Information

  • Document No.

  • Asset

  • Conducted on

  • Prepared by

  • Location
  • Inspection Team

  • Use this template for brief or full site inspections. Please see the Appendix section for examples if required.

Type of inspection

  • Is this a brief inspection (Tank and pumping station site report) or a full inspection?

Issue

  • Long grass?

  • What does this affect?

  • Access road?

  • What does this affect?

  • Weeds?

  • What does this affect?

  • Tree?

  • What does this affect?

  • Vermin?

  • What does this affect?

  • Rubbish?

  • What does this affect?

  • Other?

Condition Assessment

  • Is an internal assessment being conducted?

Internal Assessment

Cleanliness of tank?

  • Was the tank cleaned prior to inspection?

  • Describe sediment type (fine silt, sand, mud etc)

  • Sediment depth (mm)

  • Coverage (patchy, floor covered, walls etc.)

  • Has the tank been sufficiently cleaned? (i.e. are the walls and floor clean?)

  • Where required give positions as per a clock face dial with the hatch being at 6 o'clock.
    For condition scoring:
    1. Asset as new
    2. Initial signs of deterioation
    3. Satisfactory (unless in an area of high risk)
    4. Poor/action required (especially in high risk areas)
    5. Urgent action required

    For reliability grade:
    1. Never fails
    2. Fails occasionally
    3. Fails regularly
    N/A. Unsure

  • Inlet/outlet configuration

  • Location/type of inlet/outlet (e.g. Short riser from floor at 7 o'clock)

  • Is the inlet/outlet caged?

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Location/type of overflow (e.g. Through upper wall at 5o'clock))

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Location/type of inlet (e.g. Short riser from floor at 7 o'clock)

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Location/type of outlet (e.g. Short riser from floor at 7 o'clock)

  • Is the outlet caged?

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Ladder

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Wall coating/surface

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Floor condition

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Floor seals

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Columns

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Cathodic protection

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Internal roof/support beams

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Telemetry

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Miscellaneous (enter any other observations here)

External Assessment

  • Is an external assessment being done?

  • Where required give positions as per a clock face dial with the hatch being at 6 o'clock.
    For condition scoring:
    1. Asset as new
    2. Initial signs of deterioation
    3. Satisfactory (unless in an area of high risk)
    4. Poor/action required (especially in high risk areas)
    5. Urgent action required

    For reliability grade:
    1. Never fails
    2. Fails occasionally
    3. Fails regularly
    N/A. Unsure

  • Ladder

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Platform

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Entry hatch

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Any other hatches or entry points?

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Roof

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Handrails

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Wall coating/surface (including leaks)

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Miscellaneous (enter any other observations here)

Water Quality Hazards (only complete this section if conducting a full assessment)

  • Roof Type

  • Is the floating cover free of holes and tears?

  • Is the floating cover free from water pooling?

  • Is the floating cover free of vegetation growth?

  • Do all tank hatches form an adequate seal and show no signs of tampering?

  • Are all external structures (SCADA boxes etc) adequately sealed?

  • Is there evidence of vermin or bird nesting? (Nests, droppings etc)

  • Is there any evidence of contamination within the tank (visual inspection from tank hatch)?

  • Is storage/site secure and free from vandalism?

  • Miscellaneous (insert any other relevant comments/observations here)

  • Roof sheeting provides an adequate seal?

  • Roof is free of entry holes for vermin and contamination?

  • Roof is free of corrosion?

  • Are all roof bolts in place?

  • Are vermin stoppers present and in good condition providing an adequate seal?

  • Do all tank hatches form an adequate seal and show no signs of tampering?

  • Are all external structures (SCADA boxes etc) adequately sealed?

  • Do all air vents provide adequate seal and do not allow direct access to contamination or vermin

  • Do all gutters drain external to the tank? (I.e. rainwater is not directed into the tank)

  • Are all gutters clear of leaf litter, vegetation and debris?

  • Is there evidence of vermin or bird nesting? (Nests, droppings etc)

  • Is there any evidence of contamination within the tank (visual inspection from tank hatch)?

  • Is storage/site secure and free from vandalism?

  • Miscellaneous (insert any other relevant comments/observations here)

Security Inspection

  • For condition scoring:
    1. Asset as new
    2. Initial signs of deterioation
    3. Satisfactory (unless in an area of high risk)
    4. Poor/action required (especially in high risk areas)
    5. Urgent action required

    For reliability grade:
    1. Never fails
    2. Fails occasionally
    3. Fails regularly
    N/A. Unsure

  • Type of fencing/gates

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Locks

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

  • Site access

  • Condition? (Use scoring criteria above)

  • Functional? (i.e. is the asset doing what it is supposed to do?)

  • Reliability Grade (see scoring criteria above)

Issue

  • Long grass?

  • What does this affect?

  • Access road?

  • What does this affect?

  • Weeds?

  • What does this affect?

  • Tree?

  • What does this affect?

  • Vermin?

  • What does this affect?

  • Rubbish?

  • What does this affect?

  • Other?

Completion

  • Audit complete?

  • Add signature

Examples

  • Display examples?

Solid Roof

  • Roof sheeting not providing an adequate seal

    Roof sheeting not providing an adequate seal
  • Roof corrosion and entry hole

    no label
  • Absence of vermin stoppers

    no label
  • Wiring conduit resulting in direct entry (a)

    no label
  • Wiring conduit resulting in direct entry (b)

    no label
  • Vent cover adequately sealed

    no label
  • Vent holes allowing direct access

    no label
  • Tank gutter containing leaf litter/debris

    no label
  • Evidence of rodent activity

    no label
  • Evidence of bird nesting

    no label
  • Evidence of contamination on the surface

    no label
  • Evidence of contamination beneath the surface

    no label

Floating Cover

  • Hatch bolt missing

    no label
  • Water pooling on cover

    no label
  • Vegetation growth on floating cover

    no label
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.