Code: XXX-SIG-F-FG-SST-01

SAFE WORK ANALYSIS (A.T.S) Version: 0X Review: 0X

Fecha de creación: dd/mm/aaaa

PROJECT: Shift Day Night

Start Time Date: Responsible for the work First and Last Name Company
Area: Group Leader

Work to be done: (1) Supervisor / Engineer

Job location: VºBº SST

Requirements for the execution of the work and/or activity as applicable CHECK THE BOX WITH A CROSS (X): Applies (A) Not applicable (NA) (2)
Work permit A Specific procedure A NACspecific training. A Gas monitoring A Noise monitoring A NAMSDS A NA
Personal Protective Equipment
Steel toe boots A Earplugs A Leather/boiled wool gloves A Reflective vest A Mining inner A NAUniform jeans A NA
Electrical insulating boots A NAOearplugs A Dielectric gloves A NAArnés C.E. with 1 LA A Leather NAMandil A Oxy-fuel cutting lenses A NA
Rubber Boots A Respirator with cartridge for fumes A Neoprene gloves A Harness C.E. 2LA s/shock abs. A Leather socks / booties A NACareta of the grinder A NA
Safety helmet A Gas cartridge respirator A Rubber/surgical gloves A NAArnés C.E. 2 LA c/shock abs. A Long cane gloves A NATraje Tyvek A NA
Barbiquejo A Dust filter respirator A Safety glasses A Harness C.E. 2 LA c/cable ac. A Welder's mask A NAOthers_________________ A NA
Collective Protection Equipment
Rigid railings A NACintas A Signage A Vertical brake A Fire extinguisher A NAMalla against falls A NA
Cones A The orange A Lifeline A Retractable block A Air Extractor/Injector A Paletas Pair/Follow A NA
Gates A NAIluminación A Lighted buoys A NAVigías A Air mangas A Others_________________ A NA
Additional Permissions
Work in Hot A NA Excavation A Working at Heights A Load Out A NA Electrical Work A In Confined Spaces A NA

Sequence of activities (3) Dangers(4) Risks (5) Consequence(6) Control measures (7)

OBSERVACIONES / SUGERENCIAS:
1.- The ATS must include the environment: Energized lines, ground unevenness, wind speed, low lighting, temperature, etc.
Only trained and authorized persons as lookouts will be able to perform this work.
3.- Before starting a job, follow these steps: (1) What do I have to do? (2) What do I need to do it? (3) How am I going to do it? (4, 5, and 6) How could I get injured? and (7) What will I do to prevent it?
4.- The GROUP RESPONSIBLE/DIRECT SUPERVISOR: Shall not assign operational tasks of equipment and/or power tools to personnel of a lower category than Officer, who must also be qualified and trained in the use of that equipment or tool.
 DUTIES OF THE WORKER GENERAL SST RULES
Do not allow the start of any work if the start-of-day meeting and the ATS are not available, with the .1.
I will comply with ALL the directives given to me by my Employer to avoid getting injured or participation of the entire crew. In case of 'High Risk' work, verify that the
contract a disease. Work Permits
I will not perform any work: Every worker must perform the tasks if they have been trained for such work.
Without having previously developed the specific job ATS. Keep the workspace organized, marked, and clean. Separate the waste as appropriate, avoid.
.spills
If I do not have a specific order from my immediate supervisor.
Once the risk zones are defined, it is not allowed to remain under places where there may be .4
In roles and positions of a higher category than stipulated in my contract. fall of objects or movement of a load (tools, parts in the assembly process, etc.)
If I do not have all the required PPE. Do not use equipment outside of its design criteria or manufacturer specifications.
If I am not competent for the activity, that is, I have no experience, I have not been Scaffolding and/or equipment that has not been authorized for use will not be used.
trained and/or instructed in said work. .Bloquear y etiquetar líneas con energía (eléctrica, hidráulica, mecánica, etc.) antes de laborar en ellas .7
If this job is HIGH RISK and I do not have the REQUIRED PERMITS. Do not drive, operate, or intervene with mobile equipment without authorization. Do not speak on the cellphone while operating.
If I do not have all the resources to start my activity. drive these equipment
I will make proper use of my PPE at all times, I will not alter or replace them. Do not remove or eliminate systems, devices, and/or protection or security measures. Use safely.
In case of an accident, I MUST STOP MY WORK AND REPORT immediately. The authorized EPPs and keep them in good condition
report the fact to my immediate supervisor. Immediately report accidents and incidents.
I must not remove and/or eliminate systems, devices, and/or protective measures or Do not enter the work area under the influence of alcohol or unauthorized drugs, nor bring them in.
Security. products, including camps
I think and then I act, if I observe a risky act I give feedback to my partner. I tell him he can.
I will comply with the 'Fundamental Rules for Life' and the 'General SST Rules.'
get hurt if you don't do the task correctly
I will comply with the work procedures. Every worker has the right to refuse to work if the conditions for carrying out the task could be.
I will comply with the provisions of the Internal Regulations on Occupational Safety and Health. result in serious injuries
I will halt my activity in case of imminent danger. Prepare yourself physically and mentally for each task. Comply with medical provisions, take care of your health.

Knowing the dangers, risks, and control measures to be adopted in the development of my activity, I sign to indicate my conformity:
Full name Company Hour Occurrence
At the beginning At the end
Sign at the beginning (Sign at End of
Staff participating in the activity of the day) end of the (No news or describe the event)
journey) labor

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IMPORTANT NOTES TO CONSIDER:

1. TO INCORPORATE NEW PERSONNEL TO THE CREW, THE GROUP LEADER AND/OR SUPERVISOR OF THE CREW WILL COMMUNICATE TO THIS NEW PERSONNEL THE RISKS ASSOCIATED WITH EACH
TASK AND/OR ACTIVITY. IF MORE SPACE IS REQUIRED, AN ADDITIONAL FORMAT MUST BE ATTACHED.