SICIM Saudi Arabia

JAZAN - ABHA REFIND PRODUCTS PIPELINE PROJECT

BI# 10-00875 Contract# 6600045122
Form:
MOBILE DRILLING RIG JAPL-F-HE-016

DAILY INSPECTION (Crawler)

Issue No.: 1

Operator Competence Document - Required Date: 28/07/2020

Operator & Equipment Details Verify Check WARNING DEVICES Verify Check Verify Check CAB

Horn Hambone & Wedge Cleanliness

Manufacturer Amber Flashing Beacon Seat Condition OK
Reversing Alarm Operator Restraint Provided
Model Instruments Operational & Labelled
WARNING SIGNS (In Cabin) Verify Check Boom Levers / Controls Operational
Door No. Verify Check
Pivots Pedals in Good Condition
Plate No. SEAT BELTS MUST BE WORN Connecting Rods ROPS AS2294
Safety Pins Windows / Wipers / Washers
Verify Check
Equip. TPC (no excessive wear) Rear View Mirrors
DANGER – BEWARE OVERHEAD WIRES, Operator Instruction
PIPES and UNDERGROUND SERVICES
Operated By (available on plant)
Log Book
Operator Cert. SWL / Chart
Verify Check Hydraulics Verify Check
Date
Rams Slings / Ropes / Chains (Tagged and in good working order)
Hoses Sheave
Signature
Connections Pins
(check for excessive
wear, leaks and creep)

 Checklist shall be maintained at the jobsite during the work Verify Check
activity
Verify Check Drill Engine Guarding
 Operator shall be competent to operate the equipment
 Operator Certification shallColumn
be valid and original shall be kept with operator
 Equipment 3rd Party Inspection shall be valid with sticker posted on the cabin Verify Check
Shaft & Gears
Exhaust
Frame
Safety Pins
HSE Use Only
Auger/Drill
(check for excessive wear, leaks Tracks Verify Check
andallcreep)
NOTE: Sign only when items have been checked
Tracks Complete
Idlers Adjusted
Checked By:
No Signs of Cracks
Position:
Acceptance: Access Instructions:
PassVerify CheckFail Verify Box to be ticked by Owner / Supplier / Operator prior to operation
Handrails
Signature Check Box to be ticked after visual inspection by HSE Department
Steps

This is to certify that the plant being operated conforms to the relevant HSE Legislation, and the requirements as detailed above. HSE Department will assess this Checklist Acceptance to ensure the operator has verified compliance to HSE Legislative requirements and,
to register the equipment onto the site. The operator will be required to participate in ongoing training and perform work in accordance with the relevant Work Method Statement & JSA. Should the equipment be found to not conform to the above, then it will be
prevented from commencing work on the site until the non-compliance is rectified. HSE Management will not reimburse the Owner / Supplier / Contractor for any down / lost time so caused from the non-conformance.
This form does not remove any liability for the plant supplier to conform with the relevant HSE Legislation.