,

PREJOB SAFETY INSTRUCTION LIST (LABOR PROTECTION, FIRE AND INDUSTRIAL SAFETY)

:
Foreman: T :
:
/ Day Start of
Trkulja Goran Shift: / Night works: 20-07 08.00
(, ... / Position, Surname ,Nam) ( / Sign) ( / Date) ( / Time)

: /, , , , ,
Subject for current date: MK
3300-C3ACOMMO-L12-00003-00-D REV03R,3300-3ACOMMON-L12-00015-00-D_03,3300-C3ACOMMON-L12-00017-00-D_02,3300-E51WCOMMO-L12-00014-00-D_REV02
( / Description of works and working conditions)

:
Description of job location: TRAIN 1/114 SST 014, 111 PAU 002,146 SPP 001,002, JETTA (PRIAL)

(, , , , / Site, area, unit, facility, building)

/ Actual workplace hazards:

1,8 / , //
Workplaceatheightmore 1,8m , / 5 750 / 1,1 / Height of protection
Workareaaboveequipment, structures, Elevation/descending at / from height of more rail is less than 1,1m or absent
materials than 5m by stairs inclined 750 and more
( / / Swinging
) / Fall factor LackofHeight Factor back after falling (pendulum factor) 2 /
(characterization of height of possible falling) Workplace is situated closer than 2 m from
unfenced areas with height difference
, , , ,
/ / / Constrainedaccessto workplace / Items, work pieces, tools,
Openableorclosedhatches, Insecurityofanchorage, which mayfall from above
manholesinworkarea attachmentpointofsafetyharness
, , , / , /
Movingitems, materials / Uneven, slipperyworksurface Moving machinery, mechanisms Deteriorated, fragile structures
/ High light ,
/ Highvoltageinthecircuit intensity / Excesspressure in the vessels and Dangerous, harmfulchemicals
equipment
/ t 0
/ t 0
/ /
/ Veryhigh / verylowambientt0 , / Increasednoise level Increased vibration level
Very high / very low t0of surface of equipment,
materials
, ,
/ Worksorequipment, , / Flying particles , , / Highvoltageinthecircuit
producingignition ofdisintegrated materials, equipment / Flying sparks, molten metal
splashes, particles, fragments
- / ,
/ / High / High concentration of harmful / Insufficient contentof / High dust content, gas
concentration of explosive and fire hazardous vapors /gases oxygen in work environment contamination
vapors /gases
/ , , ,
/ Insufficient illumination of work area Severe weatherconditions / Sharpedges, , / Uneven,
burrsofworkpieces, toolsandequipment slipperysurfaceofwalkwaysandworkingarea

, /
(), / Deterioratedearth (soils), / Workinginaconfinedspace / Open wells/boreholes, /
stones excavations/earthworks Intakeofdangerousand/or harmful products
from adjacent production areas
() / Others (toberecorded, if any):

, / Equipmentandtools:
/ / , , / / Drill rig / Gas
Constructions for lifting Excavating machine Man lift, lifting tower, basket cylinders
, / Stairs, , / Scaffold, / Rigid /
ladders trestle / Temporarybarricade attachment line Flexibleattachment line
/ / /
Grinding machine Hand-heldpower / Handimpacttools / / Primary
Gascutting/Weldingequipment fire-fighting tools
/ , () / Others (to be recorded, if any):
/ LOTOequipment / Lightingequipment for work
place, alarmsand communication

, / JobSafetySystems, PPE:
/ Special cloth / Protective hardhat / / / Protective
Protectivefootwear(boots or shoes) goggles / Shield
/ Protective gloves / / Respirator / / Ear protection (muffles) / / /
gas mask Weldergoggles / mask / shield
/ Safety harness / /
/ ShockAbsorberLanyard Safetylanyardtractiondevice
Weldershieldwithenforcedairsupply
/ , / Forked Lanyard
Protectionforcrawling , / Steelrope, fire- Evacuationandrescuesystem
proofedsling, chain
()
/ Specific conditions for current date:

,
Recordofattendees.Labor protection, fire and industrial safety in working process
: , , ,

IMPORTANT:By undersigning this document, I confirm that I have received complete information about job, hazards and I clearly understand job tasks
/ /
/ NAME / Craft
Instructor Attendee

Trkulja
1.

6
Goran
Trkulja
2.

.
6
Goran
Trkulja
3.


6
Goran
Trkulja
4.


6
Goran
Trkulja
5.


6
Goran
Trkulja
6.

6
Goran


Trkulja
7.
6

Goran
Trkulja
8.


6
Goran
Trkulja
9.

6
Goran
Trkulja
10.



Goran
Trkulja
11.

Goran
Trkulja
12.

Goran
Trkulja
13.

Goran
Trkulja
14.



Goran

Trkulja
15.

Goran

Trkulja
16.

Goran
17.

M
Trk,,,ulja
Goran
Trkulja
18.

/
Goran
/

Trkulja
19.

 Goran
Trkulja
20.

/
Goran
/ CONTROL LIST
( ,
Itshallbefilledduringinspectionofsafeoperation and compliance with safety requirements)

/ Yes | No
,
1. ,
Content of working
team corresponds to the above mentioned record list
HSEspecialist: 20-07
(, ... / Position, Surname ,Name) (/ Signatures) ( / Date)
2. Workers are instructed and authorised

3.
Workers are aware of possible hazards at the work place
Supervisor: Trkulja 20-07
4.
, Goran
Proper safety systems and PPE are applied (, .. ./ Position, Surname ,Name) (/ Signatures) ( / Date)

5.
All measures for safe operation stated in the instruction list corresponds to actual situation at the work place

6. All rules for safe operation are observed