Name and Company:

1. TRANSIENT WORKER ORIENTATION _______________________, HAS ATTENDED A NAME TRANSIENT WORKER ORIENTATION FOR THE________________________________ FACILITY AND HAS RECEIVED A COPY OF THE AERA ENERGY LLC. CONTRACTOR HANDBOOK BY: ___________________ ISSUE DATE: ___________ EXPIRES: __________ TRANSIENT WORKER ORIENTATION Name and Company: SCOPE Description of Work: Lease or Area: Specific Location: Orientation Given By: Date: INCIDENT NOTIFICATION PROCEDURE ALL INCIDENTS MUST BE IMMEDIATELY REPORTED TO AERA ENERGY LLC BY USING THE FOLLOWING NUMBER. EMER. NOTIF. THIS INCLUDES ALL NEAR MISSES, FIRST AIDS, MOTOR VEHICLE INCIDENTS, FIRES, SPILLS AND RELEASES. Emergency Location of Phone/Radio Phone Number Base Station (Radio) CHECK THE REQUIRED PPE FOR THE TYPE OF WORK BEING DONE FALL PROTECTION/ EQUIPMENT HARD HAT GLOVES X FLAME RESISTANT CLOTHING CHEMICAL PROTECTIVE FOOT WEAR SAFETY GLASSES X PROTECT. EQUIP. RESPIRATORY EQUIPMENT SAFETY SHOES/BOOTS GOGGLES/ FACE SHIELD X PERSONAL H2S MONITOR CHEMICAL PROTECTIVE CLOTHING X Other: __________________________ HEARING PROTECTION OTHER: ____________________________ REVIEW THE FOLLOWING ITEMS WITH THE TRANSIENT WORKER PROVIDE THE WORKER A COPY OF THE AERA CONTRACTOR SAFETY HANDBOOK THE WORKER UNDERSTANDS THAT ALL WALKING/WORKING SURFACES SHALL BE CLEAR OF HAZARDS COMMUNICATE POWERLINE AVOIDANCE REQUIREMENTS IDENTIFY SMOKING AREAS WHEN A CONTROL OF WORK PLAN AND JSA ARE REQUIRED (SEE REVERSE) ARE ANY NEW CHEMICALS BROUGHT ONSITE AND ARE THE MSDS’S ON LOCATION WHEN A ENERGY CONTROL PROCEDURAL PERMIT IS REQUIRED GENERAL WORK RULES TO BE OBSERVED COMMUNICATE FACILITY ALARMS, SAFE BRIEFING AND PARKING AREAS WHEN A HOT WORK PERMIT IS REQUIRED COMMUNICATE THAT THE CONTRACTOR NAME SHALL BE VISABLE ON ALL VEHICLES PARKING OUTSIDE OF DESIGNATED PARKING AREAS WHEN A CONFINED SPACE ENTRY PERMIT IS REQUIRED COMMUNICATE ANY AIR PERMIT CONDITIONS/RESTRICTIONS SOLVENT, PAINT, & COATINGS MEET APCD REQUIREMENTS COMMUNICATE LEASE DRIVING RULES (SPEED LIMITS, STOP SIGNS, SEAT BELTS, PARKING, TRACK OUT / CARRY OUT) COMMUNICATE WASTE DISPOSAL REQUIREMENTS (TAKE IT WITH YOU – OR - BIN LOCATIONS MISC ENVIRONMENTAL ISSUES: ________________________ COMMUNICATE FACILITY SIGN IN/SIGN OUT PROCEDURE THE TRANSIENT WORKER ORIENTATION SHOULD BE VALID FOR NOT MORE THAT THE TIME REQUIRED FOR THE WORKER TO SCHEDULE AND ATTEND SITE SPECIFIC ORIENTATION Card Stock and Card to Transient Worker Revised 1/1/2012

2. JOB STEPS HAZARDS CONTROL MEASURES PRE - JOB WORK PLAN Task: _________________________ TRANSIENT WORKER ORIENTATION Basic Work Rules - CW and JSA must be completed prior to work - Wear required Personal Protective Equipment - Observe all driving rules - Smoke only in designated areas - Firearms, illegal drugs or alcoholic beverages are no permitted on Aera property Revised 1/1/2012 ______________