Oil Rig Inspection Safety Assessment Survey Form
Use this form to record oil rig inspection details, assess safety conditions, and document hazards or corrective actions.
Inspection Overview
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Rig / Site Name
*
Inspector Name
*
Inspection Shift / Type
*
Day Shift
Night Shift
Planned Inspection
Follow-up Inspection
Safety Assessment
Overall Safety Rating
*
1
2
3
4
5
Safety Status Summary
*
Rows
Compliant
Needs Attention
Critical Issue
Access / Platforms
1
2
3
Fall Protection
4
5
6
Fire Protection
7
8
9
Equipment Condition
10
11
12
Housekeeping
13
14
15
Emergency Readiness
16
17
18
Hazards and Actions
Hazard Severity
*
Low
Moderate
High
Critical
Issue Summary
*
Immediate Action Required
*
Yes
No
Corrective or Follow-up Action Notes
*
Submit Form
Should be Empty: