+----------------------------------+-----------------------------------+
| ![](                             | > **Occupational Heath & Safety   |
| media/image1.png){width="2.25in" | > (OSH) Environmental Management  |
| height="0.6666666666666666in"}   | > (EMS)**                         |
|                                  | >                                 |
|                                  | > **Integrated Safety Management  |
|                                  | > (ISM)**                         |
+----------------------------------+-----------------------------------+
| **Environmental, Safety, Health  | > **Job Training Assessment**     |
| & Quality Directorate**          | >                                 |
|                                  | > **Completion Certificate**      |
| **Safety & Health Services       |                                   |
| Division**                       |                                   |
+----------------------------------+-----------------------------------+
| > **OSH, EMS, ISM Risk           |                                   |
| > Assessment Review with         |                                   |
| > Employees**                    |                                   |
+----------------------------------+-----------------------------------+

+--------------------+-------------------------------------------------+
| JTA#               | > **JTA Title**                                 |
|                    |                                                 |
| **HP-IHP-**        |                                                 |
+--------------------+-------------------------------------------------+

> **OHSAS 18001 OSH Risk Assessment**

  --------------- ---------- -------------------------------------------------
  **JRA#**        **Rev#**   **Title**

                             

                             

                             
  --------------- ---------- -------------------------------------------------

> **EMS 14001 SHSD Operational Environmental Evaluation**

  --------------- ---------- -------------------------------------------------
  **SOEE#**       **Rev#**   **Title**

                             

                             

                             
  --------------- ---------- -------------------------------------------------

> I accept the responsibility for performing all work in accordance with
> the corresponding SOP, OSH Risk Assessment and EMS SHSD Operation
> Environmental Evaluation.

+--------------------+-----------------------+-----------+------------+
| **Employee Name:** | **Employee            | **Life    | **Date:**  |
|                    | Signature:**          | Number**  |            |
+--------------------+-----------------------+-----------+------------+
| 1.                 |                       |           |            |
+--------------------+-----------------------+-----------+------------+
| 2.                 |                       |           |            |
+--------------------+-----------------------+-----------+------------+
| 3.                 |                       |           |            |
+--------------------+-----------------------+-----------+------------+
| 4.                 |                       |           |            |
+--------------------+-----------------------+-----------+------------+
| 5.                 |                       |           |            |
+--------------------+-----------------------+-----------+------------+

SHSD IH50300 Rev0 09/21/06