Information

  • Site conducted

  • Conducted on

  • Location:

  • Well #:

  • AFE #:

  • Hilcorp Site Representative:

  • Hilcorp Safety Representative:

  • Contractors Working on Location:

  • Status of Operations:

Inspection Checklist

Applicable Permits:

  • JSA / SJA Completed with Contractor with Contractor Sign-In Sheet?

General Site Inspection:

  • Authorized Personnel Sign Posted at entrance of site?

  • Rig signage erected at entrance to the site and at all directional changes in route to the site?

  • Proper PPE Signage posted at entrance?

  • Visitor Signage (directing them to Toolpusher) upon entry to location?

  • Sign-In Sheet (required upon arrival) is Available?

  • No Smoking Signs and Designated Smoking Areas Signs posted?

  • Muster area Designated?

  • Is a Clean and Sanitary Portable Restroom Facility provided in close proximity to the location?

  • Change House Clean and Orderly?

  • Hazardous Locations Identified?

  • All Vessels Labeled as to their Contents?

  • Adequate Lighting Provided?

  • There are No Trip Hazards?

  • Proper PPE/FRC being worn by all personnel on Location?

  • Erected Windsock Visable?

  • OSHA Poster Posted?

  • Safety Equipment Available on Location?

  • Fall Protection being utilized when Required?

  • First Aid Kit and Blood Born Pathogen Kit available on Location?

  • Emergency Phone Posted on Location?

Stairs / Ladders / Handrails / Gaurdrails:

  • Adequate Stairs provided off Rig Floor?

  • All stairs on Location are Level?

  • Are there a minimum of 2 Stairways available to Rig Floor?

  • Are the Stairs on Location Secured?

  • There are No Trip Hazards on Stairs?

  • Stairs have Non-Skid Steps and are uniform size?

  • Adequate Handrails provided on stairs with 4 or more Risers?

  • Guardrails, Mid-Rails, and Toe-Boards Installed along all open side edges of Floors, Platforms, Etc...

  • Ladders on Location are Extended No More than 3.5ft above Platform?

  • All Fixed and Portable Ladders are in Good Condition and Free of Defects?

Rig Floor:

  • Rig Floor in Good Woking Condition?

  • All Unused Floor Holes Covered?

  • Weight Indicator Installed and Visible to Driller?

  • Driller's Controls Properly Labeled?

  • Air-Hoist Cable in Good Working Condition?

  • All Straps and Slings in Good Working Condition?

  • Housekeeping on Rig Floor is Adequate?

  • Eye Wash Station Provided?

  • Keepers and Pins Properly Installed?

Fuel / Storage Tanks:

  • Fuel Storage Tanks Properly Located and Labeled as to their Contents?

  • Discharge Valves, Nozzles and Hoses in Good Working Condition?

  • "Flammable" Warning Signs Properly Posted on All Sides of Storage Tanks?

  • LPG Storage Tanks and Compress Gas Cylinders are Properly Labeled and in Good Working Condiition?

  • Safety Caps / Bull Plugs are Properly Installed to Prevent Spills?

Fire Protection:

  • All Fire Extinguishers (B&C Class) are Properly Charged and in Good Working Condition?

  • All Fire Extinguishers (B&C Class) Have had their Monthly/Annual Inspection and Properly Tagged?

  • Flare Area is Clear of any Combustable Material?

  • Employees Have been Properly Trained to Operate Fire Extinguishers on Location?

Mud Pump Area:

  • All Drive Belts and Shafts have Guards Properly Installed?

  • All Rotating Parts have Guards Properly Installed?

  • Have Shear Pin Pop-Off Valves been Properly Covered?

  • Have Vibrator Hoses and High Pressure Lines been Properly Secured?

  • Have High Pressure Fittings been Used where Applicalbe?

  • Have All Discharge Lines from Relief Valves been Properly Anchored?

  • Are All Pumps, Pipes, Hoses, Valves, and Fittings have been Well Maintained and Are In Good Working Condition?

  • Are All Pumps, Pipes, Hoses, Valves and Fittings Being Operated at Pressures In Which they are Rated?

Blow Out Preventer / Accumulator / Choke Area:

  • Has the Blow Out Preventer (BOP) been tested to Function Properly?

  • Is the Blow Out Preventer (BOP) Properly Stabilzed?

  • Are All Hydraulic Lines Properly Connected?

  • Are All Unused Hydraulic LInes Capped and Properly Secured?

  • Has there been a Check Valve Installed On Kill LIne Side?

  • Have Safety Cables been Installed On the Kill Line and Choke Line?

  • Have Pollution Pans been Properly Installed?

  • Accumulator Vales have been Properly Identified as to their Purpose and Position?

  • All Gauges are Installed Properly and Located in the Correct Position?

  • Accumulator Bottles Properly Labeled with their Contents?

  • Are the Accumulator Operational Warning Signs Visible?

  • Is the Choke Manifold Accessible?

  • Are the Choke Manifold Gauges Visible and Working Properly?

Pipe Rack Area:

  • Are the Ends of the Pipe Racks Properly Chocked?

  • Are Spacers being Utilized to Separate Layers of Pipe?

  • Are Pipe Racks Stable / Level and In Good Working Condition?

Material Handling Equipment:

  • Has the Forklift Operator been Certified and Properly Trained?

  • Are all Equipment Certification Documents Available for Inspection on Location?

  • Is the Proper Type of Equipment being Utilized for Handling of Material on Location?

  • Is Proper Inspection of Equipment (Forklift) Being Done Prior to Daily Use?

  • All Safety Devices on Equipment (Seat-belts, BackUp Alarms, Etc.) In Good Working Condition?

Additional Findings:

Additional Findings / Issues or Concerns:

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Approval:

  • Hilcorp Safety Specialist:

  • Company Man:

  • Tool Pusher:

  • Other (Contractor):

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