Title Page

  • Area/Field

  • Well/Battery

  • Conducted on

  • EHS Representative

  • Location

Location (General)

  • Gate and Cattle Guard operational?

  • Well sign is posted with No Smoking and authorized personnel only?

  • Location properly identified with the lease sign containing Operator Information, Emergency Numbers and Well Name?

  • Describe the location/Equipment

  • Is the pumping unit properly guarded?

  • Are the automatic start signs visible?

  • Is there any ongoing pollution?

  • Are there any Oil Stains around the well head or gear box?

  • How many water tanks?

  • How many Oil Tanks?

  • How many Heater Treaters?

  • How many Separators?

  • List any other Equipment not listed above.

  • Are the tank valves close?

  • Are the load lines inside containment?

  • Are the load line valves closed?

  • Are the load line pots in good condition?

  • Is the firewall in good condition?

  • Is the perimeter fencing in good condition?

  • Are there any Overhead Power lines across the location?

  • Is the location free of trash?

  • Is the location free of weeds?

  • Is the location free of unused or junk equipment?

  • Are the deadman anchors marked?

  • Is the well pad in good condition?

  • Are all the above ground piping and flow lines in good conditions and free of leaks?

Electrical

  • Are the electric motors grounded?

  • Are there automatic start signs where necessary?

  • Is the conduit and wiring in acceptable condition?

  • Are all the electrical panels and switch gear properly labeled?

Guarding:

  • Are all belts and pulleys totally enclosed?

  • Are fans, flywheels and other moving parts properly guarded?

  • Are all sight glasses guarded and in good condition?

  • Are open cellars, valve boxes or open holes properly covered or identified?

Tank Battery:

  • Are all H2S warning signs up?

  • Are all wind socks in good condition and functional?

  • Do tanks have Identification numbers?

  • Do tanks have the proper placards and labels

  • Do all tanks appear to have good integrity and free of leaks?

  • Are the stairs to the catwalk in good condition?

  • Are there fall protection cages on fixed ladders above 20 feet?

  • Are there top-rail mid-rail and toe boards on the catwalks?

  • Do the thief hatches appear to be in good condition and sealed?

  • Is the dike walkover in good condition and being used?

  • Are the tank foundations in good condition and free of washouts or undercutting?

Heaters/Separators/Dehydration Units

  • Are the vessels stamped with allowable test pressures?

  • Are all pressure gauges operational?

  • Are all pressure vessels protected with relief valves?

  • Do all relief valves discharge up?

  • Does the maximum allowed vessel pressure and pressure relief valve set at or below the vessels max pressure?

  • Are all bolts in place around the the flame arrester, fire tube and inspection plate?

  • Are open ended valves protected with bull plugs and or handle removal?

  • Are there any visible leaks?

  • Do all fired vessels have stack covers to prevent wildlife entry?

Compressors:

  • Do the compressor skids have drip pans?

  • Are drip rail plugs installed?

  • Are hearing protection signs posted?

  • Are the lube oil tanks properly labeled as to manufacture guidelines?

  • Do all lubrication oil tanks over 55 gallons have secondary containment?

  • Is the bulk lube oil containment empty?

Chemical Tanks:

  • Are supply lines free of leaks and damage?

  • Are supply lines equipped with isolation valves?

  • Are chemical tanks properly labeled as to the manufacturer guidelines?

  • All chemical tanks over 55 gallons equipped with secondary containment?

  • Is the secondary containment free of chemical or rainwater?

  • Has an SDS been provided for each chemical being used?

Additional comments and photos:

  • Comments

  • Photos

  • EHS Representative Signature.

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