Information

General Information

  • Well Site Name

  • Location
  • Prepared by

  • Document No.

  • Conducted on

Location

  • Northern Operation

  • CNX

  • Rice

  • Chief

  • Williams

  • HESS

  • Statoil

  • Triad

  • Transenergy

  • Seneca

  • Talisman

  • Other

  • Southern Operation

  • Marathon

  • Halcon

  • Sabine

  • Statoil

  • Talisman

  • Other

Personnel and Equipment

  • Perf #

  • Trailer #

  • Engineer

  • Lead Operator

  • Operators

Job Type

  • Pump Down Operation

  • TCP Operation

  • Are all AHWS employees staying clear of area until ready for TCP Operations?

  • Are feet and limbs clear from under the gun when rigging down guns from coil tubing?

  • When breaking off the gun carrier, are heads down shielding their face from trapped pressure?

  • Due to the breaking down of guns in the vertical position; are employees aware of the swing radius of the pipe wrenches?

  • Are employees transporting guns safely and using lifting caps at all times?

  • Vertical Operation

  • Logging Operation

Client Specific SOP

  • Does each AHWS employee have correct and current orientation sticker or card for the location that they are on?

  • Are all employees aware of O-ring removal SOP and following correctly?

  • Does each AHWS employee have their proper fit test card along with their H2S Performance training card?

  • Are all personnel wearing AHWS issued H2S monitors (properly, that are in working order, and have been bump tested before shift)?

  • Are all AHWS employees aware of using Axiom Medical Consulting for their HSE first aid or greater incidents?

  • Are all fire extinguishers currently inspected, charged and tagged (yellow and metal)?

  • Is hard hat with face shield and bracket being used when bleeding off the setting tool and/or when disassembling a tool that may contain trapped pressure?

General Safety

  • Is location cleared and proper housekeeping practices in place?

  • Are all tools in working condition to eliminate too slippage?

  • Are employees using proper lifting techniques?

  • Are employees aware and avoid pinch points?

  • Is the electrical in the pump down trailer current with policy (conduit for external wires, proper junctions boxes for wired connections, etc.)

  • No Cheater Pipes or Torque extenders being used on location?

  • Is this location considered an H2S location?

  • Is the perforator parked so the windsock can be seen?

  • Are all personnel wearing AHWS issued H2S monitors (properly, that are in working order, and have been bump tested before shift)?

  • Are all HWS personnel on location clean shaven?

PPE

  • PPE- are all personnel wearing ANSI z87.1 eye protection?

  • PPE- are all personnel wearing face shield with glasses when using grinder or abrasive wheel?

  • PPE- are all personnel wearing FR clothing with reflective tape clearly visible?

  • PPE- do all personnel have standard F2413-05 steel toe boots? Metatarsal Boots for Victoria Operations?

  • PPE - are personnel wearing ANSI standard hard hats

  • PPE - is all jewelry removed from fingers and wrist. Any long hair or loose clothing secured when working in PPE required areas?

  • PPE - are gloves being used when required?

  • PPE - is fall protection being used when employee is at risk of falling above 4 feet?

Pressure Control

  • Is AHWS Pressure Control Gear on Location

  • Trailer Number

  • Are all hydraulic hoses marked with burst and working pressures?

  • Is the Grease used for the wireline pressure control systems rated for current weather conditions?

  • Does the Pressure Control gear have a rig up dolly and is it used during rig up/down of lubricator?

  • Has each piece of pressure control equipment been inspected and certified for use according to industry standard?

  • Are Wheels Chocked?

  • Does the Trailer have a current inspection?

  • Is the current pressure control package rated for the maximum expected wellhead pressure?

  • Does the trailer have a current registration?

  • Does the trailer have a fire extinguisher that is serviceable?

Explosives

  • Are all employees following RP 67 guidelines when handling explosives?

  • Does someone on location have a current explosives license for the state they are working in? (PA, OH)

  • Does each employee know the difference between the megohmmeter and the intrinsically safe meter used with explosives?

  • Are the grounding cables connected to the wellhead and crane... Is stray voltage low enough to continue operations?

  • Is the pump down trailer grounded?

  • Is the blast tube for detonators being used?

  • Are we using RF safe explosives?

  • Are explosives signs out and cell phones and RF transmitters turned off?

SDS

  • SDS- current legible copy for chemicals used on location?

  • SDS- Are all containers labeled for the contents?

  • HMIS-Are all containers properly labeled with the HMIS labels?

Rig Up

  • Has a per-job safety brief (M3) occurred before the start of any work?

  • Picture of the M3

  • Is the signal person listed on the M3?

  • Signal Person:

  • Is there a current copy of the Explosive Usage Tracker?

  • Take picture of Explosive Usage Tracker

  • Do all sheaves have safety pins in the Clevis to prevent the nut from backing off?

  • Has the wireline crews work area been isolated with warning tape?

  • Is the crew using bolt type anchor shackle with cotter pin?

Lifting Gear

  • Are we utilizing our lifting gear on this job?

  • Has Owners lifting certs been checked for compliance?

  • Which AHWS Employee physically checked these Certificates?

  • Who Owns the lifting gear?

  • Does the bottom sheave have a current cert?

  • S/N:

  • Expiration Date:

  • Does the top sheave have a current cert?

  • S/N:

  • Expiration Date:

  • Does chain one have a current cert?

  • S/N:

  • Expiration Date:

  • Does chain two have a current cert?

  • S/N:

  • Expiration Date:

  • Does the 12 T shackle have a current cert?

  • Expiration Date:

  • S/N:

  • Does the 6 T shackle have a current cert?

  • S/N:

  • Expiration Date:

  • Is the dog bone being used?

  • Does it have a current certification?

  • S/N:

  • Expiration Date:

Crane

  • Is the crane operated by AHWS Personnel?

  • Crane Number

  • Does the crane have a current insurance card?

  • Does the crane have current Federal/State inspection?

  • Does the crane operator have his NCCCO and state licenses on him?

  • Are the outriggers set on a firm lever surface?

  • Is the crane inspected as per AHWS policy?

  • Does the crane have a current registration?

Truck and Trailer information

  • Perforator

  • Perf Number

  • Does the Truck have a current state/federal inspection?

  • Does the Truck have a current registration?

  • Does the Truck have a current insurance card?

  • Does the Truck have a current IFTA sticker and license?

  • Is there a current HUT permit in the truck?

  • Does the truck have a current copy of the ERG, Hazardous materials compliance and safety regulation books?

  • Does the truck have a fire extinguisher that is serviceable?

  • Are the wheels chocked?

  • Pumpdown or TCP Trailer

  • Trailer Number

  • Is the trailer equipped with bench bumper/roll off guards?

  • Does the trailer have a current federal/state inspection?

  • Do the lights in trailer have the proper cages or covers?

  • Does the trailer have a current registration?

  • Does the trailer have a fire extinguisher that is serviceable?

  • Are the Wheels Chocked?

  • Pickup

  • Pickup Number

  • Does the Truck have a current state/federal inspection?<br>

  • Does the Truck have a current insurance card?

  • Does the truck have a current copy of the ERG, Hazardous materials compliance and safety regulation books?

  • Does the truck have a fire extinguisher that is serviceable?

Notes

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