HSE Certification: PRE-AUDIT CHECKLIST

The successful completion of this form is a prerequisite to requesting an

audit for HSE certification. The final audit will only be undertaken by an
independent auditor once all the requirements indicated on the form for the
type of activities in which the site is involved are in place.

Section 1

Company Details
Company Name Site
Address City or Province
Telephone Number Type of bitumen activity
Name of Contact Person Email address

Employee details
Total number of staff at work place
Number of operational staff
Number of administrative staff

Tick Type of bituminous products manufactured, Tick

Type of activities transported or used

)
(

)
(

Refinery
Penetration bitumen Modified bitumen
Transport: Binders
Asphalt Cutback bitumen Crack sealants
Manufacture: Binders
Asphalt Bitumen emulsions Hot mix asphalt
Application: Binders
Asphalt Slurry Cold mix asphalt
Other: (specify) Other: (specify)

DECLARATION

I ____________________________________________ (Name) confirm that:

• I am authorised to provide this information and sign this form;

• The information provided in this form is true and correct.

Signature: _______________________ Date: ________________________

On successfully meeting all the requirements on this form, email or fax it to Sabita:
info@sabita.co.za or fax to (021) 5312606

HSE Certification – Pre-Audit Checklist – February 2009 1

 Section 2 – Statutory Legal Compliance All shaded areas are compulsory For self audit, tick shaded area to indicate compliance
The site is required to have the following documents available (where applicable) in files for inspection during an audit: Refinery Transporter Manufacturer Applicator
Binders Asphalt Binders Asphalt Binders Asphalt
Keeps all records pertaining to the Department of Labour (UIF, SDL etc) as well as proof of payment of these items:
• Proof of Company Registration with Register of Companies
• Proof of license to operate from Registration of Factories - Machinery & OHS Act Annex Reg 15
• Proof of validity of Operators card
Keeps all records pertaining to the Compensation of Occupational Injuries and Diseases Act (COIDA) i.e.
• Registration number,
• List of occupational injuries and diseases
• Proof of last payments to COIDA
• Letter of good standing
Keeps a copy of the Occupational Health and Safety Act - displayed in an appropriate manner – General Administrative Regulation 3.
Keeps letters of appointment of:
• First Aiders (one level 1 per 10 employees)
• Health and Safety representative(s)
• Health and Safety committee members – Sect 17
• The registered person – General Machinery Regulation 2(1) – permanent employee
• Competent person of vessels under pressure – Vessels under Pressure – External agent
Keeps the following records in terms of the Occupational Health and Safety Act, 1993 and Regulations where applicable:
• Certificate of competency of First Aider(s) – General Safety Regulation 3(4)
• Inspection report by the Health and Safety representative(s) – Section 18(1)(g)
• Recommendations from Health and Safety committee nominated members – Section 20 (2) (a).
• File of incidents – General Administrative Regulation 8.
• Goods hoist record book – Driven Machinery Regulation 17 (2)
• Lifting machines (including forklift trucks) and lifting tackle records Driven Machinery Reg 18(11)
• Certificates and logbooks for pressure vessels – Vessels Under Pressure Regulation 14
• Boiler certificate and record book – Vessels Under Pressure Regulation 5(4)
• Copies of valid certificates of training of forklift and Jib crane operators – Driven Machinery Reg 18(11)
• Certificate of compliance for electrical installation – Electrical Installation Regulation 3(1).
• Air monitoring reports – Hazardous Chemical Substances Regulation 6(3)
• Medical and biological surveillance schedule - Hazardous Chemical substances Regulation 5 (1)
• Keep records of baseline medical examinations
• Noise monitoring reports
• Procedures for writing risk assessment for operating plant
• Service records of Fire Extinguishers and Emergency shower(s)

HSE Certification – Pre-Audit Checklist – February 2009 2

Section 3 – Requirements for handling bituminous products All shaded areas are compulsory For self audit, tick shaded area to indicate compliance
The site is required to do or to have the following documents available where applicable on file for inspection during the audit Refinery Transporter Manufacturer Applicator
Binders Asphalt Binders Asphalt Binders Asphalt
HSE POLICY
Holds regular safety meetings as required by law
Keeps all recorded minutes of these meetings
Has a safety notice board displaying all
• Safety Minutes and
• Bitinrep Lessons Learnt
Has a written Company Health Safety and Environmental Policy which is prominently displayed
Displays the Sabita HSE Charter Poster
Displays the BitSafe Posters at the workplace
SAFETY TRAINING (BITSAFE)
Has a procedure for conducting Induction safety training for all new employees
Keeps signed safety Induction forms for each employee
Has a written training schedule for the presentation of BitSafe training modules
Provides BitSafe training to all employees working with bituminous products within a two-year period
Keeps signed registers of persons who have received BitSafe training
ISSUE PPE
Issues BitSafe First Aid Kits to all vehicles transporting and at locations handling bituminous products
Issues fire extinguishers to all vehicles transporting and at locations handling bituminous products
Risk assessment by fire department
Issues all employees working with bitumen the appropriate PPE
Keeps signed acceptances of all employees who have received PPE
REPORT INCIDENTS (BITINREP)
Reports and keeps records of all bitumen related incidents as per the Bitinrep scheme
Keeps all signed records of Corrective Action taken
SAFE OPERATING PRACTICES
Has Material Safety Data Sheets (MSDS) for:
• all raw materials used in the manufacturing of bituminous materials
• all bituminous products manufactured
• all bituminous products used in road construction and maintenance
Has a record of quantities of all hazchem used and stored
Uses, sells or markets no coal tar products

HSE Certification – Pre-Audit Checklist – February 2009 3

 The Company is required to do or to have the following documents available where applicable: Refinery Transporter Manufacturer Applicator
Binders Asphalt Binders Asphalt Binders Asphalt
REDUCE WASTE
Has procedures for the disposal of waste either by reuse or dumping of these products at permitted landfill sites
Keeps records and receipts of payment for disposal of bituminous waste at permitted landfill sites
TRANSPORTATION
Loads bitumen only in tankers which comply with the Sabita Code of Practice
• Conducts daily vehicle inspections
• Audits transporter*
• Issues vehicles transporting bituminous products with an “orange box” containing all the necessary documents as per Sabita Manual 25
• Issues Safe Loading Passes for all vehicles loading bitumen at refineries
• Issues Dangerous Goods Declarations for all vehicles loaded with bituminous binders
• Issues Flushing Certificates or declaration for all tankers/trailers when changing product as per Sabita Manual 25

Loads or receives asphalt only from tippers which are within their legal payload
Records the tare weight of asphalt loaded or received from each tipper
Displays written instructions for offloading of bitumen at binder/HMA plant
Has a competent person(s) trained to conduct bitumen offloading
Has sufficient lighting for offloading at night
Has an emergency shower within 20m of offloading point
Has a minimum of two dry powder fire extinguishers at offloading point
Has a method statement for draining and disposing bitumen from a flexible hose or loading arm
STORAGE
Has an oil separation sump to prevent spillage entering stormwater drainage system
Has adequate bund walls around the bituminous binder storage tanks
Installs security fencing around the storage site area to prevent unauthorised entry
Has lagging on all hot bitumen transfer lines
Has level indicator gauges on all bitumen binder storage tanks
Ensures that heating flues do not pass through tankage vapour space*
Each tank is marked with a number
APPLICATION
Uses drip trays for onsite testing of sprayers prior to spraying
Uses non petroleum based release agents on tippers
Uses toluene or trichloroethylene only in laboratories with fume cupboards
*Implementation pending

HSE Certification – Pre-Audit Checklist – February 2009 4