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Watson Air LiftTechnology
Individual Tank Specifics
Company
Location
Tank # Date
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SITE SPECIFIC HEALTH, SAFETY AND ENVIRONMENTAL PLAN Page 1 of 6(Minimum Requirements)
I. Project Details
Project Information: ________________________________________________
Project Name, ________________________________________________
Project Description, ________________________________________________
Project Manager, ________________________________________________
Estimated Start and Completion Dates, ________________________________
Contractor and Sub-Contractor Names, ________________________________
Work Hours/Shift ________________________________________________
Site Information:
COP Contact Person, __________________________________________
Site Name, __________________________________________
Site Location where the work will be performed __________________________
Scope of Work:
The scope shall cover the following phases of a project, i.e.,
Mobilization, __________________________________________
Work Execution __________________________________________
Demobilization. __________________________________________
Detailed description of work/tasks to be performed during each phase, includingspecific activities, estimated duration of activities and projected dates of activities.
_______________________________________________________________
Describe how the work is to be performed, who will perform the work, what methodswill be used to accomplish the work.
_______________________________________________________________
Estimated number of workers during each phase
_______________________________________________________________
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SITE SPECIFIC HEALTH, SAFETY AND ENVIRONMENTAL PLAN Page 2 of 6
II. Personnel Information
Contractor Project Personnel:
Title _______________________________
General Description of Position _______________________________
Specific Roles/Responsibilities of position
_____________________________________________________________
Required Qualifications of position
_____________________________________________________________
General & special training requirements for position
_____________________________________________________________
Medical Surveillance requirements of position if required by regulation
_____________________________________________________________
Attach resumes for each position ________________________________
III. Health, Safety and Environmental Hazard Assessment
Overall project hazard assessment, outlining Physical, Chemical hazards and control
methods identified to eliminate or reduce the risk.
________________________________________________________________
Detailed Specific JSA or JHA for activities/tasks noted in each phase of the scope ofwork.
________________________________________________________________
IV. General Site HSE Requirements
Describe the requirements for the following specific categories;
Facility Requirements
Parking __________________________________________
Gate Entry __________________________________________
Orientation __________________________________________
SITE SPECIFIC HEALTH, SAFETY AND ENVIRONMENTAL PLAN Page 3 of 6
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Personnel Requirements
Break Times & Areas ____________________________________
Smoking Areas ____________________________________
Hygiene (contaminant control, i.e., hand washing, disposal clothing
management, etc._______________________________________________________
Continuous HSE Improvement Requirements
HSE & Performance Expectations __________________________
Safety/Tool box meetings __________________________
Auditing field activities/tasks __________________________
Auditing contract requirements __________________________
Drug/Alcohol Testing __________________________
Incentive Program __________________________
Housekeeping __________________________
Training/Documentation on Site Specific HSE Plan _______________
General HSE Requirements
Cell Phone Usage __________________________
Camera Usage __________________________
Vehicle/Mobile Equipment Usage/Operation _____________________
Transporting Workers __________________________
Equipment/Building/Trailer locations __________________________
Personal Protection Equipment (PPE) __________________________
Specific Program Requirements
Permit Management __________________________
Energy Isolation/LOTO __________________________
SITE SPECIFIC HEALTH, SAFETY AND ENVIRONMENTAL PLAN Page 4 of 6
Confined Space __________________________
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Fall Protection __________________________
Personal Protection Equipment (PPE) __________________________
Respiratory Protection Program __________________________
Excavation __________________________
Hydro Blasting/Jetting __________________________
Abrasive Blasting __________________________
Painting/Coating __________________________
Lead Removal __________________________
Asbestos Removal __________________________
Alloy/Carbon Steel Welding __________________________
Torch/Arc cutting __________________________
Critical Lifts __________________________
Hazardous Waste Management __________________________
V. Site Emergency/Contingency Plan
Emergency Contact list
Personal Name __________________________________________
Title/Company __________________________________________
Address __________________________________________
Phone Home # __________________________________________
Phone Cell # __________________________________________
Facilities/Services
Name, __________________________________________
Title/Company __________________________________________
SITE SPECIFIC HEALTH, SAFETY AND ENVIRONMENTAL PLAN Page 5 of 6
Address; _________________________________________
Phone Number(s) _________________________________________
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Fire Emergency Contingency Plan:
Step by step process on what to do in the event of a fire situation.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Hazardous Material Release (Liquid/Solid/Vapor) Emergency Contingency Plan:
Step by step process on what to do in the event of a Hazardous MaterialRelease.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Evacuation Plan:
Step by step process on what to do in the event evacuation is required.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
SITE SPECIFIC HEALTH, SAFETY AND ENVIRONMENTAL PLAN Page 6 of 6
Injury Contingency Plan:
What is to be reported _________________________________________
How to report, _________________________________________
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Who is to be contacted, _________________________________________
Where injured person(s) will be treated, _______________________________
When to report _________________________________________
Report to whom _________________________________________
____________________________________________________________________
____________________________________________________________________
VI. List of Attachments
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
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Watson Air LiftTechnology
Individual Tank Specifics Page 1 of 2
Company: __________ Date:_________________
Location: ______ Tank #:
1. Tank Site/Safety Checklist and Permits (Check Appropriate Box) Yes No N/A
(a) Site/Safety Briefing Procedures Manual Page 37 __ __ __
(b) Tank Pre-Lift Checklist and Authorization Procedures Manual Page 38 __ __ __
Procedures Manual Page 39 __ __ __
(c) Local work permit __ __ __
2. Tank Information
(a) General Tank Information Procedures Manual Page 34 __ __ __
Procedures Manual Page 35 __ __ __
(b) Engineers Calculation Summary Sheet Procedures Manual Page 36 __ __ __
Tank Information Sheets are same as tank to be lifted. __ __ __
3. Set Up Tank
From Calculation Summary Sheet, set up:
(a) Air bag lifting points __ __ __
(b) Tank support points __ __ __
4. Tank Field Survey
Tank Pre-Lift Field Survey Procedures Manual Page 40 __ __ __
Procedures Manual Page 41 __ __ __
Procedures Manual Page 42 __ __ __
Procedures Manual Page 43 __ __ __
Procedures Manual Page 44 __ __ __
Tank Post Lift Field Survey Procedures Manual Page 45 __ __ __
A. R. Watson USAProcedures Manu
Rev. 2003Page 32
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"Watson Air Lift " Technology
Individual Tank Specifics Page 2 of 2
5. Mark Out At Tank Site Location (Check Appropriate Box) Yes No N/A
(a) Emergency Access
(b) Compressor(c) Hoses(d) Manifold(e) Site Sheds(f) Parking
6. Lift Inspection
From Engineers Calculation Summary Sheet:
(a) Set air pressure regulator __ __ __
(b) Check that air hoses are connected correctly __ __ __
(c) Safe working distance from airbags while inflating and deflating: ______ft. __ __ __
7. Storm Anchors
From Calculation Summary Sheet (if required):
(a) Set up position on tank __ __ __
(b) Weld lugs onto tank __ __ __
(c) Locate anchors in position __ __ __
8. Internal Lifting
From Engineers Calculation Summary Sheet (if required):
(a) Column supports __ __ __
(b) Wires ropes to support floor __ __ __
9. The Following Procedures May Be Required:
(a) Foundation __ __ __
(b) Containment Membrane __ __ __
(c) Cathodic Protection __ __ __
(d) Floor Replacement / Repairs __ __ __
A. R. Watson USAProcedures Manu
Rev. 2003Page 33
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"Watson Air Lift " Technology
General Tank Information Sheet Page 1 of 2
Contact: _________________________ Date: _________ Tank #: _______
Company: __________________________ Telephone: _______________________
Address: __________________________ Facsimile: _______________________
City: __________________________ Location: _______________________
State / Zip: __________________________
Reason To Lift Tank
Alabama State: Washington State New Zealand:7040 McDonald Rd. 4016 E. Maryland St. P.O. Box. 13858 Onehunga
Irvington, AL 36544 Bellingham, WA 98226 Auckland New ZealandPhone # (251) 653-8886 Phone # (360) 734-9157 Phone # (64) (9) 528-7905Toll Free # (800) 294-5102 Toll Free # (866) 734-9157
Fax # (251) 653-7385 Fax: # (360) 752- 1779 Fax # (64) (9) 528-7904
Website:www.arwatson.com E-Mail: arwatson@msn.com
A. R. Watson USAProcedures Manu
Rev. 2003Page 34
Yes No
Inspection of underside of floor ___ ___
Repair existing foundation ___ ___
Construct new raised foundation ___ ___
Possible floor repair ___ ___
Level tank rim settlement ___ ___
Install double containment membrane ___ ___
Install cathodic protection ___ ___
Install leak detection system ___ ___
Relocate tank ___ ___
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"Watson Air Lift " Technology
General Tank Information Sheet Page 2 of 2
Company: _____________________________ Date: _______________
Location: _____________________________ Tank #: ________________
Existing Tank Foundations: Concrete ring wall Crushed rock Sand
Tank Compound: Truck access Wet Dry
Website: www.arwatson.com E-Mail: arwatson@msn.com
A. R. Watson USAProcedures Manu
Rev. 2003Page 35
Diameter: _______ Ft.
Height: _______ Ft.
Weight: _______ Tons.
Shell Courses: Thickness Height
Bottom No. 1 ____ ____
No. 2 ____ ____
No. 3 ____ ____
No. 4 ____ ____
No. 5 ____ ____
No. 6 ____ ____
No. 7 ____ ____
No. 8 ____ ____
Floor Plate: ____ Thickness
Roof Plate: ____ Thickness
Annular Plate: ____ ThicknessAnnular Plate Protrusion: ____ Inches
Design Code: ______Tank Age: ______ Years
Design Wind Velocity: ______ Miles/Hour
Tank Construction: Riveted Welded
Floor Type: Flat Cone up Cone down
Cone Slope: ______ Inches/Foot
Roof Type: Floating Fixed Geo Dome
Roof Slope: ____ Inches/FootDesign Snow Load: ____ Inches
Wind Girders: ____ Number
Floating Pontoon: Double Deck Pan
Internal Columns: ____ Center ____ Inner Ring
____ Inter Ring ____ Outer Ring
Heating Coils: No Yes ____ Est. Weight
Double Bottom: No Yes ____ Est. Weight
Internal liner: No Yes ____ Est. Weight
Other Internal Fittings: No Yes ____Est. Weight
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"Watson Air Lift " Technology
Pre Lift Site Briefing
A site briefing is conducted prior to the commencement of work. Generally thisbriefing is used to reinforce safety procedures and to inform the on site personnel ofthe measures which apply specifically to that location.
The agenda for this site briefing is drawn up with reference to the following items:
Use of protective clothing / safety equipment
Requirements for personnel identification on site
Emergency egress and assembly procedures
Location and use of fire fighting equipment
Sources of ignition prohibited
Definition of Authority and introduction of Supervision Personnel
Explanation of fire hazard areas on site
Access to work areas
Site liaison / contractor liaison
Work permits, prohibited works / permitted works
Work in confined spaces
Connecting equipment and connecting to existing services
Excavations
Use of electrical equipment
Use of Owner supplied equipment
Hours of work
Bund / Dike containment walls
Washing / eating facilities
Terminal operators specific requirements
Safe use of vehicles on site
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Rev. 2003Page 36
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A. R. Watson USAProcedures Manu
Rev. 2003Page 37
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"Watson Air Lift " Technology
Tank Pre-Lift Checklist and Authorization Page 1 of 2
Company: __________ Date:_________________
Location: ______ Tank #:
A. R. Watson USAProcedures Manu
Rev. 2003Page 38
Tank Pre-Lift Checklist
All items contained in the following checklist are to be inspected and checked in accordance withthe Procedures Manual by both the A.R. Watson USA Supervisor and the PrincipalsRepresentative.
(Check Appropriate Box) Yes No N/A
1 Work Permit Provided __ __ __
2 Gas Free Certificate Provided __ __ __
3 All Staff Briefed on Site Emergency Procedures __ __ __
4 Fire Fighting Equipment Mobilized and Appropriate __ __ __
5 Inlet and Outlet Pipeline Disconnected and Blanked __ __ __
6 Fire Water Pipelines Disconnected __ __ __
7 Foam Lines Disconnected __ __ __
8 Tank Heating Pipelines Disconnected __ __ __
9 Manholes Covered with Safety Mesh __ __ __
10 Tank Stairs or Walkway Barricaded and free from ground fixing __ __ __
11 Floating Roof Set to High Level Legs __ __ __
12 Under Floor Appurtenances Clear for lifting __ __ __
13 Electrical Wiring Services Disconnected __ __ __
14 Electrical Ground Straps Disconnected __ __ __
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A. R. Watson USAProcedures Manu
Rev. 2003Page 39
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"Watson Air Lift " Technology
Tank Pre-Lift Checklist and Authorization Page 2 of 2
A. R. Watson USAProcedures Manu
Rev. 2003Page 40
Tank Pre-Lift Checklist Continued. (Check Appropriate Box) Yes No N/A
15 Any Surface Irregularities in the Shell or Roof. (Procedure Manual page 44) __ __ __
16 Designed Support Positions Marked on Tank Shell __ __ __
17 Specified Number of Air Bags Provided and Inspected __ __ __
18 Control Manifold Gauges and Pressure Regulator Inspected __ __ __
19 Control Manifold Preset to Design Pressure __ __ __
20 Compressor Located in Designated Safe Area __ __ __
Tank Lift Authorization
The principal confirms receipt and acceptance of the tank lift calculations, has completed this pre-liftinspection of the site and tank and authorizes A.R. Watson USA to commence the lifting of the Tank
Site Supervisor: Principals Representative:A.R. Watson USA Principal
Name: _________________________ Name: ________________________
Date: ____________________ Date: ____________________
Tank Lift Completion
The tank lift has been completed to the principals requirements and they accept completion of thetank lift work
Site Supervisor: Principals Representative:A.R. Watson USA Principal
Name: _________________________ Name: ________________________
Date: ____________________ Date: ____________________
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"Watson Air Lift " Technology
Tank Pre-Lift Field Survey Page 1 of 6
Company: __________ Date:_________________
Location: ______ Tank #:
1. Benchmark
Benchmark location ______________________
Benchmark ______________
Top of Annular Ring ______________
S 1 ____________ Inches
S 2 ____________ Inches
S 3 ____________ Inches
S 4 ____________ Inches
S 5 ____________ Inches
S 6 ____________ Inches
S 7 ____________ Inches
S 8 ____________ Inches
Measurement between S 1 and S 2 can be no more than 32 feet apart
Measure tank circumference taken at floor level. ___________________ Feet.
Mark piping connection locations relative to reference point on above diagram
Notes: __________________________________________________________________
A. R. Watson USAProcedures Manu
Rev. 2003Page 41
S 3
S 2
S 4
S 5
S 1
S 6
S 7
S 8
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"Watson Air Lift " Technology
Tank Pre-Lift Field Survey Page 2 of 6
Company: __________ Date:_________________
Location: ______ Tank #:
2. Diameter Measured at Floor Level(If floor is to be replaced)
S 1 to S 5 ________________ Feet
S 2 to S 6 ________________ Feet
S 3 to S 7 ________________ Feet
S 4 to S 8 ________________ Feet
3. Diameter Measured at Roof Line.
(open top and dome roof)
S 1 to S 5 _________________ Feet
S 2 to S 6 _________________ Feet
S 3 to S 7 _________________ Feet
S 4 to S 8 _________________ Feet
Notes:___________________________________________________________________________
A. R. Watson USAProcedures Manu
Rev. 2003Page 42
S 2
S 1
S 3
S 4S 5
S 6
S 7
S 8
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"Watson Air Lift " Technology
Tank Pre-Lift Field Survey Page 3 of 6
Company: __________ Date:_________________
Location: ______ Tank #:
4. Shell Edge Settlement
Measurements
S 1 A _______ B _______ Inches
S 2 A _______ B _______ Inches
S 3 A _______ B _______ Inches
S 4 A _______ B _______ Inches
S 5 A _______ B _______ Inches
S 6 A _______ B _______ Inches
S 7 A _______ B _______ Inches
S 8 A _______ B _______ Inches
Notes: _____________________________________________
A. R. Watson USAProcedures Manu
Rev. 2003Page 43
Leveled Straight Edge
Inside Tank Shell
Measurements B Taken Inside Tank
Measurement ATank Floor
S 1
S 2
S 3
S 4
S 5
S 6
S 7
S 8
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"Watson Air Lift " Technology
Tank Pre-Lift Field Survey Page 4 of 6
Company: __________ Date:_________________
Location: ______ Tank #:
5. Out of Plane Settlement and Planer Tilt
Survey points from inside tank to determine out of plane settlement
Bench mark by entry manhole
S 1 _____________ Inches
S 2 _____________ Inches
S 3 _____________ Inches
S 4 _____________ Inches
S 5 _____________ Inches
S 6 _____________ Inches
S 7 _____________ Inches
S 8 _____________ Inches
6. Floor Sag at Center
Tank center ____________ Inches
A. R. Watson USAProcedures Manu
Rev. 2003Page 44
Floor sag
S 1
S 2
S 3
S 4
S 5
S 6
S 7
S 8
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"Watson Air Lift " Technology
Tank Post-Lift Field Survey Page 6 of 6
Company: __________ Date:_________________
Location: ______ Tank #:
8. Post Lift Survey(Fill out this sheet after tank has been lifted)
1. Mark inlet pipe and manways
2. Note any water lying around the tank
3. Note any uneven settlement of the tank foundation
4. Note any debris that might cause the tank floor to corrode
5. Note any abnormalities in the floor and foundation that could caused the tank to fail
6. Mark any debris and standing water for each quadrant as well as low/high areas
7. Record tank circumference and note any reduction after lifting
# 1______________________________________________________________________________________________
# 2 _____________________________________________________________________________
# 3 _____________________________________________________________________________
# 4 _____________________________________________________________________________
Other comments: __________________________________________________________________
_____________________________________________________________________________
A. R. Watson USAProcedures Manu
Rev. 2003Page 46
#1
#3
# 2
# 4
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A. R. WatsonUSA,
Procedures ManuR
Page 48
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To: A. R. Watson Corp4016 E. Maryland St.Bellingham, WA 98226
Confidentiality Undertaking
I (Insert Full name) ______________________________________________________do hereby acknowledge and agree as follows:
1. That I am presently engaged in or am about to be engagedin certain negotiations with A. R. Watson USA, LLC.
2. That I am aware that because of my association with such negotiations, certaininformation and material will become known to me or divulged to me, which isregarded by A. R. Watson Corporation as being highly confidential andcommercially sensitive.
3. That I accordingly undertake in recognition of the proprietary and sensitivecommercial nature of these negotiations that I will:
a) not discuss the negotiations or any details thereof with any third party without theconsent of A. R. Watson Corporation, and;
b) not distribute any such material regarding the negotiations or copies thereof toany other third party whatsoever, and;
c) limit the preparation and distribution of copies of any material to an absoluteminimum, and;
d) return to A. R. Watson Corporation all material including copies forthwith at A. R.Watson Corporations request.
4. That such undertakings shall continue indefinitely or until such time as A. R.Watson Corporation releases me from the same.
Dated this _________________day of ________________________ 20______.
Signed by the above named in the presence of:
A. R. Watson USAProcedures Manu
Rev. 2003Page 46
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A.R. WATSON USA, LLC
By my signature below, I acknowledge that I have received information and training regarding:
Process Safety Management Training
Hazard Communication Program
New Hire & Supervisors Safety Orientation
How to Conduct Safety Meetings & Pre-Job Safety Planning Tailboard Meeting
Accident Reporting
Assured Equipment Grounding Conductor Program
Bloodborne Pathogens Exposure Control Plan
Confined Space Entry Program
Forklift Training
Tank Lifting Training Manual
Supervisors Safety Orientation Program
Control of Hazardous Energy Procedure
Fire Prevention and Protection
Confined Space Entry Program
Area Work Clearance
Safe Work Permits
Flame Resistant Clothing (NOMEX)
Safety Watch Guidelines
The training session was conducted by: ______________________________________
The training session location: _______________________________________________
_______________________________________________________________________
DATE EMPLOYEES NAME SOCIAL SECURITY NUMBER
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Rev. 2003Page 47
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"Watson Air Lift " Technology
TANK LIFT LEVEL TRAINING LEGEND
COLOR CODE LEVEL QUALIFICATIONSRED 1 Understands tank lifting fundamentals.
Basic construction techniques of styes.Basic understanding of air bag systems.
Needs SupervisionORANGE II Completed Level 1.
Experienced in tank lifting = completed a tank lift.Understands setout procedure.Completed training in use of air bags.
SupervisionYELLOW III Completed Level 1 and 2.
Experienced in tank lifting and relocation.Experienced lifting column roof tanks.Is competent to supervise Level 1 tank lifter.
Minimum SupervisionWHITE IV Completed Levels 1, 2 and 3.
Experienced in all areas of tank lifting.Is competent to run tank lifting process.Is competent to train tank lifting process.
No Supervision
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"Watson Air Lift " Technology
Tool Box Meeting
Company: __________ Date:_________________
Location: ______ Tank #:
Name: Company: S.S. No:
Topics:
Personal protective equipment Steel toe footwearHard hats Eye protectionHand protection Fall protectionHearing protection Respiratory protection
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"Watson Air Lift " Technology
Job Safety Analysis
Company: __________ Date:_________________
Location: ______ Tank #:
Name: Company: S.S. No:
Job Safety Analysis: On the Job Safety; For Everyone; Everyday; All the timeHouse keeping; Follow written procedures; ask for assistance, if needed
ASSESS the risk; What could go wrong? What is the worst thing that could happen if somethingdoes go wrong?ANALYSE how to reduce the risk; Do I have the necessary Training and Knowledge to do this jobsafely? Do I have the proper Tools and Personal Protective Equipment?ACT to ensure safe operation; Take necessary Action to ensure the job is done safely
DO NOT PROCEED UNLESS EVERYTHING IS SAFE
Job Steps Potential Hazards Recommended Action or Procedure
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A R Watson USA
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