Station Site Evaluation

• Document No.

• Conducted on

  Date
• Location
  Address

• Station Name

• Prepared by

• Additional Personnel

General

• Do all indoor and outdoor light bulbs working properly?

  Yes

  No

  N/A

• Are all valves and pipe openings plugged?

  Yes

  No

  N/A

• Is conduit and small diameter pipe visibly stress-free?

  Yes

  No

  N/A

• Are valve indicator in place and functioning?

  Yes

  No

  N/A

• Are threaded plugs, nipples and fittings secure and tight?

  Yes

  No

  N/A

Corrosion

• Are jumpers and bonding wires secure?

  Yes

  No

  N/A

• Is piping atmosphere/ground interface properly coated?

  Yes

  No

  N/A

General

• Are all exits marked? (inside building exits signs must be visible during power loss)

  Yes

  No

  N/A

• Is a First Aid Kit(s) available on-site?

  Yes

  No

  N/A

• Does the First-aid kit have any expired supplies?

  Yes

  No

  N/A

• Is the first aid kit completely supplied?

  Yes

  No

  N/A

• Is there a first aid kit sign posted?

  Yes

  No

  N/A

• Are on-site tools in appropriate working condition?

  Yes

  No

  N/A

• Check if there is any compressed gas cylinders on site.

• Are compressed gas cylinders labeled with contents?

  Yes

  No

  N/A

• Are fuel and oxygen compressed gas cylinder separated appropriately? (by 20 feet or fire rated barrier)?

  Yes

  No

  N/A

• Are compressed gas cylinder secured upright and with caps?

  Yes

  No

  N/A

• Are empty compressed gas cylinders marked empty?

  Yes

  No

  N/A

• Does equipment show any signs of weak points or leaks?

  Yes

  No

  N/A

• Does Isolated piping, equipment and instruments in traffic areas have barricades and/or visible indicators?

  Yes

  No

  N/A

• Are all confined space labeled?

  Yes

  No

  N/A

• Are weep holes free of obstructions?

  Yes

  No

  N/A

• Is there any excess construction material left on-site?

  Yes

  No

  N/A

Electrical

• Is electrical equipment protected to prevent unauthorized use and/or entry?

  Yes

  No

  N/A

• Is electrical equipment labeled to indicate voltage?

  Yes

  No

  N/A

• Are rubber mats present in front of all electrical equipment? (over 480 volts)

  Yes

  No

  N/A

• Are PLC Panel closed and labeled?

  Yes

  No

  N/A

• Are electrical breaker and disconnects labeled showing the power they supply?

  Yes

  No

  N/A

• Does site have any exposed electrical wiring?

  Yes

  No

  N/A

• Are any extension cords on-site?

  Yes

  No

  N/A

• Are the extension cords if good working condition?

  Yes

  No

  N/A

• Are they being used for any permanent equipment?

  Yes

  No

  N/A

• Take extension cord out of service. Extension cord can not be left in continuous use for more than 90 days

• Are conduit poured to seal from product vapors? (randomly check a few in facility)

  Yes

  No

  N/A

• Is explosion proof equipment properly sealed and all bolts in place?

  Yes

  No

  N/A

• Are light poles secure and straight in ground?

  Yes

  No

  N/A

• Are MOV cover bolts in place?

  Yes

  No

  N/A

Fall Protection

• Do stairways with more than four(4) steps have hand rails with mid-rails?

  Yes

  No

  N/A

• Are handrails, mid-rails, and toe-boards on elevated platform over 6' high?

  Yes

  No

  N/A

• Are all elevated platform both secure and stable?

  Yes

  No

  N/A

• Is there any type of fall arrest system on-site?

  Yes

  No

  N/A

• What types of equipment

  Select Body Harness Shock absorbing lanyard Self retracting lanyard Anchor Non shock absorbing lanyard

  • Body Harness
  • Shock absorbing lanyard
  • Self retracting lanyard
  • Anchor
  • Non shock absorbing lanyard

• Has all fall arrest equipment been inspected

  Yes

  No

  N/A

• Is all fall arrest equipment is good working condition

  Yes

  No

  N/A

• Is all fall arrest equipment appropriately stored

  Yes

  No

  N/A

• Photos of fall arrest equipment

  Media

Ladders

• Are any ladders stored at the station site?

  Yes

  No

  N/A

• Are the ladders in good working conditions?

  Yes

  No

  N/A

• Are all the ladders warning labels and signs visible and legible?

  Yes

  No

  N/A

Hazcom

• All containers with chemicals or products have HMIS label communicating hazards (including pump drippings containers)

  Yes

  No

  N/A

• Is there a flammable cabinet on site?

  Yes

  No

  N/A

• All flammable and hazardous chemicals in cabinet identified and labeled

  Yes

  No

  N/A

Fire Protection

• Are flammable solids stored 4' away from electrical equipment?

  Yes

  No

  N/A

• Are flammable liquids stored outside of MCC Room

  Yes

  No

  N/A

• How many fire extinguishers are on-site?

• Are fire extinguishers easily identifiable?

  Yes

  No

  N/A

• Are fire extinguisher appropriately labeled and tagged?

  Yes

  No

  N/A

• Are fire extinguisher properly located according to NFPA?

  Yes

  No

  N/A

• Are extinguisher hose ends free of debris or obstructions?

  Yes

  No

  N/A

• Fire extinguisher have buffer material between the extinguisher and the soil

  Yes

  No

  N/A

Security & Signage

• Are exit gates fully functional?

  Yes

  No

  N/A

• Can entrance gates be secured in the open position?

  Yes

  No

  N/A

• Is required PPE posted at entrance?

  Yes

  No

  N/A

• Is speed limit sign posted? (if driving is allowed inside facility)

  Yes

  No

  N/A

• Unit Starts automatically posted on all equipment or at entrance? (if necessary)

  Yes

  No

  N/A

• Doors with padlock and hasp are labeled to prevent inadvertent locking while occupied (employees are aware of requirements)

  Yes

  No

  N/A

• Are emergency stations (eye wash, first aid, and fire blanket) labeled for identification?

  Yes

  No

  N/A

Documentation

• Has a site noise survey been completed? (on station)

  Yes

  No

  N/A

• Are all on-site chemical SDS's on MSDS online?

  Yes

  No

  N/A

Safety Comments

• Any additional safety concerns

• Add media

  Media

General

• Is flare and vent log utilized on-site?

  Yes

  No

  N/A

• Does each employee maintains for all their sites?

  Yes

  No

  N/A

• Is a station log book provided and utilized on-site?

  Yes

  No

  N/A

• Do all containers have lids to prevent rain collection and are secure from the wind (include trash dumpsters)

  Yes

  No

  N/A

• All flange bolts are flush with the nut or extend past the nut?

  Yes

  No

  N/A

• Is site free from significant erosion and/or soil channeling on-site?

  Yes

  No

  N/A

• Is site free of significant soil staining around pumps and equipment?

  Yes

  No

  N/A

• Are all oil filled transformers labeled to show ownership?

  Yes

  No

  N/A

Waste Management

• Is station clean of trash/debris and orderly?

  Yes

  No

  N/A

• Are all trash containers and sinks labeled to prevent accumulation of contaminated wastes?

  Yes

  No

  N/A

• Are all trash cans & dumpsters clear of Industrial Waste? (oily rags, oily debris, batteries, light bulbs, etc.)

  Yes

  No

  N/A

• Is Universal Waste (fluorescent bulbs, batteries) place in the appropriate container and labeled prior to shipment?

  Yes

  No

  N/A

• Are used shop towel containers (in buildings) labeled as hazardous waste prior to disposal?

  Yes

  No

  N/A

• Are containers with oil or hazardous material stored on secondary containment? (igloo)

  Yes

  No

  N/A

• Are drums and containers free of rust and dents?

  Yes

  No

  N/A

• Are all drums and containers containing waste labeled? (as Haz, Non-Haz, or Pending analysis)

  Yes

  No

  N/A

• Do All liquid drums have secondary containment?

  Yes

  No

  N/A

• Do pig traps have containers for sediments?

  Yes

  No

  N/A

Corrosion

• Does all pipeline supports have insulation material between pipe and support? (make CP group aware of exceptions)

  Yes

  No

  N/A

• Is piping and equipment free of visible atmospheric corrosion?

  Yes

  No

  N/A

• Do piping points of facility have pipe to soil reading that meets the established criteria? (randomly check a few locations)

  Yes

  No

  N/A

Asbestos

• Are annual inspection report available for ACM / PACM location?

  Yes

  No

  N/A

• Are Asbestos warning posted either at entrance or in building on site peculiarity sheet?

  Yes

  No

  N/A

Security & Signs

• Are emergency contact numbers posted?

  Yes

  No

  N/A

• Are driving direction to local hospital are posted?

  Yes

  No

  N/A

• Are all entrance and perimeter gates locked and secured?

  Yes

  No

  N/A

• Is perimeter fence a minimum of 6' in height with three strands of barbed wire?

  Yes

  No

  N/A

• Is perimeter fence free of corrosion?

  Yes

  No

  N/A

• Is the Company name and phone number on site sign at the entrance correct?

  Yes

  No

  N/A

• Are Authorized Personnel Only signs posted at entrance?

  Yes

  No

  N/A

• Are DOT Valves marked with the valve ID number?

  Yes

  No

  N/A

• Are emergency shut down(ESD) buttons labeled and all buttons are red?

  Yes

  No

  N/A

• Is a No open flame/ No smoking signs at the entrance?

  Yes

  No

  N/A

• Are Pipeline ROW signs on all four sides of facility?

  Yes

  No

  N/A

• Pipeline ROW signs on yellow posts over all pipeline in and out of facility?

  Yes

  No

  N/A

Safety

• Are facility site specific manual, P&ID with MOP setting and Electrical diagram available and current?

  Yes

  No

  N/A

• Are extinguisher monthly and annual inspection tags current and legible?

  Yes

  No

  N/A

• Is the site clear of vegetation?

  Yes

  No

  N/A

• Are Over Pressure Devices (OPD) isolation sealed in open position? (include thermal relief and isolation valves)

  Yes

  No

  N/A

Traps

• Are mainline valves on pig traps locked in normal position?

  Yes

  No

  N/A

• Do Trap and Vessel enclosures have tattle tail with chain connected to enclosure?

  Yes

  No

  N/A