AASD001 ENVIRONMENTAL CHECKLIST INSPECTION Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Company / Work Group:*Date* Date Format: MM slash DD slash YYYY Time* : HH MM AM PM Inspected By (Include All Personnel Who Took Part In The Inspection) Name First Last PositionINSPECTION ITEMS 1. Have all actions raised in the previous inspections been closed out? *N/A if not applicable*YESNON/AComments2. Have all actions from any recent environmental incidents been adequately investigated and appropriately addressed? *N/A if not applicable*YESNON/AComments3. Is the work area free from visible incidents and/or Risks?*YESNON/AComments4. Have all possible drainage points where chemical spills can occur been blocked to prevent spills?*YESNON/AComments5. Has all efforts been made to protect other people of any falling risks pending the start of works?*YESNON/AComments6. 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?*YESNON/AComments8. Are activities in the area creating minimal dust?*YESNON/AComments9. Is dust suppression of dirt roads and other cleared areas being undertaken where excessive dust is visible?*YESNON/AComments10. 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?*YESNON/ACommentsHazardous 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?*YESNON/AComments12. If stored in a portable bunding, is it in good condition? (i.e. liner in good condition, free from waste)*YESNON/AComments13. Are spill containment bunds and drip trays free of water and is a process in place to remove and dispose of contaminated water?*YESNON/AComments14. Are stationary equipment (e.g. generators) which holds >20L of fuel secondarily contained?*YESNON/AComments15. Is equipment containing hazardous materials (including hydrocarbons (combustible), and hoses/pipes) free of spills/leaks?*YESNON/AComments16. Are service trucks and fuel trailers in a good working order with fully stocked spill kits on board?*YESNON/AComments17. Are adequate spills kits available and fully stocked?*YESNON/AComments18. Are there an adequate number of hydrocarbon waste bins?*YESNON/AComments19. 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?*YESNON/AComments20. Is the work area free from waste, including cigarette butts and windblown litter?*YESNON/AComments21. Has a designated smoking area been provided with appropriate fireproof receptacles?*YESNON/AComments22. Are bins labelled correctly, in good working condition and have lids?*YESNON/AComments23. Do bins have adequate capacity to contain rubbish disposed within them?*YESNON/AComments24. Has waste been adequately segregated and stored in the correct bins (general, steel, hydrocarbons, oily etc.)?*YESNON/AComments25. Have sumps been cleaned out adequately as part of routine maintenance?*YESNON/AComments26. Are contaminated wastes removed offsite by an approved contractor for disposal at an approved location?*YESNON/ACommentsSurface Water Management 27. Is potentially contaminated storm water prevented from being discharged into the environment?*YESNON/ACommentsWeed Management 28. Is the area (and any topsoil stockpiles) free of weeds (i.e. non-native species)?*YESNON/AComments29. Are vehicle hygiene certificates available for machinery that has accessed uncleared areas?*YESNON/ACommentsFauna 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?*YESNON/AComments31. Have all pipe ends and bore openings been capped or covered?*YESNON/AComments32. 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?*YESNON/AComments33. 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?*YESNON/ACommentsClearing and Ground Disturbance Management 34. Is the clearing or ground disturbance being undertaken?*YESNON/AComments35. Are vegetation clearing and earthworks being avoided during high wind (>50 km/hr) conditions where possible?*YESNON/ACommentsTopsoil Management 36. Are topsoil areas appropriately signed to prevent access?*YESNON/AComments37. Is there a stormwater diversion structure around the base of the topsoil stockpiles?*YESNON/AComments38. Is there evidence of disturbance to topsoil stockpiles (i.e. tyre tracks)?*YESNON/ACommentsOther 39. Inspection ItemYesNoN/AComments40. Inspection ItemYesNoN/ACommentsISSUES/NON-CONFORMATIES RAISED DURING INSPECTION ISSUE ONE Insert Inspection # Item action relates to:Actions RequiredDue Date Date Format: MM slash DD slash YYYY Responsible PersonEntered in Action Tracking System (yes/no)YesNoISSUE TWO Insert Inspection # Item action relates to:Actions RequiredDue Date Date Format: MM slash DD slash YYYY Responsible PersonEntered in Action Tracking System (yes/no)YesNoISSUE TWO Insert Inspection # Item action relates to:Actions RequiredDue Date Date Format: MM slash DD slash YYYY Responsible PersonEntered in Action Tracking System (yes/no)YesNoISSUE THREE Insert Inspection # Item action relates to:Actions RequiredDue Date Date Format: MM slash DD slash YYYY Responsible PersonEntered in Action Tracking System (yes/no)YesNoOther Comments/ Notes:CAPTCHA