Inspection Information
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Conducted On:
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Location:
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Statoil Site Representative:
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Statoil Safety Representative:
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Contractors Working on Location:
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Equipment on Location:
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Status of Operations:
Inspection Check List
Signage:
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Safety Billboard in Place?
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PPE & FRC's signage in Place at Entrance?
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Lease Signs in Place?
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No Smoking Signage at the Entrance of Location?
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Confined Space Labels in Correct Location on Tanks?
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Tanks Labeled with Placards in Place?
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LACT Unit Building Labeled?
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Saltwater Pump Room Labeled?
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Electrical Room Labeled?
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Electrical Breakers Properly Indicated?
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Electrical Board Panels with Warning Labels in Place?
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All Containers Labeled with their Contents?
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Hearing Protection Signage in Place?
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Automatic Start Signage in Place?
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Stay Off Berm Signage in Place?
Applicable Permits
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JSA / SJA Completed with Contractor Sign-in Sheet?
General Site Inspection:
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Interior / Exterior Berm in Place?
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Knife Gate Valve Closed and Secured with Lock & Chain?
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Dead Man Marked / Visible and within its Life Expectancy?
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All Caps and Plugs in Place?
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Plumbing Appeared to Teflon Tape on all Threads?
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Tanks, Walkways, Stairs Properly Grounded?
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Grounds Available for Transport while Loading and Unloading?
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Stairs and Catwalk Secured on Tanks with Two Threads Showing on Bolts?
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Adequate Hand-Rails Provided on Stairs and Catwalk?
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Windsock Up and Visible and in Good Shape?
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Are Chemicals Stored Properly with SDS Available?
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Electrical Covers in Place?
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Location Clean with Pathways Clear (No Obstructions)?
Contractor Inspection
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All Crew Members Wearing Proper PPE & FRC's?
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H2S Monitors Being Utilized?
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Fall Protection Being Utilized?
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First Aid Kit Available on Location?
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Good Housekeeping with Work Area Clean and Organized?
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Crew Utilizing Proper Lockout / Tag Out?
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Roll Over Protection in Place with No Obvious Defects?
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Fire Watch Being Utilized?
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Spotter Be Utilized while Equipment is in Operations?
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Backup Alarms on Equipment Working Properly?
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Contractor Equipment on Location Appears to Have no Fluid Leaking?
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Does Contractor Equipment on Location Have Seat Belts (Being Utilized by Operator)?
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Are Pipe Thread Cuttings be Collected?
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Are Chock Blocks Being Utilized?
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Are Compressed Cylinder Tanks Secured Upright with Valve Caps in Place?
General Facility Inspection (Office, Pipe Yard, SWD, Oil Facilities)
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Eye Wash Station Up to Date and Available?
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Hearing Protection Available?
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Flammable Storage Cabinet Being Utilized?
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SDS Binders at Location with Updated SDS Sheets?
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No Combustibles Being Kept in Electrical Room?
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Is all Electrical Wiring Incased in Conduit with Covers in Place?
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Are Rubber Mats in Place on Flooring of Electrical Building?
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Oil Facility Pressure Relief Valve was in the Locked Open Position?
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Are All Transformers Enclosed with Safety Barrier (Bollards)?
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Underground Injection Control (UIC) Permit Available?
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Spill Prevention Control and Countermeasure Plan (SPCC) Available?
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Facilities Response Plan (FRP) Available?
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Fire Extinguishers Available with Monthly/ Annual Inspection Completed?
Additional Findings
Additional Findings or Concerns:
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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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Approval
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Statoil Safety Representative:
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Consultant / Company Man:
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Contractor Supervisor / Foreman:
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Person In Charge (PIC):
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