Daily Field HSSE Report


Daily Field HSSE Report

Document Number: TES-HS-1009

Revision Level: 3.0

Release Date: 11/19/13

  • Customer Location

  • Date (mm/dd/yyyy)

  • Name

  • Product Line


  • Data Van/ CT cabin clean

  • Location Access unobstructed

  • Data cable runs protected

  • Trip hazards clearly marked

  • Appropriate signage installed

  • Safety chains installed on handrails of movers and hydration

  • Dual handrails firmly installed

  • Whip-checks installed on pressurized lines

  • Noise, vehicles and dust are compliant

  • MSDS available and in shower trailer

  • All containers labeled correctly

  • Chemical area clearly established

  • Safecard Counts

  • All JSEA's signed

  • Room for egress between equipment

  • Exclusion Zone established

  • Shower trailer function test (daily)

  • Equipment physical appearance (rust, paint etc.)

  • Sand operations area established

  • Correct PPE observe

  • All wheels chocked

  • All containments in place / sides upright

  • Respiratory protection / facial hair

  • Lock Out / Tag Out Equipment available

  • Fall Protection inspected (within annual date on tag)

  • Controlled work instructions on site (jump drive)

  • Chemical Transport manifest on site and signed by driver

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

  • Incident recorded and reported

  • NPT has been recorded and reported

  • Calibration Devices (PRV's, torque)

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

  • Hose color coding correct

  • PPE stock level

  • Lifting equipment inspected and stored correctly

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


  • Did an incident occur?

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

  • Category* (check all that apply)

  • Provide details of NPT > 30 minutes


  • Item

  • Safe Cards:

  • JSEA's:

  • Spills

  • Recordable Injuries:

  • First Aid incidents:

  • Equip. Related Spills

  • Vehicle Incidents:

  • Comments

  • Weather delay (what)
  • Weather delay (what)

  • Start Time

  • End Time

  • 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)

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