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CCIC QGX II CCC CCIC HSE Training Team CCIC HSE Training Team Welcome to: Welcome to: JSTI Training JSTI Training CCIC Ras Laffen QGX II, CCIC Ras Laffen QGX II, Qatar Qatar

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Page 1: CCIC JSTI for Safety Officers

CCIC QGX II

CCC

CCIC HSE Training TeamCCIC HSE Training Team

Welcome to:Welcome to:

JSTI TrainingJSTI Training

CCIC Ras Laffen QGX II, QatarCCIC Ras Laffen QGX II, Qatar

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CCIC QGX II

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HSE InstructorHSE Instructor

Page 3: CCIC JSTI for Safety Officers

CCIC QGX II

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J.S.T.I

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Classroom Safety Classroom Safety في في السالمة السالمة القاعةالقاعة

Medical Emergency ResponseMedical Emergency Response

الطبيّـة الخدمات الطبيّـة طوارئ الخدمات طوارئ

Fire Fire الحريق الحريق طوارئ طوارئ

General Information General Information تعليمات تعليمات عامّـةعامّـة

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Classroom SafetyClassroom Safety في في السالمة السالمة القاعةالقاعة

• Tripping Hazards Tripping Hazards التعثّـر التعثّـر خطر خطر– Power cordsPower cords الكهرباء الكهرباء بوصالت بوصالت

– Cables Cables الكهربائيّـة الكهربائيّـة بالتمديدات بالتمديدات

– Stairs Stairs الساللم على الساللم الحركة على الحركة

• Chairs Chairs على على جلوسك جلوسك الكرسيالكرسي

– Do not lean back in your Do not lean back in your chairschairs

فقد بظهرك فقد التسترخي بظهرك التسترخيإتزانك إتزانك تفقد تفقد

– Look before you sitLook before you sit

قبل سالمته من قبل تأكد سالمته من تأكدعليه عليه جلوسك جلوسك

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Medical Emergency ResponseMedical Emergency Responseالطبيّـة الخدمات الطبيّـة طوارئ الخدمات طوارئ

Call for help Call for help إتصل الطوارئ إتصل عند الطوارئ عند

To call CTJV Paramedics and report To call CTJV Paramedics and report information provided to responders information provided to responders 474 1453 474 1453 or or 474 1455474 1455

الحالة بنوع وأبلغهم الطبيّـة بالخدمات الحالة إتصل بنوع وأبلغهم الطبيّـة بالخدمات إتصلأعاله األرقام أعاله على األرقام على

Wait at outside location to direct emergency Wait at outside location to direct emergency responders to classroomresponders to classroom

لتوجيههم الطبيّـة الفرقة لمالقات لتوجيههم أخرج الطبيّـة الفرقة لمالقات أخرج

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Emergency Call Emergency Call الطوارئ الطوارئ شارة شارة

You are located in the MTSF HSE BlockYou are located in the MTSF HSE Blockالشركة مكاتب مجموعة في اآلن الشركة موقعك مكاتب مجموعة في اآلن موقعك

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Fire Emergency Fire Emergency طوارئ طوارئالحريقالحريق

If There is a fire: If There is a fire: الحريق نشوب حال الحريق في نشوب حال : :في

Raise the alarm immediately Raise the alarm immediately زامور زامور إطلق إطلق T فورا T الطوارئ فورا الطوارئ

Shout ”Shout ”Fire, Fire, Fire Fire, Fire, Fire ” حريق إصرخ ” إصرخ حريق حريق حريقحريقحريق

Evacuate the building to Muster Point Evacuate the building to Muster Point (ZONE 5) (ZONE 5) at at Block 6 Block 6 التجمّـع نقطة الى وتوجّـة الموقع التجمّـع إخلي نقطة الى وتوجّـة الموقع إخلي

))55رقم (رقم ( Conduct accountability of all personnelConduct accountability of all personnel إحصي إحصي

العَـددالعَـدد Direct fire services Direct fire services لموقع اإلطفاء فرقة لموقع وجّـه اإلطفاء فرقة وجّـه

الحريقالحريق

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General Information تعليماتعامّـة

Toilet Block Toilet Block الحمّـامات الحمّـامات موقع موقع

Drinking waterDrinking water الشرب الشرب مياه مياه

No Smoking No Smoking ممنوع ممنوع التدخين التدخين

No cell phone usageNo cell phone usage إستعمال إستعمال يمنع يمنع الهاتفالهاتف

Listen and ask questions Listen and ask questions واسأل واسأل إنتبه إنتبه

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Class RulesClass Rules

No sleeping in classNo sleeping in class Police up your own trashPolice up your own trash Please turn off Cell PhonesPlease turn off Cell Phones No leaning back on the chairsNo leaning back on the chairs Do not disrupt the classDo not disrupt the class Ask questionsAsk questions

Page 11: CCIC JSTI for Safety Officers

Health, Safety & EnvironmentCCIC QGX II, Qatar

Program of InstructionProgram of Instruction

JSTIJSTI

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Purpose of Instruction Job Safety Task Instructions is an essential part Job Safety Task Instructions is an essential part

of our safety program of our safety program It is a simple technique to plan safety into the It is a simple technique to plan safety into the

workplaceworkplace Everyone involved in the process, it empowers Everyone involved in the process, it empowers

all employees to become the eyes and ears to all employees to become the eyes and ears to identify potential hazards in the workplaceidentify potential hazards in the workplace

This program will identify the process and This program will identify the process and different techniques that can be used to different techniques that can be used to effectively perform and document Job Safety effectively perform and document Job Safety Task InstructionsTask Instructions

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JSTI Assists in standard-specific complianceAssists in standard-specific compliance Helps plan safety into the employees’ work via Helps plan safety into the employees’ work via

teamworkteamwork Provides instruction for the new employee on Provides instruction for the new employee on

the jobthe job Promotes employee discussion and Promotes employee discussion and

involvementinvolvement Discovers possible improvement for job methodDiscovers possible improvement for job method Assists with review of job procedures after Assists with review of job procedures after

accidentsaccidents

Reduces InjuriesReduces Injuries

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Benefits of JSTI

What are the benefits of a JSTI?What are the benefits of a JSTI?

1.1.A safer worksiteA safer worksite2.2.An informed workforceAn informed workforce3.3.Improved safety recordImproved safety record4.4.Lower production costsLower production costs5.5.Quality work performance and a Quality work performance and a satisfied customer satisfied customer

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What is a JSTI? A integration of safety into a particular A integration of safety into a particular

tasktask A method of identifying hazardsA method of identifying hazards A method of breaking the process downA method of breaking the process down A system for employees to easily A system for employees to easily

understand hazardsunderstand hazards A two way communication process A two way communication process

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A copy of the JSA should be used A copy of the JSA should be used when preparing a JSTI if availablewhen preparing a JSTI if available

Helps to identify hazardsHelps to identify hazards Should be reviewed periodically or Should be reviewed periodically or

when the task changes when the task changes

Job Safety Analysis (JSA)

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What is the task Break the task down Identify potential

hazards Determine

preventative measures to eliminate

Communicate with task performer

Revise the JSTI when necessary

Six Stages to Conducting a JSTI

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Job Safety Task InstructionJSTI is a safety communication, task planning and risk management systemأإلنجاز مراحل أثناء المخاطر تقدير مع المهام إلنجاز وتخطيط للتواصل أسلوب هي .

(Complete each box before proceeding to the next box.) ( ( بعد لما اإلنتقال قبل قسم كل هأكمل

Administrative

Permit/Work _____________ Contractor _________ Craft/Dept ___________ Date __/ __ / __Task Description المهمّـة _______________________________________________________ نوع________________________________________________________________________________________________________________________________________________________Area Specific Training:________________COMPANY Required ______ CTJV Required ______

Emergency Action Plan (Risk Management المخاطر ( تقدير الطوارئ خطة

Area / Unit ___________ __________________________________________________ الوحدة/ الموقعEmergency # 473 7777 474 8888 (Escape Route Identified( اإلخالء مسار تحديد Yes No تمNearest Muster Point Location _________________________________________ تجمّـع نقطة أقرب

Communication - Task Planning - Risk Management (JSA) ال بحسب المخاطر وتقدير التواصل

Section 1 - Task Planning للمهمّـة) – 1القسم ( التخطيط

Job Steps العمل Potential Hazards خطوات المحتملة Eliminate / Control Hazards المخاطر المخاطر على السيطرة أو إنهاء

Stop Work Conditions (Remindersللتذكير ) العمل وقف تستدعي أسباب+ Adjacent Work Hazards مجاور عمل من Excessive Noise + مخاطر الشديدة الضوضاء+ Fires & Explosions اإلنفجار أو سيّـئة Extreme Weather + الحريق جويّـة ضروف+ Change in Conditions العمل ظروف في الخطر Evacuation Alarm + تغيير صافرة+ Chemical Spills-Releases الكيماويات Unusual Odors + نضوح مالئمة غير روائح

Section 2 – Communication التواصل) - 2القسم (

Employee Comments / Changes in conditions / العمل ظروف في تغيير أي التنفيذ فريق مالحظات

Physical للجسم أألذى___ Arcing / Sparking Equip.___ Dust (weather created)___ Electricity-Close Proximity ___ Electricity, loss of ___ Engulfment___ Entanglement___ Falling Objects___ Fall Potential___ Fire / Explosion___ Flying Debris___ Heavy Bulky Material___ High Voltage-5KV +___ Hot & Cold Surfaces ___ Lighting – Inadequate___ Moving Hazards

Environmental – Air-Soil-Waterالبيئة ___ Chemical Spills / Releases___ Waste WaterOther _________________________

Health الصحيّـة أآلثار___ Airborne Particles (work created)___ Chemical – Liquid / Vapor___ Contaminated Soil or Water ___ Fatigue___ Fumes___ Noise (excessive)___ Oxygen Deficient Atmosphere ___ Temperature-Extreme Heat / Cold___ UV Rays – Eyes / Skin ___ Other _______________________

Physical (continuedتتمة ) ___ Pinching & Crushing___ Pressurized Systems & Equipment___ Radiation – X-ray___ Sharp / Jagged Objects___ Slips / Tripping Potential___ Structural-Surface Openings___ Tight/Close Work Quarters___ Vibration (excessive)___ Water-Drowning

Other ___________________________________________

Section 3 - Hazard Recognition / Considerations (Risk Management) ) الخطر) - 3القسم لمكامن ف eالتعر

Basic Safeguards أألساسية أإلحتياطات___ Arc Shields___ Barricades___ Crane Suspended Work Platform___ Fire Extinguishers Located___ Fire Watch___ Hole Covers___ Hole Watch___ Housekeeping___ Lighting - Additional___ Post Warning Signs___ Scaffolding___ Tools/Equip in good condition ___ Ventilation / Exhaust Systems

Safe Work Practices المطلوب السليم العمل___ Confined Space Entry___CSE Supervisor Checklist___CSE Hole watch/entrants Checklist___ Crane Lift Study/Daily Inspection___ Electrical-Close Proximity___ Excavations & Shoring___ Hot Taps___ Line Breaking/Equipment Opening___ Lock-Out / Tag-Out___ MSDS & Labeling ___ Other____________________________________________________

PPE Required الشخصيّـة الوقاية لوازم___ Arc Suit___ Chem. Resistant Clothing___ Eye Protection___ Fall Protection___ Foot Wear___ Hand Protection___ Head Protection___ Hearing Protection___ Respirator___ Nomex Overalls___ Fire Resistant Clothing___ Other ________________________________________

I acknowledge receiving and understanding these instructions, I will fully comply with the assigned task requirements. Sign on the back side if need more space to sign. أألمان متطلبات كل بتنفيذ وسأقوم للتعليمات، وفهمي باطالعي أقر Print Nameأإلسم ID الرقم Print Nameاإلسم ID الرقم___________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ ____________ Supervisor (Signature) المشرف أألسم ___________________________ (Print) ____________________ توقيع

Section 4 - Risk Management األخطار) - 4القسم ( تقدير

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I. What is the Task

Determine what the task is to be doneDetermine what the task is to be done Document the task in section 1Document the task in section 1 Emergency Action PlanEmergency Action Plan Task PlanningTask Planning Section 2 CommunicationSection 2 Communication

Page 20: CCIC JSTI for Safety Officers

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Job Safety Task InstructionJSTI is a safety communication, task planning and risk management systemأإلنجاز مراحل أثناء المخاطر تقدير مع المهام إلنجاز وتخطيط للتواصل أسلوب هي .

(Complete each box before proceeding to the next box.) ( ( بعد لما اإلنتقال قبل قسم كل هأكمل

Administrative

Permit/Work _____________ Contractor _________ Craft/Dept ___________ Date __/ __ / __Task Description المهمّـة _______________________________________________________ نوع________________________________________________________________________________________________________________________________________________________Area Specific Training:________________COMPANY Required ______ CTJV Required ______

Emergency Action Plan (Risk Management المخاطر ( تقدير الطوارئ خطة

Area / Unit ___________ __________________________________________________ الوحدة/ الموقعEmergency # 473 7777 474 8888 (Escape Route Identified( اإلخالء مسار تحديد Yes No تمNearest Muster Point Location _________________________________________ تجمّـع نقطة أقرب

Communication - Task Planning - Risk Management (JSA) ال بحسب المخاطر وتقدير التواصل

Section 1 - Task Planning للمهمّـة) – 1القسم ( التخطيط

Job Steps العمل Potential Hazards خطوات المحتملة Eliminate / Control Hazards المخاطر المخاطر على السيطرة أو إنهاء

Stop Work Conditions (Remindersللتذكير ) العمل وقف تستدعي أسباب+ Adjacent Work Hazards مجاور عمل من Excessive Noise + مخاطر الشديدة الضوضاء+ Fires & Explosions اإلنفجار أو سيّـئة Extreme Weather + الحريق جويّـة ضروف+ Change in Conditions العمل ظروف في الخطر Evacuation Alarm + تغيير صافرة+ Chemical Spills-Releases الكيماويات Unusual Odors + نضوح مالئمة غير روائح

Section 2 – Communication التواصل) - 2القسم (

Employee Comments / Changes in conditions / العمل ظروف في تغيير أي التنفيذ فريق مالحظات

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II. Break Task Down into Basic Steps

Keep the steps in their correct sequenceKeep the steps in their correct sequence Focus on Focus on whatwhat is done, not is done, not howhow its done its done ““Rule of Thumb”….no more than 10 stepsRule of Thumb”….no more than 10 steps Don’t make them too general or too detailedDon’t make them too general or too detailed Discuss with all employees…”two heads are Discuss with all employees…”two heads are

better than one”better than one”

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Job Steps Job Steps Potential HazardsPotential Hazards

1. Park vehicle1. Park vehicle

2. Remove spare and tool2. Remove spare and tool kitkit

3. Pry off hub cap and3. Pry off hub cap and loosen lug bolts (nuts)loosen lug bolts (nuts)

And so on…..And so on…..

II. Break Task Down into Basic Steps

Changing a TireChanging a Tire

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III. Identify Potential Hazards

Identify hazards and potential Identify hazards and potential accidents! accidents!

What can go wrong?What can go wrong? Once identified, hazards are recordedOnce identified, hazards are recorded Be aware of hazards that exist within Be aware of hazards that exist within

the environment and/or job taskthe environment and/or job task Evaluate the task, not the personEvaluate the task, not the person 5 questions to ask5 questions to ask

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III. Identify Potential HazardsQuestion One

Is there a danger of striking against, Is there a danger of striking against, being struck or otherwise harmful being struck or otherwise harmful contact?contact?

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III. Identify Potential Hazards

Question Two

Can the employee be caught in, by, or Can the employee be caught in, by, or between objects?between objects?

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III. Identify Potential Hazards

Is there a potential for a slip, Is there a potential for a slip, trip, or fall?trip, or fall?

Question Three

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III. Identify Potential Hazards

Can strain be caused by pushing, pulling, Can strain be caused by pushing, pulling, lifting, bending, or twisting?lifting, bending, or twisting?

Question Four

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Is the environment hazardous to safety Is the environment hazardous to safety or health?or health?

III. Identify Potential Hazards

Question Five

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III. Identify Potential Hazards

The Best Question to Ask: What can go wrong? How can someone be hurt?

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Sections 3 & 4Sections 3 & 4

Section 3 Hazard RecognitionSection 3 Hazard Recognition Use section as reminders when Use section as reminders when

conducting the hazard analysisconducting the hazard analysis Section 4 Risk Management Section 4 Risk Management

Use section 4 to help manage the risk to Use section 4 to help manage the risk to ensure proper PPE usage, proper training ensure proper PPE usage, proper training conducted, permits used and basic safety conducted, permits used and basic safety standards are followed standards are followed

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Physical للجسم أألذى___ Arcing / Sparking Equip.___ Dust (weather created)___ Electricity-Close Proximity ___ Electricity, loss of ___ Engulfment___ Entanglement___ Falling Objects___ Fall Potential___ Fire / Explosion___ Flying Debris___ Heavy Bulky Material___ High Voltage-5KV +___ Hot & Cold Surfaces ___ Lighting – Inadequate___ Moving Hazards

Environmental – Air-Soil-Waterالبيئة ___ Chemical Spills / Releases___ Waste WaterOther _________________________

Health الصحيّـة أآلثار___ Airborne Particles (work created)___ Chemical – Liquid / Vapor___ Contaminated Soil or Water ___ Fatigue___ Fumes___ Noise (excessive)___ Oxygen Deficient Atmosphere ___ Temperature-Extreme Heat / Cold___ UV Rays – Eyes / Skin ___ Other _______________________

Physical (continuedتتمة ) ___ Pinching & Crushing___ Pressurized Systems & Equipment___ Radiation – X-ray___ Sharp / Jagged Objects___ Slips / Tripping Potential___ Structural-Surface Openings___ Tight/Close Work Quarters___ Vibration (excessive)___ Water-Drowning

Other ___________________________________________

Section 3 - Hazard Recognition / Considerations (Risk Management) ) الخطر) - 3القسم لمكامن ف eالتعر

Basic Safeguards أألساسية أإلحتياطات___ Arc Shields___ Barricades___ Crane Suspended Work Platform___ Fire Extinguishers Located___ Fire Watch___ Hole Covers___ Hole Watch___ Housekeeping___ Lighting - Additional___ Post Warning Signs___ Scaffolding___ Tools/Equip in good condition ___ Ventilation / Exhaust Systems

Safe Work Practices المطلوب السليم العمل___ Confined Space Entry___CSE Supervisor Checklist___CSE Hole watch/entrants Checklist___ Crane Lift Study/Daily Inspection___ Electrical-Close Proximity___ Excavations & Shoring___ Hot Taps___ Line Breaking/Equipment Opening___ Lock-Out / Tag-Out___ MSDS & Labeling ___ Other____________________________________________________

PPE Required الشخصيّـة الوقاية لوازم___ Arc Suit___ Chem. Resistant Clothing___ Eye Protection___ Fall Protection___ Foot Wear___ Hand Protection___ Head Protection___ Hearing Protection___ Respirator___ Nomex Overalls___ Fire Resistant Clothing___ Other ________________________________________

I acknowledge receiving and understanding these instructions, I will fully comply with the assigned task requirements. Sign on the back side if need more space to sign. أألمان متطلبات كل بتنفيذ وسأقوم للتعليمات، وفهمي باطالعي أقر Print Nameأإلسم ID الرقم Print Nameاإلسم ID الرقم___________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ ____________ Supervisor (Signature) المشرف أألسم ___________________________ (Print) ____________________ توقيع

Section 4 - Risk Management األخطار) - 4القسم ( تقدير

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Job Steps Potential Hazards Eliminate / Controls HazardsJob Steps Potential Hazards Eliminate / Controls Hazards

1.1. Park vehiclePark vehicle 1.1.a) Vehicle too close to passing traffica) Vehicle too close to passing trafficb) Vehicle on uneven, soft groundb) Vehicle on uneven, soft groundc) Vehicle may rollc) Vehicle may roll

2.2. Remove spare and toolRemove spare and tool 2.2.

a) Strain from lifting sparea) Strain from lifting spare kitkit

3.3. Pry off hub cap and 3. Pry off hub cap and 3. loosen lug bolts (nuts) a) Hub cap may pop off and hit youloosen lug bolts (nuts) a) Hub cap may pop off and hit you

b) Lug wrench may slip and make contact b) Lug wrench may slip and make contact with bodywith bodyAnd so on…..And so on…..

III. Identify Potential HazardsChanging a TireChanging a Tire

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IV. Determine Preventative Measures

Eliminate the hazardEliminate the hazard Contain/control the hazardContain/control the hazard Revise work proceduresRevise work procedures Reduce the exposureReduce the exposure

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Job Steps Potential Hazards Eliminate / Control HazardsJob Steps Potential Hazards Eliminate / Control Hazards

1. Park vehicle 1. a) Vehicle too close to passing traffic 1. a) Drive to area well clear of1. Park vehicle 1. a) Vehicle too close to passing traffic 1. a) Drive to area well clear of traffic. Turn on emergencytraffic. Turn on emergency flashersflashers

b) Vehicle on uneven, soft ground b) Choose a firm, level b) Vehicle on uneven, soft ground b) Choose a firm, level areaarea

c) Vehicle may rollc) Vehicle may roll c) Apply parking brake; c) Apply parking brake; leave transmission in gearleave transmission in gear or in PARK; place or in PARK; place blocksblocks

in front and back of thein front and back of the wheel diagonally wheel diagonally

oppositeopposite to the flatto the flat

IV. Determine Preventative MeasuresChanging a Tire

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Employee Sign-in and CommentsEmployee Sign-in and Comments

Conduct the JSTI secession before Conduct the JSTI secession before starting work and have all employees starting work and have all employees assigned to the task sign the JSTI formassigned to the task sign the JSTI form

Add any employee comments and Add any employee comments and concerns to the form of the form in concerns to the form of the form in section 2 Communicationsection 2 Communication

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Physical للجسم أألذى___ Arcing / Sparking Equip.___ Dust (weather created)___ Electricity-Close Proximity ___ Electricity, loss of ___ Engulfment___ Entanglement___ Falling Objects___ Fall Potential___ Fire / Explosion___ Flying Debris___ Heavy Bulky Material___ High Voltage-5KV +___ Hot & Cold Surfaces ___ Lighting – Inadequate___ Moving Hazards

Environmental – Air-Soil-Waterالبيئة ___ Chemical Spills / Releases___ Waste WaterOther _________________________

Health الصحيّـة أآلثار___ Airborne Particles (work created)___ Chemical – Liquid / Vapor___ Contaminated Soil or Water ___ Fatigue___ Fumes___ Noise (excessive)___ Oxygen Deficient Atmosphere ___ Temperature-Extreme Heat / Cold___ UV Rays – Eyes / Skin ___ Other _______________________

Physical (continuedتتمة ) ___ Pinching & Crushing___ Pressurized Systems & Equipment___ Radiation – X-ray___ Sharp / Jagged Objects___ Slips / Tripping Potential___ Structural-Surface Openings___ Tight/Close Work Quarters___ Vibration (excessive)___ Water-Drowning

Other ___________________________________________

Section 3 - Hazard Recognition / Considerations (Risk Management) ) الخطر) - 3القسم لمكامن ف eالتعر

Basic Safeguards أألساسية أإلحتياطات___ Arc Shields___ Barricades___ Crane Suspended Work Platform___ Fire Extinguishers Located___ Fire Watch___ Hole Covers___ Hole Watch___ Housekeeping___ Lighting - Additional___ Post Warning Signs___ Scaffolding___ Tools/Equip in good condition ___ Ventilation / Exhaust Systems

Safe Work Practices المطلوب السليم العمل___ Confined Space Entry___CSE Supervisor Checklist___CSE Hole watch/entrants Checklist___ Crane Lift Study/Daily Inspection___ Electrical-Close Proximity___ Excavations & Shoring___ Hot Taps___ Line Breaking/Equipment Opening___ Lock-Out / Tag-Out___ MSDS & Labeling ___ Other____________________________________________________

PPE Required الشخصيّـة الوقاية لوازم___ Arc Suit___ Chem. Resistant Clothing___ Eye Protection___ Fall Protection___ Foot Wear___ Hand Protection___ Head Protection___ Hearing Protection___ Respirator___ Nomex Overalls___ Fire Resistant Clothing___ Other ________________________________________

I acknowledge receiving and understanding these instructions, I will fully comply with the assigned task requirements. Sign on the back side if need more space to sign. أألمان متطلبات كل بتنفيذ وسأقوم للتعليمات، وفهمي باطالعي أقر Print Nameأإلسم ID الرقم Print Nameاإلسم ID الرقم___________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ _______________________________________ __________ ___________________________ ____________ Supervisor (Signature) المشرف أألسم ___________________________ (Print) ____________________ توقيع

Section 4 - Risk Management األخطار) - 4القسم ( تقدير

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Communication

Communicate with task performer

If task performer can not reach on an agreement with supervisor/designee , the appropriate manager will be consulted for designation.

Take feed back from task performer

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When an accident or injury occursWhen an accident or injury occurs After a close callAfter a close call If equipment suffers damageIf equipment suffers damage When the job or scope of work changesWhen the job or scope of work changes

Revision of the JSTI

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A JSTI shall be completed for each task at A JSTI shall be completed for each task at each jobsite; warehouse, shop, construction each jobsite; warehouse, shop, construction site, etc.) before operations beginsite, etc.) before operations begin

All employees on that task must understand All employees on that task must understand and sign the JSTI form before starting any and sign the JSTI form before starting any work for that task. work for that task.

Safety officer review of completed JSTISafety officer review of completed JSTI

JSTI

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CCIC HSE Training TeamCCIC HSE Training Team

Thank You for Attending;Thank You for Attending;

JSTI TrainingJSTI Training

See See YouYou at our next class at our next class