Automotive LPG Audit
Site Name:
*
Name of Auditor:
*
First Name
Last Name
Staff on site at the time of audit:
Staff Name
Role or Position
1.
2.
3.
4.
Is the separation from ignition sources at least 6m? Check potential ignition, e.g. electrical equipment
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take Photo
Take Photo
Take Photo
Are the break free coupling wires in good condition? Check wires, fixings and coupling
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take Photo
Take Photo
Take Photo
Are the operating instructions clearly readable? Check customer instructions on dispenser
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take photo of operating instructions:
Take photo of operating instructions:
Take photo of operating instructions:
Are the safety warning signs clearly readable? Check signs at dispenser and storage cylinder
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take photo of warning signs:
Take photo of warning signs:
Take photo of warning signs:
Is the equipment leak free? Check for typical LPG odour at dispenser and storage vessel
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take Photo
Take Photo
Take Photo
Are the emergency shutdown switches tested every week? Check records that emergency switches at front of shop, console and storage cylinder have been operated each week
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take Photo
Take Photo
Take Photo
LPG emergency stop sign present at each activation point with how to activate?
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take Photo
Take Photo
Take Photo
Is LPG tank impact protection equivalent to crash barriers or bollards in place?
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take photo of bollards:
Take photo of bollards:
Take photo of bollards:
Is contact number for 24-hour specialist advice visible on tank?
*
Yes
No
N/A (please put reason in comments)
Comment/Action Required:
Take photo of aboveground LPG tank:
Take photo of aboveground LPG tank:
Take photo of aboveground LPG tank:
If there is anything else you would like to note relating to this audit, do so here:
Auditor Signature:
*
Submit
Should be Empty: