Sample compliance check template

AEISG Code of Practice - Ammonium Nitrate Emulsions, Suspensions or Gels – ANEs (UN3375)
Edition 2 April 2012

Company Name:
Location of Proposed/Existing Storage or Handling Facility:


Details of Proposed/Existing Storage of Ammonium Nitrate Emulsions, Suspension or Gels

Class/
Division / UN No / Name of Dangerous Good / Quantity(kL) / Description of Storage (Package) / ID Number(if applicable)
SECTION 1 SCOPE AND GENERAL / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
1. Scope / 4
SECTION 2 Definitions / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
2. Definitions / 6
SECTION 3 SAFETY AND SECURITY MANAGEMENT SYSTEM / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
3.1 SAFETY POLICY / 11
3.2 SAFETY AND SECURITY MANAGEMENT PLAN (SSMP) / 11
3.3 TRAINING / 12
3.4 PROCEDURES / 12
3.5 EMERGENCY RESPONSE PLAN (ERP) / 13
3.6 OTHER / 14
SECTION 4 LICENSING AND REGULATORY REQUIREMENTS / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
LICENSING AND REGULATORY REQUIREMENTS / 15
SECTION 5 ANE PREMISES DESIGN, LAYOUT AND MATERIALS OF CONSTRUCTION / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
5.1 GENERAL / 16
5.2 FIRE / 16
5.3 LAYOUT / 16
5.4 DESIGN OF ANE TANKS / 18
5.5 ELECTRICAL/ POWER / 18
5.6 LIGHTNING / 19
SECTION 6 REQUIREMENTS FOR THE LOCATION OF ANE PREMISES / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
6.1 STEPS IN DETERMINING ACCEPTABLE SITE LOCATIONS / 20
6.1.1 POTENTILN EXPLOSION SITES (PES) / 21
6.1.2 SISE OF EACH POTENTIAL EXPLOSION / 21
6.1.3 EXPOSED SITES / 22
6.1.4 REQUIRED MINIMUM DISTANCES / 22
SECTION 7 HAZARD STUDIES / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
7.1 SITE / 24
7.2 PLANT / 24
7.3 OPERATIONAL REQUIREMENTS / 25
SECTION 8 ANE PUMPS / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
8.1 PUMP HAZARDS / 26
8.2 PUMP SELECTION / 26
8.3 GENERAL REQUIREMENTS / 28
8.4 PUMP PROTECTIVE SYSTEMS / 29
8.4.1. GENERAL / 29
8.4.2. PUMP PROTECTIVE ELEMENTS / 29
8.5 PUMP SIGNIFICANT INCIDENTS / 30
SECTION 9 PERSONNEL / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
9.1 FRAMEWORK / 31
9.2 SPECIFIC ON-SITE TRAINING REQUIREMNETS / 31
9.3 DRIVERS (INCLUDING CONTRACTOR DRIVERS) / 32
SECTION 10 SECURITY REQUIREMENTS / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
SECURITY REQUIREMENTS / 33
SECTION 11 WASTE MANAGEMENT AND ENVIRONMENTAL CONTROLS / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
11.1 GENERAL / 34
11.2 STORAGE OF WASTE / 34
11.3 CALIBRATION / 34
11.4 RECYCLING / 35
11.5 ENVIRONMENTAL DISCHARGES / 35
11.6 DISPOSAL / 35
SECTION 12 TRANSPORT / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
12.1 GENERAL / 36
12.2 EMERGENCIES / 36
12.3 TRANSPORT ROUTES / 37
SECTION 13 APPLICATIONS FOR NEW ANE PREMISES / Page / COP Specification / Describe what is proposed/actual to demonstrate compliance / Complies
(Y/N/NA) /
APPLICATIONS FOR NEW ANE PREMISES / 38

Areas of Non-conformance and Action Plan

Non Conformance Number / Section
Number / Action Plan / Action
by / Due
Date / Completion
Date / Comments

Compliance check summary

This proposed / existing - storage of (describe storage) - complies/does not comply with the AEISG Code of Practice - Ammonium Nitrate Emulsions, Suspensions or Gels – ANEs (UN3375) Edition 2 April 2012


Name of assessor/s …………………………………………………… ……………………………………………………………… Date ……………………

Signature/s ……………………………………………………………… Date of next review …………………………………………………………………

Department of Mines and Petroleum Resources Safety Division Published 25 July 2013