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
Safety Training
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Has the Trainee completed HSE Training?
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Trainee Signature
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Evaluator signature
Equipment Knowledge
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Can the Employee properly identify and state the purpose of:
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MDU
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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MCU
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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SMD
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Mono Pump
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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VFD
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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DWT
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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SMC
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Employee code
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Evaluator signature
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Where did the evaluation take place.
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Drying Shakers
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Diaphragm (Peanut) Pump
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Centrifugal Pump
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Where did the evaluation take place.
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Employee code
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Evaluator signature
Operations and Maintenance
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Can the employee demonstrate how to:
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Change the piston plates on a diaphragm pump?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change the shaft and O-rings on a diaphragm pump?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change discharge balls and seats on a diaphragm pump?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Open inspection port and check inner screen for blinding?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Gauge the clearance of the flights to the screen
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Rotate Oil Strainer?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Inspect the condition of the Rotor Wear Ring?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change the Kick Arm of Torque Assembly?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Measure tension of Torque Assembly?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change wear plates?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change plows?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change hanger bearing assembly?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change out BICC or other type of cable glands?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Change Shaft Seal of Screw Conveyor?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Grease all parts with the proper grease?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
Technical Support
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Can the employee demonstrate how to collect a sample from;
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Frac tank, catch tank or holding tank?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Active System?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Dryer Discharge?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Centrifuge Discharge?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Burn a Retort?
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Solids?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Liquids?
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Where did the evaluation take place.
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Employee code
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Evaluator signature
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Completely fill out a DOR?
