Name of Supervisor
Facility identified at entrance to access road?
Access to well facility suitably maintained?
Well facility suitably identified?
Approximate size of location?
Type of adjacent land usage?
Single well or cluster?
Amount of wells in cluster?
Well site fenced?
Well site area flood prone?
Well site area shows sign of recent flooding?
Well site area shows signs of recent erosion?
Well site area shows signs of public trespassing?
Are there frequent complaints from neighboring communities / establishments about this facility?
Well operating status?
Condition of stuffing box acceptable?
Condition of well head acceptable?
Condition of site tank acceptable?
Is casing venting to atmosphere?
Pumping unit properly installed?
Belt guard suitably maintained?
Fan/motor guard suitably maintained?
Pipes and fittings rated for safe operation?
Flow lines properly identified?
Electrical cable to motor suitably insulated/protected?
Electrical switch box suitably maintained?
All applicable safety/warning signs prominently displayed?
Oil saver / earthen pits present?
Oil saver fenced or covered?
Infrastructure of oil saver/sump?
Approximate size of oil saver?
Is there an inflow of storm water into the oil saver?
Is there a storm water bypass?
Are there doglegs present?
Are the doglegs suitably maintained?
What is the color and quality of effluent?
Condition of effluent drain acceptable?
Oil saver pumped down frequently?
Are there evidence that the saver has overflowed or leaked?
Facility free of litter?
Waste and other miscellaneous trash adequately disposed?
Are there any abandoned drilling / effluent pits present?
Dimension of drilling pits?
Surface pit contents
As there procedures for the operation and maintenance of this facility?
Are these procedures technically sound to ensure regulatory compliance?
Is ERP readily available?
Is Risk Register available?