Summit Utilities Security Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Location

• Add location
  Address

• Select date

  Date

• Is the site readily accessible?

  Yes

  No

  N/A

• Is the site subject to traffic damage ( within 100 ft. of a road)?

  Yes

  No

  N/A

• Is the site subject to flooding?

  Yes

  No

  N/A

• Is the sight located within close proximity to power lines?

  Yes

  No

  N/A

Security Information

• Is the location surrounded by a fence?

  Yes

  No

  N/A

• Does the location contain bollards or other crash protection devices?

  Yes

  No

  N/A

• Does the location have the appropriate signage?

  Yes

  No

  N/A

• Are all valves locked?

  Yes

  No

  N/A

Additional Operations Safety Information

• Does the location contain Regulators?

  Yes

  No

  N/A

• Does the location contain a relief?

  Yes

  No

  N/A

• Does the location contain SCADA?

  Yes

  No

  N/A

• Does the sight have blowdowns?

  Yes

  No

  N/A

• Are gauges in use?

  Yes

  No

  N/A

• Do the gauges display the appropriate range?

  Yes

  No

  N/A

• Is the atmospheric corrosion protection sufficient?

  Yes

  No

  N/A

• Are all studs compliant?

  Yes

  No

  N/A

• Does the sight contain any odor to suggest a gas leak?

  Yes

  No

  N/A

Other Concerns

• Are there any other additional safety or security concerns?

  Yes

  No

  N/A

Signature

• Inspectors name and signature

  Sign