Sample PSM Audit Report Form

Exhibit 2.13

DOE-HDBK-1101-96

PSM Compliance Status

Information Source

Notes/Comments

Major Issues/Questions

None

Partial

Complete

Sample PSM Audit Report Form

Explanation of Levels of Process Safety Management (PSM) Compliance Status (as shown on the following form)

None:

Little or no information is available to determine compliance to the proposed OSHA PSM rule; a lack of information or inability to easily

provide information would constitute little proof of compliance.

Partial:

Significant information is available, but not enough to determine compliance with the proposed OSHA PSM rule; incomplete documentation

(process descriptions, P&IDs, written procedures, etc.) would constitute partial compliance. Lack of formal methods (verbal only) of handling

changes to process information would also constitute partial compliance.

Complete:

The available information is sufficient to verify compliance to the proposed OSHA PSM rule. Personnel responsibilities are clearly established

and the documentation is complete and easily accessible.