Title Page
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Site conducted
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Date and Time
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Task
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Work Location
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Conducted on
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Prepared by
Exposure to Hazardous Substances
Access Control
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1. Is access to hazardous substance storage areas controlled?
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2. Are hazardous substances only stored in designated areas?
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3. Is the training of each person in the hazardous storage area up-to-date?<br>Note: Check the Competency Card is being carried by the individual and it is<br>valid.
Alarms Systems
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4. Do sensors display the date they were last calibrated?
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5. Is the testing and calibration date within the last year?
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6. Are sensors and alarms in good physical condition?
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7. Did the team perform a visual check of the sensors and alarms before<br>commencing work?
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8. Does the team know response procedures for possible alarms in their<br>work area?
Chemical PPE
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9. Have all hazardous substances involved with the task been clearly<br>identified and written on the Permit to Work?
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10. Do the team know the potential health effects of the chemicals they are<br>working with?
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11. Is the team using the correct hazardous substances PPE for this task?
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12. Was the Hazardous Substances PPE inspected prior to use and in good<br>condition?
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13. Is the Hazardous Substances PPE being worn correctly?
Handling Requirements
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14. Is the SDS for the hazardous substance(s) readily available and are the<br>requirements being followed?
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15. Are the handling tasks completed as per the written procedure?
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16. Does the team know what to do in an emergency when handling<br>hazardous substances?<br>
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17. Is piping and other process equipment labeled indicating the hazardous<br>contents?
Loading and Unloading Protection
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18. Are hazardous substance bulk loading and unloading facilities secured?
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19. Is the team following the procedure for safe loading and unloading of<br>bulk hazardous substances?
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20. Is the delivery driver familiar with the delivery and safe loading /<br>unloading procedure?
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21. Have the contents of the delivery truck been verified?
Mechanical Integrity of Storage and Distribution
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22. Are hazardous substances stored and segregated as per MSDS?
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23. Are there written procedures for the use, storage and disposal of<br>identified hazardous substances?
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24. Are hazardous substance containers correctly and clearly labelled?
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25. Are pipes or other distribution systems used for hazardous substances<br>clearly identified?
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26. Are structural beams, supports, pipes and vessels free from structural<br>damage and excessive corrosion/rust?
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27. Are all vessels, pipes, flanges and fittings free from visible leaks?
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28. Is the Hazardous Storage Area free from unnecessary combustibles and<br>incompatible substances?
PHA - Protection against exposure to Chlorine Gas © Rio Tinto
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29. Has a weekly inspection of containers been completed?
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30. Is the cylinder/ drum within inspection date? (within 5 yrs of date stamp)
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31. Have the drums/ cylinders been inspected and verified safe for use?<br>i.e there should be no visual physical damage or degradation of drum /<br>cylinder shell, valve cap, container<br>valve etc
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32. Is the gland packing on the valve spindle intact and at least hand tight?
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33. Have all piping, fittings, flexible hose, small chlorinator and injector<br>been inspected and verified safe for<br>use? i.e. There should be no visual physical damage, no blistering, kinks or<br>blockages and no chlorine leaks<br>suspected through visual or audio cues etc<br>
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34. Has a 52 week service been completed?
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35. Has a weekly inspection of the Vacuum Regulator Device (VRD),<br>including the drip leg heater and carbon canister, been completed?
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36. Has a visual check been conducted on the Vacuum Regulator Device?<br>i.e. inspected for signs of corrosion and dirt?
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37. Has the drip leg heater been checked that they are operational by<br>feeling for warmth?
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38. Has a 26 weeks service on the Vacuum Regulator Device and drip leg<br>heater been completed?
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39. Has a weekly inspection of the Chlorine Gas Detection, Alarm and<br>Shutdown System been completed?
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40. Has a function test been performed on the whole of the system?<br>This is to confirm the following:<br>- Alarm light up on Hydra Sentinel Panel,<br>- Display on on-line chlorine gas leak monitoring system,<br>- Activation of the audio alarm, and<br>- Operation of the ratchets<br>- Chlorine gas detection results alarmed to operations centre
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41. Have the gas detectors been inspected to ensure they are<br>unobstructed, clean and in safe working condition?
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42. Does the display panel show chlorine gas level at zero?
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43. Has the Shutdown device / ratchet arm been inspected to ensure that<br>there is no damage?<br>This includes no corrosion, or loose fittings, or an other abnormalities.
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44. Has the pneumatic lines been inspected to ensure that they are free<br>from damage or degradation?
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45. Is the 24 hour auto gas leak detector panel clear of any alarms?<br>Note: If the auto test has failed, there should be a trouble/ warning lamp<br>and an audible alarm
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46. Has a 4 weekly inspection of the Chlorine Gas Detection, Alarm and<br>Shutdown System been completed?<br>This should include:<br>- A check that the Pneumatic Panel air pressure greater than 600 kPa<br>- There is no low pressure or low battery alarm is present on the Check<br>Hydra Sentinel Panel<br>
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47. Is the Pneumatic Panel air pressure greater than 600 kPa?
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48. Is the Hydra Sentinel Panel clear of any low pressure or low battery<br>alarm? i.e. if no alarm is activated, tick yes
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49. Has a 24 weekly inspection of the Chlorine Gas Detection, Alarm and<br>Shutdown System been completed?
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50. Is the relevant SWP(s) available at the facility?<br>- RTIO-HSE-0164531 SWP 70kg Chlorine Cylinder Changeout<br>- RTIO-HSE-0165384 SWP 920kg Chlorine Drum Changeout
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51. Is the relevant SWP(s) current?<br>- RTIO-HSE-0164531 SWP 70kg Chlorine Cylinder Changeout<br>- RTIO-HSE-0165384 SWP 920kg Chlorine Drum Changeout
