Chaparral Energy Monthly Service Rig Inspection

• Audit Title

• Field Office

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Rig Operator

• Service Rig #

General

• Adequate distance from overhead power lines?

  Yes

  No

  N/A

• Is the service rig hazard sign displayed?

  Yes

  No

  N/A

• Is a first aid kit available on the rig location?

  Yes

  No

  N/A

• Are the service rig guy wires flagged?

  Yes

  No

  N/A

• Is the fall lane of the derrick clear?

  Yes

  No

  N/A

• Are vehicles out of the fall lane?

  Yes

  No

  N/A

• Is the overall housekeeping on the service rig satisfactory?

  Yes

  No

  N/A

• Are pipe racks and catwalks satisfactory?

  Yes

  No

  N/A

• Are fire hazards controlled?

  Yes

  No

  N/A

• Is the latitude and longitude board displayed on the service rig? Is it updated with current well location coordinates?

  Yes

  No

  N/A

Guying

• Are there wind guys?

  Yes

  No

  N/A

• Are the condition of the guy lines acceptable?

  Yes

  No

  N/A

• Is the diameter of the guy line correct per manufacturers recommendations?

  Yes

  No

  N/A

• Is there a minimum of three wire rope clamps on each guy wire?

  Yes

  No

  N/A

• Are the ground anchors in good condition and pull tested to 18,600 lbs. Is there a tag attached to the ground anchors?

  Yes

  No

  N/A

• Are the tubing board guys strung and crossed for racking?

  Yes

  No

  N/A

• Is there a minimum of three wire rope clamps on tubing guy wires?

  Yes

  No

  N/A

• Are the internal guys adjusted for tension?

  Yes

  No

  N/A

Foundation

• Is adequate supplemental flooring available?

  Yes

  No

  N/A

Hand Tools

• Are hand tools in good condition?

  Yes

  No

  N/A

• Are hand tools clean condition?

  Yes

  No

  N/A

• Are hand tools properly stored away?

  Yes

  No

  N/A

Mast & Derrick

• Is the manufacturers specifications plate on the Derrick?

  Yes

  No

  N/A

• Is the mast/ derrick free of excess corrosion and damage?

  Yes

  No

  N/A

• Is the ladder in good condition?

  Yes

  No

  N/A

• Is the racking platform walk around in satisfactory condition?

  Yes

  No

  N/A

• Is the rod basket in good working order?

  Yes

  No

  N/A

• Is the crows nest in good working order?

  Yes

  No

  N/A

• Is the manual latch dog extension and retraction mechanism satisfactory?

  Yes

  No

  N/A

• Are the latch dogs satisfactory.

  Yes

  No

  N/A

• Is the scoping ram stabilizer in good working order?

  Yes

  No

  N/A

• Are the crown sheave guards in good working order?

  Yes

  No

  N/A

• Is the finger board safety cable operational?

  Yes

  No

  N/A

• <br>Are the hinge points free of signs of metal failure such as cracks?

  Yes

  No

  N/A

• Are the derrick locking pins in place?

  Yes

  No

  N/A

• Are hinge point dowel pins provided with a safety retainer?

  Yes

  No

  N/A

• Is the derrick hydraulic system free of leaks?

  Yes

  No

  N/A

• Is there a lighting system on the service rig?

  Yes

  No

  N/A

• Is there any purging of air from the hydraulic raising cylinder?

  Yes

  No

  N/A

Vehicles

• Is the vehicle glass and mirrors intact and free of cracks?

  Yes

  No

  N/A

• Are the road gear, lights and reflectors intact and in working order?

  Yes

  No

  N/A

• Is the cab free of clutter?

  Yes

  No

  N/A

• Is the doghouse free of housekeeping issues?

  Yes

  No

  N/A

• Is the stove condition acceptable?

  Yes

  No

  N/A

• Are the lights in the doghouse free of hazards?

  Yes

  No

  N/A

• Are the hitch and safety chains free of defects?

  Yes

  No

  N/A

• Are flammable liquid storage cans satisfactory?

  Yes

  No

  N/A

Carrier

• Are handrails in place on elevated walkways and steps?

  Yes

  No

  N/A

• Are the headlights, taillights and signal lights working properly?

  Yes

  No

  N/A

• Are the wheels chocked?

  Yes

  No

  N/A

• Are the tires and wheels in good working order? Are they free from cuts, gouges. Is the wheel showing any defects?

  Yes

  No

  N/A

• Are the fuel tanks labeled?

  Yes

  No

  N/A

• Is the carrier free of leaking any fuel?

  Yes

  No

  N/A

• <br>Is the cab free of any fuel or flammable materials stored in the cab?

  Yes

  No

  N/A

• Are the glass and mirrors intact and free of cracks?

  Yes

  No

  N/A

• Do the windshield wipers operate correctly?

  Yes

  No

  N/A

• Are the hydraulic leveling jacks secured by mechanical lock nuts?

  Yes

  No

  N/A

Drawworks Condition

• Are there any guarding hazards on the drawworks?

  Yes

  No

  N/A

• Is the tubing line and sandline free of defects? Is there any kinking or crushing on the wire rope?

  Yes

  No

  N/A

• Is there sufficient wraps left on the drum with the blocks in the down position,

  Yes

  No

  N/A

• Is the dead line anchor retainer free of defects?

  Yes

  No

  N/A

• Is the road gear lockout satisfactory?

  Yes

  No

  N/A

• Is the handling winch satisfactory,

  Yes

  No

  N/A

Operator Station/Work Platform/Floor

• Are all operator controls labeled?

  Yes

  No

  N/A

• Is the work floor free of hazards(i.e slip, trip and fall)?

  Yes

  No

  N/A

• Are the steps and handrails in place?

  Yes

  No

  N/A

Tools and Equipment

• Is the the safety gate on the tongs satisfactory?

  Yes

  No

  N/A

• Is the backup satisfactory?

  Yes

  No

  N/A

• Is the stiff arm and snub line satisfactory?

  Yes

  No

  N/A

• Are the head guards in good condition?

  Yes

  No

  N/A

• Are the hoses and fittings securely connected and free of defects?

  Yes

  No

  N/A

• Is the tong in good working order?

  Yes

  No

  N/A

• Are the traveling blocks in good condition and free of defects?

  Yes

  No

  N/A

• Are the sheave guards in good working order?

  Yes

  No

  N/A

• Are the bales/links free of defects?

  Yes

  No

  N/A

• Are the elevators operational and in good working order?

  Yes

  No

  N/A

• Is the rod hook operational and free of defects?

  Yes

  No

  N/A

• Are the transfer elevators free of defects?

  Yes

  No

  N/A

• Is the standpipe secure on the mud circulating system?

  Yes

  No

  N/A

• Is the rotary hose secured to the gooseneck and swivel with safety hobbles?

  Yes

  No

  N/A

• Is there high pressure fittings in the high pressure system?

  Yes

  No

  N/A

• Is there safety pressure relief valves?

  Yes

  No

  N/A

• Is the discharge line from the relief valves anchored?

  Yes

  No

  N/A

• Is there any machine guarding hazards with the pumps?

  Yes

  No

  N/A

• Are the mud pit/tank walkways free of tripping hazards?

  Yes

  No

  N/A

• Is the mud mixing area satisfactory?

  Yes

  No

  N/A

• Are the BOP's installed, tested and functional?

  Yes

  No

  N/A

Safety Equipment

• Is there a safety harness and restraint lanyard provided at the tubing board, rod basket and stabbing board?

  Yes

  No

  N/A

• Is the derrick ladder climbing device operational and free of hazards?

  Yes

  No

  N/A

• Is there an emergency derrick escape equipment on the service rig or nearby? Is it operational and easily accessible?

  Yes

  No

  N/A

• Is there 2 - 20 lb Class A, B, C Extinguishers on the service rig? Are they charged and free of defects?

  Yes

  No

  N/A

• Is PPE being worn by the service rig crew?

  Yes

  No

  N/A

• Is the self retracting lifeline in good working order and free of defects?

  Yes

  No

  N/A

• What is the serial # on the self retracting lifeline? <br>

  Safe

  At Risk

  N/A

• SRL Information

• What is the model #, lot # on the fall protection harnesses that were inspected?

  Safe

  At Risk

  N/A

• Fall Protection Harness Information

• Notes

Safety Specialist

• Safety Specialist

  Sign

Date/Time