Drilling Company

• Document No.

• Rig No:

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel on site at time of Inspection

***NOTE*** this inspection report is to be considered uncontrolled unless printed out and original signatures of all participants are next to iPad signatures

Rig Box

• Is an Safety Management Plan Available?<br>

  Yes

  No

  N/A
Tap to enter information

• SMP Is Current (within 12 months)

  Yes

  No

  N/A

• Have all Crew Signed onto SMP?

  Yes

  No

  N/A

• Is SMP authorised with Current Signatures?

  Yes

  No

  N/A

• Emergency Response Plan Available?

  Yes

  No

  N/A
Tap to enter information

• ERP Authorised with Current Signatures?

  Yes

  No

  N/A

• ERP Current (within 12 Months)?

  Yes

  No

  N/A

• Crew signed onto ERP?

  Yes

  No

  N/A

• Safety Data Sheet Folder Available?

  Yes

  No

  N/A
Tap to enter information

• Inventory of Chemicals Correct?

  Yes

  No

  N/A

• All Products approved on Site?

  Yes

  No

  N/A

• All SDS's are within 5 years issue date?

  Yes

  No

  N/A

• Chemical Risk Assessments done? (kept electronically by EHS)

  Yes

  No

  N/A

• First Aid Kit Available?

  Yes

  No

  N/A

• First Aid Kit Sealed & Inspection Date within 6 Months

  Yes

  No

  N/A

• First Aid Kit maintained on Rig Register (Kept Electronically by EHS)

  Yes

  No

  N/A

Rig Register

• Fire Extiguisher Test and Tag in date.

  Yes

  No

  N/A

• Electrical Test and Tag in date

  Yes

  No

  N/A

• Visitors Induction Book at Rig?

  Yes

  No

  N/A

• Daily Pre-Starts complete?

  Yes

  No

  N/A

Safety Equipment

• Eye Wash available?

  Yes

  No

  N/A
Tap to enter information

• Adequate for chemicals on site?

  Yes

  No

  N/A

Signage

• Eye Wash Station?

  Yes

  No

  N/A

• E-Stops?

  Yes

  No

  N/A

• Fire Extinguishers?

  Yes

  No

  N/A

• Spill Kit?

  Yes

  No

  N/A

• Smoking Area?

  Yes

  No

  N/A

• PPE Requirements?

  Yes

  No

  N/A

• Rotating Parts?

  Yes

  No

  N/A

• Overhead electrical hazards (Sticker/plaque on rig panel)?

  Yes

  No

  N/A

• Site Entry Sign (Sandwich Board)?

  Yes

  No

  N/A

• MEX Stickers?

  Yes

  No

  N/A

• Isolation Points?

  Yes

  No

  N/A

• Laser?

  Yes

  No

  N/A

• Correct Company Labelling?

  Yes

  No

  N/A

• MSDS Location?

  Yes

  No

  N/A

• First Aid Location?

  Yes

  No

  N/A

• Crush Points (MDR)?

  Yes

  No

  N/A

PPE

• Metatarsal Boots?

  Yes

  No

  N/A

• Hi Viz Gloves

  Yes

  No

  N/A

• Hard Hat wthin 3 years of Manufacture?

  Yes

  No

  N/A

• Hard Hat harnesses within 2 years of issue?

  Yes

  No

  N/A

• Long Sleeve Hi Viz shirts correctly worn?

  Yes

  No

  N/A

• Long Trousers Hi Viz strip?

  Yes

  No

  N/A

• Cap Lamp?

  Yes

  No

  N/A

• Self Rescuer?

  Yes

  No

  N/A

• Safety Glasses clean and servicable?

  Yes

  No

  N/A

• Hearing protection used and correctly fitted?

  Yes

  No

  N/A

• Aderquate potable water available for crew size?

  Yes

  No

  N/A

• Electrolytes available?

  Yes

  No

  N/A

• Compliance to Jewellery Policy?

  Yes

  No

  N/A

• Dust Masks used when applicable?

  Yes

  No

  N/A

Housekeeping

• Is Site free from Trip Hazards?

  Yes

  No

  N/A

• Is Drill Pad / Decking / Cab clean from Grease?

  Yes

  No

  N/A

• Is Drill Pad / Decking / Cab free from Trip Hazards?

  Yes

  No

  N/A

• Is Drill RIG decking stable and level?

  Yes

  No

  N/A

• Are ther gaps or uneven levels on Drill Pad / decking / Cab?

  Yes

  No

  N/A

• Are the stairs leading from decking / cab built to Australian Standards?

  Yes

  No

  N/A

• No Loose rubbish around site?

  Yes

  No

  N/A

• Is Drainage adequate?

  Yes

  No

  N/A

• Are Hoses managed to eliminate trip hazards?

  Yes

  No

  N/A

Rig Setup / Compliance

• Is rig stable and pinned (face plate secured) ?

  Yes

  No

  N/A

• All E-Stops tested for Function?<br><br><br><br>

  Yes

  No

  N/A

• Are scaffold pipe supports utilised to support feed frame?

  Yes

  No

  N/A

• Is rod handler laser in place and operational?

  Yes

  No

  N/A

• Are handrails on decking to Australian Standards?

  Yes

  No

  N/A

• Are all High Pressure Hydraulic hoses shielded to prevent hydraulic injection injury?

  Yes

  No

  N/A

• Is the correct setup away from J Cables?

  Yes

  No

  N/A

• Is Adequate lighting in place?

  Yes

  No

  N/A

• Are control lables and gauges legible?

  Yes

  No

  N/A

• Do control levers return to centre when released?

  Yes

  No

  N/A

• Are rod lifting tools used to handle rods?

  Yes

  No

  N/A

• Is a Wiki Tool used to push core splits?

  Yes

  No

  N/A

• Is ezy lock mechanism on overshot serviceable?

  Yes

  No

  N/A

• Are latching / lifting dogs on overshot sharp?

  Yes

  No

  N/A

• Is condition of wireline servicable ( no kinking or fraying)?

  Yes

  No

  N/A

• Are Stilson Handles straight?

  Yes

  No

  N/A

• Are Vehicles parked in designated parkings as per site requirements?

  Yes

  No

  N/A

• Are threads on rods not worn?

  Yes

  No

  N/A

• Are exclusion zones adhered to when using rod handlers ( if fitted)?

  Yes

  No

  N/A

• Is water swivel servicable?

  Yes

  No

  N/A

• Is Gas Monitored used?

  Yes

  No

  N/A

• Are Fire Extinguishers placed around Rig?

  Yes

  No

  N/A

• Is Fire Suppression fitted to Power Pack / MDR?

  Yes

  No

  N/A
Tap to enter information

• Is fire suppresion tagged and tested within 6 months?

  Yes

  No

  N/A

• Is fire suppression gauges reading in the Green Zone?

  Yes

  No

  N/A

• Are Hand Tools in an operational condition?

  Yes

  No

  N/A

• Are Outriggers down while drilling (MDR Only)?

  Yes

  No

  N/A

• Is Stinger Leg installed on boom (MDR Only) ?

  Yes

  No

  N/A

• Are correct procedures being followed when equipment needs to be isolated and/or tagged out?

  Yes

  No

  N/A

Environmental

• Are Rubbish bins fitted with lids?

  Yes

  No

  N/A

• Is relevant site waste management / segregation being adhered to?

  Yes

  No

  N/A

• Are waste bins / hazardous waste bags / oil being eptied as required?

  Yes

  No

  N/A

• Is the site free of spills?

  Yes

  No

  N/A

• Are liquids stored in a manner to ensure containment?

  Yes

  No

  N/A

• Are all substances labelled in a legible manner?

  Yes

  No

  N/A

• Are Spills reported as per site requirements?

  Yes

  No

  N/A

• Is all liquid waste stored in closed containers?

  Yes

  No

  N/A

• Site is free of open containers?

  Yes

  No

  N/A

• All bunded areas are free of water?

  Yes

  No

  N/A

• Are Spill Kits available and stocked?

  Yes

  No

  N/A

General

• Al Mex Labels present on all equipment?

  Yes

  No

  N/A

• Do all roadworthy equipment have current registration?

  Yes

  No

  N/A

• Is the Power Pack Padlocked?

  Yes

  No

  N/A

• Do employees have a Stop Work Authority card on them?

  Yes

  No

  N/A

• Have all Daily Pre-Starts been completed?

  Yes

  No

  N/A

• Are all vehicles clean and tidy?

  Yes

  No

  N/A

• Is there a current Drill Plan on site?

  Yes

  No

  N/A

• Is Mine Radio Working?

  Yes

  No

  N/A

• Is trailing cable stored correctly?

  Yes

  No

  N/A

• Is Kelly Hose Bulk Head fitted correctly?

  Yes

  No

  N/A

• Are the company policies, procedures (SCP), SWP's on-site?

  Yes

  No

  N/A

• Are SLAM's / Take 5's / Etc being completed?

  Yes

  No

  N/A

Site Supervisors comments

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Client Representative comments:

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Safety Advisor comments:

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Company Management comments:

• Add comments:

  Select yes no

  • yes
  • no

• Comments:

• Name & Sign

  Sign

• Name & Sign

  Sign

Issues Raised

• Issues raised that need actioning:

Issue:

• Issue status:

  Safe

  At Risk

  N/A

• Assigned to:

• Completion date:

  Date

• Issue has been closed out appropriately:

• Time and date action closed out

  Date

• ID of person closing out action

  Sign