Information

  • Document No.

  • Audit Title

  • Prepared by

Facility Information

Facility Details

  • Date

  • Facility status

  • Facility Address (include property #)
  • Add signature

Hazcom / General Conditions

HAZCOM & General Site Conditions

  • Were all gates locked upon arrival?

  • We're wind socks installed and in good condition?

  • Are safety data sheets available and accesible?

  • Is the truck loading area properly marked (oil /water load-out, vent, grounding, etc.)?

  • Are all containers properly labeled (NFPA or HMIS labels, ID's, etc)?

  • What is the condition of secondary containment systems on site?

  • Are there any containers (empty or with contents) being stage on the pad or lease road?

  • List containers

  • Storage containers
  • Describe unit / container (contents, capacity, serial #)

  • Add media

  • What is the level of cleanliness on the pad?

  • Describe conditions if less than a 9 rating.

  • List any other items, if needed.

NORM

NORM

  • Have any NORM surveys been completed at this facility?

  • List NORM surveys completed for this facility.

  • NORM Survey
  • Select the type of survey completed?

  • Note the NORM levels.

  • Are NORM survey being done within BMP appropriate frames for the type of facility?

  • If applicable, are NORM labels and signs posted per CHK BMP's?

  • If applicable, are worker protection plans being adhered to?

Spill Prevention

Spills

  • Has any spills or releases been reported for this site?

  • Spill or Release Information
  • Date of occurrence

  • describe (material / amount / pathways affected)

  • Was it reported to a regulatory agency?

Spill Prevention

  • Is a Spill Prevention and Control Plan required to be prepared and implemented?

  • Is a copy of the SPCC Plan available?

  • Has the operator of the facility reviewed the plan within the last 5 years?

  • Has there been a modification in facility design, construction, storage capacity, operation or maintenance which renders the existing SPPC Plan inadequite?

  • Describe modification

  • Does the SPCC Plan establish a program for regular inspection of all storage tanks, separators, and related and transfer equipment?

  • Does the SPPC Plan include provisions for annual monitoring of flow line integrity through a combination of visual inspection and pressure testing or through the use of an approved alternate technology?

  • Are inspection records available on site?

  • Does the SPCC Plan establish provisions for access to, and rapid deployment of, containment booms, spill containment, and cleanup equipment?

  • Are all work over, completion, and drill rigs, completion, and production, facilities equipped with pollution containment devices that under normal operating conditions prevent unauthorized discharges?

  • Are all from diked or containment areas equipped with valves that are kept in the closed position except during periods of supervised discharge?

  • Is the earth perimeter berm a minimum 40" in height from the pad's ground surface with established vegetation (70%), and lacks erosion all features?

  • Select deficiency.

  • Explain.

  • Does the truck loading lines drain into the production tank containment?

Water / stormwater

Water / Stormwater

  • Is the facility required to have a water discharge permit?

  • Does the facility have, or applied for a permit?

  • List permit #.

  • Are there any outfalls or discharges at the facility that are not authorized by the permit or CHK's BMP's?

  • Describe

  • Add media

  • Has the facility had a reportable discharge of storm water?

  • Select date

  • Describe

  • Are all discharges being monitored / recorded as required an being maintained for a period of three years?

  • Is or has turbidity, conductivity, or pH outside normal regulatory or CHK BMP's standards?

  • Describe?

  • Are there any visible evidence of surface water (ponds, streams, wetlands, etc.) off the pad being impacted?

  • Describe.

  • Add media

  • Is there on soil, equipment, or decking that could cause a sheen during the next rain event?

  • Describe

  • Add media

Erision & Sedimentation

Erosion and Sedimentation

  • Is an erosion and Sedimentation Control Plan on site?

  • Has clean storm water run off been diverted from areas to be disturbed?

  • Describe

  • Add media

  • Have bodies of water that are in the vicinity of the site been identified and protected?

  • Describe feature

  • Water Feature
  • Are excavated / cleared areas being stabilized in conjunction with each other?

  • Describe.

  • Are stockpiles, slopes, and berms stabilized with vegetation / mulch (>70% cover)?

  • What is % coverage for area 1

  • Percent Coverage
  • % coverage.

  • Add media

  • Is there visible evidence that evidence that any surface body is being affected?

  • Describe.

  • Are silt fences installed within specifications and BMP's?

  • Describe.

  • Are fence / socks joints compromised? Are the post stable and driven to the proper depth? Are without rips?

  • Compromised Area
  • Add media

  • Describe.

  • Are sedimentation / detention basins, sedimentation traps, barriers installed?

  • Describe

  • Are level spreaders, interceptor dikes, swales, and checks dams installed and maintained (sediment removal, stable, & not undermined)?

  • Has a temporary construction entrance to capture mud and debris from construction vehicles been installed and working to standard?

  • Is mud / debris being kept off public roads?

  • Are sediment controls installed 10' from the toe of the slope, on contour, & not across conveyance channels?

Air Quality

Air Quality

  • Does the facility have an air permit?

  • Is it current?

  • Is dust adequately controlled?

  • Describe

  • Is there any smoke being emitted from equipment at the facility?

  • Describe the equipment / unit.

  • Equipment
  • Add media

  • Do the GPU units and similar devices have screened caps in place?

  • Describe Equipment.

  • Equipment
  • Add media

  • Are there production tanks on site.

  • Identify tank

  • Tanks
  • Type and Capacity

  • Is there control equipment (combusted or flare) operating at the facility?

  • Type and is it metered?

  • Is there a corrective action plan for relighting the combustor and / or flares

  • Any visible evidence of leaks?

  • List equipment and location of leak

  • Equipment
  • Describe.

  • Are there compressors on site?

  • Type and size of compressor

  • Compressor
  • Describe

  • Are there any pneumatic pumps or controllers that use natural gas located on site?

  • List pumps
  • Describe

  • Is flash gas vented, burned in a combustor, flared, or routed back to the system?

  • Are emissions being controlled from the production tank load out activities?

  • Describe

  • If observable, are procedures for liquid transfer from a condensate tank being followed?

Waste (Universal, NORM, Haz, & NonHaz)

Universal Waste

  • Select all that apply

  • Is each waste stream stored in media and containers that prevents human exposure or release a release to the environment?

  • Select all that apply

  • List waste and at risk condition

  • Are associated storage and waste containers properly labeled?

  • Select waste steam not properly labeled

  • Describe the deficiency

  • Deficient HAZCOM
  • Add media

  • Do waste containers have an accumulation date of less than one (1) year?

  • Select if the facility has copies of universal waste shipping documents and are they available for review?

NORM Waste

  • Check if facility has containers storing NORM waste

  • Sketch areas and containers within those areas on site.

  • List container type, ID, condition, and date generated.

  • Container
  • Type of container

  • Container Identification

  • Condition of the container.

  • Are all valves, latches, lids, or other openings closed?

  • Describe open item(s).

  • Add media

  • Date waste waste was generated

  • Check if waste has been stored greater than 90-days.

  • Check if A NORM Equipment staging area is located on site?

  • Add drawing

  • Is there a clearly marked boundary warning personnel that area is restricted?

  • Has the material been stage for more than a year?

NonHazardous Waste

  • Does the facility generate or store NonHazardous Waste?

Hazardous Waste

  • Does the facility generate or store Hazardous Waste?

Other

  • Photographs

  • Additional information

  • Additional information
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