Thiess Asset Condition Audit Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

ASSET DETAILS

• Asset Number

• Asset Type

  Select pump valve tank motor other

  • pump
  • valve
  • tank
  • motor
  • other

• Date and Time of Inspection

  Date
• Location of Asset
  Address

• Make

• Model

• Serial Number

ASSET AUDIT CHECKLIST

• Safety Guards

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Emergency Stops and Safety a Devices

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Hand Stations and Controls

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Instrumentation

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Asset spilling or leaking material

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Vibration

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Heat

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Noise

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Corrosion

  Select Pass Fail Not Applicable

  • Pass
  • Fail
  • Not Applicable

• Condition Score<br>

  As New Condition

  Good Condition Fit for Use

  Fit For Use Requires Minor Repair

  Requires Repair to Maintain Fit for Use

  Not Fit For Use Requires Replacement

• Condition Comments

• Take photo of asset, identification tags and any damage that requires corrective maintenance

  Media

• Signature

  Sign