Title Page

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

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?

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

  • Is there a windsock?

  • If yes is the windsock in good condition?

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

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

  • If fencing is required is it in good shape?

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

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

  • What is the condition of the storage tanks?

  • Are the thief hatches closed?

  • Do the tanks have an external gauge?

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

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

  • Comments

OSHA Compliance

  • 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?

  • Are the tanks properly labeled?

  • Is the berm in good shape?

  • Is there liquid inside the berm area?

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

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

  • Are all units properly grounded?

  • Comment

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

  • Is there a load line ground for haulers?

  • Are electrical boxes properly labeled with signs?

  • Are the stairs in good shape?

  • Is there trash or litter on location?

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

  • Do all lines or valves have plugs where needed?

  • Comments

Flare Stack

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

  • Is there proper signage on the Heater Treater?

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

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

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

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

  • Comments

Heater Treater

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

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

  • Are the berms in good condition?

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

  • Do all lines and valves have plugs where needed?

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

  • Comments


  • Comments

  • Other pictures

  • Signature

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