• Conducted on

  • Location:

  • Well #:

  • AFE #:

  • Statoil Site Representative (Day):

  • Statoil Site Representative (Night):

  • Statoil Safety Representative:

  • Contractors Working on Location:

  • Stage of Drill-Out:

  • Weather Condition on Location:

Inspection Checklist

Applicable Permits:

  • JSA / SJA Completed for Each Contractor on Location with Contractor Sign-In Sheet?

  • Hot Work Permit Completed?

  • Confined Space Permit Completed and Posted?

  • Critical Lift Permit Completed?

  • Ground Disturbance Permit Completed?


  • Proper Signage in Place at the Entrance to Location?

  • No Smoking Signs and Designated Smoking Areas Signs posted?

  • Proper PPE Signage posted at entrance?

  • "Hearing Protection Required" Warning Signs are Properly Poseted?

  • Muster area Designated?

  • Warning Signs Clean and Visable?

  • Tank Battery Signs Posted?

  • Emergency Contact Information Posted on Location?

  • OSHA Poster Posted?

General Site Inspection:

  • LEL and H2S Monitors Deployed?

  • Statoil 350lbs Fire Extinguishers Deployed?

  • Statoil 30lbs Fire Extinguishers Deployed?

  • Material Safety Data Sheets (MSDS) and Shipping Papers are on Location and Easily Accessible?

  • There are No Fluid Leaks, Discharges or Spills on Location?

  • Adequate Lighting Provided?

  • Interior / Exterior Berms Present on Location?

  • There are No Trip Hazards?

  • All Vessels Labeled as to their Contents?

  • Proper PPE/FRC being worn by all personnel on Location?

  • Is a Clean and Sanitary Portable Restroom Facility provided in close proximity to the location?

  • Erected Windsock Visable?

  • Production Equipment Set?

  • Hearing Protection Provided and Available?

  • Fall Protection being utilized when Required?

  • First Aid Kit and Blood Born Pathogen Kit available on Location?

  • Are Proper Tools being Utilized for the Job at Hand?

  • Are all Tools in Proper Working Condition?

  • Adequate Handrails provided on stairs with 4 or more Risers?

  • Stairs have Non-Skid Steps and are uniform size?

  • Proper Lifting Mechanics are being Used by Personnel?

  • Dead-Men are Properly Marked with Visible Yellow Stakes?

  • Housekeeping is Good in all Work Areas?

  • Backup Alarms are Working Properly on Material Handling Equipment?

  • Seat-belts are being Used by Operator of Material Handling Equipment?

  • All Parked Vehicles are Properly Chocked?

  • Back-In Parking is being Utilized on Location?

  • Spotters are being Utilized on Location?

  • Fire Extinguishers are Properly Placed and have Current Inspection Tags?

  • Whip-Check are in Place and Cement Blocks are Set on High Pressure Lines?

  • Trucks Observing 5mph Speed Limit on Location?

  • Water-Haul Supervisor Present on Location?

Fueling Vehicles:

  • Is Fuel Transfer from Tanker Truck being Conducted Off Location?

  • Fuel Storage Tanks Properly Located and Labeled as to their Contents?

  • Grounding and Bonding is being Utilized when Refueling Equipment or Vehicles?

  • Discharge Valves, Nozzles and Hoses in Good Working Condition?

  • "Flammable" Warning Signs Properly Posted on All Sides of Storage Tanks?


  • All Electrical Equipment, Trailers and Generators are Properly Grounded?

  • All Electrical Equipment Properly Marked as to its Function?

  • "High Voltage" Warning Signs Properly Posted?

  • LOTO Devices Provided and Available?

  • All Electrical Wiring is off the Ground?

  • All Electrical Cords, Receptacles, and Plugs in Good Working Condition?

  • All Exterior Electrical Outlets are Covered?


  • Operator is Certified and the Certification is within its 3 year Validity?

  • Daily Inspection of Crane has been Completed?

  • Crane has Annual Inspection Certification?

  • Lines, Tanks, Valves, Pumps, and Other Parts of the Crane's Hydraulic System are in Good Working Condition?

  • Lifting Hooks and Lines are in Good Working Condition Free from Defects or Cracks?

  • Safety Latch on Hook is in Good Working Condition?

  • Crane's Control Levers are Clearly Marked?

  • Load Charts are Legible and Near Operator Controls?

  • Boom Angle Indicator is Working Properly?

  • Slings and Straps are in Good Working Condition and Free from Defects?

Rig Inspection:

  • Derrick Lights and Crown Light are in Good Working Condition?

  • Wind Walls are Erected and Placed Properly?

  • Locking Nuts are Properly Tightened on All Hydraulic Leveling Jacks?

  • Safeguards Properly Installed over all Moving Parts?

  • Pipe Racks are Level and Secured with Chocks in Place for Pipe?

  • Pipe Wrangler is Level and Secure?

  • Danger Area around Pipe Wrangler is Properly Marked?

  • All Fuel Tanks are Stored at the Proper Distance from Ignition Sources?

  • Guy-lines are Properly Connected to Tested Ground Anchors?

  • Guy-Lines are Properly Clamped?

  • Statoil Safety Banners are Clean and Attached to Guy-Lines?

  • Operator is at Controls?

  • Tool Pusher is Present on Location?

  • All Equipment with Motors are Located at Least 50ft from Well-Head or Ignition Source?

  • Pump is Located at Least 50ft from Well-Head and Rig Tank?

Snubbing Unit:

  • Snubbing Truck has Emergency Egress?

  • Snubbing Truck is Properly Chocked?

  • There are No Leaks on the Snubbing Unit?

Additional Findings:

Additional Findings / Issues or Concerns:

  • Issue #1:

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  • Issue #2:

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  • Issue #3:

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  • Issue #4:

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  • Issue #5:

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  • Issue #6:

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  • Issue #7:

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  • Issue #8:

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  • Issue #9:

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  • Issue #10:

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  • Statoil Safety Representative:

  • Company Man:

  • Tool Pusher:

  • Contractor Supervisor / Foreman:

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.