SAFETY CHECK FOR

LUBE OIL FLUSHING

Name of site: -
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Date: -

Job Location: - Equipment Number:

SI. Observation
Description Remarks
No. Yes/No/NA
1. Circulation loop identified

2. Leak test of the line completed

3. Permit available

4. Housekeeping of the area complete

5. Greasing done on the rotary parts

6. Guards provided on rotary parts

7. Entry to area restricted & warning board placed

8. Proper light and Access ensured

9. Information communicated through tool box talks

10. Fire extinguishers/ sand buckets placed

11. SIMOPS in the area stopped

12. Emergency stop button provided

13. Temporary connections are checked for integrity

14. Tagging of the lines

Name of Site Engineer: _______________________Name of HSE Engineer: ____________________

Signature: _________________________________ Signature: ______________________________

Date: _____________________________________ Date: __________________________________

Document number 1