Department Document Version Creation Date Last Revision

SFTY HSE 006 01 22.09.10 31.08.11

DRILL RIG INSPECTION CHECKLIST

SECTION 1 - GENERAL INFORMATION

DATE: RIG NO: LOCATION:
TIME: INSPECTED BY:

SECTION 2 - PPE (Behavioural) Compliance

All using appropriate PPE and in good condition? N/A YES NO Comments
1. Ear Protection
2. Gloves
3. Hardhat
4. Overalls
5. Safety Boots
6. Safety Glasses
7. Dust Mask
8. Safety Harness
Total Behavioural:

SECTION 3 - WORK AREA Compliance

Description of condition N/A YES NO Comments
1. Free from slippery substances?
2. Trip or other obstruction hazards?
3. Adequate lighting (illumination) for work at night?

SECTION 4 - DRILL RIG Compliance

Description of condition N/A YES NO Comments
1. Inspection list and Toolbox talk completed?
2. Equipment in good condition?
3. All hazardous machine parts guarded?
4. Whip checks on all air hoses secure?

SECTION 5 - ENVIRONMENTAL Compliance

Description of condition N/A YES NO Comments
1. Waste / rubbish adequately controlled?
2. Oil / Hazardous Substance Spillages controlled?
3. Adequate disposal systems and spill kits?

SECTION 6 - DEMARCATION Compliance

Description of condition N/A YES NO Comments
1. Access and exit routes demarcated?
2. Demarcation around work area and sumps?
3. Demarcation / Barricading in good condition?

SECTION 7 - HOUSEKEEPING Compliance

Description of condition N/A YES NO Comments
1. Working area clean and tidy?
2. No redundant materials?
3. Tools and Items stored away after use?
4. Adequate storing space?
5. Stacking of Drill Rods safe?

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 Department Document Version Creation Date Last Revision
SFTY HSE 006 01 22.09.10 31.08.11

DRILL RIG INSPECTION CHECKLIST

SECTION 8 - SAFETY & EMERGENCY Compliance

Description of condition N/A YES NO Comments
1. Stretcher in place?
2. First Aid boxes available and Contents correct?
3. Trained First Aiders available on site?
4. Safety Signage displayed?
5. 2 x Fire Extinguishers available and checked?
Total Operational:

SECTION 9 - TOTAL OBSERVATIONS Safe Unsafe % Safe

Behavioural
Operational
Total

SECTION 10 - RECOMMENDATIONS / COMMENTS

SECTION 11 - SUPERVISOR ACTION PLAN - Action to be taken Commitment Date

Safety Representative Signature Drilling Supervisor Signature

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