Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Safety Critical Components - Shall be in good condition or completed prior to work continuing

  • Pre-shift inspection complete

  • Gas monitoring system operational

  • Brake linkage and adjustment current and verified by operator

  • Derrick locking system inspected and flagged

  • SRL and harnesses inspected and in good condition

  • Guy line anchors installed correctly and adjusted

  • Grease inspect traveling blocks

  • Fans/air moving equipment functional and placed correctly

  • No Hydraulic leaks present

  • Energy control in place and filled out

Approach

  • Delineation and site control in place

  • Rig fall lane clear (2-4 and 8-10 o'clock)

  • Is Aera PowerLine Avoidance program adhered to (keyhole diagram 65' double, 35' single Appendix A)

  • Is the general housekeeping around the rig appropriate

  • JSA/CW paperwork filled out correctly

  • Daily/monthly inspection filled out and complete?

  • BOP drill data available?

  • All vehicles 1 ton or greater chocked

Rig cab

  • Housekeeping inside the cab acceptable

  • Breaks and accelerator pedal, free movement and in good condition

  • Doors, mirrors, glass, clean and in good condition

  • Gauges, mounting, operation in good condition

  • Decals, safety warning labels in place and in good condition

  • Look up and live sign hung on steering wheel (or rig mast)

Carrier

  • Free of cracks in welds or beams

  • Is machine guarding in place on all moving equipment

  • Is road gear disengaged and pinned

  • Are battery covers secure and is battery in good condition

  • Spools/drums, at least 3 full wraps, no damage or sharp edges, overall good condition

  • Main scoping rams free of leaks, hoses and fittings secured and in good conditions

  • Hydraulic fluid levels appropriate

  • Weight indicator present and installed correctly per SOP

  • Weight indicator wrapped with impact sleeve

  • Deadman anchor and cable retainer welds free of damage

  • Are leveling jacks pinned (If required) and pads available

  • Kill switches, marked, tested, and operational

  • Are the ground/ bond points checked and can the crew demonstrate

  • Escape rope secured and in good condition (Bowline Knot)

Operators platform/Controls

  • Are stairs and handrails/guards pinned and clipped

  • Sandline Deck secured and level

  • Are controls clearly labeled and accessible

  • Crown Out Floor Out (COFO) in use and demonstrated

Work floor

  • Are floor and railings clean, secure, pinned and clipped

  • Is TIW valve stored on the hanger in the open position

  • Tools stored and in good condition

  • Winch Line(s) in good condition tagged and free of damage

  • Rigging: Braided wire rope/nylon slings tagged and in good condition

  • Tubing rod tongs, oil levels, greased, and showing no damage

  • Tubing and rod tongs door installed and operational

  • Tong hanger and support in good condition

  • Hose and fitting free of leaks and in good condition

  • Two cables on tongs and stiff arm bolted and clipped

  • Proper back-up in good condition and functional

Traveling blocks

  • Bails, links, elevator, Cleve's and hook in good operational condition

  • Block bolts secured with keeper pins

  • Traveling blocks and sheaves, operational and in good condition

Derrick/Mast

  • Manufacturer's specifications plate installed and legible

  • Load guys correctly installed and flagged (check sag of line)

  • Board guys flagged and tensioned appropriately

  • Wind guys flagged and installed correctly (check sag)

  • Rod/tubing boards hinges, cables, secured and in good condition

  • Girts and braces in good condition

  • Ladders secured and in good condition (no major gaps)

  • Derrick hinge points, retainer pins, greased and in good condition

  • Crown sheaves greased and in good operational condition

  • Locking dogs at mast hinge point fully engaged (hand crank or automatic)

Blow out prevention equipment

  • BOP installed and the correct size

  • All bolts installed around wellhead

  • Bolts, rams, rings, related equipment installed and in good condition

  • Is the ground clamp attached and was it checked with an Ohm meter

  • Kill lines, blow down lines, and choke lines, installed, secured and in good condition

  • Accumulator lines marked and in good condition

  • BOP threaded accumulator hose connections secured and in good condition

Hydra-walk trailer

  • Good housekeeping on and around the hydra-walk

  • Wheels, chocks, lights in good condition

  • Securing straps in good condition

  • working deck (located near stairs) free of trip hazards

Pump

  • Are all gauges visible and in good condition

  • Has the relief valve been tested

  • Is the manifold pressure operating within its allowable limits

  • Are the hoses and hobbles in good condition and properly rated

  • Are hammer unions dressed and or replaced to minimize "mushroom" effect

  • Are all guards installed and in good condition

  • Fluid end free of leaks and all bolts and nuts in place

Accumulator Trailer

  • Relief valve operational and tested

  • Manifold pressure within allowable limits

  • Annular pressure within allowable limits

  • Accumulator pressure within allowable limits

  • Hoses inspected and in good condition, leak free

  • Green house gas log present and filled out

  • General house keeping acceptable

  • Controls clearly marked and functioning

  • Daily/monthly trailer inspection filled out and available

  • Nitrogen backup available and ready to use

  • Tires, wheel chocks, tow package, and lights in working order

Return Bin, 500 bbl tank, or Sand-X

  • Is the tank bonded/ grounded to an unpainted metal surface

  • Are hoses and connections secured with strap, pins and in good condition

  • Are there any cracked welds or leaks

  • Are the appropriate signs in place on the tank

  • Has a continuity check been performed

Tool truck

  • Are items properly secured for transport

  • Are the tools/ equipment in good condition

  • Are rigging components, stored or on location, in good condition

  • Are all of the features in place for safe driving (seat belts, lights, horn, etc.)

Miscellaneous

  • General housekeeping of the location acceptable

  • Is the Boatswain's chair, rescue kit, and emergency response materials in good condition

  • Are the Fire Extinguishers on location secured and in good condition

Final assessment

  • Pass/Needs repairs/Fail (no work until issues resolved)

  • Rig operator/supervisor

  • Auditor

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.