Facility Cover Sheet

FACILITY COVER SHEET # of Data Templates
Attached
Data Collected By: Entry Date:
Facility: Unit / Yard:
Location: LE /LSD Sec. Twp. Rge. W /ES
Functional Location Code
Cost Center: Direct Charge AFE
Ownership Status: q 100% q Joint Venture

Comments
Version 1.4 November 2010

Communications Husky Purchase Order No.

P&ID # :
Equipment q LAN q Radio System q RTU Parent Equip # :
Class q SCADA Host q Tower
Equipment Description: Exist. Equip. ID : Tag No.:

Unit Yard Acquis Value $ Acquis Date
Equipment Status: q In-Service Fully Utilized q In Service Under-utilized q Idle q Scrap
q Field Idle
Ownership Status: q Leased q Rented q Owned
Manufacturer: Year Built:
Equipment Condition: Model No.: Serial No.:
Construction: q Skidded q Packaged q Housed q Packaged Portable q Packaged Stationary
Skid Weight: Kg / Lbs Skid Size: W x L x H m / ft
Additional Characteristics for Tower

Type: Height of Tower m / ft
Comments
Additional Characteristics for LAN

Type: Size:
Output Signals: Power Supply:
Comments
Additional Characteristics for Radio System

Type: Size:
Enclosure Class: Power Supply:
Comments
Material Transfer Information
Transfer Recorded by: Date
From LSD Sec Twp Rge W/

Transfer Yard
To LSD Sec Twp Rge W/

Facility Receiving AFE:
Version 1.5 February 2012

Buildings Husky Purchase Order No.
& Structures
Data Collected By: Entry Date: P&ID # :
Equipment q Bridge q Building q Fence Parent Equip # :

Class: q Gate q HVAC q Lift Equipment Existing Equip. ID #
q Monorail q Railway q Road
q Structure q Secondary Containment
Equipment Description: Tag No.:
q Field Idle
Additional Characteristics for Buildings

Construction Type: Foundation Type:
Shell: Color:
Building Heat Type: Building Elec. Class:
Wall Insulation R Value: Roof Insulation R Value:
Humidifier: q Yes q No Air Conditioner: q Yes q No Elevator: q Yes q No
Additional Characteristics for Monorails

Ton
Capacity: Tonnes
Additional Characteristics for HVAC

Type: Heating Capacity: KW
Additional Characteristics for Railways

Start of Track: End of Track: Length: m / ft
Gauge: m / ft Rail Tie Material:

Additional Characteristics for Fence
Type: Length: m / ft Height: m / ft
Additional Characteristics for Bridges

Ton
Type: q Portable q Permanent Capacity: Tonnes Foundation:
Width: m / ft Length: m / ft Deck:
Additional Characteristics for Lift Equipment
Type: Power: q Manual q Electric q Air
Width: m / ft Length: m / ft Height: m / ft
Wire/Chain Mat. Type: Hook Type: Lift Capacity: Kg / Lbs
Type of Engine: Crane Type: Capacity: Tonnes
Comments

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Rotating Mechanical Husky Purchase Order No.
Compressors
Equipment q Blower q Centrifugal q Fan P&ID # :
Class q Reciprocating q Rotary q Turbo Expander Parent Equip # :

Equipment Status: q In-Service Fully Utilized q In Service Under-utilized q Idle q Scrap q Field Idle
Common Characteristics
Fluid Description: Service: q Sweet q Sour Driven by:
Rotation (Viewed from Drive End): q CW q CCW # of Stages
Design Capacity: m3/d mmcf/d Design Suction: kPag / psig Design Discharge: kPag / psig
Frame HP Rating: kPag / psig Max Frame Speed: RPM Coupler Type:
Lubrication Type: q Pressurized Lubricator Make:
q Non Pressurized Lubricator Model:
Additional Characteristics for Reciprocating Compressor
# of Throws: Rod Size: mm / in Stroke: mm/in
Cyl #1 Size: mm / in Cyl #1 S/N Cyl #1 MAWP kPag / psig
Cyl #2 Size: Cyl #2 S/N Cyl #2 MAWP

Valve Manufacturer: Cyl Valve Mat'l: Cyl Valve Type:
VVCP: q Cyl #1 q Cyl #2 q Cyl #3 q Cyl #4 q Cyl #5 q Cyl #6 Cyl Cooling: q Yes q No
Inlet Pressure: KPa Inlet Temperature: °F
Input Speed: rpm Discharge Temperature: °F
Additional Characteristics for Rotary Compressor

Rotary Comp Type: q Screw q Lobe q Vaneq Gear q Scroll Shaft Size: mm
Csg MAWP: kPag / psig Csg Mat'l Slide Valve q Auto q Manual
Maximum Inlet Pressure: KPa Maximum Oulet Pressure: KPa
Additional Characteristics for Centrifugal Compressor and Turbo Expander

Casing Type: q Hort. Split q Vertical Split q Barrel Csg MAWP: kPag / psig
Csg Mat'l Shaft Seal Make: Shaft Seal Model:

Additional Characteristics for Blower and Fan

Impeller / Blade Type: Impeller / Blade Size: mm/ in Imp. Shaft Size: mm/ in
Sheave Type: Sheave Size: mm/ in Seal Model:

Comments

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Electrical Husky Purchase Order #

P&ID # :
Equipment q Battery q Battery Charger Parent Equip # :
Class q Breaker q Bus Ducts
q Cathodic Protection Systems q Electric Circuit q Electric Heater q Electrical Starter
q Electrical Substation q Heat Tracing q Lighting q MCC
q Motor Operated Valve q Pole q Power Conditioner q Substations
q Switchgear q Transformers q Unit Heater q UPS Systems q VFD

Size / HP Rating: kW / HP Service: q Sweet q Sour
Elec. Class: Elec. Division: Elec. Group:
Primary Voltage: Primary Current: Winding Confiq:
No. of Phases: Frequency: Hz Current: Amps
Operating Temp.: °C / °F Enclosure Style: Enclosure Class:
Additional Characteristic for Cathodic Protection Systems, UPS Systems and Variable Frequency Drive
Input Voltage: V Output Voltage: V kVA Rating: kVA
Input Current: Amps Output Current: Amps CSA Approved #:
Additional Characteristic for Electric Circuit

AMP Rating: Amps
Additional Characteristic for Lighting and Electric Heater

Connection: Type: Size:
Power: Watt KiloWatt Rating: KW
Additional Characteristic for Motor Control Centers and Switchgear

Main / Horizontal Bus - Material: q Copper q AluminumRating: Enclosure EEMAC: q 1 q 2 q 3q 5
Vertical Bus - Material: q Copper q Aluminum Rating: q 12
Main Breaker Size: kW / HP Metering: Starter:
Additional Characteristics for Motor Operated Valve

Torque Switches: q Yes q No Loc/Remote Selecter: q Yes q No Handwheel: q Yes q No
Auxiliary Limit Switches: q Yes q No Loc/Remote Interlock: q Yes q No
Fireproofing Exists: q Yes q No Valve Stem Cover: q Yes q No
Additional Characteristics for Pole
Voltage: V Height: m Size:
Electrical Service Type:
Additional Characteristics for Transformers

Secondary Voltage: V Secondary Current: Amps Winding Config.:
Power Factor: Efficiencies:
Rating: q H Windings q X Windings q Y Windings Insulating Liquid:
Tap Voltages: q H Windings q X Windings Excitation:
Additional Characteristics for Unit Heater

Heater Type: q Forced Air q Radiant q Other Voltage: Kilowatt Rating: KW Heating Capacity: _________________ KW
Amp Rating: Amp Full Load Current: Amp Fluid Descr: Temperature Code:
Comments

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Fire & Safety Husky Purchase Order No.
Equipment
Parent Equip # :
Equipment q AED - Automatic External Defibrillator q Breathing Air - SABA q Breathing Air - SCBA
Class:
q Fire Detection q Fire Extinguishing Equip. - Fixed
q Fire Extinguishing Equip. - Portable q Gas Detection q Safety Alarm System
q Safety Facilities & Equip. q Safety Trailer q Safety Training Equip.

Additional Characteristics for Breathing Air System SCBA / SABA

Air Tank Material: Date of Tank Hydro Test: Length of Hose: Meter
Portable/Fixed: Trailer/Skid: Breathing Air Time: min's
# of Breathing Units:
Additional Characteristics for Safety Trailer

# of SCBA Units: SCBA Pack Air Time: min's # of Escape Packs:
# of SABA Units: SABA Air Time: min's Length of Hose: Meter
Respirator: q Yes q No # of First Kit:* Shower: q Yes q No

Additional Characteristics for Fixed Fire Extinguishing Equipment
lpm
Type: Hydrant Dis. Rate: gpm Hydrant Dis. Pressure kPag Psig
Fire Monitor:
Additional Characteristics for Portable Fire Extinguishing Equipment
Weight: Kg / Lbs Hand/Wheeled:
Additional Characteristics for Fire Detection / Gas Detection
q Fire Detection q Gas Detection Type: Current Voltage: v
Elec. Current Type: q AC q DC Current Voltage: v
Combustible Gases: q Yes q No H2S: q Yes q No Oxygen: q Yes q No

CO2: q Yes q No # of Channels:
Additional Characteristics for Safety Alarm System:
Noise Rating: No of Horns: No of Lights:
Color of Light: Elec. Current Type: q AC q DC Voltage: V
Additional Characteristics for Safety Facilities and Equipment & Safety Training Equipment:
Quantity:
Additional Characteristics for Automatic External Defibrillator:
Output Energy Certification Number
Comments

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Version 1.5 february 2012

Fired Equipment Husky Purchase Order No.
Boilers & Heaters
P&ID # :
Equipment Class q Boiler - Firetube Power q Boiler - Heating Parent Equip # :
q Boiler - Watertube Power q Burner System q Heater - Direct Fired q Heater - Indirect Fired
q Reaction Furnace q Reboiler - Fired q Thermal Electric Generator q Well / Line Heater
Fluid Description: Service: q Sweet q Sour Burner Duty:
Prov. Reg. No.: CRN: Code Stamp: q S q H q B31.3
Shell MAWP: kPag / psig @ Max. Temp: °C / °F MDMT: °C / °F
Shell Mat'l: Shell Thickness: mm / in Shell C.A.: mm / in
Tube MAWP: kPag / psig @ Max. Temp: °C / °F MDMT: °C / °F
Tube Mat'l: Tube Thickness: mm / in Tube C.A.: mm / in
Nozzle Type: Nozzle Rating: Ansi
Nozzle Mat'l: Nozzle Thick.: mm / in Nozzle C.A.: mm / in
X-Ray: q Full q Spot Stress Relief: q HT q PHT

# Manways: # of Inspection Ports:
Tube Diameter: mm /in # of Tube Passes: Heating Surface ft3 / m3
Volume m3 / ft3 Design Flow: Sm³/d / mmscfd Heat Medium:

Vessel Diameter: Length/Height (S/S):
mm /in mm / ft Orientation: q H q V
Support Type: q Skirt q Legs q Saddles q Other
Internal Coating: q Yes q No Int. Coating / Cladding Type:
Insulated: q Yes q No Insulation Thick.: mm / in Painted / Primed: q Yes q No
Burner Type # of Burners Burner Duty:
Auto Controls Tubes Removable: q Yes q No Refractory q Yes q No
Additional Characteristics for Firetube Power Boiler, Reaction Furnace and Indirect Fired Heater
Firetube Boiler Design:
Firetube Mat'l: Firetube Thickness: mm / in Firetube S/N:
Head Mat'l: Head Thickness: mm / in Head C.A. mm / in
Burner Duty: Stripping Gas Present:

Still Column Vent Type: Heat Medium:
Additional Characteristics for Watertube Power Boiler
Watertube Boiler Design:
Watertube Mat'l: Watertube Thickness: mm / in Head C.A.: mm / in
Steam Drum Mat'l: Steam Drum Thk: mm / in Steam Drum Lgth: m / ft
Watertube Mat'l: Watertube Thk: mm / in
Super Heater Tube Mat'l: Super Heater Tube Thk: mm / in
Mud Drum Mat'l: Mud Drum Thk: mm / in Mud Drum Lgth: m / ft
Additional Characteristics for Direct Fired Heater

Direct Fired Heater Design:
Radiant Tube Mat'l: Radiant Tube Thk: mm / in Radiant Tube C.A. mm / in
Convection Mat'l: Convection Thk: mm / in Convection C.A. mm / in
Shock Tube Mat'l: Shock Tube Thk: mm / in Shock Tube C.A. mm / in
Additional Characteristics for Reboiler - Fired

Firetube Serial # : Still Column Vent Type:
Stripping Gas Present:
Additional Characteristics for Burner System

CSA B149 Compliant : q Yes q No Size of Mixer Head: in
Type of Mixer Head: Burner Orifice Size: in
Type of Orifice: Heating Capacity: KW / Btu/hr
Flame Arrestor Model: Manufacturer of Flame Arrestor:
Additional Characteristics for Thermo Electric Generator

Fuel Type TEG: q Propane q Natural Gas Electrical Power Out: Watts KVA Rating: KVA
Output Voltage: Volts Elect Class: Elect Division Elect Group:
Comments

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Fired Equipment Husky Purchase Order No.
Incinerator & Stack

P&ID # :
Equipment q Incinerator q Stack Parent Equip # :
Class

q Field Idle
Fluid Description: Service: q Sweet q Sour

Stack Mat'l: Stack Thickness: mm / in Stack C.A.: mm / in
Tip Mat'l: Tip Thickness: mm / in
Design Flow: Sm³/d / mmscfd Design Max. Temp: °C / °F Design Min. Temp: °C / °F
Design Flow Mass: lb/hr Length: m
Stack Diameter: mm /in Height : mm / ft
Painted / Primed: q Yes q No Support Type: q Guide Wires q Free Standing

Igniter Type: Igniter Fuel: Igniter Manufacturer:
Burner Type: # of Burners: Burner Controls: q Auto
Internal Coating: q Yes q No External Coating: q Yes q No q Manual
Steam Pressure: psi Steam Temperature: °F
Comments

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Husky Purchase Order No.
Rotating Mechanical
Gearbox, Generators and Mixers
Equipment q Generator q Gear Box q Mixer Parent Equip # :

Class


Prime Mover : Prime Mover Size: kW/HP Fuel Type:
Driven Equip. Speed: RPM Coupler Type: Shaft Size: mm / in
Power Transmitter Type: Voltage: V
Additional Characteristic for Generator

Power Rating: kVA Power Factor: Frame:
Voltage: V No. of Phases: Frequency: Hz
Electrical Class: Elec. Division: Elec. Group:

Enclosure Type: Mounting Type: Voltage: V
Style of Generator:
Additional Characteristics for Mixer

Seal type: Propeller Diameter: mm / in Gearbox Make:
Gearbox Model: Sheave Type: Sheave Size: mm / in
Gear Ratio (Out/In): Rotation (Viewed from Drive End): q CW q CCW

Orientation: q H q V Power Rating:
Additional Characteristics for Gear Box

Type ft-lbs
Torque Rating: ft-lbs Rotation (Viewed from Drive End): q CW q CCW

Input Speed: RPM Output Speed.: RPM Gear Ratio (Out/In):
Comments

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Rotating Mechanical
Conveyor, Coupling, Centrifuge, Hammer
Mill
Equipment q Bearing q Centrifuge q Conveyor Parent Equip #:

Class
q Coupling q Hammer Mill q Propeller
q Shaft
Equipment Description: Exist. Equip. ID: Tag No.:
q Field Idle
Rated Speed: RPM Shaft Size: mm / in
Additional Characteristic for Conveyer

Type: q Auger q Belt q Bucket q Chain q Drag q Pneumatic q Rotary Feeder
Normal Feed Rate: kg/hr HP Rating: HP
Material: Density of Material: kg/m3
Maximum Volume Flow: m3/hr
Additional Characteristics for Coupling

Type: Size:
KiloWatt Rating: KW
Additional Characteristics for Bearing, Shaft, Propeller

Type: Equipment/Material Supplier:
Material: Purchase Order Number:
Comments

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Pressure Vessels Husky Purchase Order No.
Condensers / Heat Exchangers

Parent Equip # :
Equipment q Air Cooled Ht Ex q Condenser q Cooling Tower
Class q Plate Ht Ex q Shell & Tube Ht Ex q Spiral Coil Ht Ex

q Field Idle
Fluid Description: Service: q Sweet q Sour Code Stamp: q U q U2 q UM q HV
Prov. Reg. No.: CRN: q H q UD q UV q S q E q M
Shell MAWP: kPag / psig @ Max. Temp: °C / °F Shell MDMT: °C / °F
Head Mat'l: Head Thickness: mm / in Head C.A.: mm / in
Nozzle Type: Nozzle Rating: Ansi
X-Ray: q RT1 q RT2 q RT3 q RT4 Stress Relief: q HT q PHT

# Manways: # of Inspection Ports: # of Phases:
Volume: m3 / ft3 Design Flow: Sm³/d / mmscfd Design Flow Mass: lb/hr
Vessel Diameter: mm /in Length/Height (S/S): mm / ft Orientation: q H q V

Additional Characteristics for Condenser, Shell and Tube Exchanger and Air Cooled Exchanger
TEMA Nomenclature: Shell Side Fluid: Service: q Sweet q Sour
No. of Passes: Tube Side Fluid: Service: q Sweet q Sour
Tube MAWP: kPag / Psig @ Max. Temp: °C / °F Tube MDMT: °C / °F
Tube Mat'l: Tube Thickness: mm / in Tube C.A.: mm / in
Tube Ferrules: Tube Diameter: mm / in
Channel or Header Box Material: Thickness: mm / in C.A.: mm / in
Additional Characteristic for Air Cooled Exchanger

Fan Type: q Force Draft q Induced Draft Louver Type: No. of Banks:
Additional Characteristic for Plate and Spiral Coil Exchanger
Hot Side Fluid Description: Service: q Sweet q Sour
Cold Side Fluid Description: Service: q Sweet q Sour
Plate / Coil Mat'l: Plate / Coil Thick.: mm / in Plate / Coil C.A.: mm / in
Comments

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Instrumentation Husky Purchase Order No.
(See Safety Equipment Template for Detectors & Alarms)

P&ID # :
Equipment q Accelerometer q Analyzer q Controller Parent Equip # :
Class q Diffuser q Emitter q Enclosure
q Control Panel q Control Systems q Level Element q Meter q Nuclear Gauge q Flame Detector
q Gauge q Indication q Regulators q Scales q Switches
q Orifice q Power Supply q Transmitter q Temp Element q Thermowell q Vibration Element
Service: q Sweet q Sour CRN #: Code:
Product: Alarms: Shutdowns:
Mounting: End Connection: Size:
Thk. Schedule Oper Temp: °C / °F Oper Press: kpag/ psig
Enclosure Class: Enclosure Style: Power Supply:

Input Signals: Output signals: Display:
Electrical Class: Electrical Group: Electrical Division:
Material: Internal Coating: q Yes q No Painted / Primed q Yes q No
Additional Characteristics for Accelerometer, Controller, Orifice, Diffuser, Emitter, Flame Detector
Gauge, Power Supply
Measurement Type: KPa Flow Rate: Size:
Pipe Size: mm Suction Pressure: Supply Voltage:
KPa V
Discharge Pressure: KPa Type: Sound Output Level:

Operating Range: Operating Teperature: °C Frequency: Hz
Additional Characteristics for Meter, Transmitters, Indication and Time Element

Operating Range: Measurement Type:
Size: Lab Sample Point Number:
Date of Calibration: Date of Sample:
Measurement Type: Operating Range:
Design Min Temp: Design Max Temp:
Additional Characteristics for Nuclear Gauges and Scales

Nuclear Substance: Max. Activity: License #: Leak Test Date:
Scale Type : Load Capacity :
Additional Characteristics for Thermowell

Connection: Imersion Profile:
Material: Pressure Rating:
Comments


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VERSION 1.5 February 2012

Instrumentation Husky Purchase Order No.
Actuators & Oil Detectors

(See Safety Equipment Template for Detectors & Alarms)

P&ID # :
Parent Equip # :
Equipment q Actuator - Air Operated q Actuator - Electric q Actuator - Hydraulic q Oil Detector
Class
Service: q Sweet q Sour CRN #: Code:
Actuator Motion: q Linear q Rotary Stroke Length: inches / cm Fire Safe:
Design Min. Temp: °C / °F Design Max. Temp: °C / °F Torque Rating:
Fail Action: q Open q Close q Last Spring Loaded: q Yes q No Material:
Mounting: End Connection: Size:
Thk. Schedule Oper Temp: °C / °F Oper Press: kpag/ psig
Input Signals: Output signals: Display:

Alarms: Painted / Primed q Yes q No Shutdowns:
Additional Characteristics for Electric Actuators
Electrical Class: _______________ Electrical Group: Electrical Division:

Voltage:___________ Service Factor:______________ # of Phases:________ Insulation Class:____________
Electric Motor Type:_________________ Horsepower Rating:_______________ Frequency:_______________ Hz
Full Load Current: Amps
Additional Characteristics for Hydraulic & Pneumatic Actuators

Diaphragm Operated: q Yes q No Diaphragm Material:
Piston Operated: q Yes q No MAWP: KPa Fluid Description:
Piston Action: q Single q Double
Additional Characteristics for Oil/Mist Detector

Equipment/Material Supplier: Purchase Order #:
Operational Limit: Ingress Protection:
Instrument Classification: Emergency/Process Fuction:
Hazardous Area Classification:
Comments


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VERSION 1.5 February 2012

Mobile Equipment Husky Purchase Order No.
P&ID # :
Data Collected By: Entry Date: Parent Equip # :
Equipment q Ambulance q ATV q Backhoe q Bobcat q Fire Truck

Class q Grader q Lawn Mower q Loader q Locomotive q Mobile Crane
q Mobile Lift q Railcar q Snowmobile q Trackmobile q Tractor
q Welding Unit

q Field Idle
Ownership Status: q Leased q Rented q Owned License #:
Additional Characteristics for Ambulance / Fire Truck

Truck Chassis Man.: Truck Model: Truck Model Year:
GVWR: Kg / Lbs Engine HP: HP Truck License # :
Capacity: Safety Equipment: Medical Supplies:
Respirator:
Type: Tank Capacity: Gallons Pump Capacity: GPM
Additional Characteristics for Mobile Crane

Crane Type: Lift Height: m / ft Hydraulic/Cable:
# of Lift Lines: Rated Max. Lift Capacity: Kg / Lbs
Additional Characteristics for Welding Unit

Portable / Stationary: Welding Process Type: Acetylene: q Yes q No
Arc: q Yes q No Elec. Current Type: q AC q DC AMP Rating: AMP
Mount: q Truck q Trailer Welding Arc Flag:

Additional Characteristics for ATV / Grader / Lawn Mower / Tractor / Bobcat
Engine HP: HP Track Type: q Rubber Tire q Track
Type of Engine: Fuel Type: Load Capacity: tonne
Additional Characteristics for Mobile Lift

Lift Height: m / ft Lift Capacity: Kg / Lbs Horizontal Reach: m / ft
Track Type: q Rubber Tire q Track Self-Propelled: q Yes q No Engine HP: HP
Type of Engine: q Vortec q Non-Vortec Fuel Type: Lift Type:
Additional Characteristics for Railcar, Trackmobile, Locomotive

Wheel Size: in Load Capacity: tonne
Fuel Tank Capacity: Gal Fuel Type:

Lube Oil Capacity: Gal HP Rating: HP
Minimum Continuous Speed: Wheel Size: in
Number of Axles: Governer Model:

Wheel Size: in
Comments

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Non Pressure Storage Husky Purchase Order No.

P&ID # :
Equipment q Bin q Gas Boot q Pond Parent Equip # :
Class q Silo q Sump q Tank

q Field Idle
Fluid Description: Service: q Sweet q Sour Volume: m3 / ft3
MAWP: kPag / psig / oz @ Max. Temp: °C / °F MDMT: °C / °F
Diameter: mm /in Length/Height (S/S): m / ft Depth: m / ft
Floor Mat'l: Floor Thickness: mm / in Floor C.A.: mm / in
Roof Mat'l: Roof Thickness: mm / in Roof C.A.: mm / in
Nozzle Mat'l: Nozzle Thickness: mm / in Nozzle Rating: Ansi
Insulated: q Yes q No Insulation Type Insulation Thick.: mm / in
# Manways: # of Inspection Ports: Painted / Primed: q Yes q No

Secondary Containment Type: q Earthen Clay q Imperious Synthetic Material
q Double Wall q Other
Internals:
Component Types: Component Man. Component Model:
Component Romovable: q Yes q No Component C.A.: mm / in
Additional Characteristics for Tank

Tank Type: q Underground q Surface # Of Walls: q single q Double
Design Standard: q API 650 q API 620 q API 12F q Other
Fabrication Type: q Shop q Field
Pressure Protection: q Vent q Thief Hatch Vacuum Breaker Manufacturer:
q Vacuum Breaker Vacuum Breaker Model:
Fire Tubes Exists: q Yes q No Vacuum Breaker Service Date:
# of Firetube: Firetube S/N: Firetube Rating: Btu/hr
Desand Type: Desand Connection: mm / in Truck Connection: mm / in
Enviro Vault: q Yes q No Burner Manufacturer:

Sacrificial Anodes: q Yes q No # of Sacrificial Anodes:
Additional Characteristics for Gas Boot
Prov.Reg. No.: CRN#
Additional Characteristics for Pond, Silo

Volume: m3 Liner : q Yes q No Liner Material:
Diameter: m Depth: mm
Design Min Temp: °C Design Max Temp: °C
Capacity: tonne
Comments

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Pressure Vessels Husky Purchase Order No.

Parent Equip # :
Equipment q Accumulator q Air Receiver q Blowcase q Bullet q Dampener
Class
q Deaerator q Dehydrator q Desalter q Drum q Dryer
q Filter q Knockout q Reactor q Scrubber q Separator
q Softener q Sphere q Tower q Treater

q Field Idle
Fluid Description: Service: q Sweet q Sour Code Stamp: q U q U2 q UM q HV
Prov. Reg. No.: CRN: q H q UD q UV q S q E q M
Nozzle Type: Nozzle Pressure Rating: Ansi
X-Ray: q RT1 q RT2 q RT3 q RT4 Stress Relief: q HT q PHT

# Manways: # of Inspection Ports:
Volume: m3 / ft3 Design Flow: Sm³/d / mmscfd # of Phases:
Vessel Diameter: mm /in Length/Height (S/S): mm / ft Orientation: q H q V
Insulation Type: Design Pressure: KPa
Operating Temp: °C / °F Operating Pressure: kPag / psig
Internals:
Component Type: Manufacturer: Model:
Component Mat'l: Component Size: Component C.A.: mm / in
Removable: q Yes q No
Additional Characteristics for Treater
Treater Type: Desand System: q Yes q No
# of Firetubes: Firetube S/N: Firetube Rating: kW / Btu/h
Additional Characteristics for Reactor, Tower, Dryer and Dehydrator

Regeneration Type: q Heat Regen. q Non-heat Regen.
Catalyst Bed Mat'l: Desiccant Type: Cycle Time: min's
# of Trays: Packing Height: mm
Comments

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Prime Movers
Equipment Class q Electric Motor q Gas Turbine q Reciprocating Engine Parent Equip # :
q Steam Turbine
Power Rating: kW / HP Rated Speed: RPM Service: q Sweet q Sour
Rotation (Viewed from Drive End): q CW q CCW RPM Shaft Size: mm / in
Fuel Type: Lubrication Type: q Pressurized q Non Pressurized

Emission Controls Function: q Gas Comp q Liq. Pump q Artificial Lift q Solids Hndlg q Mob Eq q Generator
Type of Emission Control: q Manual AFR q Auto AFR q Rich Burn q Lean Burn q Open Loop q Clsd Loop
q Other
Power Transmitter Type: Coupler Type:
Variable HP Rating: Design Max Temp: °C/°F
Additional Characteristics for Reciprocating Engine

Aspiration Type: q Natural q Turbocharged q Other:
Compression Ratio: No. of Cylinders: Fuel type:
Cyl. Bore: mm / in Cyl. Stroke: mm / in Governor Type:
Starter Type: Max. Jacket Water Temperature: °C / °F
Glycol Booster Pump Manufacturer: Type of Drive Belt:
Additional Characteristics for Electric Motor

Motor Type: q Induction q Synchronous q Other:
Elec. Class: Elec. Division: Elec. Group:
Voltage: V No. of Phases: Frequency: Hz
Service Factor: Frame: Enclosure Type:

Insulation Class: Full Load Efficiency: % Full Load Current: Amps
Rated Speed: Orientation:

KVA Rating: KVA NEMA Design:
Additional Characteristics for Steam Turbine

Turbine Type: q Backpressure q Condensing q Induction q Extraction q Other
Steam Flow (Design): kg/h / Lbs/h Inlet Pres. (Design): kPag/Psig Exhaust Pres. (Design): kPag/Psig
MAWP Inlet: kPag / Psig MAWP Exhaust: kPag/Psig No. of Nozzles:

Governor Type: Governor Make: Governor Model:
Primary Trip: RPM Mechanical Trip: RPM Rated Speed:
Maximum Inlet Pressure: kPag/Psig Maximum Outlet Pressure: kPag/Psig
Additional Characteristics for Gas Turbine

Shaft Config.: q Single Shaft q Two Shaft Fuel Type:
Design Speed: rpm Power Turbine: rpm Gas Generator: rpm
# of Stages (Power Turbine): Maximum Exhaust Temp: °C/°F Design Exhaust Pres.: kPag / Psig
Starter Type: Inlet Air Filter Type:
Comments:

Transfer Yard


Rotating Mechanical
Pumpjack, Top Drive &
Hydraulic Skid
Equipment q Hydraulic Skid q Pumpjack q Top Drive Parent Equip # :

Class

q Field Idle
Additional Characteristics for Top Drive

Type: q Hydraulic q Mechanical Rated Speed: RPM Service: q Sweet q Sour
Additional Characteristics for Pumpjack

Type: q Conventional q Mark V q Hydraulic q Strap q Other
Torque Rating: ft-lbs Structural Load: lbs Stroke Length: cm /in
Jackshaft: q Yes q No Pumping Unit Type: q Conventional q Mark V q Hydraulic

q Strap q Other
Gear Box Type: Gearbox S/N: Gearbox Model:
Additional Characteristics for Hydraulic Skids

Reservoir Size: Height_________ Width__________ Length____________ Pump Model:____________
Secondary Containment attached to Skid: Yes_____ No_____ Pump Manufacturer: ________________
Second Pump Model: Second Pump Manufacturer:
Comments

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Pumps
P&ID # :
Parent Equip # :
Equipment q Centrifugal Pump q Controlled Volume Pump
Class q Reciprocating Pump q Rotary Pump

q Field Idle
Fluid Description: Service: q Sweet q Sour Orientation: q H q V
Design Capacity: lpm / gpm Min. Suction Head: m/ft Driven by
Pump MAWP: kPag / psig Pump HP Rating Hp /Kw Rated Head: m/ft
Rotation (Viewed from Drive End): q CW q CCW Coupler Type:

Seal Manufacturer Seal Make: Seal Model:
# of Stages Max Frame Speed: RPM
Sheave Type Sheave Size mm / in Belt Size mm/in
Lubrication Type: q Pressurized Lubricator Make

q Non Pressurized Lubricator Model
Additional Characteristics for Reciprocating Pump
# of Cylinders: Plunger Size: mm / in Stroke: mm/in
Valve Type: q Disc q Wing q Double Ported q Other Plunger Type:

Piston Action: q Single q Double Liquid End Lubrication: q Pkg'd q Lubed q Flush
Valve Manufacturer: Liner: q Yes q No Liner Mat'l:
Additional Characteristics for Rotary Pump
Rotary Pump Type: q Screw q Lobe q Vane q Gear Csg Mat'l:
Rotor Mount: q Overhung q Between Bearing q Vertical
Additional Characteristics for Centrifugal Pump
Casing Type: q Hort. Split q Vertical Split q Barrel Design Max Temp: °C/°F
Csg Mat'l: Internal Coating: q Yes q No Max Inlet Pressure:

Impeller Diameter: mm / in Impeller Mat'l: Max Outlet Pressure:
Rotor Mount: q Overhung q Between Bearing q Vertical Pump Max Capacity: G/M
Additional Characteristics for Controlled Volume Pump

# of Cylinders: Displacement l/d gal/d
Plunger Mat'l Diaphragm Mat'l

Stroke: mm/in Operating Temp:
Packing Material: Design Max Temp:
Comments

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Valve, Piping & Fitting Husky Purchase Order No.

P&ID # :
Equipment Class q Airlock q Choke q Control Valve Parent Equip # :
q ESD Valve q Meterrun q Piping Systems q PSV (Safety Valve)
q Rupture Disc q Specialty Fitting q Specialty Piping q Specialty Valve
Equipment Description: Exist. Equip. ID .: Tag No.:
Skid Weight: Kg / Lbs Skid Size: W x L x H m / ft Diameter: mm /in
Fluid Description: Service: q Sweet q Sour Pressure Rating: ANSI
CRN: Code Stamp: q UV q SV q HV q U q U2 q UM # of Phases

Piping Body Mat'l Schedule Thk.: mm / in C.A.: mm / in
Nominal Size mm / in Painted / Primed: q Yes q No Internal Coating: q Yes q No

Design Flow: Sm³/d / mmscfd Design Flow Mass: Lb/Hr External Coating: q Yes q No
MAWP: kPag / psig # of Inspection Ports Volume: m3 / ft3
X-Ray: q RT1 q RT q RT3 q RT4 Length/Height (S/S): mm / ft Orientation: q H q V
Additional Characteristics for Airlock

Input Speed: rpm Gear Ratio: Output Speed: rpm Sheave Type:
Additional Characteristics for ESD Valve, Choke Valve, Specialty Valve, Control Valve
Design Valve Type: q Gate q Globe q Check q Ball q Needle q Plug q Butterfly Actuator Type:
Trim: Internal Mat'l: Bonnet Design: Fire Safe:
Additional Characteristics for Safety Valve / Rupture Disk
Capacity: gals/hr /scfm / lbs./h Service Date:
Set Pressure: kPag / psig Pop Pressure: kPag / psig Back Pressure : kPag / psig
Inlet Size: mm / in Inlet Connection : Bonnet Design:

Outlet Size: mm / in Outlet Connection:
Rupture Pressure: kPag / psig Capacity: Sm³/d / mmscfd Disc Mat'l: Trim Mat'l:
Equip. Protected: S/N: Prov.#
Additional Characteristics for Specialty Piping, Manifold and Launcher

Design Pressure: kPag / psig Type:
# of Inlets: Inlet Diameter: mm / in Inlet Connection:
# of Outlets: Outlet Diameter: mm / in Outlet Connection:
Additional Characteristics for Meterrun

Type: q Junior q Senior Recorder Manf:. Equipped with SCADA: q Yes q No
Chart Recorder q Yes q No Straighting Vanes q Yes q No AGA Figure Number:
Upstream Internal Diameter: in Downstream Internal Diameter: in Internal Corrosion Allowance: mm
Additional Characteristics for Flame Arrestor

Flow Rate: Operating Pressure: Kpa Operating Temp: °C / °F
Casing Material: Internals Material:
Additional Characteristics for Vacuum Breaker

Design Flow: Sm³/d / mmscfd Set Pressure: Kpa Vacuum Set Pressure: Kpa

Inlet Size: mm/in Inlet Connection: Outlet Connection:
Outlet Size: mm/in Service Date: Back Pressure: Kpa Diaphram Material:
Comments


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Vehicle-Fleet Husky Purchase Order No.
P&ID # :
Data Collected By: Entry Date: Parent Equip # :
Equipment q Bus q Passenger Car q Trailer q Trucks q Van

Class

q Field Idle
Ownership Status: q Leased q Rented q Owned License #:
Transmission Type: q Automatic q Standard Vehicle Location/Assignment:
Tire Size:
Additional Characteristics for Truck

Truck Type: q Passenger q Tanker q Owned q Fuel
# of Axles: Truck Capacity: Motor Manufacturer:
Additional Characteristics for Trailer

Load Capacity: Kg / lbs Hitch (Tongue) Type: # of Axles:
Trailer Brakes: q Air q Electric q N/A Deck Material: Dimensions: m/ft
Comments

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Package Husky Purchase Order No.
Equipment Package
Class
Equipment Description: Tag No.:

Facility: Unit / Yard: Exist. Equip. ID .:
Location: LE /LSD Sec. Twp. Rge. W /ES
Cost Center: Acquis Value: Acquis Date:
q Field Idle
Design Flow: Sm³/d / mmscfdService: q Sweet q Sour
Compressor / Pump Packages
Compressor Type q Reciprocating q Centrifugal q Rotary q Blower / Fan
Pump Type q Reciprocating q Centrifugal q Rotary q Controlled Volume
Driver q Motor q Gas # of Stages
Inlet ANSI Rating ANSI Final Discharge ANSI Rating ANSI
Separator / Dehydrator / Treater / Line Heater / Tank Package

Orientation q Vertical q Horizontal Vessel Diameter mm/in
ANSI Rating ANSI MAWP kPa/psi Internally Coated q Yes q No
Reboiler / Burner Duty BTU/hr / KW
Inlet/Metering & Group/Test packages

ANSI Rating ANSI # of Inlets
Comments

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Version 1.4 November 2010

Facility Cover Sheet

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Facility Cover Sheet

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FACILITY COVER SHEET # of Data Templates

Data Collected By: Entry Date:

Facility: Unit / Yard:

Location: LE /LSD Sec. Twp. Rge. W /ES

Functional Location Code

Cost Center: Direct Charge AFE

Ownership Status: q 100% q Joint Venture

Version 1.4 November 2010

Data Collected By: Entry Date:

Equipment Description: Exist. Equip. ID : Tag No.:

Additional Characteristics for Tower

Additional Characteristics for LAN

Additional Characteristics for Radio System

Material Transfer Information

Transfer Recorded by: Date

From LSD Sec Twp Rge W/

To LSD Sec Twp Rge W/

Version 1.5 February 2012

Equipment q Bridge q Building q Fence Parent Equip # :

Additional Characteristics for Buildings

Additional Characteristics for Monorails

Additional Characteristics for HVAC

Additional Characteristics for Railways

Gauge: m / ft Rail Tie Material:

Additional Characteristics for Bridges

Wire/Chain Mat. Type: Hook Type: Lift Capacity: Kg / Lbs

Type of Engine: Crane Type: Capacity: Tonnes

Material Transfer Information

Transfer Recorded by: Date

From LSD Sec Twp Rge W/

To LSD Sec Twp Rge W/

Version 1.5 February 2012

Equipment Description: Exist. Equip. ID : Tag No.:

Cyl #1 Size: mm / in Cyl #1 S/N Cyl #1 MAWP kPag / psig

Cyl #2 Size: Cyl #2 S/N Cyl #2 MAWP

Input Speed: rpm Discharge Temperature: °F

Additional Characteristics for Rotary Compressor

Additional Characteristics for Centrifugal Compressor and Turbo Expander

Csg Mat'l Shaft Seal Make: Shaft Seal Model:

Input Speed: rpm Discharge Temperature: °F

Additional Characteristics for Blower and Fan

Sheave Type: Sheave Size: mm/ in Seal Model:

Input Speed: rpm Discharge Temperature: °F

Material Transfer Information

Transfer Recorded by: Date

From LSD Sec Twp Rge W/

To LSD Sec Twp Rge W/

Version 1.5 February 2012

Data Collected By: Entry Date:

Equipment Description: Exist. Equip. ID : Tag No.:

Operating Temp.: °C / °F Enclosure Style: Enclosure Class:

Input Current: Amps Output Current: Amps CSA Approved #:

Additional Characteristic for Electric Circuit

Additional Characteristic for Lighting and Electric Heater

Additional Characteristic for Motor Control Centers and Switchgear

Additional Characteristics for Motor Operated Valve

Additional Characteristics for Transformers

Additional Characteristics for Unit Heater

Material Transfer Information

Transfer Recorded by: Date

From LSD Sec Twp Rge W/

To LSD Sec Twp Rge W/

Version 1.5 February 2012