Casing Crew Field Audit Form

"*" indicates required fields

Region*

Select your location

Audit Information

Auditor*

First Last

Date*

MM slash DD slash YYYY

Supervisor*

Customer*

Crew Pusher*

Rig*

Salesman*

Location*

Audit conducted during:*

Rig-Up

During Job

Rig-Down

EMERGENCY, SAFETY ADMINISTRATION, AND HOUSEKEEPING

Do employees know who to contact in case of emergency?*

Yes

N/A

Do employees know where the muster points are?*

Yes

N/A

Are all exits and paths free of obstructions?*

Yes

N/A

Do all employees have the minimum required safety training?*

Yes

N/A

Have all employees been trained on the equipment they operate?*

Yes

N/A

Is the proper safety documentation being completed?*

Yes

N/A

• Safety Meetings*

Yes

N/A

• JSA'S*

Yes

N/A

• Safe Task and Hazard Analysis*

Yes

N/A

• Job Performance Tickets*

Yes

N/A

• Equipment Performance Tickets*

Yes

N/A

Are all employees well rested?*

Yes

N/A

Is all required PPE being used?*

Yes

N/A

Is work areas clear of slip, trip, and fall hazards?*

Yes

N/A

PRE JOB AND RIG-UP

Dropped objects-personel are in safe zone during overhead lifts*

Yes

N/A

All tong doors are equiped with functionng safety interlocks*

Yes

N/A

All danger labels are in place and pinch points painted yellow*

Yes

N/A

Hand and finger safety-hands off suspended loads and clear of pinch points*

Yes

N/A

Is company man aware of TRK/PP person in charge?*

Yes

N/A

Spider mounted on top of rotary is secured from rotating during make-up*

Yes

N/A

The crew is out of the danger zone, aka line of fire*

Yes

N/A

The snubline is secured properly and located at 90° to the tong*

Yes

N/A

Pinch points/obstructions during tong operations were eliminated*

Yes

N/A

There is a safety cable on the tong spring which is rigged properly*

Yes

N/A

Tong stand is being used*

Yes

N/A

Visual inspection of rigging acceptable*

Yes

N/A

The V-door rope is in good condition and is rigged properly*

Yes

N/A

An emergency shut off device (ESD) is ran to the rig floor from the power unit*

Yes

N/A

Whip check are being used on all connections*

Yes

N/A

Cables and hoses are being lifted to rig floor by hoist*

Yes

N/A

Rig-Up Comments

DURING JOB

JSA was held and documented before running casing*

Yes

N/A

All side door elevators must have a safety pin & shall be latched & pinned*

Yes

N/A

Crew is checking to ensure the yc/yt is properly latched before lifting casing*

Yes

N/A

All bolts on YC/YT are properly secured*

Yes

N/A

The tong door is being closed before tong is energized*

Yes

N/A

Bars for spider or elevator are approved and being used properly*

Yes

N/A

The crew is out of danger zone, aka line of fire during running of casing*

Yes

N/A

If safety clamp is being utlized, it is being used correctly*

Yes

N/A

Is comunication effective*

Yes

N/A

V-door hand and lD/Catwalk operator are using proper hand signals*

Yes

N/A

Power tongs were properly secured during back out operations*

Yes

N/A

Were any changes or corrections made during audit? explain below*

Yes

N/A

Were observation cards utilized if not why, explain below*

Yes

N/A

During Job Comments

RIG-DOWN

JSA/Tailgate meeting held before rig down*

Yes

N/A

The crew is out of the danger zone aka line of fire during rig down*

Yes

N/A

The catwalk is clear of personel and obstructions*

Yes

N/A

The tools are removed from the catwalk*

Yes

N/A

All tools and accessories have been gathered and stored for departure*

Yes

N/A

Rig-Down Comments

DEBRIEFING

Auditor discussed this audit with the creew beefore leaving location.*

Yes

N/A

Discussion included at minimum what went well and gaps found*

Yes

N/A

Auditor asked supervisor about any issues with tools*

Yes

N/A

Auditor disscused with crew about what did not go as planned*

Yes

N/A

Auditor asked if any suggestions for next job. eplain in comments*

Yes

N/A

Company man provided auditor with feed back when signing out*

Yes

N/A

Debriefing Comments

AUDITS SHOULD BE DONE ON 25% OF JOBS AND TURNED IN TO SAFETY DEPARTMENT FOR PROCESSING

CORRECTIVE ACTION PLAN FOR IDENTIFIED GAPS, IMPROVEMENTS OR NON-COMPLIANCE FINDINGS

Add entries as needed

Corrective Action Plan

DESCRIPTION OF GAP / IMPROVEMENTS OR NON COMPLIANCE

ACTION OR IMPROVEMENT PLANS

ASSIGNED TO

TARGET DATE

Did Crew Meet Safety Expectations?*

Excellent

Very Good

Good

Fair

Poor

Did Crew Meet Performance Expectations?*

Excellent

Very Good

Good

Fair

Poor

Did Equipment Meet Expectations?*

Excellent

Very Good

Good

Fair

Poor

CASING CREW EVALUATION

Add entries as needed

1 UNACCEPTABLE
2 SHOWS SIGNIFICANT WEAKNESS
3 SHOWS MINOR WEAKNESS
4 MEETS REQUIRMENTS OF JOB
5 EXCEEDS REQUIRENETS FOR JOB

Casing Crew Evaluation

Score

This field is for validation purposes and should be left unchanged.