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APPENDIX
Appendix

APPENDIX

Appendix 1.1: Environmental Inspection Checklist 

Sample Environmental Inspection checklist

Time and Date of Inspection;

 

Location of Inspection:

 

Issue:

Yes/No/NA

Comments

Corrective Action Required?

Yes/No/NA

Corrective Action

Are hazardous substances stored appropriately?

 

 

 

 

Are spill kits present on site and maintained?

 

 

 

 

Any evidence of spills or leaks?

Any Spills reported?

 

 

 

 

Any litter or Waste, spills or leaks evidence outside of appropriate receptacles?

 

 

 

 

Any evidence of weed infestations or pest problems?

 

 

 

 

Is there a programme in place to monitor Air Quality and Noise?

 

 

 

 

Is there any training offered to relevant personnel on safety issues?

 

 

 

 

Is there any inventory of all emissions?

 

 

 

 

Is there any waste water recycled?

 

 

 

 

Are the regular meetings on the improvement of working environment?

 

 

 

 

Have there been any formal complaints received on noise generated within the facility?

 

 

 

 

Name of recorder and/or witness?

 

 

 

 

Time and date recorded?

 

 

 

 

 

 Appendix 1.2: Incident Response Form 

Sample Incident Response Form

ITEM

REMARK

Type of incidence

 

Time and date of occurrence

 

Any injured person?

 

Exact location of incidence

 

Any dangerous goods in the vicinity?

 

Size of spill or leakage

 

Presence of any sensitive areas nearby? (e.g.) Streams, shoreline, marine ecosystems, protected area etc.)

 

Extent of damage

 

Weather or other site conditions (e.g. high wind and direction, rain, extreme heat)

 

Additional information about the incidence

 

On-site actions or remediation taken?

 

Name of recorder and/or witness/es

 

 

 APPENDIX 

 

 

 


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