Jsa for Surface Coating

SAFE WORK METHOD STATEMENT (SWMS) – Incorporating Job Safet Ana!"i"

De"cription of Acti#it to be carrie$ o%t&

Abo#e Abo#e 'ro%n$ 'ro%n$ Etern Eterna! a! S%rfac S%rface e protec protectio tion n ainting of iping* E+%ip,ent - Str%ct%re.

Wor/ 0ocation&

J'1 appro#e t3e %"e of t3i" MSJSA &

b M12

Ri"/ A""e"",ent 0og Section&

Step

1ritica! Step" in t3i" Acti#it&

5.6

0oa$ing of Erection Materia! on Trai!er (%"ing Trai!er* Trai!er* 1rane* For/!ift etc.)

Corridors of Ras Laffan, Tank form area, B110, B120, B130, B140, B150, B160, B310, C110, C110, C120, C130, C140, C160, C300, D100, D200

Na,e&

o"ition& JGC HSE Manager

Signat%re&

Date &

Acti#it '%i$e!ine" %"e$&

otentia! Ha4ar$"& 

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Improper loading of material. Falling material Personnel Injury

HSE 1ontro!" to be I,p!e,ente$&

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7.6

S3ifting of ,ateria! to Site 8 Off !oa$ing b Trai!er* 1rane* etc

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,oad Traffic #ccidents -aterial fall during transportation #ccident due to improper loading Improper Offloading

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Loading of material will be under proper supervision. Only Third party certified and color coded lifting gears will be used Only Bansman with !igh visibility "est will give signals to crane operator. Barricade the loading area. #pproved operator will will operate the crane. Tag line to be used. #ccess to be provided in case of re$uirement %ecure all material &nsure that overloading is prevented For the lifting of load wind speed should be less than '( nots confirmed by )*+ #ll drivers / operators will will be oriented for safe access to site. Only approved trailer to be used 0o standing at the bac of Trailor. ,oad traffic signs to be followed.


Step

2.6


S3ifting of Too!" an$ !ant 9 E+%ip,ent at "ite.

otentia! Ha4ar$"&

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1efective / unserviceable machines %ource of Ignition / Fire &arth / +ables etc.


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:.6

'rit b!a"ting b %"ing 'arnet

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Occupational !ealth problem due to *rit Blasting dust. Irritation on %in Personnel Injury due to Improper containment of area Inade$uate / 1efective PP&s 4nfiller / Improper #ir %uction and $uality Inade$uate coupling / !ose connection Poor +ommunication Poor !ouse 5eeping %lips / Trips

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&nsure all compressor checed prior to shifting to site #ll blasting accessories lie blasting parts no22les blasting hoods filters and tools are approved / certified / inspected prior to use. +ompressors with Fire e3tinguisher Trained personnel will be involved in shifting of tools and plant / e$uipment

Tool Bo3 tal will be conducted regarding ha2ards of *arnet being used for blasting material6 -%1% attached. The *rit Blast Operator will wear an air supplied hood approved for *rit Blasting. #de$uate periphery protection will be done. Other worers in or around the area will wear dust mass approved for Blasting #rea. *rit Blast no22le will be with dead man control that will shut off the flow if no22le is dropped6 +ontrol %witch will be in reach of the blaster. !ose no22le6 coupling6 fittings will be checed visually to be well in place. !ose joint will be provided with safety chain / pin *rit blast operator will wear %hot resis tant apron6 %afety boots6 *auntlet gloves6 heavy shirt and trouser.


Step

2.6


S3ifting of Too!" an$ !ant 9 E+%ip,ent at "ite.


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1efective / unserviceable machines %ource of Ignition / Fire &arth / +ables etc.


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'rit b!a"ting b %"ing 'arnet

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Occupational !ealth problem due to *rit Blasting dust. Irritation on %in Personnel Injury due to Improper containment of area Inade$uate / 1efective PP&s 4nfiller / Improper #ir %uction and $uality Inade$uate coupling / !ose connection Poor +ommunication Poor !ouse 5eeping %lips / Trips

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&nsure all compressor checed prior to shifting to site #ll blasting accessories lie blasting parts no22les blasting hoods filters and tools are approved / certified / inspected prior to use. +ompressors with Fire e3tinguisher Trained personnel will be involved in shifting of tools and plant / e$uipment

Tool Bo3 tal will be conducted regarding ha2ards of *arnet being used for blasting material6 -%1% attached. The *rit Blast Operator will wear an air supplied hood approved for *rit Blasting. #de$uate periphery protection will be done. Other worers in or around the area will wear dust mass approved for Blasting #rea. *rit Blast no22le will be with dead man control that will shut off the flow if no22le is dropped6 +ontrol %witch will be in reach of the blaster. !ose no22le6 coupling6 fittings will be checed visually to be well in place. !ose joint will be provided with safety chain / pin *rit blast operator will wear %hot resis tant apron6 %afety boots6 *auntlet gloves6 heavy shirt and trouser.


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0o one will be allowed within range of *rit jet while wor is in progress. 7orers attending e$uipment will not leave the e$uipment unattended and wear all PP&s 8having proper with blaster. %upply rate of #ir to Blasting hood will be 9 cfm per hood without vorte3 tube and '( cfm with vorte3 tube. #pproved Blasting material will be used. 7or area will be barricaded and sign posted as :0O &0T,; < *,IT BL#%TI0* I0 P,O*,&%%: %ite %upervisor will be responsible for observing distance of rebound and for moving ropes and barricades and signs clear of rebound. # proper bonded or electrically conductor hose will be used to prevent accumulation of static electricity in the operator=s body. -aintain woring area clean and tidy. Only e3perienced personnel to do this activity. 7aste from blasting yard will be disposed off as per )*+ / 1olphin waste management system.


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0o one will be allowed within range of *rit jet while wor is in progress. 7orers attending e$uipment will not leave the e$uipment unattended and wear all PP&s 8having proper with blaster. %upply rate of #ir to Blasting hood will be 9 cfm per hood without vorte3 tube and '( cfm with vorte3 tube. #pproved Blasting material will be used. 7or area will be barricaded and sign posted as :0O &0T,; < *,IT BL#%TI0* I0 P,O*,&%%: %ite %upervisor will be responsible for observing distance of rebound and for moving ropes and barricades and signs clear of rebound. # proper bonded or electrically conductor hose will be used to prevent accumulation of static electricity in the operator=s body. -aintain woring area clean and tidy. Only e3perienced personnel to do this activity. 7aste from blasting yard will be disposed off as per )*+ / 1olphin waste management system.


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;.6

<"e of Air co,pre""or

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Occupational !ealth problem due to noisy atmosphere

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+ompressed air leaage due to improper hose connection or damaged hose

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%in injury due compressed air.

to

improper

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%lip / Trip !a2ard

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Improper grounding

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0o / improper guard on moving parts

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4se of defective e$uipment

use

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of -

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#ll air compressor6 #ir receivers and other e$uipment will be )*+ Inspected6 color coded. Perform regular inspection on daily basis to identify defects Periodic maintenance to be done Immediately report any defect/damage/malfunction or missing part to supervisor &nsure all safety gadgets and gauges woring properly 7ear hearing protection in noisy environment. &nsure drip tray to avoid any spill due to leaage Provision of fire e3tinguisher with the air compressor. #ir >uality to be checed regularly and moisture drained. This will be done by checing the air using personal gas monitor periodically as described in #ir >uality Procedure. +ompressed air not to be used for cleaning purpose Inspection of air hose assembly and hose connections before each use. 7ire checs will be used on hose joints !oses to be routed properly to prevent slip / trip ha2ard Proper earthing of the air compressor to be done


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;.6

<"e of Air co,pre""or

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Occupational !ealth problem due to noisy atmosphere

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+ompressed air leaage due to improper hose connection or damaged hose

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%in injury due compressed air.

to

improper

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%lip / Trip !a2ard

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Improper grounding

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0o / improper guard on moving parts

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4se of defective e$uipment

use

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of -

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#ll air compressor6 #ir receivers and other e$uipment will be )*+ Inspected6 color coded. Perform regular inspection on daily basis to identify defects Periodic maintenance to be done Immediately report any defect/damage/malfunction or missing part to supervisor &nsure all safety gadgets and gauges woring properly 7ear hearing protection in noisy environment. &nsure drip tray to avoid any spill due to leaage Provision of fire e3tinguisher with the air compressor. #ir >uality to be checed regularly and moisture drained. This will be done by checing the air using personal gas monitor periodically as described in #ir >uality Procedure. +ompressed air not to be used for cleaning purpose Inspection of air hose assembly and hose connections before each use. 7ire checs will be used on hose joints !oses to be routed properly to prevent slip / trip ha2ard Proper earthing of the air compressor to be done


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=.6

Storage of c3e,ica!"

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Occupational !ealth ha2ard due to e3posure to to3ic chemicals

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&nvironmental !a2ard due to spillage

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Fire ha2ard due to flammable chemicals

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Improper handling and disposal of waste

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Improper houseeeping

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Ignition source / hot wor near flammable material

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The design and specification of chemical storage areas will be in compliance with )*+ Procedure. 7aste storage areas will comply with the re$uirements stated within the )*+ 7aste -anagement Procedure ,LO ????FP,(?@'9. -anagement of spills of chemicals will comply with the measures stated in the %pill +ontingency6 Procedure ,LO???? FP,(?@'A. 1isposal procedures and control measures for chemical waste will comply with the procedure and measures stated in the 7aste -anagement Procedure ,LO????FP,(?@'9. &nsure the availability of -%1% of chemicals being used. 4se of drip trays to avoid spillage &nsure availability of Fire e3tinguisher at chemical storage area. +ontrol measures and emergency contacts are provided in case of any spill or fire. *ood houseeeping to be maintained at all the times at chemical storage area. Labeling of all chemical containers &nsure that all containers are tightly paced List of emergency contact numbers is provided. 0o smoing in or around chemical storage area. 0o hot wor/ignition source nearby to chemical storage area


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Storage of c3e,ica!"

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Occupational !ealth ha2ard due to e3posure to to3ic chemicals

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&nvironmental !a2ard due to spillage

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Fire ha2ard due to flammable chemicals

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Improper handling and disposal of waste

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Improper houseeeping

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Ignition source / hot wor near flammable material

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The design and specification of chemical storage areas will be in compliance with )*+ Procedure. 7aste storage areas will comply with the re$uirements stated within the )*+ 7aste -anagement Procedure ,LO ????FP,(?@'9. -anagement of spills of chemicals will comply with the measures stated in the %pill +ontingency6 Procedure ,LO???? FP,(?@'A. 1isposal procedures and control measures for chemical waste will comply with the procedure and measures stated in the 7aste -anagement Procedure ,LO????FP,(?@'9. &nsure the availability of -%1% of chemicals being used. 4se of drip trays to avoid spillage &nsure availability of Fire e3tinguisher at chemical storage area. +ontrol measures and emergency contacts are provided in case of any spill or fire. *ood houseeeping to be maintained at all the times at chemical storage area. Labeling of all chemical containers &nsure that all containers are tightly paced List of emergency contact numbers is provided. 0o smoing in or around chemical storage area. 0o hot wor/ignition source nearby to chemical storage area


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0o accumulation of chemicals in wor area / walways where it poses a health ha2ard/fire ha2ard. #ll spills to be cleaned immediately. Flammable li$uids to be dispensed over drip trays in a safe area away from an ignition source Flammable li$uids not to be used for cleaning machinery or its parts %uitable signs to be posted


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0o accumulation of chemicals in wor area / walways where it poses a health ha2ard/fire ha2ard. #ll spills to be cleaned immediately. Flammable li$uids to be dispensed over drip trays in a safe area away from an ignition source Flammable li$uids not to be used for cleaning machinery or its parts %uitable signs to be posted


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ainting Wor/"

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Occupational !ealth problem due to inhalation of paint fumes. Trips / %lips / Falls Inade$uate storage / disposal of paint and empty container 0onavailability of eye wash it %ign boards Over spray in adjacent areas 4se of defective paint spray e$uipment &ye Injury Fire !a2ard &nvironmental ha2ard due to spillage of paint


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TBT to be conducted on the ha2ards and ris to health by paint materials -%1% attached. Proper planning before starting activity to minimi2e the ris to human health6 safety and environment PP&% to be used as an e3tra protection or where other control measures are not practicable &nsure that all containers are tightly paced when not in use. List of emergency contact numbers is provided. 4se of paint will be performed on open areas as for possible. The >uantity of paint brought into the wor area will be controlled and restricted to the anticipated or intended amount to be used. Only trained personnel will be allowed to use and handle paint. +onsumption of food and smoing will be prohibited when woring with paint. %upervisor to ensure that worforce is aware of all precautions given in the -%1% of paint and follow these fully.


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ainting Wor/"

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Occupational !ealth problem due to inhalation of paint fumes. Trips / %lips / Falls Inade$uate storage / disposal of paint and empty container 0onavailability of eye wash it %ign boards Over spray in adjacent areas 4se of defective paint spray e$uipment &ye Injury Fire !a2ard &nvironmental ha2ard due to spillage of paint


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TBT to be conducted on the ha2ards and ris to health by paint materials -%1% attached. Proper planning before starting activity to minimi2e the ris to human health6 safety and environment PP&% to be used as an e3tra protection or where other control measures are not practicable &nsure that all containers are tightly paced when not in use. List of emergency contact numbers is provided. 4se of paint will be performed on open areas as for possible. The >uantity of paint brought into the wor area will be controlled and restricted to the anticipated or intended amount to be used. Only trained personnel will be allowed to use and handle paint. +onsumption of food and smoing will be prohibited when woring with paint. %upervisor to ensure that worforce is aware of all precautions given in the -%1% of paint and follow these fully.


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,espiratory protection will be used as per -%1%. Paint will be stored in a safe manner6 material will be segregated in accordance with good practice eeping o3idi2ing and reducing apart. Paint will be stored in well ventilated and cool place. 0o !ot wor6 in and around the painting area. 4se proper access wor plat 4se ade$uate rope to lift / lower the paint containers / brush while woring at height. -aintain area clean and tidy at all times. In case of any paint spillage6 it will be cleaned immediately. Left out paint will be ept in separate container and disposed as per )*+ / 1olphin waste management system. Fire e3tinguisher will be ept as re$uired in the area. :0O 0#5&1 FL#-&: or :!OT 7O,5: sign boards will be placed. #ll area nearby will be mased prior to spray. #ll tools / e$uipment will be inspected6 approved and color coded. &mergency eye wash it will be placed in the painting area. %afety glasses will be worn at all time6 especially during the paint spray and mi3ing.


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,espiratory protection will be used as per -%1%. Paint will be stored in a safe manner6 material will be segregated in accordance with good practice eeping o3idi2ing and reducing apart. Paint will be stored in well ventilated and cool place. 0o !ot wor6 in and around the painting area. 4se proper access wor plat 4se ade$uate rope to lift / lower the paint containers / brush while woring at height. -aintain area clean and tidy at all times. In case of any paint spillage6 it will be cleaned immediately. Left out paint will be ept in separate container and disposed as per )*+ / 1olphin waste management system. Fire e3tinguisher will be ept as re$uired in the area. :0O 0#5&1 FL#-&: or :!OT 7O,5: sign boards will be placed. #ll area nearby will be mased prior to spray. #ll tools / e$uipment will be inspected6 approved and color coded. &mergency eye wash it will be placed in the painting area. %afety glasses will be worn at all time6 especially during the paint spray and mi3ing.


Step


?.6

Ref%e!ing of E+%ip,ent" e.g. Air 1o,pre""or etc


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&nvironmental ha2ard due to %pillage of oil during refueling. Fire !a2ards during refueling. Personal injury due to slip / trip Inade$uate hose connection %truc against / %truc by Over fueling


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%tay near your e$uipments fueling point when refueling. &nsure a safe access to the e$uipment to be refueled 7earing of appropriate PP&% at all time during refueling %witch off e$uipment before starting refueling 0ever overstretch refueling hose 0ever overfill or top the fuel tan ,efueling to be done at slow rate to reduce the potential for spillage and static ignition buildup Let the fuel dispenser shut off automatically and leave the no22le in the tan for si3 to eight seconds so the fuel can settle down and any fuel in the no22le can drip down into fuel tan &nsure drip tray under the e$uipment to be refueled. !ose and refueling assembly should be in good condition ,efueling to be done only by refueling vehicle and trained person. If fuel is needed to be taen on site in cane6 use the recommended jerry cane &nsure the availability of fire e3tinguisher near refueling point 0o ignition source /smoing near refueling point %witch off mobile phone before starting refueling


Step


?.6

Ref%e!ing of E+%ip,ent" e.g. Air 1o,pre""or etc


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&nvironmental ha2ard due to %pillage of oil during refueling. Fire !a2ards during refueling. Personal injury due to slip / trip Inade$uate hose connection %truc against / %truc by Over fueling


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%tay near your e$uipments fueling point when refueling. &nsure a safe access to the e$uipment to be refueled 7earing of appropriate PP&% at all time during refueling %witch off e$uipment before starting refueling 0ever overstretch refueling hose 0ever overfill or top the fuel tan ,efueling to be done at slow rate to reduce the potential for spillage and static ignition buildup Let the fuel dispenser shut off automatically and leave the no22le in the tan for si3 to eight seconds so the fuel can settle down and any fuel in the no22le can drip down into fuel tan &nsure drip tray under the e$uipment to be refueled. !ose and refueling assembly should be in good condition ,efueling to be done only by refueling vehicle and trained person. If fuel is needed to be taen on site in cane6 use the recommended jerry cane &nsure the availability of fire e3tinguisher near refueling point 0o ignition source /smoing near refueling point %witch off mobile phone before starting refueling


Step


@.6

Man$ator - 9 or Reco,,en$e$ er"ona! rotecti#e E+%ip,ent (Tic/ Appropriate E) 8888888 !ard !at  %afety *lasses6 *oggles6 Face %hield  %afety %hoes  +overall < Long %leeve 0ome3  #ir %upplied Blasting !ood  !earing Protection  !and *loves 8+otton6 Leather6 ,ubber

OthersC

 Full Body !arness D Lifeline  ,espiratory Protective &$uipment  !'% *as #lert clip  %+B# on standby  Others


This )%#6 including all relevant checlists6 will be used in conducting Tool Bo3 Tals 8TBTC with all concerned worers. '. Only diesel e$uipment / tools inspected and approved by )*+ are allowed in the wor area. E. !eat %tress prevention will always be emphasi2ed in TBT. . Provided that all the necessary PP& are used6 relevant PT7 re$uirements are followed and all the control measures stated above are adhered to6 the activity can proceed. 0oteG #ny worer has the right to refuse to wor due to safety and environmental concern. %uch concern will at once be reported to his supervisor / foreman or to the operation and &!% personnel at site.


@.

Prepared By GHHHHHHHHHHHHHHHH 8Painting %ubcontractorC

,eviewed By GHHHHHHHHHHHHHHHH 8%ubcontractor  %afetyC

#pproved By GHHHHHHHHHHHHHHH 8)*+  1iscipline D %afetyC 1ate GHHHHHHHHHHHH


Step


@.6

Man$ator - 9 or Reco,,en$e$ er"ona! rotecti#e E+%ip,ent (Tic/ Appropriate E) 8888888 !ard !at  %afety *lasses6 *oggles6 Face %hield  %afety %hoes  +overall < Long %leeve 0ome3  #ir %upplied Blasting !ood  !earing Protection  !and *loves 8+otton6 Leather6 ,ubber

OthersC

 Full Body !arness D Lifeline  ,espiratory Protective &$uipment


This )%#6 including all relevant checlists6 will be used in conducting Tool Bo3 Tals 8TBTC with all concerned worers. '. Only diesel e$uipment / tools inspected and approved by )*+ are allowed in the wor area. E. !eat %tress prevention will always be emphasi2ed in TBT. . Provided that all the necessary PP& are used6 relevant PT7 re$uirements are followed and all the control measures stated above are adhered to6 the activity can proceed. 0oteG #ny worer has the right to refuse to wor due to safety and environmental concern. %uch concern will at once be reported to his supervisor / foreman or to the operation and &!% personnel at site.


@.

Prepared By GHHHHHHHHHHHHHHHH 8Painting %ubcontractorC

,eviewed By GHHHHHHHHHHHHHHHH 8%ubcontractor  %afetyC

#pproved By GHHHHHHHHHHHHHHH 8)*+  1iscipline D %afetyC 1ate GHHHHHHHHHHHH

 !'% *as #lert clip  %+B# on standby  Others


HSE Infor,ation 9 Re+%ire,ent" Resources and Competency 1oes the 7or Team have the necessary capacity6 capability6 e3perience D authority to avoid6 minimi2e6 monitor and control the riss 8Training / Awareness / Equipment, etc.C 1etail minimum e3pected re$uirementsG

Peoples have been trained by Descon HSES Training Manager. Tool box Talk has been delivered to the crew by their Supervisor, Euip!ent has been inspected and certi"ed by #

%$Communications / Workforce Consultation !ave all members of the 7or Party attended the Toolbo3 Tal6 and have they been made fully aware of the riss that they are taing 8Residual risksC

TBT ,ecord 0o.

&es

External Risk !as an assessment been conducted to identify all e3ternal 8to the activityC ha2ards and potential riss 8rd parties suc! as "t!er w"rk#"rce teams "r "t!er ad$acent partiesC 7hat is the result ,is #ssess. 0o.

Job Safet Ana!"i" 3a" been carrie$ o%t /eeping in #ie a!! eterna! Ri"/" 9 Ha4ar$". No "i,%!taneo%" acti#itie" are carrie$ o%t b Ot3er artie" in t3e #icinit of Bob area. Area i!! be barrica$e$ an$ "ignboar$" i!! be po"te$.

H&S Training &mployees should be trained in the proper interaction with e$uipment6 and the proper response to incidents involving this e$uipment. List the training your employee8sC has received.

A!! e,p!oee" atten$e$ J'1 in$%ction training.

Specialist Training 7ill the worforce re$uire any specialist training CES 9 NO 8%& 'ES, list t!e specialist training required #"r t!e $"(CG

'o, because e!ployees are already trained (or painting )ob.


HSE Infor,ation 9 Re+%ire,ent" Resources and Competency 1oes the 7or Team have the necessary capacity6 capability6 e3perience D authority to avoid6 minimi2e6 monitor and control the riss 8Training / Awareness / Equipment, etc.C 1etail minimum e3pected re$uirementsG

Peoples have been trained by Descon HSES Training Manager. Tool box Talk has been delivered to the crew by their Supervisor, Euip!ent has been inspected and certi"ed by #

%$Communications / Workforce Consultation !ave all members of the 7or Party attended the Toolbo3 Tal6 and have they been made fully aware of the riss that they are taing 8Residual risksC

TBT ,ecord 0o.

&es

External Risk !as an assessment been conducted to identify all e3ternal 8to the activityC ha2ards and potential riss 8rd parties suc! as "t!er w"rk#"rce teams "r "t!er ad$acent partiesC 7hat is the result ,is #ssess. 0o.

Job Safet Ana!"i" 3a" been carrie$ o%t /eeping in #ie a!! eterna! Ri"/" 9 Ha4ar$". No "i,%!taneo%" acti#itie" are carrie$ o%t b Ot3er artie" in t3e #icinit of Bob area. Area i!! be barrica$e$ an$ "ignboar$" i!! be po"te$.

H&S Training &mployees should be trained in the proper interaction with e$uipment6 and the proper response to incidents involving this e$uipment. List the training your employee8sC has received.

A!! e,p!oee" atten$e$ J'1 in$%ction training.

Specialist Training 7ill the worforce re$uire any specialist training CES 9 NO 8%& 'ES, list t!e specialist training required #"r t!e $"(CG

'o, because e!ployees are already trained (or painting )ob.


High Potential Risks 1oes the tas re$uire special access / egress / heavy lifting / entry into confined spaces or wor at height / in e3cavations 8%& 'ES, a separate Risk Assessment needs t" (e c"mpleted).

CES 9 NO

,is #ssess. 0o.

No W3ere practicab!e 8 Attac3 "%pporting Ri"/ A""e"",ent

ther !mpacts #re there any other ways in which the wor will be affecting and/or protecting the !ealth and %afety of the team members CES 9 NO 8%# s", please descri(e (el"w CG

'o

PTW / !solations" ther Certificates / Permits 7hat other precautions 8e.g. electrical isolation6 permits to worC are re$uired and who will authori2e them

PT7 / +ert. 0os.

'o

Contingency / Emergency Response %hould special emergency procedures be instituted6 e.g. &mergency 1rill6 providing Fire 7ardens6 e3tra First #id cover6 etc.

CES 9 NO 8%# s", please descri(e (el"w CG

'o

#ir Emissions 7ill the wor you perform produce or cause the release of any air emissions

'o

CES 9 NO

8If 'ES, list air emissi"ns and met!"d #"r pre*enting impact t" t!e en*ir"nment )+


High Potential Risks 1oes the tas re$uire special access / egress / heavy lifting / entry into confined spaces or wor at height / in e3cavations 8%& 'ES, a separate Risk Assessment needs t" (e c"mpleted).

CES 9 NO

,is #ssess. 0o.

No W3ere practicab!e 8 Attac3 "%pporting Ri"/ A""e"",ent

ther !mpacts #re there any other ways in which the wor will be affecting and/or protecting the !ealth and %afety of the team members CES 9 NO 8%# s", please descri(e (el"w CG

'o

PTW / !solations" ther Certificates / Permits 7hat other precautions 8e.g. electrical isolation6 permits to worC are re$uired and who will authori2e them

PT7 / +ert. 0os.

'o

Contingency / Emergency Response %hould special emergency procedures be instituted6 e.g. &mergency 1rill6 providing Fire 7ardens6 e3tra First #id cover6 etc.

CES 9 NO 8%# s", please descri(e (el"w CG

'o

#ir Emissions 7ill the wor you perform produce or cause the release of any air emissions

CES 9 NO

8If 'ES, list air emissi"ns and met!"d #"r pre*enting impact t" t!e en*ir"nment )+

'o


Water $ischarges 7ill the wor you perform produce or cause the release of any wastewater

CES 9 NO 8%& 'ES, !"w will t!e wastewater (e !andledCG

'o

%aterials 7hat materials 8chemicals6 oils6 etc.C and/or e$uipment will you be handling or bringing onsite to perform the contracted wor

Paint and related Material will be handled

Enironmental Training !ave employees been trained in the proper handling of materials and e$uipment6 and the proper response to incidents involving these materials List the training your tas employees have received.

En#iron,enta! a"pect" are a!rea$ co#ere$ in Job Safet Ana!"i" training

Waste 'eneration 7ill the wor you perform result in any wastes CES 9 NO 8%& 'ES, list t!e disp"sal l"cati"n, as well as am"unts and t-pes "# wastes epected and t!e pr"p"sed disp"sal met!"d CG

-

*aste generated will be disposed o+ as per J'1 Wa"te Manage,ent roce$%re R0O866668FR8;657=.

Energy 7ill the wor you perform consume energy 8electricity6 compressed air6 natural gas6 steam6 etc.C CES 9 NO 8%& 'ES, eplain w!at t-pe "# energ- will (e c"nsumed, and !"w -"u will minimie c"nsumpti"nCG

Ce"* Die"e! f%e! i!! be %"e$ in crane"* generator"* air co,pre""or" etc. E+%ip,ent i!! be "toppe$ if it i" not nee$e$ to re$%ce f%e! con"%,ption

ther !mpacts #re there any other ways in which the wor will be affecting and/or protecting the environment

No

CES 9 NO 8%# 'ES, please descri(e (el"w CG


Water $ischarges 7ill the wor you perform produce or cause the release of any wastewater

CES 9 NO 8%& 'ES, !"w will t!e wastewater (e !andledCG

'o

%aterials 7hat materials 8chemicals6 oils6 etc.C and/or e$uipment will you be handling or bringing onsite to perform the contracted wor

Paint and related Material will be handled

Enironmental Training !ave employees been trained in the proper handling of materials and e$uipment6 and the proper response to incidents involving these materials List the training your tas employees have received.

En#iron,enta! a"pect" are a!rea$ co#ere$ in Job Safet Ana!"i" training

Waste 'eneration 7ill the wor you perform result in any wastes CES 9 NO 8%& 'ES, list t!e disp"sal l"cati"n, as well as am"unts and t-pes "# wastes epected and t!e pr"p"sed disp"sal met!"d CG

-

*aste generated will be disposed o+ as per J'1 Wa"te Manage,ent roce$%re R0O866668FR8;657=.

Energy 7ill the wor you perform consume energy 8electricity6 compressed air6 natural gas6 steam6 etc.C CES 9 NO 8%& 'ES, eplain w!at t-pe "# energ- will (e c"nsumed, and !"w -"u will minimie c"nsumpti"nCG

Ce"* Die"e! f%e! i!! be %"e$ in crane"* generator"* air co,pre""or" etc. E+%ip,ent i!! be "toppe$ if it i" not nee$e$ to re$%ce f%e! con"%,ption

ther !mpacts #re there any other ways in which the wor will be affecting and/or protecting the environment

CES 9 NO 8%# 'ES, please descri(e (el"w CG

No


Enironmental %onitoring 1escribe any environmental monitoring to be performed6 including sampling methods6 fre$uency6 analytical re$uirements and laboratory to be usedG

'ot pplicable (egal re)uirements Identify environmental legal re$uirements applicable to the wor that has not already been addressed by the Project.

'ot pplicable


Enironmental %onitoring 1escribe any environmental monitoring to be performed6 including sampling methods6 fre$uency6 analytical re$uirements and laboratory to be usedG

'ot pplicable (egal re)uirements Identify environmental legal re$uirements applicable to the wor that has not already been addressed by the Project.

'ot pplicable


Training ,o$%!e" re+%ire$ to co,p!ete Acti#it&

0i"t 1o$e" of ractice* 0egi"!ation* Stan$ar$" 3ic3 app! to t3i" Acti#it&

JSA i!! be %"e$ a" a training ,o$%!e

Stan$ar$ 1o$e"

ASTM85;@@ ASME 25.2 ASME 5=.;

0i"t !ant 9 E+%ip,ent 9 E re+%ire$ for t3i" Acti#it&

0i"t E+%ip,ent 9 Maintenance 13ec/" re+%ire$ for t3i" Acti#it&

Engineering 1ertificate" 9 er,it" 9 Appro#a!" re+%ire$ for t3i" Acti#it

1rane* poer generator* e!$ing ,ac3ine"* re Bob e+%ip,ent c3ec/ co,pre""or. i!! be $one before "tarting t3e Bob

0e.g. R1C 2ermit R"ad cl"sure, 3tilit- is"lati"n, Special 4aste license, etc.)

E"&

Tpe

Safet He!,et

No Reference9Doc%,ent"

Safet S3oe" Safet 'ogg!e" Safet '!o#e" D%"t Ma"/"

er"on(") Re"pon"ib!e for S%per#i"ing 9 In"pecting Wor/& er"on(") re"pon"ib!e for "%per#i"ing t3e or/* in"pecting an$ appro#ing or/ area"* or/ ,et3o$"* protecti#e ,ea"%re"* p!ant e+%ip,ent an$ poer 9 ot3er too!"&

N& List of $ualifications/e3perience is held in local )*+ files < see )*+ !%& *roup for details.

Na,e& .

Ra

Na,e& .

Meeran

o"itionG

o"ition&

S%per#i"or ('R)

S%per#i"or (DES1ON)

Signat%re& .................................................................

Signat%re& .................................................................

For a !i"t of na,e" an$ "ignat%re" of "taff in"tr%cte$ in t3i" Safe Wor/ Met3o$ State,ent an$ JSA* "ee J'1 training recor$". 1op 5 8 To be posted at the 7orsite / %upervisor at the 7orsite 1op 7  To be retained by )*+ !%& *roup 8' monthsC 1op 2 8 To be held by the subcontractor 8' monthsC


Training ,o$%!e" re+%ire$ to co,p!ete Acti#it&

0i"t 1o$e" of ractice* 0egi"!ation* Stan$ar$" 3ic3 app! to t3i" Acti#it&

JSA i!! be %"e$ a" a training ,o$%!e

Stan$ar$

ASTM85;@@

1o$e"

ASME 25.2 ASME 5=.;

0i"t !ant 9 E+%ip,ent 9 E re+%ire$ for t3i" Acti#it&

0i"t E+%ip,ent 9 Maintenance 13ec/" re+%ire$ for t3i" Acti#it&

Engineering 1ertificate" 9 er,it" 9 Appro#a!" re+%ire$ for t3i" Acti#it

1rane* poer generator* e!$ing ,ac3ine"* re Bob e+%ip,ent c3ec/ co,pre""or. i!! be $one before "tarting t3e Bob

0e.g. R1C 2ermit R"ad cl"sure, 3tilit- is"lati"n, Special 4aste license, etc.)

E"&

Tpe

Safet He!,et

No Reference9Doc%,ent"

Safet S3oe" Safet 'ogg!e" Safet '!o#e" D%"t Ma"/"

er"on(") Re"pon"ib!e for S%per#i"ing 9 In"pecting Wor/& er"on(") re"pon"ib!e for "%per#i"ing t3e or/* in"pecting an$ appro#ing or/ area"* or/ ,et3o$"* protecti#e ,ea"%re"* p!ant e+%ip,ent an$ poer 9 ot3er too!"&

N& List of $ualifications/e3perience is held in local )*+ files < see )*+ !%& *roup for details.

Na,e& .

Ra

Na,e& .

Meeran

o"itionG

o"ition&

S%per#i"or ('R)

S%per#i"or (DES1ON)

Signat%re& .................................................................

Signat%re& .................................................................

For a !i"t of na,e" an$ "ignat%re" of "taff in"tr%cte$ in t3i" Safe Wor/ Met3o$ State,ent an$ JSA* "ee J'1 training recor$". 1op 5 8 To be posted at the 7orsite / %upervisor at the 7orsite 1op 7  To be retained by )*+ !%& *roup 8' monthsC 1op 2 8 To be held by the subcontractor 8' monthsC

SAFE A1TIGITC RE81HE1K (SA) SHEET

1o,pan&

Date&

Fore,an ( print name)&

0ocation&

Ta"/ De"cription&

M
(tic/ bo) CES NO N9A

Ke Ta"/ Re!ate$ Ha4ar$"

Eca#ation" Acce"" On! !ant - E+%ip,ent E!ectrica!

Ke re#entati#e 1ontro! Mea"%re"

1onfine$ Space" I"o!ation" 0oc/ O%t 9 Tag O%t Hot or/ In"tr%,entation re 9 1o,,i""ioning 9 START8< E1AGATION

CES

NO

N9A

HOTWORK (Non TW contro!!e$)

CES

NO

N9A

SAFE A1TIGITC RE81HE1K (SA) SHEET

1o,pan&

Date&

Fore,an ( print name)&

0ocation&

Ta"/ De"cription&

M
Ke Ta"/ Re!ate$ Ha4ar$"

(tic/ bo) CES NO N9A

Eca#ation" Acce"" On! !ant - E+%ip,ent E!ectrica!

Ke re#entati#e 1ontro! Mea"%re"

1onfine$ Space" I"o!ation" 0oc/ O%t 9 Tag O%t Hot or/ In"tr%,entation re 9 1o,,i""ioning 9 START8< E1AGATION

CES

NO

N9A

HOTWORK (Non TW contro!!e$)

%!O,&1 / %LOP&1 / B&0+!&1

FI,& &JTI0*4I%!&,

L#11&,% P,O"I1&1

FI,& BL#05&T

B4,I&1 %&,"I+&% I1&0TIFI&1

+;LI01&,% 4P,I*!T D %&+4,&1

"&!I+L& %TOP B#,,I&,% / BO#,1%

+O-B4%TIBL&% ,&-O"&1

&J+#"#TIO0 I0%P&+T&1

FI,& 7#T+! 8%afety Passport checC

1ONFINED SA1ES

CES

NO

N9A

&-&,*&0+; +O--40I+#TIO0%

"&0TIL#TIO0

7O,5 B&LO7 ,&%T,I+T&1

P&,-IT to 7O,5

B#,,I&,% / %I*0% PO%T&1

*#% T&%T +O-PL&T&1

FL#-& #,,&%TO,% FITT&1

T#LL; BO#,1 or similar

7&L1I0* +#BL&% I0 *OO1 +O01ITIO0

&-&,*&0+; #++&%%

1HEMI1A0S

+O--40I+#TIO0%

-%1% ,&"I&7&1 / #"#IL#BL&

%#F&T; !#,0&%%&%

%5I0 / &;& / T!,O#T I,,IT#0T

%4IT#BL& 8&3.C LI*!TI0*

%!O7&, or &;&7#%! #"#IL#BL&

S1AFFO0DIN'

%P&+I#L PP& #"#IL#BL& #% P&, -%1%

NO

N9A

%+#FFOL1 I0%P&+T&1

+O0T#I0&,% L#B&LL&1 P,OP&,L;

I0%P&+TIO0 %+#FT#* PO%ITIO0&1 D I0 1#T&

%I*0% PO%T&1

%#F& #++&%% / &*,&%% P,O"I1&1

,I%5 #%%&%%-&0T +O014+T&1

TO&BO#,1%6 5I+5PL#T&% I0 O,1&,

!#K#,1% +O--40I+#T&1

!#01,#IL% %&+4,&1

*,O401I0*

!#,0&%% D L#0;#,1% I0%P&+T&1

+O0T#I0-&0T ,&>4I,&1 / P,O"I1&1

%T#TI+ LI0&%  TI& OFF POI0T%

#B%O,B&0T #"#IL#BL& %5 S%T3 .

0ANT - E
CES

NO

N9A

ORTA0E TOO0S

PL#0T D &>4IP-&0T I0%P&+T&1

TOOL%6 #PPLI#0+&% I0%P&+T&1

LIFTI0* *&#,6 ,I**I0* I0%P&+T&1 D +&,T%.

1&F&+T% ,&PO,T&1

B#05%-#0 / +O-P&T&0T P&,%O0 I1&0TIFI&1

PO,T#BL& #PPLI#0+&% I0%P&+T&1

LIFTI0* PL#0 / +#L+% D -/% +!&+5&1

&JT&0%IO0 +#BL& +!&+5&1 D T#**&1

OP&,#TO, +&,TIFI&1

OP&,#TO,% +&,TIFI&1

+#BL&%6 !O%&% I0%P&+T&1

PP& ,&>4I,&-&0T% I1&0TIFI&1

FL#*-&0 T,#I0&1 / PO%ITIO0&1

*4#,1% PO%ITIO0&1

O11<ATIONA0 HEA0TH

CES

NO

N9A

NO

N9A

CES

NO

N9A

CES

NO

N9A

CES

NO

N9A

%P&+I#L PP& 8"I%O,%6 *LO"&%6 etcC

%T#01B; -#0

CES

CES

E

SAFE A1TIGITC RE81HE1K (SA) SHEET FI,%T #I1&, / FI,%T #I1 5IT

!#,1 !#T

!&#T %T,&%%

BOOT%

14%T

*L#%%&%

!;*I&0& 8FOO1 / 7#T&,C +O0T#I0&,%

+O"&,#LL% / !I*!"I%IBILIT; "&%T%

0OI%&

F#+& -#%5%

"IB,#TIO0

*&0&,#L 7O,5 *LO"&%

CES

E0E1TRI1ITC

NO

N9A

SE1IA0IST E

PT7 ,&"I&7&1 8+O-P&T&0T P&,%O0C

7&L1&,%6 FI,& ,&T#,1#0T *LO"&%

%;%T&- LO+5 O4T

&L&+T,I+#L ,4BB&, *LO"&%

%;%T&- T#**&1 O4T

&#, 1&F&01&,% / PL4*%

)%# / -&T!O1 %T#T&-&0T I0 PL#+&

!#,0&%%&% / L#0;#,1%

%;%T&- 1I%+O00&+T&1

7&L1&,% %+,&&0

%;%T&- T&%T&1

F#+& -#%5 814%T  F4-&%C

MAN
CES

NO

N9A

%&LF +O0T#I0&1 B,&#T!I0* #PP#,#T4%

LIFTI0*6 P4LLI0*

FI,& ,&T#,1&0T +LOT!I0*

%T,&T+!I0*

ENGIRONMENTA0 1ONSTRAINTS

%!#,P OB)&+T%6 PI0+! POI0T%

&0". %T41; ,&PO,T +O-PL&T&1

8T,OLL&;%6 FO,5LIFT%6 etcC available

&0". !#K#,1% I1&0TIFI&1 I0 -%

%O401 *,O401 / 401&,FOOT +O01ITIO0%

7 O,5 #,&# +!&+5&1 8,D& %P&+I&%C

CES

NO

N9A

N9A

CES

NO

N9A

CES

NO

N9A

7#%T& +O0T#I0&,% / #,&# I1&0TIFI&1

FL;I0* P#,TI+L&%

%PILL +O0T#I0-&0T

+#BL&% %&+4,&1 #BO"& ! !&I*!T

&0". -O0ITO, I0FO,-&1 / #"#IL#BL&

"OI1% / !OL&% +O"&,&1 D %&+4,&1

SITE 0ANT - GEHI10ES

B#,,I&,% D T#P& P,O"I1&1

%#F& 1I%T#0+&  "&!I+L&% D P&1&%T,I#0%

#LL !#K#,1% +O--40I+#T&1

NO

,&%PI,#TO,%

7O,5&,8%C T,#I0&1 8%afety Passport checC

'ENERA0

CES

%I*0% &,&+T&1 #01 "I%IBL&

OT!&, 7O,5&,% %#F&T; +O0%I1&,&1

0OI%& / &J!#4%T !#K#,1% I1&0TIFI&1

Fore,an 9 S%per#i"or& I 3a#e $i"c%""e$ t3e abo#e potentia! 3a4ar$" in#o!#e$ in t3e ta"/* re#iee$ t3e SA 1ar$ it3 t3e e,p!oee" %n$er , contro!* an$ i,p!e,ente$ "%itab!e an$ "%fficient contro!" to ,ini,i4e t3e ri"/" in#o!#e$. Na,e (print)

Signat%re

E,p!oee"& I 9 WE A11ET THE RESONSII0ITC FOR THE SAFE EHAGIO
SI'NAT
EM0OCEE NAME

5.

56.

7.

55.

2.

57.

:.

52.

;.

5:.

=.

5;.

>.

5=.

?.

5>.

@.

5?.

SI'NAT

Jsa for Surface Coating

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