Title Page

  • Station and Lease site concerns must be reported appropriate trader and the On-shore HSSE group

  • PRODUCER / OPERATOR NAME

  • DATE & TIME

  • STATION / LEASE NAME
  • COMPANY TRADER:

  • CITY:

  • STATE:

Road Conditions

  • Your Road

  • Jay
  • 1. Roads and pathways are maintained and clear of obstructions?

  • 2. Facility free of heavy traffic?

  • 3. Adequate facility entrance turn around radius and exit?

  • 4. Roadways within facility are of adequate width?

  • 5. Roadways are prepared with shoulders?

Station / Lease Conditions

  • Station

  • Jay
  • 6. Grounding Rod Present?

  • 7. Ground cable in good condition?

  • 8. Facility beams are in good condition?

  • 9. Wind Sock on Location?

  • 10. Signage present for Station Name, Producer Name, Lease Name and Tank #'s?

  • 11. Facility is free of overgrown vegetation?

  • 12. Facility has NO evidence of spill or tank overfill.

  • 13. Facility tank(s) and equipment in good condition and shows no signs of corrosion?

  • 14. Tank stairs and hand rails in good condition?

  • 15. Walking surface free of slip and trip hazards?

  • 16. Is loading or unloading area free of animal hazards (Bees, Wasp, Snakes, etc)?

H2S Safety Controls on site

  • 17. Posted signs indicating “H2S site”?

  • 18. Posted sign on stairwell “do not enter”?

  • 19. Vapor Recovery Unit present?

  • 20. Vapor Recovery Hose is good condition?

  • 21. SABA- supplied breathing apparatus available?

Closing

  • IF ANY OF THE ABOVE QUESTIONS ARE ANSWERED NO, PLEASE COMMENT:

  • POSITIVE FEEDBACK AND ADDITIONAL COMMENTS:

  • PREPARED BY:

  • COMPANY (CONTRACTORS ONLY)

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