Journey Management Form for Rig Trip

Company/Contractor Name: United Safety Intl.

Date: 27-01-2019

Purpose: (Crew mobilization)

Journey Start-point: (MIANO-22)

Journey End-point: (Karachi)

Name Position Contact No Vehicle No Date and Time of Date and time of Arrival
Departure

Shahzad Sultan H2S Engineer 03008570303

BBC742 Sindh 27-01-2019 27-01-2019
07:00hrs 20:00hrs

Note: Please plan the journey to make sure that drop off vehicle must drive back to base before sunset.
Only operation-essential personnel will be accommodated on site.
Document handling:
 A copy of the form will be handed over to Material Coordinator or Company man at rig site, records will be
kept for auditing purposes.
 The filled form has to be sent 3-5 hours prior to commence the journey.
f.pk.isb.sc15@uep.com.pk + 92 (51) 2089594
f.pk.isb.drill15@uep.com .pk + 92 (51) 2089593

f.pk.isb.mat15@uep.com .pk + 92 (51) 2089592

f.pk.isb.hse15@uep.com.pk + 92 (51) 2089595

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 JOURNEY MANAGEMENT FORM

Checklist to be filled:

Sr. No. Description Yes/No/NA Comments

1 Is CNIC, Company cards available with all people in Yes

journey?

2 Does fit to work certificate available from recognized Yes

hospital?

3 Is technical staff (intended to work on rig/live well) holding Yes

H2S level 2 certificates?

4 Are CV’s of all personnel, certificates of equipment shared Yes

with the UEP ISB office?

5 Vehicle certified by certified vendor? Is vehicle fit for N/A

purpose?

6 Is driver holding valid license and defensive driving Yes

certificate?

7 Are Spark arrestors installed in vehicles to work near N/A

Wellhead?

8 Is Equipment properly latched? Certificates of lashing N/A

equipment available?

9 Is Equipment sent to site properly color coded on lifting N/A

eyes/pads?

10 Is Proper certification of equipment (sent to site) N/A

available?

11 Is Vehicle loaded within allowed load limits? N/A

12 Is Everyone name/position/contact info properly filled on Yes

the JMF form?

13 Is JMF sent 3-5 hrs. earlier or before the Yes

personnel/equipment leaves the base and vice versa?

14 Is the Load manifest attached with this JMF? N/A

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