Inspection Information

  • Conducted On:

  • Location:

  • Statoil Site Representative:

  • Statoil Safety Representative:

  • Contractors Working on Location:

  • Equipment on Location:

  • Status of Operations:

Inspection Check List

Applicable Permits:

  • JSA / SJA Completed with Contractor Sign-in Sheet

  • Ground Disturbance Permit Completed

  • Hot Work Permit Completed

  • Confined Space Permit Completed and Posted

General Inspection:

  • All Crew Members Wearing Proper PPE & FRC's

  • H2S Monitors Being Utilized

  • Fall Protection Being Utilized

  • First Aid Kit Available on Location

  • Fire Extinguishers On Location with Current Inspection

  • Crew Utilizing Proper Tools for Job

  • 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

  • Are Pipe Thread Cuttings be Collected

Material Handling Equipment:

  • Spotter Be Utilized while Equipment is in Operations

  • Backup Alarms on Equipment Working Properly

  • Roll Over Protection in Place with No Obvious Defects

  • Equipment on Location in Good Working Condition (No Fluid Leaks)

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

  • Rigging Equipment (Side Boom Pulleys, Pins, and Wire Rope) Appears to be in Good Working Condition

  • Inspected Tag Lines are Being Utilized when Lifting Loads

  • Proper Rigging Techniques are Being Utilized while Lifting Loads


  • Fire Watch Being Utilized

  • Utilizing Safety Glasses/Grinding Shields while Grinding

  • Are Compressed Cylinder Tanks (Oxygen/Acetylene) Labeled, Secured Upright, and Valve Caps in Place

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

  • Is Operator Exposing Charged Line in Safe Manner (Potholing, Positive ID, Probing Etc..)

  • Are Warning Signs Being Utilized and Safe Distance Being Maintained for Hydro-Testing Area

  • Are Warning Signs Being Utilized and Safe Distance Being Maintained for X-Ray Area

  • Proper Respirators Being Utilized


  • All Material Contained (No Spills on Location)

Additional Findings

Additional Findings or Concerns:

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  • Issue #2:

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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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  • Contractor Supervisor / Foreman:

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  • Person In Charge (PIC):

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