Spreadsheet: 163177d1340212083-if-index-match-problem-audits
Sheet: Breck Rig 4444 June 2012

 | Nabors Well Services Co. |  |  |  |  | Rig Audit Form
Rig # | Breckenridge 4444 |  |  |  | Date | 2012-06-03 00:00:00
Supervisor | Breckenridge Supervisor |  |  |  | Customer | Apache
Inspector | Breckenridge Inspector |  |  |  | Company Rep | Apache Company Rep
Job in Progress | Drilling
[NAME] |  | YES | NO | N/A | DATE CORRECTED | COMMENTS
1. GENERAL
a. Did anyone perform the meet & greet? |  | x |  |  | (date not in totals | (Should not show in totals
[NAME] from overhead power lines - min. 10' |  |  |  | x | date not in totals) | Should not show in totals)
c. Fall lane of derrick clear |  |  | x |  | date in totals #1 | These notes should show in totals #1 Rigs
d. Auxiliary equipment exhaust - min. 50' from well - API Standard |  |  | x |  | date in totals #2 | These notes should show in totals #2 Rigs
e. Spark arrestor - exhaust system |  |  | x |  | date in totals #3 | These notes should show in totals #3 Rigs
f. Registration & Insurance Card |  | x
g. Transportation Permits in cab |  | x
h. Driver Daily Log & Post-Trip are current |  |  |  | x
2. GUYING
a. Crown to ground guy wires in good condition |  | x
i. Appropriate number of guy wires |  | x
ii. Condition of guy wires adequate |  |  | x |  | date in totals #4 | Notes in totals #4 Rigs
iii. Turnbuckle minimum 1-1/4" |  | x
iv. Guy wires flagged |  | x
v. [NAME] wires tightened correctly |  | x
vi. Guy line safety anchors tested within 2 years |  | x
[NAME] board guys |  | x
[NAME] and crossed for racking |  | x
c. Internal guys adjusted properly |  | x
d. Proper number of cable clamps and spacing |  | x
3. FOUNDATION
[NAME] mat in good condition |  |  |  | x
b. Adequate footing provided |  | x
[NAME] stands in good condition |  |  |  | x
[NAME] in good condition and adequate for rig |  |  |  | x
4. MAST/DERRICK
a. Mast/Derrick in good condition |  | x |  | x
[NAME] specification and guying plates in place |  | x |  | x
[NAME] in good condition |  | x |  | x
d. Tubing board in good condition |  | x |  | x
[NAME] basket in good condition |  |  | x |  | date in totals #5 | Notes in totals #5 Rigs
f. Lower derrick locking pins in place w/ safety pins
g. Scoping ram stabilizers in good condition and alignment
h. Crown sheave guards in place and in good condition
[NAME], tubing fingers safety chain in good condition
j. Upper derrick locking pins in place w/ safety pins
k. Top section breaking/landing point flagged
l. Standpipe secured
[NAME] hose secured at gooseneck and swivel end with safety hobbles
[NAME] |  | YES | NO | N/A | DATE CORRECTED | COMMENTS
5. CARRIER
[NAME] is clean and orderly |  |  |  | x
[NAME] / handrails in place & good condition & pinned |  |  |  | x
[NAME], tail & signal lights clean & operational |  |  |  | x
d. Wheel chocks in place |  |  |  | x
e. Brakes, tires & wheels in good condition |  |  |  | xx
f. No fuel, oil or other fluid leaks on rig |  |  |  | x
g. No loose or flammable materials stored in cab |  |  |  | x
h. Glass & mirrors in good condition |  |  |  | x
[NAME] wipers functional and blades in good condition |  |  |  | x
j. Emergency brake set |  |  |  | x
k. Emergency reflectors available |  |  |  | x
l. Battery covers in place |  |  |  | x
m. Hydraulic leveling jacks secured by mechanical lock nuts |  |  |  | x
[NAME] air warning device functional |  |  |  | x
o. Seat belt in good condition & being used |  |  |  | x
p. All controls labeled |  |  |  | x
q. All guages functioning properly |  |  |  | x
r. Diesel and other storage tanks are labeled correctly |  |  |  | x | date not appear* | Notes should not appear*
s. Drive lines secured, greased and free of damage |  |  |  | x
6. DRAWWORKS
[NAME] are in place |  | x
[NAME] line in good condition |  | x
[NAME] in good condition |  | x
d. Winch-line in good condition |  | x |  |  | date not appear! | Notes should not appear!
e. Deadline anchor & retainer in good condition |  | x
f. Road/Hoist shift lever secured |  | x
[NAME]/sand line brake systems functioning properly & inspected weekly |  | x
h. Tubing/sand line brake latch in good condition |  |  |  | x | date not appear^ | Notes should not appear^
i. Sufficient wraps on drum to allow blocks to be laid on ground or rig floor |  | x
j. Sand line clutch/throttle guarded or locked |  | x
k. Brake linkage to drawworks in good condition |  | x
l. Drum brakes adjusted properly |  |  | x |  | date in totals #6 | Notes in totals #6
7. WORK PLATFORM / FLOOR
a. Work floor in good condition
[NAME]/handrails/guardrails/toeboards are pinned, in place, proper length, good condition
c. Workfloor suspension safety hooks in good condition
d. V-door guard rails are in place or protected by chain
e. Wook floor stored in the vertical or up position, is secured on both sides w/ positive locks
f. Work floor sliding section has stops to prevent sliding closed with floor in the vertical postion
[NAME] |  | YES | NO | N/A | DATE CORRECTED | COMMENTS
8. TOOLS AND EQUIPMENT
[NAME] tongs in good condition |  |  | x |  | date in totals #7 | Notes in totals #7
[NAME] arm, tong safety sling in good condition, correct length and properly secured |  |  | x |  | date in totals #8 | Notes in totals #8
[NAME] safety gate (door) in place |  |  | x |  | date in totals #9 | Notes in totals #9
[NAME]. back ups in good condition |  |  | x |  | date in totals #10 | Notes in totals #10
e. Tong hanger safety cable in good condition and tongs are hung with a positive latching hook |  |  | x |  | date in totals #11 | Notes in totals #11
f. Hand tools in good condition |  |  | x |  | date in totals #12 | Notes in totals #12
g. Condition of slings, annual inspection and tagged |  |  | x |  | date in totals #13 | Notes in totals #13
h. Block assembly in good condition |  |  |  | x | date not appear+ | Notes should not appear+
[NAME] latch retainer bolts (4) secured w/ castle nuts & pins |  | x |  |  | date not appear% | Notes should not appear%
[NAME] / tubing elevators in good condition |  |  | x |  | date in totals #14 | Notes in totals #14
k. Air slips in good condition |  |  | x |  | date in totals #15 | Notes in totals #15
[NAME] door-bolt in place |  |  | x |  | date in totals #16 | Notes in totals #16
m. Rod hook in good condition |  |  | x |  | date in totals #17 | Notes in totals #17
[NAME] transfer in good condition |  |  | x |  | date in totals #18 | Notes in totals #18
o. Rod transfer and other tools not left in derrick |  |  | x |  | date in totals #19 | Notes in totals #19
9. SAFETY EQUIPMENT PRACTICES
a. Safety harness in good condition |  | x
b. Positioning lanyards are provided in the rod basket & tubing board |  |  |  | x
[NAME] with soft stop in good condition
d. SRL/climbing device in good condition & stored retracted |  |  | x |  | date in totals #20 | VERY LONG NOTES #20 ;a;ldkjf ;adjf ;akdj ;akdjf; akdjf ;adkjf; adlskjf ;adksjf;asdlkjf;asdkj
e. Emergency derrick escape equipment installed and in good condition |  |  | x |  | date in totals #21 | Notes in totals #21
[NAME] extinguishers current / good condition / on base |  | x
g. Static line installed/ in good condition |  | x
h. Emergency kill switches labeled / working |  | x
i. Stored energy locked out with lock and tag: dated and signed with completed written permit |  |  |  | x
j. Pumping unit weights are secured/located at the bottom |  |  |  | x
k. Emergency derrick rescue equipment immediately available and in good condition |  |  |  | x
l. MSDS / EMERG./ SPCC book on site and complete |  |  |  | x
m. First aid kit stocked and available |  |  |  | x
[NAME] current/completed/reviewed with all affected |  |  |  | x
o. Rig inspected by rig supervisor or crew within 30 days |  |  |  | x
p. Crew training is current in First Aid/CPR, HAZ/COM, H2S and Confined Space Awareness |  |  |  | x
q. Rig Safety Man Book complete and current |  |  |  | x
r. Lifting equipment annual inspection is current |  |  |  | x
[NAME] |  | YES | NO | N/A | DATE CORRECTED | COMMENTS
10. WELL CONTROL EQUIPMENT
a. BOP installed with all bolts/nuts and is tested as necessary and operating properly |  | x
[NAME] sling condition w/ tag & annual inspection
c. Safety valve with (wrench) handle on floor |  | x
d. Accumulator valves in open / closed position |  | x | x
e. Accumulator engine / controls minimum 50' from well |  | x
f. Manual BOP closing handles properly installed & pinned |  | x
g. BOP closed sign or device being used |  | x
11. DOG HOUSE TRAILER
[NAME] safety hitch in good condition (safety chains, trailer lights & brake plug, hitch tongue not damaged |  | x
b. Trailers are equipped with brakes that are functional |  | x
[NAME] tires in good condition and chocked |  | x
d. LPG tanks are secured, labeled and in good condition |  | x
e. UL approved regulator is attached to LPG tank |  |  | X |  |  | Capital X in totals #22
f. LPH hose from regulator to heater is LPG rated & in good condition |  |  |  | x
[NAME] has a UL approved thermo-coupling and is in good condition |  | x
h. Trailer is clean, neat and orderly |  | x
[NAME] registration is current |  |  | X |  |  | Bold X in totals #23
[NAME] can available and being used |  |  |  | x
k. Minimum 5lb. Fire extinguisher securely mounted & in good condition with a current inspection |  | x
12. CREW TRUCK / TOOL TRUCK
a. Current registration, inspection sticker and insurance |  |  | x |  | date #24 | Notes in totals #24
[NAME] numbers and company logo signs are in good condition and visible |  |  | x |  | date #25 | Notes in totals #25
[NAME] belts are readily available and in good condition |  |  | x |  | date #26 | Notes in totals #26
d. Truck overall appearance is clean, neat & orderly |  |  | x |  | date #27 | Notes in totals #27
e. Auxiliary fuel tanks have correct labels |  |  | x |  | date #28 | Notes in totals #28
f. Windshield, wipers, mirrors and heater are in good condition |  |  | x |  | date #29 | Notes in totals #29
g. All lights working properly |  |  | x |  | date #30 | Notes in totals #30
h. Tires in good condition |  |  | x |  | date #31 | Notes in totals #31
i. Hazardous materials weigh bill in truck if transporting diesel over 119 gal or other hazmat |  |  | x |  |  | Notes in totals #32
j. Tie down system in good condition |  |  | x |  | date #33 | Notes in totals #33
[NAME] completed |  |  | x |  | date #34 | Notes in totals #34
l. Minimum 10lb. Fire extinguisher securely mounted & in good condition w/ current inspection |  |  | x |  | date #35 | Notes in totals #35
Form Directions:
Step 1  Upon completing an field audit, the safety specialist or manager is to complete this form
Step 2  The safety specialist or manager is to email this form to the responsible area manager and rig supervisor
Step 3  The rig supervisor is to review the audit, correct deficiencies, and enter the correction dates on the form.
Step 4  the rig supervisor is to email the field audit form with corrections made and dated to the responsible area manager and the safety specialist
Step 5  The responsible area manager is to review and verify that all corrections were addressed on the form
Step 6  The responsible area manager is to save the audit form to the appropriate file set up in the shared drive.
Select "W" drive.  "NWS" ,  "Shared" ,  "SOUTH TEXAS DISTRICT" ,  "2011 Rig Audit Tracker" ,  "Alice" or "Victoria. El Campo"  and lastly the correct "Quarter"