TES FIELD SAFETY AUDIT

• Audit No.

• Pickup Unit #

• Field Supervisor

• Logging Unit #

• Operator

• Operator

• Other

• Conducted on

  Date

• Prepared by

• Location
  Address

• Client

• LSD

• Client Rep

Logging Unit Exterior

• Placards Displayed

  Yes

  No

  N/A

• Tire Condition

  Yes

  No

  N/A

• Fire Extinguisher

  Yes

  No

  N/A

• Wheel Chocks

  Yes

  No

  N/A

• Lights

  Yes

  No

  N/A

• Lug Nuts

  Yes

  No

  N/A

Logging Unit Drivers Cab

• Pre-Trip Inspection

  Yes

  No

  N/A

• Log Books

  Yes

  No

  N/A

• CVIP Certificate

  Yes

  No

  N/A

• Insurance, Registration, Cab Card

  Yes

  No

  N/A

• Air Brakes Applied

  Yes

  No

  N/A

• Accident Kit

  Yes

  No

  N/A

• Truck Binder

  Yes

  No

  N/A

• Steering Wheel Club

  Yes

  No

  N/A

• PTO Service Record

  Yes

  No

  N/A

Logging Unit Recording Cab

• Fire Extinguisher

  Yes

  No

  N/A

• Eye Wash Station

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• Safety Policy

  Yes

  No

  N/A

• Safety Manual

  Yes

  No

  N/A

• Radiation Safety Manual

  Yes

  No

  N/A

• MSDS Binder

  Yes

  No

  N/A

• Hoisting Equipment Certificates

  Yes

  No

  N/A

Logging Unit Equipment

• Sheaves

  Yes

  No

  N/A

• Pin Wrenches

  Yes

  No

  N/A

• Sheave Sling(s) (bottom)

  Yes

  No

  N/A

• Hoisting Handcuffs

  Yes

  No

  N/A

• Rubber Source Catcher

  Yes

  No

  N/A

• C-Plate

  Yes

  No

  N/A

• Brass Thread Protectors

  Yes

  No

  N/A

• Clevis(s)

  Yes

  No

  N/A

• Sheave Hanger (upper)

  Yes

  No

  N/A

• Lubricator Sling

  Yes

  No

  N/A

• Line Clamp

  Yes

  No

  N/A

• Pipe Wrenches

  Yes

  No

  N/A

Radiation Equipment and Procedures

• Yes

  No

  N/A

• TLD Badges

  Yes

  No

  N/A

• Time/Distance/Shielding

  Yes

  No

  N/A

• ALARA (As Low As Reasonably Achievable)

  Yes

  No

  N/A

• CNSC/TESCa Exposure Limits

  Yes

  No

  N/A

• Type "A" Containers

  Yes

  No

  N/A

• Source Handling Tool(s)

  Yes

  No

  N/A

• Radiation Warning Sign

  Yes

  No

  N/A

• Radiation Survey Meter

  Yes

  No

  N/A

• Source Handling

  Yes

  No

  N/A

• Unauthorized Personnel Removed

  Yes

  No

  N/A

• Radioactive Materials Transfer Form

  Yes

  No

  N/A

Explosives Equipment and Procedures

• Pre-Blast Safety Meeting

  Yes

  No

  N/A

• Perforating Warning Sign

  Yes

  No

  N/A

• Check Fire Light

  Yes

  No

  N/A

• Detonator Tube(s)

  Yes

  No

  N/A

• Stray Voltage

  Yes

  No

  N/A

• Transmitting Devices

  Yes

  No

  N/A

• Safety Key

  Yes

  No

  N/A

• Logger Generator

  Yes

  No

  N/A

• Magazines

  Yes

  No

  N/A

• Unauthorized Personnel

  Yes

  No

  N/A

• Smoking

  Yes

  No

  N/A

• Transported Guns

  Yes

  No

  N/A

Pressure Control

• Certificates for all Pressure Gear

  Yes

  No

  N/A

• Needle Valve and Pressure Gauge

  Yes

  No

  N/A

• O-Rings Checked or Replaced

  Yes

  No

  N/A

• Flange Ring in Good Condition

  Yes

  No

  N/A

• Pack-Off Pump Working

  Yes

  No

  N/A

• Pack-Off Rubber in Good Condition

  Yes

  No

  N/A

• Wellhead Bolts Tight

  Yes

  No

  N/A

• Return Hose Tied Down

  Yes

  No

  N/A

• Operator at Injector at All Times

  Yes

  No

  N/A

• Enough/Proper Grease for Job

  Yes

  No

  N/A

• Clean Equipment Brought to Site

  Yes

  No

  N/A

• Thread Protectors Used

  Yes

  No

  N/A

• Yes

  No

  N/A

• Flange Ring Groove Clean and in Good Condition

  Yes

  No

  N/A

Crew PPE/Documentation

• Hard Hat

  Yes

  No

  N/A

• Safety Footwear

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Safety Certificates

  Yes

  No

  N/A

• Fire Retardant Coveralls

  Yes

  No

  N/A

• FLRA Completed and Signed

  Yes

  No

  N/A

• Clean Shaven

  Yes

  No

  N/A

Pickup Truck

• Windshield

  Yes

  No

  N/A

• No Body Damage

  Yes

  No

  N/A

• Lights

  Yes

  No

  N/A

• Tires

  Yes

  No

  N/A

• Two-Way Radio

  Yes

  No

  N/A

• Fire Extinguisher, First Aid Kit

  Yes

  No

  N/A

• Safety Triangles

  Yes

  No

  N/A

• Documents

  Yes

  No

  N/A

• Steering Wheel Club

  Yes

  No

  N/A

• Accident Kit

  Yes

  No

  N/A

• Cargo Securement Devices

  Yes

  No

  N/A

• Placards

  Yes

  No

  N/A

Crane

• Daily Inspection completed.

  Yes

  No

  N/A

• FLRA / Critical Lift completed.

  Yes

  No

  N/A

• Certifications for all hoisting equipment.

  Yes

  No

  N/A

• Chains & Load Binders

  Yes

  No

  N/A

• Outriggers $ Pads.

  Yes

  No

  N/A

• Pad Charts

  Yes

  No

  N/A

• Crane Certification.

  Yes

  No

  N/A

• Auditor Comments

• Auditor Signature

  Sign