Facility Induction Checklist

Vice President - HSE

FM-CO-HSE-051
7-Oct-19

NAME (PRINT): DATE: RIG:

NOTE: Please INITIAL each section to acknowledge your understanding of the topics discussed during
Facility Induction. If you do not understand a certain topic, ask the Facilitator for clarification.
Did you sustain an off-the-job injury? Yes No Describe:
Has Valaris’ HSE Orientation eLearning been completed since hired? Yes No Not Sure

Facility Induction (Part A) – Applies to all personnel upon each arrival to the facility
___________ OIM (or Delegate) Briefing – Current operational status and key topics
Operational Update Company Initiatives
Facility Performance Reporting Injuries, Illnesses, and Medication
Lifting Gear and Color Code Medical Information Form
Valaris Management System Security Levels (If applicable)
Global Induction Video (Part A) – Applies to all arriving personnel
Watch Global Induction Video Actions if you observe a fire?
Valaris Purpose and Values Actions if you witness man overboard?
Facility Hazards Reporting Injuries and Illnesses
Personal Protective Equipment (PPE) Reporting Medications and Prescriptions
Safety Systems of Work (SSoW) Prohibited items
Valaris 10 Life Savers Jewelry and housekeeping
Environmental Management & Waste
Emergency Situations and Responses
Segregation
What to do if an alarm sounds? Other:
Welcome Aboard Card (Part B) - Assign Cabin and Survival Craft
New or transferred personnel and
visitors receive Valaris Welcome Survival
Aboard Card Cabin # Craft #
Facility Induction (Part B) – Applies to new or transferred personnel or returning personnel over 6
months
Valaris Purpose and Values Org Structure / Chain of Commands
Expectations to Work Safely Meetings and Drills Schedule
Stop Work Authority &Process Galley Hours and Accommodation Information
Dropped Objects Prevention &
Cybersecurity
Mitigation
Hand Safety Specific Rig or Region Information
Facility Management and Offices Demonstration of Alarms
Facility Induction Tour (Part B)
Muster Points and Main Escape Routes Accommodations and Meeting Rooms
Fire Control Plan and Lifesaving
Equipment Sickbay
Restricted Access and Conditions to
Enter Designated Smoking Area
Dropped Object Prevention and Red
Zone Other:
Acknowledgement of Facility Induction Part A and / or Part B
I confirm that I have participated, understand and agree to abide by the information contained in the Valaris HSE
Orientation and Induction Process.
Employee Company: Position

Confidential Information and Uncontrolled When Printed or Copied Page 1 of 2

 Facility Induction Checklist
Vice President - HSE
FM-CO-HSE-051
7-Oct-19

Signature: :

Facilitator Position
Name: :

Confidential Information and Uncontrolled When Printed or Copied Page 2 of 2