<p> Form 000.653.F0145 Supervisor HSE Responsibilities</p><p>Project Name Project Location Project No./Contract No.</p><p>Supervisor (print) Employer Date</p><p>As a supervisor you are required to:</p><p> Possess a comprehensive knowledge of incident prevention processes and project HSE requirements.  Accept responsibility for the implementation of incident prevention processes and safe work practices at the project/site.  Ensure that each employee has received an initial HSE orientation and a copy of the P2S Craft Employee Handbook and Health, Safety, and Environmental Requirements (Form S1), or for contractor personnel, the Contractor/Subcontractor Health, Safety, and Environmental Requirements (Form S19) and has signed an acknowledgment of the receipt of such handbook.  Explain applicable rules, requirements, and procedures to employees under your direct supervision and ensure each employee understands the rules, requirements, and procedures.  Consistently enforce HSE rules, requirements, and procedures.  Maintain a zero tolerance for unsafe acts.  Supervise the instruction and training of new employees.  Monitor employees’ performance to ensure the use of safe work practices.  Be responsible for the use, and maintain personal protective devices, equipment, and safeguards.  Notify direct supervisors and/or the HSE Representative concerning work areas where unique HSE hazards exist and/or special assistance is required.  Perform routine and organized HSE inspections in your work areas.  Attend and participate in supervisor HSE meetings.  Conduct “toolbox” incident prevention meetings for employees under your supervision as required by project procedures.  Immediately report all incidents that have, or could have, resulted in personal injury or property damage.  Assist in incident investigations and submit a report promptly on required forms.  Analyze work in detail for the purpose of issuing safety task assignments (STAs) and for the establishment of safe work practices.  Participate in the preparation of departmental or project HSE rules.  Correct HSE hazards on the spot.  Maintain a consistent use of the STA process.</p><p>Field supervisors, foremen, and general foremen are to read and sign this form acknowledging receipt and understanding of their HSE responsibilities as defined above.</p><p>Name: </p><p>Social Security/ID No.: </p><p>Supervisor Position/Craft: </p><p>By signing below, I acknowledge that I have read and understand my HSE responsibilities.</p><p>Signature: </p><p>Note: This form is referenced in Practices 000.653.0020 and 000.653.1001.</p><p>Copyright © 2009, P2S. All Rights Reserved. Page 1 of 1 Health, Safety, and Environmental Form Date: 01May2009</p>