EMPC JOB SAFETY ANALYSIS REVIEW FORM

July 2010 Rev. 1.1

Facility / Site: Lawit Platform Location it!in Site: Pe"#it No: Pe"#it Ty$e: %ate:
Ta&' %e&c"i$tion (include Equipment Numer! a! Practical"# $p%radin% &or'! for ((( controller! from )erie! *+ to )erie! *++
RE()IRE% REFERENCES JSA REVIEW
,ave t-e relevant Procedure!. )tandard!. /uideline!.
or )afe &or' Practice! een reviewed0
1e! N23 Pendin% confirmation y t-e 4a!' Leader of !ite condition!. 5 a%ree t-at t-e attac-ed J)3 identifie! t-e
!i%nificant 4a!' )tep!. ,a6ard!. and (ontrol!.
JSA REVIEWER *S)PERVISOR OR %ESI+NATE, SI+NAT)RE:
3ttac- or Li!t Procedure!#
RIS- ASSESSMENT
7u!t e8i!tin% Procedure! or &or' Practice! e
modified to perform t-i! wor'0 (79( required"
1e! No NAME *PRINT,: Co#$any: (ompre!!or (ontrol (operation
3fter miti%ation. are t-ere any -a6ard! t-at continue to
pre!ent a potentially !i%nificant ri!'0 (5f ye!. contact
Ri!' )creener"
1e! No
WOR- SITE VERIFICATION
4-e &or' 4eam -a! a!!e!!ed t-e wor'!ite condition! and confirm!#
4-e J)3 addre!!e! t-e applicale -a6ard! and nece!!ary control!.
4-e 4eam -a! t-e appropriate re!ource! (people and equipment" to do t-e :o !afely.
9t-er! t-at could e affected y t-e wor' -ave een informed.
Ener%y i!olation (if applicale" -a! een ;ER5<5E= and =E79N)4R34E=.
TAS- LEA%ER SI+NAT)RE:
IF YES TO EIT.ER ()ESTION ABOVE/ ATTAC. T.E
MOC OR RIS- ASSESSMENT BEFORE PROCEE%IN+
PPE RE()IRE% %)RIN+ T.IS TAS-
()ummari6e PPE fron t-e 4,3 and2or ,a6ard 7ana%ement <orm"
,3R= ,34 )3<E41 /L3))E)
)3<E41 ),9E) 2 >994)
<3(E ),5EL=
/9//LE)
,E3R5N/ PR94E(459N#
)5N/LE
=9$>LE
/L9;E)#
(9449N
LE34,ER
57P3(4 PR94E(459N
94,ER (!pecify"#

(,E75(3L (!pecify"#

NAME *PRINT,: Co#$any: (ompre!!or (ontrol (operation
COMPLETE T.E SECTION BELOW IF T.IS JSA IS NOT PART OF A PERMIT PAC-
*Si0n on to t!e Pe"#it %ecla"ation i1 t!i& JSA i& a&&ociate2 it! a Pe"#it Pac',
RE)P5R349R 41PE
(!pecify"#
)(>3
=$)4 73)?
Wo"' Tea# %ecla"ation:
I ac'nole20e t!at I !a3e "e3iee2 t!e attac!e2 JSA/ I 4n2e"&tan2 #y "ole&
an2 "e&$on&i5ilitie&/ an2 I ill co#$ly it! t!e in&t"4ction& 1o" t!i& ta&'6
Na#e *$"int,: Na#e *$"int,:

<3LL PR94E(459N
<3LL RE)4R35N4
(,E75(3L )$54
3PR9N


L5<E ;E)4
&9R? ;E)4
<9$L &E34,ER /E3R (!pecify"#



<L37E RE)5)43N4
(L94,5N/


94,ER PPE (!pecify"#

EMPC JOB SAFETY ANALYSIS TAS- .A7AR% ASSESSMENT FORM
July 2010 Rev. 1.1
Version 1.1: April 2013
T!i& ta5le o1 .a8a"2& an2 Cont"ol& can a&&i&t t!e o"' 0"o4$ to #ana0e !a8a"2& 1o" t!e $"o$o&e2 o"'6 T!e ta5le 2oe& not incl42e all $o&&i5le !a8a"2&6 It i& e9$ecte2
t!at t!e "e:4i"e2 PPE 1o" t!e acti3ity an2 o"' con2ition& ill 5e 4&e26 %ete"#ine t!e .a8a"2& t!at a"e $"e&ent 1o" t!e ta&' an2 i2enti1y t!e Cont"ol& to 5e i#$le#ente26
P"e&&4"i8e2
E:4i$#ent
Poo" Li0!tin0
o" 3i&i5ility
Pe"&onnel Con1ine2 S$ace
Si#4ltaneo4&
O$e"ation&
*SIMOPS,
Weat!e" I0nition So4"ce&
Perform i!olation L9249.
lindin%. or defeat
=epre!!uri6e. drain. pur%e.
and vent
Relieve trapped pre!!ure
3void auto@refri%eration
w-en depre!!uri6in%
3nticipate re!idual pre!!ure
or fluid!
)ecure temporary -o!e!
Provide alternate li%-tin%
&ait or defer until vi!iility
improve!
No wor' over water t-at
could require re!cue
(includin% !ea !tate"
Provide induction or trainin%
for new wor'er!
7entor. coac-. or !upervi!e
;erify competencie!. !'ill!.
and e8perience
3ddre!! applicale limitation!
(fati%ue. e8-au!tion. and
re!tricted duty"
7ana%e multiple lan%ua%e!
=i!cu!! confined !pace
entry !afe wor' practice
(onduct atmo!p-eric te!tin%
7onitor acce!! or entry
Protect !urface! from
inadvertent contact
=o not locate moile en%ine!
near confined !pace
Provide o!erver
=evelop re!cue plan
<ollow )579P) matri8
79( required for deviation
from )579P) re!triction!
5nterface etween %roup!
$!e arrier! and !i%n! to
!e%re%ate activitie!
,ave permit counter !i%ned
y leader of affected %roup!
5mplement control! for
!lippery !urface!
,i%- wind! %o%%le!
,eat -yrdration. rea'!
(old PPE. -eater!
Li%-tenin% tool !election.
defer wor'
Remove. i!olate. or contain
comu!tile material!
Provide fire fi%-tin% equipment
(on!truct a fire@!afe -aitat
Provide a fire watc- durin%
and after -ot wor'
(onduct continou! %a! te!tin%
>ond or eart- for !tatic
electricity or cat-odic protection
.a8a"2o4&
S45&tance
Potential S$ill&
E:4i$#ent
.ot o" Col2
.i0! Noi&e
Fallin0 o"
%"o$$e2 O5;ect&
Li1tin0
E:4i$#ent
Wo"' at .ei0!t&
=rain or pur%e equipment
<ollow 7)=) control!
5mplement -ealt- -a6ard!
control! (Lead. 3!e!to!.
,2). 5ron )ulp-ide.
)ulfur =io8ide. N9R7"
4e!t or analy6e material
=rain equipment
Provide !pill containment
equipment
,ave !pill clean up material!
and equipment on -and
Re!train and i!olate -o!e!
w-en not in u!e
,eat or cool equipment
efore wor' !tart!
5n!tall arrier!
Provide warnin% !i%n!
5mplement cold temperature
and rittle failure control!
&ear t-ermal %love!
&ear correct -earin% PPE
7ana%e e8po!ure time!
)-utdown equipment
$!e AquietA tool!
)ound arrier! or curtain!
Provide or u!e !uitale
communication tec-nique!
$!e !i%n! and arrier! to
re!rict entry or acce!! under
wor' at elevation
$!e liftin% equipment to rai!e
tool! to or from t-e wor'
platform
)ecure tool! (tie@off"
(onfirm liftin% equipment
condition and certification
9tain approval for lift!
over proce!!in%
equipment
,ave a documented and
approved lift plan
=i!cu!! wor'in% at -ei%-t! !afe
wor' practice
;erify fall re!traint and arre!t
equipment certification
3pply a!eilin% !afe wor'
practice
Po"ta5le Elect"ical
E:4i$#ent
Ra2iation .a8a"2
Mo3in0 O5;ect&
o" E:4i$#ent
Man4al .an2lin0
E:4i$#ent
an2 Tool&
Vi5"atin0
E:4i$#ent
Sli$&/ T"i$&/
an2 Fall&
5n!pect equipment for
condition and te!t date
currency
5mplement continuou! %a!
te!tin%
Protect electrical lead! from
impact or dama%e
$!e arrier! and !i%n! to
re!trict acce!!
Notify per!onnel w-o may
e affected
5mplement N9R7 control!
(onduct R3= te!tin%
(onfirm mac-inery %uard
inte%rity
Provide protective arrier!
9!erver to monitor pro8imity
of people and equipment
)-ut down or loc'out
equipment
=o not wor' in t-e line of fire
3!!e!! manual -andlin% ta!'
Limit load !i6e
7ana%e po!ture
(onfirm !taility of load and
wor' platform
/et a!!i!tance or mec-anical
aid to avoid pinc- point!
5n!pect equipment and tool!
No u!e of modified tool!
$!e protective %uard!
$!e correct tool! and
equipment for ta!'
Protect or remove !-arp
ed%e!
3pply -and !afety principle!
7ana%e e8po!ure time!
3!!e!! affect of viration
on equipment
$!e low viration
equipment
3pply noi!e control!
5dentify and !-ield uneven
!urface or pro:ection!
)ecure or cover cale!. cord!.
and tuin%
(lean up liquid!
>arricade or rope@off openin%!
and -ole!
.i0! Ene"0y o"
.i0! Volta0e
E9ca3ation&
Wa&te Clean )$
an2 %i&$o&al
Ot!e" Ene"0y
So4"ce&
Mo5ile
E:4i$#ent
Ot!e" .a8a"2&
E#e"0ency
Re&$on&e
Re!trict acce!! to aut-ori6ed
per!onnel only
=i!c-ar%e equipment and
ma'e electrically dead
9!erve !afe wor' di!tance!
for live cale!
$!e fla!- urn PPE !uit
$!e in!ulated %love!. tool!.
and mat!
,ave an e8cavation plan or
!afe wor' practice
Locate under%round pipe!
or cale! y -and di%%in%
=e@ener%i6e under%round
!ervice!
5mplement confined !pace
entry control!
3pply environmental
mana%ement practice!
<ollow !ite wa!te
mana%ement procedure!
(lean up equipment and
material! at !ite
9ptimi6e ta!' to minimi6e
wa!te production
)prin% compre!!ion or
e8pan!ion control
5mplement electroma%netic
(radio" control!
7ana%e pre!!ure or vacuum
7ana%e -eat %eneratin%
proce!!e!
$!e !ei!mic activity !afe wor'
practice
3!!e!! equipment condition
5mplement control! on u!er!
or acce!!
Limit and monitor pro8imity to
live equipment or cale!
7ana%e over-ead -a6ard!
3d-ere to road and !ite rule!
5mplement ara!ive
la!tin% control! (for
equipment and practice!"
Prepare a dive plan
7ana%e potential loc'ed
or plu%%ed equipment
79( required for
temporary connection!
or modification!
?eep e%re!! route open
?eep !-ower and eye wa!-
!tation! acce!!ile
,ave a re!cue plan in place
?eep emer%ency alarm. fire
equipment. and !-utdown
location! uno!tructed
Version 1.1: April 2013
EMPC JOB SAFETY ANALYSIS .A7AR% MANA+EMENT FORM
July 2010 Rev. 1.1
Ta&' %e&c"i$tion *&a#e a& $a0e <,: $p%radin% &or'! for ((( controller! from )erie! *+ to )erie! *++
Note: I1 t!e &co$e o1 o"' o" t!e con2ition& c!an0e &i0ni1icantly/ STOP T.E JOB6 Re3i&e t!e JSA to a22"e&& t!e !a8a"2& 5e1o"e $"ocee2in06
Co#$lete Ta&' Ste$& / Potential .a8a"2& / .a8a"2 Cont"ol& PRIOR to t!e JSA Re3iee"6 Co#$lete A&&i0ne2 Pe"&on AT T.E WOR- SITE *a1te" JSA Re3iee" !a& &i0ne2,
TAS- STEPS
*Incl42e N4#5e",
POTENTIAL .A7AR%S
*W!at co4l2 0o "on0=,
.A7AR%S CONTROLS
*.o can !a"# 5e $"e3ente2=,
ASSI+NE% PERSON
Na#e Co#$lete
















Le!!on! Learned and 5mprovement!# 5n !ection elow de!crie difficultie! encountered w-ile performin% t-i! ta!'B or any activitie!. !tep!. or !afe%uard! (includin%
PPE" t-at could e improved if t-i! ta!' i! performed a%ain in t-e future.

Version 1.1: April 2013