Aquadrill Safety Inspection Audit Checklist

• AQUADRILL INTERNATIONAL

• Client

• Conducted on

  Date
• Client location
  Address

• Prepared by

• Task Being Performed:

• Personnel Audited

1) Job site Information

• Site to orientation required (Safety council cards available )

  Yes

  No

  N/A

• Job safety plan available and reviewed

  Yes

  No

  N/A

• Safety meeting held and documented

  Yes

  No

  N/A

• Daily JSA reports form completed/used

  Yes

  No

  N/A

• SDS ( available or required)

  Yes

  No

  N/A

• Work permits ( general, hot work or confined space)

  Yes

  No

  N/A

  Follow Up

• Emergency procedures know and phone numbers

  Yes

  No

  N/A

HOUSEKEEPING/ SANITATION

• Area barricaded to 20/50 feet

  Yes

  No

  N/A

• Construction Area ( housekeeping maintained)<br>

  Yes

  No

  N/A

• Material storage

  Safe

  At Risk

  N/A

• Adequate sanitation facilities and drinking water

  Safe

  At Risk

  N/A

  Follow Up

• Awkward Hand Postures Identified <br>

  Safe

  At Risk

  N/A

Fire Protection

• Fire Extinguisher inspected and accessible (less than 100')

  Yes

  No

  N/A

• Fire Hazards (Flammable material's)

  Safe

  At Risk

  N/A

• Flammable liquid storage

  Safe

  At Risk

  N/A

  Follow Up

HAND TOOLS

• General condition?

  Safe

  At Risk

  N/A

• Proper tools for the job

  Safe

  At Risk

  N/A

  Follow Up

POWER TOOLS

• General condition? ( properly grounded and guards in place)

  Safe

  At Risk

  N/A

  Follow Up

LADDERS

• General condition and has safety feet or shoes

  Yes

  No

  N/A

  Follow Up

• Proper use and tie off

  Safe

  At Risk

  N/A

  Follow Up

SCAFFOLDING

• Properly erected and taged

  Safe

  At Risk

  N/A

• Plank condition and Properly secured.

  Safe

  At Risk

  N/A

• Proper guardrail and access ladder

  Safe

  At Risk

  N/A

• Crew knows proper tie off points

  Yes

  No

  N/A

  Follow Up

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats

  Safe

  At Risk

  N/A

• Eye protection (glasses dark or clear w/ side shields)

  Yes

  No

  N/A

• Hearing protection

  Safe

  At Risk

  N/A

• Foot protection ( leather / rubber steel toe boots)

  Safe

  At Risk

  N/A

• Respirators (half face mask or supplied air)

  Safe

  At Risk

  N/A

• Protective clothing (FRC's, or Tyvex)

  Safe

  At Risk

  N/A

• Rain gear (slicker suit required)

  Safe

  At Risk

  N/A

• Gloves ( leather or rubber required)

  Safe

  At Risk

  N/A

• Additional PPE.

• Does all PPE meet the standard of the permit

  Safe

  At Risk

  N/A

  Follow Up

VEHICLES

• General condition and appearance

  Safe

  At Risk

  N/A

  Follow Up

• Fluids, tires and ect checked and maintained

  Safe

  At Risk

  N/A

  Follow Up

• Insurance cards, Inspection, and Tags

  Safe

  At Risk

  N/A

  Follow Up

RESPIRATORS

• Approved by MSA and OSHA

  Yes

  No

  N/A

  Follow Up

• Proper respirator / cartridge for the task or hazard

  Safe

  At Risk

  N/A

  Follow Up

• Respirator user fit tested

  Yes

  No

  N/A

• Respirator inspected and maintained

  Yes

  No

  N/A

• Respirator cleaned and Properly stored daily

  Yes

  No

  N/A

EQUIPMENT

• Water available ( frac/poly tank level verified)

  Yes

  No

  N/A

  Follow Up

• High pressure pump operational

  Safe

  At Risk

  N/A

  Follow Up

• High pressure hoses in good condition <br>

  Safe

  At Risk

  N/A

  Follow Up

• Air hose in good condition

  Safe

  At Risk

  N/A

  Follow Up

• Fire hoses in good condition

  Safe

  At Risk

  N/A

  Follow Up

• Quarterly hose inspection

  Yes

  No

  N/A

• Twister in good condition

  Safe

  At Risk

  N/A

  Follow Up

• Feeder in good condition

  Safe

  At Risk

  N/A

  Follow Up

• Lance machine in good condition

  Safe

  At Risk

  N/A

  Follow Up

• Lances in good condition and appropriate number available

  Yes

  No

  N/A

  Follow Up

• Safety pins and hoses in place

  Safe

  At Risk

  N/A

• Whip checks used, 20mm secured

  Safe

  At Risk

  N/A

  Follow Up

• Doors open on the rig

  Yes

  No

  N/A

• Ladders/rails in place and secured

  Safe

  At Risk

  N/A

• Emergency stop manned

  Yes

  No

  N/A

• Lockout/ Tapout (LOTO) or confined space required

  Safe

  At Risk

  N/A

• Anti-withdrawl devices secured and verified (smash gate, stinger,protection plate)

  Safe

  At Risk

  N/A

  Follow Up

• Right levels checked ( Fuel,Oil, Filter, air in tires)

  Safe

  At Risk

  N/A

  Follow Up

FIRST AID

• First aid kits (on rig)

  Yes

  No

  N/A

FLOORS, STAIRS, AND WALKWAYS

• Proper guardrail and floor openings covered

  Safe

  At Risk

  N/A

• Adequate lighting

  Safe

  At Risk

  N/A

• Stairs and walkways clear

  Safe

  At Risk

  N/A

MANLIFTS OR JLG

• Operators trained

  Safe

  At Risk

  N/A

• All guardrails, gates/chains closed before elevated

  Safe

  At Risk

  N/A

• Body harness & lanyard for each person in lift

  Safe

  At Risk

  N/A

• Operated on level footing or area

  Safe

  At Risk

  N/A

ASSURED EQUIPMENT GROUNDING

• GFCI's in use or bounding cable used

  Safe

  At Risk

  N/A

• Extention cords in good condition

  Safe

  At Risk

  N/A

  Follow Up

MATERIAL HANDLING

• Employees using proper lifting procedures

  Safe

  At Risk

  N/A

• Materials properly stacked

  Safe

  At Risk

  N/A

• Inspected by

  Sign

• Reviewed by

  Sign