AASD001 ENVIRONMENTAL CHECKLIST INSPECTION Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Company / Work Group:* Date* MM slash DD slash YYYY Time* : Hours Minutes AM PM AM/PM Inspected By (Include All Personnel Who Took Part In The Inspection) Name First Last Position INSPECTION ITEMS 1. Have all actions raised in the previous inspections been closed out? *N/A if not applicable* YES NO N/A Comments2. Have all actions from any recent environmental incidents been adequately investigated and appropriately addressed? *N/A if not applicable* YES NO N/A Comments3. Is the work area free from visible incidents and/or Risks?* YES NO N/A Comments4. Have all possible drainage points where chemical spills can occur been blocked to prevent spills?* YES NO N/A Comments5. Has all efforts been made to protect other people of any falling risks pending the start of works?* YES NO N/A Comments6. Auditee task: What environmental hazards were identified by the supervisor during the inspection? How would they address these hazards?Dust Management 7. Is the work area free from excessive visible dust?* YES NO N/A Comments8. Are activities in the area creating minimal dust?* YES NO N/A Comments9. Is dust suppression of dirt roads and other cleared areas being undertaken where excessive dust is visible?* YES NO N/A Comments10. Are dribble bars being used where water containing >5,000 mg/L total dissolved solids is approved for dust suppression, or other means to prevent overspray or drainage onto adjacent vegetation or waterways of any chemicals or hazards?* YES NO N/A CommentsHazardous Materials and Hydrocarbons Management 11. Are all hazardous materials including hydrocarbons (any combustible material/chemical) stored within appropriate containment areas away from risk and direct work areas?* YES NO N/A Comments12. If stored in a portable bunding, is it in good condition? (i.e. liner in good condition, free from waste)* YES NO N/A Comments13. Are spill containment bunds and drip trays free of water and is a process in place to remove and dispose of contaminated water?* YES NO N/A Comments14. Are stationary equipment (e.g. generators) which holds >20L of fuel secondarily contained?* YES NO N/A Comments15. Is equipment containing hazardous materials (including hydrocarbons (combustible), and hoses/pipes) free of spills/leaks?* YES NO N/A Comments16. Are service trucks and fuel trailers in a good working order with fully stocked spill kits on board?* YES NO N/A Comments17. Are adequate spills kits available and fully stocked?* YES NO N/A Comments18. Are there an adequate number of hydrocarbon waste bins?* YES NO N/A Comments19. Has all contaminated soil been stored in a bunded area or placed in bins prior to removal from site, or transported to a bioremediation area where available?* YES NO N/A Comments20. Is the work area free from waste, including cigarette butts and windblown litter?* YES NO N/A Comments21. Has a designated smoking area been provided with appropriate fireproof receptacles?* YES NO N/A Comments22. Are bins labelled correctly, in good working condition and have lids?* YES NO N/A Comments23. Do bins have adequate capacity to contain rubbish disposed within them?* YES NO N/A Comments24. Has waste been adequately segregated and stored in the correct bins (general, steel, hydrocarbons, oily etc.)?* YES NO N/A Comments25. Have sumps been cleaned out adequately as part of routine maintenance?* YES NO N/A Comments26. Are contaminated wastes removed offsite by an approved contractor for disposal at an approved location?* YES NO N/A CommentsSurface Water Management 27. Is potentially contaminated storm water prevented from being discharged into the environment?* YES NO N/A CommentsWeed Management 28. Is the area (and any topsoil stockpiles) free of weeds (i.e. non-native species)?* YES NO N/A Comments29. Are vehicle hygiene certificates available for machinery that has accessed uncleared areas?* YES NO N/A CommentsFauna Management 30. Have all excavations, trenches or large receptacles that cannot be covered, been provided with adequate fauna egress to enable fauna to climb out if trapped?* YES NO N/A Comments31. Have all pipe ends and bore openings been capped or covered?* YES NO N/A Comments32. Have lids or fixed covers been fitted to receptacles (containers, bins, tanks and receptacles) or have they been up-ended or stored so that they cannot be accessed by fauna?* YES NO N/A Comments33. Have drill muds on the drill pad surface or within the sump been covered with dry soil to prevent entrapment of wildlife as soon as drilling of that hole has been completed?* YES NO N/A CommentsClearing and Ground Disturbance Management 34. Is the clearing or ground disturbance being undertaken?* YES NO N/A Comments35. Are vegetation clearing and earthworks being avoided during high wind (>50 km/hr) conditions where possible?* YES NO N/A CommentsTopsoil Management 36. Are topsoil areas appropriately signed to prevent access?* YES NO N/A Comments37. Is there a stormwater diversion structure around the base of the topsoil stockpiles?* YES NO N/A Comments38. Is there evidence of disturbance to topsoil stockpiles (i.e. tyre tracks)?* YES NO N/A CommentsOther 39. Inspection Item Yes No N/A Comments40. Inspection Item Yes No N/A CommentsISSUES/NON-CONFORMATIES RAISED DURING INSPECTION ISSUE ONE Insert Inspection # Item action relates to: Actions RequiredDue Date MM slash DD slash YYYY Responsible Person Entered in Action Tracking System (yes/no) Yes No ISSUE TWO Insert Inspection # Item action relates to: Actions RequiredDue Date MM slash DD slash YYYY Responsible Person Entered in Action Tracking System (yes/no) Yes No ISSUE TWO Insert Inspection # Item action relates to: Actions RequiredDue Date MM slash DD slash YYYY Responsible Person Entered in Action Tracking System (yes/no) Yes No ISSUE THREE Insert Inspection # Item action relates to: Actions RequiredDue Date MM slash DD slash YYYY Responsible Person Entered in Action Tracking System (yes/no) Yes No Other Comments/ Notes:CAPTCHA
