HAK - ANS Environmental Field Inspection

• HAK - Environmental Field Insapection

• Location
  Address

• Conducted on

  Date

• Pad or Area Supervisor

• Prepared by

Environmental Considerations

• 1.1 Spots or discoloration on pad surfaces or along bullrails?

  Yes

  No

  N/A

• 1.2 Graveled snow pushed off road or pad surfaces?

  Yes

  No

  N/A

• 1.3 Drill cuttings or other foreign materilas on pad surfaces?

  Yes

  No

  N/A

• 1.4 Drums or liqui-totes tipped over or punctured?

  Yes

  No

  N/A

• 1.5 Drums / Totes stored on the outer edge of the pad without containment?

  Yes

  No

  N/A

• 1.6 Parked / stored equipment stored on the edge of the pad without containment? (Exclude items with built in containment)

  Yes

  No

  N/A

• 1.7 Flowlines / process piping showing signs of drips or leaks?

  Yes

  No

  N/A

• 1.8 Hydrocarbons / sheeens visible in reserve pits, on pad, or off the side of the pad?

  Yes

  No

  N/A

• 1.9 Portable or permanent liners in good condition without visible signs of tears or other deterioration?

  Yes

  No

  N/A

• 1.10 Unauthorized trenching for purposes of drainage of liquid from pad or pit locations?

  Yes

  No

  N/A

• 1.11 Unauthorized discharge of fluids into/onto tundra or waterbodies?

  Yes

  No

  N/A

• 1.12 Gravel erosion due to water runoff?

  Yes

  No

  N/A

• 1.13 Duckpond / Liner use not in compliance with HAK - ANS standards?

  Yes

  No

  N/A

• 1.14 Fluid transfers not in compliance with HAK - ANS fluid transfer guidelines?

  Yes

  No

  N/A

• 1.5 Wildlife concerns?

  Yes

  No

  N/A