Prepared By: Approval

TOOLBOX JHA
Technical Advisory Committee OEP Approval Board
Document Number Document Classification Document Level Revision NO. Issue Date:
GL-WFT-HSE-L4-02.01 Controlled L5 000 29 Nov 2012

Hazard / Risk Identification Hazard / Risk Management

Does the operation involve:
Bad Weather
PRIOR TO STARTING A TASK, ALL TEAM MEMBERS MUST
BE ABLE TO ANSWER YES TO THE FOLLOWING
TOOLBOX JHA
Ballistics Significant Hazards Identified? ✔

Bulk Fuels / Fuel Transfer Hazard Controls Identified? ✔

BEFORE STARTING THE JOB: Take 5
Bulk Liquids Responsible Persons for Controls Identified? ✔

Chemicals Pre-Requisite Controls in Place? ✔

Before starting a task, I will always take time to complete a TAKE 5
Cold / Hot Equipment Lines of Communication Clear and Agreed? ✔
Assessment, I will:
Communication Problem Chain of Command Clear? ✔
1. STOP - Engage brain before you act.
Confined Space Understand Operation? ✔
2. LOOK - Identify any hazards.
Dropped Objects Understand Role in Operation? ✔
3. ASSESS - What damage could those hazards cause?
Electrical Equipment ✔ Changes must be Communicated to All? ✔
4. MANAGE - Implement controls, tell others.
Energy Isolation / Lock Out Tag Out ✔ Comfortable with STOPPING the Job? ✔
5. SAFELY - Complete the task.
Equipment at Height Using the correct tools for the job? ✔

Explosives Using the correct PPE? ✔

If I am unable to complete any of the above, I MUST NOT proceed and
Hydrogen Sulphide will immediately speak with my supervisor for further instructions.
Lifting Equipment TEAM MEMBERS
Before starting a task, I will always remember that I am the last person
Lithium Batteries 1 Rajat 7 that can prevent an unsafe act; I will always take time to identify what
Manual Handling 2 Farhat 8 can hurt me and MUST not continue until I am sure that it can be done
Mast Unit / Crane Ops 3 Anish 9 safely.
Moving Objects 4 10
Noise 5 11 TOOLBOX OR JHA: TOOL BOX MEETING JHA
Poor Light / Restricted Space 6 12 WORKSITE: Rig 807
Potential Environmental Spill / Release LOCATION: mwp # 5
Pressure and PCE NOTES / COMMENTS: WFT LEADER: hEMANT
Radiation SUPERVISOR: RAJAT
Restricted Line of Sight OPERATION: PULLOUT
Rig Up / Rig Down Equipment DATE: 25-06-2019
Rotating Equipment TIME: 10;20
Simultaneous Ops. WIND DIRECTION:
Slip / Trip / Fall Potential ✔
MUSTER POINT(S):
Vehicles
Working at Height ✔ EMERGENCY CONTACT NUMBERS (24 HRS)
WEATHERFORD
What mechanism of injuries exist? CLIENT
Caught In Ignition DRILLING
Caught Between Inhalation
Caught On Overexertion Reviewed by (initial): Action Required:
Cuts / Lacerations Slip / Trip / Fall TAKE 5 PROMPT REMINDER WFT Leader Is a revision to the procedure
Explosion Struck Against REMEMBER TO REVIEW CARD: Supervisor required?
Exposure to Heat / Cold Struck By If conditions change Location YES NO
Fall from Height ✔ At regular intervals PROCEED WITH OPERATION? YES NO
© 2012 Weatherford All Rights Reserved Proprietary and Confidential.
 Prepared By: Approval
TOOLBOX JHA
Technical Advisory Committee OEP Approval Board
Document Number Document Classification Document Level Revision NO. Issue Date:
GL-WFT-HSE-L4-02.01 Controlled L5 000 29 Nov 2012

TOOLBOX JHA
USE THIS SECTION TO HIGHLIGHT AND SUMMARIZE THE SIGNIFICANT HAZARDS IDENTIFIED AND THE SUBSEQUENT CONTROLS REQUIRED

Procedure Reference: Permit To Work Number: 1483 Risk Assessment Reference: SOP Number:

Job to be Assessed: VFD AC # 3 BLOWER MOTOR BELT CHANGE

TASK HAZARD* CONTROLS RESPONSIBILITIES IN PLACE

The Steps involved in the Operation Identifying the Hazard Preventing the Hazard Who is taking Action? YES NO
PTW & LOTO MISS COMUNICATIONS FOLLOW PTW & LOTO C/E ✔

CLIMBING ON VFD UNIT FALL & TRIP USE FULL BODY HARNESS ALL ✔

OPEN VFD AC COVER CUTS USE PROPER HAND TOOLS AND PPE ALL ✔

LOOSEN DRIVE BELT PINCH POINTS USE PROPER HAND TOOLS AND PPE ALL ✔

REMOVE OLD BELT AND FIX NEW BELT PINCH POINTS USE PROPER HAND TOOLS AND PPE ALL ✔

TIGHT NEW BELT FIX COVER AV COVER PINCH POINTS AND CUTS USE PROPER HAND TOOLS AND PPE ALL ✔

CLOSE PTW AND REMOVE LOTO MISS COMUNICATIONS FOLLOW PTW & LOTO C/E ✔

RUN AND CHECK VRD AC FOR BELT NOISE NONE NONE ALL ✔

DEBRIEF SHIFT HANDOVER

Based on team debrief, can this task be improved? Yes No
Explain:

Name: RAJAT Name: ANISH Name: Name: Name:

Signature: Signature: Signature: Signature: Signature:
Name: FRAHAT Name: Name: Name: Name:
Signature: Signature: Signature: Signature: Signature:

* Any or all applicable hazards relating to health, safety, the environment and/or service quality should be noted and assessed.
© 2012 Weatherford All Rights Reserved Proprietary and Confidential.