

  Yes

  No

  N/A

• Protective gauntlets, clean apron and tongs available in good condition and being<br>used?<br><br>Protective gauntlets, clean apron and tongs available in good condition and being<br>used?<br><br>Protective gauntlets, clean apron and tongs available in good condition and being<br>used?<br><br>Due Diligence, Cleaning Schedule and Rota Production Sheets Completed?

  Yes

  No

  N/A

• Probe Calibration monthly check completed?

  Yes

  No

  N/A

CCTV

• Time & date correct on recording unit?

  Yes

  No

  N/A

• Recording system working correctly, images clear and sharp on payback?

  Yes

  No

  N/A

• Digital recorder back-up system in place and working correctly (VHS or hard disk)?

  Yes

  No

  N/A

• 28 days (minimum) footage to be retained?

  Yes

  No

  N/A

Safes

• All safes operational (both free standing and floor safes - are they being used,<br>combinations confidential and keys safe and secure) Note date of last combination<br>change?<br><br>

  Yes

  No

  N/A

Due Diligence

• Stock rotation sheet up to date (note date of most recent check) / SEL check?

  Yes

  No

  N/A

• Competent person and all training up to date for all employees?

  Yes

  No

  N/A

• COSHH Register signed by all team member?

  Yes

  No

  N/A

• Chiller, Freezer and Delivery Vehicle temperature checks up to date?

  Yes

  No

  N/A

Wet Stock management

• Gauges working and clear of All alarm conditions?

  Yes

  No

  N/A

• NO WATER confirmed (attach print our to checklist)?

  Yes

  No

  N/A

• Missing or inaccurate ticket issues identified and resolved?

  Yes

  No

  N/A

• Monthly wet stock check completed?

  Yes

  No

  N/A

Site register

• Register in place and up to date?

  Yes

  No

  N/A

• Site details and staff training sheet signed by all team members?

  Yes

  No

  N/A

• Vapour recovery annual/three yearly maintenance certificate present?

  Yes

  No

  N/A

• Vapour Recovery permit (LAPPC permit)?

  Yes

  No

  N/A

• Vapour Recovery fault log?

  Yes

  No

  N/A

• Competent Person register up to date and all certificates current?

  Yes

  No

  N/A

• Interceptor Cleaning certificate?

  Yes

  No

  N/A

• Electrical Test certificate?

  Yes

  No

  N/A

• Fire Extinguisher certificate?

  Yes

  No

  N/A

• DSEAR action plan / resolved items print-off available?

  Yes

  No

  N/A

• Current Petroleum Licence or Petroleum Storage Certificate?

  Yes

  No

  N/A

• Asbestos register up to date?

  Yes

  No

  N/A

• Accident book in use and up to date?

  Yes

  No

  N/A

• Car Valeting Daily Checklist up to date (attach previous month's copy)?

  Yes

  No

  N/A

• Slips & Trips daily checklist up to date (attached previous month's copy)?

  Yes

  No

  N/A

First Aid

• 1 pair disposable gloves?

  Yes

  No

  N/A

• 2 x Eye Pad?

  Yes

  No

  N/A

• 4 x Triangular Bandage?

  Yes

  No

  N/A

• 6 x Safety Pins?

  Yes

  No

  N/A

• 6 x Medium Dressings 120mm x 120mm?

  Yes

  No

  N/A

• 2 x Large Dressings 180mm x 180mm?

  Yes

  No

  N/A

• 20 x Assorted Adhesive Plasters ?

  Yes

  No

  N/A

• Blue food plasters ?

  Yes

  No

  N/A

• 2 pairs disposable paper overalls ?

  Yes

  No

  N/A

• Location of First Aid box is clearly signed and all items are available?

  Yes

  No

  N/A