Daily Field HSSE Report

Daily Field HSSE Report

TES-HS-1009

Daily Field HSSE Report

Document Number: TES-HS-1009

Revision Level: 3.0

Release Date: 11/19/13

• Customer Location

• Date (mm/dd/yyyy)

  Date

• Name

• Product Line

  Stim

  CT

  CH WL

INSPECTION ITEM

• Data Van/ CT cabin clean

  Safe

  At Risk

  N/A

• Location Access unobstructed

  Safe

  At Risk

  N/A

• Data cable runs protected

  Safe

  At Risk

  N/A

• Trip hazards clearly marked

  Safe

  At Risk

  N/A

• Appropriate signage installed

  Safe

  At Risk

  N/A

• Safety chains installed on handrails of movers and hydration

  Safe

  At Risk

  N/A

• Dual handrails firmly installed

  Safe

  At Risk

  N/A

• Whip-checks installed on pressurized lines

  Safe

  At Risk

  N/A

• Noise, vehicles and dust are compliant

  Safe

  At Risk

  N/A

• MSDS available and in shower trailer

  Safe

  At Risk

  N/A

• All containers labeled correctly

  Safe

  At Risk

  N/A

• Chemical area clearly established

  Safe

  At Risk

  N/A

• Safecard Counts

  Safe

  At Risk

  N/A

• All JSEA's signed

  Safe

  At Risk

  N/A

• Room for egress between equipment

  Safe

  At Risk

  N/A

• Exclusion Zone established

  Safe

  At Risk

  N/A

• Shower trailer function test (daily)

  Safe

  At Risk

  N/A

• Equipment physical appearance (rust, paint etc.)

  Safe

  At Risk

  N/A

• Sand operations area established

  Safe

  At Risk

  N/A

• Correct PPE observe

  Safe

  At Risk

  N/A

• All wheels chocked

  Safe

  At Risk

  N/A

• All containments in place / sides upright

  Safe

  At Risk

  N/A

• Respiratory protection / facial hair

  Safe

  At Risk

  N/A

• Lock Out / Tag Out Equipment available

  Safe

  At Risk

  N/A

• Fall Protection inspected (within annual date on tag)

  Safe

  At Risk

  N/A

• Controlled work instructions on site (jump drive)

  Safe

  At Risk

  N/A

• Chemical Transport manifest on site and signed by driver

  Safe

  At Risk

  N/A

• Delivery notes on site and signed by the driver and the receiver

  Safe

  At Risk

  N/A

• Incident recorded and reported

  Safe

  At Risk

  N/A

• NPT has been recorded and reported

  Safe

  At Risk

  N/A

• Calibration Devices (PRV's, torque)

  Safe

  At Risk

  N/A

• Caps are installed on unused fill ports on sand movers when blowing off sand

  Safe

  At Risk

  N/A

• Hose color coding correct

  Safe

  At Risk

  N/A

• PPE stock level

  Safe

  At Risk

  N/A

• Lifting equipment inspected and stored correctly

  Safe

  At Risk

  N/A

• Hot fueling vent hoses in place and directed to temporary containment

  Safe

  At Risk

  N/A

INCIDENTS:

• Did an incident occur?

  YES

  NO

• If yes, Has PIN been submitted? <br>Note: DO NOT SUBMIT PIN FOR UNSHADED AREAS BELOW

  YES

  NO

• Category* (check all that apply)

  Select FA MT LTA NM PROP / VEH HIPO SCE SPILL >1gal SPILL <1 gal [No PIN] NPT >60 min [No PIN] EQUIP [No PIN] HR [No PIN]

  • FA
  • MT
  • LTA
  • NM
  • PROP / VEH
  • HIPO
  • SCE
  • SPILL >1gal
  • SPILL <1 gal [No PIN]
  • NPT >60 min [No PIN]
  • EQUIP [No PIN]
  • HR [No PIN]

• Provide details of NPT > 30 minutes

STATISTICS

• Item

• Safe Cards:

• JSEA's:

• Spills

• Recordable Injuries:

• First Aid incidents:

• Equip. Related Spills

• Vehicle Incidents:

• Comments

Weather delay (what)

• Weather delay (what)

  Lightning

  Wind

  Tornado

  Snow/Ice

  Rain

• Start Time

  Date

• End Time

  Date

• Total

• Comment

• SAFECARD Action Issue [Review safecards, note any action for Base to communicate / take action. At least one action per week (or as arises) should be noted or best SOC

SAFECARD Action Issue

• SAFECARD Action Issue

• Comments:

• Other Issues / Suggestions / NCR's:

• *Codes: FA=First Aid MT=Medical Treatment LTA=Lost Time Accident NM=Near Miss Prop/Veh = Property or Vehicle Damage HIPO = Hi Potential SCE = Safety Critical Equipment NPT = Non-productive Time EQUIP = Equipment failure PIN = Preliminary Incident Notification HR = Compliance Issue / labour Relations (use HSSE Violation Form)