FORM

Pre-Job Safety Meeting Form

Region : Department:
Netcore Management System
DOC No: NISNL/QHSE/JSA/FO/001
Nigeria Coiled Tubing, Pumping & N2
Owner: Aproved by: Job Revision By: Rev Date: Rev No: Page:
Austin E. Ochuko O. 07 JULY 2021 2.0 1 of 5
Dumbari N
TOOL BOX TALK FORM HAZARD/ RISK IDENTIFICATION Critical Focus Area
Work Location
Lifting Operations Are required Barriers in place?

Forklift Operations If a barrier is lost, immediately stop, assess and

fix it if it's safe to do so.
Work Activity
Equipment or connections under pressure Know your well control equipment and confirm
it’s certified and tested.

Manual handling Inexperienced personnel Are hydrocarbons controlled to surface?

Hot Work Know and communicate subsurface

uncertainties

Working at Height No Trapped Pressure? Carefully bleed lines

prior to rigging down.

Use of Ladder(s) ‘Walk the line’ on temporary rig-ups and

confirm set-up = layout drawing

Conditions which can result in a slip, trip or fall Drilling trajectory not interfering with
neighbour wells

Activities near objects that may move/fall Perform risk assessments during planning and
for any changes

Electrical equipment Are safety measures in place to control

radiation?

Substances hazardous to health Are safety measures in place to control

explosives?

Explosives or radiation Test your emergency responses and conduct

regular drills

Activities that could impact the environment Use MOC for any on the job systems / process/
equipment/ personnel changes .
DATE / TIME TBT Leader
Activities in an area with poor lighting Confirm all people are trained and competent
for the task.

Restricted or Confined Spaces Report Wells Process Safety incidents –

investigate, share, learn.
JSA reference Permit to Work reference
Use of Nitrogen (Trapped Pressure)
Are the tools and meterial needed at the task
site
Other Hazards (e.g. simultaneous operations) Are procedures and manuals up to date?
Lift Plan reference Other Doc. Reference

HOC - complete and return these as directed.

 Title. Name Originator:
JSA Date:
Complete /Review the JSA and identify all hazards and control
measures for the specific task to be carried out.
TARGETS: P – People • E – Equipment • ENV – Environmental • M – Location.
Materials • DT – Downtime All personnel have the authority to STOP a job if
they are concerned about the safety of an operation

Hazard / Hazard Effect Immediate Risk Risk Reduction Control Residual Risk
Task
Environmental Aspect / Impact Target Severity Prob. RPC Measures Severity Prob. RPC Accept

POTENTIAL CONSEQUENCES PROBABILITY RATING

Hazard Descrip- tive Personal Equipment Environmental A B C D E F
Severity reason. Extreme
Word Illness / Injury Loss(s) (Any incident that...) Frequent Occasional Remote Impossible
Category Probable Improb.

Cata- Fatal or perm. Potentially harms or adversely affects the general public and has the potential for
1
strophic
disabling injury / >$ 1,000,000 widespread public concern of Net Core operations. Can have serious economic 1 1 1 2 3 3
illness liability on the operation.

$200,000
Severe injury Potentially harms or adversely affects trained employees and the environment.
2 Critical
or illness
to $
Requires specialised expertise or resources for correction. 1 1 2 3 3 3
1,000,000

$10,000
Minor injury Presents limited harm to the environment and requires general expertise and
3 Marginal
or illness to resources for correction. 2 2 3 3 3 3
$200,000

No injury or Presents limited harm to the environment and requires minimum corrective
4 Negligible
illness
<$10,000
actions (CPI). 3 3 3 3 3 3
 No injury or Presents limited harm to the environment and requires minimum corrective
4 Negligible
illness
<$10,000
actions (CPI). 3 3 3 3 3 3
Safety Meeting Attendance Sheet Date:
S/N Name Employee Present Signature Position / Job Role

Detail any alert /engineering bulletins discussed: Enter Bulletin Number:

Safety Meeting Attendance Sheet
S/N Name Employee Present Signature Position / Job Role
Safety Meeting Attendance Sheet
S/N Name Employee Present Signature
Position / Job Role
Conducting an Effective Pre-Job Safety Meeting
Follow these quick steps with pre-job meetings so that meetings are effective in ensuring your team understands wh
1.       Prepare yourself.
a)      Have a sign-up sheet listing all expected names onsite for your crew with blank spaces available for visitor, this ca
b)      Know the Hazards onsite for the job (use HSE guideline form.)
c)       Roles / Responsibilities – All personnel on site must have a reason for being onsite. All to be listed/ confirmed on
d)      Work scope – Briefly tell all what we are going to do with expected job parameters.
e)      Request Feedback.
2.       Deliver the Pre-Job Meeting
a)      Have everyone gather around in a circle, stand up wind, noise has been reduced, ask if all can hear.
b)      Headcount Required. Everyone is to sign the signup sheet, will confirm # of personnel onsite. Detail the muster ar
3.       Talk about the Onsite Hazards / Controls in Place.
a)      PPE used by all. In addition, Hearing protection, dust masks, face shields, goggles to be used where required and
b)      Safety Signs in place, review red zone, minimize time in, Chemical area identified.
c)       Pressure, pumping iron is 15k rated/certified, iron has been walked, know rating.
d)      Chemicals – MSDS, Safety showers in place, PPE for chemicals used, Chemical area identified. Safety Showers in p
e)      Ignition sources – Fuel, all units fueled up, no refueling during this job, No smoking other that at designated area
f)       Environment – wind direction, temperature, water, shade, etc.
g)      Other? Any vehicle movement? Any crane movement? Wind? Extra hot day?
4.       Roles and Responsibilities.
a)      The signup sheet can include on site job function. Confirm with each crew member what they are going to do. Eac
5.       Work Scope
a.       Briefly inform all on what the planned work scope is, for example “After this meeting we will go to our stations,
is 6,000psi whilst milling at 10,500ft depth at 2bpm. Plan to pump FR with gel sweeps every 100ft. Finally pum
6.       Request Feedback from OCR/Visitors
7.       Meeting closed
8.       Deliver Post Job Meeting.
a.       Gather all personnel together and discuss the job just performed, the goods and the needs improvement.  
b.      Assign people to tasks and review necessary JSA to tasks.
c.       Discuss anything out of the normal like working with other PSL or 3 rd party in the same area
ng your team understands what will happen next.

aces available for visitor, this can be a duty of the engineers to ensure all names are on the sheet and is circulated for signatures. This is th

. All to be listed/ confirmed on what they are doing.

ask if all can hear.

nnel onsite. Detail the muster areas and responsibility of counting personnel if needed at muster area to engineer.

to be used where required and appropriate

a identified. Safety Showers in place. Buddy system in place.

ng other that at designated area and not during the job. Fire extinguishers are positioned/certified, no mobile phones on location

r what they are going to do. Each crew member to confirm they understand.

eting we will go to our stations, perform a radio check. Max. expected pump pressure
sweeps every 100ft. Finally pump 1.5 times well volume prior to POH.”

he needs improvement.  
ulated for signatures. This is the confirmation of the headcount onsite.

e phones on location
Date Issued Rev. No. Summary of Key Revisions
10-Feb-15 3 Updated document references from B&C to HPS
27-Apr-16 3 Document reviewed and no changes required

To obtain a copy of a previous version of this document, please contact GPASQM