Advanced Energy Group

• Document No.

• Rig No:

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel on site at time of Inspection

***NOTE*** this inspection report is to be considered uncontrolled unless printed out and original signatures of all participants are next to iPad signatures

Before entering site

• Is an Emergency Evacuation Point (Muster Point) sign visible?

  Yes

  No

  N/A

• Warning signs posted and legible?

  Yes

  No

  N/A

• Are access tracks clear of obstructions?

  Yes

  No

  N/A

• Are vehicles reversed parked / parked to allow access?

  Yes

  No

  N/A

• Rig set up level and stable?

  Yes

  No

  N/A

• Refuelling vehicle parked in a safe position?

  Yes

  No

  N/A

• Is the drill pad set out to allow emergency access and exit?

  Yes

  No

  N/A

• Designated smoking area set up at least 10m away from drill hole?

  Yes

  No

  N/A

• Is there communication on site (mine radio / mobile phone / sat phone / etc)?

  Yes

  No

  N/A

Site Housekeeping

• Worksite is free from obstructions? (Slips, trips, fall hazards & rubbish)

  Yes

  No

  N/A

• Is worksite rubbish being disposed of correctly (correct waste bins etc)?

  Yes

  No

  N/A

• Is waste management book being used to record waste disposal?

  Yes

  No

  N/A

• Tools & Equipment is being stored correctly?

  Yes

  No

  N/A

• Walkways & Platforms clean & free of oil, grease & tools?

  Yes

  No

  N/A

• Spill kit is on-site and readily accessible?

  Yes

  No

  N/A

• Spill kit is adequately stocked?

  Yes

  No

  N/A

Rig Emissions (dust, water & cutting control)

• Dust is being adequately suppressed where practical?

  Yes

  No

  N/A

• Water & Cuttings are routed to sumps and are contained within the channels?

  Yes

  No

  N/A

• Sumps are containing all water & cuttings ( no leaks/overflow)

  Yes

  No

  N/A

Guarding

• Adequate guarding in place for all rotating engine/drivetrain components, exhausts etc?

  Yes

  No

  N/A

• Adequate rod guarding (spin cage / rod fall protection / etc) in place and being used properly?

  Yes

  No

  N/A

• Foot clamp guards in place?

  Yes

  No

  N/A

• Interlocks are fitted and working?

  Yes

  No

  N/A

• Sumps have bunding, barricading or some other form of guarding in place?

  Yes

  No

  N/A

Fluid Leaks

• Are there any obvious fluid leaks from engine, drivetrain or hydraulic system including rod handler?

  Yes

  No

  N/A

Fire Fighting Equipment

• Does the rig have a fire suppression system fitted?

  Yes

  No

  N/A

• Is the system charged and ready for use

  Yes

  No

• Details

• Portable fire extinguishers on all vehicles?

  Yes

  No

  N/A

• Fire extinguishers in current test & tag

  Yes

  No

  N/A

• Are all portable fire extinguishers firmly secured?

  Yes

  No

  N/A

• All persons on site have an understanding of how to use all the fire fighting equipment?

  Yes

  No

  N/A

First Aid Equipment

• Are first aid kits easily accessible?

  Yes

  No

  N/A

• Kits are stocked / clean and inspected?

  Yes

  No

  N/A

• Are there trained first aiders on site?

  Yes

  No

  N/A

"E" Stops and Alarms

• "E" Stop(s) have been checked and are all in working condition?

  Yes

  No

  N/A

• Remote "E" stop(s) have been checked and in working condition?

  Yes

  No

  N/A

• Mast raise and lower alarms working?

  Yes

  No

  N/A

• Gas monitor used and in working condition?

  Yes

  No

  N/A

• Bump test and calibration in date?

  Yes

  No

  N/A

Lighting arrangements

• Is there lighting provided for night shift?

  Yes

  No

  N/A

• Does the lighting tower have a current test & tag sticker/certificate?

  Yes

  No

  N/A

• Is all the electrical cabling positioned/fastened in such a way that is safe from getting damaged?

  Yes

  No

  N/A

Equipment Tag out & Isolation

• Do all the isolation/lock-out points have an identification sticker?

  Yes

  No

  N/A

• Are correct procedures being followed when equipment needs to be isolated and/or tagged out?

  Yes

  No

  N/A

• Do the isolation switches work?

  Yes

  No

  N/A

Equipment Inspections

• Daily pre-starts for each vehicle is being conducted as required?

  Yes

  No

  N/A

• Daily pre-starts for the rig is being conducted?

  Yes

  No

  N/A

• Manufacturers recommended inspections are being completed within the correct timeframe? (as per the operators manual)

  Yes

  No

  N/A

Servicing of Equipment

• Rig is being serviced as required?

  Yes

  No

  N/A

High Pressure Hoses, Pressure vessels & Relief Valves

• Do all hoses appear to be structurally sound through a visual inspection?

  Yes

  No

  N/A

• Do all hose fittings appear to be structurally sound through a visual inspection?

  Yes

  No

  N/A

• Do all hose fittings appear to be fitted correctly?

  Yes

  No

  N/A

• Are any of the fittings or hoses showing signs of leakage?

  Yes

  No

  N/A

• Are high pressure lines barricaded / delineated?

  Yes

  No

  N/A

• Are whipchecks placed on all pressure hoses and a secured correctly (2 x shackles to 2 x separate anchor points)?

  Yes

  No

  N/A

• Are pressure vessels registered? (If applicable)

  Yes

  No

  N/A

• Are pressure vessels tested and tests are current?

  Yes

  No

  N/A

• Pressure relief valves are tested and operational?

  Yes

  No

  N/A

Winches, Ropes & Rod/Plug threads

• Is lifting register available and in date?

  Yes

  No

  N/A

• Main winch rope is free from bird nesting, kinks, frays, twists etc?

  Yes

  No

  N/A

• Wireline rope is free from bird nesting, kinks, frays, twists etc?

  Yes

  No

  N/A

• Haul plug is in good operating condition?

  Yes

  No

  N/A

• Plugs and rods have serviceable threads?

  Yes

  No

  N/A

• Sheaves & Blocks are in good condition?

  Yes

  No

  N/A

• Shackles are rated and in good condition?

  Yes

  No

  N/A

• Clam shell rope approx 2/3 the length of rods / casing and in good condition?

  Yes

  No

  N/A

• Safety strop for overshot in place and serviceable?

  Yes

  No

  N/A

Visual Inspection

• Walkway railings are secure and in a serviceable condition?

  Yes

  No

  N/A

• Walkway steps/rungs have non-slip treads?

  Yes

  No

  N/A

• Walkways have securing pins and are being used?

  Yes

  No

  N/A

• Rod handler is in good operating condition?

  Yes

  No

  N/A

• Foot clamps are operating correctly?

  Yes

  No

  N/A

• Foot clamp jaws are secured correctly?

  Yes

  No

  N/A

• Breakout tool is in good serviceable condition?

  Yes

  No

  N/A

• Slips table is in good operating condition?

  Yes

  No

  N/A

• Stilsons are in good working condition?

  Yes

  No

  N/A

• Visual inspection of the mast; are there any?<br>* cracks, warps, bends or other visual defects?

  Yes

  No

  N/A

• Mast locks are in place and in good condition?

  Yes

  No

  N/A

• Hydraulic jack legs are in good condition?

  Yes

  No

  N/A

• Hydraulic jack legs have fluid leaks?

  Yes

  No

  N/A

• Work platforms are secured and free from obstructions?

  Yes

  No

  N/A

• Mandatory, Caution, Prohibition, Danger, Fire, First Aid, Traffic, HAZCHEM signage is present, visible and legible at all required locations?

  Yes

  No

  N/A

• Dunnage (jack blocks) in good condition?

  Yes

  No

  N/A

• Is VLC equipment compliant and in good condition?

  Yes

  No

  N/A

• Is there a crew member on site who is trained, competent and authorised to use VLC?

  Yes

  No

  N/A

• All pumps are diesel not petrol motors?

  Yes

  No

  N/A

Gauges and Controls

• All gauges are working?

  Yes

  No

  N/A

• All gauges are easily readable?

  Yes

  No

  N/A

• All controls are in good working order?

  Yes

  No

  N/A

• All controls are easily identifiable?

  Yes

  No

  N/A

Power/Hand tools

• Equipment seems to be in good working order when visually inspected?

  Yes

  No

  N/A

• Power cords/plugs are in good condition?

  Yes

  No

  N/A

• Electrical tools have a current test & tag sticker/certificate?

  Yes

  No

  N/A

• Tools are stored correctly when not in use?

  Yes

  No

  N/A

Documentation

• Have all workers been inducted & the correct paperwork has been completed for the site?

  Yes

  No

  N/A

• Are all contractors, visitors or client representatives inducted for the site?

  Yes

  No

  N/A

• Are toolbox meetings held as required?

  Yes

  No

  N/A

• Are there records of hazard observations?

  Yes

  No

  N/A

• Are there records of per-shift huddles?

  Yes

  No

  N/A

• Are the company policies, procedures (SCP), SWP's on-site?

  Yes

  No

  N/A

• Are SWP's being referenced / reviewed?

  Yes

  No

  N/A

• Are MSDS documents available for all products on-site?

  Yes

  No

  N/A

• Are MSDS documents current?

  Yes

  No

  N/A

• Are all persons on-site aware of where to find all the documentation?

  Yes

  No

  N/A

• Workers are competent in filling out the required paperwork?

  Yes

  No

  N/A

• Do all vehicles have Equipment Compliance stickers?

  Yes

  No

  N/A

• Is there an up to date Emergency Response Sheet including contact numbers available at the drill pad?

  Yes

  No

  N/A

• Are JSA pads available at the drill pad?

  Yes

  No

  N/A

• Are SLAM's / Take 5's / Etc being completed?

  Yes

  No

  N/A

Personal Hygiene

• Fresh, clean and cool drinking water is available?

  Yes

  No

  N/A

• Food is being stored in a hygienic manner?

  Yes

  No

  N/A

• Hand cleaning products are available?

  Yes

  No

  N/A

• Waste food products are being disposed of in the correct manner?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Site has adequate supplies of company issued PPE?

  Yes

  No

  N/A

• Is further PPE required to ensure safety on this site?

  Yes

  No

  N/A

• Workers are using the supplied PPE?

  Yes

  No

  N/A

• When not in use, is PPE being stored correctly?

  Yes

  No

  N/A

• Disposable PPE is being discarded correctly? (gloves, earplugs, etc in bins)

  Yes

  No

  N/A

• Is UV protection being used? (hats, sunscreen, long sleeve shirt/pants)

  Yes

  No

  N/A

• Crew workwear (long sleeve shirts & pants) in good condition

  Yes

  No

  N/A

• Sleeves rolled down, buttoned up and no loose clothing?

  Yes

  No

  N/A

Personnel Attitudes and Training

• All personnel on-site are displaying a positive attitude towards Health, Safety & Environmental protocols?

  Yes

  No

  N/A

• Do you feel that the crew have identified all the hazards on site?

  Yes

  No

  N/A

Site Supervisors comments

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Client Representative comments:

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Safety Advisor comments:

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Company Management comments:

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Issues Raised

• Issues raised that need actioning:

Issue:

• Issue status:

  Safe

  At Risk

  N/A

• Assigned to:

• Completion date:

  Date

• Issue has been closed out appropriately:

• Time and date action closed out

  Date

• ID of person closing out action

  Sign