Inspection Information

  • Conducted On:

  • Location:

  • Statoil Site Representative:

  • Statoil Safety Representative:

  • Contractors Working on Location:

  • Equipment on Location:

  • Status of Operations:

Inspection Check List


  • 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?

  • Separator Building Labeled?

  • Heater Treater Building Labeled?

  • Generator Fuel Tank Labeled?

  • Electrical Room Labeled?

  • Electrical Breakers Properly Indicated?

  • Electrical Board Panels with Warning Labels in Place?

  • Pumping Unit Safety Warning Labels in Place?

  • All Containers Labeled with their Contents?

  • Automatic Start Signage in Place?

  • Stay Off Berm Signage in Place?

Applicable Permits

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

  • Ground Disturbance Permit Completed?

  • Hot Work Permit Completed?

  • Confined Space Permit Completed and Posted?

  • Critical Lift Permit Completed?

General Site Inspection:

  • Interior / Exterior Berm or Containment Walls in Place?

  • Pinch Valve Closed and Secured with Lock & Chain?

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

  • Pumping Unit Safety Guards in Place, Ladders with Fall Protection Cage?

  • Ignitor Wire Functioning?

  • All Caps and Plugs in Place?

  • Plumbing Appeared to Teflon Tape on all Threads?

  • Heater Treater Ladder with Fall Protection Cage in Place?

  • 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 MSDS 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?

  • Utilizing Safety Glasses/Grinding Shields while Grinding?

  • First Aid Kit Available on Location?

  • Fire Extinguishers Available with Monthly / Annual Inspection Completed?

  • Crew Utilizing Proper Tools for Job Functions?

  • Crew Using Proper Lifting Techniques?

  • Tools with Safety Guards in Place?

  • 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?

  • 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?

  • Proper Rigging Techniques are Being Utilized while Lifting Loads?

  • Inspected Tag Lines are Being Utilized when Lifting Loads?

  • Rigging Equipment Appears to be in Good Working Condition?

Contractors Excavating and Trenching

  • Caution Tape / Barriers Fencing Off Around Open Pits and Trenches?

  • All Bell Holes are Properly Sloped and/or Benched?

  • Ladders, Steps, or Ramps Located in Bell Hole so No More than 25ft of Lateral Travel is Required?

  • Excavated Soil, Other Material, Or Equipment are Stored at Least 2ft from the Edge of the Excavation?

Additional Findings

Additional Findings or Concerns:

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  • Issue #2:

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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:

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  • Consultant / Company Man:

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  • Contractor Supervisor / Foreman:

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