Statoil bakken business unit :: facilities and civil construction safety report checklist
F&c inspection and safety checklist
What does this form include?
This form contains 22 sections:
Signage:
- Safety Billboard in Place?
- PPE & FRC's signage in Place at Entrance?
- Lease Signs in Place?
- No Smoking Signage at the Entrance of Location?
- Confined Space Labels in Correct Location on Tanks?
- Tanks Labeled with Placards in Place?
- Chemical Pump Room Labeled?
- LACT Unit Building Labeled?
- Separator Building Labeled?
- Saltwater Pump Room Labeled?
- Heater Treater Building Labeled?
- Generator Fuel Tank Labeled?
- Electrical Room Labeled?
- Electrical Breakers Properly Indicated?
- Electrical Board Panels with Warning Labels in Place?
- Pumping Unit Safety Warning Labels in Place?
- All Containers Labeled with their Contents?
- Hearing Protection Signage in Place?
- Automatic Start Signage in Place?
- Stay Off Berm Signage in Place?
Applicable Permits
- JSA / SJA Completed with Contractor Sign-in Sheet?
- Ground Disturbance Permit Completed?
- Hot Work Permit Completed?
- Confined Space Permit Completed and Posted?
- Critical Lift Permit Completed?
General Site Inspection:
- Interior / Exterior Berm in Place?
- Drain Pinch Valve Closed and Secured with Lock & Chain?
- Dead Man Marked / Visible and within its Life Expectancy?
- Pumping Unit Safety Guards in Place, Ladders with Fall Protection Cage?
- Ignitor Wire Functioning?
- All Caps and Plugs in Place?
- Plumbing Appeared to Teflon Tape on all Threads?
- Heater Treater Ladder with Fall Protection Cage in Place?
- Tanks, Walkways, Stairs Properly Grounded?
- Grounds Available for Transport while Loading and Unloading?
- Stairs and Catwalk Secured on Tanks with Two Threads Showing on Bolts?
- Adequate Hand-Rails Provided on Stairs and Catwalk?
- Windsock Up and Visible and in Good Shape?
- Are Chemicals Stored Properly with MSDS Available?
- Electrical Covers in Place?
- Location Clean with Pathways Clear (No Obstructions)?
- Stairs Exist Over all Interior Berms Where Needed?
- Cam-Lock Nipples are in Place on all Transport Loading Outlets?
Contractor Inspection
- All Crew Members Wearing Proper PPE & FRC's?
- H2S Monitors Being Utilized?
- Fall Protection Being Utilized?
- Utilizing Safety Glasses/Grinding Shields while Grinding?
- First Aid Kit Available on Location?
- Fire Extinguishers Available with Monthly / Annual Inspection Completed?
- Crew Utilizing Proper Tools for Job Functions?
- Crew Using Proper Lifting Techniques?
- Tools with Safety Guards in Place?
- Good Housekeeping with Work Area Clean and Organized?
- Crew Utilizing Proper Lockout / Tag Out?
- Roll Over Protection in Place with No Obvious Defects?
- Fire Watch Being Utilized?
- Spotter Be Utilized while Equipment is in Operations?
- Backup Alarms on Equipment Working Properly?
- Does Contractor's Equipment on Location Appear to be free of any Fluid Leakage?
- Does Contractor's Equipment on Location Have Seat Belts (Being Utilized by Operator)?
- Are Pipe Thread Cuttings be Collected?
- Are Chock Blocks Being Utilized?
- Are Compressed Cylinder Tanks Secured Upright with Valve Caps in Place?
- Proper Rigging Techniques are Being Utilized while Lifting Loads?
- Inspected Tag Lines are Being Utilized when Lifting Loads?
- Rigging Equipment Appears to be in Good Working Condition?
Contractors Excavating and Trenching
- Caution Tape / Barriers Fencing Off Around Open Pits and Trenches?
- All Bell Holes are Properly Sloped and/or Benched?
- Ladders, Steps, or Ramps Located in Bell Hole so No More than 25ft of Lateral Travel is Required?
- Excavated Soil, Other Material, Or Equipment are Stored at Least 2ft from the Edge of the Excavation?
General Facility Inspection (Office, Pipe Yard, SWD, Oil Facilities)
- First Aid Kits are Up to Date and Available?
- Eye Wash Station Up to Date and Available?
- Hearing Protection Available?
- Flammable Storage Cabinet Being Utilized?
- MSDS Binders at Location with Updated MSDS Sheets?
- Is Electrical Room free of stored Combustibles?
- Is all Electrical Wiring Incased in Conduit with Covers in Place?
- Are Rubber Mats in Place on Flooring of Electrical Building?
- Oil Facility Pressure Relief Valve was in the Locked Open Position?
- Are All Transformers Enclosed with Safety Barrier (Bollards)?
- Underground Injection Control (UIC) Permit Available?
- Spill Prevention Control and Countermeasure Plan (SPCC) Available?
- Facilities Response Plan (FRP) Available?
- Fire Extinguishers Available with Monthly/ Annual Inspection Completed?
Issue #1:
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Issue #10:
Statoil Safety Representative:
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Consultant / Company Man:
Contractor Supervisor / Foreman:
Person In Charge (PIC):
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