IPS Coil Tubing Field Inspection - Belle Vernon, PA District Rev 3

• Document No.

• Site / Location

• Client

• Client Representative

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0-Pre-Job Safety Meeting

• 1.1 JSA Complete and signed bay all employees on location? Standard: API RP 54 6.1.7

  Yes

  No

  N/A

• 1.2 Job Hazards Identified? Standard: API RP 54 6.1.7

  Yes

  No

  N/A

• 1.3 Responsibilities Outlined and understood? Standard: IPS Standard

  Yes

  No

  N/A

• 1.4 Restricted work area identified? Standard: 29 CFR 1910.1200(f)(5-6)

  Yes

  No

  N/A

• 1.5 Emergency plan in place and understood by all employees? Standard: OSHA 29 CFR 1910.38.(b)

  Yes

  No

  N/A

• 1.6 Evacuation / All clear alarm Standard: OSHA CFR 1910.38(d)

  Yes

  No

  N/A

• 1.7 Mentor assigned to SSE's? Standard: API RP 54.6.1.7

  Yes

  No

  N/A

• 1.8 SIMOPS coordinated through company man? Standard: API RP 54.6.1.7

  Yes

  No

  N/A

• 1.9 All persons sign in/out when entering/exiting location? Standard: OSHA CFR 1910.38(c)(4)

  Yes

  No

  N/A

• 1.10 All personnel using designated smoking area? Standard: API RP 54.1.2-3, OSHA 29 CFR 1910.145(c)(2)(i)

  Yes

  No

  N/A

• 1.11 Safety briefing area designated? Standard: OSHA 29 CFR 1910.38(c)(4)

  Yes

  No

  N/A

• 1.12 At least 2 people on location trained in CPR/First Aid? Standard:API RP 54 4.3.1, OSHA 29 CFR 1910.151(b)

  Yes

  No

  N/A

• 1.13 Are 2 people on location trained in well control? Standard: API RP 54 6.4.4, 20 AAC 25.527

  Yes

  No

  N/A

• 1.14 Personnel H2S Awareness Trained? Standard: API RP 49 5.1

  Yes

  No

  N/A

• 1.15 Other

  Yes

  No

  N/A

• 1.16 Other

  Yes

  No

  N/A

2.0 Mandatory Safety Equipment

• 2.1 FRC's Properly worn by all employees? (zipped up and sleeves rolled down) Standard: OSHA 29 CFR 1910.132, NFPA 2113

  Yes

  No

  N/A

• 2.2 Hard Hats (Plastic no metal) being worn by all employees? Standard: API RP 54 5.2.1, OSHA 29 CFR 1910.135(a)(1-2)

  Yes

  No

  N/A

• 2.3 Safety Glasses - All employees Standard: API RP 54 5.2.2, OSHA 29 CFR 1910.135(a)(1-5)

  Yes

  No

  N/A

• 2.4 Safety boots - All employees Standard: API RP 54 5.2.3, OSHA 29 CFR 1910.136(a)

  Yes

  No

  N/A

• 2.5 Gloves - All employees Standard: OSHA 29 CFR 1910.132(a)

  Yes

  No

  N/A

• 2.6 Hearing protection available? Standard: OSHA 29 CFR 1910.95

  Yes

  No

  N/A

• 2.7 Fall arrest system ( inspected and labels readable) Standard: OSHA 29 CFR 1910.66 App C(f), ANZI Z359.5 1.2

  Yes

  No

  N/A

• 2.8 Lanyards (inspected and labels readable) Standard: OSHA 29 CFR 1910.66 App C(f), ANZI Z359.5 1.2

  Yes

  No

  N/A

• 2.9 Hard hat and safety glasses available for visitors Standard: OSHA 29 CFR 1910 132(a)

  Yes

  No

  N/A

• 2.10 Other

  Yes

  No

  N/A

• 2.11 Other

  Yes

  No

  N/A

3.0 Rig Up - General / Wellhead

• 3.1 Spotter used when backing equipment. Standard: IPS Standard

  Yes

  No

  N/A

• 3.2 20# Fire extinguisher located at left front bumper of each pice of equipment. Standard: API RP 54 7.2.4 & 5

  Yes

  No

  N/A

• 3.2(a) Fire extinguisher annual and monthly inspections current.

  Yes

  No

  N/A

• 3.3 Is Fall arrest system used while working in aerial lift? Standard: OSHA 29 CFR 1926.453(b)(2)(v)

  Yes

  No

  N/A

• 3.4 Is Fall arrest system used from heights greater than 4 ft? Standard: OSHA 29 CFR 1910.453(b)(2)(v)

  Yes

  No

  N/A

• 3.5 Do Personnel using forklifts and aerial lifts have current certification cards? Standard: OSHA 29 CFR 1910.178(i) & 1926.453(b)(2)(ii)

  Yes

  No

  N/A

• 3.6 Was an inspection done before use on Forklift? Standard: OSHA 29 CFR 1910.178(p)(7), API RPB56.6 6.5.1-2

  Yes

  No

  N/A

• 3.7 Is seat belt used while operating forklift? Standard: API RP B 56.1 5.3.19

  Yes

  No

  N/A

• 3.8 Are ropes used on hammer wrenches? Standard: IPS Standard

  Yes

  No

  N/A

• 3.9 Are endless loops used to secure iron? (Ribs & Spine) Standard: IPS Standard

  Yes

  No

  N/A

• 3.10 Are lubricators permanently marked with a serial #? Standard: API RP 54 13.6.5C

  Yes

  No

  N/A

• 3.11 Are Lubricator Certifications current? Standard: API RP 54 13.6.2

  Yes

  No

  N/A

• 3.12 BOP's Tested? Standard: API 54 6.4.1

  Yes

  No

  N/A

• 3.13 Are all bolts in place in all flanges? Standard: API RP 54 6.4.1

  Yes

  No

  N/A

• 3.14 Is caution tape put up around all High Pressure and crane working area? Standard:API RP 54 16.1.10

  Yes

  No

  N/A

• 3.15 Are all persons not involved in pressure testing standing outside the taped off area? Standard: API RP 54 16.1.10

  Yes

  No

  N/A

• 3.16 Are H2S Portable Detection Devices and chargers available in CT doghouse? Standard: API RP 49 3.4

  Yes

  No

  N/A

• 3.17 Are at least two employees wearing four gas Portable Detection Monitors? Standard: API RP 49 3.4

  Yes

  No

  N/A

• 3.18 Other

  Yes

  No

  N/A

• 3.19 Other

  Yes

  No

  N/A

4.0 Rig Up (CT Unit)

• 4.1 CT unit placed up wind of the well head? Standard: API RP 49 11.6.1, API RP 68 12.7.1

  Yes

  No

  N/A

• 4.2 Are steps leading to doghouse secure, level, and have hand rails with keeper pins in place? Standard: OSHA 29 CFR 1910.23 ,29 & 1910.36

  Yes

  No

  N/A

• 4.3 Are all railings in place and keeper pins in place? Standard: OSHA 29 CFR 1910.23(c)(1)

  Yes

  No

  N/A

• 4.4 Are all hydraulic lines in good condition and without leaks? Standard: IPS Standard

  Yes

  No

  N/A

• 4.5 Are all pins and keepers in reel saddle? Standard: IPS Standard

  Yes

  No

  N/A

• 4.6 Only necessary personnel in area when rigging up. Standard: IPS Standard

  Yes

  No

  N/A

• 4.7 Is the injector gooseneck pinned? Standard: IPS Standard

  Yes

  No

  N/A

• 4.8 Is there a field safety guide in the CT doghouse? Standard: IPS Standard

  Yes

  No

  N/A

• 4.9 Are emergence phone numbers filled out and posted? Standard: API RP 54 4.2.1 - 49 7.6-7 - 54 7.7-8

  Yes

  No

  N/A

• 4.10 Current MSDS book in CT doghouse? Standard: OSHA 29 CFR 19101200(g)(1), API RP 54 6.1.12

  Yes

  No

  N/A

• 4.11 Current emergency response plan. Standard: IPS Standard

  Yes

  No

  N/A

• 4.12 First Aid kit stocked and has a bloodborne pathogen kit. Standard: OSHA 29 CFR1910.151(b), API RP 54 4.3.2

  Yes

  No

  N/A

• 4.13 Fire extinguisher Monthly & Annual inspection current? Standard: OSHA 29 CFR 1910.157(e)(1), 1910.157(e)(2)

  Yes

  No

  N/A

• 4.14 Good housekeeping practices used? Standard: OSHA 29 CFR 1910.22(a)(1), 1910.141(a)(3)

  Yes

  No

  N/A

• 4.15 Other

  Yes

  No

  N/A

• 4.15 Other

  Yes

  No

  N/A

5.0 Rig Up (N2 Pump)

• 5.1 Iron certifications current? Standard: API RP 54 12.5.1

  Yes

  No

  N/A

• 5.2 Hammer unions in goos shape and not mushroomed. APIRP 54 12.5.1

  Yes

  No

  N/A

• 5.2 Are steps leading to doghouse secure, level, and have hand rails with keeper pins in place? Standard: OSHA 29 CFR 1910.23 ,29 & 1910.36

  Yes

  No

  N/A

• 5.3 N2 PPE being used? (safety glasses, face shield and proper gloves) Standard: Osha 29 CFR 1910.133(a)(1) - 1910 138(a)

  Yes

  No

  N/A

• 5.4 Other

  Yes

  No

  N/A

• 5.5 Other

  Yes

  No

  N/A

6.0 Rig Up (Fluid Pump)

• 6.1 Are steps leading to doghouse Secure,Level, Have hand rails with keeper pins in place? Standard: OSHA 29 CFR 1910.23 ,29 & 1910.36

  Yes

  No

  N/A

• 6.2 Iron certification current? Standard: API RP 54 12.5.1

  Yes

  No

  N/A

• 6.3 Hammer unions in goos shape and not mushroomed. APIRP 54 12.5.1

  Yes

  No

  N/A

• 6.4 All chemicals labeled and MSDS's on location. Standard: OSHA 29 CFR 1910.1200(b)(1)

  Yes

  No

  N/A

• 6.5 All bagged materials stacked properly? Standard: OSHA 29 CFR 1910.176(b)

  Yes

  No

  N/A

• 6.6 Assessment for respirator conducted? Standard: OSHA 29 CFR 1910.134(b)(1-3), API RP 54 5.4.1

  Yes

  No

  N/A

• 6.7 Personnel wearing proper PPE per MSDS? Standard: OSHA 29 CFR 1910.1200(B)(1)

  Yes

  No

  N/A

• 6.8 Other

  Yes

  No

  N/A

• 6.9 Other

  Yes

  No

  N/A

7.0 Rig Up (Crane)

• 7.1 Lifting slings inspected and labels readable. Standard: OSHA 29 CFR 1910.184 - 1910.112(b)

  Yes

  No

  N/A

• 7.2 Chains inspected and tagged Grade 8 or better. Standard: OSHA 29 CFR 1910.112(c) - 1910.184

  Yes

  No

  N/A

• 7.3 Tag-lines inspected and used when lifting. Standard: OSHA 29 CFR 1910.180 (h)(3)(vi), API RP 54 6.2.12

  Yes

  No

  N/A

• 7.4 Only one person signaling crane operator. Industry Standard

  Yes

  No

  N/A

• 7.5 Outriggers fully extended and approved pads under them. Standard: OSHA 29 CFR 1910.180(h)(3)(i)(a)

  Yes

  No

  N/A

• 7.6 Outrigger Floats secured with pad pins. Standard: OSHA 29 CFR 1910.180(h)(3)(iv)

  Yes

  No

  N/A

• 7.7 Cones or CAUTION tape designating the cranes swing path. Standard: OSHA 29 CFR 1910.180(h)(3)(iii)[b]

  Yes

  No

  N/A

• 7.8 Hydraulic system has no apparent leaks. Standard: OSHA 29 CFR 1910.180(d)(3)(iv)

  Yes

  No

  N/A

• 7.9 Air system has no audible leaks. Standard: OSHA 29 CFR 1910.180(d)(3)(iv)

  Yes

  No

  N/A

• 7.10 Boom exhibits no damage to structure.(wear pads, boom, stops, or cylinders) Standard: OSHA 29 CFR 1910.180(h)(3)(ix)

  Yes

  No

  N/A

• 7.11 Wire rope free of dirt, excess lube, kinks, and spooled properly. Standard: OSHA 29 CFR 1910.180(g)

  Yes

  No

  N/A

• 7.12 Block in good condition and greased. Standard: Per Manufacture

  Yes

  No

  N/A

• 7.13 No damage to the hook and it swivels freely. Standard: OSHA 29 CFR 1910.180(d)(3)(v)

  Yes

  No

  N/A

• 7.14 All guards in place. Standard: OSHA29 CFR 1910. 212(a)(1)

  Yes

  No

  N/A

• 7.15 All hand rails in place, secured and not damaged. OSHA 29 CFR 1910.21(f)(10)

  Yes

  No

  N/A

• 7.16 Cab glass free of cracks and wipers working properly. Standard: Per Manufacture.

  Yes

  No

  N/A

• 7.17 Anti-two block in place and functioning. Standard: OSHA 29 CFR 1910.180(b)(3)(iii)

  Yes

  No

  N/A

• 7.18 All lights and horn working properly. Standard: OSHA 29 CFR 1910.180(b)(3)(iii)

  Yes

  No

  N/A

• 7.19 Fire extinguisher monthly / annual current. Standard: OSHA 29 CFR 1910.157(e)(1) & (e)(2), 1910.180(i)(5)(i) API RP 54 16.1.10

  Yes

  No

  N/A

• 7.20 Daily crane inspection filled out. Standard: OSHA 29 CFR 1910.180(d)(2)(i)

  Yes

  No

  N/A

• 7.20 Annual inspection current. Standard: OSHA 29 CFR1910.180(d)(2)(ii)

  Yes

  No

  N/A

• 7.21 Operators manual in cab. Standard: Per Manufacture

  Yes

  No

  N/A

• 7.22 Load chart legible and visible to operator. Standard: OSHA 29 CFR 1910.180(c)(2)

  Yes

  No

  N/A

• 7.23 Hand signal chart visible to workers. Industry Standard

  Yes

  No

  N/A

• 7.24 Hand held wind sped indicator available. Industry Standard

  Yes

  No

  N/A

• 7.25 Other

  Yes

  No

  N/A

• 7.26 Other

  Yes

  No

  N/A

8.0 Job Execution

• 8.1 Supervisor / PIC identified and in control? Standard: IPS Standard

  Yes

  No

  N/A

• 8.2 Do employees work as a team? Standard: IPS Standard

  Yes

  No

  N/A

• 8.3 Are there any equipment failures?

  Yes

  No

  N/A

• 8.4 Are regular checks of equipment done? Standard: API RP 54 8.3.3

  Yes

  No

  N/A

• 8.5 Are tools in good working order? API RP 54 6.8.6

  Yes

  No

  N/A

• 8.6 NO homemade tools on location. Industry Standard

  Yes

  No

  N/A

• 8.7 General housekeeping Standard: OSHA 29 CFR 1910.22(a)(1), API RP 54 6.5.1

  Yes

  No

  N/A

• 8.8 Fluid leaks on equipment contained EPA Standard

  Yes

  No

  N/A

• 8.9 Spill Kit Easily accessible Standard: IPS Standard

  Yes

  No

  N/A

• 8.10 Spill containment in place.

  Yes

  No

  N/A

• 8.11 Safety procedures followed.

  Yes

  No

  N/A

• 8.12 Other

  Yes

  No

  N/A

• 8.13 Other

  Yes

  No

  N/A

9.0 Outside Of Equipment.

• 9.1 Is Equipment clean? Standard: IPS Standard

  Yes

  No

  N/A

• 9.2 Fuel Tanks (Caps, Straps, Mounts) in place and in good condition. Standard: API RP 54 8.3.3

  Yes

  No

  N/A

• 9.3 Fuel, hydraulic, and other tanks properly labeled. Standard: OSHA 29 CFR 1910.1200(f)(5)

  Yes

  No

  N/A

• 9.4 All Belts, Chains, and rotating parts have guards in place. Standard: OSHA 29 CFR 1910.212(a)(2), API RP 54 .8.2-3

  Yes

  No

  N/A

• 9.5 All hoses on equipment in good condition. Standard: OSHA 29 CFR 1910.5(a)(1)

  Yes

  No

  N/A

• 9.6 At least one axle on each pice of equipment chocked. Standard: API RP 54 11.1.2

  Yes

  No

  N/A

• 9.7 Trailer plugs, wires, and chains in good condition and show no signs of damage. Standard: DOT

  Yes

  No

  N/A

• 9.8 Break away cables on light duty trailers connected and working properly. Standard: DOT

  Yes

  No

  N/A

• 9.9 Tool / parts boxes uncluttered and lids are able to close and lock.

  Yes

  No

  N/A

• 9.10 All loose items on trailers are able to be secured.

  Yes

  No

  N/A

• 9.11 Other

  Yes

  No

  N/A

• 9.12 Other

  Yes

  No

  N/A

10.0 CT Unit Tractor Standard: 49 CFR (DOT)

• Picture of vehicle.

  Media

• 10.1 Tractor equipment number.

• 10.2 Name of IPS employee who drove CT Unit to location.

• 10.3 Does driver have a current driver's license and proper endorsements to operate vehicle?

  Yes

  No

  N/A

• 10.4 Does driver have a current medical card?

  Yes

  No

  N/A

• 10.5 Is driver's log book current?

  Yes

  No

  N/A

• 10.6 If the load is placarded, does the driver have the proper endorsements?

  Yes

  No

  N/A

• 10.7 Is there a copy of M-938 (map) in the cab?

  Yes

  No

  N/A

• 10.8 Is there a copy of the previous day's DVIR in the cab?

  Yes

  No

  N/A

• 10.9 Is the cab clean and free of trash?

  Yes

  No

  N/A

• 10.10 Are the windows clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 10.11 Are the mirrors clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 10.12 Is the fire extinguisher accessible, fully charged, and secured?

  Yes

  No

  N/A

• 10.12(a) Does the fire extinguisher have a current annual and monthly inspection?

  Yes

  No

  N/A

• 10.13 Are the emergency triangles present and stored properly?

  Yes

  No

  N/A

• 10.14 Are the vehicle's registration and insurance cards in the cab and current?

  Yes

  No

  N/A

• 10.15 Is there a copy of the Federal Motor Carrier Safety Regulation (green book) and a copy of the Emergency Response Guidebook (orange book) in the cab?

  Yes

  No

  N/A

• 10.16 Are shipping papers/Bills of Lading (w/MSDS sheets) in the cab?

  Yes

  No

  N/A

• 10.17 Are headlights, marker lights, and til lights clean and free from cracks or other visible damage?

  Yes

  No

  N/A

• 10.18 Are the license plates on the truck and trailer mounted properly and legible?

  Yes

  No

  N/A

• 10.19 Is the IFTA decal current and visible on both side of the tractor?

  Yes

  No

  N/A

• 10.20 Is the company name and DOT number visible on both side of the tractor?

  Yes

  No

  N/A

• 10.21 Are the tractor and trailer equipment numbers visible?

  Yes

  No

  N/A

• 10.22 Are fuel tanks free from leaks and equipped with caps?

  Yes

  No

  N/A

• 10.23 Are mud flaps present where required?

  Yes

  No

  N/A

• 10.24 If the vehicle is over width, are there flags on the widest points and oversize banners on front and rear?

  Yes

  No

  N/A

• 10.25 Are tire free of excessive wear and damage? (tread 4/32 steer, 2/32 others)

  Yes

  No

  N/A

• 10.26 Are all rims in good condition and free of bends and cracks?

  Yes

  No

  N/A

• 10.27 Are all placards in good condition and and visible on all four sides?

  Yes

  No

  N/A

• 10.28 Are electrical wires in good shape with no frays,cracks, or cuts?

  Yes

  No

  N/A

• 10.29 Other

  Yes

  No

  N/A

• 10.30 Other

  Yes

  No

  N/A

11.0 Fluid Pump Tractor Standard: 49 CFR (DOT)

• Picture of vehicle.

  Media

• 11.1 Tractor equipment number.

• 11.2 Name of IPS employee who drove Fluid Pump to location.

• 11.3 Does driver have a current driver's license and proper endorsements to operate vehicle?

  Yes

  No

  N/A

• 11.4 Does driver have a current medical card?

  Yes

  No

  N/A

• 11.5 Is driver's log book current?

  Yes

  No

  N/A

• 11.6 If the load is placarded, does the driver have the proper endorsements?

  Yes

  No

  N/A

• 11.7 If the vehicle is a permitted load, s there a copy of M-938 (map) in the cab?

  Yes

  No

  N/A

• 11.8 Is there a copy of the previous day's DVIR in the cab?

  Yes

  No

  N/A

• 11.9 Is the cab clean and free of trash?

  Yes

  No

  N/A

• 11.10 Are the windows clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 11.11 Are the mirrors clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 11.12 Is the fire extinguisher accessible, fully charged, and secured?

  Yes

  No

  N/A

• 11.12(a) Does the fire extinguisher have a current annual and monthly inspection?

  Yes

  No

  N/A

• 11.13 Are the emergency triangles present and stored properly?

  Yes

  No

  N/A

• 11.14 Are the vehicle's registration and insurance cards in the cab and current?

  Yes

  No

  N/A

• 11.15 Is there a copy of the Federal Motor Carrier Safety Regulation (green book) and a copy of the Emergency Response Guidebook (orange book) in the cab?

  Yes

  No

  N/A

• 11.16 Are shipping papers/Bills of Lading (w/MSDS sheets) in the cab?

  Yes

  No

  N/A

• 11.17 Are headlights, marker lights, and til lights clean and free from cracks or other visible damage?

  Yes

  No

  N/A

• 11.18 Are the license plates on the truck and trailer mounted properly and legible?

  Yes

  No

  N/A

• 11.20 Is the company name and DOT number visible on both side of the tractor?

  Yes

  No

  N/A

• 11.21 Are the tractor and trailer equipment numbers visible?

  Yes

  No

  N/A

• 11.22 Are fuel tanks free from leaks and equipped with caps?

  Yes

  No

  N/A

• 11.23 Are mud flaps present where required?

  Yes

  No

  N/A

• 11.24 If the vehicle is over width, are there flags on the widest points and oversize banners on front and rear?

  Yes

  No

  N/A

• 11.25 Are tire free of excessive wear and damage? (tread 4/32 steer, 2/32 others)

  Yes

  No

  N/A

• 11.26 Are all rims in good condition and free of bends and cracks?

  Yes

  No

  N/A

• 11.27 Are all placards in good condition and and visible on all four sides?

  Yes

  No

  N/A

• 11.28 Are electrical wires in good shape with no frays,cracks, or cuts?

  Yes

  No

  N/A

• 11.29 Other

  Yes

  No

  N/A

• 11.30 Other

  Yes

  No

  N/A

12.0 N2 Tractor Standard: 49 CFR (DOT)

• Picture of vehicle.

  Media

• 12.1 Tractor equipment number.

• 12.2 Name of IPS employee who drove N2 Unit to location.

• 12.3 Does driver have a current driver's license and proper endorsements to operate vehicle?

  Yes

  No

  N/A

• 12.4 Does driver have a current medical card?

  Yes

  No

  N/A

• 12.5 Is driver's log book current?

  Yes

  No

  N/A

• 12.6 If the load is placarded, does the driver have the proper endorsements?

  Yes

  No

  N/A

• 12.7 If the vehicle is a permitted load, s there a copy of M-938 (map) in the cab?

  Yes

  No

  N/A

• 12.8 Is there a copy of the previous day's DVIR in the cab?

  Yes

  No

  N/A

• 12.9 Is the cab clean and free of trash?

  Yes

  No

  N/A

• 12.10 Are the windows clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 12.11 Are the mirrors clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 12.12 Is the fire extinguisher accessible, fully charged, and secured?

  Yes

  No

  N/A

• 12.12(a) Does the fire extinguisher have a current annual and monthly inspection?

  Yes

  No

  N/A

• 12.13 Are the emergency triangles present and stored properly?

  Yes

  No

  N/A

• 12.14 Are the vehicle's registration and insurance cards in the cab and current?

  Yes

  No

  N/A

• 12.15 Is there a copy of the Federal Motor Carrier Safety Regulation (green book) and a copy of the Emergency Response Guidebook (orange book) in the cab?

  Yes

  No

  N/A

• 12.16 Are shipping papers/Bills of Lading (w/MSDS sheets) in the cab?

  Yes

  No

  N/A

• 12.17 Are headlights, marker lights, and til lights clean and free from cracks or other visible damage?

  Yes

  No

  N/A

• 12.18 Are the license plates on the truck and trailer mounted properly and legible?

  Yes

  No

  N/A

• 12.19 Is the IFTA decal current and visible on both side of the tractor?

  Yes

  No

  N/A

• 12.20 Is the company name and DOT number visible on both side of the tractor?

  Yes

  No

  N/A

• 12.21 Are the tractor and trailer equipment numbers visible?

  Yes

  No

  N/A

• 12.22 Are fuel tanks free from leaks and equipped with caps?

  Yes

  No

  N/A

• 12.23 Are mud flaps present where required?

  Yes

  No

  N/A

• 12.24 If the vehicle is over width, are there flags on the widest points and oversize banners on front and rear?

  Yes

  No

  N/A

• 12.25 Are tire free of excessive wear and damage? (tread 4/32 steer, 2/32 others)

  Yes

  No

  N/A

• 12.26 Are all rims in good condition and free of bends and cracks?

  Yes

  No

  N/A

• 12.27 Are all placards in good condition and and visible on all four sides?

  Yes

  No

  N/A

• 12.28 Are electrical wires in good shape with no frays,cracks, or cuts?

  Yes

  No

  N/A

• 12.29 Other

  Yes

  No

  N/A

• 12.30 Other

  Yes

  No

  N/A

• 12.27 Are all placards in good condition and and visible on all four sides?

  Yes

  No

  N/A

13.0 Crane Tractor Standard: 49 CFR (DOT)

• Picture of vehicle.

  Media

• 13.1 Tractor equipment number.

• 13.2 Name of IPS employee who drove Crane to location.

• 13.3 Does driver have a current driver's license and proper endorsements to operate vehicle?

  Yes

  No

  N/A

• 13.4 Does driver have a current medical card?

  Yes

  No

  N/A

• 13.5 Is driver's log book current?

  Yes

  No

  N/A

• 13.6 If the load is placarded, does the driver have the proper endorsements?

  Yes

  No

  N/A

• 13.7 If the vehicle is a permitted load, s there a copy of M-938 (map) in the cab?

  Yes

  No

  N/A

• 13.8 Is there a copy of the previous day's DVIR in the cab?

  Yes

  No

  N/A

• 13.9 Is the cab clean and free of trash?

  Yes

  No

  N/A

• 13.10 Are the windows clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 13.11 Are the mirrors clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 13.12 Is the fire extinguisher accessible, fully charged, and secured?

  Yes

  No

  N/A

• 13.12(a) Does the fire extinguisher have a current annual and monthly inspection?

  Yes

  No

  N/A

• 13.13 Are the emergency triangles present and stored properly?

  Yes

  No

  N/A

• 13.14 Are the vehicle's registration and insurance cards in the cab and current?

  Yes

  No

  N/A

• 13.15 Is there a copy of the Federal Motor Carrier Safety Regulation (green book) and a copy of the Emergency Response Guidebook (orange book) in the cab?

  Yes

  No

  N/A

• 13.16 Are shipping papers/Bills of Lading (w/MSDS sheets) in the cab?

  Yes

  No

  N/A

• 13.17 Are headlights, marker lights, and til lights clean and free from cracks or other visible damage?

  Yes

  No

  N/A

• 13.18 Are the license plates on the truck and trailer mounted properly and legible?

  Yes

  No

  N/A

• 13.19 Is the IFTA decal current and visible on both side of the tractor?

  Yes

  No

  N/A

• 13.20 Is the company name and DOT number visible on both side of the tractor?

  Yes

  No

  N/A

• 13.21 Are the tractor and trailer equipment numbers visible?

  Yes

  No

  N/A

• 13.22 Are fuel tanks free from leaks and equipped with caps?

  Yes

  No

  N/A

• 13.23 Are mud flaps present where required?

  Yes

  No

  N/A

• 13.24 If the vehicle is over width, are there flags on the widest points and oversize banners on front and rear?

  Yes

  No

  N/A

• 13.25 Are tire free of excessive wear and damage? (tread 4/32 steer, 2/32 others)

  Yes

  No

  N/A

• 13.26 Are all rims in good condition and free of bends and cracks?

  Yes

  No

  N/A

• 13.27 Are all placards in good condition and and visible on all four sides?

  Yes

  No

  N/A

• 13.28 Are electrical wires in good shape with no frays,cracks, or cuts?

  Yes

  No

  N/A

• 13.29 Other

  Yes

  No

  N/A

• 13.30 Other

  Yes

  No

  N/A

14.0 BOP Truck Standard: 49 CFR (DOT)

• Picture of vehicle.

  Media

• 14.1 Equipment Number

• 14.2 Name of IPS employee who drove Crane to location.

• 14.3 Does driver have a current driver's license and proper endorsements to operate vehicle?

  Yes

  No

  N/A

• 14.4 Does driver have a current medical card?

  Yes

  No

  N/A

• 14.5 Is driver's log book current?

  Yes

  No

  N/A

• 14.6 If the load is placarded, does the driver have the proper endorsements?

  Yes

  No

  N/A

• 14.7 If the vehicle is a permitted load, s there a copy of M-938 (map) in the cab?

  Yes

  No

  N/A

• 14.8 Is there a copy of the previous day's DVIR in the cab?

  Yes

  No

  N/A

• 14.9 Is the cab clean and free of trash?

  Yes

  No

  N/A

• 14.10 Are the windows clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 14.11 Are the mirrors clean and free of cracks that might impair the driver's ability to see?

  Yes

  No

  N/A

• 14.12 Is the fire extinguisher accessible, fully charged, and secured?

  Yes

  No

  N/A

• 14.12(a) Does the fire extinguisher have a current annual and monthly inspection?

  Yes

  No

  N/A

• 14.13 Are the emergency triangles present and stored properly?

  Yes

  No

  N/A

• 14.14 Are the vehicle's registration and insurance cards in the cab and current?

  Yes

  No

  N/A

• 14.15 Is there a copy of the Federal Motor Carrier Safety Regulation (green book) and a copy of the Emergency Response Guidebook (orange book) in the cab?

  Yes

  No

  N/A

• 14.16 Are shipping papers/Bills of Lading (w/MSDS sheets) in the cab?

  Yes

  No

  N/A

• 14.17 Are headlights, marker lights, and til lights clean and free from cracks or other visible damage?

  Yes

  No

  N/A

• 14.18 Are the license plates on the truck and trailer mounted properly and legible?

  Yes

  No

  N/A

• 14.19 Is the IFTA decal current and visible on both side of the tractor?

  Yes

  No

  N/A

• 14.20 Is the company name and DOT number visible on both side of the tractor?

  Yes

  No

  N/A

• 14.21 Are the tractor and trailer equipment numbers visible?

  Yes

  No

  N/A

• 14.22 Are fuel tanks free from leaks and equipped with caps?

  Yes

  No

  N/A

• 14.23 Are mud flaps present where required?

  Yes

  No

  N/A

• 14.24 If the vehicle is over width, are there flags on the widest points and oversize banners on front and rear?

  Yes

  No

  N/A

• 14.25 Are tire free of excessive wear and damage? (tread 4/32 steer, 2/32 others)

  Yes

  No

  N/A

• 14.26 Are all rims in good condition and free of bends and cracks?

  Yes

  No

  N/A

• 14.27 Are all placards in good condition and and visible on all four sides?

  Yes

  No

  N/A

• 14.28 Are electrical wires in good shape with no frays,cracks, or cuts?

  Yes

  No

  N/A

• 14.29 Other

  Yes

  No

  N/A

• 14.30 Other

  Yes

  No

  N/A

15.0 Post Job

• 15.1 Is area policed and all trash picked up? Standard: IPS Standard

  Yes

  No

  N/A

• 15.2 Are all spills cleaned up before leaving location? Standard: IPS Standard

  Yes

  No

  N/A

• 15.3 Location Clean after equipment is removed from location? Standard IPS Standard

  Yes

  No

  N/A

• 15.4 Are Drivers Logs current? Standard: DOT & IPS Standard

  Yes

  No

  N/A

• 15.5 Has a journey management been conducted? Standard: IPS Standard

  Yes

  No

  N/A

• Comments

• PIC Signature

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• Auditors Signature

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