Rig Move Inspection

• Client

• Conducted on

  Date

• Prepared by

• Location
  Address

• Rig number?

• Tool Push

• Weather?

• Truck Push

Personal Protective Equipment

• Wearing approved Reflective Vests?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing approved Head Protection?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing approved Hand Protection?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing approved Safety Glasses?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing Fall Protection?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing approved Footwear?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing approved Fire Retardant Clothing?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

Lease Condition

• Entrance to lease safe? Hills maintained, ample room, etc.

  Safe

  At Risk

  N/A

• Indicate risk level below.

  Good but some points could be improved on

  Minor Risk

  Significant Risk

  Dangerous

Rig Equipment/tools

• Junk boxes sufficient to hold loose misc rig equipment?

  Safe

  At Risk

  N/A

• How was the junk box situation ?

  Almost Enough junk boxes

  Some junk boxes but not enough

  Junk Boxes are a load securement hazard.

  No junk boxes for Misc loose rig equipment

• Lease free of debris and spills?

  Safe

  At Risk

  N/A

• Rig mats in good condition with all shackles in working order?

  Safe

  At Risk

  N/A

• Are the shackles in good working order? The matting is not broken or warped? Has the matting been cleaned for transport ?

• Select Shackles are in good working order. Matting not broken or warped. Matting Cleaned for transport.

  • Shackles are in good working order.
  • Matting not broken or warped.
  • Matting Cleaned for transport.

• Mixing bins have been emptied and ready for transport ?

  Safe

  At Risk

  N/A

• How bad are the mixing bins?

  Mixing bins have very little debris but some remain.

  Mixing bins are not empty.

  Mixing bins are full to the point of being a weight issue.

• Pipe is ready for transport and properly stored off the ground to prevent injury during sling up?

  Safe

  At Risk

  N/A

• Illumination for work site adequate?

  Safe

  At Risk

  N/A

• How is the lighting on location.

  Decent attempt at lighting location

  Dark in a few work areas

  Dark in most areas

  No lighting

• Hand tools are in good condition?

  Safe

  At Risk

  N/A

• Pipe tubs clear of junk and not overloaded?

  Safe

  At Risk

  N/A

First Aid

• First aid supplies?

  Safe

  At Risk

  N/A

• First Aid Certifcation?

  Yes

  No

  N/A

• Ambulance ?

  Yes

  No

  N/A

Safety Meeting

• Safety meeting held and copies of minutes completed / Prior to Rig up / Tear Down?

  Yes

  No

  N/A

• Workers Visibility ?

  Safe

  At Risk

  N/A

• Workers not in unsafe Positions?

  Safe

  At Risk

  N/A

• Sufficient signallers?

  Safe

  At Risk

  N/A

• Over head power lines identified and safe work clearance ensured?

  Safe

  At Risk

  N/A

• Warning signs in place?

  Yes

  No

  N/A

• Designated signal persons where applicable ?

  Yes

  No

  N/A

• Procedures in place?

  Yes

  No

  N/A

• Green hats Identified?

  Yes

  No

  N/A

WHMIS

• Work site labels in place?

  Yes

  No

  N/A

• Worker training in place?

  Yes

  No

  N/A

• Location of MSDS made known?

  Yes

  No

  N/A

TDG

• Training in place?

  Yes

  No

  N/A

• Placarding supplied to trucking company?

  Yes

  No

  N/A

Personal Protective Equipment

• Wearing Approved Fire Retardant Clothing?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing Approved Fall Protection?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing Approved Safety Glasses?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing Approved Reflective Vests?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing Approved Foot Wear?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

• Wearing Approved Head Protection?

  Safe

  At Risk

  N/A

• What is the severity of Non-Compliance?

  One Short isolated Incident

  One prolonged Incident

  Multiple Incidents

  Defiance of Policy

• Short Duration Infraction. Isolated to one individual over a short period of time.

• Longer duration or multiple short duration infractions involving one individual.

• Multiple infractions involving multiple individuals.

• Disregard of policy or ignorance of policies.

Rigging Equipment and Trucks

• Condition of winch lines?

  Safe

  At Risk

  N/A

• Condition of Hooks?

  Safe

  At Risk

  N/A

• Condition of Slings

  Safe

  At Risk

  N/A

• Condition of Truck Beds

  Safe

  At Risk

  N/A

• Trucks in good working order. No leaks, body damage, lights functioning?

  Yes

  No

  N/A

• Trucks back up alarms working and audible?

  Yes

  No

  N/A

• Picker / Crane Operator Certifaction?

  Yes

  No

  N/A

• Picker / Crane Inspection Certification Valid?

  Yes

  No

  N/A

• No riders on moving equipment?

  Safe

  At Risk

  N/A

• Tag lines utilized and in good condition?

  Safe

  At Risk

  N/A

First Aid

• Personnel trained in required First Aid

  Yes

  No

  N/A

Safety Meeting

• Safety meeting held and copies of minutes completed / Prior to Rig up / Tear Down?

  Yes

  No

  N/A

• Workers Visibilty?

  Safe

  At Risk

  N/A

• Workers not in unsafe positions?

  Safe

  At Risk

  N/A

• Sufficient signallers?

  Yes

  No

  N/A

• Over head power lines identified and safe work clearance ensured?

  Yes

  No

  N/A

• Warning signs in place?

  Yes

  No

  N/A

• Designated signal persons where applicable ?

  Yes

  No

  N/A

• Critical Lift Meetings held where applicable?

  Yes

  No

  N/A

• Procedures in place?

  Yes

  No

  N/A

• Green hats Identified?

  Yes

  No

  N/A

TDG

• Personnel Trained in TDG?

  Yes

  No

  N/A

• Material Loading Tickets utilized and current ?

  Yes

  No

  N/A