ADNOC Classification: Internal

Selection Interview of Contractor HSE Professional - HSE Officer

1.General Information (Completed by the Contractor)

Candidate Name:___Aashil Dev N S___ Nationality:_Indian__________ Age:__29_ Mob No. 0567027105

Candidate Passport No. T6679917__ Candidate EID No. 784-1994-2445603-8______

Name of the Contracting Company: _ THE PETROLEUM& TECHNICAL CONSULTATION CO. (PETROJET) _________
Total Manpower:___
Contract Title: BAB FAR NORTH DEVELOPMENT PROJECT___ From: __________ To: __________

Is the candidate already approved by ADNOC Onshore for another contract Yes No
(If Yes, provide copy of the approval)

I, the undersigned Contractor Sr. Manager, representing the above contracting company hereby confirm that the above mentioned information and the attached CV are
verified and found true.

Name: ___________ Title: Project Manager Signature: ___________________ Date: _______________

2. Interview Details (ADNOC Onshore Use Only)

Date of Interview Face to Face: Video Conference:
Interview:___________ Method:
Educational
Qualification: Degree Diploma Others (Specify) Specify: ___________________
√ Professional/Technical:
_______________________

HSE Work Experience (Years): Total: __8____ Oil &Gas: __6____ Job Related: __________

Oil & Gas Construction/ Commissioning Experience: Yes No

√ √
Skills & Competencies WMS/Gas
HSE Plan H2S & BA Road Safety
(Examine relevant items) Testing √
√ Sub-
Risk √ Contractor
HSE HSE
√
Assessment Inspections Orientation/Induction
Management

Remarks: _______________________________________________________________________________________________________________________

3. Recommendation (Accepted candidate MUST complete WMS Training and Certification, H2S & TRA training prior to deployment at work site)

Acceptable Not Acceptable Conditions (If any):_____________________________________________________

Title Name Signature

ADNOC Onshore Senior HSE

Engineer (P&C)

ADNOC Onshore TL HSE (P&C) /

HSE Manager (Major Projects)

ADNOC Onshore CA Representative

(P&C)

Approved by HSEM (P&TC): _______________________________

4. Probation Assessment (if applicable)

Accepted Not Accepted Remarks: _____________________________________________________

TL HSE (P&C): ________________ Contract Administrator Representative (P&C): ________________