EE&I LTO Facility / Producer Audit Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Berms and Drainage

• Acceptable berm wall integrity (free from cracks, openings, erosion)

  Yes

  No

  N/A

• Berm and drainage free of excessive vegetation and weeds

  Yes

  No

  N/A

• Drain valves locked and/or sealed

  Yes

  No

  N/A

• Berm capacity (free of fluids)

  Yes

  No

  N/A

Tanks and Vessels

• Tanks and vessels free of drips, leaks, weeps

  Yes

  No

  N/A

• Tanks and vessels free of corrosion

  Yes

  No

  N/A

• Tanks and vessels free of integrity issues such as cracks, bulges, distortions, or warping

  Yes

  No

  N/A

• Tanks and vessels free of foundation issues such as gaps between tank and damaged foundation

  Yes

  No

  N/A

• Evidence of adequate drainage (no standing water)

  Yes

  No

  N/A

• Condition of the insulation satisfactory (no tears, evidence of oil, CUI)

  Yes

  No

  N/A

• Grounding system (adequately grounded, no leads disconnected)

  Yes

  No

  N/A

• Condition of associated piping

  Yes

  No

  N/A

• Appurtences (i.e. man ways, thief hatch, gas blankets, dikes, trash, vegetation, CP, ladders, stairways, platforms

  Yes

  No

  N/A

• Foundation (no signs of settlement)

  Yes

  No

  N/A

• Plugs in place at all single block bleed points

  Yes

  No

  N/A

Pumps, Piping, Valves, & Fittings

• Pumps, piping, valves, and fittings free of drips, seeps, weeps, leaks, spills, corrosion, and evidence of impact

  Yes

  No

  N/A

• Supports, footings, foundations

  Yes

  No

  N/A

• Labeling of pumps, piping, valves, and fittings

  Yes

  No

  N/A

• Pipe coating at soil surfaces and through walls and dikes

  Yes

  No

  N/A

• Required locks or seals in place on all pumps, piping, valves, and fittings

  Yes

  No

  N/A

• Plugs in place at all single block bleed points

  Yes

  No

  N/A

• Pressure Relief Valves installed correctly and tag up to date

  Yes

  No

  N/A

Portable Equipment

• Portable equipment free of drips, leaks, weeps, and corrosion

  Yes

  No

  N/A

• Portable equipment free of integrity issues such as cracks bulges, distortions, or warping

  Yes

  No

  N/A

• Condition of the insulation satisfactory (no tears, evidence of oil, CUI)

  Yes

  No

  N/A

• Grounding System (adequately grounded, no leads disconnected)

  Yes

  No

  N/A

• Condition of portable equipment associated piping (satisfactory)

  Yes

  No

  N/A

• Appurtences (i.e. man ways, thief hatch, gas blanket, dikes, trash, vegetation, CP, ladders, stairways, and platforms

  Yes

  No

  N/A

• Plugs in place at all single block bleed points

  Yes

  No

  N/A

• Pressure relief valves installed correctly and tag up to date

  Yes

  No

  N/A

Electrical

• Electrical equipment free of excessive vegetation and weeds

  Yes

  No

  N/A

• Labeling of electrical enclosures

  Yes

  No

  N/A

• Electrical cords in acceptable condition (no exposed wires)

  Yes

  No

  N/A

• Grounding system (adequately grounded, no leads disconnected)

  Yes

  No

  N/A

Well Cellar

• Confined space sign near cellar if applicable (not required if <4")

  Yes

  No

  N/A

• Cellar free of all fluids

  Yes

  No

  N/A

• Cellar properly covered

  Yes

  No

  N/A

• Adequate berms around cellar

  Yes

  No

  N/A

Well Head

• Proper well sign that includes Operator Name (unless exempt), Lease Name (if applicable), and Well #

  Yes

  No

  N/A

• Proper well sign if on BLM that also includes section, township, range, quarter section, BLM number, and/or SAC code

  Yes

  No

  N/A

• Wellhead free of drips, leaks, weeps, and corrosion

  Yes

  No

  N/A

• Minimum of 15' clearance of all weeds or brush from wellhead

  Yes

  No

  N/A

• Casing vents are closed unless permitted by air district

  Yes

  No

  N/A

• Plugs in place at all single block bleed points

  Yes

  No

  N/A

Pumping Unit

• Pumping unit tie downs and structure free of loose bolts

  Yes

  No

  N/A

• Flag pin and throat bolt installed properly

  Yes

  No

  N/A

• Lube line connected and free from holes or leaks

  Yes

  No

  N/A

• Pumping unit contains well sign and other hazard identifiers (Danger H2S May Be Present)

  Yes

  No

  N/A

• Rod and/or tubing rotator in place and properly hooked up

  Yes

  No

  N/A

• Accurate well # on walking beam

  Yes

  No

  N/A

• Adequate clearance between stuffing box and carrier bar

  Yes

  No

  N/A

• Pumping unit fence guards in place and secured

  Yes

  No

  N/A

• Pumping unit pad free of cracks, erosion, excessive vibration or movement during operation

  Yes

  No

  N/A

• Pumping unit head aligned with unit

  Yes

  No

  N/A

• Gear box free of leaks

  Yes

  No

  N/A

• Pumping unit and gear box free of unusual noise

  Yes

  No

  N/A

Access Roads

• Locations / Roads free of standing fluids

  Yes

  No

  N/A

• Free of surface expressions / depressions, heat cracks, or mounds

  Yes

  No

  N/A

• Access to the facilities is unimpeded

  Yes

  No

  N/A

SPCCC

• Pit, EOB, or sump free of excessive fluids

  Yes

  No

  N/A

• Netting in acceptable condition

  Yes

  No

  N/A

• Fencing in acceptable condition

  Yes

  No

  N/A

• Location free of evidence of animal entrapment and animal droppings

  Yes

  No

  N/A

General

• General housekeeping on entire location

  Yes

  No

  N/A

• Site free of unnecessary hazardous waste

  Yes

  No

  N/A

• Appropriate Restricted Access / Danger signs on location

  Yes

  No

  N/A

• Chemical containers properly labeled (Aera Chemical PPE, NFPA 704 Diamond, Product Name, etc)

  Yes

  No

  N/A

• Green house gas log on location and filled out daily for completeness (all portable internal combustion equipment)

  Yes

  No

  N/A

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