Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
Crew:
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Pusher:
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Add media
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Operator:
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Add media
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Derrick:
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Add media
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Floor:
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Add media
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Other:
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Add media
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Location Map:
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Draw map of location:
Location /Rig Up
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Add location
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Hazard sign at entrance?
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Guy wires flagged?
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Fall lane of Derrick clear?
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All engines 100' from well?
Guying
Crown to Ground Lines
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Condition of Guy Lines?
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Four clamp minimum?
Tubing Board Guys
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Strung for racking?
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Four clamp minimum?
Internal Load Guys
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Adjusted for tension?
Draw-works
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Guard at draw-works?
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Sufficient wraps left on drum?
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Brake linkage (condition with hair pins)?
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Crown Saver connected and set?
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Woven brake blocks & condition?
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Lube / Inspect Drill Line?
Tong Line
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Breaks, Kinks, Bird Cage?
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Grade 8 Chain with serial # ?
Winch Line
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Breaks, Kinks, Bird Cage?
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Grade 8 Chain with serial # ?
Sand Line
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Breaks, Kinks, Bird Cage?
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Rope Socket condition?
Rod Transfer Line
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Breaks, Kinks, Bird Cage?
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Four clamp minimum?
Geronimo
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Breaks, Kinks, Bird Cage?
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Four clamp minimum?
Dead Line
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Breaks, Kinks, Bird Cage?
Mast Derrick
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Manufacturers Operation / Specification Plate?
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Ladder condition?
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Tubing Board condition?
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Latch Dogs visually / inspected prior to loading?
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Derrick Locking Pins in place with Safety Pins?
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Derrick Hydraulic System free of leaks?
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Visual damage to any Gert, Guides or structures?
Carrier
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Handrails, Guardrails on Elevated Walkways and Steps?
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Head! Tail and Signal Lights?
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Walkways free of Slip / Trip Hazards?
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All tanks labeled?
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Wheels chalked?
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Hydraulic Level Jacks Secured by Mechanical?
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Grounded to Wellhead?
Traveling Assembly
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Blocks?
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Bails / Links?
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Elevators?
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Hair Pins in place?
Operator Station
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All Controls labeled?
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E-Kill Function?
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Free of Slip / Trip Hazard?
Work Floor
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Work Floor secured in up position w/ Positive Securement on both sides?
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Steps / Handrails
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Performed By:
