Risk Assessment - Oil & Gas Field Location

• Operator

• Location Name / Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Other Personnel on site

Entrance

• Location Sign

  Yes

  No

  N/A

• Muster Area Sign

  Yes

  No

  N/A

Driving Surface

• Gravel/Scoria present?

  Yes

  No

  N/A

• Is location free of mud?

  Yes

  No

  N/A

• Is location free of snow / ice?

  Yes

  No

  N/A

• Is location free of standing water?

  Yes

  No

  N/A

• Is the drive path accessible?

  Yes

  No

  N/A

• Is the drive path free of tools / equipment?

  Yes

  No

  N/A

• Are the deadmen clearly marked?

  Yes

  No

  N/A

• Are the deadmen free of damage?

  Yes

  No

  N/A

• Is the drive path clear of obstructions? (Work-over, etc.)

  Yes

  No

  N/A

Plumbing

• Is the Getty Box free of damage / corrosion?

  Yes

  No

  N/A

• All valves free of damage?

  Yes

  No

  N/A

• All pipes and flow lines free of damage?

  Yes

  No

  N/A

• All pipe or flow line INSULATION free of damage?

  Yes

  No

  N/A

Infrastructure

• Tank battery containment wall free of damage?

  Yes

  No

  N/A

• Location outer containment free of damage?

  Yes

  No

  N/A

• All other barriers free of damage?

  Yes

  No

  N/A

• Location fence free of damage?

  Yes

  No

  N/A

• All doors / windows free of damage?

  Yes

  No

  N/A

Atmospheric Hazards

• H2S / Hydrogen Sulfide

  Safe

  At Risk

  N/A

• O2 / Oxygen

  Safe

  At Risk

  N/A

• CO / Carbon Monoxide

  Safe

  At Risk

  N/A

• LEL / Lower Explosive Limit

  Safe

  At Risk

  N/A

• Natural Gas / Methane

  Safe

  At Risk

  N/A

• Any other Atmospheric Hazard (dust, smoke, etc.)

  Safe

  At Risk

  N/A

Breathing Air System

• Air Cylinder on location?

  Yes

  No

  N/A

• Masks available on location?

  Yes

  No

  N/A

• Condition of hose line?

  Safe

  At Risk

  N/A

Fluid Leak / Spill

• Well head free of any fluid?

  Yes

  No

  N/A

• Tanks / Tank Battery free of any fluid?

  Yes

  No

  N/A

• Treater free of any fluid?

  Yes

  No

  N/A

• Fresh water tank free of any fluid?

  Yes

  No

  N/A

Safety Signs

• Windsock visible?

  Yes

  No

  N/A

• Condition of windsock?

  Safe

  At Risk

  N/A

• 'H2S May Be Present' signs?

  Yes

  No

  N/A

• 'PPE Required' sign?

  Yes

  No

  N/A

• 'High Voltage' signs?

  Yes

  No

  N/A

• 'Dangerous Noise' signs?

  Yes

  No

  N/A

• 'Equipment Starts/Stops Automatically' signs?

  Yes

  No

  N/A

• 'Hazardous Chemicals' signs?

  Yes

  No

  N/A

• 'High Pressure' signs?

  Yes

  No

  N/A

• 'No Smoking/Open Flame' signs?

  Yes

  No

  N/A

• 'Permit Required Confined Space' signs?

  Yes

  No

  N/A

• 'First Aid Kit' signs?

  Yes

  No

  N/A

• 'Fire Extinguisher' signs?

  Yes

  No

  N/A

• 'Eyewash' signs?

  Yes

  No

  N/A

Walking / Working Surfaces

• General location walking surface?

  Safe

  At Risk

  N/A

• Containment / Berm walkover stairs?

  Safe

  At Risk

  N/A

• Tank battery stairs?

  Safe

  At Risk

  N/A

• Tank battery catwalk?

  Safe

  At Risk

  N/A

• General stairs?

  Safe

  At Risk

  N/A

• Fixed ladders?

  Safe

  At Risk

  N/A

• Trench / Excavation / Open Hole?

  Safe

  At Risk

  N/A

Fire / Explosion Hazards

• Flare condition?

  Safe

  At Risk

  N/A

• Fixed electrical equipment?

  Safe

  At Risk

  N/A

• Temporary electrical equipment?

  Safe

  At Risk

  N/A

• Pumps / Motors?

  Safe

  At Risk

  N/A

• Smoking area off site?

  Yes

  No

  N/A

• Combustible material near ignition source?

  Safe

  At Risk

  N/A

• Grounding clamp available?

  Yes

  No

  N/A

Other:

• Any other hazard?

  Safe

  At Risk

  N/A

• Any other hazard?

  Safe

  At Risk

  N/A

• Any other hazard?

  Safe

  At Risk

  N/A

• Any other hazard?

  Safe

  At Risk

  N/A

Sign Off

• Auditor's signature

  Sign