HSE CHECKLIST

For

NW-Tunu 3D TZ Project

Crew 8611-TOTAL
 PT. BGP INDONESIA
CREW 8611(TOTAL) NW-Tunu 3D TZ Project

PT BGP INDONESIA

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Review & Approval Page:

Version Date Details Reviewed By Signature

V 1.0 6/Nov/2012 Draft Qin Lin

V 1.1 Review by client Patrick

V 1.2 Issue for use Zhang Xuedong

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Table of contents

1. SURVEY................................................................................................................................................................................5

2.DRILLING.............................................................................................................................................................................6
CHECKLIST: DRILL PERSONNEL..............................................................................................................................................6
CHECKLIST: DRILL SUPERVISOR.............................................................................................................................................7
CHECKLIST: EXPLOSIVE HANDLING CREW.............................................................................................................................8
3.RECORDING........................................................................................................................................................................9
CHECKLIST: TZ-AIR-GUN BOAT.........................................................................................................................................9
CHECKLIST: SHOOTERS.........................................................................................................................................................10
4.TRANSPORTATION.........................................................................................................................................................11
CHECKLIST: LAND VEHICLE （LIGHT）..............................................................................................................................11
CHECKLIST: LAND VEHICLE （HEAVY）............................................................................................................................12
CHECKLIST: VEHICLE DRIVER..............................................................................................................................................13
CHECKLIST: FUEL TRUCK.....................................................................................................................................................14
CHECKLIST: TZ - SMALL BOAT (ZODIAC)............................................................................................................................15
5. CAMP..............................................................................................................................................................................16
CHECKLIST: MINIMUM CAMP ACCOMMODATION................................................................................................................16
CHECKLIST: QC OFFICE........................................................................................................................................................17
6.MEDICAL............................................................................................................................................................................18
CHECKLIST: MEDICAL DRUGS ADMINISTERED BY DOCTOR.................................................................................................18
CHECKLIST: CLINIC/DOCTOR................................................................................................................................................19
CHECKLIST: DRUGS ADMINISTERED BY NURSE....................................................................................................................20
7.GENERAL HSE..................................................................................................................................................................21
CHECKLIST: DEPARTMENTAL DOCUMENTATION..................................................................................................................21
CHECKLIST: HYGIENE...........................................................................................................................................................22
CHECKLIST: SEISMIC PERSONNEL.........................................................................................................................................23
CHECKLIST: HEALTH AND HYGIENE.....................................................................................................................................24
CHECKLIST: ENVIRONMENTAL..............................................................................................................................................25
CHECKLIST: TRANSPORT SUPERVISOR..................................................................................................................................26
CHECKLIST: EXPLOSIVE MAGAZINE.....................................................................................................................................28
CHECKLIST: EXPLOSIVE TRANSPORTATION..........................................................................................................................29
CHECKLIST: FIRE PROTECTION AND EXTINGUISHERS..........................................................................................................30
CHECKLIST: FUEL CLERK AND FUEL STORAGE....................................................................................................................31
CHECKLIST: GENERATOR & ELECTRICAL INSTALLATION....................................................................................................32
CHECKLIST: WELDING, CUTTING AND EQUIPMENT...............................................................................................................33
CHECKLIST: BENCH/HAND GRINDER....................................................................................................................................34
CHECKLIST: MECHANIC WORKSHOP....................................................................................................................................35
CHECKLIST: SAFETY.............................................................................................................................................................36
CHECKLIST: AVOIDING SNAKE BITE....................................................................................................................................37
CHECKLIST: ENHANCED HSE MANAGEMENT......................................................................................................................38
CHECKLIST: TZ - NAVIGATION BOAT..................................................................................................................................39
CHECKLIST: INLAND WATER MARINE VESSEL....................................................................................................................40
CHECKLIST: FRIST AID KIT..................................................................................................................................................41
CHECKLIST: CLINIC...............................................................................................................................................................42
CHECKLIST: AMBULANCE VEHICLE......................................................................................................................................43
CHECKLIST: FOOD STORE.....................................................................................................................................................44
CHECKLIST: DYNAMITE MAGAZINE.....................................................................................................................................45
CHECKLIST: CATERING STAFF..............................................................................................................................................46
CHECKLIST: CAP MAGAZINE................................................................................................................................................47
CHECKLIST: GPS / MONUMENT CREW.................................................................................................................................48
CHECKLIST: LAND CAMP......................................................................................................................................................49
CHECKLIST: LAYOUT CREW.................................................................................................................................................50
CHECKLIST: SEISMIC HEADMAN...........................................................................................................................................51
CHECKLIST: HSE DOCUMENTATION.....................................................................................................................................52
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CHECKLIST: FIRE PROTECTION.............................................................................................................................................53
CHECKLIST: DRIVERS COMPETENCY....................................................................................................................................54
CHECKLIST: FUEL AREA.......................................................................................................................................................55
CHECKLIST: SURVEY CREW..................................................................................................................................................56
CHECKLIST: DRILL CREW.....................................................................................................................................................57
CHECKLIST: LINE CREW.......................................................................................................................................................58
CHECKLIST: VIBRATOR CREW..............................................................................................................................................59
CHECKLIST: SHOOTING CREW..............................................................................................................................................60
CHECKLIST: BATTERY CHARGING ROOM.............................................................................................................................61
Checklist: Tyre Shop............................................................................................................................................................62

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1. Survey

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2. Drilling
Checklist: Drill Personnel

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Receive drill program, line trace and hazard map of area
Check PPE
-Buoyancy aids, rope sling, pipe wrenches
-Fire extinguisher
-Earmuffs for engine operator
-Steel capped shoes
-shovels
-Metal fuel CAN, funnel, water bottles
-Carrier bag
-First aid kit to standard
-Hard hats, gloves with rubber studs
-Goggles or face visors
Safety pep talks held daily
Boat and/or vehicle entry/exit procedure followed
Stop work at the start of thunderstorm
Fire extinguishers and first aid kit 5m off line
Engine and exhaust 5m away from workers
Clear shot hole area before loading
Refuel engine only after 5 minutes cooling
Never carry load on head
Complete drill report
Fill in mud pit
Portable stretcher available if ambulance not in field

Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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Checklist: Drill Supervisor

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Set a good example
Check PPE of drillers and loaders
HSE toolbox meeting held with crew in the morning
Supervisor trained on explosives handling
Men enter boat or vehicle in orderly manner
Boat properly balanced when loaded (if by boat)
Supervisor ensure drill and loading procedures are followed
Supervisor knows procedure to carry out medevac on line
Supervisor trained in
- HSE MS
- First Aid
HSE Policy
Safety distance procedure observed
First aid kit to standard
Communication with drill crew
Supervisor involved in accident investigation
Supervisor accept responsibility of all his personnel
Supervisor carry out audits and document it
Stop work at the start of extreme weather e.g. thunderstorm & lighting etc.
Supervisor knows Emergency Response Plan
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Explosive Handling Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Vehicle and Equipment Check
General vehicle condition – Vehicle License, Insurance etc.
Vehicle daily checklist available and Speed limit posted
Vehicle Radio for communication, fire extinguisher and First-aid kit
Crew Emergency Contact list and safety map
Vehicle Jack, jack plate, spare tyre, tools kit, tow-rope, shovel etc
Earth chain and Air pump pressure
Seatbelt available and functional
Vehicle lights – Beacon light, headlamps, indicator lights, horn
Crew takes water to line daily
PPE Check
Hard hats, coverall, reflective vest, handgloves, goggles,
Steel-toed safety shoes/safety footwear
Anti-static uniform for shooters
Life jacket for Shallow water shooting (where applicable)
Waterproof trousers for Shallow water shooting (where applicable)
Procedure and Regulation
Crew conducted Daily Pep-talk (Topic - )
Shooting crew has whistle, red flag, wear reflective vest etc
Only authorized persons in shooting operation
Prohibit the use of electronics, radio, mobile phone etc in shooting
operation
Shooter observe Safety distance from facilities (refer to GDAD standard)
Ensure firing lines are shunted before connecting
Shooters and other people “Keep Away” 30m from loaded shot points on
Land shooting operation
Shooters and other people “Keep Away” 50m from loaded shot points on
Marine shooting operation
Stop operation in bad weather condition
Shooter maintains effective communication with Recorder
Follow shooting procedure
Follow Misfire procedure
Observe “No Night” shooting policy
Observe “No Night Sailing” policy
Driver obeys road traffic regulations, company speed limit
No person sleep or sit under vehicle
Maintain shooting equipment
Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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3. Recording
Checklist: TZ-AIR-GUN BOAT

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE available: Hardhat, Eye goggles, Ear protection, Coveralls, Hand gloves,
And Safety boots
Life jackets for all personnel on board
Life rings – minimum 2, one with lifeline
Fire extinguishers present, minimum. 2 type ABC located for easy access
Work procedures available and emergency procedures posted
All personnel aware of procedures
A gun firing and maintenance log exists to record all activities of compressor
and guns
Visual warning signs “Authorized Personnel Only” – “Danger – High Pressure
Air”
Pep-talk in morning- topic? (_____________________________)
Gun operator is qualified to handle equipment
Chief gunner checks all exposed hoses, lines and fittings for wear daily
Guns are never pressurized on deck
Pressure does not exceed 500 p.s.i with booms out and guns in water
Only chief gunner and assistants allowed on deck during layout/retrieval of
guns
Guns are never pressurized up to firing pressure until guns are at proper water
depth
Air pressure always bled off before guns are brought on deck
Firing line connected to firing unit after guns are lowered in water
Firing line disconnected from firing unit before removing guns from water
Check is carried out to establish status of guns prior to working on them
Vessel clean – no collection of waste- no oil spillage
Vessel navigation system, lights, alarm light and radio working
Man-overboard drills conducted and documented
Navigator watchful of gunner and assistant on back deck
Wheel house orderly – equipment properly mounted?
Navigator a trained first Aider
First Aid Kit compatible with number of personnel on vessel
Navigator/quartermaster aware of emergency radio protocol

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Shooters

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE – Hardhat, safety shoes, whistle, reflective jacket, red flags
Shooter and Helpers trained
No Smoking/Naked lights
Check charge before firing
Distance 50m from overhead cables
Safety distance observed from next charge
Blow whistle and clear area before shooting
Follow radio procedure for shooting
Misfire and release procedures known and observed
Shooter tools are nonferrous
All detonators shunted until shooting
In thunderstorm and lighting
Stop operations
Disconnect firing line
Switch off radio
Follow thunderstorm procedures
Safety Distance - Minimum
Houses 100m
Overhead cables 50m
Waterwells 200m
Pipeline 60m
Tarmac road 25m
Houses 150m
Shooters do not carry mobilephone
Wait 5 minutes after a misfire
Audit Remarks:
Follow-Up Audit

Name Name:
Signature: Signature:

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4. Transportation
Checklist: Land Vehicle （Light）

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Remark

S = Satisfactory
U = Unsatisfactory G S U
Registration Ins & No Plates
Driver insurance and License
Authorization letter
Emergency Contact List
Journey Management Procedure
Safety map
Working VHF Radio
Crew map
Vehicle ID/Logo 3 Sides
Tire Condition plus spares
Safety Stickers IE wear Seat Belt
Drive Right or equivalent
GPS if applicable
Reverse Warning
Working Vehicle Lights
Working gauges
Mirrors
Wipers
hand Brake working (test 2nd gear)
Seat Belts (Good working order)
General cleanliness (Garbage etc.)
Vehicle Equipment check List
Jack
Jacking Plate
Lug wrench
Sand Boards
Roll Over Protection
Protective Barriers
Strobe Light / Beacon
Reflective Triangles
Fire Extinguisher
First Aid Kit (Updated with Supplies
Water Storage (Cooler)
Tow Rope
Basic Tool Kit
Shovel
Storage Box
Air Pump

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Checklist: Land Vehicle （Heavy）

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow up

S = Satisfactory
U = Unsatisfactory G S U G S U
Registration Ins & No Plates  
Driver insurance and License  
Authorization letter  
Emergency Contact List  
Journey Management Procedure  
Safety map  
Working VHF Radio  
Crew map  
Vehicle ID/Logo 3 Sides  
Tire Condition plus spares  
Safety Stickers IE wear Seat Belt  
Drive Right or equivalent  
GPS if applicable  
Reverse Warning  
Working Vehicle Lights  
Working gauges  
Mirrors  
Wipers  
hand Brake working (test air brakes)  
Seat Belts (Good working order)  
general cleanliness (Garbage etc.)  
Vehicle Equipment check List  
Jack  
Jacking Plate  
Lug wrench  
Sand Boards *  
Roll Over Protection  
Protective Barriers  
Strobe Light / Beacon  
Reflective Triangles  
Fire Extinguisher  
First Aid Kit (Updated with Supplies  
Water Storage (Cooler)  
Tow Rope *  
Basic Tool Kit *  
Shovel *  
Storage Box *  
Air line  

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Checklist: Vehicle Driver

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Driver has current license & DDC trained?
Emergency drivers attend Clinic test?
Follow journey management policies
Driver ensures that all passengers seat belts are fastened
Drivers feet can reach pedals comfortably
Does the driver check mirrors before moving?
Does he start the vehicle in neutral position with clutch depressed
Check the vehicle before start up
Responsible for passengers
Engage gear smoothly
Is the driver alert and regulates speed limit in built up area
Obeys traffic signals/signs
Know and Obeys company alcohol policy
Knows and Obeys company no smoking in vehicle policy
Knows and Obeys company non use of telephone while driving policy
Knows the highway code
Overtaking well done and well timed
Indicators used
Horn used to alert other road users?
Observes safe distance limit to front vehicle
Drives defensively and courteously
Confident and experienced
Execution of hand brake start
No prohibited seats in use
Displays correct attitude
Attend daily pep talk
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Fuel Truck

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE: Hardhats, gloves, goggles, non slip steel toed shoes
Signs: Danger “Highly Flammable” No Smoking, authorized personnel available etc
Lighting protector
Correct dispensing, pumps, funnel, spout
Are relevant procedure available
No fuel in buckets or bowls
Are content of storage tanks boldly written with capacity
Correct dispensing pumps, funnels, spout
Metal containers used for fuel storage and transfer
Only fuel clerks to fill tanks
Dispense fuel in well ventilated area
Fuel location have security lights
Bund walls, sand pits around bulk to contain spills
Correct fire extinguishers
Fuel storage clean with no sign of leaks or spillage
Pump heads and materials non ferrous
Pumping hoses and storage leak free
Storage tanks grounded and labelled accordingly
Fuel never discharged into running engine
Fuel clerk trained for emergency conditions
Manual gauging or level indicator system
Disposal of waste oil/fuel ARAMCO standard
Storage area minimum
Minimum distance of 100m from camp, living areas and others storages
Minimum distance of 250m from explosive magazine
Electronics & phones prohibited in fuel storage area
MSDS available
ERP available for fire, spillage etc
Audit Remarks:

Name: Signature:
Follow-Up Audit:

Name: Signature:

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Checklist: TZ - Small Boat (Zodiac)

Inspected by: ____________ Department: ____________ Date: ____________ No. of Zodiac: ____________
G = Good Audit Follow-up
S = Satisfactory
U = Unsatisfactory G S U G S U
Boat of sound construction and hull well maintained
Engine in good working condition, with cover, no oil leakage
Boat daily checklist on board.
Boat motorist is certificated regarding local regulations. Knows and respects
the rules of navigation
Training for motorist and helper, including MOB, fire procedure, and etc.
PPE for crew - overalls, safety shoes, hat, gloves, sun glasses
All personnel on boat use life jackets, all life jackets in good condition
Radio communication
Journey management procedure respected (call on arrival and departure from
work site)
VTS monitor system
Is there basic equipment: map, fire extinguisher (2Kg ABC), two paddles,
bailer, proper fuel tanks, adequate spare fuel, anchor, pump, tool kit, First Aid
kit with checklist, signal mirror, whistle, canvas for shelter, red flag, flashlight
with spare batteries(dry wrapped), lifebuoy with flotation string (15mts),
plastic bags for rubbish collection
Floor covered with non-slip material
Is boat marked with passenger and cargo capacity
Is the boat marked with an identification number
" No smoking" - "Wear life jackets" signs posted
The motorist use the deadman switch and laniard
Boat motorist ties up the boat before unload and load, directs personnel
orderly embarking and disembarking
All passengers seated before moving
Boat motorist slows down near shrimp ponds, meet with local small wooden
boat, at bends and narrow creeks
Motorist: balance the boat when carrying cargo, control the
passengers, ensure passengers are holding the grab rope, ensure
passengers wear PFD
Audit Remarks:

Name: Signature:
Follow-Up Audit:

Name: Signature:

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Checklist: TZ - Cable Boat (Fanglan)

Inspected by: ____________ Department: ____________ Date: ____________ Name of Cable boat: ____________
G = Good Audit Follow-up
S = Satisfactory
U = Unsatisfactory G S U G S U
Vessel of sound construction and hull well maintained. Name of the boat can
be read easily
Registration in conformity with country regulations, adequate boat document
vessel clean and ordered
Non slippy floor on engine room
Sign: Wear lifejacket
Sign: no smoking
Sign: Wear ear protection in engine room
Radio communication
Journey management procedure respected (call on arrival and departure from
work site)
VTS monitor system
Fixed firefighting equipment in engine room
Engine room isolated
Navigation equipment in good working condition
First Aid kit available, with checklist
Fire extinguishers in sufficient quantity
Lifebuoy with lighted buoy, 15 meter rope.
Drying pump on board
Life raft on board, and adequate for POB
Life raft in good condition and inspected
Map of the prospect on board
Store the life jackets at designated place while on board.
Pilot certified and competent
All workers trained and aware of: Procedure "Lost Vessel", "Medevac", "Man
Over Board", " Fire on board ", "Abandon ship"
Regularly emergency drill conducted.
All personnel trained in fire fighting
Personnel trained in first aid
Maximum number of POB posted
Audit Remarks:

Name: Signature:
Follow-Up Audit:

Name: Signature:

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Checklist: TZ - Airgun Boat

Inspected by: ____________ Department: ____________ Date: ____________ Name of Airgun boat: ___________
G = Good Audit Follow-up
S = Satisfactory
U = Unsatisfactory G S U G S U
Vessel of sound construction and hull well maintained. Name of the boat can
be read easily
Registration in conformity with country regulations, adequate boat document
Vessel in general good condition
Hull appears to be in good condition
vessel clean and ordered, non slippy floor
Sign: Wear lifejacket
Sign: no smoking
Sign: Wear ear protection
Radio communication
Journey management procedure respected (call on arrival and departure from
work site)
Binoculars
VTS monitor system
Fixed firefighting equipment in engine room
Engine room isolated
Navigation equipment in good working condition
First Aid kit available, with checklist
Fire extinguishers in sufficient quantity
Lifebuoy with lighted buoy, 15 meter rope.
Drying pump on board
Life raft on board, and adequate for POB
Life raft in good condition and inspected
Map of the prospect on board
Store the life jackets at designated place while on board.
Pilot certified and competent
All workers trained and aware of: Procedure "Lost Vessel", "Medevac", "Man
Over Board", " Fire on board ", "Abandon ship"
Gun mechanic trained and aware of: procedure of "Test for airgun"
Regularly emergency drill conducted.
All personnel trained in fire fighting
Personnel trained in first aid
Maximum number of POB posted

Compressors certified
Bottles<5 years, and certified
Hydraulic hoses in good condition
Air hoses in good condition
Manometers are functioning well
Made deployment of arrays at low pressure
Audit Remarks:

Name: Signature:

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Checklist: TZ - Catamaran

Inspected by: ____________ Department: ____________ Date: ____________ Name of Catamaran: ___________
G = Good Audit Follow-up
S = Satisfactory
U = Unsatisfactory G S U G S U
Catamaran of sound construction and hull well maintained
Engine in good working condition, with cover, no oil leakage
Steering system in good condition
Catamaran daily checklist on board.
Manual winch and the 4 legs in good condition
Drilling equipment stable on catamaran
Detonator and dynamite are separately stored, keep distance.
Detonator and dynamite are stored in box with lock, link to the rope (15
meters) with 2 buoys. Fix on the catamaran.
No radio or mobiles on catamaran.
Explosive handling procedure is aware and respected.
Explosive cautions sighs is posted.
Motorist is certificated regarding local regulations.
Training for motorist and helper, including MOB, fire procedure, and etc.
PPE for motorist - overalls, life jackets, safety shoes, hard hat, gloves, sun
glasses
Store the life jackets at designated place while on board.
Is there basic equipment: map, fire extinguisher (6Kg ABC, Foam), proper fuel
tanks, adequate spare fuel, anchor , tool kit, First Aid kit with checklist,
flashlight with spare batteries(dry wrapped), lifebuoy with flotation string
(15mts), plastic bags for rubbish collection
Floor covered with non-slip material
Catamaran surrounded with handrails and safety chains.
Marked with passenger and cargo capacity
Marked with an identification number
" No smoking", "Wear PPE", "Wear Ear Protection" signs posted
Emergency stop button of engines in good condition
While moving , motorist balance the catamaran, control the passengers,
ensure passengers are holding the handrail, ensure passengers wear PFD
Audit Remarks:

Name: Signature:
Follow-Up Audit:

Name: Signature:

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5. Camp
Checklist: Minimum Camp Accommodation

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Communications - Effective and manned 24 hours
Accommodation with lockers
Ventilation/cooling per room
Emergency exits clear
Dedicated medical clinic and staff at all times
Sanitary facilities, one for 10 persons
Smoke detectors in each room
Electrical system suitable
Muster map
Windows screened
Maximum double bunks
Emergency light
Relevant HSE signs
MUSTER POINT located
|Fire extinguishers available
Recreation area - To accommodate 1/3 persons
Recreation facilities available
Generator Area clear of spills
Berm available
Waste collection Area Mark
Water storage or treatment area hygienic
Portable drinking water filtered and checked regularly
Regular disposal of waste
Black water collected in fenced area according to GDAD Regulations
Grey water collected in fenced area according to GDAD Regulations
Regular removal of Black and Grey water

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: QC Office

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
HSE Equipment and Signs
Smoke Detector
Heat Detector
Emergency Muster map
Emergency light
Fire extinguishers and Signs
Temperature Monitor
UPS Warning signs
Dustproof cover for workstation, tape cartridge, plotter, etc
Office Conditions
Door conditions
Windows Conditions
Room Cleanness status
Indoor air conditions
AC conditions
Indoor circuitry conditions
Lighting conditions
Seismic data and Supporting data
Seismic raw data and copy data stored separately
Seismic raw data and copy data kept under dry, dust free, anti-shock and air-
conditional environment
Appropriate seismic data storage and transportation procedure
Seismic data backup in hard disk two monthly basis
Seismic data tape deliver list kept
Seismic supporting data stored and backup appropriate
Seismic supporting data uploaded feedback list kept

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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6. Medical
Checklist: Medical Drugs administered by Doctor

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Anti hypertensitives – Adomet tab, Brinerdin
Tenormin, apresoline
Antibiotics - Cap, tetracycline, tab, or susp. Septrin
Ampicillin syrup or cap, seclopen inj.,
Amoebicides - tab, metronidozole
Bronichial spasmrelaxant - Tab, ventolin,
Ventolin syrup, ventolin inhaler
Amnophylin i/v and i/m
Urinary antiseptics - motro furatoin
Analgesics and antipyrectics -
Diuerectics - Moduretic tab.
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Clinic/Doctor

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Qualified medical Doctor at all times
Separate resting area
Radio/Telephone communication
List of personnel allergic to drugs listed
Records kept daily
Doctor involved in first aid training
Pre-employment medical, refresher courses
Referral clinic established
Ambulance ready 24 hours
Emergency kit for ambulance with medevac drugs
Health lectures
Clinic clean and ventilated
Drugs kept hygienically
Adequate supply of drugs as per requirement.
Regular inspection of kitchen and conveniences
Decide on accident classification
Conversant with medevac procedure

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Drugs administered by Nurse

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Antacids - tab, gelusil - mist mag, trisilicate
Antispasmodics – tab, buscopan
Laxatives - dulcolax tab - milk of magnesia
Antihelmintics - tab – vermox
Anti-diarraoeals – cap Immodium
Anti-histamines - tab, zyrtec, lorin,xyzal (levocitrizine)
Anti-emetics – tab, Primpiron
Vitamin preparation – tab, multivitamin, multivite syrup
Vit B Co, Vit. C folic acid
Cough preparations - ezipect, bisalvan, kyposed
Ear/eye/Nose preparation – Eye drops, Neoctef drops
-reactants on the nasopharynx - tab, actifed, actifed syrup –
otrivne nasal drops
Analgestics - tab. Panadol
Audit Remarks:
Follow-Up Audit:

Name Name:
Signature: Signature:

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7. General HSE
Checklist: Departmental Documentation

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Copies of HSE committee meeting minutes files in chronological order
Copies of HSE sectional meeting minutes files in chronological order
Daily pep talk in chronological order
Minutes of meetings includes attendance list, action points and date
Safe operating procedures and checklist for department
Copies of all audits for department and follow -ups
Posted on departmental or camp notice board: (where applicable)
Emergency contingency plans posted
Safety awards of the month
Recent accidents on crew
Targets and goals
Meeting schedule
Audit schedule
Quarterly HSE Newsletter
Bound copy of following excerpt from the SMS:
MSDS information on file for chemicals used in department
Crew Organizational chart
Policy statements
Years Targets
Crew goals and objectives
Incentive program
Meeting schedule
Task listings
Job descriptions for department
Procedures and checklists for department
Monthly revision form for binder up to date
Seismic contract, section pertinent to department
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Hygiene

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
All relevant health hazards identified and addressed
Control measures exist for identified hazards
Pest control (insect) spraying performed on regular basis, documented
Control mosquito breeding / water collection
Mosquito repellent used at night
Wearing of long trousers and long sleeves at night enforced
Evidence of alcohol and drug abuse on crew
Random alcohol testing performed and documented if allowed by law
Food garbage disposed daily
Kitchen waste stored in tight fitting bins and disposed daily
Camp waste segregated (paper and plastics, tins, food waste)
Waste data base exists and is updated monthly
Functioning toilets exist (One for 15 men)
Toilets are cleaned and disinfested daily
Functioning shower units exists (One for 10 persons)
Cleaning schedule posted and followed by cleaning staff
Hygienic cleaning materials available (stop, shampoo, toilet paper etc)
Enforcement of no food in sleeping areas
Drinking water filtered
Hygiene notices posted
Health lectures given by crew Medical Doctor
Drinking water analysis tests performed every month and documented
Field personnel provided with portable water
New crew members are briefed about local health hazards, dehydration,
poisonous plants, sunburn.
Audit Remarks: Follow-Up

Name Name:
Signature: Signature:

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Checklist: Seismic Personnel

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Identity card
Pre-employment Medical
Safety induction course
First aid Training
Checklist
Has appropriated work procedure
Buoyancy aids if working on boats
Water bottles
Rain coats
First aid kits
Safety shoes
Hard hat
Eye goggles
Ear muffs
Hand gloves
Fire extinguishers
Whistle
Reflective jackets
Overalls
Red flags
Audit Remarks: Audit follow-up

Name Name:
Signature: Signature:

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Checklist: Health and Hygiene

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Messing area
Seating served for 30%
Floor Easy to clean
Cooling areas audited weekly
Kitchens
Clean, hygienic, washable floor
Separate cutting for meat and fish
Disinfected daily
Surfaces smooth, easily cleaned
Kitchen personnel
Medically checked twice a year
Clean uniforms/hats/gloves
Adequate laundry facilities
Convenience
Washable floor, running water, soap
Clean uniforms/hats/gloves
Hygiene notices, one for 15 persons
Showers - One for 10 people
Hygienic food storage preparation
Raw food segregated from cooked food
Food chilled before freezing
Cooked food stored above ground
Potable water to ARAMCO / WHO standard
Water not chilled in food freezer
Kitchen/food preparation areas screened
Adequate ventilation
Loose food in sealable containers
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Environmental

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
WASTE DISPOSAL:
Documented
Non Biodegradable separated
Rubbish disposed daily by certified garbage removal company
Collect used oil and disposed of at certified waste management
Co.
Medical waste incinerated under supervision or taken to hospital
Explosive boxes returned to base for burning
Pollution controlled
Drilling holes covered filled up
Cap wires picked up at end of shooting
Key personnel trained in environmental issues
Environmental control included in meetings
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Transport Supervisor

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Set a good example
Monitor drivers, progress report
Establish company driving test, training
Monitor drivers duty hours and scheduled leaves
Enforce rules on
Wearing seat belts
Observing speed limits
Regular vehicle condition checks, maintenance
Incorporate driving safety into briefings
Supervisor accountable for driving performance
Monitor vehicle movements, Eta, etc.
Accident prevention measures
Investigate potential accidents
-Unsafe Acts
-Unsafe Condition
-Near Miss
Install warning signs in appropriate operational areas
Action in case of breakdown / accident
Emergency search procedures known
Safety inspections, audits, meetings
All passengers seated before moving
Involve in investigation of accidents
Provide route definition for regularly used routes

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Explosive Magazine

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Two armed Saudi Policemen on guard
250m away from habitat and fuel dumps, 100m from highways
Danger and no smoking signs
Two different keys to magazines
Minimum two fire extinguishers and sand buckets per magazine
Lightning conductor as per regulation
Two pairs of rubber shoes
Functioning thermometer installed inside the magazine
Magazine fenced and has search lights
Explosives stacked on wooden sticks for ventilation
Explosives stacked 6” away from walls
Cut pieces of explosives or foreign objects not stored
Record and check on stock daily by senior staff
Only authorised personnel handle explosives
License valid and displayed inside the magazine
License number written outside the magazine
Empty explosives boxes disposed by burning and record documented
Guards trained in emergency conditions
Communication of alarm to base camp
Distance between magazines is 75m.
Magazines are earthed to ground
Audit Remarks: Follow-Up

Name Name:
Signature: Signature:

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Checklist: Explosive Transportation

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Explosive supervisor collect and return explosives daily
Log books kept and reconciled
Field log book kept and reconciled daily
Rubber shoes/slippers are used to withdraw explosives
Danger explosive and no smoking signs displayed
Fire extinguishers
Red flags
Explosives are stored in
Original boxes
Licensed magazines
Approved boxes protected
Dynamite and detonators carried in separate vehicles / boats
Vehicle or boat diesel powered
Vehicle or boat dedicated for this task
No unauthorized personnel or goods carried
Only licensed/ trained personnel to handle explosives
No radio in explosive vehicles or boats
Explosives are separated minimum of 25m in the field and guarded
Explosive vehicle/boat storage lined with wood
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Fire Protection and Extinguishers

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Portable extinguishers colour coded: Red – powder; Red – C02 in Saudi
Arabia
Extinguishers distributed at strategic locations
Location map of extinguishers displayed
Powder extinguishers re-charged regularly
Personnel trained on basic use of extinguishers
Emergency escape routes well lit and unobstructed
Fire alarms positioned at strategic locations
Fire wardens are established and trained
Written emergency procedures/plan
New arrivals briefed on procedures
Regular realistic fire drills
Effective roll call system
Muster points
Good housekeeping, sufficient waste bins
Flammable substances stored safely
Separation of all building/caravans/tents min. 3m
Proper cleaning fluid used
All waste disposed as per procedures
Communal areas - 2 escape routes
Fire hose reel system or alternative
Rescue boat for mother vessel
Adequate life rings with 5m ropes
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Fuel Clerk and Fuel Storage

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE: Hardhats, gloves, goggles, non slip steel toed shoes
Signs: Danger and No Smoking, authorized personnel available
Correct dispensing, pumps, funnel, spout
No fuel in buckets or bowls
Dispense fuel in well ventilated area
Only fuel clerks to fill tanks
Fuel location to have security lights
Bund walls, sand pits around bulk to contain spills
Correct fire extinguishers
Fuel storage clean
Pump heads and materials non ferrous
Pumping hoses and storage leak free
Storage tanks grounded and labelled accordingly
Fuel never discharged into running engine
Fuel clerk trained for emergency conditions
Manual gauging or level indicator system
Disposal of waste oil/fuel ARAMCO standard
Storage area minimum
Minimum distance of 100m from camp, living areas and others storages
Minimum distance of 250m from explosive magazine
Electronics & phones prohibited in fuel storage area
MSDS available
ERP available for fire, spillage etc
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Generator & Electrical Installation

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Distribution board on/off switch
Switches accessible all times
Switching devices pad-lockable
Earmuffs available
Distribution board made from metal
Interlocking isolation switch on door
Outgoing circuits earth sensitive devices
Overhead cable clear of building stairs walkways
Colour coded and heavy duty flex
One common earth grid with two electrodes
Three phases connections same order
Socket and plug protection
Generator under cover
Alternator and exciter totally enclosed, air cooled
Noise level <85dB(A) at one metre
Radio frequency suppression
Rotating parts guarded
Drip tray for fuel / oil
Fuel tank rigid support with armoured pipe
Exhaust lagging and away from habitat
Emergency stop button clearly displayed
Generator earthen
Maximum load/ammeter readings spec
No smoking and no entry signs
Over current protective devices (CD) installed
Requirements of IEE wiring regulations fulfilled
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Welding, cutting and equipment

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Always inspect equipment before start
Regulators, torch or electrode, gauges, valves, nozzle
Labeled cylinder connections
No smoking signs displayed
H2O Hoses tested for leakage
PPE
Eye protection
Face shield/gloves to elbows
Leader gloves to elbows
Overalls with apron
Safety boats with steel toes
Cooling quench for materials
…...Two 9kg Extinguishers
Fire watch manning
If not in workshop area, obtain hot work permit
Clear area before welding
Avoid welding fuel tanks and drums
Welding cylinder kept upright
Wait 30 minutes after welding
Materials being welded free of oil or grease
Avoid welding at height or use safety belt
Cylinders stored in cool place with flashback arrestors
Cylinders pressure checked regularly, dated, color coded
Have protective guard over valves
Audit Remarks Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Bench/Hand Grinder

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Only competent personnel to use a bench or a hand grinder?
The workshop has a designed area for grinder?
Bench grinder area marked with warning signs “DANGER” “EYE
PROTECTION MUST BE WORN”?
No combustible or flammable substances within the vicinity.
No one within the vicinity?
Grinder in good condition and grinder cable checked for leakage, and
plugged on separate wall socket?
All safety guards are functioning?
Operator wears eye goggles, helmet, gauntlets, long sleeve coveralls,
apron and safety boots?
When ready to start operator switches on the socket switch and then the
grinder?
Operator grips firm at the handle and moves grinder gently over object to
be ground?
On completion of grinding, operator switches off the grinder an then the
socket switch?
Grinder cable wounds up neatly?
Area kept clean?
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Mechanic Workshop

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
All Mechanic staff wears appropriate PPE’s including safety shoes,
coveralls, hand-gloves? In addition:
- Eye goggles for welder and grinder?
- Helmet for crane operator and helpers?
- Insulation shoes, long rubber hand gloves, mask; eye goggles for Battery
harging personnel?
Appropriate Safety Signs displayed in the Workshop:
“Safety Shoes Area” sign posted in the workshop
“No Smoking” sign posted in the workshop
Bench grinder area marked with warning signs
“Restricted Area”, “Danger”, “Eye Protection must be Worn”?
Battery Charging Area marked with warning signs.
- “Restricted Area”, “Danger”
Eye wash station to be located close to the battery charging area.
Fire fighting procedure:
-Muster points with adequate fire extinguishers located in the Workshop
area?
Fire extinguisher location diagram and Fire plan clearly displayed?
-“Fire Alarms” at strategic locations with adequate number of:
Fire Alarm Switches” and “Emergency Exits” well established”
-Tag System for personnel monitoring?
-All oils clearly labeled?
-Proper cleansing agents used?
No smoking signs inside/outside Workshop store?
No electric cables running across Workshop area surface?
All rubbish in bins provided?
MSDS information available in workshop
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Safety

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
All HSE meeting minutes files chronologically?
All accident reports for same accident together?
All accident reports file chronologically?
Safe procedure guides on file?
PPE records show all issues?
All routine safety inspection? Audits on file?
Details of current Emergency contingency plan on file?
Minutes of all safety meetings on file?
Details of all training courses into attendance on file.
Driver’s safety incentive points kept current?
Names of all monthly safety awards winners on file?
Current health certificates for all food handlers on file?
Emergency Response Drill Reports kept on file
MSDS information on file
Checklists on File
Fire register on file?
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Avoiding Snake Bite

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
TO AVOID A SNAKE BITE
Identify snakes in the prospect area
Watch where you step; step on top of logs not across
Look closely before parting bushes
Use sticks not hands for turning over stones / logs
Never Tease, pick-up or corner snakes
Never pick up dead snakes
Do not sleep on top of dry wood or grass
Check bedding clothes or packs before using them.
:
WHAT TO DO AFTER SNAKE BITE
Do not panic, keep the victim calm, lying down
Immobilize affected part
Apply broad pressure bandage above bite.
Position affected limb lower than the heart
If possible kill the snake for identification
Do not cut open the skin or suck the venom by mouth
Start a Medevac operation for the victim
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Enhanced HSE Management

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Visible Management Commitment to HSE
Sound HSE Policy
Competent Safety Advisers
High, well understood, HSE standards
HSE to be a line management responsibility
Techniques to measure HSE performance
Realistic HSE Targets and objectives
Audits of HSE Standards and practices
Effective HSE Training
Thorough investigations and follow up of injuries accidents
Effective motivation and communication.
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: TZ - Navigation Boat

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE available: Hard Hat, Hand Gloves, Steel Toed Boot &
Life jacket (Buoyancy Aid)
Operator has laminated procedures and ID card
Minimum two life-rings, one with life line & two paddles
First aid kit complete and contents to specifications
Life jackets for boat complement
Fire extinguishers, min 2 type ABC/CO2 & located for easy access
Pep talk in morning- topic? (……………………………………….)
Deck hands are aware of last accident on crew
Deck hands trained in man over board procedure
Deck hands know what a near miss and unsafe act is & can give example
“No Smoking” advisory displayed and obeyed
Boat tied off before boarding-loading & entering conducted in orderly fashion
Equipment arranged orderly with no tripping or entanglement hazards
Water boxes & anchors secured & not obstructing passage
Worker employ proper pulling & lifting techniques
Dropping of water boxes done with utmost care no leaning over water
Equipment well prepared to avoid entanglement with worker’s feet, no haste /
panic
Navigator / Quarter master have full visibility of deck crew during operations
Vessel clean with no collection of waste or oil spillage
Vessel navigation system, conducted regularly and documented
Man - over board drills conducted regularly and documented
Navigator watchful of deck crew & maintains order
Wheelhouse arrangement orderly with equipment properly mounted or stowed
Navigator a trained first aider
Contingency procedures for emergency posted – navigator / quarter master
conversant
Navigator / Quartermaster aware of emergency radio protocol
Radio Communications
Life Raft in date and capacity equal to passengers on vessel

Audit Remarks: Signature:

Follow-Up Audit: Signature:
Name
Name:

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Checklist: Inland Water Marine Vessel

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE available: Hard Hat, Coveralls, Hand Gloves, Steel Toed Boot & Work Vest
(Buoyancy Aid}
First aid kit complete and contents to specifications
Operator has laminated procedures and ID card
Minimum two life-rings, one with life-line & two paddles
“No Smoking” sign displayed and obeyed
Life jackets for boat complement
Fire extinguishers, min 2 type ABC / CO2 & located for easy access
Evacuation procedures posted and crew aware of same, demonstrate.
River master aware of emergency radio protocol
Vessel navigation system, lights and radios functional
Valid Vessel and operator license
River master ensures all personnel on board hold valid swimming passport
River master ensures buoyancy – load distributions and security.
Pep-Talk in the morning, Topic? (__________________________________)
Deck hands are aware of last accident on crew.
Deck hands know what a Near Miss and unsafe act is and can give example.
Man-overboard drills conducted regularly and documented
Equipment arranged orderly with no tripping or entanglement hazards
Deck hands employ proper pulling and lifting techniques
Bilge’s clean and pumps working correctly
Generator and switchgear in good conditions
Steering and linkages in good conditions
Main engine and propulsion in good conditions
Safety rails, ladders and deck in good conditions
Hatches and bulkhead doors operational
Vessel clean with no collection of waste or oil spillage
Deck Machinery in safe working condition
Wheelhouse arranged orderly with equipment properly mounted or stowed.
Radio Communications

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Frist Aid Kit

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
First aid box is sealed & inside water proof container
Personnel aware of sealed first aid kit procedures (Opened only for accident)
First aid box checked weekly & replenished after use
First aiders have red cross sticker on helmet and box
One first aider trained to Level 1 on field unit
One first aider trained to Level 2 on field unit
Canvas stretcher available on field crew & its use known
First aiders attend refresher course yearly
Contents of First Aid Box:
Qty 6 Small sterilized dressing
Qty 3 Mexium sterilized dressings
Qty 3 Large sterilized dressings
Qty 12 Adhesive wound dressing
Qty 2 Zinc oxide plaster (3cm x 5m)
Qty 2 Triangular bandages
Qty 10gr Sterilized cotton wool
Qty 2 sterilized eye pads
Qty 1 Leaflet (Laminated to show basic principles of first aid)
Qty 1 Water proof dressings and plasters
Qty 1 Packet safety pins
Qty 1 Tube antiseptic cream
Qty 1 Scissors
Qty 2 Laerdal type pocket masks
Qty 1 Notebook to record incidents
Qty 4 Antiseptic towelettes
Qty 1 Pair Sterile gloves
Qty 1 Laminated check list of the above
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Clinic

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Clinic managed by medical doctor or nurse at all times
Medical staff are accommodated near clinic
Workers pre-employment medical records available
Medical Doctors involved in first aid training & health lectures
All new workers medically checked before employment
All visitors medically checked
Referral hospital established for emergency
Are medical records properly documented
Are medical drugs properly stored on the rack and refrigerator
MEDEVAC plan established and drill carried out monthly
Camps/vessels/boat regularly fumigated, minimum once per month
Medical doctor reports accidents to HSE Department
Door of clinic large enough for stretcher access
Clinic is well ventilated & cooled
Rooms are available in clinic: one for examination and for consultation
Wash hand basin with running water and towels available
First aid materials store is available, clean & organized
Staff wear clean medical uniforms
A suitable system is in place for record keeping arranged properly in filling
cabinets.
Appropriate items & medical supplies as per contract
Project map posted.
Telephone and list of telephone numbers for Hospital, PC, HSEA etc.
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Ambulance Vehicle

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Inspected as per daily vehicle checklist
Ambulance is a 4 wheel drive robust vehicle
Air condition installed & functioning
Spacious & accessible enough to carry therapeutic measures
Good interior lightning
Drug & equipment cabinet secure, lockable & easily accessible, well displayed
& labeled.
Hooks for drip bottles
Good house keeping maintained
Radio Installed & functioning GPS and mobile telephone
Prospect map available with travel times labeled.
White in color & has Red Cross sign & Ambulance written on both sides
Siren & rotating warning light both functional
Ambulance used for emergency situations only
Driver is aware of speed limits
Driver starts ambulance daily to ensure its reliability
Doctor is always aware of ambulance drivers whereabouts
Emergency medical bag available
Contents of Emergency Equipment for the Ambulance
Intravenous solution & giving sets
Oxygen enough to carry victim from the furthest location to the clinic
Suction unit (battery operated)
Inflatable stretcher
Arm/leg splints, spinal boards, cervical collars
Simple airways
List of injections in the Emergency Bag
Pentazocine/Pethidine, Diazepam, Morphine, Amionphylline,
Aprosolin, Phenergan, Hydrocortisone, Xylocaine, adrenaline,
Calcium,Gluconate.
LV infusion: Dextrose saline, Normal saline, Haemacel/Dextran,
Dextrose water.
Ambulance & emergency bag to be audited weekly & documented.
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Food Store

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Enforcement of “Authorized Personnel Only”
Good ventilation or cooling provided, room temperature minimal
Store adequate in size – no over crowding
Shelves constructed of material that can be easily cleaned – Well painted
plywood or aluminum / stainless steel
All food stuffs properly organized on shelves & labeled accordingly
All bulk foods stored in covered containers
Washing soaps/detergents isolated from food items
Daily products & tinned foods inspected regularly for expired items
Flammable items (Matches, napkins, etc) not stored with food stuffs
Shelf separation adequate, no heavy items stored on high shelves
General high standard of cleanliness and tidiness
Discarded paper cartons & packing boxes not accumulated
Posted schedules for cleaning of food store
Posted schedule for inspection of standards by camp boss
Posted schedule for defrosting/cleaning of freezers/fridges countersigned by
Doctor or Nurse.
Food store audited minimum weekly by medical staff
Electrical fittings adequate
Lightening adequate
Restocking controlled and inspected by camp boss
No stacking on floor except for bulk food containers
Plastic and glass containers on containment trays in case of spillage or
breakage
Vegetable/fruit stored under controlled temperature minimal?
Store man monitored by Medical Officer & has scheduled Medical
examinations
Emergency fire fighting equipment nearby
Emergency alarms audible within store.
Inside door release to escape walk in cooler or freezer
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Dynamite Magazine

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Proper PPE Available: Hard hat, Anti-Static Safety Boats, Hand gloves, First Aid
Kit
Emergency procedures posted and known by master blaster
Anti-static mats at entrance way of magazine
ABC type fire extinguishers present, qty 2
Warning signs posted: “Danger Explosives”, “No smoking” – No open flame”,
“No Radio Transmission”.
Master blaster/Security challenge all personnel that approach & conduct body
search
Magazine equipped with lightning conductor
Explosive magazine complies with Saudi and BGP/CNPC regulations
License current & prominently displayed
Magazine grounded at minimum two points
Two padlocks secure door with covered hasps – tamper proof
Inventory log book for daily consumption inside magazine
Ventilation ducting adequate & covered with mesh
Min/Max thermometer hanging inside wall temperature
Contents of magazine stacked correctly, away from walls and no overcrowding
Magazine is illuminated during dark hours
Magazine clean, no collection of waste materials
Emergency contingency procedures posted, master blaster/Security
conversant
Provision of emergency evacuation as on-shore muster area and radio
communication
Site of magazine is located well away from local communities.
Master blaster/security aware of emergency radio protocol
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Catering Staff

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Medically inspected before employment as per food handlers medical
examination (See Doctor)
Food handlers monitored by Medical Officer quarterly
All staff have appropriate clothing; White Uniform, Safety Footwear, Cap,
Apron & gloves (when required), 2 pairs of all
Uniforms neat, clean and washed regularly
Kitchen staff understand and demonstrate use of fire blanket and fire
extinguisher
Kitchen staff understand emergency procedures
Kitchen staff have ID’s
Pep talk in morning – topic?
Kitchen staff aware of last accident on crew
Kitchen staff know what near miss and unsafe act is and can give examples
Kitchen staff have reported unsafe act/near miss recently - documented
Kitchen staff have attended an HSE meeting recently
Kitchen staff aware of reporting procedures for accidents and bad PPE
Kitchen staff recently received course from Doctor/Nurse on “Food Hygiene &
Sanitation for field Crews”
Kitchen staff have recently attended health lectures by Doctor/Nurse
Kitchen staff aware of danger of diseases spread by contaminated food
Kitchen staff aware of how to prevent cross-contamination of food during
transport, storage, preparation and thawing
Kitchen staff aware how to dispose of separate kitchen waste in labeled
rubbish bins and can demonstrate
All personnel forbidden to smoke in the catering premises
Antiseptic soap, nails brushes and disposable towels available
Posted hygiene signs to wash hands after using toilets

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Cap Magazine

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Proper PPE available: Hard Hat, Anti-Static Safety Boots, Hand Gloves, First Aid
Kit.
Emergency procedures posted and known by master blaster
Anti-static mats at entrance way of magazine
ABC type of fire extinguishers present, Qty 2
Warning signs posted: “Danger Explosives” No Smoking “ – No Open Flame”,
“No Radio Transmission”
Master blaster/security challenge all personnel that approach and conduct
body search.
Barge equipped with lightning conductor
Explosive magazine complies with Saudi Arabia and BGP/CNPC regulations
License current and prominently displayed
Magazine grounded at minimum two points
Two padlocks secure door with covered hasps – tamper proof
Inventory log book for daily consumption inside magazine
Ventilation ducting adequate and covered with mesh
Min/Max thermometer hanging on inside wall temperature
Contents of magazine stacked correctly, away from walls and no overcrowding
Magazine barge is illuminated during dark hours
Barge clean, no collection of waste materials
Emergency contingency procedures posted, master blaster/security conversant
Provision for emergency evacuation has on-shore muster area and radio
communications
Site of barge mounted magazine is located well away from local communities
Master blaster/security aware of emergency radio protocol.

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: GPS / Monument Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE Available: Hard hat, Job Master, First Aid Kit Complete, Emergency
procedures, coverall ski belts if applicable
Laminated procedures with headman and known by all crew members
Personnel have ID’s
Pep talk in morning topic
Canvas stretcher with crew at all times and it’s use known if in remote area
Headman verifies all workers present at start / end of day
Headman aware of emergency radio protocol
Trained first aider aware of pressure points to stop bleeding
Trained first aider and headman aware of MEDEVAC procedures
Radio communication available and effective
Personnel aware of last accident on crew
Personnel aware of near miss or unsafe act
Personnel attended HSE meeting recently
Personnel aware of any crew member receiving HSE award recently
Personnel have reported seeing any wildlife lately to the Supervisor
Personnel aware of thunderstorm, irate villagers and lost man procedures
Personnel aware of reporting procedures for accident and bad PPE
Personnel aware of last time audited by Supervisor or Party chief
Personnel have drinking water
Machete handlers – use line cutting audit checklist
Equipment stowed with sharp points directed away from personnel
Sledge hammer operator and assistant wear goggles and gloves
Assistant holds monument pipe firmly and near ground on first blows
Less force used on first strike to determine force required
Gloves always worn when mixing cement.
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Land Camp

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Fire alarm and central fire muster point clearly labelled
Fire extinguishers placed at strategic locations and above ground level
First aid kits available
Safety notice board and signs on site with current information
Radio communications available and effective
Radio antenna earthed properly
Contingency plans displayed near radio
Effective lighting in camp and in offices
Fuel storage area as per fuel use checklist
Accommodation and work areas of camp separated
Adequate accommodation available for all personnel
Doctor/nurse permanently on site with working clinic
Camp boss / Safety Advisor permanently on site
Security (Company - Police, Coast Guard or Army) permanently on site
Dedicated vehicle parking area
Camp site and building areas exhibit good housekeeping
Noise levels less than 85dB
Waste disposal as per environmental checklist
Waste bins marked for separation: paper and plastics – tins – food waste
Temperature of offices and rooms agreeable
Water supply and storage sufficient for camp
Water quality good and tested on regular basis
Toilets and showers adequate for quantity of personnel occupying camp
Kitchen and personnel as per kitchen hygiene checklist
Food storage as per food store checklist
Generator and electrical wiring as per generator / electrical checklist

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Layout Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
PPE available: Cap, Safety Shoes, Hand gloves, First Aid Kit, , Coveralls,
Sun Glasses, life jacket if applicable
Emergency Procedures
Laminated procedures with headman and known by all crew members
Personnel have IDs.
Pep talk in morning – topic?
Canvas stretcher with crew at all times and its use known for remote area
Headman verifies all workers present at start / end of day
Headman aware of emergency radio protocol
Personnel always travel in groups or minimum in pairs
Trained first aider present
Trained first aider aware of pressure points to stop bleeding
Trained first aider and headman aware of MEDEVAC procedure
Radio communication available and effective
Personnel aware of last accident on crew
Personnel aware of near miss or unsafe act or unsafe condition
Personnel attended HSE meeting recently
Personnel aware of any crew members receiving HSE Award recently
Personnel have reported seeing any wildlife lately to the supervisor
Personnel aware of thunderstorm, irate villagers and lost man
procedures
Personnel aware of reporting procedures for accident and bad PPE
Personnel aware of last time audited by supervisor or Party Chief
Personnel received job related or HSE training other than induction
Personnel have drinking water & are trained in identification of heat
stress
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Seismic headman

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Set a good example for others to follow
Enforce company rules and procedures
Attend pep talks daily
Has laminated procedures
Received job related or HSE training other than HSE induction
Trained in first aid and unsafe act auditing
Knows where pressure points are to stop bleeding
Knows the last time medevac drill was conducted on his crew or other crews
Know what is unsafe act, near miss, unsafe condition and can give past examples
Correct unsafe acts as seen or reported
Is aware of last accident on crew
Reviewed learning points from last accident with his crew
Knows whom to report accidents, bad PPEs etc
Has attended HSE meeting recently
Knows what to do before and during thunderstorm
Know what to do with irate villagers
Responsible for safety of his personnel
Is aware of company HSE Policy, drug Policy etc
Aware of company HSE News Letter
All his personnel are medical and swim tested and safety inducted
Received any HSE award know who received recently

Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: HSE Documentation

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
HSE minutes of meeting files in chronological order for all departments
Minutes of meetings includes attendance list, action points, party and date
HSE suggestions
Unsafe act and near miss
PPE record issued in store and balance figures
All audits for departments and follow-ups
Emergency contingency plans
Training course on database for staff
All safety incentives awards recorded and up to date
Swim passport, health check, and HSE induction for all employees
Fire alarms testing logs
Medevac drills
Water analysis for camp
Fire extinguisher logs on monthly basis
HSE weekly report
A copy of targets, plan, policy, accidents with all the department heads
BGP/CNPC Policy Manual
BGP/CNPC HSE Modules
BGP/CNPC Health – Safety – Environment Management System (HSE MS)
Saudi Arabia government Laws and Regulations:
Explosives Regulations
Inland Waterways Regulation
Petroleum Storage act
Factories Decree
Minerals Oils Safety Regulation
Workmen Compensation
MSDS on file for all crew chemical hazards
ARAMCO Seismic contract, section pertinent to HSE
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Fire Protection

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Potential fire hazards are identified and appropriate measure taken
Correct type of extinguishers available at strategic locations
Extinguisher mounted off the ground
Local Fire Department telephone number posted
All extinguishers are visually checked on a monthly basis and documented as
so
Fire wardens established and trained
Emergency drill carried out minimum monthly and documented
Personnel trained at basic use of extinguishers
Emergency escape routes are clearly marked and unobstructed
Fire alarms (Electrical and manual) positioned at strategic locations
Electric alarms have documented logs including testing and maintenance on
a monthly basis
Independent smoke alarms are tested minimum monthly and documented as
so
Fire emergency procedures written
All premises cleared by dedicated fire warden during drill exercise
Effective roll call system in place
Separations of all caravans / tents minimum 5 m
All waste disposed as procedures so as not to create fire hazard
No smoking signs are displayed at appropriate place and obeyed
Semi fixed fire fighting system in place
Area around cooking stoves covered by fire retardant material
Flammable substances stored in dedicated areas / stores
Audit Remarks:
Follow-Up Audit

Name Name:
Signature: Signature:

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Checklist: Drivers Competency

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-Up

S = Satisfactory
U = Unsatisfactory G S U G S U
Checks right, left and behind before starting
Adjusts seat to reach pedals comfortably
Anticipates need to stop well in advance
Starts in neutral gear with clutch depressed
Executes hand brake to start on hill
Completes daily checklist
Maintains safe distance
Gear change is smooth and double clutch used when necessary
Maintains firm grip of the wheel and steers smoothly
Pressures clutch only when changing gear
Observes right – of – way rules
Lower gear and slows before turning corner
Uses indicators and checks mirrors before moving off
Gives proper signals well in advance
Does not interrupt flow of oncoming traffic
Uses mirror and checks blinds spot, checks mirrors regularly
Overtaking done with signals and quickly
Horn used to alert pedestrian and drivers
Tolerant of poor driving actions of others
Makes turn from correct lane and turns into proper lane
Reduces speed in built up areas
Patient during delays
Has adequate visibility of road ahead
Does not cut back into lane too soon after overtaking
Uses seat belts and ensures that passengers do so also
Applies brakes early and smoothly
Stops well behind vehicles in front
Comes to complete stop at stop signs / red lights
Alert for pedestrians, especially children and obeys traffic signs
Maintains vehicle clean and tidy
Attends daily pep talks
Has a current license for the vehicle category driven
Has at least one year driving experience
Attended defensive driving course recently
Know when and how to engage 4 wheel drive
If the vehicle was yours, will you let him operate it
Audit Remarks: Follow-Up Audit:

Name Name:
Signature: Signature:

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Checklist: Fuel Area

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Documents – Vehicle documents
PPE: Hardhats, gloves, goggles, non slip steel toed shoes life vest
“Danger Highly Inflammable Liquid” and “No Smoking” “Only
Authorised personnel” etc signs visible
Lightning Protector available
Are relevant procedures pasted
Content of storage area written boldly with capacity
Correct dispensing, pumps, funnel, spout
Metal containers used for transfer of fuel
Dispense fuel in well ventilated place
Only fuel clerks to fill tanks
Fuel location to have security lights
Bund walls, sand pits around bulk to contain spills
No sign of spillage on the barge
Fuel Clerk updates fuel issue logs daily
Pump heads and materials non ferrous
Communication or alarm with Base
Pumping hoses and storage leak free
Storage tanks grounded and labelled accordingly
Adequate fire extinguishers available
Fuel never discharged into running engine
Fuel clerk trained in emergency procedures
Manual gauging or level indicator system
Disposal of used oil/fuel to ARAMCO standard
Storage area minimum
100m from camp
………..250m from explosive magazines

Audit Remarks: Follow-Up Audit:

Name: Name:
Signature: Signature:

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Checklist: Survey Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Vehicle and Equipment Check
General vehicle condition – Vehicle License, Insurance etc.
Vehicle daily checklist available and Speed limit posted
Vehicle Radio for communication, fire extinguisher and First-aid kit
Crew Emergency Contact list and safety map
Vehicle Jack, jack plate, spare tyre, tools kit, tow-rope, shovel etc
Air pump pressure
Seatbelt available and functional
Vehicle lights – Beacon light, headlamps, indicator lights, horn
Crew takes water to line daily
PPE Check
Coverall, handgloves, reflective vest, goggles etc
Steel-toed safety shoes/safety footwear
Life jacket for Shallow water operation (where applicable)
Procedure and Regulation
Crew conducted Daily Pep-talk (Topic - )
Driver and passengers wear seatbelt
Crew complies with Safe working procedures
Crew observes road crossing procedure (where applicable)
Crew observe safety distance during survey marking ( where applicable)
Crew wears reflective vest in road crossing operation (where applicable)
Stop operation in bad weather condition
Store work materials safely in vehicle
Vehicle and/or boat entry/exit procedure followed
Observe no horseplay on the line
Know that no one man should work alone on the line
Nobody wander on the line
Practice teamwork
Collect and return their wastes back to camp
Driver obeys road traffic regulations, company speed limit
No person sleep or sit under vehicle
Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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Checklist: Drill Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Vehicle and Equipment Check
General vehicle condition – Vehicle License, Insurance etc.
Vehicle daily checklist available and Speed limit posted
Vehicle Radio for communication, fire extinguisher and First-aid kit
Crew Emergency Contact list and safety map
Vehicle Jack, jack plate, spare tyre, tools kit, tow-rope, shovel etc
Air pump pressure
Seatbelt available and functional
Vehicle lights – Beacon light, headlamps, indicator lights, horn
Crew takes water to line daily
PPE Check
Hard hats, coverall, handgloves, goggles,
Steel-toed safety shoes
Anti-static uniform for explosive Chargemen
Life jacket for Shallow water operation (where applicable)
Waterproof trousers for Shallow water operation (where applicable)
Procedure and Regulation
Crew conducted Daily Pep-talk (Topic - )
No wearing of loose clothing & jewelry in drill operation
Drill crew complies with maintenance procedure
Drill rig Emergency Button
Prohibit the use of radio, mobile phone etc in explosive operation
Rotating parts are guarded
Stop operation in bad weather condition
Vehicle and/or boat entry/exit procedure followed
Unauthorized persons keep away from drill and explosive operation
Crew observe Safety distance from facilities (refer to GDAD standard)
Dynamite and Detonators stored in separate boxes
Chargemen ensures firing lines are shunted before connecting to charge
Explosive charge primed just prior to completing drilling
Chargemen ensure charge are poled to reached desired depth
Driver obeys road traffic regulations, company speed limit
No person sleep or sit under vehicle
Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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Checklist: Line Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Vehicle and Equipment Check
General vehicle condition – Vehicle License, Insurance etc.
Vehicle daily checklist available and Speed limit posted
Vehicle Radio for communication, fire extinguisher and First-aid kit
Crew Emergency Contact list and safety map
Vehicle Jack, jack plate, spare tyre, tools kit, tow-rope, shovel etc
Air pump pressure
Seatbelt available and functional
Vehicle lights – Beacon light, headlamps, indicator lights, horn
Crew takes water to line daily
PPE Check
Coverall, handgloves, goggles etc
Steel-toed safety shoes/safety footwear
Life jacket for Shallow water operation (where applicable)
Procedure and Regulation
Crew conducted Daily Pep-talk (Topic - )
Driver and passengers wear seatbelt
Line crew complies with material layout & Pick-up procedure
Crew observes road crossing procedure (where applicable)
Crew complies with layout and pick up of overhead cable crossing road
procedure (where applicable)
Crew wears reflective vest in road crossing operation (where applicable)
Stop operation in bad weather condition and report to Supervisor
Vehicle and/or boat entry/exit procedure followed
Observe no horseplay on the line
Know that no one man should work alone on the line
Material truck workers firmly hold truck during vehicle movement on line
Nobody wander on the line, No hunting for wildlife
Practice teamwork
Environmental protection: Collect and return their wastes back to camp
Driver obeys road traffic regulations, company speed limit
No person sleep or sit under vehicle
Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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Checklist: Vibrator Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Vehicle and Equipment Check
General vehicle condition – Vehicle License, Insurance etc.
Vehicle daily checklist available and Speed limit posted
Vehicle Radio for communication, fire extinguisher and First-aid kit
Crew Emergency Contact list and safety map
Vehicle Jack, jack plate, spare tyre, tools kit, tow-rope, shovel etc
Air pump pressure
Seatbelt available and functional
Vehicle lights – Beacon light, headlamps, indicator lights, horn
Crew takes water to line daily
PPE Check
Coverall, hardhat, handgloves, reflective vest, goggles etc
Safety shoes
Ear defenders
Vibrator has fire extinguisher and first-aid kit
Procedure and Regulation
Crew conducted Daily Pep-talk (Topic - )
Driver and passenger wear seatbelt
Supervisor scouts the line ahead
Lead vehicle ahead of vibrators
Vibrator Pusher wears reflective vest and at 50m min. from vibrators
Vibrators maintain safe distance from each other
Vibrators maintain effective communication with Recorder and Supervisor
Vibrators observe safe distance from facilities
Vibrator entry/exit procedure followed
Vibrators observes safe road crossing procedure (where applicable)
Drivers use vibrator beacon and headlamps during night operation
Cover pads with blanket during vibration on roads
Crew wears reflective vest in road crossing operation (where applicable)
Work use traffic police in city operation (where applicable)
People maintain minimum 5m distance from vibrator
Environmental protection: Collect and return waste-oil, used filters etc back to camp
Vibrators detour in orderly manner
No person sleep or sit under vehicle or vibrator
Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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Checklist: Shooting Crew

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Vehicle and Equipment Check
General vehicle condition – Vehicle License, Insurance etc.
Vehicle daily checklist available and Speed limit posted
Vehicle Radio for communication, fire extinguisher and First-aid kit
Crew Emergency Contact list and safety map
Vehicle Jack, jack plate, spare tyre, tools kit, tow-rope, shovel etc
Air pump pressure
Seatbelt available and functional
Vehicle lights – Beacon light, headlamps, indicator lights, horn
Crew takes water to line daily
PPE Check
Hard hats, coverall, handgloves, goggles,
Steel-toed safety shoes/safety footwear
Anti-static uniform for shooters
Life jacket for Shallow water shooting (where applicable)
Waterproof trousers for Shallow water shooting (where applicable)
Procedure and Regulation
Crew conducted Daily Pep-talk (Topic - )
Shooting crew has whistle, red flag, wear reflective vest etc
Only authorized persons in shooting operation
Shooting crew complies with safe shooting operation procedure
Prohibit the use of electronics, radio, mobile phone etc in shooting
operation
Shooter observe Safety distance from facilities (refer to GDAD standard)
Ensure firing lines are shunted before connecting
Shooters and other people maintain min. distance of 30m from loaded
shot points
Shooters and other people “Keep Away” 30m from loaded shot points on
Land shooting operation
Shooters and other people “Keep Away” 50m from loaded shot points on
Marine shooting operation
Stop operation in bad weather condition
Shooter maintains effective communication with Recorder
Observe “No Night” shooting policy
Driver obeys road traffic regulations, company speed limit
No person sleep or sit under vehicle
Audit Remarks: Audit Follow-up

Name Name:
Signature: Signature:

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Checklist: Battery Charging Room

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
Is take off all jewelry sign posted?
Is battery charging PPE signs posted?
Are electricity danger signs posted?
Is there an eye wash station available?
Could the eye wash fluid keep wash the eyes for five minutes without stop?
Is the rubber glove available?
Is the earth the charging machine?
Is the feather apron available?
Is the face guard available?
Are all charging machine in good working condition?
Does all electricity wires installation comply with the IAGC guide line
Is the basic tools available?
Is the battery charging area clean and tidy?
Is the battery charging procedures posted in English and in local language?
Is the electrician familiar with the charging procedures?
Is the battery acid properly stored and labelled?
Are the charging batteries sit on rubber or wood floor?
Is there any emergency light?
Proper ventilation
Is there any RCD device installed?
Audit Remarks:

Name
Signature:

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Checklist: Tyre Shop

Inspected by: ____________ Department: ____________ Date: ____________

G = Good Audit Follow-up

S = Satisfactory
U = Unsatisfactory G S U G S U
The worker was trained for performing the work
The workers experienced
Before starting repair mechanic inspected the rim, ring and locking ring etc
Workers wear proper
Mechanic secure the ring and locking ring by himself
Tools in good condition
Mechanic inspect give a brief talk about safety of tyre repair to workers
Enough chain locked for the prevention of ring blow off
Pressure gauge used while inflation
Mechanic make final check for air leakage, valve setting, setting of ring and
locking ring
Locking ring toward the ground while the wheel stored

Audit Remarks:

Name
Signature:

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