KIPIC Al Zour Refinery Project

FDH JV HSE Weekly Assessment

Subcontractor / Contract No
Observations should be noted on the attached observation sheet. Upon completion of the inspection each category should be rated
Sungbo K-415B
only as: 10 Excellent, 7.5 Good, 5.0 Needs improvement 2.5 Needs Immediate Attention, 0 Not Acceptable, or N/A Not
Applicable. Our Goal is up 90%. Unit 39
92%
Audit Leader: Tomas Santos SCORE: Date:
Audit Members: Ronald Magsino, Arun, Javed, HG Kim,CK Kim ,Kishore 92% 25 Jan 2018
PMC: Abbreviations
PMT: NC: Not Corrected
NA: Not Applicable
NE: Not Evaluated
1 Housekeeping Possible points Points Awarded

1 Project work areas are clean and maintained free of trash, debris, lumber, welding rod stubs, etc 10 7.5
2 Walkways and passageways provided, clear and sign posted for pedestrian access/ Jersey barriers installed if applicable 10 7.5
3 Warehouse, storage areas, material, tools, or equipment properly stored / Defective material tagged "out of service" 10 7.5
4 Electrical cords, hoses, welding leads, routed to provide clear passage and/or elevated at least 7 feet 10 10
5 Scrap wood, metal, paper, or other material disposed of in the proper containers 10 10
6 Trash receptacles labeled are provided for work areas (Hazardous waste - yellow / non hazardous waste - black) 10 10
7 Caution (yellow) / Danger (red) barricades erected properly, tagged properly and have gates for entry and exist points 10 10
8 Rebar caps or other impalement protection devices installed and maintained / Protruding nails bent or removed from lumber 10 7.5
9 Non Hazardous wasted material are being separate and/or classified in accordance with the site colors coding 10 10
10 Housekeeping signage posted as required 10 10
100 90
90%
2 Personal Protective Equipment Possible points Points Awarded

1 Hard hats worn and maintained as required / approved as per FDH JV & KIPIC requirements 10 10
2 Hearing protection worn as required by JSA or hazard assessment 10 10
3 Eye protection worn in a proper manner as required by JSA / STA or hazard assessment / approved as per KIPIC req's. 10 7.5
4 Hand protection ANSI level 4 gloves worn as required by JSA / STA or per hazard assessment / approved as per KIPIC req's. 10 7.5
5 Metatarsal / appropriate foot protection worn as required by JSA / STA or hazard assessment 10 10
6 Face shields, goggles or spoggles worn as required by JSA / STA or hazard assessment / approved as per KIPIC req's. 10 10
7 Adequate PPE for hot work and Maintained / approved as per KIPIC req's. 10 10
8 Respirators, dust masks and coveralls, worn as required by JSA / STA or hazard assessment / approved as per KIPIC req's. 10 10
9 Is the PPE properly stored when not in use? 10 10
10 Are workers trained in the proper use, care and maintenance of PPE (documented) ? 10 7.5
100 92.5
93%
3 Fall Protection Possible points Points Awarded

1 Body harnesses worn in a proper manner two lanyards - 100% tie off policy in use 10 10
2 Lanyards and anchors (including its length) are properly secured to suitable anchorage point capable of supporting 5.000 lbs 10 10
3 Fall Protection Work Plan in place and approved by FDH JV HSE Representative 10 7.5
Use of horizontal or vertical life lines (3rd party manufactured/Certified) or designed and installed under the supervision of a
4 n/a
designated qualified personnel
5 Fall protection arrest systems & equipment is used only for fall protection purposes 10 10
6 Handrails or rigid barriers installed at 42'', 21'' and toe/kick board 3.5'' when applicable. 10 10
7 Elevated working platforms controlled and clear from loose / Unsecured materials 10 7.5
8 SRLs (Self Retractable Lines) in use as required - 30 degree angle policy - Horizontal Movement n/a
9 Fall protection arrest system / equipment maintained and has current inspection by qualified & competent personnel 10 10
10 Potential falling objects controls in place / tool lanyards in use when working at height 10 7.5
11 Are required personnel being trained under the FDH JV Working at Heights Practice, P055BZOR.00.10.51.005 Fall Protection 10 10
12 Open floor holes, wall openings, grating removal appropriately protected or adequately guarded and identifiable 10 10
100 92.5
93%
4 Excavations Possible points Points Awarded

1 Excavation permit valid with all signatures approved by Designated Competent person in place 10 10
2 Daily Excavation insp. is performed by competent person prior to entry into excavation/trench as P055BZOR-00-51-4-S010 10 10
3 Spoil pile a minimum of 2' from leading edge of excavation / trench 10 7.5
4 Personnel working in excavation / trench are properly protected from potential cave in / Proper excavation slope 1:1.5 10 10
5 Handrails, fence or warning / danger tape to barricade off excavated area properly placed where applicable? 10 7.5
6 Appropriate access every 25ft, Ladders over exceed 3ft above the landing area, proper egress / access maintained? 10 7.5
7 Atmosphere Test (Air Test) conducted and recorded every shift for 1.2m depth excavations/trenches, AGT Available n/a
8 Appropriate warning safety signage placed around excavation area 10 10
9 Excavation perimeter being equipped with flash lights were applicable for night shift operations? 10 10
10 Visible and adequate supervision in the work area 10 10
90 82.5
92%
5 Scaffold and Ladders Possible points Points Awarded

1 Scaffolds built as per manufacturer specifications and sample material approved as per FDH JV and KIPIC requirements 10 10
2 Proper access and egress provided including swing gravity gates as required 10 7.5
3 Retractable systems as required in ladders are being installed at vertical access equal or longer that 6m (18ft) n/a
4 Are scaffolding users being trained in FDH JV Working at Heights and Scaffolding Safety practices ? 10 10
5 Scaffolding inspected by an project approved qualified designated inspector (appropriate color tag dated / signed per shift) 10 10
6 Are FDH JV Scaffold Inspection Checklist being implemented and recorded? 10 10
7 Are scaffold builders 3rd party Certified and trained in FDH JV Scaffolding Safety ? 10 10
8 Proper ladder angle / ratio (4:1) for the job performed and properly secured on the top 10 10
9 Only approved ladders class I, IA, II rated for heavy industrial duty 10 10
10 Are areas being barricaded off (Danger Tape - RED & tagged) when erecting scaffolding 10 10
11 Are scaffold builders use tool lanyard (wrenches, hammers, etc.) in order to secure their tools when WAH? 10 7.5
12 Are ladders being inspected by designated competent person on monthly basis (documented inspection / tag) 10 10
13 Are fiber glass ladders being used for work near electrical equipment by the electricians n/a
110 105
95%

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 KIPIC Al Zour Refinery Project
FDH JV HSE Weekly Assessment
6 Hoisting and Lifting Equipment Possible points Points Awarded

1 Proper rigging techniques (slinging) - include do not move load [suspended] over workers n/a
2 No load touch policy in use n/a
3 Lifting accessories (Chain falls, come-a-longs, slings, etc.) 3rd party certified and inspected by designated competent person n/a
4 Softeners used as required to protect slings from sharp edges n/a
5 Tag lines in use, lifting swing area barricaded off and warning sound given prior to start the lift n/a
6 Rigger 3rd party certified and FDH JV trained/Approved in place with red helmet / orange high visibility vest and whistle. n/a
7 Cranes operators are third party certified and FDH JV Cranes Safety Trained w/sticker n/a
8 Are cranes-lifting equipment's 3rd party KIPIC safety Certified & Inspected on Monthly basis by competent person n/a
9 Daily equipment operator checklist completed daily, filled out completely and reviewed by supervision before noon n/a
10 Pre-lifting meeting have been conducted ? Green Lift Checklist / Critical Lift Permit performed, approved as required? n/a
11 Cranes outriggers have being fully extended and leveled before works commence / Anti-two block devices inspected? n/a
12 Safe Work Limits marked/ imposed on crane / hook and lifting gears? n/a
13 Are Man baskets 3rd party certified and load tested (trial test) before used, FDH JV Man basket permit approved and in use n/a
0 0
N/A
7 Vehicles / Mobile Equipment Possible points Points Awarded

1 Daily operator checklist sheet completed and filled out completely and verified by supervision before noon 10 10
2 Good housekeeping maintained and driver / operator counts with FDH JV Defensive Driving Training 10 10
3 Vehicles /mobile equipment free of oil leaks (check under de crane motor, chassis, hydraulic drums, etc.) oil spills kits available 10 10
4 The portable generators as lighting towers, electrical generators, etc. count with secondary containment in case oil, fuel leaks 10 7.5
5 Wheel chock on board or being in use while vehicle is parked on incline, sloped areas 10 10
6 Safety warning signage - labels / decals on/in the vehicle and Equipment 10 10
7 Vehicles and mobile equipment operators are FDH JV Mot. Heavy Cons. Eq. Trained / qualified to operate assigned equipment 10 10
8 Back up alarm and beacon lights installed and operable 10 10
9 Does project equipment (cranes, trucks, heavy equipment, etc.) counts with a valid KIPIC Safety Certificate 10 7.5
10 Does vehicles or mobile equipment have fire extinguisher / first aid kit and seat belts 10 7.5
100 92.5
93%
8 Tools and Equipment Possible points Points Awarded

1 Tools & equipment are in good condition with current monthly inspection color coded by designated competent person 10 7.5
2 Are power tool being provided with "dead man-switch" 10 10
3 Hand tools are being properly stored, maintained, carried, and use as per manufactures recommendations 10 7.5
4 Air and water hose connections properly secured (anti - whip checks / safety pins in) 10 7.5
5 Insintrically safe equipment approved for use in hazardous classified areas as required by KIPIC HSE standards. n/a
6 No home-job made tools 10 10
7 Grinder's RPMs are lower than manufacture disk's RPM specs? 10 10
8 Are abrasive disks being used properly as per manufacture recommendations and are disks valid (expired) for safe use? 10 10
9 Are table saws / hand saw equipment provided with safety guards/ safe guards on for rotating equipment 10 10
10 Are electrical industrial plug sockets installed on power tools 10 10
11 Engine driven equipment counts with KIPIC Safety Certificate n/a
12 Are power tools double insulation protection? 10 10
100 92.5
93%
9 Fire Protection Possible points Points Awarded

1 Flammables and combustibles properly stored in designated safe locations 10 10

2 Chemical containers properly labeled as to their content / SDS available and approved by KIPIC 10 10
3 Fire extinguishers located / shaded, fully charged, enough capacity for that location and inspected by competent personal 10 7.5
4 Fire watch employee identified, FDH JV Trained, on place and knows duties involved in the JSA. 10 10
5 Compressed gas cylinders properly maintained (vertical), secured and stored in shaded areas n/a
6 Fire retardant containment for hot work and welding screens provided and used as required - FDH JV hot work permit in place 10 10
7 Flash arrestors, check valves, gas valves protector devices (caps) and regulator gauges are properly installed and maintained n/a
8 Maintain a register of all fire extinguishers showing their location available in the work area. 10 7.5
9 Oxygen and acetylene separated (20 ft.) when not in use within 24 hours n/a
10 Are workers being trained in the use of fire extinguishers 10 10
70 65
93%
10 Confined Space Possible points Points Awarded

1 Count with Confined Space Entry Permit for that purpose, signed, available and are filled by competent personal n/a
2 Hole watch / attendant in present at all the time at the designated entry point / FDH JV entry log maintained n/a
3 Does the attendees have CSE medical fitness certification by KIPIC authorized clinic / FDH JV CSE Trained w/stickers n/a
4 Do exist emergency extraction rescue equipment/plan and its operable and inspected accordingly manufacture recommendations n/a
5 Does exits good ventilation controls, comfortable temperature and illumination both inside / outside the confined space n/a
6 Do the gas monitoring instrumentation is calibrated as required and count with its certification updated as per KIPIC rules n/a
The entry access to the confined space count with retractable systems, handrails / rigid barriers as required in order to avoid fall
7 n/a
hazards.
8 Exist appropriate safety awareness signage for warn the personnel about the risks and hazards associated with the CSE. n/a
Does gases concentration are written down in the permit and are they met/comply with OSHA & Project standards 0 2 : 19.5-23.5%,
9 n/a
LEL:<10%, H 2 S:10ppm, CO:35ppm
10 CS- DO NOT ENTER PERMIT REQUIRED signage in place at each entry point n/a
0 0
N/A
11 Electrical Safety Possible points Points Awarded

1 Electrical Generators are being properly grounded with copper rods / appropriate clamps and appropriate cable size 10 10
2 UG Utilities (i.e electrical cables are being demarked, signaled above ground - as builts prepared and given to FDH JV Engineering 10 7.5

3 Extension cords or electrical contact outlets are 3 wire receptacles and rated for the proper location (wet proof locations, gases, etc) 10 10
4 Electrical distribution panels with appropriate electrical warning hazards signage and outlets labeled accordingly voltage usage. 10 7.5
5 Extension cords (both ends) and electrical equipments have been inspected by designated qualify electrician 10 10
6 Are cranes or mobile equipment operators aware and/or away at least 10m from overhead power lines n/a
7 Electrical equipment are not being operated near/standing over water 10 10
8 Does Project LOTO procedure is being implemented and followed? 10 7.5
9 Designated qualified electrician identified by project manager 10 10
10 GFCIs / ELCB interruptors in use and inspected by qualified personen 10 10
90 82.5
92%

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 KIPIC Al Zour Refinery Project
FDH JV HSE Weekly Assessment
12 Hygiene & Facilities Sanitization Possible points Points Awarded

1 Are eye wash stations being provided for chemical exposure and/or as per JSA/STA 10 10
2 Portables toilets are clean and enough quantity as per personnel ratio, daily checklist provided. 10 7.5
3 Hand wash stations provided with soap or sanitizer gel near the toilets and dinning / mess hall areas 10 7.5
4 Hygiene & Facilities Sanitization signage in placein restroom and in mess hall facilities. 10 10
5 Does medical service reps provide current medical & health information to the workers, (bulletins, handouts, etc) n/a
6 Drinking water supplied and portable kegs cleaned on daily basies or as per shift and dated - documented inspections. 10 10
Are shelters being provided as per the project ratio / water kegs, first aid box, emergency contact, evacuation route available,
7 10 7.5
ventilation provided / fire extinguishers
8 Are proper food storage racks are being provided to the employees 10 10
9 Are medical waste (blood borne/sharp) being managed, classified and disposed accordingly as per project regulations (KEPA) n/a
10 Designated smoking areas located and identified, ash tray and fire extinguishers, signage provided 10 10
11 Mess hall facilities are clean and sanitized before and after personnel eat there. n/a
80 72.5
91%
13 Environmental Possible points Points Awarded

1 Drainage systems clean and fuctional 10 10

2 The materials storage count with protection against sediment control 10 7.5
3 Enough and adequate waste containers, identified, signs and labeled 10 10
4 Waste materials classification segregation is correct as per FDH JV / KIPIC Environmental requirements. 10 10
Hazardous waste is being managed and disposed as required by project requirements, manifests/weighbridge tickets / authorized
5 waste collector 10 7.5
6 Are oil spills kits available enough on site as per project requirement 10 7.5
7 Work areas are irrigated with water to control / mitigate dust 10 7.5
8 NFPA Fuel Cans type II class in sued for flammable liquids during transportation 10 10
9 Are portable/mobile engine equipment being provided with containment trays (drip trays) 10 10
10 Are proper vehicle maintenance facility "bay" provided as per KIPIC requirements 10 10
11 All chemical containers count with NFPA Diamonds tags/labels (Hazard Communication) 10 10
110 100
91%
14 Another HSE Requirements Possible points Points Awarded

1 Permit to Work and supplementary permits are valid and available in the work area 10 10
The JSAs, STAs have been filled out, signed and communicated correctly between the foreman and his crew? Reviewed by
2 10 10
Supervision?
3 Work method statement have been communicated with all personnel affected and available at site 10 7.5
4 Effective procedure and communication devices in place to properly respond in case an emergency - QRC 10 10
5 Shelters available where personnel can use for refuge in case of an electrical storm or adverse weather away from roads 10 7.5
6 Route evacuations signs and assembly points zones identified in case an Emergency 10 10
7 Work areas with proper safety signage (hazards, warning, mandatory, information, etc) 10 7.5
8 Are the weekly scorecard assessments open observations being closed-off as required by FDH JV HSE 10 10
9 Have the PMCs / KIPICs HSE Observations Reports (FI, SIR, SST, Audits, etc ) being closed out by FDH JV Subcontractors? 10 10
10 Are MS20 and Safe Observations Cards program being implemented by CM and HSE personnel 10 10
11 Visible and adequate HSE and Construction supervision in the work area available 10 10
110 102.5
93%
15 Behaviors Based Safety Total People Observed People working Safely

1 Total numbers of persons observed vs numbers of people working safely 30 27

30 27
90%

SCORE BEFORE REDUCTION 1190 1097

92%

FOLLOW-UP & REDUCTION Quantity Reduction

Number of items without correction since last inspection 0 0

Number of imminent danger(s) 0 0

FINAL SCORE: 92%

100% - 96%= Excellent

95% - 90%= Good
89% - 76%= Marginal
<75% = Substandard
Safety Thermometer Indicator

The responsible Management / individual for observations requiring corrective action shall sign off as corrected and return this report within 24 hours of receipt
to FDH JV HSE and CM Mgt. A status report shall be attached for observations that are not corrected. If Contractor scored 75% or less , such area HSE
inspected must be shutdown and all items must be corrected before resume activities, a rectification HSE walk down will take place accordingly when
contractor advise all items has been corrected.

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