Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Paper Work and Qualifications
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1 JSA Completed/Meaning Full Conversation
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2 Proper Permit Completed
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3 Meet & Greet Procedures/EAP
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4 Gang Truck Inspection/ Rig Cab Inspection
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5 Pre-Job Safety Meeting
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6 Designated Smoking Area
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7 Training Documentation
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8 Operators Trained & Certified
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9 Drivers License
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10 First Aid/CPR certified
Standard Job Safety
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11 Minimum PPE Worn
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12 H2S Monitor/Gas Monitor
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13 First Aid Kits & Inspection
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14 Fire Extinguisher & Inspection
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15 Adverse Weather Conditions
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16 Fall Protection
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17 Hearing Protection @ 85 dec.
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18 House Keeping
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19 Ladder Use and Condition
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20 Proper Tools for the Job
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21 Tools In Good Condition
Specific Job Task Safety
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22 Energy Isolation/ LOTO
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23 Traffic Control
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24 Guards on Equipment
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25 Tongs, Slips, Dies in Good Condition
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26 Back Up Slings on Tongs(length, tag, condition)
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27 All guard rails & Toe Guards
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28 Static/Ground
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29 Derrick/Out Rigger
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30 BOP Equipment (size, bolts, tests; function/pressure)
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31 Work Floor Platform Stairs
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32 Equipment Clean and in Order
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33 SRL/Harness/Lanyards
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34 Proper Lifting Techniques (mechanical means/buddy system, flex the knees
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35 Slings Shackles & Rigging
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36 Rig Stickers
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37 Power LIne Avoidance
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Auditor Signature