Inspection Information

  • Conducted On:

  • Location:

  • Statoil Site Representative:

  • Statoil Safety Representative:

  • Contractors Working on Location:

  • Equipment on Location:

  • Status of Operations:

Inspection Check List

Signage:

  • Safety Billboard in Place?

  • PPE & FRC's signage in Place at Entrance?

  • Lease Signs in Place?

  • No Smoking Signage at the Entrance of Location?

  • Confined Space Labels in Correct Location on Tanks?

  • Tanks Labeled with Placards in Place?

  • LACT Unit Building Labeled?

  • Saltwater Pump Room Labeled?

  • Electrical Room Labeled?

  • Electrical Breakers Properly Indicated?

  • Electrical Board Panels with Warning Labels in Place?

  • All Containers Labeled with their Contents?

  • Hearing Protection Signage in Place?

  • Automatic Start Signage in Place?

  • Stay Off Berm Signage in Place?

Applicable Permits

  • JSA / SJA Completed with Contractor Sign-in Sheet?

General Site Inspection:

  • Interior / Exterior Berm in Place?

  • Knife Gate Valve Closed and Secured with Lock & Chain?

  • Dead Man Marked / Visible and within its Life Expectancy?

  • All Caps and Plugs in Place?

  • Plumbing Appeared to Teflon Tape on all Threads?

  • Tanks, Walkways, Stairs Properly Grounded?

  • Grounds Available for Transport while Loading and Unloading?

  • Stairs and Catwalk Secured on Tanks with Two Threads Showing on Bolts?

  • Adequate Hand-Rails Provided on Stairs and Catwalk?

  • Windsock Up and Visible and in Good Shape?

  • Are Chemicals Stored Properly with SDS Available?

  • Electrical Covers in Place?

  • Location Clean with Pathways Clear (No Obstructions)?

Contractor Inspection

  • All Crew Members Wearing Proper PPE & FRC's?

  • H2S Monitors Being Utilized?

  • Fall Protection Being Utilized?

  • First Aid Kit Available on Location?

  • Good Housekeeping with Work Area Clean and Organized?

  • Crew Utilizing Proper Lockout / Tag Out?

  • Roll Over Protection in Place with No Obvious Defects?

  • Fire Watch Being Utilized?

  • Spotter Be Utilized while Equipment is in Operations?

  • Backup Alarms on Equipment Working Properly?

  • Contractor Equipment on Location Appears to Have no Fluid Leaking?

  • Does Contractor Equipment on Location Have Seat Belts (Being Utilized by Operator)?

  • Are Pipe Thread Cuttings be Collected?

  • Are Chock Blocks Being Utilized?

  • Are Compressed Cylinder Tanks Secured Upright with Valve Caps in Place?

General Facility Inspection (Office, Pipe Yard, SWD, Oil Facilities)

  • Eye Wash Station Up to Date and Available?

  • Hearing Protection Available?

  • Flammable Storage Cabinet Being Utilized?

  • SDS Binders at Location with Updated SDS Sheets?

  • No Combustibles Being Kept in Electrical Room?

  • Is all Electrical Wiring Incased in Conduit with Covers in Place?

  • Are Rubber Mats in Place on Flooring of Electrical Building?

  • Oil Facility Pressure Relief Valve was in the Locked Open Position?

  • Are All Transformers Enclosed with Safety Barrier (Bollards)?

  • Underground Injection Control (UIC) Permit Available?

  • Spill Prevention Control and Countermeasure Plan (SPCC) Available?

  • Facilities Response Plan (FRP) Available?

  • Fire Extinguishers Available with Monthly/ Annual Inspection Completed?

Additional Findings

Additional Findings or Concerns:

  • Issue #1:

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  • Issue #2:

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  • Issue #9:

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Approval

  • 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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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.