Title Page

  • Location Name

  • Foreman

  • Safety Captain

  • Conducted on

  • Expected Completion Date

  • Prepared by


  • Is there cattle panels in place around production tree?

  • Is the walking/working surface smooth and free of obstruction in the entrance and/or location?

  • Are the weeds controlled?

  • Is the facility fenced or blocked off?

  • Is an emergency number posted?

  • Is the entrance signage properly displayed on location?

  • Are there H2S signs in the appropriate areas?

  • Is there a PPE Required sign on location?


  • Structural support good? Stairways and Catwalks in good condition?

  • Are there chains with signage across stairs?

  • Does the tank(s) have NFPA labels?

  • Are the tanks/load lines grounded

  • Do the thief hatches close and latch properly?

  • Is the Enardo Valve in place?

  • Are the thief hatch gaskets in good condition?

  • Is there a wind sock in place?

  • Are there lightning eliminators in place?

  • Are the Berms/Firewalls in good condition?

  • Is there a working Murphy Meter/other gauge in place?


  • Level indicators functioning and not damaged?

  • Has the Pineapple been inspected?

  • Are the pressure gauges in good condition?

  • Are weep holes in place on low and high pressure separators?

  • Are the car seals in place on the relief valves?

  • Are the relief valves anchored?


  • Is the compressor unit(s) have hearing protection sign signs?

  • Is the compressor grounded?

  • Is the compressor oils leaks contained within the skid?


  • Is the fire extinguisher checked and inspected?

  • Is there a SCBA properly staged with signage?

  • Additional Comments

  • Safety Tech

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