Payzone Completion Services Flare Stack Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

Well Information

• Customer:

• Well Name:

• Asset Number:

• Owned or Rental? If rental, who does the equipment belong to?

• Add location
  Address

• Select date

  Date

Job Box

• Hydraulic Fluid Levels in Reservoir Acceptable?

  Safe

  At Risk

  N/A

• Function Test Remote- Up & Down

  Yes

  No

  N/A

• Hydraulic Jack Moving Up/Down?

  Yes

  No

  N/A

• Battery in working order?

  Yes

  No

  N/A

• Igniter Control Panel Connections Secured?

  Yes

  No

  N/A

• Function Test Igniter- Functioning Properly

  Yes

  No

  N/A

Trailer

• FMCSA Annual Inspection Sticker Present

  Yes

  No

  N/A

• Trailer Fit for Travel - Tires, Towing Chains, Break Away Cable, Lights Wiring, Leveling Jack etc.

  Yes

  No

  N/A

• Propane Tank Full and Secured? Warning Stickers Visible?

  Yes

  No

  N/A

• SDS for Propane

  Yes

  No

  N/A

• Spare Tire Present?

  Yes

  No

  N/A

• Left and Right Jacks Working Properly on Stabilizers

  Yes

  No

  N/A

• Stabilizer Locking Pin Secured

  Yes

  No

  N/A

• Turnbuckles Present on all 3 Wire Cables

  Yes

  No

  N/A

• Wire Cables In Good Condition

  Yes

  No

  N/A

• Wire Cable Clamps Installed Properly - "Never Saddle A Dead Horse" - 3 Clamps per cable

  Yes

  No

  N/A

• 3" Plumbing Secured- Unions, Flanges, Threads etc.

  Yes

  No

  N/A

Stack

• Stack Tube Straight- Not bent or damaged.

  Yes

  No

  N/A

• Damage to Horn?

  Yes

  No

  N/A

• D- Rings for Cables Present? Welds Not Cracked?

  Yes

  No

  N/A

• Pin in place with keeper while transporting or not in use?

  Yes

  No

  N/A

• Visual Inspection Inside Horn for trash or debris

  Yes

  No

  N/A

• Other Information that Requires Attention Not Listed On This Check List

• I agree this inspection as completed to the best of my abilities.

  Sign