General Site Inspection
HSE ONLY
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Division
*
AB - HSE
SK - HSE
Surface Location
*
Information
Safe Work Permit/Hazard Assessment/Stick Program
Take Picture / Upload Files
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of
Site Release (optional)
Take Picture / Upload Files
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of
Ground Disturbance (optional)
Take Picture / Upload Files
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of
Site Specific ERP
Take Picture / Upload Files
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of
Fire and Explosion Form
Take Picture / Upload Files
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of
Are the safety permits uploaded into Petrosight?
*
Satisfactory
Unsatisfactory
Safety Permit Comments
*
Lease signs in place?
*
Satisfactory
Unsatisfactory
Lease Sign Comments
*
Conditions on location
*
Clear
Cloudy
Raining
Snowing
Other
Temperature
*
Wind direction
*
Spacing requirements being met?
*
Satisfactory
Unsatisfactory
N/A
Spacing Comments
*
Proper PPE being worn?
*
Satisfactory
Unsatisfactory
N/A
PPE Comments
*
Surface vent valves open?
*
Satisfactory
Unsatisfactory
Vent Valves Comments
*
Housekeeping on location?
*
Satisfactory
Unsatisfactory
Housekeeping Comments
*
Additional Comments (optional)
Additional Photo
Browse Files
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of
Submit
Should be Empty: