Florence Copper Daily Site Inspection

• Was the rig active or laid over?

  Active

  Laid Over

• Rig Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• List Rig Personnel

• EAP & Permit Posted?

  Yes

  No

  N/A

• Nearest emergency medical facility identified and reviewed by all?

  Yes

  No

  N/A

• Nearest non-emergency medical (urgent care) facility identified?

  Yes

  No

  N/A

• Is there cell phone service on site?

  Yes

  No

  N/A

• Is 911 available?

  Yes

  No

  N/A

• Have all employees completed new hire training?

  Yes

  No

  N/A

• Will there be at least one employee certified in CPR and 1st Aid on each shift?

  Yes

  No

  N/A

• Is there at least one trained and authorized employee on each shift to drive a company vehicle?

  Yes

  No

  N/A

• Have all employees completed forklift training?

  Yes

  No

  N/A

• Discuss any shift limitations...ie rig hand experience spread, new driller, sound ordinances, weather

• Are toolbox safety briefings being performed and signed by all employees? (may be 1 per day but when operations change a new one must be accomplished)

  Yes

  No

  N/A

• Are site visitors being briefed and signing the toolbox safety briefing?

  Yes

  No

  N/A

• Is the PPE/rig sign posted?

  Yes

  No

  N/A

• Have underground and overhead utilities been identified/moved?

  Yes

  No

  N/A

• Is there adequate drainage on site for water accumulation or rain/snow?

  Yes

  No

  N/A

• Is there a traffic control issue?

  No

  Yes

  N/A

• Has it been addressed?

  Yes

  No

  N/A

• Is there an established parking area for all vehicles?

  Yes

  No

  N/A

• Is there an established loading/unloading area (vehicles will not be parked in this area longer than it takes to load or unload)?

  Yes

  No

  N/A

• Is there an established hazardous waste collection area with secondary containment?

  Yes

  No

  N/A

• Has a protective barrier been placed under equipment known to have leaks?

  Yes

  No

  N/A

• Are compressed gas cylinders separated and secured as applicable?

  Yes

  No

  N/A

• Are all chemical containers on-site labeled of their contents?

  Yes

  No

  N/A

• Is lighting acceptable for operations during the hours of darkness?

  Yes

  No

  N/A

• Are fire extinguishers mounted and serviceable?

  Yes

  No

  N/A

• Is the 1st aid kit stocked?

  Yes

  No

  N/A

• Is the current OSHA/DOL poster posted in the doghouse?

  Yes

  No

  N/A

• Is there an SDS available for all chemicals on site?

  Yes

  No

  N/A

• Does everyone know where it is at and what type of information can be found in the SDS?

  Yes

  No

  N/A

• Is there an eyewash station available?

  Yes

  No

  N/A

• Is there anything blocking or impeding access to the eyewash station??

  No

  Yes

  N/A

• Is the eyewash solution expired?

  No

  Yes

  N/A

• Is there adequate fall protection on site?

  Yes

  No

  N/A

• Has it been inspected by a competent person within the last year?

  Yes

  No

  N/A

• Is it clean and serviceable?

  Yes

  No

  N/A

• Is there a lock-out tag-out kit on site with a minimum of ties and tags?

  Yes

  No

  N/A

• Is PPE available to all employees?

  Yes

  No

  N/A

• Is there an on hand inventory of PPE (gloves, glasses, hearing protection, face shields)?

  Yes

  No

  N/A

• Do all employees have safety toed shoes?

  Yes

  No

  N/A

• Are there gas monitors on location?

  Yes

  No

  N/A

• Do they have current calibration dates?

  Yes

  No

  N/A

• Are GFCI's present and being used?

  Yes

  No

  N/A

• Are emergency stops present?

  Yes

  No

  N/A

• When was the last time it was tested?

• Are stairs and handrails in place?

  Yes

  No

  N/A

• Do hand rails have kick boards or mid support as required by OSHA?

  Yes

  No

  N/A

• Will handrails support at least 200 pound of weight?

  Yes

  No

  N/A

• Do any chains in use show signs of wear?

  No

  Yes

  N/A

• Do any of the cables show signs of wear?

  No

  Yes

  N/A

• Are the rig floor and doghouse grounded?

  Yes

  No

  N/A

• Is the rig floor free of voids, trips hazards, and any open holes larger than 4" in diameter?

  Yes

  No

  N/A

• Are safety pins and keepers used where required (no welding rods)?

  Yes

  No

  N/A

• Are all rotating parts guarded?

  Yes

  No

  N/A

• Are there any exposed electrical wires?

  No

  Yes

  N/A

• Are circuit breaker panels accessible?

  Yes

  No

  N/A

• Are there open voids or knockouts in the panel?

  No

  Yes

  N/A

• Is the diesel tank properly placarded?

  Yes

  No

  N/A

• Are all hammer union style hoses secured?

  Yes

  No

  N/A

• Are all flammable chemicals stored in a flammable locker?

  Yes

  No

  N/A

• Are combustible materials stored around the flammable locker?

  No

  Yes

  N/A

• Is there an ignition source near the flammable locker?

  No

  Yes

  N/A

• Are there any damaged hydraulic cylinders?

  No

  Yes

  N/A

• Are derrick inspection checklists being performed for each shift of operation? (Look at previous 7 days if applicable)

  Yes

  No

  N/A

• Are there any visible bends of the derrick structure or structure components to include the crown?

  No

  Yes

  N/A

• Are there any visible cracks or broken welds?

  No

  Yes

  N/A

• Are the blocks in serviceable condition?

  Yes

  No

  N/A

• Is the derrick pinned with appropriate keepers?

  Yes

  No

  N/A

• Are there any hydraulic leaks?

  No

  Yes

  N/A

• Are the controls in good operating condition?

  Yes

  No

  N/A

• Is the kelly hose serviceable with no visible defect or wear?

  Yes

  No

  N/A

• Does the anti-two block system function as designed?

  Yes

  No

  N/A

• Are the kelly arm guide tracks serviceable?

  Yes

  No

  N/A

• Are auxiliary hoists serviceable?

  Yes

  No

  N/A

• Are all cable clamps installed correctly?

  Yes

  No

  N/A

• Are hold back lines in place and serviceable?

  Yes

  No

  N/A

• Are stairs and handrails in place?

  Yes

  No

  N/A

• Do hand rails have kick boards or mid support as required by OSHA?

  Yes

  No

  N/A

• Will handrails support at least 200 pound of weight?

  Yes

  No

  N/A

• Are there holes larger than 4" in diameter in the floor?

  No

  Yes

  N/A

• Are all hammer union style hoses secured?

  Yes

  No

  N/A

• Are there any exposed electrical wires?

  No

  Yes

  N/A

• Are circuit breaker panels accessible?

  Yes

  No

  N/A

• Are there open voids or knockouts in the panel?

  No

  Yes

  N/A

Forklift

• Are there any issues with braking, steering, or lifting?

  No

  Yes

  N/A

• Are the tires serviceable?

  Yes

  No

  N/A

• Does the forklift have operational lights?

  Yes

  No

  N/A

• Are the forks and any other attachments serviceable?

  Yes

  No

  N/A

• Are all engine and other covers in place?

  Yes

  No

  N/A

• Are there any leaks, hydraulic, fuel, or oil?

  No

  Yes

  N/A

• Are there any broken windows?

  No

  Yes

  N/A

• Are the load charts present and legible?

  Yes

  No

  N/A

• Is the pre-shift inspection completed?

  Yes

  No

  N/A

Backhoe/Front End Loader

• Are there any issues with braking, steering, or lifting?

  No

  Yes

  N/A

• Are the tires serviceable?

  Yes

  No

  N/A

• Does the backhoe/front end loader have operational lights?

  Yes

  No

  N/A

• Area all engine and other covers in place?

  Yes

  No

  N/A

• Are there any leaks, hydraulic, fuel, or oil?

  No

  Yes

  N/A

• Are there any broken windows?

  No

  Yes

  N/A

• Are the outriggers functional?

  Yes

  No

  N/A

Compressor

• Area all engine and other covers in place?

  Yes

  No

  N/A

• Are rotating parts guarded?

  Yes

  No

  N/A

• Are hoses secured?

  Yes

  No

  N/A

• Are compressors being ran through the regeneration cycle?

  Yes

  No

  N/A

• Are there any foreign objects stored inside the unit?

  No

  Yes

  N/A

Generator

• Are all engine and other covers in place?

  Yes

  No

  N/A

• Are all rotating parts guarded?

  Yes

  No

  N/A

• Are there any exposed electrical wires?

  No

  Yes

  N/A

• Is the generator properly grounded?

  Yes

  No

  N/A

• Are there any foreign objects stored inside the unit?

  No

  Yes

  N/A

• Are the voltage warning signs/stickers present?

  Yes

  No

  N/A

Mud Pump

• Are all rotating parts guarded?

  Yes

  No

  N/A

• Are there any exposed electrical wires?

  No

  Yes

  N/A

• If using an earth pit, is it properly barricaded?

  Yes

  No

  N/A

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