JSA Samples for Steel Energy Services

Page 1

ThisdocumentisdesignedtoEliminate,Control,orProtect(ECP)againstthehazards intrinsictothejob/taskathand.

Division:

BHESNorth

BHESNDEmail: tyler.noah@steelteams.com;jeff.peterson@steelteams.com;gerardo.borja@steelteams.com; NDSuperintendents@steelteams.com;jon.matson@steelteams.com

RigNumber 305

LocationName:

LBJ24-14HU

JOBSAFETYANALYSIS(JSA)
Page 1

Date: Time(24hrs): 05/01/2023 07:23

Client: Shift:

Chord Day Night

Ifmorethanoneshift,additionalJSAisrequired

RigManager: CompanyMan/Consultant

DanAdkins

Ifhotworkisplanned,permitisrequired,orthereisaplannedliftover200lbsusedrop down.

RequiredPersonalProtectiveEquipment(PPE)

HardHat SafetyToeBoots ImpactGloves SafetyGlasses

FRClothing Goggles FaceShield ChemicalGloves ChemicalBoots

ChemicalApron HearingProtection FallProtection(IncSRL)

Respirator H2S/4-GasMonitor ExtremeHeat/ColdPrep

Liftingover200lbs ChemicalGoggles ChemicalFaceMask Other:

PPEOTHER:

PPEassessmentconductedby(initial):

Page 2
Pre-LiftCheck Yes/NA PersonnelResponsible Payload-EquipmentWeightVerified Yes N/A Pusher Operator Superintendant LiftingEquipmentinGoodCondition Yes N/A Pusher Operator Superintendant YT&MYTSlipGripElevatorsSize&Function Yes N/A Pusher Operator Superintendant SIMOPSJSAfortaskcompletedandsigned Yes N/A Pusher Operator Superintendant Approval/Permitgiven Yes N/A Pusher Operator Superintendant Weather/WindConditionsGood Yes N/A Pusher Operator Superintendant Liftareabarricadednoentry Yes N/A Pusher Operator Superintendant ContingencyPlaninplace Yes N/A Pusher Operator Superintendant EmergencyPlanifNeeded. Yes N/A Pusher Operator Superintendant IfliftingwithLoader-RatingofLoader verified Yes N/A Pusher Operator Superintendant IfliftingwithLoader-BackupAlarm Functioning Yes N/A Pusher Operator Superintendant IfliftingwithaLoader-Isthehorn functional? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-Seatbeltfunctioning? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-TiresinGood condition? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-FireExtinguisher functional? Yes N/A Pusher Operator Superintendant Page 3

IConfirmthattheliftplanhasbeenexplainedtome,thatwehavediscusseditandI understandtheoperationandmyroleandresponsibilityasitpertainstotheLiftingPlan

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

HASYOURRODTRANSFERSAFETYSYSTEM(RTSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TOTRIPPINGRODS"TOORFROM"THEDERRICK?

If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

RiggingCheck Yes/NA PersonnelResponsible LiftingEquipmentInspections/TagsCurrent Yes N/A Pusher Operator Superintendant RatingofSlingorLiftingChainVerified Yes N/A Pusher Operator Superintendant RatingofSlingorLiftingChainEXCEEDS ItembeingLifted? Yes N/A Pusher Operator Superintendant UsingCorrectLiftingEquipment Yes N/A Pusher Operator Superintendant LiftingEquipmentInspectedPriortoUse Yes N/A Pusher Operator Superintendant SlingAngle/Placement/WeightAcceptable Yes N/A Pusher Operator Superintendant Liftpoints/FixingsInspectedandApproved Yes N/A Pusher Operator Superintendant TagLinesattached Yes N/A Pusher Operator Superintendant
Name Signature Date EricDavis 05/01/2023 Xavierwaggoner 05/01/2023 Sergiooliveros 05/01/2023 JamesMyers 05/01/2023 Angelcastrellon 05/01/2023 EntereachtimethePosi-Stopwasset EnterN/AifPosi-Stopwasnotused WasthePosi-StopSet TopNumberReading BottomNumber Reading Signature Yes No 100 0 Yes No 100 0 Yes No 100 0
Yes No
Yes No Page 4

ISYOURRIGEQUIPPEDWITHANORANGECONETOBEPLACEDONTHEOPERATOR'SSTAND ALONGWITHAPLACARDONACHAINTOBEPLACEDONTHEOPERATOR'SCLUTCHVALVE HANDLEASAREMINDERIFTHEBOPRAMS(PIPEORBLINDS)AREOPENORCLOSEDPRIOR TORESUMINGOPERATIONS???-MUSTBECONFIRMEDEACHANDEVERYTIME!!!!

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM???

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM??? HESSRIGSPAYATTENTION

HASYOURBOPSAVERSAFETYSYSTEM(BSSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TO"MOVINGPIPE-AGAIN,DONOTMOVEPIPEUNTILTHISISCONFIRMEDEACH ANDEVERYTIME-LOOKATTHELIGHTSONTHEDISPLAYPANEL! If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

SAFETYALERTSCONFIRMATION

CONFIRMYOUHAVEREADTHELATESTSAFETYALERTSONTHETABLETBYPRINTINGYOUR NAMEANDSIGNINGBELOW

PrintName Signature

EricDavis

XavierWaggoner

Sergiooliveros

JamesMyers

Angelcastrellon

On Off
Yes No
Yes No
Page 5

1 CrewTravel CrewTravelHazards

Hittingwildlife,falling asleepwhiledriving, poppingtires,truck breakingdown, accidentswithother drivers

2 NippleDownBOP NipplingDownHazards

Partedpipewhilepulling over,parteddrillline whilepullingover, droppedblocks,hands caughtinbetweenslips, struckbyBOP,BOP fallingtotheground, struckbyloader,loader hittingequipment, trippingonice/scoria, h2shazard

CrewTravelMitigations

Defensivedriving,payattention, makesurethedriverisfitfor duty,makesurewholecrewis awakeintruck

NippleDownMitigations

Standbackwhilepullingover, completebrakeinspection, completedrilllineinspection, watchyourhandswhenbringing inslips,wearimpactgloves, inspectliftingequipment,make sureliftingequipmentsratings exceedtheloadbeinglifted, dontstandbetweenBOPand wellhead,100%spottersduring loaderops,qualifieddriverin theloader,wearicecleats,clear theareaofanylargechunksof scoria,makesurecreware wearingh2smonitorsand SCBA'sareinagoodlocation, knowthewinddirection

3 RigDownRig RigDownHazards

Struckbybasebeam, struckbyrig,hands crushedbyderrick, caughtlines,struckby loader,loaderhitting equipment,fallingfrom heights,handscrushed bylevelngjacks,rig fallingover,equipment crushedinfallpathofrig

RigDownMitigations

Dontstandbetweenbasebeam andwellhead,dontstand betweenrigandwellhead,watch handplacementandusegood communicationwhileleveling out,watchyourlinesanduse SWAifanythinggetscaughtup, checkwinddirectionbefore riggingup,domtspot equipmentwithinfallzones, 100%spotterswhileusing loaders,qualifieddriversonly usingloader,threepointsof contactwhileworkingat heights,100%tieoffwhile workingatheights

Step Task Hazard(s) (Eliminate,Control,orProtectECP)Controls (who,what,when)
Page 6

SSE(ShortServiceEmployees)orARE(AtRisk Employees)EmployeesPresent?

SSE/AREunderstandprocess? (SelectNoifnoSSE/AREarepresent)

Yes No Yes No

Oliveros

JobInvolvementbyanyThirdPartycompaniesoremployees?

Yes No

DropsLogBook-TooltrackingforitemstakenintotheDerrick

Yes No

BysigningthisJSAyouareacknowledging,understandthetaskslaidoutaboveandthat you'refitforduty.Byyoursignatureyoualsoindicatethatyoudidnotsustainany injuries!

VisitorLog

MentorName: SSEorAREName: XavierWaggoner Sergio
CrewMembersOnDuty NumberofCrewMembers 5 CrewMembers Employee: Position: Yearsof Experience: DaysonHitch: Sign: EricDavis Operator 5 10 XavierWaggoner Hamd 1 11 Sergiooliveros Fh 5m 1 JamesMyers Derrickhand 15 1 Angelcastrellon Op 16 1
Page 7

NearestHospitalandDirections: Stanley.Northonhwy8

RigLocation

EmergencyResponse/EvacuationPlan

(DirectionofTravel,MusterPoint,etc):

Crosswindandupwind.Doghouseorentrancetolocation

OtherSafetyConcerns/TopicsDiscussed:

(DirectionofTravel,MusterPoint,etc):

PostJob/TaskSummary

Incidents/NearMissesoccuredduringshift? (requireadditionaldocumentation)

Yes No

Yes No

DidyouinitiateanSWA(StopWorkAuthority)today?

Name Sign Company ReasonforVisit? TimeIn TimeOut DanAdkins Steel Supervisor 07:39AM Daniel Summit ESPTech 08:25AM
Page 8
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ThisdocumentisdesignedtoEliminate,Control,orProtect(ECP)againstthehazards intrinsictothejob/taskathand.

Division:

SWS

SWSEmail: jeff.peterson@steelteams.com;tyler.noah@steelteams.com;gerardo.borja@steelteams.com; NDSuperintendents@steelteams.com;jon.matson@steelteams.com

RigNumber 20

LocationName:

Blessings11-36H

JOBSAFETYANALYSIS(JSA)
Page 1

Date: Time(24hrs): 05/01/2023 07:36

Client: Shift:

Cord Day Night

Ifmorethanoneshift,additionalJSAisrequired

RigManager: CompanyMan/Consultant

VincentO'Donnell

FIRERISKASSESSMENT-APIRF54

PeterHorvath

Ifhotworkisplanned,permitisrequired,orthereisaplannedliftover200lbsusedrop down.

RequiredPersonalProtectiveEquipment(PPE)

HardHat SafetyToeBoots

ImpactGloves

FRClothing Goggles FaceShield

SafetyGlasses

ChemicalGloves

ChemicalApron HearingProtection FallProtection(IncSRL)

Respirator H2S/4-GasMonitor

Liftingover200lbs ChemicalGoggles

PPEOTHER:

PPEassessmentconductedby(initial):

ExtremeHeat/ColdPrep

ChemicalBoots

ChemicalFaceMask Other:

Page 2
Pre-LiftCheck Yes/NA PersonnelResponsible Payload-EquipmentWeightVerified Yes N/A Pusher Operator Superintendant LiftingEquipmentinGoodCondition Yes N/A Pusher Operator Superintendant YT&MYTSlipGripElevatorsSize&Function Yes N/A Pusher Operator Superintendant SIMOPSJSAfortaskcompletedandsigned Yes N/A Pusher Operator Superintendant Approval/Permitgiven Yes N/A Pusher Operator Superintendant Weather/WindConditionsGood Yes N/A Pusher Operator Superintendant Liftareabarricadednoentry Yes N/A Pusher Operator Superintendant ContingencyPlaninplace Yes N/A Pusher Operator Superintendant EmergencyPlanifNeeded. Yes N/A Pusher Operator Superintendant IfliftingwithLoader-RatingofLoader verified Yes N/A Pusher Operator Superintendant IfliftingwithLoader-BackupAlarm Functioning Yes N/A Pusher Operator Superintendant IfliftingwithaLoader-Isthehorn functional? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-Seatbeltfunctioning? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-TiresinGood condition? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-FireExtinguisher functional? Yes N/A Pusher Operator Superintendant Page 3

IConfirmthattheliftplanhasbeenexplainedtome,thatwehavediscusseditandI understandtheoperationandmyroleandresponsibilityasitpertainstotheLiftingPlan

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

HASYOURRODTRANSFERSAFETYSYSTEM(RTSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TOTRIPPINGRODS"TOORFROM"THEDERRICK?

If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

RiggingCheck Yes/NA PersonnelResponsible LiftingEquipmentInspections/TagsCurrent Yes N/A Pusher Operator Superintendant RatingofSlingorLiftingChainVerified Yes N/A Pusher Operator Superintendant RatingofSlingorLiftingChainEXCEEDS ItembeingLifted? Yes N/A Pusher Operator Superintendant UsingCorrectLiftingEquipment Yes N/A Pusher Operator Superintendant LiftingEquipmentInspectedPriortoUse Yes N/A Pusher Operator Superintendant SlingAngle/Placement/WeightAcceptable Yes N/A Pusher Operator Superintendant Liftpoints/FixingsInspectedandApproved Yes N/A Pusher Operator Superintendant TagLinesattached Yes N/A Pusher Operator Superintendant
Name Signature Date DaneReing 05/01/2023 SaulGutierrezflores 05/01/2023 JoseRodriguez 05/01/2023 JoseCamacho 05/01/2023 EntereachtimethePosi-Stopwasset EnterN/AifPosi-Stopwasnotused WasthePosi-StopSet TopNumberReading BottomNumber Reading Signature Yes No 100 0 Yes No 100 0 Yes No 100 0
Yes No
Yes No Page 4

ISYOURRIGEQUIPPEDWITHANORANGECONETOBEPLACEDONTHEOPERATOR'SSTAND ALONGWITHAPLACARDONACHAINTOBEPLACEDONTHEOPERATOR'SCLUTCHVALVE HANDLEASAREMINDERIFTHEBOPRAMS(PIPEORBLINDS)AREOPENORCLOSEDPRIOR TORESUMINGOPERATIONS???-MUSTBECONFIRMEDEACHANDEVERYTIME!!!!

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM???

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM??? HESSRIGSPAYATTENTION

HASYOURBOPSAVERSAFETYSYSTEM(BSSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TO"MOVINGPIPE-AGAIN,DONOTMOVEPIPEUNTILTHISISCONFIRMEDEACH ANDEVERYTIME-LOOKATTHELIGHTSONTHEDISPLAYPANEL! If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

SAFETYALERTSCONFIRMATION

CONFIRMYOUHAVEREADTHELATESTSAFETYALERTSONTHETABLETBYPRINTINGYOUR NAMEANDSIGNINGBELOW

PrintName Signature

DaneReing

SaulGutierrezflores

JoseRodriguez

JoseCamacho

On Off
Yes No
Yes No
Page 5

1 Crewtravel Hittingwildlife,falling sleepwhiledriving poppingtirestruck breakingdownaccidents withothersdrivers,

2 Rods Motion

Rodsswinginginhitting floorhand,rodsnot latchingproperly, slippingortrippingon somethingtailingrods in,blockshittingrod hangs,derrickhand gettinghandcaughton transferwhenmaking uprod,rodsnotmaking upproperly.

Mechanical

Rodtongsbreaking,rod tongsmalfunctioning, blocksnotstoppingin timeandhittingfloor hand,backuppin breaking,elevatorsnot latchingproperlyand rodsfallingoutof elevators

Gravity

Rodsfallingoutof elevators,fallingwhile tailinginrods,fallingoff floortransferbottle fallingoutofderrick whensendingitup,rods fallingoutofderrick, rodsrollingorfallingoff trailer,handtrippingand fallingofftrailer

(Eliminate,Control,orProtectECP)Controls (who,what,when)

Adjustspeedduetotheroad conditionswatchforwildlife checkoilbeforedrivingdoa walkaroundvehiclebefore

Motion

Alwayshaveachaintiedtothe unitandtherigwithasleeveor coveronitatalevelaboveorat therodtabletoavoidrods swinginginandhittingfloor hand,sleevetopreventmetalto metalcontact,Inspecttransfer bottlebeforesendingitup, derrickhandneverplacehand ontransferbottlewhilemaking uprods,placehandsabovethe swivel,alwayschecktorqueon firstrodofeverytapertoensure rodsarenotoverorunder torqued

Mechanical

Inspecttongsthoroughlybefore useforanycracks,wears,orand malfunctions,checkbrakesand adjustmentofbrakehandleto ensureblocksarestopping properly,checkthebackuppin foranycracksorwearinganddo notpulloutbackupswhilepinis stillin,inspectelevators thoroughlybeforeuseand functiontestbeforesendingrod up

Gravity

Neverstandunderrodasitis beingtailedin,keepaclearand levelwalkingpathatalltimes whiletailingrodsintoavoidany triphazardsorfallingwiththe rods,installtransfercable properlyontorodhooktoavoid thetransferfallingoutand dropping,securerodsproperly inderrickroavoidrodsfalling outofderrick,ensurerodsdo notgettooclosetotheedgeof thetrailersotheydonotfalloff trailer,trytoworkontopof traileraslittleaspossible,butif necessaryneverwalkotstand neartheedgeofthetrailerto avoidfallingoff,neverjumpoff trailerwhilegettingofftoavoid anyinjuries

Step Task Hazard(s)
Page 6

SSE(ShortServiceEmployees)orARE(AtRisk Employees)EmployeesPresent? SSE/AREunderstandprocess?

JobInvolvementbyanyThirdPartycompaniesoremployees? Yes No

DropsLogBook-TooltrackingforitemstakenintotheDerrick

BysigningthisJSAyouareacknowledging,understandthetaskslaidoutaboveandthat you'refitforduty.Byyoursignatureyoualsoindicatethatyoudidnotsustainany injuries!

VisitorLog

(SelectNoifnoSSE/AREarepresent) Yes No Yes No MentorName: SSEorAREName:
CrewMembersOnDuty NumberofCrewMembers 4 CrewMembers Employee: Position: Yearsof Experience: DaysonHitch: Sign: DaneReing Dh 5 1 SaulGutierrez flores Rm/Op 9 1 JoseRodriguez Fh 8 2 JoseCamacho Op 20 2
Yes No
Page 7

NearestHospitalandDirections: Trinitycommunityclinisnewtown RigLocation

EmergencyResponse/EvacuationPlan

(DirectionofTravel,MusterPoint,etc):

Entranceoflocationupwind.CRosswind

OtherSafetyConcerns/TopicsDiscussed:

(DirectionofTravel,MusterPoint,etc):

PostJob/TaskSummary

Incidents/NearMissesoccuredduringshift? (requireadditionaldocumentation)

Yes No

Yes No

DidyouinitiateanSWA(StopWorkAuthority)today?

ReasonforinitiatingSWA?

Heldasecondarytailgate.Meetingdiscussingprocedureofstrippingoverbops

Name Sign Company ReasonforVisit? TimeIn TimeOut Peter Horvath ChordEnergy WSS 07:00AM
Page 8
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Powered by

ThisdocumentisdesignedtoEliminate,Control,orProtect(ECP)againstthehazards intrinsictothejob/taskathand.

Division:

BHESNorth

BHESNDEmail: tyler.noah@steelteams.com;jeff.peterson@steelteams.com;gerardo.borja@steelteams.com; NDSuperintendents@steelteams.com;jon.matson@steelteams.com

RigNumber 307

LocationName: Ma

JOBSAFETYANALYSIS(JSA)
Page 1

Date: Time(24hrs): 05/01/2023 07:09

Client: Shift:

Oasis Day Night

Ifmorethanoneshift,additionalJSAisrequired

RigManager: CompanyMan/Consultant

MikePantoja

FIRERISKASSESSMENT-APIRF54

MikePantoja

Ifhotworkisplanned,permitisrequired,orthereisaplannedliftover200lbsusedrop down.

RequiredPersonalProtectiveEquipment(PPE)

HardHat SafetyToeBoots

FRClothing Goggles

ImpactGloves

FaceShield

ChemicalApron HearingProtection

Respirator H2S/4-GasMonitor

Liftingover200lbs ChemicalGoggles

PPEOTHER:

PPEassessmentconductedby(initial):

SafetyGlasses

ChemicalGloves

FallProtection(IncSRL)

ExtremeHeat/ColdPrep

ChemicalBoots

ChemicalFaceMask Other:

Page 2
Pre-LiftCheck Yes/NA PersonnelResponsible Payload-EquipmentWeightVerified Yes N/A Pusher Operator Superintendant LiftingEquipmentinGoodCondition Yes N/A Pusher Operator Superintendant YT&MYTSlipGripElevatorsSize&Function Yes N/A Pusher Operator Superintendant SIMOPSJSAfortaskcompletedandsigned Yes N/A Pusher Operator Superintendant Approval/Permitgiven Yes N/A Pusher Operator Superintendant Weather/WindConditionsGood Yes N/A Pusher Operator Superintendant Liftareabarricadednoentry Yes N/A Pusher Operator Superintendant ContingencyPlaninplace Yes N/A Pusher Operator Superintendant EmergencyPlanifNeeded. Yes N/A Pusher Operator Superintendant IfliftingwithLoader-RatingofLoader verified Yes N/A Pusher Operator Superintendant IfliftingwithLoader-BackupAlarm Functioning Yes N/A Pusher Operator Superintendant IfliftingwithaLoader-Isthehorn functional? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-Seatbeltfunctioning? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-TiresinGood condition? Yes N/A Pusher Operator Superintendant IfliftingwithLoader-FireExtinguisher functional? Yes N/A Pusher Operator Superintendant Page 3

IConfirmthattheliftplanhasbeenexplainedtome,thatwehavediscusseditandI understandtheoperationandmyroleandresponsibilityasitpertainstotheLiftingPlan

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

HASYOURRODTRANSFERSAFETYSYSTEM(RTSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TOTRIPPINGRODS"TOORFROM"THEDERRICK?

If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

RiggingCheck Yes/NA PersonnelResponsible LiftingEquipmentInspections/TagsCurrent Yes N/A Pusher Operator Superintendant RatingofSlingorLiftingChainVerified Yes N/A Pusher Operator Superintendant RatingofSlingorLiftingChainEXCEEDS ItembeingLifted? Yes N/A Pusher Operator Superintendant UsingCorrectLiftingEquipment Yes N/A Pusher Operator Superintendant LiftingEquipmentInspectedPriortoUse Yes N/A Pusher Operator Superintendant SlingAngle/Placement/WeightAcceptable Yes N/A Pusher Operator Superintendant Liftpoints/FixingsInspectedandApproved Yes N/A Pusher Operator Superintendant TagLinesattached Yes N/A Pusher Operator Superintendant
Name Signature Date Jesusbencomo 05/01/2023 AbimaelLozano 05/01/2023 Franciscoochoa 05/01/2023 Joelretana 05/01/2023 MikePantoja EntereachtimethePosi-Stopwasset EnterN/AifPosi-Stopwasnotused WasthePosi-StopSet TopNumberReading BottomNumber Reading Signature Yes No 156 0 Yes No 145 0 Yes No 145 0
Yes No
Yes No Page 4

ISYOURRIGEQUIPPEDWITHANORANGECONETOBEPLACEDONTHEOPERATOR'SSTAND ALONGWITHAPLACARDONACHAINTOBEPLACEDONTHEOPERATOR'SCLUTCHVALVE HANDLEASAREMINDERIFTHEBOPRAMS(PIPEORBLINDS)AREOPENORCLOSEDPRIOR TORESUMINGOPERATIONS???-MUSTBECONFIRMEDEACHANDEVERYTIME!!!!

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM???

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM??? HESSRIGSPAYATTENTION

HASYOURBOPSAVERSAFETYSYSTEM(BSSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TO"MOVINGPIPE-AGAIN,DONOTMOVEPIPEUNTILTHISISCONFIRMEDEACH ANDEVERYTIME-LOOKATTHELIGHTSONTHEDISPLAYPANEL! If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

SAFETYALERTSCONFIRMATION

CONFIRMYOUHAVEREADTHELATESTSAFETYALERTSONTHETABLETBYPRINTINGYOUR NAMEANDSIGNINGBELOW

PrintName

Signature

Jesusbencomo

AbimaelLozano

Franciscoochoa

Joelretana

MikePantoja

On Off
Yes No
Yes No
Page 5

1 LSR Driving Driving

2 Rigup

1a)Cablecouldget caughtandbreakor breakwhatitgets caughton.MOTION

1b)Strainedbackwhen liftingjackstandsand boards.GRAVITY

1c)Slickandmuddy surfacesaroundrigand location.Buriedobjects inthesnow

3 Tripoutofholewithrods TripRods

1a)Operatorcould crownoutordrop blocks.MOTION

1b)Pinchpointswith tongs,rodhook, elevators,rodelevators settingonrodtable. MECHANICAL

1c)operatorcouldpart transferlinewhen trippingrods.MOTION

1a)Haveeveryoneintherespot, watchingallcables,keepgood communicationwitheachother andwithoperator.PROTECT

1b)Useproperlifting,gethelpif needed.Useloaderforallheavy objects.ELIMINATE

1c)Watchfooting,walkslowerif needed.Gethelpcarringboards andjackstands

1a)OperatormustsetPOSI STOPandtestit,beforetripping anyrods.ELIMINATE

1b)knowwhereallpinchpoints areat.Keephandsandbody positionclearatalltimes.Wear ImpactGlovesandallPPEatall times.PROTECT

1c)SetRTSSandtestit.Derrick handneedstoflagtransferline soit'svisibletotheoperator. Floorhandneedstokeeprod elevatoronuntilDerrickhand removestransferbottle.

4 Loaderoperations

1a)loaderattachment maynotbelockedin properlyandcouldfall offwiththeload. GRAVITY

2a)Backingintoor runningoversomething withloader.MOTION

3a)loadcouldfalloff forkswhenmovingthe load.MOTION

1a)ensureloaderattachmentis onand100percentlockedin andsecuredbeforepickingup anyload.ELIMINATE

2a)Haveaspotteratalltimes whenmovingloader.Haveclean widowsandmirrorsonloader. ELIMINATE

3a)Secureloadontheforks beforemoving,5MPHon locationwithloader.PROTECT

Step Task Hazard(s) (Eliminate,Control,orProtectECP)Controls (who,what,when)
Page 6

SSE(ShortServiceEmployees)orARE(AtRisk Employees)EmployeesPresent?

SSE/AREunderstandprocess? (SelectNo

JobInvolvementbyanyThirdPartycompaniesoremployees? Yes No

DropsLogBook-TooltrackingforitemstakenintotheDerrick Yes No

BysigningthisJSAyouareacknowledging,understandthetaskslaidoutaboveandthat you'refitforduty.Byyoursignatureyoualsoindicatethatyoudidnotsustainany injuries!

VisitorLog

TrevorHall

Tomas Martinez Chordenergy Safetyvisitq

if
SSE/ARE
Mentor
SSE
Name:
no
arepresent) Yes No Yes No
Name:
orARE
CrewMembers
Duty NumberofCrewMembers 5 CrewMembers Employee: Position: Yearsof Experience: DaysonHitch: Sign: Jesusbencomo Ro 3 1 AbimaelLozano Operator 10 1 Franciscoochoa Dh 3 11 Joelretana Op 7 11 MikePantoja RM 22 11
On
Name Sign Company ReasonforVisit? TimeIn TimeOut
Page 7

NearestHospitalandDirections:

TiogaND

RigLocation

EmergencyResponse/EvacuationPlan

(DirectionofTravel,MusterPoint,etc):

Entrancetolocation

OtherSafetyConcerns/TopicsDiscussed:

(DirectionofTravel,MusterPoint,etc):

PostJob/TaskSummary

Incidents/NearMissesoccuredduringshift? (requireadditionaldocumentation)

Yes No

Yes No

DidyouinitiateanSWA(StopWorkAuthority)today?

Powered by www.doForms.com

Page 8

ThisdocumentisdesignedtoEliminate,Control,orProtect(ECP)againstthehazards intrinsictothejob/taskathand.

Division:

BHESNorth

BHESNDEmail: tyler.noah@steelteams.com;jeff.peterson@steelteams.com;gerardo.borja@steelteams.com; NDSuperintendents@steelteams.com;jon.matson@steelteams.com

RigNumber 309-1

LocationName: Hansen

JOBSAFETYANALYSIS(JSA)
Page 1

Date: Time(24hrs): 05/01/2023 18:25

Client: Shift:

Whiting Day Night

Ifmorethanoneshift,additionalJSAisrequired

RigManager: CompanyMan/Consultant

Richardcarrasco

FIRERISKASSESSMENT-APIRF54

DavidPittman

Ifhotworkisplanned,permitisrequired,orthereisaplannedliftover200lbsusedrop down.

RequiredPersonalProtectiveEquipment(PPE)

HardHat SafetyToeBoots ImpactGloves

SafetyGlasses

FRClothing Goggles FaceShield ChemicalGloves

ChemicalApron HearingProtection FallProtection(IncSRL)

Respirator H2S/4-GasMonitor

ExtremeHeat/ColdPrep

ChemicalBoots

Liftingover200lbs ChemicalGoggles ChemicalFaceMask Other:

PPEOTHER:

PPEassessmentconductedby(initial):

EntereachtimethePosi-Stopwasset EnterN/AifPosi-Stopwasnotused

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

ISYOURRIGEQUIPPEDWITHARODTRANSFERSAFETYSYSTEM(RTSS)?

HASYOURRODTRANSFERSAFETYSYSTEM(RTSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TOTRIPPINGRODS"TOORFROM"THEDERRICK?

If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

ISYOURRIGEQUIPPEDWITHANORANGECONETOBEPLACEDONTHEOPERATOR'SSTAND ALONGWITHAPLACARDONACHAINTOBEPLACEDONTHEOPERATOR'SCLUTCHVALVE HANDLEASAREMINDERIFTHEBOPRAMS(PIPEORBLINDS)AREOPENORCLOSEDPRIOR TORESUMINGOPERATIONS???-MUSTBECONFIRMEDEACHANDEVERYTIME!!!!

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM???

WasthePosi-StopSet TopNumberReading BottomNumber Reading Signature Yes No 101 0 Yes No 101 0 Yes No 101 0
No
Yes
Yes No
On Off
Page 2

ISYOURRIGEQUIPPEDWITHABOPSAVERSAFETYSYSTEM??? HESSRIGSPAYATTENTION

HASYOURBOPSAVERSAFETYSYSTEM(BSSS)BEENTESTEDANDISITFUNCTIONING "PRIOR"TO"MOVINGPIPE-AGAIN,DONOTMOVEPIPEUNTILTHISISCONFIRMEDEACH ANDEVERYTIME-LOOKATTHELIGHTSONTHEDISPLAYPANEL! If"NO"isselectedYOUMUSTnotPROCEEDwiththeJOB-STOPWORKIMMEDIATELY!!!

SAFETYALERTSCONFIRMATION

Yes No
Yes No
Page 3

1 Lsr Lineoffire

KeepyourselfandothersOutof thelineoffire

Ipositionmyselftoavoid movingobjects

Vechicles

Pressurereleases

Droppedobjects

Iestablishedandobeybarriers andexclusionzones

Itakeactiontosecureloose objectsandreportpotential droppedobjects

2 Lsr Workingatheights

Protectyourselfagainstafall whenworkingatheights

Iinspectmyfallprotection equipmentbeforeuse

Isecuretoolsandwork materialstopreventdropped objects

Itieoff100%toapproved Anchorepointswhileoutsidea protectedarea

3 Inspections

BRAKE/DRILLLINE HAZARDS

Failuretoinspectbrakes anddrilllinepriorto startingwork.

Failuretotestposistop. Droppingblocks.

4 Loaderops LOADERHAZARD

Speedingonlocation. Failuretousespotter. Failuretoinspectloader orperformwalkaround priortousing.

Failuretoinspectlifting equipment.

BRAKE/DRILLLINE

Alwaysdoagoodbrakeandand drilllineinspectionpriorto startingwork. Setandtestposistop. Ifanythingfeelsorlookswrong stopthejob.

LOADER

Nospeedingonlocation.5mph speedlimit. Alwaysusespotter. Alwayscheckfluidsandperform awalkaroundloaderpriorto moving.

Alwaysinspectliftingequipment beforeusing.

Nopiggyridingloader. Checkpinsandinspectdifferent loaderattachments.

Step Task Hazard(s) (Eliminate,Control,orProtectECP)Controls (who,what,when)
Page 4

6 Layingdowntubing

Wrangleroperations. Miscommunicationwith wrangleroperator. Inadequatehand signals.

Pipefallingoffracks. Personnelwalking underneathwrangler.

WRANGLEROPERATIONS

alwayskeepgood communicationwithwrangler operator.

Useadequatehandsignals whencommunicating. Alwayshavesafetystopperson piperackstoavoidpiperolling off.

Inspectwranglerpriortousing. Flagoffnonwalkingareas aroundwrangler.

Nocommunicationwith eachother Slipsnotsetright Elevatorsnotlatched right

Pose-stopnotset Torquenotsetright Pinchpoints

Strikezones

Badhandsignals

Notlookingupup Suspendedloads

Hydraulicleaks

Notlockingslipswhen pipelight Weather conditions

Havegoodcommunicationwith eachotheralwaysmakesure slipssetgoodbeforebefore unlatchingelevatorsalways doublecheckelevatorsmake suretheyarelatchedupgood  alwaysmakesurepose-stopis setbeforestartingwork

Makesureyourtorqueisset rightwatchwereyouplaceyour handsanfingerssodon'tpinch thembetweenorsmashsmash thembetweenpipeantongsor elevatorsantongs

Usegoodhandsignalswith wrangleroperator

Neverstandunderneaththe pipewhenitisgettingpickedup  Alwayslookupsoyoudon'thit thetubingboard

Whenyouarepipe lightmake sureyouarelockingtheslips

Beawearoftheweather conditionsifitistowindystop soyoudon'tdamgethepipean sonoonegetshurt

7 TOH Trippingpipe. Workinginheights. Fallingfromheights. Failuretoinspectfalling protection. Slippingortrippingin derrick.

Failuretorigupescape device.

Failuretoinspect elevatorsand equipment.

Pinchpoints

TRIPPINGPIPE

derrickhandalwaysinspect fallingprotectionpriortousing. CheckSRL,harness,and lanyards.

Watchyourfooting,always3 pointsofcontact.

100percenttieoffabove4ft. InspectGeronimocartand cable.

Goodcommunicationwithin operatorandDerrickhand. Slowdownandlatch/unlatchwill bepracticed.

Alwaysinspectelevators,slips, andblocks.

Watchhandplacementwhen operatingtongmachineryand whenlatchingorunlatchingtbg

5
ops
Wrangler
Page 5

9 Makeuptools

Nocommunication

Suspendedload

Winchanchainnot hookedupcorrectly

Drilllinehungup

Drilllinenotwrapped rightondeadline anchore

Strikezones

Pinchpoints

Drilllinenotwrapped rightondrum

Havegoodcommunicationwith eachothermakesureyoudont getundertheblocksorbetween theblocksoranythingmake sureyour Winchanchainarehookedup correctly Watchwereyouareplacingyour handsanfingerssoyoudont smashorpinchthembetween thedrilllineitselfondrumor deadlineanchoralwaysmake sureyouholdongood toline  whenwrappingitondeadline anchoresodoesn'thityou alwayslookaroundanwatch yourdrilllinesoitsnothungup anywhere

Nocommunicationwith eachother Strikezones

Pinchpoints

Weddingbandclampnot onright

Torquenotsetright

Gettinghitbyahammer

Slipsnotsetright

Havegood communicationwith eachotherwatchwereyouplace yourhandsanfingerssoyou dontsmashbetweentongsan collarsortoolsantongs or betweentheelevatorsanstump alwaysmakesuremakesure weddingsbandclamponright antight

Anslipsaresetgood before unlatchingelevators

Makesureelevatorsarelatched goodlatchedbeforepickingup outtheslipsorpickingup anythingoffthewrangler

Alwaysmakesureliftingsubs gettightenproperlyand  markedalwayslookwhen makinguporbreakingout collarsantools thatwayyou liftingsubsaren'tlosingup makesureareslackedoff enoughontheelevators

Beawareofyourstrickzones especialwhenswinginga hammerlookbeforeswinging anbealertofhammersbeing swung

8 Godoublefast
Page 6

Trippingpipe. Workinginheights. Fallingfromheights. Failuretoinspectfalling protection. Slippingortrippingin derrick.

Failuretorigupescape device. Hittingrodbasketwith blocks. Failuretoinspect elevatorsand equipment. Pinchpointsoperating tongmachinery.

TRIPPINGPIPE

derrickhandalwaysinspect fallingprotectionpriortousing. CheckSRL,harness,and lanyards.

Watchyourfooting,always3 pointsofcontact.

100percenttieoffabove4ft. InspectGeronimocartand cable.

Goodcommunicationwithin operatorandDerrickhand. Slowdownandlatch/unlatch

Alwaysinspectelevators,slips, andblocks.

Watchhandplacementwhen operatingtongmachineryand whenlatching

SSE(ShortServiceEmployees)orARE(AtRisk Employees)EmployeesPresent?

SSE/AREunderstandprocess?

10 TIH
(SelectNoifnoSSE/AREarepresent) Yes No Yes No MentorName: SSEorAREName:
Involvementby
employees? Yes No DropsLogBook-TooltrackingforitemstakenintotheDerrick Yes No CrewMembersOnDuty NumberofCrewMembers 6 CrewMembers Page 7
Job
anyThirdPartycompaniesor

BysigningthisJSAyouareacknowledging,understandthetaskslaidoutaboveandthat you'refitforduty.Byyoursignatureyoualsoindicatethatyoudidnotsustainany injuries!

Employee: Position: Yearsof Experience: DaysonHitch: Sign: Richardcarrasco Rm 19 1 Leonel Op 11 1 Marcoacardenas Ro 8 1 JuanFavela Dh 8 1 Joelwaldner Dh 2 1 Brandon Rodriguez Fh 4 1
Name Sign Company ReasonforVisit? TimeIn TimeOut JCWehmeyer LES Flowback 06:32PM WalKhat LES Flowback 06:32PM Johnnie Sanders LES Flowback 06:32PM Michael Forest LES Flowback 06:32PM David Pittman Chord Companyman 06:33PM Page 8
VisitorLog

NearestHospitalandDirections: Stanley RigLocation

EmergencyResponse/EvacuationPlan

(DirectionofTravel,MusterPoint,etc):

Locationentrance

OtherSafetyConcerns/TopicsDiscussed:

(DirectionofTravel,MusterPoint,etc):

Havegoodcommunicationwitheachother

PostJob/TaskSummary

Incidents/NearMissesoccuredduringshift? (requireadditionaldocumentation)

Yes No

Yes No

DidyouinitiateanSWA(StopWorkAuthority)today?

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