Atlantic Resources Company

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Railroad Commission Compliance

• Has an H9 been filed with the Railroad Commission on this site?

• Is there an Operator lease sign at the tank battery that includes the Company name, Lease name, RRC & and acreage?

  Yes

  No

  N/A

• Do all storage tanks have the Railroad Commission number on them?

  Yes

  No

  N/A

• Is there a windsock?

  Yes

  No

  N/A

• If yes is the windsock in good condition?

  Yes

  No

  N/A

• Is there an H2S caution or danger sign if required:

  Yes

  No

  N/A

• If H2S is present is there a sign at the stairway stating that "Respiratory Equipment Required Beyond this Point"?

  Yes

  No

  N/A

• If fencing is required is it in good shape?

  Yes

  No

  N/A

• Does the company provide personal H2S monitors for each employee?

  Yes

  No

  N/A

• If not is there a monitoring system in place for H2S?

  Yes

  No

  N/A

• What is the condition of the storage tanks?

  Safe

  At Risk

  N/A

• Are the thief hatches closed?

  Yes

  No

  N/A

• Do the tanks have an external gauge?

  Yes

  No

  N/A

• If not is there supplied air on location for gauging the tanks?

  Yes

  No

  N/A

• Do all employees and contractors entering the site have H2S training?

• Comments

• Is the location entrance warning signage in place that displays Company name, lease name and acreage along with PPE Required, No Smoking, Authorized Personnel only, and Caution H2S Gas Present?

  Yes

  No

  N/A

• Are the tanks properly labeled?

  Select NFPA Signs Flammable Tank contents Confined Space Signs Emergency Phone #

  • NFPA Signs
  • Flammable
  • Tank contents
  • Confined Space Signs
  • Emergency Phone #

• Is the berm in good shape?

  Yes

  No

  N/A

• Is there liquid inside the berm area?

  Yes

  No

  N/A

• Is there leak control (load line catch pans) on each load line?

  Yes

  No

  N/A

• Is the leak control in good shape with no residue or trash in them?

  Yes

  No

  N/A

• Are all units properly grounded?

  Yes

  No

  N/A

• Comment

• is the Vapor Recovery Unit free from leaks, oil drum labeled, all lines and valves plugged and current inspection on PRV?

  Yes

  No

  N/A

• Is there a load line ground for haulers?

  Yes

  No

  N/A

• Are electrical boxes properly labeled with signs?

  Yes

  No

  N/A

• Are the stairs in good shape?

  Yes

  No

  N/A

• Is there trash or litter on location?

  Yes

  No

  N/A

• If there are fire extinguishers on site are they inspected and charged?

  Yes

  No

  N/A

• Do all lines or valves have plugs where needed?

  Yes

  No

  N/A

• Comments

• Is the flarestack the proper distance from the storage tanks (75') and any combustable materials?

  Yes

  No

  N/A

• Is there proper signage on the Heater Treater?

  Yes

  No

  N/A

• Are the flare guide wires anchored properly, and marked or flagged?

  Yes

  No

  N/A

• is there a separator/scrubber or knock-out pot present and does it have the GHS?NFPA labeling?

  Yes

  No

  N/A

• Is there a flare arrestor or check valve in the line?

  Yes

  No

  N/A

• Is the flare ignition set to auto and is it working?

  Yes

  No

  N/A

• Comments

• Are the separator and heater treaters labeled with proper NFPA/GHS labels?

  Select Caution Hot Surface Danger Confined Space

  • Caution Hot Surface
  • Danger Confined Space

• Do the chemical storage containers around this area have the GHS labeling and stored in secondary containment?

  Yes

  No

  N/A

• Are the berms in good condition?

  Yes

  No

  N/A

• Are all of the Pressure Relief Valves current on inspection dates?

  Yes

  No

  N/A

• Do all lines and valves have plugs where needed?

  Yes

  No

  N/A

• Are any of the lines or valves in this area leaking?

  Yes

  No

  N/A

• Comments

• Comments

• Other pictures

  Media

• Signature

  Sign