February 2014
WYOMING DRILLING WORKSHEET
Date
Company:
Rig #
Manufacture Date of Rig:
Date of Most Recent Cat IV Inspection:
Well Owner:
Location:
Spud Date:
T.D.:
Multi-well Pad:
Current Well Depth:
Rig Type:
Sub Height:
T.D. Date:
Estimated Depth of Target Formation:
OPENING
First Aid Station Marked
First Aid Kit (NLT 24 Unit)
Adjustable Arm (1) & Leg Splint (1)
Wool Blankets (2)
Stretcher
Eyewash (15 min Continuous)
Emergency Numbers And Tested
Wire Hoist Rope 30 Day Inspection
Ton Mile Cut-off Report – Not For CBM
BOP Test Record
COMMENTS
4-5(k)(ii)
4-5(k)
4-5(k)(v)(A)
4-5(k)(v)(B)
4-5(k)(v)(C)
4-5(m)
4-5(j)(i)&(ii)
6-6(b)
6-6(b-c)
7-3(a)(ix)
PROGRAMS/PROCEDURES/TRAINING
OSHA 300/300A (3 yrs)
Cat IV Inspection Report
First Aid and CPR Card Holder (1)
BOP Well Control Training (1/Shift)
Safety Health Program
Haz-Comm Program
MSDS Book(s) Indexed/List
All MSDS Available
Container Labeling
Training
30 year Retention of MSDS
Permit Required Confined Space Progra m
Lockout/Tagout Procedure
Respiratory Protection Program
Training
Fit Testing
Medical Evaluation
Program Administrator
Respirator Storage
Appendix D (Voluntary Use)
Hot Work Program
Written Rescue Plan
Rescue Training
Fire Extinguisher – Annual Training
Equipment Operator Training
No of Tours:
COMMENTS
1904.1(a)(2)
4-5(l)
7-3(a)(x)
(optional)
1910.1200(e)
1910.1200(e)(1)(i)
1910.1200(g)(1)
1910.1200(f)(5)
1910.1200(h)(1)
1910.1200(d)(1)(ii)(B)
1910.146(d)
5-1(iv)/(v)
1910.134(c)(1)
1910.134(k)
1910.134(f)(2)
1910.134(e)(1)
1910.134(c)(3)
1910.134(h)(2)(i)
1910.134(k)(6)
5-2(a)
6-8(c)(iv)
7-4(a)(vii)(B)
7-4(a)(vii)(C)
3-4(b)(ix)(B)
5-1(a)(ii)
Page 1
February 2014
WALKAROUND
H2S SAFETY EQUIPMENT AND PROCEDURES (if applicable)
H2S Hazard Determination
(none, low, med, high)
H2S Gas Detectors (2) (med & high)
Wind Sock/streamer (2) (med & high)
H2S Signs 500’ out from wellhead
H2S Training
Escape Packs (1/person)(med & high)
SCBA – 30 minute (2) (low, med, high)
9-2(a)
9-2(a)
9-2(a)
9-3(a)(iii)
9-2(b)
9-2(a)
9-2(a)
GENERAL
Work Areas Clean (Housekeeping)
Walkways/Stairways Condition
Stairway Railing at 4 Risers
Standard Railing for Work Surface at 4’
Adequate Lighting
Pipe Rack Pins (Each Corner)
Spacers Between Pipe Layers
Fuel Tank Line Protected
Fuel Tank(s) Marked
Load Rating for Beam Hoist
Modifications to Equipment
No smoking within 75 ‘ of wellbore
COMMENTS
6-1(a)(ii)
6-1(a)(iii)&(v)
6-1(a)(v)(A)
6-1(a)(vi)
3-6(a)
6-3(a)(i)(B)
6-3(a)(ii)(B)
8-7(a)(4)
8-7(a)(iii)
1910.179(b)(5)
5-1(a)(xii)
7-7(a)
PERSONAL PROTECTIVE EQUIPMENT
PPE Hazard Assessment
PPE Hazard Assessment Certification
Hard Hats
Eye Protection
Foot Protection
Fire Resistant Clothing (FRCs)
FRCs Sign Posted
No Loose Clothing
Long Hair Contained
Hazardous Jewelry
COMMENTS
1910.132(d)(1)
1910.132(d)(2)
4-1(a)
4-2(a)(i)
4-3(a)
4-4(f)
4-4(f)(ii)
4-4(a)
4-4(d)
4-4(c)
DERRICK EMERGENCY DECENT DEVICE
Installed per Manufacturers Specifications
Escape Line Diameter Adequate for Use
Landing Area Free From Obstructions
Personnel Trained in Application & Use
COMMENTS
7-4(a)(v)
7-4(a)(ii)
7-4(a)(ii)(A)
7-4(a)(vi)
COLD WEATHER
Pipe Drainage
Weather Curtain
Stove/Fire 75’ From Well Bore
COMMENTS
COMMENTS
6-3(a)(iii)
7-4(a)(xii)
6-8(c)(ii)
Page 2
February 2014
BOILER & PRESSURE VESSELS
Located 100’ From Well Bore
Reclaimed Water Not Contaminated
With Crude or Other Oils (Site Glass)
Safety Pressure Relief Valve
Not To Exceed Working Pressure
Pressure Relief Valve Discharge Location
Certified Yearly By Insurance Co. or Equal
Clamps/Cables on Discharge Side
COMMENTS
10-1(e)
10-1(j)
10-1(f)/10-3(c)
10-1(d)/10-3(e)
3-5(a)
10-3(l)
FIRE EXTINGUISHERS
Fire Extinguishers - 20# (4)
CBM – 20#(2)
Yearly/Monthly Inspection
Suitably Located
Mounting of Extinguishers
COMMENTS
3-4(b)(ix)
3-4(b)(ix)(A)
3-4(b)(viii)
3-4(b)(ii)
1910.157(c)(1)
ZONE I – ELECTRICAL
(Within 6’ Area Of Shaker) 6-8(a)(i)
Motors Totally Enclosed/Fan Cooled
Explosion Proof Breakers/Switches
Explosion Proof Lighting
Flexible Cords (SO, ST, SJO)
Strain Relief all Electrical Cords
COMMENTS
6-8(b)(i)(A)
6-8(b)(i)(C)
6-8(b)(i)(E)
6-8(b)(i)(B)
1910.305(g)(2)(iii)
ZONE II – ELECTRICAL
(6’x 10’ Around Well Bore, 6’ of Mud Tanks & All of Cellar) 6-8(a)(ii)
Motors Totally Enclosed/Fan Cooled
Vapor Proof Lights/Switches/Outlets
Flexible Cords (SO, ST, SJO)
Strain Relief On All Flexible Cords
COMMENTS
6-8(b)(ii)(A)
6-8(b)(ii)(C)
6-8(b)(ii)(B)
1910.305(g)(2)(iii)
ZONE III – ELECTRICAL
(All Other Locations) 6-8(a)(iii)
COMMENTS
Electrical Panel (36” Clearance)
1910.303(h)(3)
Electrical Breakers Labeled
1910.303(f)(2)
Electrical Breakers Covered
1910.305(b)(1)(ii)
Flexible Cords Protected From damage
1910.305(a)(2)(x)
Strain Relief all Electrical Cords
1910.305(g)(2)(iii)
Grounding Properly Installed ( >25 Ohms) 1910.304(g)(5)
CELLAR
BOP Hand Wheels Attached & Operational
No Oil Accumulation
House Keeping
Cellar Opening (guarded)
COMMENTS
7-3(a)(vi)
3-4(b)(v)
6-1(a)(ii)
1910.23(a)(5)
Page 3
February 2014
MUD PUMP HOUSE
Shear Pin Guarded (Safety Relief Valve)
Exits (2 Locations)
Pressured Discharge Hoses Secured
COMMENTS
10-3(d)
7-4(a)(xiv)
10-3(l)
MUD HOUSE HOPPER
PPE Hazard Assessment
Face Shield
Gloves/Apron
Eye Wash
PPE Maintained (Clean and Serviceable)
COMMENTS
1910.132(d)(1)
4-5(m)
1910.132(a)
MUD TANKS
Discharge Lines Secured
Mud Guns Pinned or Hobbled When
Unattended
Standard Railing on Inside of Walkway
Railing Required on Both Sides at 4’
Guardrail/Walkway Good Condition
COMMENTS
7-5(a)(ii)
7-5(a)(iv)
7-5(a)(vii)
7-5(a)(vii)
6-1(a)(v)(A)
WELDING
Cylinders Secured In Upright Position
Cylinders Stored 20’ From Combustibles
Cylinders Not kept in Unventilated Bldgs
Oxygen/Acetylene 20’ Separation or
Fire Barrier 5’ tall, ½ hour
COMMENTS
5-2(d)(i)
5-2(d)
5-2(d)
5-2(d)(ii)
MACHINERY OPERATIONS/TOOLS/GUARDING
Aerial Lift - Body Harness/Lanyard (GI)
Aerial Lift - Body Harness/Lanyard (CO)
Heavy Equipment Condition
Backup Alarm
Lights
Leaks
Mirrors
Windows
Tools/Equipment in Good Condition
1910.67(c)(2)(v)
1926.502(d)(16)(iii)
5-1(a)(x)
5-1(x)&(xii)
RIG FLOOR
Slip/Trip Hazards
Body Harness/Lanyard Over 4’
Exits (3 Unobstructed)
Weight Indicator
Weight Indicator Secured
”A” Legs Pinned
Drill Stem Safety Valve
Wire Rope Condition - Monthly Inspection
COMMENTS
COMMENTS
6-1(a)(v)
7-4(a)(vii)
7-4(a)(xiii)
6-7(a)(xv)
6-7(a)(xvi)
7-4(a)(i)(D)
7-3(a)(vii)
6-6(h)
Page 4
February 2014
Wire Rope Condition On Tongs
Machine Guarding
Tugger Lines shall not lift personnel
unless manufacturer specifically allows
Slip Hooks Safety Latch
V-Door Guarded
Pressured Discharge Hoses Hobbled
Kelly Hose Hobbled at Standpipe & Swivel
Lifting Chains Rated
6-6(h)(ii)
5-1(a)(vii)
6-6(l)
6-7(a)(ii)
6-1(vi)
10-3(l)
10-3(k)
6-6(m)
SPINNING CHAIN (if applicable)
Spinning Chain Tail 8” to 12”
Spinning Chain – No Repairs
COMMENTS
6-6(o)
6-6(q)
CAT HEAD (if applicable)
Rope Divider NMT ¼” Clearance
Grooves 3/8” or Less
Unused Catline Coiled or Spooled
Unattended Cathead No Rope Wrapped
COMMENTS
6-7(a)(xxxiv)
6-7(a)(xxxv)
6-7(a)(vi)
6-7(a)(vii)
TONGS
COMMENTS
Rotary Tong Secured to Derrick/
Back-Up Post
Tong Counterweights Secured
Tong Dies Condition
Chain Lines to Tongs - NLT 3/8”
6-7(a)(xxi)
6-7(a)(xiii)
5-1(a)(xii)
6-6(m)
DERRICK
Ladder Climbing Device
Step Across Distance - NMT 12”
Fall Protection Equipment Inspected
Pipe/Drill Collars Secured to Boards
Traveling Block Emergency Stop or
Crown Bumper Blocks
COMMENTS
6-2(l)
6-2(c)(iv)
4-4(e)(iii)
7-4(a)(xxv)
5-1(a)(xxvi)
COALBED METHANE DRILLING
Fire Extinguishers - 20# (2)
Running lights, tail light, etc. will not
operated during drilling operations
Drilling rigs & auxiliary equipment
equipped with over rev device
LEL monitor located at operator’s control
LEL monitor calibrated
Approved flowline minimum 30’, 6” dia
20 line pipe or equiv, anchored & bonded
COMMENTS
3-4(b)(ix)(A)
6-8(a)(ii)(E)
6-8(c)(ii)
6-8(c)(v)
6-8(c)(v)
7-6(e)(i)
Drilling With Air (Coalbed Methane Drilling)
Compressor 125’ from Well Bore
Blooie Line 150’ Laid Straight
COMMENTS
8-4(a)(i)
8-4(a)(ii)
Page 5
February 2014
-- Blooie Line Securely Coupled/Anchored
Combustible Material 100' From
Blooie Line/Pit
Vehicles Parked 75'+ From Well Bore
1 -Class B-C Fire Extinguisher
(150# Dry Chemical or Equivalent)
:4 - 20# Fire Extinguishers
8-4(a)(ii)
8-4(a)(iv)
8-4(a)(vi)
8-4(a)(xvi)
8-4(a)(xvi)
Page 6