Information

  • Rig Number

  • Inspection date

  • Rig Series

  • Rig Model

  • Inspected by

  • Rig Make

  • Manufacturer

  • Operator

  • Supervisor

  • Derrick Height (ft)

  • Engine

  • Rig Location

General

  • Fortis Energy Services Logo & Signs

  • Rig driver has Class B license.

  • Registration & insurance card

  • Transportation permits in cab.

  • Housekeeping

  • Driver daily log & post trip current.

  • Does driver have current dispatch and trip report if traveling interstate?

  • Driver has annual inspection sheet in cab.

Guying

  • External guy lines strung out properly

  • External guy lines tightened to specifications

  • Guy lines condition

  • Turnbuckle minimum 1 1/4"

  • Guy lines flagged

  • External guy line safety anchors tested within 2 years.

  • Tubing board guy lines strung & crossed for racking & tubing

  • Internal guy lines adjusted to specifications

  • Outriggers in place and pinned

  • Proper number and spacing of cable clips

  • Crown to ground guy wires

  • Appropriate number of guy wires

Mast/Derrick

  • Mast/Derrick

  • Manufacturer's specifications operation plate

  • Derrick ladder

  • Tubing board

  • Rod basket/board

  • Lower derrick locking pins in place w/ safety pins

  • Scoping ram stabilizers

  • Crown-sheave guards

  • Rod, tubing fingers safety chains

  • Upper derrick locking pins in place w/ safety pins

  • Upper latch mechanism flag

  • Standpipe secured.

  • Circulating hose secured to gooseneck with safety hobbles

  • Lighting system functional, rated & adequate.

  • Crown painted a contrasting color

  • Bottom ladder rung w/i 18" of floor or ground

  • Top section breaking/landing point flagged

  • All pivot pins in derrick trapped

Rig Carrier

  • Housekeeping, flags are in place.

  • Guardrails/handrails in place with safety pins.

  • Head, tail & signal lights

  • Wheel chocks

  • Fluid systems free of leaks

  • Cab free of loose or flammable materials

  • Glass & mirrors

  • Windshield wipers & blades

  • Emergency brake set

  • Emergency reflector kit in rig cab

  • Battery covers in place

  • Hydraulic leveling jacks secured by mechanical lock nuts.

  • Seat belt

  • 6th gear locked out

  • All controls labeled

  • All gauges functioning properly

  • Road to drawworks shift lever secured

  • Brakes, tires & wheels

  • Diesel and other storage tanks are labeled

  • Full diesel fuel tank.

  • Kill switches functional

  • Emergency air intake shut down functional

  • Drive line recently greased

  • Low air warning device functional

Crew Truck

  • Registration, inspection sticker and insurance card

  • Vehicle numbers and company logo signs are visible

  • Seat belt condition

  • Truck overall appearance

  • Auxiliary fuel tanks have correct labels

  • Windshield, wipers, mirrors, and heater

  • All lights are working properly

  • Minimum 10 lb fire extinguisher securely mounted with a current inspection

  • Steering tires have a minimum 4/32 tread and other tires a minimum 2/32 tread

  • Tie down system

  • Pre-trip/Post-trip completed

Signatures

  • Supervisor

  • Yard represntative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.