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HALLIBURTON
Stationary Slips PM Meter Equipment # 11959870-309923836
MO#

H01A Suggested interval: 120 DAYS Shop Location and # DATE (ddMMMyyyy)

(Hrs/Miles/KM)

SN#57

CJ8

Page 1 of 3

Preventive Maintenance Check Sheet H01A

Revision Date: 4/20/2011

HALLIBURTON
Stationarv Slios

-. FUNCTION TEST

H01A Suggested interval: 120 DAYS CH

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25 Hook up hydraulic power source and open and close slips. 26 Insert test pipe of same size slip inserts and extend hydraulic cylinders. Assure slip segments contact. pipe ~n.q top .suifa~e of all four slip insert segments. Are on 0Il~ horizontal plane. Retime
bowl if not. LIFTING SYSTEM

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27 Check condition of lifting eyes and welds. 28 Verify lifting slings are in good condition and has up to date certification tag on them. 29 Verify shackles, nuts and pins are secure and in good condition. Verify they meet local and
customer regulations. REQUIRED PAPER WORK

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30 Check regulatory documents and decals per State and/or Country Requirements (DOT, CVIP,
MMS Coast Guard, etc.)

31 Verify that proper company logos and decals are installed as per the Branding initiative. Verify that
the SAP equipment number is clearly marked on the unit (see the ESG Branding web page for guidelines).

32 Install new sticker to indicate when the next PM is due 33

ENVIRONMENTAL Dispose of all waste properly. Ensure all spills are cleaned up and properly contained.

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Page 2 of 3

Preventive Maintenance Check Sheet H01A

Revision Date: 4/20/2011

HALLIBURTON
Stationarv SIiDS H01A Suggested interval' 120 DAYS LIST ALL REPAIRS THA T WERE FOUND DURING THE INSPECTION. THIS LIST WILL BE USED AS A TOOL TO RESCHEDULE ANY REPAIRS THAT WERE FOUND DURING PM INSPECTION. 1
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Mechanic name: Repair date: 2 Mechanic name: Repair date:

3

Approval acquired: Maintenance order #:

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Approval acquired: Maintenance order #:

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Mechanicname: Repair date: 4

Approval acquired: Maintenance order #: .

Mechanicname: Repairdate: 5

Approval acquired: Maintenance order #:

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Mechanic name: Repair date: 6 Mechanic name: Repair date: 7 Mechanicname: Repairdate: 8 Mechanic name: Repair date: 9 Mechanic name: Repair date: 10 Mechanicname: Repairdate: Report any errors found on check sheet to supervisor

Approval acquired: Maintenance order #:

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Approval acquired: Maintenance order #:

Approval acquired: Maintenance order #:

Approval acquired: Maintenance order #:

Approval acquired:

Maintenance order #:

Approval acquired: Maintenance order #:

Page 3 of 3

Preventive Maintenance Check Sheet H01A

Revision Date: 4/20/2011