ENVIRONMENTAL Document Number : EMS-EP18-F02
MANAGEMENT SYSTEM Edition Number : Initial Issue
ISO 14001:2015 Revision Number : 00
Form: Environmental Site Effective Date : 01.01.2023
Inspection Template Page Number : 1 of 5
1 PURPOSE
This document provides a template for an Environmental Site Inspection Form. It is to be noted that
Business Lines are expected to modify the Environmental Site Inspection Form based on their identified
environmental aspects and potential nonconformities.
2 INSTRUCTIONS
• Fill in the information in the blank cells and adapt the template accordingly.
3 TEMPLATE
Location: Dammam BSP
Project No: 4400016886
Inspection Date 17/Jan/20254
Inspection Time 01:00 pm
Inspected by Mazan Hassan
Remarks (i.e., specify
Implemented? location, good practices, N/A
problem observed, possible
Inspection Items N/A
cause of nonconformity
Yes No and/or proposed corrective/
preventative actions)
1. Documentation
To be completely available is
✓
1.1. Environmental Documents
required as per SEC EMS
update are available?
procedures.
2. Air Pollution Control
2.1. Do the stack emissions monitoring
data meets the Executive Regulation ✓
for Air Quality standards?
2.2. Does the ambient air quality within
the Executive Regulation for Air ✓
Quality standards?
2.3. Does the indoor environment meet
OSHA 3430 – 2011 standards for
Indoor Air Quality in Commercial and ✓
Institutional Buildings?
3. Water Pollution Control
✓
3.1. Is there wastewater discharge outside
power plant?
3.2. Are conditions of the discharge
compiled with
Executive Regulations for the
Protection of Aqueous Media from ✓
Pollution? (Check the continuous
monitoring records and observe
physically)
3.3. Is the wastewater treatment system
✓
being used (sewage wastewater) and
properly maintained on site? (e.g.,
evaporation pond/collection tank)
EMS-EP14-F02; Issue No: EMS-EP18-F02-01: This is page modify on document of change.
Remarks (i.e., specify
Implemented? location, good practices, N/A
problem observed, possible
Inspection Items N/A
cause of nonconformity
Yes No and/or proposed corrective/
preventative actions)
3.4. Is there any wastewater discharged to
the stormwater drains? Is the ✓
wastewater being treated?
3.5. Are measures provided to control
direct effluent to collection facilities? ✓
(e.g., tanks/ponds)
✓
3.6. Are surrounding are free of waste
discharge and sediment?
✓
3.7. Are oily water traps are applied for
storm water discharge?
✓
3.8. Is the domestic wastewater directed
to treatment?
3.9. Is the borehole for ground water
available? (Numbers and data ✓
analysis for water quality last quarter)
4. Noise Control
✓
4.1. ls the PP (poise measurements are
done at pp?
✓
4.2. Are the power plant areas complying
with Executive Regulation for Noise?
✓
4.3. Is control noise measures applied at
pp units?
4.4. Do air compressors and hand-held
breakers have noise emission labels ✓
(measured?
4.5. Any noise mitigation measures
adopted (e.g., use noise barrier/ ✓
enclosure)?
4.6. Are silenced equipment's utilized? ✓
5. Waste Management
✓
5.1. Is the site kept clean and tidy? (e.g., See below the observations
litter free, good housekeeping) and findings summary.
✓
5.2. Are separate locations used for See below the observations
hazards and non-hazards waste and findings summary.
5.3. Are separated labelled containers /
✓
See below the observations
areas provided for facilitating
and findings summary.
recycling and waste segregation?
5.4. Are non-hazard wastes / recyclable
✓
See below the observations
wastes and general refuse removed
and findings summary.
off site regularly?
5.5. Are wastes collected and disposed of
properly by licensed contractors?
ENVIRONMENTAL Document Number : EMS-EP18-F02
MANAGEMENT SYSTEM Edition Number : Initial Issue
ISO 14001:2015 Revision Number : 00
Form: Environmental Site Effective Date : 01.01.2023
Inspection Template Page Number : 3 of 5
Remarks (i.e., specify
Implemented? location, good practices, N/A
problem observed, possible
Inspection Items N/A
cause of nonconformity
Yes No and/or proposed corrective/
preventative actions)
5.6. Are chemical wastes, if any, collected
and disposed of properly by licensed
contractors?
5.7. Does chemical waste producer
license cover all major chemical
wastes produced on site?
5.8. Are chemical wastes properly stored
and labelled?
✓
5.9. Are oil drums and plants/equipment's
provided with drip trays?
5.10. Are drip trays free of oil and water? ✓
✓
5.11. Is there any oil spillage? Clean-up the
contaminated soil immediately?
5.12. Is litter, foam or other objectionable
matters in nearby water drain/sewer ✓
cleaned?
5.13. Are hazards wastes handled by
registered professionals?
5.14. Hazards and non-hazards waste
quantities for last month (kg/ton/ cubic
meter) professionals?
6. Storage of Chemicals and Dangerous Goods
6.1. Are chemicals stored and labelled
properly?
6.2. Does storage of Chemicals and
Dangerous Goods comply with
license conditions (include types and
quantities if DG store is available,
check the Chemicals and Dangerous
Goods store license)?
6.3. Are proper measures to control oil
✓
spillage during maintenance or to
control other chemicals spillage?
(e.g., provide drip trays)
6.4. Are spill kits / sand / saw dust used
✓
See below the observations
for absorbing chemical spillage
and findings summary.
readily accessible?
7. Protection of Flora, Fauna, and Historical Heritage
7.1. Are disturbance to terrestrial flora
minimized (e.g., Plants to be ✓
preserved)?
✓
7.2. Are disturbance to terrestrial fauna
minimized (if rare species identified)?
EMS-EP14-F02; Issue No: EMS-EP18-F02-01: This is page modify on document of change.
Remarks (i.e., specify
Implemented? location, good practices, N/A
problem observed, possible
Inspection Items N/A
cause of nonconformity
Yes No and/or proposed corrective/
preventative actions)
7.3. Any historical heritage exists on site?
If yes, ensure appropriate measures ✓
taken to preserve it?
8. Resource Conservation
✓
8.1. Is water recycled wherever possible
for planting?
✓
8.2. Is water pipe leakage and wastage
prevented?
8.3. Are clean fuel-powered plants and
equipment's replaced to reduce ✓
excessive emissions?
8.4. Are materials stored in good condition
to prevent deterioration and wastage ✓
(e.g., covered, separated)?
8.5. Are pesticides used under the
requirement Agriculture, Conservation ✓
Department?
9. Pollution Abatement Systems
9.1. FGD U#1 ✓
9.2. FGD U#2 ✓
9.3. FGD U#3 ✓
9.4. ESP U#1 ✓
9.5. ESP U#2 ✓
9.6. SCR U#1 ✓
9.7. SCR U#2 ✓
9.8. CEMS U#1 ✓
9.9. CEMS U#2 ✓
ENVIRONMENTAL Document Number : EMS-EP18-F02
MANAGEMENT SYSTEM Edition Number : Initial Issue
ISO 14001:2015 Revision Number : 00
Form: Environmental Site Effective Date : 01.01.2023
Inspection Template Page Number : 5 of 5
Observation and Finding Summary:
Risk
EMS Observation Corrective Action
Level
Low
1: Remove non spill kit items from the spill
kit and provide the daily inspection TAG for 1:
the spill kit
Low
2: Renew the Environmental board data
2:
damaged by Rain water
EMS-EP14-F02; Issue No: EMS-EP18-F02-01: This is page modify on document of change.
