Validus Energy SIMOPS

Validus Energy SIMOPS

Pad Specific Safety Plan
This form identifies the activities and/or procedures specific to multiple high-risk operations occurring on the same well pad or location.
Pad Name of SIMOPS Activity*
Beginning Date of SIMOPS Activity*

MonthDayYear
Date
Ending Date of SIMOPS Activity*

MonthDayYear
Date
Activity being conducted (Select All)*

DrillingCompletionsConstructionDrill OutWell ServicingPad ConstructionOther
Specify Other
Describe the scope of each activity taking place and the person in charge of each activity.*
SIMOPS Lead*
Specify Lead for Each Activity*
Work Permits Needed (List All)*
Muster Point(s)*
Alarms*
Emergency Services Contacts (Name and Phone #)*
Nearest Hospital Driving Directions*
Communication Methods between Crews*
Is there a potential language barrier?*

YesNo
How will the language barrier be overcome? (Describe)
Is there H2S anticipated on Site?*

YesNo
What are the H2S mitigation activities? (Monitoring...etc.)
Are there controlled access zones? (High Pressure, Fall Hazard...etc.)*

YesNo
How are the controlled access zones marked and managed?
List all contract companies and # of personnel for each *
Additional Activities or potential hazards not covered above.
Conducted by:*

First NameLast Name
Email*
example@example.com
Signature*
Completed on:*

MonthDayYear
Date
Should be Empty:

This form identifies the activities and/or procedures specific to multiple high-risk operations occurring on the same well pad or location.