Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

  • Supervisor in Charge

  • Customer

  • Well Name

  • State

  • Home Terminal

Pre-Trip Safety

  • Vehicle Pre-trip inspections complete?

  • Convoy Briefing Complete?

  • Equipment Secured?

  • Tractor and trailer paperwork Present and Current?

  • Drivers logs Up to date?

Pre-job Safety Meeting

  • JSA Completed?

  • Everyone Present?

  • Job hazards Identified?

  • Out line of services being performed?

  • Job responsibilities outlined?

  • Restricted work areas identified?

  • Other?

Safety Equipment being used

  • Hard hats

  • Safety glasses

  • Gloves

  • Hearing protection

  • Gas detectors

  • Breathing apparatus

  • Safety harness

  • Fire extinguishers annual and monthly inspection current?

  • Fire extinguishers in front of trucks

  • SLP being used and current

  • Other

Rig up

  • Equipment layout satisfactory

  • Iron certification current

  • Whip checks on iron

  • Injector and lubricator secured properly

  • Crane inspection complete

  • Does crane have an anemometer to check wind speed

  • Crane set up

  • Guard rails and ladders pinned

  • Slings and straps condition

  • Injector goose neck pinned

  • Well head bolted properly

  • Hydraulic line placement

  • Slobber hose draining into containment or basin

Job Execution

  • Job started on time

  • Supervisor in control

  • Employees working as a team

  • Any equipment failures

  • Regular checks of equipment being performed

  • Tools in good working order

  • Have all tools required to perform the job

  • Trash cleaned regularly

  • Leaks on equipment contained

  • Spill kits available and stocked

  • Spill containment in place

  • High pressure areas flagged or taped

Outside of equipment

  • Is equipment clean

  • Condition of paint

  • Unit numbered

  • GVW# on vehicle

  • IFTA Sticker on vehicle

  • Company logo

  • Condition of wiper blades

  • Condition of all glass and mirrors

  • Lights and reflectors

  • Turn and emergency signals

  • Fuel tank mounts, caps

  • Placards and holders

  • Chocks blocks

  • Tire chains

  • Mud flaps

  • Trailer plugs and hitch

  • Trailer brakes system

  • Tool boxes uncluttered

  • 2-20LBS fire extinguishers stored on equipment

  • Other

Driving cab

  • Current registration and insurance

  • Current annual inspection

  • Overall condition in cab and sleeper Clean

  • Up to date haz paper work

  • First aid kit on site

  • 1-2 1/2LBS fire extinguisher in cab and secured

  • Addition vehicle issues

CT Unit operators cab

  • Emergency phone numbers posted

  • Copy of field safety manual

  • Copy of emergency response plan

  • Up to date line log book

  • 1- 2 1/2LBS fire extinguisher in cab

Post job

  • Job performance review with client

  • Required paperwork left with client

  • Area policed

  • Spills cleaned up before leaving location

  • Location left clean

  • Other

  • Comments from supervisor

  • Comments from client

  • Supervisor signature

  • Field inspector signature

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.