Form 000.653.F0101Form 000.653.

F0101
Safety Task AssignmentSafety Task Assignmen MA’ADEN FIRE EMERGENCY SERVICE 0539176001/0136686230

We understand the contents of the STA and agree to adhere to the controls identified.我们了解 following 管理层参与 STA 交底或审阅 STA 后，请填写:
STA 中的内容并遵守相关要求 Name 姓名: Time 时间:
INVOLVED CREW MEMBERS 班组成员 Signature 签字:
POST POST
NAME INJURY STA
INITIAL
NAME INJURY STA
INITIAL
POST STA 关闭 STA
OCCURRED? OCCURRED?
姓名 是否受伤 作业完成 姓名 是否受伤 作业完成 Foreman 班长: Date 日期: Time 时间:
后签名 后签名 Was anyone injured or did an unplanned incident (near miss) occur today?是否有人受伤或发生事故
Yes 是 No 否
If yes, explain 如果是，请描述:

Was it reported to the HSE Department?是否汇报 HSE 部 Yes 是 No 否 N/A 不符合

What changes occurred and how were they addressed 有何变化，是否讲清楚?

What can we do to improve HSE performance?如何在安全方面做得更好

Concerns/Hazards 危险因素:

SAFETY TASK ASSIGNMENT 任务安全分配 STA

Project Name 项目名称: U&I PACKAGE 6.1

Foreman 班组长: Company 公司

Date 日期: Time 时间: Task Location 作业地点:

Task Description 作业描述:

INSTRUCTIONS FOR COMPLETING STA 填写说明

The STA is a team effort. Together, management/supervisors and employees STA 是团队作业，
需要管理层、施工员、员工共同完成:
 Review and ensure that all personnel
 List steps for the task.
understand the STA.审阅并确保每个
列出作业步骤
人都了解上面的要求
REVIEWERS 审阅  Identify known and potential HSE hazards.  Safely perform the task.
General Foreman/Superintendent 施工主任/队长: 辨识一直和位置风险 安全作业
HSE Department 安全员:  Determine work practices and equipment  Revise the STA when the task or
Direct Supervisor 施工员: (including PPE) necessary to complete the task conditions change.当作业条件变化
safely.确定安全完成作业的方式和所以设备 后，更新 STA
MANAGEMENT PARTICIPATION 管理层参与  Encourage participation in this process by all  When the task is finished, complete the
Did a member of management participate?管理层成员是否参与 Yes 是 No 否 Reviewed only crew members.鼓励班组成员参与安全作业程 Post STA.作业完成后，关闭 STA
仅审阅 序
If a member of the management participated in this STA meeting or reviewed this STA, complete the
Copyright © 2015, Fluor Corporation. Page 4 of 4 Health, Safety, and Environmental Copyright © 2015, Fluor Corporation. Page 1 of 4 Health, Safety, and Environmental
All Rights Reserved. Form Date: 6Oct2015 Rev. Ref. No.: MPP-STA-06102015 All Rights Reserved. Form Date: 6Oct2015 Rev. Ref. No.: MPP-STA-06102015
 Form 000.653.F0101Form 000.653.F0101
Safety Task AssignmentSafety Task Assignmen MA’ADEN FIRE EMERGENCY SERVICE 0539176001/0136686230

STAs will be maintained in the work area throughout the duration of the task. Each crew member Guardrail Removal 钢格栅移除
involved with the task will sign the STA prior to starting work and initial upon completion of the A risk assessment using the JSA/Risk Platform/Workbaskets 平台/吊篮
task.作业期间，STA 要一直放在作业区域。参与作业人员在作业开始前和完成后都要在 Assessment Form 000.653.F0100 or
STA 上签字 equivalent has been completed prior to starting Safe Works Hazardous Work
work.风险评使用 000.653.F0100 版本，或者 安全作业风险作业
EMERGENCY PROCEDURES 应急程序 在作业开始前完成。 Line Break/Hot Tapping
打磨钻孔作业
Emergency Phone Number/Channel 应急电话: 0531692677(HSE) 0557489528(CONSTRUCTION)
Other: ________________________________
Assembly Point 紧急集合地点: ERROR PRECURSORS/POTENTIAL ISSUES LICENSES/CERTIFICATIONS REQUIRED
Fire Extinguisher Location:灭火器地点 Change Departure 转变 Crane Operator 吊车操作工
Repetitive Routine 程序重复 Heavy Equipment 重型设备
Eye Wash Location 洗眼台: from Routine Crane Signal Person 吊车信号工
Actions/Monotonous 单调 Signal Persons 信号工
First Aid Location:急救点
Complacency 自满 First Aid/CPR 应急救援
Other 其他应急设施: Rework Powder Actuated 粉驱工具
Emergency Responders 应急响应人员: Confusing/Congested Forklift Operator 叉车操作手
Simultaneous Tool User
Rescue Plan 应急方案 Work AreaOperations Hazardous Waste
Rigging
Return to your HSE Department upon completion of this task. 风险废弃物吊装
High Workload 过载 Heavy Equipment
作业完成后关闭 STA 并上交 HSE 部 Time Pressure (in a Traffic Control 交通控制

CHECK AND DISCUSS ALL THAT APPLY 检查并讨论下面主题 Illness/Fatigue 疾病疲劳 hurry) Operator
Vehicle Operator 车辆操作手
LIFE CRITICAL OPERATIONS PERMITS REQUIRED Lack of Proficiency/Unclear Communication 生 Other ________________________________
Aerial Lifts 升降机 Sandblasting/Painting 喷砂除锈 疏，缺乏交流
LineBreak/Hot Tapping Live Electrical Work 带电操作 Inexperience/Training 无经验/培训
打磨钻孔作业 PERSONAL PROTECTIVE EQUIPMENT
Unclear Direction 无指导作业
Confined Space Entry Break-In 磨合 Lockout/Tagout Mental Shortcuts 错误捷径 CLOTHING FOOT PROTECTION 衣 服
Loading/Unloading Material 挂牌上锁 Unclear Roles/规则不清楚 和鞋保护
New Technique, Not Responsibilities High Visibility 高能见度
Cranes/Lifting/ Rigging 吊装作业 Safety Data Sheet 安全数据单
Substantial Footwear 劳保鞋
Overhead Power Lines 电力线路架空
Used Before 新设备 Fire Retardant 防火材料
Unclear Standards Safety-toed Boots 脚趾保护安全鞋
Electrical Work 电工作业 Confined Space Entry Radiation Work
受限空间作业射线探伤作业 Non-Routine Task 非日常任务 Chemical Resistant 耐化学性
Motorized Heavy
Grating/Floor Plate/钢格栅/底板 Critical Crane Lift Roof Work Unexpected 不可预期的 Metatarsal Protection 跖骨保护
吊装作业屋顶作业 Personality Conflicts 性格冲突 EYE/FACE 眼睛和面罩保护
Equipment/Human 设备/人 Equipment Condition 设备状况 Chemical Resistant 耐化学性
Guardrail Removal 护栏拆除 Excavation/Trenching Scaffolds Unfamiliar with Task/First Time Safety Glasses 安全眼镜
Machine Interface 机器接口 开挖作业脚手架作业 Electrically Insulated 电绝缘
Hazardous Energy Control 危 险 能 源 控 制 Fall Protection Plan Face Shield 面罩
防坠计划 Goggles 护目镜
OTHER HSE CONCERNS/TASKS
Trenching/Excavation 开挖 Signs/Barricades 标识、维护 Welding Hood 焊接面罩
Working at Height 高处作业 t Grating/Floor Plate/钢格栅/底板 FALL PROTECTION
Chemical Exposure 化学暴露 Full Body Harness 安全带
Suspended Personnel 停工人员 Mechanical PinchPoints 机械割伤

Copyright © 2015, Fluor Corporation. Page 4 of 4 Health, Safety, and Environmental Copyright © 2015, Fluor Corporation. Page 1 of 4 Health, Safety, and Environmental
All Rights Reserved. Form Date: 6Oct2015 Rev. Ref. No.: MPP-STA-06102015 All Rights Reserved. Form Date: 6Oct2015 Rev. Ref. No.: MPP-STA-06102015
 Form 000.653.F0101Form 000.653.F0101
Safety Task AssignmentSafety Task Assignmen MA’ADEN FIRE EMERGENCY SERVICE 0539176001/0136686230
Demolition 拆除
HEARINGHEAD 听力和头部保护
Dust/Fumes 灰尘烟雾 Ear Plugs 耳塞
Powder Actuated Tools 粉粹工具 PERMIT NUMBERS 作业票号
Environmental 环境 Hard Hat 安全帽 Ear Muffs 耳罩
Safe Works 安全作业
Power Lines 电力线
Erosion 侵蚀 HAND 手保护 RESPIRATORY 呼吸保护 Hazardous Works 风险作
Power Tools 电动工具 业
Falling Objects 高处坠落 General Duty 一般保护 Confined Space Entry
Pressurized Equipment 加压设备 Disposable 一次性 受限空间作业
Flammable Material 易燃材料 Work Gloves 劳保手套 Critical Crane Lift 吊
Sanitation 环境卫生 Half Face 半面罩 装作业
Grinding 打磨 Cut Resistant 防割伤劳保 Excavation/Trenching
Steel Erection 钢结构装配 Full Face 全面罩 开挖作业
High Pressure Cleaning 高压清洗 Chemical Resistant 化学耐性 Grating/Floor Plate
Tank/Pipe Testing 罐体/管道试验 Supplied Air 供风 钢格栅平台
Housekeeping 文明施工 Thermal/Welding 热焊接 Live Electrical Work
Toxic Exposure 毒雾接触史 Other ________________ 带电作业
Ignition Sources 着火源 Electrical Work Gloves 电工手套
Lockout/Tagout 挂牌上锁
Traffic Management 交通控制 ___________________________
Other
Insects/Vermints 昆虫
INSPECTIONS REQUIRED 其他:
Waste Streams 废水
Ladders/Scaffolds 梯子/脚手架 Aerial Lift 升降车 Ladder 梯子
Weather Conditions 天气状况 TASK STEPS 作业描述
Lead Exposure 铅暴露 Crane 吊车 Motor Vehicle 机动车辆
Working In Cold/Heat 寒冷、炎热处作业
Manual Handling 手工搬运 Electrical Leads/ Equipment 电线/设备
Working with Sharps 使用锋利工具 Respirator 呼吸机
Document Required 文档要求
Utility Locators 工具定位 Rigging 吊索具
Safety Data Sheet 安全数据单 Excavation 开挖
Sound Barriers 声障 Scaffolding 脚手架
Scaffolds 脚手架 Fall Protection 坠落防护
Marine Operations 船舶操作 Welding Equipment 焊接设备
Live Electricals 带电 Forklift 叉车
Other ____________
HAZARDS 潜在风险
Heavy Equipment 重型设备
_________________

HAZARD CONTROLS

HAZARD CONTROLS 风险控制

Copyright © 2015, Fluor Corporation. Page 4 of 4 Health, Safety, and Environmental Copyright © 2015, Fluor Corporation. Page 1 of 4 Health, Safety, and Environmental
All Rights Reserved. Form Date: 6Oct2015 Rev. Ref. No.: MPP-STA-06102015 All Rights Reserved. Form Date: 6Oct2015 Rev. Ref. No.: MPP-STA-06102015