Inspection Information
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Conducted On:
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Location:
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Well #:
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AFE #:
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Cantera Site Representative:
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Cantera Safety Representative:
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Contractors Working on Location:
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Equipment on Location:
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Status of Operations:
Inspection Check List
Signage:
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Is Production/ Well Sites Properly Identified?
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Safety Billboard in Place?
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PPE & FRC's signage in Place at Entrance?
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Lease Signs in Place?
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No Smoking Signage at the Entrance of Location?
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Confined Space Labels in Correct Location on Tanks?
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Tanks Labeled with Placards in Place?
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Chemical Pump Room Labeled?
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LACT Unit Building Labeled?
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Separator Building Labeled?
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Well water Pump Labeled?
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Heater Treater Labeled?
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Generator Fuel Tank Labeled?
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Electrical Room/ Panel Labeled?
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Electrical Breakers Properly Indicated?
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Electrical Board Panels with Warning Labels in Place?
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Pumping Unit Safety Warning Labels in Place?
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All Containers Labeled with their Contents?
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Hearing Protection Signage in Place?
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Automatic Start Signage in Place?
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Stay Off Berm Signage in Place?
Applicable Permits
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JSA / SJA Completed with Contractor Sign-in Sheet?
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Ground Disturbance Permit Completed?
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Hot Work Permit Completed?
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Confined Space Permit Completed and Posted?
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Critical Lift Permit Completed?
General Site Inspection:
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Interior / Exterior Berm in Place?
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Knife Gate Valve Closed and Secured with Lock & Chain?
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Dead Man Marked / Visible and within its Life Expectancy?
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Pumping Unit Safety Guards in Place, Ladders with Fall Protection Cage?
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Ignitor Wire Functioning?
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All Caps and Plugs in Place?
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Teflon Tape on all Plumbing Threads?
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Heater Treater Ladder with Fall Protection Cage in Place?
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Tanks, Walkways, Stairs Properly Grounded?
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Grounds Available for Transport while Loading and Unloading?
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Stairs and Catwalk Secured on Tanks with Two Threads Showing on Bolts?
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Adequate Hand-Rails Provided on Stairs and Catwalk?
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Windsock Up and Visible and in Good Shape?
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Are Chemicals Stored Properly with MSDS Available?
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Electrical Covers in Place?
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Location Clean with Pathways Clear (No Obstructions)?
Contractor Inspection
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All Crew Members Wearing Proper PPE & FRC's?
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H2S Monitors Being Utilized?
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Fall Protection Being Utilized?
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Utilizing Safety Glasses/Grinding Shields while Grinding?
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First Aid Kit Available on Location?
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Fire Extinguishers Available with Monthly / Annual Inspection Completed?
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Crew Utilizing Proper Tools for Job Functions?
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Crew Using Proper Lifting Techniques?
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Tools with Safety Guards in Place?
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Good Housekeeping with Work Area Clean and Organized?
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Crew Utilizing Proper Lockout / Tag Out?
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Roll Over Protection in Place with No Obvious Defects?
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Fire Watch Being Utilized?
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Spotter Be Utilized while Heavy Equipment is in Operations?
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Backup Alarms on Equipment Working Properly?
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Does Contractor Equipment on Location Appear to Have Any Fluid Leaking?
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Does Contractor Equipment on Location Have Seat Belts (Being Utilized by Operator)?
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Are Spill Kits on site and Marked
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Are Chock Blocks Being Utilized?
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Are Compressed Cylinder Tanks Secured Upright with Valve Caps in Place?
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Proper Rigging Techniques are Being Utilized while Lifting Loads?
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Inspected Tag Lines are Being Utilized when Lifting Loads?
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Rigging Equipment Appears to be in Good Working Condition?
Contractors Excavating and Trenching
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Caution Tape / Barriers Fencing Off Around Open Pits and Trenches?
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All Bell Holes are Properly Sloped and/or Benched?
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Ladders, Steps, or Ramps Located in Bell Hole so No More than 25ft of Lateral Travel is Required?
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Excavated Soil, Other Material, Or Equipment are Stored at Least 2ft from the Edge of the Excavation?
General Facility Inspection (Office, Pipe Yard, SWD, Oil Facilities)
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Are AED's Properly Marked and Inspected?
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First Aid Kits are Up to Date and Available?
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Eye Wash Station Up to Date and Available?
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Hearing Protection Available?
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Flammable Storage Cabinet Being Utilized?
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MSDS Binders at Location with Updated MSDS Sheets?
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Are Combustibles Being Kept in Electrical Room?
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Is all Electrical Wiring Incased in Conduit with Covers in Place?
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Are Rubber Mats in Place on Flooring of Electrical Building?
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Oil Facility Pressure Relief Valve was in the Locked Open Position?
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Are All Transformers Enclosed with Safety Barrier (Bollards)?
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Underground Injection Control (UIC) Permit Available?
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Spill Prevention Control and Countermeasure Plan (SPCC) Available?
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Are Catch Pans Located on All Transfer Valves?
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Facilities Response Plan (FRP) Available?
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Fire Extinguishers Available with Monthly/ Annual Inspection Completed?
Additional Findings
Additional Findings or Concerns:
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Issue #1:
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Issue #2:
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Issue #3:
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Issue #4:
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Issue #5:
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Issue #6:
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Issue #7:
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Issue #8:
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Issue #9:
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Issue #10:
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Approval
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Contractor Safety Representative:
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Consultant / Company Man:
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Contractor Supervisor / Foreman:
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Person In Charge (PIC):
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