HSE MANAGEMENT VISIT CHECKLIST

Rev. 00 Date: 09/06/12

Page 1 of 6



Well Site: Rig Number: Management Representative (s)



Date:


Item
Nr.
ITEMS VERIFIED Yes No Remedial actions
Due
Date
1. Visible Safety and Induction
1.1
Is there a welcome board with key safety information
posted in high visibility location?


1.2
Did you receive a safety/security induction briefing
on arrival on site?


1.3 If there is POB control, did you receive a T-card?

2. Tool Pusher / Rig Manager Office
2.1
Are the updated HSE policies (Corporate, Company
and Project) posted (in English, Arabic and other
user language)?


2.2
Is the HSE documentation available?
1. HSE Onshore procedures Manual
2. Emergency Procedures Manual
3. HSE Plan and Appendices
4. Health Plan
5. Bridging Document
6. Safety Case













2.3 Are all the folders well organized?

2.4
Is the updated telephone numbers list (including
emergency numbers) posted?


2.5 Is the updated MEDEVAC flowchart posted?

2.6
Is Well Control procedure current?
Is there a kick control work sheet, indicating local
well maximum working pressures, and circulating
rates?









2.7 Is the BOP stack drawing posted?

2.8
Are the records of the BOP test updated and
available?


2.9
Is all certification for rig equipment (mast,
substructure, BOPs, etc) available on site


2.10
Is the technical documentation covering all the
equipment on site?


2.11
Is the Preventive Maintenance System available and
updated?


2.12
Are the Rig layout and the Safety equipment lay out
posted?


2.13
Is there a register of weights for all standard rig
inventory heavy items which may be lifted or
winched?
Are critical or tandem lift procedures / lift plans
available and followed?









2.14
Is the tubular material Rotation Hours Tally
available?



HSE MANAGEMENT VISIT CHECKLIST

Rev. 00 Date: 09/06/12
Page 2 of 6


2.15
Are the minimum of 2 x 2 SCBA sets are available?
Are they functional, and ready to be deployed?
Are they located in opposite corners of the location
so wind direction will not restrict the rescue
capability?











2.16
Does this well require more H2S equipment than
basic minimum, including H2S detection/ alarm
systems as well as air supply for workforce to carry
out operations in a toxic environment?
Is the reserve, resupply or supplied air rescue and
work breathing equipment package available?
Correctly installed on the Rig?
Is it fully supplied with air and equipment functional?

















2.17 Is the updated POB posted?

2.18
Is the Work Permit notice board updated with the
Work Permits currently opened?


2.18 Is the Tag out / Lock out key panel available?

2.19
Do mobile cranes have valid certificates of
inspection/acceptance from competent authority by
Intl Standards [LOLER, LEEA equivalent?


2.20
Are lifting accessories slings [soft, wire rope,
chain], shackles, hooks, in good shape?


2.21
Is there a bin/container/ process to quarantine or
destroy, damaged lifting accessories?


2.22
Is the general housekeeping to an acceptable
standard?



3. HSE Supervisor Office
3.1
Are the updated HSE policies posted (in English and
Arabic)?


3.2 Is the Safety Induction folder up to date?

3.3 Are the folders well organized?

3.4
Are all the practicably valuably HSE documentation
available?
1. Hazard Risk Register for work scope
2. JHA / JSA
3. HSE Onshore procedures Manual / Method
statements / Checklists
4. Emergency Procedures Manual
5. Incident Investigation Reporting
6. UA/UC observation tools [Safety Observation cards,
and register]
7. Drills Reports
8. Training Plan and Register
9. Bridging Document
10. HSE Plan and Appendices
11. Health Plan































3.5 Is the housekeeping to an acceptable standard?

3.6
Is there an HSE store with supplies of basic PPE and
tools, [Toolbox talk cards, checklists, PTW system
supplies, LOTO materials, atmosphere testers]?
Is it well organized?









3.7
Is the safety equipment well maintained and ready to
be used?



HSE MANAGEMENT VISIT CHECKLIST

Rev. 00 Date: 09/06/12
Page 3 of 6


3.8
Does the HSE engineer have connection to email or
intranet / internet for contact with Client?


3.9
Are meetings for analysis of the UA/UC Tracking
Log, Event Report Log, and Lessons Learned Log
held on regular basis? [weekly? bi weekly?]


3.10
Are the Event Investigation Reports received from
the Contractors primary support Base available and
presented in the weekly safety meetings with the rig
crew?


3.11
Is there any evidence Contractor has a program of
safety campaigns, and that these campaigns are
communicated to the rig crew if formal presentation
meetings, posted and the presence of personnel to
the presentation of these recorded?


3.12
Is the Daily HSE Tour performed properly, and
distributed to the Contractors Base and/or client on a
daily basis?


3.13
Is the Monthly Rig Inspection check list available and
completed as per the HSE Procedures?


3.14


4. Dog House
4.1 Is the current well shut-in procedure posted?

4.2 Is the Kill sheet updated and available?

4.3
Are the (SCR
1
) recorded?


4.4
Is the current (MAASP
2
) posted beside the
Choke/Kill Control Panel?


4.5 Is the trip sheet updated?

4.6
Is the BHA Tally Book (including drawings, sizes,
type of threads) updated?


4.7 Is the Handovers Register available?

4.8
Are charts / technical data regarding tubulars
available?


4.9
Is the BOP drawing posted and showing the pipe
rams sizes?



4.10
Are all the gauges and pump stroke counter showing
correct values on the Power choke control panel?



4.11 Is the First Aid Box available and completed?

4.12
Is the Crown-O-Matic procedure posted and the tests
carried out as per procedure?


4.13 Is the derrick climbing procedure posted?

4.14 Is racking board rescue procedures posted?

4.15
Has a simulated derrick rescue been performed and
documented once a year?


4.16
Is the condition of harnesses and other fall protection
devices acceptable?


4.17 Is the housekeeping to an acceptable standard?


HSE MANAGEMENT VISIT CHECKLIST

Rev. 00 Date: 09/06/12
Page 4 of 6


1
SCR - Slow Circulating Rate
2
MAASP Maximum Allowable Annular Shut-in Pressure

5. Rig Floor
5.1
Is the inside BOP [Hydraulic] located in easy to
access location, and is valve handle located nearby
in secure location?


5.2 Are all the gauges properly functioning?

53 Is the PVT working properly?

5.4
Is the Kelly hose properly set up with safety lines
& clamps?


5.5 Is the torque indicator working properly?

5.6 Is the RPM indicator working properly?

5.7 Is the Weight Indicator working properly?

5.8
Are draw works controls clearly and correctly
identified, guarded, with provision for locking
devices?


5.9 Are the air winches clearly labeled with the SWL?

5.10
Are the air winches air supply valves functioning
properly?


5.9
Are the air winches controls working properly?
(operating lever must revert to off position when not
operated)


5.10
Are the braided wire rope cables correctly coiled on
all air winches drums?


5.11
Are rotary tongs correctly anchored to prevent
uncontrolled movement


5.12
Are cat heads in place, if so are they covered? There
should be a plan to remove them / replace them with
air tuggers.


5.13 Are all the drilling tools in good shape?

5.14
Are the drilling tongs back up line attaching points
secured with safety pins?


5.15
Are all the gauges showing the correct values on the
remote BOP panel?
Shear rams = 3000 psi; Pipe rams = 1500 psi;
Annular = 1200 psi for drill string or 1500 psi for
casing (cover values)


5.16
Are the lights functioning properly on the remote
BOP panel?


5.17
Are all the pipe rams type and sizes clearly labeled
on the remote BOP panel?


5.18
Are the blind/shear rams properly protected against
accidental operating on the remote BOP panel?


5.19
Is the MATHEY Unit [Wireline] properly functioning
and the meter counter having correct indications?


5.20
Are protective guards in place on all rotating wire
drums? (Hoists & Winches)


5.21
Does the V Door have a barrier chain or gate
deployed across the opening?



HSE MANAGEMENT VISIT CHECKLIST

Rev. 00 Date: 09/06/12
Page 5 of 6


5.22
Is the Basket type stretcher available and in good
condition?


5.23 Is the general housekeeping at an acceptable level?


6. Rig Power Supply, Pump House, Mud Mixing Area
6.1
Are all engine exhausts equipped with spark arrestor
and / or water spray?


6.2
Are all electric feeds from main electric control panel
clearly identified and labeled in language of
responsible users?
Are unused electric outlets covered?


6.3
Are all rig power main electric switches capable of
being locked out?
Multiple lockout?








6.4
Are High Voltage signs posted in easily visible
locations?


6.5
Is the mixing area organised, clean, & with
appropriate PPE available?


6.6
Is all rotating machinery equipped with proper
guards?


6.7
Are there any stairs with more than 4 risers, that do
not have hand rails?


6.8 Is there an exhaust fan in mud mixing room?

6.9
Are sufficient fire extinguishers in place on the rig? [4
x 40 or 8 x 20], [ABC or BC]
Securely mounted to protect from damage, and
indicated with high visibility signs?








6.10
Are high pressure mud lines, shock hoses, equipped
with clamps and properly secured?


6.11
Are the mud pits & trip tanks provided with electric
devices that are intrinsically safe as sources of
ignition?


6.12
Are the eye wash stations & showers in good
working order, and easy to access?


6.13
Are all noise hazard areas identified, signs in place,
and PPE available? Used by workforce?


6.14
Is the rig configured to allow one generator to be
designated as an emergency generator?


6.15 Is an emergency lighting system in place?

6.16
Do all alarms, Gas/kick, fire alarm & abandon rig
alarm exist on the rig?
Do they all function?
Can they be heard everywhere? [SCR room, Mud Pump
area, Generator Area, in sub base & BOP area]










7. Clinic
7.1
Is the housekeeping of the clinic to an acceptable
standard?


7.2
Are the updated Medevac procedures and
Contractor Health Plan available?



7.3
Are SCBA inspection and maintenance records
available?



7.4 Is the updated MEDEVAC flowchart posted?


7.5
Are the emergency telephone numbers posted
beside the MEDEVAC flowchart?




HSE MANAGEMENT VISIT CHECKLIST

Rev. 00 Date: 09/06/12
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7.6
Is the register of employees treated in the Clinic
available and kept inside the locked drawer?


7.7
Are the personnel medical fitness certificates still
valid?


7.8 Is the Treatment Room access free of obstruction?

7.9
Is the date of last check posted on the Medical
Oxygen Cylinder?


7.10
Is the medical equipment (inclusive stretcher) in
good condition and ready to be used?


7.11
Are copies of water analysis available and up to
date?


7.12 Are copies of weekly camp inspection properly filled?

7.13 Are the First Aid Boxes checked and kept full?

7.14 Are the MEDEVAC drills performed and recorded?

7.15


8. Camp issues
8.1
Are offices and accommodation are located at least
25 meters from well bore?


8.2
Are power cables to trailers from energy supply
suspended or otherwise protected from damage by
machinery?






8.3
All electrical outlets are in good shape and weather
proofed?
Connectors and cables are not damaged, structures
properly grounded?


8.4
Are smoke and fire detectors in each room and
office?


For simple evaluation of the hygiene aspects of the camp, managers and others without specific competence or
qualifications to make the assessment, can use good judgment . . based on humanity . . the basic criteria would
be would I accept to eat and live here?
If it is not good enough for us, then we should be critical of its acceptability for any person who must work under
such extreme adverse conditions as exist in this environment.
8.5 Showers, sinks, toilets?

8.6 Camp dining room?

8.7 Food storage?

8.8 Bedrooms, and bedding?

8.9 Waste disposal, including sewage?

8.10




General comments:

Note: The Tool Pusher shall ensure that the remedial actions (if any) will be carried out and that the due dates
given for closing the remedial actions are respected. Also, the updated check list shall be provided to the Base
Management.