BASF Contractor Pre-Access Checklist Purpose The purpose of this document is to ensure that BASF communicates all EHS requirements and expectations to each contractor company and that each contractor company understands them before work start-up. Also, each contractor must understand the partnership that their company and BASF have entered into, that it is unacceptable to be injured on our sites, and that it is imperative that they follow all rules and processes 100% of the time. Background Historical data shows that companies not familiar with policies, procedures and expectations associated with work on-site have contributed to a significant number of injuries. Required The company participating in work at this site should have a member of management and a safety representative present during the discussion. Contractor Company Name: (pre-job start time) Company Mgr. Name: Company Mgr. Phone Number: Company Mgr. E-Mail Address: Foreman s Name: Superintendent s Name: What is the work history of the project/job superintendent and or the job foreman? (previous work history) Who will be the project/job safety representative? (List name(s) and phone number(s).) Full Time Part Time Circle one. Safety Rep. Name Safety Rep. Name Circle and/or list current training for project/job safety representative or supervisor: CSST Certified CHST Certified OHST Certified Other: Does the safety representative have all applicable safety training for the work being performed? Yes No Circle one. If no, when will this training occur? Saved: 6/1/2015 3:55 PM Page 1 of 5
Who is the BASF business contact for the company performing the work, and how can he/she be contacted? (Include E-mail address if available.) BASF Contact Name: BASF contact in attendance? BASF Contact Phone Number: Yes No What will be the duration of the initial job? (two days, week, months, etc.) What is the block location, area, or unit of the initial job? Scope of Work Has ISTC conducted background check and have your employees completed WGSO or Basic Plus and BASFAP or BASFSA as appropriate for the site they will be working on? Yes No Circle one. If yes, circle (indicate) the training that will be applicable for the work being conducted. LOTO Scaffold (3 years) Aerial Lift(3 years) Confined Space (2 years) Excavation (once) Fire Watch (3 years) Forklift (3 years) Qualified Rigger (3 years) Heavy Equipment If no, proof of training must be provided to indicate training that has been completed before work begins on the BASF work site. When will training occur? Saved: 6/1/2015 3:55 PM Page 2 of 5
Managing Incidents and Accidents Procedure for Reporting Incidents or Accidents List those who need to be contacted in case of incident: 1. BASF Operations (permit issuer): 2. BASF Job Contact or Rep.: 3. BASF Security: 4. (Other) Employees must receive prompt medical evaluation for any injury or suspected injury. Incident Investigation Process. (Explain process to the pre-job receiver.) Has your company identified a medical provider in local area? Any contractor employee involved in an accident or incident must submit to a post-accident/incident substance abuse test. Steps leading to the test must include supervision escort to the testing location to assure chain of custody before testing. (Failure to comply will be grounds for removal from the site.) Saved: 6/1/2015 3:55 PM Page 3 of 5
Pre-Task Planning (PTP) or Job Hazard Analysis Process A Job Hazard Analysis (JHA) describes job tasks in step-by-step fashion, identifies associated hazards at each step, and outlines proper hazard controls that minimize/mitigate the risk of injury or illness to the individual(s) performing that task. All contract companies approved to work at BASF facilities via Safe Work Permits are required to complete the BASF PTP and individual JSA. Other common terms - Job Safety Analysis (JSA). The BASF Construction Engineer, BASF Maintenance Manager, BASF Contract Safety Representative, or designee will audit the PTP for the following elements: job/project title job location date crew members signoff task description / job step hazard description / hazard recognition for each task / job step hazard Controls / elimination / mitigation for each recognized hazard equipment / tools EH&S Safety Concept (All contract employees will complete, review, sign, and date the EH&S Safety Concept before performing any work. This is required for major project work) Policies Does your company have a copy of the Contractor Safety Manual? Yes No Did you issue a CD? Y or NA Did you issue a hard copy? Y or NA The on-site supervisor shall be familiar with the policies, rules, procedures, and guidelines set forth in the Contractor Safety Manual. (The supervisor will be held responsible for ensuring that his/her crew is familiar with the above mentioned polices, rules, procedures, and guidelines associated with the work that they are performing.) Personal Protective Equipment Policy for Contractors (Discuss and list minimum requirements for the site.) Hard Hat, Safety Glasses, Safety Toe shoes, Long Pants, Sleeved shirts, Gloves, Hearing protection. Saved: 6/1/2015 3:55 PM Page 4 of 5
Plant Emergencies 1. Discuss horns. 2. Discuss weekly test. 4 Eyes Process Big 5 1. Safe Work 2. Confined Space 3. Lock, Tag, and Try 4. Hot Work 5. Line and Equipment Breaking Scaffolds Removal from Site Contractor Firm (print) Contractor On-Site Supervisor or Foreman I have been informed of the requirements identified on this document and agree to these conditions for work on the BASF site. Print: Sign: Date / Time: EH&S Specialist or Rep. Comments: Issued EHS company business card? Yes or Issued Contractor Safety Manual? Issued BASF map? Yes or Yes or Saved: 6/1/2015 3:55 PM Page 5 of 5