Title Page

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

Policy & Procedure

  • Have your employees read Pioneer's "Safety Principles" and agree to follow them?

  • Have your employees read Pioneer's "Rules to Live By" and agree to follow them?

  • All PPE in use where & when required?

  • Are live electrical components de-energized prior to working on or near them?

  • Are JSA's being performed and documented?

  • Are Lock Out / Tag Out procedures being used and documented?

  • Are employees attending Pre-Tour & Safety meetings?

  • Do employees follow all lease or ranch posted speed limits?

Environmental

  • Are Berms in place & functional around all SCE?

  • Is the overflow on Torpedo Tank plumbed back into the Active System?

  • Are drip pans being used?

  • Are all openings in drip pans properly plugged to prevent fluid from escaping drip pan?

  • Are drip pans empty at this time?

  • Is the work area clean of any excess oil & dirt?

Signs & Placards

  • Are "Fall Protection Required " signs posted in all location where needed?

  • Are "Danger High Voltage" signs posted where needed?

Equipment

  • Are all hand rails in place & properly secured?

  • Is grating on shaker tank secure?

  • Are brackets that secure shakers to tank in good condition?

  • Are all pins & keepers for hand rails and walkways in place and secured?

  • Is grating on Polishing Centrifuge Stand secure?

  • Do the legs on the Polishing Centrifuge Stand have proper pins and keepers in place?

  • Is grating on Active Centrifuge Stand secure?

  • Are motors and electrical panels free of excessive oil and dirt?

  • Do the legs on the Active Centrifuge Stand have proper pins and keepers in place?

  • Is the ladder on Polishing Centrifuge Stand properly secured to the stand?

  • Is the effluent line of Polishing Centrifuge secure?

  • Is the ladder on the Active Centrifuge Stand properly secured to the stand?

  • Has blue glue and tap screws been used on the Polishing Centrifuge effluent line?

  • Has blue glue and tap screws been used on the Active Centrifuge effluent line?

  • Is the effluent line of Active Centrifuge secure?

  • Has blue glue and tap screws been used on overflow line from Torpedo Tank?

  • Is connection from effluent discharge on Polishing Centrifuge to effluent line secure?

  • Are all hoses in good condition?

  • Are "goose necks" being used where hoses go over tank top edge?

  • Is connection from effluent discharge on Active Centrifuge to effluent line secure?

  • Are all connections Hammer Unions or Flanged?

  • Do all hoses with any pressure have Whip Checks?

  • Are all tank openings Bull Plugged or Blind Flanged?

  • Are all hoses Factory made?

  • There are no visible drips on effluent or overflow lines correct?

  • Is Fall Protection device in place where needed?

  • Is harness & lanyard readily available?

  • Is excavator being inspected for damages and documented prior to each tour?

Electrical

  • Is the Active Centrifuge grounded?

  • Is effluent tank grounded?

  • Are the VFD Panel doors secured, air & water tight?

  • Is the Polishing Centrifuge grounded?

  • Is the Polishing Centrifuge Pump grounded?

  • Is the Polishing Centrifuge Stand grounded?

  • Is the Active Centrifuge Stand grounded?

  • Do all electrical panels have "High Voltage" stickers?

  • Is the Active Centrifuge Pump grounded?

  • Electrical plugs to panel have no wire showing, correct?

  • Are all electrical panels grounded?

  • Are all electrical caps secured on all unused outlets?

  • Are all electrical plugs plugged in properly and securely?

  • Do Shaker stop / start panels have all bolts secured?

  • Are all electrical lines tied off with black zip ties or cable?

  • Do all ground rods have impalement caps?

  • Are Drying Shakers grounded?

  • Is there sufficient lighting in the backyard?

House Keeping

  • Is office & equipment clean and in order?

  • Is living quarters clean and in order?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.