Information
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Document No.
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Conducted on
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Client
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Location
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Rig
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Well Name
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Shift Roster
- Day 14/7
- Day 18/9
- Day 10/4
- Day 5/2
- Day 15/13
- Night 14/7
- Night 18/9
- Night 10/4
- Night 5/2
- Night 15/13
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Injury Free Days
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Personnel
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Supervisor
Safety
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Toolbox completed
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Add media
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Reason why
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Person making decision
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PRA Completed?
PRA
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Name
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Date
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Job Location
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Job Description
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STOP, THINK AND IDENTIFY THE TASK , MANAGE THE RISK
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Do I fully understand the task?
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Controls
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Am I fit to carry out the task?
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Controls
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Do I have the correct tools for the task?
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Controls
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Is there a procedure for the task?
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Controls
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Am i trained and competent to carry out this task?
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Controls
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Do I have the correct PPE for the task?
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Controls
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Is my work area safe?
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Controls
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Can I get caught in or between anything?
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Controls
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Can my work effect anybody else's safety eg interaction?
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Controls
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Have I identified and isolated all dangerous energy sources?
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Controls
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Is there exposure to excessive heat/dust/noise/vibration?
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Controls
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Can anything fall on me?
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Controls
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Is a permit required?
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Controls
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Can my actions harm the environment?
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Controls
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Have you identified and controlled all potential hazards
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STOP WORK AND INFORM YOUR SUPERVISOR
Code Hours
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Pickup move setup
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Drill Actual
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Coring
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Reaming
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Cementing
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Circ/Flush Hole
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Pre Start/ Lube Rig
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Logging / Surveying
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Run / Pull Casing
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Standby
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Wet Weather Standby
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Breakdown
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Water Carting
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Tripping Rods
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Travel (crew)
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Nipple up/down
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Scheduled Maintenance
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Sign in /Sign out
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Safety and Training
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Miscellaneous
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Workshop
Meter age
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Hole
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Hole Number
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Time start
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Time finish
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From
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To
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Total
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Bit Type
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Formation
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Size (inch)
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Size (mm)
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Air /Mud
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Comments
Recovery
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Hole
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Hole Number
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Time start
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Time finish
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From
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To
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Total
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Recovery
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%
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Comments
Consumables
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Hole
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Hole Number
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Type
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Amount
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Add media
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Comments
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Sign off
Person
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Name and position