• Document No.

  • Audit Title

  • Client / Site

  • Add location
  • Conducted on

  • Prepared by

  • Location
  • Site contact(s)


  • Planned start date:

  • Expected duration:

  • Description of work to be carried out:

  • Summary of customer actions before commencing work:

  • Site induction

  • Tool storage / lockers

  • Canteen / welfare facilities

  • Skip / Disposal Requirements


  • Attach photos if applicable

  • Are site plans available

  • Is this a new installation or modification of existing?

  • Type of installation

  • Agree with customer any downtime required:

Installation requirements

  • List equipment to be installed.

  • Other:

  • What are the arrangements for loading and unloading?

  • Describe access to site for unloading purposes:

  • Add media

  • Add drawing

  • Is access equipment required for work at height?<br>List requirements:

  • Floor surface condition

  • Are procedures available for all tasks to be carried out?

  • Are contractors involved?

  • Name of contractors?

  • Has code of practice been issued

  • Have risk assessments and procedures been obtained?

  • Training certificates been obtained

  • Insurance certificates

  • Issued and discussed with customer

  • Does waste need to be disposed of?

  • Who will arrange & location to be agreed?

  • Is there an asbestos register?

  • Confirm there is no asbestos present in Engineers work area

  • Other hazards in the area

  • Additional hazard details:

  • Add media

Chemical Storage / Dosing Area

  • Are all chemicals to be supplied by Christeyns

  • Can chemicals be segregated as per the segregation matrix, if not what measures will be put in place?

  • Area for chemicals to be used / size

  • Add media

  • Add drawing

  • Are there drains in the vicinity?<br>If so what measures need to be put in place to prevent any chemicals entering the drain?

  • Spill Prevention Required:

  • Can chemicals be stored away from pedestrians or access restricted?

  • What is the distance from storage area to dosing area

  • Does the area require a barrier / door to prevent access?

  • Are there any temperature requirements?

Working at height

  • Will there be any working at height / access issues once the work is complete?


  • Do our Engineers hold relevant qualifications / experience to carry out all tasks?

  • List training requirements for the customer

Bulk tank details

  • Are bulk tanks to be installed?

  • Who owns the tank(s)?

  • Material of construction?

  • Tank
  • What is the approx capacity of the tanks?

  • Tank
  • Top fill or other?

  • What is the method for positioning bulk tanks?

  • Overfill prevention method?

  • Are overfill alarms required?

  • Is the bulk tank bunded?

  • Type of bund

  • Is there clean water for cleaning pipe work?<br>Describe?

  • Are there facilities for disposal of contaminated water?<br>Describe?

  • Are there drains in the vicinity?<br>If so what measures need to be put in place to prevent any chemicals entering the drain?

  • Outline location of bulk tanks

  • Add media

Vehicle access to bulk tank

  • Add media

  • Are there any problems with vehicle access or manoeuvring on site e.g narrow roadways / restricted access / Turning circles / blocking access routes etc.

  • What is the distance from the vehicle to the bulk tank inlet point / what is the length of pipe required

  • What is the distance from bulk inlet point to walkways / fire exit/ pedestrian access

  • Min 5 metres

  • Is the pipe run straight and level or are there any inclines / areas where the pipe work will not be visible?

  • Are there any pedestrians working or who require access to the area, whilst a bulk delivery is taking place?

  • Are there obstructions

  • Are static pumps required?


  • Has the customer been made aware of the requirement for supervision of bulk deliveries?

  • Has the customer been issued with a copy of the bulk delivery procedure? (Hazardous & non hazardous)

First aid facilities

  • Eye wash facilities should be located within or near to the dosing area.

  • Is there a drench shower available near the delivery area

  • Ensure customer is aware of the following requirements: (ANSI Z358.1 2009)

  • Ensure continuous water supply delivering 76 litres per minute for 15 mins. Installed so the shower head is between 208 - 244cms off the floor. Safety showers must be located within 10 seconds / 15 metres of a potential hazard. Must be located on the same level as the hazard.

Customer to provide

  • Laundry Requirements

  • Service Requirements

  • Other comments / requirements

  • Completed by:

  • Select date

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