Virtual Survey Report - SafetyCulture Care

• Name of insured / client

• New or existing business or Renewal

  New or existing business

  Renewal

• What is the policy or quote number?

• What is the policy number?

• Customer email

• Name of Broker, if applicable

• Broker contact number, if applicable

• Broker email, if applicable

• Location
  Address

• Conducted on

  Date

• Prepared by

Key risk improvement recommendations (definitions on priorities)

• Actions marked as "High" – Recommendation to address significant deficiencies in relation to the level of controls where they do not meet best industry practice or internationally recognised standards. This must apply where there is a significant likelihood of a loss event and in the event of a loss, the consequence is expected to be significantly higher in comparison to where adequate controls are in place.

• Actions marked as "Medium" – Recommendation to address deficiencies in relation to the level of controls whereas they do not meet best industry practice and internationally recognised standards. Deficiency may increase the likelihood of a loss event, or consequence in the event of a loss event.

• Actions marked as "Low" – Considered to be best industry practice with a low likelihood and consequence in relating to loss exposure.

• Our opinion

• Hazard class

  Standard

  EPS

  High Hazard

• Occupancy Overview

• Fire load/spread

  Select Low fire load and fire spread risk Medium fire load Moderate fire spread risk High fire load Rapid fire spread risk

  • Low fire load and fire spread risk
  • Medium fire load
  • Moderate fire spread risk
  • High fire load
  • Rapid fire spread risk

• Construction

  Fire Resistive Construction

  Non-combustible

  Mixed Construction

  Combustible

• Is there any Composite Panel/Insulated Sandwich Panel

  Yes

  No

• Overall percentage of floorspace

  Select <5% <10% <15% >20% Over 50% Over 70%

  • <5%
  • <10%
  • <15%
  • >20%
  • Over 50%
  • Over 70%

• What is the core (insulating material)?

  Select Architectural Cladding EPS xFlam/PIR or FM Class 1 Rock wool or other non-combustible material Unknown

  • Architectural Cladding
  • EPS
  • xFlam/PIR or FM Class 1
  • Rock wool or other non-combustible material
  • Unknown

• Fire separation exposures

• Loss Record

  Select No recent claims or losses reported and nothing evident at the time of the survey to cause concern Recent losses report

  • No recent claims or losses reported and nothing evident at the time of the survey to cause concern
  • Recent losses report

• Please provide details

• Amount Subject / Maximum Foreseeable Loss (AS/MFL)

  Select One building presenting as a single overall risk from a loss projection perspective Multiple buildings presenting as a single overall risk from a loss projection perspective Other

  • One building presenting as a single overall risk from a loss projection perspective
  • Multiple buildings presenting as a single overall risk from a loss projection perspective
  • Other

• Probable Maximum Loss (PML)

  Select No change under a PML as there is no perfect internal fire separation (acceptable and compliant) Other

  • No change under a PML as there is no perfect internal fire separation (acceptable and compliant)
  • Other

• Please provide further details

• Net Loss Expectancy (NLE)

  Select 100% - No change to the PML under an NLE as there is no sprinkler protection installed Other

  • 100% - No change to the PML under an NLE as there is no sprinkler protection installed
  • Other

• Please provide further details

Building details

Building/Structure Construction

• Year of Construction

• Floor Area ~m2

• No. Storeys

• Any other information

Structure

• Walls

  Select Timber Masonry Concrete Steel Other

  • Timber
  • Masonry
  • Concrete
  • Steel
  • Other

• Floors

  Select Timber Masonry Concrete Steel Other

  • Timber
  • Masonry
  • Concrete
  • Steel
  • Other

• Roof

  Select Metal Sheet on unprotected steel frame Metal sheet with translucent skylight bands on unprotected steel frame Tile roof on Mixed Frame Concrete roof with membrane lining Other combustible material Asbestos cement sheeting on a mixed frame Other

  • Metal Sheet on unprotected steel frame
  • Metal sheet with translucent skylight bands on unprotected steel frame
  • Tile roof on Mixed Frame
  • Concrete roof with membrane lining
  • Other combustible material
  • Asbestos cement sheeting on a mixed frame
  • Other

• Provide further information

Insulated Panel

• Is there insulated panel installed to the building

  Yes

  Not installed

• Core Material

  Select EPS - Expanded Polystyrene XFlam or other Fire Rated Other

  • EPS - Expanded Polystyrene
  • XFlam or other Fire Rated
  • Other

• Provide details

• Usage

  Select Cold Storage Freezer Unit Cold storage/freezer unit Insulation - external walls Insulation - internal walls Insulation - internal/external Compartment for production Other

  • Cold Storage
  • Freezer Unit
  • Cold storage/freezer unit
  • Insulation - external walls
  • Insulation - internal walls
  • Insulation - internal/external
  • Compartment for production
  • Other

• Provide detail

• Condition

  Satisfactory

  Satisfactory in main

  Poor

• Hot/Cold Work Procedure

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• Regular Self-Inspections

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• Panel faces along all sections are in good condition with no exposed core material

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• All electrical cabling/wiring is fully enclosed within approved plastic or metal conduit with appropriate seals/flashing/capping where it passes through insulated panels

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• All flues have appropriate clearances and flashing/capping through insulated panels

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• Diffusers (covers) are fitted to all light bulbs/lamps so that any failure of a bulb/lamp, or its associated ballast, will not result in heated components potentially falling onto combustible items stored below

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• Where insulated panels form external wall sections of a building, combustible items and/or rubbish bins are not stored within 6m of these external panels

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• All heat sources are kept at least 2 metres from any insulated panels

  Select Yes No Not applicable in this instance

  • Yes
  • No
  • Not applicable in this instance

• Battery chargers are positioned 2 metres from any insulated panels or non-combustible material such as Fyrchek or checkerplate has been installed between the chargers and the insulated panels

  Yes

  No

  NA

Other factors

• Does the building construction include asbestos?

  Yes

  Not sure

  No

• What building elements include asbestos materials?

• What percentage of the overall building contains asbestos?

  Less than 10%

  10-20%

  Over 20%

• Is the building heritage listed?

  Yes

  Not sure

  No

• What elements of the building are heritage listed?

General comments about this building

• General comments

Overall

• What is the occupancy use / use of this property

Overview of Occupancy

• Are any hazardous processes are undertaken?

  Select Cooking Suburban Supermarket Spray painting Cabinet Making or Joinery Spray painting Hot works Plastic moulding Commercial Printing Baking Other

  • Cooking
  • Suburban Supermarket
  • Spray painting
  • Cabinet Making or Joinery
  • Spray painting
  • Hot works
  • Plastic moulding
  • Commercial Printing
  • Baking
  • Other

• Commercial Kitchen Overview

• No. of kitchens

  1

  2

  3

• Equipment

  Select Natural Gas or LPG Cook Tops Natural Gas or LPG Wok Burners Natural Gas or LPG Ovens Electric baking or combi ovens Deep fat fryers Other

  • Natural Gas or LPG Cook Tops
  • Natural Gas or LPG Wok Burners
  • Natural Gas or LPG Ovens
  • Electric baking or combi ovens
  • Deep fat fryers
  • Other

• Provide details

Deep Fryers

• Installed

  Yes

  No

  NA

• Type

  Select Floor mounted Bench mounted

  • Floor mounted
  • Bench mounted

• Heating source

  Select Natural Gas Fired LPG Fired Electric

  • Natural Gas Fired
  • LPG Fired
  • Electric

• Capacity (L)

• Temp (C)

  Select <160 degrees C <180 degrees C <200 degrees C

  • <160 degrees C
  • <180 degrees C
  • <200 degrees C

• Frequency of changing oil

• Where is waste oil stored?

Solid Fuel

• None at this siteIs there any soild fuel cooking at this site?

  Yes

  No

  NA

• What type of solid fuel cooking?

  Select Wood fired oven Charcoal Grill/rotisserie Meat smoking Other

  • Wood fired oven
  • Charcoal Grill/rotisserie
  • Meat smoking
  • Other

• List types

• Are the charcoals extinguished and allowed to cool before closing at the end of the day?

  Yes

  No

• Are charcoals removed from the building when extinguished?

  Yes

  No

• What type of meat smoking?

  Select Dry chip smoking Wet chip smoking

  • Dry chip smoking
  • Wet chip smoking

• Heat source

  Natural gas

  Electric

  Solid fuel

Cleaning and maintenance

• Cookers/fryers/ovens within commercial kitchens are adequately maintained and in a clean condition with no build-up of food debris around the cooker rings or heating elements

  Yes

  No

• Cookers/fryers/ovens are appropriately separated to/from internal wall linings to eliminate the potential of radiant heat transfer

  Yes

  No

• A gas isolation/shut-off valve is readily available to kitchen workers so that the gas can be quickly isolated in an emergency situation

  Yes

  No

• Fire blanket and extinguisher/s installed and accessible, with appropriate extinguishing agent (CO2 or dry chemical powder for general kitchen areas and wet chemical for deep fryers)

  Yes

  No

• Deep fryers are fitted with appropriate flame failure controls, thermostat controls and automatic over-temperature cut-out provisions

  Yes

  No

• The oil is skimmed to remove any food scraps and replaced regularly (timing of replacement based on the frequency of fryer use)

  Yes

  No

• Cleaning frequencies are adequate based on the amount and type of cooking being carried out in the kitchen. In general, we use the standards advised by IKECA in this regard

  Yes

  No

• Lighting within canopies is fully enclosed

  Yes

  No

• Canopy exhaust fans are maintained so that they run freely with no evidence of excessive bearing noise or vibration

  Yes

  No

• How often is the canopy and filters cleaned/replaced?

  Weekly

  Fortnightly

  Monthly

  Not at all

• How often is the ducting cleaned to the external atmosphere?

  Quarterly

  6 monthly

  Annually

  Not cleaned

• Is the cooking equipment hoods / exhaust duct subject to cleaning?

  Yes

  No

• How often are the hoods / exhaust cleaned?

  Quarterly

  Bi-Annually

  Annually

• Who is engaged to conduct the cleaning?

  Contractor

  Internal Cleaner

• Is there photographic evidence to support the cleaning schedule?

  Yes

  No

• Products are displayed on non-combustible shelving and in state of the art display fridges/freezers?

  Yes

  No

• There is no bulk storage of aerosols (only those on display)?

  Yes

  No

• Chicken and baking ovens are state of the art units that are appropriately extracted via overhead, non-combustible extraction canopies?

  Yes

  No

• Cleaning of overhead extraction systems above ovens occurs with adequate frequency?

  Yes

  No

• Storage in back of house section of supermarket is well supported on non-combustible shelving, racking or trolleys?

  Yes

  No

• There is no high piled storage in the back of house section or elsewhere in the supermarket?

  Yes

  No

• Refrigeration plant for the cool/freezer compartments and fridges is installed within an appropriately fire separated area with no combustibles in the vicinity?

  Yes

  No

• Refrigeration plant was found to be operating well (no evidence of excessive bearing noise or vibration) and is subject to scheduled maintenance?

  Yes

  No

• Is there an ATM installed

  Yes

  No

• Who refills the machine?

  Cash recycling by the insured?

  Third Party

• Is the ATM installed in an area well separated from entry points to mitigate the risk of ram raid?

  Yes

  No

• Number of spray booths

• Number of open spray booths

• Number of enclosed spray booths

• What material are the spray booth walls and ceilings constructed of?

  Insulated Sandwich Panel (EPS)

  Metal sheet with no insulation

  Other

• What is the spray booth constructed of?

• Is the Spray Booth Heated?

  Yes

  No

• What is the heating source?

  Diesel

  Electric

  Natural Gas

• Are the heating burners well separated to/from internal walls (no radiant heat transfer issues)?

  Yes

  No

• Has the spray booth been designed, constructed and installed to comply with AS/NZS 4114.1 – Spray Painting Booths?

  Yes

  No

• Are procedures available and up to date for the operation and maintenance of all spray booths?

  Yes

  No

• Are all persons who operate spray booths trained in the operation, use of and storage hazardous materials being used in the the booth?

  Yes

  No

• Is health monitoring being conducted based on the chemicals sprayed in the spray booths?

  Yes

  No

• Are records stored in a secure place?

  Yes

  No

• Is the Spray Booth fitted with an exhaust capture system or ventilation system that includes a filter for removing airborne contaminants?

  Yes

  No

• Is the system operational?

  Yes

  No

• Are filters cleaned regularly and free of built up overspray?

  Yes

  No

• Is the ducting to the external environment cleaned at least annually and free from built up overspray?

  Yes

  No

• When was the last service conducted and is it maintained to manufacturer’s specifications?

  Yes

  No

• Are spray guns pneumatically actuated?

  Yes

  No

• Are spray gun nozzles cleaned regularly and tested?

  Yes

  No

• When was the last service conducted?

  Date

• Are employees required to wear appropriate PPE?

  Yes

  No

• Are lights fitted with diffuser covers and cleaned regularly from overspray?

  Yes

  No

• Are spray paints stored in a separate area well separated to/from ignition sources

  Yes

  No

• Are solvents and other flammable liquids stored in a compliant Dangerous Goods Storage Unit

  Yes

  No

• Are solvent soaked clean up rags disposed of in a non-combustible bin with well fitting lid and removed from the building at the end of the day?

  Yes

  No

• Are suitable fire extinguishers readily available to spray paint booths, painting areas and paint storage areas?

  Yes

  No

• Are they kept free from obstruction?

  Yes

  No

• Are extinguishers fully charged?

  Yes

  No

• Tested on a 6 monthly basis as per AS1851?

  Yes

  No

• What other hazardous activities are in place and are safety controls adequate?

• Cabinet Making Hazards

• Equipment

  Select CNC Machines Edge Bander Router Bench/Drop saw Drilling machine Other

  • CNC Machines
  • Edge Bander
  • Router
  • Bench/Drop saw
  • Drilling machine
  • Other

• Raw Materials

Extraction bags for internal systems are emptied regularly and removed to bulk waste bins

• Built up dust and other combustible materials are removed from around the extraction system

  Yes

  No

  NA

• External extraction system empties into bulk waste bin which is replaced regularly and not allowed to overfill at any time

  Yes

  No

  NA

• Dust collector is fitted with appropriate blast doors

  Yes

  No

  NA

• Ducting and filters are cleaned regularly to avoid sawdust building up within the system

  Yes

  No

  NA

• There is no built up sawdust or combustible materials around the motors of the extraction system

  Yes

  No

  NA

• Dust collector is adequately separated from the building or installed against a full height non-combustible wall

  Yes

  No

  NA

• Sawdust and other combustible materials are regularly removed from around the machines including motors and other ignition sources

  Yes

  No

  NA

• Machines have appropriate safety guards and safety cut offs installed and are not disabled

  Yes

  No

  NA

• All production plant/equipment including air compressors and similar are subject to preventative maintenance

  Yes

  No

  NA

• Electrical/electronic control panels and distribution boards are enclosed within non-combustible cabinets which remain closed to prevent ingress of dust and other raw materials

  Yes

  No

  NA

• Appropriate PPE is worn by operators at all times

  Yes

  No

  NA

• There is no significant accumulation of packaging materials and/or finished products adjacent to the machines (they are transferred to an appropriately separated storage section)

  Yes

  No

  NA

• Moulding Type

  Injection Moulding

  Blow Moulding

  Extrusion Moulding

  Other

• What type of moulding?

Raw Material

• What type of plastics are used in the production processes?

  Select Polypropylene Polycarbonate Teflon High-Density Polyethylene (HDPE) Low-Density Polyethylene (LDPE) Polystyrene Polyurethane Acrylonitrile Butadiene Styrene Kostrate Santoprene Poly Vinyl Chloride (PVC) Acrylic Polyester Other

  • Polypropylene
  • Polycarbonate
  • Teflon
  • High-Density Polyethylene (HDPE)
  • Low-Density Polyethylene (LDPE)
  • Polystyrene
  • Polyurethane
  • Acrylonitrile Butadiene Styrene
  • Kostrate
  • Santoprene
  • Poly Vinyl Chloride (PVC)
  • Acrylic
  • Polyester
  • Other

• Provide details

• Bulk silos

  Yes

  No

  NA

Storage configurations, quantity and transfer

• Storage of raw materials - bags, palletised, bulk 1 tonne bags, silos?

  Select Silos Bags/palletised 1 tonne bulk bags Other

  • Silos
  • Bags/palletised
  • 1 tonne bulk bags
  • Other

• Provide details

• How many silos?

  Select 1 2 3 4 5 or more NA

  • 1
  • 2
  • 3
  • 4
  • 5 or more
  • NA

• Capacity of silos (metric tonnes)

• Bags/palletised - volume or quantity stored - metric tonnes

• Bulk storage silos are non-combustible, structurally well supported, impact protected, fully enclosed and appropriately grounded.

  Yes

  No

  NA

• Plastic raw materials (beads/granules) pumped into bulk silos utilising pumps positioned on delivery tankers, and then vacuumed into the building to individual moulding units via fully enclosed, appropriately supported and impact protected non-combustible piping

  Yes

  No

  NA

• Filters installed within the pipes and/or the pipes are blown out regularly to prevent accumulation of fines

  Yes

  No

  NA

• Vacuum pumps/motors appropriately enclosed and separated from the plastic raw materials so as not to present a potential ignition source

  Yes

  No

  NA

• There is no significant accumulation of plastic raw materials adjacent to the moulding units (they are stored in an appropriately separated section of the building/site)

  Yes

  No

  NA

• There is no significant accumulation of packaging materials and/or finished products adjacent to the moulding units (they are transferred to an appropriately separated storage section)

  Yes

  No

  NA

Moulding Units maintenance & housekeeping

• The moulding units are state of the art with electronic controls with integrated cut-out provisions and audible alarms for over/under temperature or other abnormal operating conditions

  Yes

  No

  NA

• Moulding units are electrically heated, with no gas heating as part of the production processes

  Yes

  No

  NA

• There is no operating any production plant/equipment on an unattended basis after hours (automated pre-warming of electrically heated equipment prior to employees arriving on site in the morning is acceptable)

  Yes

  No

  NA

• Pre-warming processes are electronically controlled and do not involve production/manufacturing

  Yes

  No

  NA

• Finished products are appropriately cooled prior to being packed into cardboard cartons

  Yes

  No

  NA

• All production plant/equipment including the moulding units, chillers (if installed), air compressors and similar are subject to preventative maintenance

  Yes

  No

  NA

• Electrical/electronic control panels and distribution boards are enclosed within non-combustible cabinets which remain closed to prevent ingress of dust/plastic raw materials

  Yes

  No

  NA

• The floor and other surfaces in the production areas are kept clear of plastic raw materials, oils/lubricants and other combustibles

  Yes

  No

  NA

• Plastic waste/offcuts are stored appropriately separated from potential ignition sources and regularly removed from the site

  Yes

  No

  NA

• Granulating of recyclable materials takes place in an appropriately separated area utilising a state of the art granulator that is supervised at all times when operating and fitted with readily accessible emergency stop provisions that shut down the conveyor and granulator

  Yes

  No

  NA

• There is no accumulation of waste plastic products or granulated products around this granulating unit

  Yes

  No

  NA

• Yes

  No

  NA

What type of ovens

• Please select the type of ovens used

  Select Electric Natural Gas Liquid Petroleum Gas Solid Fuel (wood-fired, charcoal etc) Other

  • Electric
  • Natural Gas
  • Liquid Petroleum Gas
  • Solid Fuel (wood-fired, charcoal etc)
  • Other

• Please specify type of ovens

• What is the fuel source?

  Wood

  Charcoal

  Other

• Please specify

• Are the ovens extinguished and allowed to cool at the end of the day?

  Yes

  No

• Best practise risk mitigation is to extinguish the fuel and allow to cool before leaving for the day to prevent re-ignition and a fire spreading through the business

• Please specify what is done with the charcoal or burnt wood once extinguished - choose as many as appropriate

  Select Charcoal is removed from the oven and placed in a non-combustible bin with a well fitting lid and removed external to the building The wood fire oven flue is closed and door sealed to remove oxygen from the environment. Nothing the coals are left as is and unattended

  • Charcoal is removed from the oven and placed in a non-combustible bin with a well fitting lid and removed external to the building
  • The wood fire oven flue is closed and door sealed to remove oxygen from the environment.
  • Nothing the coals are left as is and unattended

• Best practise if to remove the coals/charcoal from the oven in a non-combustible sealed container and remove from the building. Alternatively if using a traditional wood fire oven the oven should be completed seal and flue closed once the coals are extingusihed.

• Are flues and chimneys cleaned regularly removing any built up creasote (black tar like substance that lines the chimney or flue)?

  Yes

  No

• Chimneys and Flues of wood fired ovens need regular cleaning and maintenance - creosote build up not only impacts the efficiency of the wood fired oven but is highly combustible and can ignite in the chimney and rapidly spread throughout the building. Please arrange to have your chimney serviced and cleaned as soon as practiable.

• How many ovens in total

Flour storage

• How is the flour stored?

  Select Bulk silos Bags/sacks Other

  • Bulk silos
  • Bags/sacks
  • Other

• How many silos?

• Capacity of the silos

• Bulk storage silos are non-combustible, structurally well supported, impact protected, fully enclosed and appropriately grounded

  Yes

  No

• Flour is pumped into bulk silos utilising pumps positioned on delivery tankers, and then vacuumed into the building to individual moulding units via fully enclosed, appropriately supported and impact protected non-combustible piping

  Yes

  No

• How is the flour in bags/sacks stored?

  Select Stored on non-combustible shelving Stored encapsulated on pallets on pallet racking Stored on pallets on the floor Other

  • Stored on non-combustible shelving
  • Stored encapsulated on pallets on pallet racking
  • Stored on pallets on the floor
  • Other

• Please provide details

General Risk Management

• Baking ovens within commercial bakery are adequately maintained and in a clean condition with no build-up of food debris around the heating elements

  Yes

  No

• Baking ovens are appropriately separated to/from internal wall linings to eliminate the potential of radiant heat transfer

  Yes

  No

• A gas isolation/shut-off valve is readily available to kitchen workers so that the gas can be quickly isolated in an emergency situation

  Yes

  No

• Baking ovens are not operated when facility is unattended, and ovens are shut down and allowed to cool before facility closes at the end of the day

  Yes

  No

• Extinguisher/s installed and accessible, with appropriate extinguishing agent (CO2 or dry chemical powder for general kitchen areas and wet chemical for deep fryers)

  Yes

  No

• Filters installed within the pipes and/or the pipes are blown out on a regular basis to prevent the accumulation of flour

  Yes

  No

• Vacuum pumps/motors appropriately enclosed and separated from the flour products so as not to present a potential ignition source

  Yes

  No

• There is no significant accumulation of flour near ignition sources (bulk flour is stored in an appropriately separated section of the building/site)

  Yes

  No

• Are all electrical installations including plant and equipment adequately static protected to eliminate static discharge leading to the risk of explosion?

  Yes

  No

• There is no operating any baking equipment on an unattended basis after hours (automated pre-warming of electrically heated equipment prior to employees arriving on site in the morning is acceptable)

  Yes

  No

• Pre-warming processes are electronically controlled and do not involve production/manufacturing

  Yes

  No

• Finished products are appropriately cooled prior to being packed

  Yes

  No

• All production plant/equipment including the ovens, refrigeration units, freezers and blast freezers and similar are subject to preventative maintenance

  Yes

  No

• Electrical/electronic control panels and distribution boards are enclosed within non-combustible cabinets which remain closed to prevent ingress of flour dust and other raw materials

  Yes

  No

• The floor and other surfaces in the production areas are kept clear of flour and other combustibles

  Yes

  No

• Cleaning frequencies are adequate based on the amount and type of cooking being carried out in the kitchen. In general, we use the standards advised by IKECA in this regard

  Yes

  No

• Lighting within the canopy is fully enclosed

  Yes

  No

• Canopy exhaust fans are maintained so that they run freely with no evidence of excessive bearing noise or vibration

  Yes

  No

Utility

• Utilities that present site exposures?

  Select Electricity Gas Water Wastewater

  • Electricity
  • Gas
  • Water
  • Wastewater

• Describe hazards associated with utilities.

• Are all electrical boards enclosed and well separated to/from combustible materials?

  Yes

  No

• Is there a formalised annual program of thermal scanning implemented?

  Yes

  No

• Is all electrical installations, power boards, extension cords and appliances tested and tagged

  Yes

  No

• Is there a solar installation?

  Yes

  No

• Are the inverters installed in a well ventilated position well separated to/from combustible material?

  Yes

  No

Storage

General storage

• List any storage arrangements, height and material stored

• Is racking provided with impact protection on uprights?

  Yes

  No

  Not applicable

• Are racking inspections undertaken?

  Yes

  No

  Not applicable

• Is lighting adequately separated from storage?

  Yes

  No

  NA

• Are there any items stored on the floor?

  Yes

  No

• Are the items stored on the floor considered high piled?

  Yes

  No

• Are forklifts or other mobile plant utilised

  Yes

  No

• What type of forklift

  Select LPG Diesel Electric Manual Pallet Lifter

  • LPG
  • Diesel
  • Electric
  • Manual Pallet Lifter

• Are LPG Cylinders securely stored and upright

  Yes

  No

• Are electric forklift charging areas provided with >2m separation from storage?

  Yes

  No

Dangerous goods

• What dangerous goods are stored and in what arrangement?

  Select Class 1 - Explosive Class 2 - Gases - compressed, liquified, dissolved under pressure Class 3 - Flammable Class 4 - Flammable Solids Class 5 - Oxidising Agents & Organic Peroxides (non-flammable) Class 7 – Radioactive Materials Class 8 – Corrosive Substances and Articles (non-flammable) Class 9 - Miscellaneous Dangerous Goods (Dry Ice, Asbestos and Environmentally Hazardous Substances) (non-flammable) Other – Combustible Dusts or Metals Minimal dangerous good stored (predominantly cleaning chemicals)

  • Class 1 - Explosive
  • Class 2 - Gases - compressed, liquified, dissolved under pressure
  • Class 3 - Flammable
  • Class 4 - Flammable Solids
  • Class 5 - Oxidising Agents & Organic Peroxides (non-flammable)
  • Class 7 – Radioactive Materials
  • Class 8 – Corrosive Substances and Articles (non-flammable)
  • Class 9 - Miscellaneous Dangerous Goods (Dry Ice, Asbestos and Environmentally Hazardous Substances) (non-flammable)
  • Other – Combustible Dusts or Metals
  • Minimal dangerous good stored (predominantly cleaning chemicals)

• Please list types of Dangerous Goods

• Are gas cylinders adequately secured (for stability)?

  Yes

  No

• Are dangerous goods (such as cylinders) segregated? <br>(e.g. oxygen away from flammable gases)

  Yes

  No

• Are appropriate hazards material placard in place?

  Yes

  No

Flammable liquids/dangerous goods

• What flammable liquids are stored and in what arrangement?

• Are suitable storage and containment practices in place?

  Yes

  No

• Are flammable liquid transfer practices, e.g. earthing and bonding in place? <br>(e.g. placing a fuel tank on the bottom to reduce static discharge)

  Yes

  No

Loss prevention management controls

Contractor controls

• Are contractors vetted, insurance details and licencing details confirmed?

  Yes

  No

• Are contractors supervised on site?

  Yes

  No

• Are the contractors provided induction training?

  Yes

  No

• Do contractors follow site loss prevention management controls?

  Always

  Most of the time

  Sometimes

  Never

Hazardous works

• Is there a documented hot works procedure and permit system in place and implemented?

  Yes

  No

  NA

• Does the hot works permit require a fire watch during and 30 minutes after the completion of work?

  Yes

  No

  NA

• Is a monitoring period undertaken after the completion of fire watch (minimum 1 hour)?

  Yes

  No

  NA

• Is a minimum of 10m separation from combustible materials, or fire resistant shielding / covers required?

  Yes

  No

  NA

• Is equipment checked prior to use and the flashback arrestors fitted?

  Yes

  No

  NA

Fire impairment mangement

• Is a fire impairment procedure in place?

  Yes

  No

  NA

Smoking controls

• Is there a dedicated smoking area provided with adequate signage?

  Yes

  No

  NA

• Are self-extinguishing bins provided?

  Yes

  No

  NA

• Is the smoking area separated from any entry door or combustible storage by at least 4 meters?

  Yes

  No

  NA

Building maintenance

• Is housekeeping adequate? (Note: no build up of combustible materials around electrical switchboards and waste materials removed from building?)

  Select Daily Weekly Monthly Quarterly Annually Never

  • Daily
  • Weekly
  • Monthly
  • Quarterly
  • Annually
  • Never

• How often are self-inspections undertaken and by whom?

  Internal

  External

• Is vegetation appropriately cut back from buildings?

  Yes

  No

• Is roofing (gutters & drains) subject to routine inspections and clearing?

  Yes

  No

Liability exposure & emergency planning

• Is liability coverage required?

  Yes

  Not sure

  No

• How often are inspections of public accessible areas undertaken? (Eg. identification of trip hazards, etc)

  Select Daily Weekly Monthly Quarterly Annually Never

  • Daily
  • Weekly
  • Monthly
  • Quarterly
  • Annually
  • Never

• Are public accessible areas in adequate condition?

  Yes

  No

  NA

• Is emergency lighting and exit signs operational and maintained?

  Yes

  No

  NA

• Do you undertake regular fire drills?

  Yes

  No

  NA

• Are emergency egress routes clear?

  Yes

  No

  NA

• Is an evacuation plan in place and is it displayed in common areas?

  Yes

  No

  NA

Summary / wrap up

• General comments about occupancy

Fire water supply

• What is the fire water supply to site?

  Select Onsite water supply Towns mains None

  • Onsite water supply
  • Towns mains
  • None

• What type of fire water supply is available?

  Select Sprinkler Hydrant Combined Hose Reels Not applicable in this instance

  • Sprinkler
  • Hydrant
  • Combined
  • Hose Reels
  • Not applicable in this instance

Automatic sprinkler protection

• Sprinklers/drenchers

  Select Not installed. Impractical to consider installation. Installed. Other

  • Not installed. Impractical to consider installation.
  • Installed.
  • Other

• Classification

  Select Residential Hazard Light Hazard Ordinary Hazard 1 Ordinary Hazard 2 Ordinary Hazard 3 High Hazard Early Suppression Fast Response (ESFR)

  • Residential Hazard
  • Light Hazard
  • Ordinary Hazard 1
  • Ordinary Hazard 2
  • Ordinary Hazard 3
  • High Hazard
  • Early Suppression Fast Response (ESFR)

• Compliance To

  Ordinance 70

  AS2118 - 1982

  AS2118.1 - 1999

  AS2118.1 - 2017

• Impairment Handling

  Select Formalised impairment handling procedure in place No formalised procedure in place - see Recommendation Formalised procedure not required in this instance

  • Formalised impairment handling procedure in place
  • No formalised procedure in place - see Recommendation
  • Formalised procedure not required in this instance

• Pumpsets - Diesel

  None installed or required

  1 installed

  2 installed

• Pumpsets - Electric

  None installed or required

  1 installed

  2 installed

• Pump Testing

  Select Not applicable Monthly testing as required by AS1851 Inadequate testing of pumps - see Recommendation

  • Not applicable
  • Monthly testing as required by AS1851
  • Inadequate testing of pumps - see Recommendation

• Water Supply

• Mains

  Select Adequate town main supply - no onsite tanks Onsite tanks in-filled from the town main supply No main supply - onsite tanks only

  • Adequate town main supply - no onsite tanks
  • Onsite tanks in-filled from the town main supply
  • No main supply - onsite tanks only

• Town main size (mm)

• Tank/s

  Steel tank/s installed

  Concrete tank/s installed

  Plastic tank/s installed

  No onsite water storage

• Eff Capacity (kL)

• Status

  Select Overall system online System online however see Recommendation System not online

  • Overall system online
  • System online however see Recommendation
  • System not online

• Monthly Testing

  Select Tested monthly as required by AS1851 Not tested monthly - see Recommendation Monthly testing not required in this instance

  • Tested monthly as required by AS1851
  • Not tested monthly - see Recommendation
  • Monthly testing not required in this instance

• Annual flow test

  Select Completed / Passed Completed / Failed - see Recommendation Not completed - see Recommendation Not completed however not required in this instance

  • Completed / Passed
  • Completed / Failed - see Recommendation
  • Not completed - see Recommendation
  • Not completed however not required in this instance

Private Hydrants

• Private Hydrants

  Select Not installed. Impractical to consider installation. Installed internally and/or externally

  • Not installed. Impractical to consider installation.
  • Installed internally and/or externally

• Pumpsets - Diesel

  None installed or required

  1 installed

  2 installed

• Pumpsets - Electric

  None installed or required

  1 installed

  2 installed

• Pump Testing

  Select Not applicable Monthly testing as required by AS1851 Inadequate testing of pumps - see Recommendation

  • Not applicable
  • Monthly testing as required by AS1851
  • Inadequate testing of pumps - see Recommendation

• Water Supply

• Mains

  Select Adequate town main supply - no onsite tanks Onsite tanks in-filled from the town main supply No main supply - onsite tanks only

  • Adequate town main supply - no onsite tanks
  • Onsite tanks in-filled from the town main supply
  • No main supply - onsite tanks only

• Town main size (mm)

• Tank/s

  Steel tank/s installed

  Concrete tank/s installed

  Plastic tank/s installed

  No onsite water storage

• Eff Capacity (kL)

• Valve inspections

  Select 6 monthly inspections as per AS1851 Inadequate valve inspections - see Recommendation

  • 6 monthly inspections as per AS1851
  • Inadequate valve inspections - see Recommendation

• Locking caps

  Select Locking caps installed to prevent malicious valve opening Not installed - see Recommendation Not installed but acceptable in this instance

  • Locking caps installed to prevent malicious valve opening
  • Not installed - see Recommendation
  • Not installed but acceptable in this instance

• Annual flow test

  Select Completed / Passed Completed / Failed - see Recommendation Not completed - see Recommendation Not completed however not required in this instance

  • Completed / Passed
  • Completed / Failed - see Recommendation
  • Not completed - see Recommendation
  • Not completed however not required in this instance

Automatic Fire Detection System

• Detection Systems

  Installed

  Not installed

• What type of automatic fire detection system is installed?

  Select Hard wired smoke or thermal detectors Battery smoke detectors Thermal switch Other

  • Hard wired smoke or thermal detectors
  • Battery smoke detectors
  • Thermal switch
  • Other

• undefined

• Coverage

  Select Not applicable Installed to all areas of the building Not installed to all areas however considered acceptable and effective in this instance Not installed to all areas - see Recommendation

  • Not applicable
  • Installed to all areas of the building
  • Not installed to all areas however considered acceptable and effective in this instance
  • Not installed to all areas - see Recommendation

• Monitoring

  Select Detectors are monitored via a security monitoring centre Detectors linked to an FDCIE panel which is monitored via an ASE unit Detectors linked to an FDCIE panel with no ASE (not monitored) Not monitored - detectors sound locally only (acceptable & compliant) Not applicable

  • Detectors are monitored via a security monitoring centre
  • Detectors linked to an FDCIE panel which is monitored via an ASE unit
  • Detectors linked to an FDCIE panel with no ASE (not monitored)
  • Not monitored - detectors sound locally only (acceptable & compliant)
  • Not applicable

• Online

  Yes

  No

  NA

• Inspected to AS1851

  Yes

  No

  NA

• Isolation Procedure

  Yes

  No

  NA

Fire Hose Reels, extinguishers and fire blankets

• Hose Reels

  Select Installed Not installed. Impractical to consider installation. Not installed - see Recommendation Other

  • Installed
  • Not installed. Impractical to consider installation.
  • Not installed - see Recommendation
  • Other

• Adequate Coverage

  Yes

  No

• Tested to AS1851

  Yes

  No

• Extinguishers

  Select Installed Not installed. Impractical to consider installation. Other

  • Installed
  • Not installed. Impractical to consider installation.
  • Other

• Adequate Coverage

  Yes

  No

• Inspected to AS1851

  Yes

  No

• Fire Blankets

  Select Installed Not installed. Impractical to consider installation. Other

  • Installed
  • Not installed. Impractical to consider installation.
  • Other

• Adequate Coverage

  Yes

  No

• Inspected to AS1851

  Yes

  No

Safety Controls

• Special Haz System

  Select Not installed - not required based on the occupancy classification Other

  • Not installed - not required based on the occupancy classification
  • Other

• Occ Warning System

  Select Not installed (acceptable and compliant) Installed to all areas

  • Not installed (acceptable and compliant)
  • Installed to all areas

• Evacuation Procedure

  Select Not formalised however considered acceptable considering the size/layout of the building and position of egress points Formalised evacuation program is in place and tested Not formalised - see Recommendation

  • Not formalised however considered acceptable considering the size/layout of the building and position of egress points
  • Formalised evacuation program is in place and tested
  • Not formalised - see Recommendation

• Water Supply

  Select Adequate town main supply and pressures No town main supply - onsite tanks only

  • Adequate town main supply and pressures
  • No town main supply - onsite tanks only

• Additional Comments

Fire response

• Is the local fire brigade a full time or volunteer?

  Select Full time brigade Volunteer services Trained onsite fire brigade Other (add to notes)

  • Full time brigade
  • Volunteer services
  • Trained onsite fire brigade
  • Other (add to notes)

• What's the local fire brigade response time?

  less than 10 mins

  10-15 mins

  greater than 15 mins

• Is fire brigade access available to all aspects of the building?

  Yes

  No

• General comments about fire protection

Security controls

• Are site and building physical access controls adequate?

  Yes

  No

• Is the building provided with an intruder detection system?

  Select Motion detection Door contacts Site perimeter

  • Motion detection
  • Door contacts
  • Site perimeter

• What monitoring is provided?

  Local alarm

  Back to base monitoring

  None

• What response on alarm is provided?

  Select Keyholder response (indicate expected response time) Security guard automatic Security guard on keyholder request Onsite personnel Notify Police

  • Keyholder response (indicate expected response time)
  • Security guard automatic
  • Security guard on keyholder request
  • Onsite personnel
  • Notify Police

• Where is CCTV installed?

  Select Internal to the building External to the building None CCTV is the responsibility of the tenant

  • Internal to the building
  • External to the building
  • None
  • CCTV is the responsibility of the tenant

• Is CCTV coverage adequate?

  Select Yes No

  • Yes
  • No

• Is CCTV monitored offsite?

  Yes

  No

• Is there remote access to the CCTV

  Yes

  No

• Where are CCTV recording retained?

  Onsite

  Offsite

  Not retained

Security patrols

• Are security patrols undertaken?

  Select Onsite security Out of hours periods only None

  • Onsite security
  • Out of hours periods only
  • None

• Where are security patrols undertaken?

  Select Perimeter Onsite external to building Internal to building None

  • Perimeter
  • Onsite external to building
  • Internal to building
  • None

• What types of security patrols undertaken?

  Random

  Scheduled

  On request

  None

Cash management

• Is cash retained or collected onsite?

  Yes

  No

• Is cash handling undertaken in a secure area?

  Yes

  No

  NA

• Do you vary cash handling protocols?

  Yes

  No

  NA

• Do you vary banking of cash protocols?

  Yes

  No

  NA

• Is there a cash handling procedure including checks to deter employee theft and dishonesty?

  Yes

  No

  NA

Onsite external exposures

• Are idle pallets adequately separated from the building? <br>(>10 meters)

  Yes

  No

• Are waste bins adequately separated from buildings?<br>(>10 meters)

  Yes

  No

• Is there any other combustible storage within 10 meters of the building?

  Yes

  No

  Not applicable

Offsite external exposure (neighbouring facilities)

• Is the building set back from the boundary (10 metres)?

  Less than 10 metres

  10 - 30 metres

  > 30 metres

• What is the neighbouring premises exposure?

  Low

  Moderate

  High

• Is there any combustible storage along adjoining boundary?

  Yes

  No

Natural and other hazards (note any previous incidents/claims)

• Flood

  Low

  Moderate

  High

  NA

• Windstorm

  Low

  Moderate

  High

  NA

• Storm surge

  Low

  Moderate

  High

  NA

• Bushfire

  Low

  Moderate

  High

  NA

• Earthquake

  Low

  Moderate

  High

  NA

• Lightning

  Low

  Moderate

  High

  NA

• Hailstorm

  Low

  Moderate

  High

  NA

• Collapse / subsidence

  Low

  Moderate

  High

  NA

• Impact damage

  Low

  Moderate

  High

  NA

Business interruption and continuity

• Is there business interruption coverage?

  Yes

  Not sure

  No

• What BI coverage applies to this policy?

  Loss of rental income

  Loss of gross income

• Yes

  No

  NA

• Are there any interdependancies / Internal single point dependencies?<br>(Such as a specific component that is only produced in one area of the business)

  Yes

  No

• Are there any suppliers that provide greater than 25% of supplies to the business?

  Yes

  No

• Is there any critical equipment that accounts for 25% of reduction?

  Yes

  No

• Are there any customers that account for greater than 25% of output to the business?

  Yes

  No

• Is there a high dependency on any of the following utilities?

  Select Electricity Gas Water Communications

  • Electricity
  • Gas
  • Water
  • Communications

• Is there in built power redundancy?

  Yes

  No

  NA

• Describe redundancy

• Is there a formalised Business Continuity Plan in Place

  Yes

  No

  NA

Follow up & final comments

• Overall summary

• Recommend onsite assessment?

  Yes

  No

  NA