HAZARD ANAYLSIS SAFETY ACTION PLAN

US METHANOL
Liberty ONE

Dow Institute Site

Institute, WV

Revision 0
Date Issued: August 4, 2016
 Hazard Analysis Safety Action Plan (HASAP)

US Methanol (Engineering)

TABLE OF CONTENTS

1.0 GENERAL SITE INFORMATION

2.0 SITE AND PROJECT DESCRIPTION

3.0 PROJECT SCOPE AND SCHEDULE

4.0 HSE REQUIREMENTS

5.0 KEY PROJECT CONTACTS

6.0 SITE ACCESS REQUIREMENTS AND TRAINING

7.0 HSE PROGRAM

8.0 RISK IDENTIFICATION AND ASSESSMENT

9.0 SITE ACCESS AND CONTROL

10.0 INJURY MANAGEMENT

11.0 GENERAL EMERGENCY RESPONSE

12.0 DOCUMENT CHANGE HISTORY

12.0 HASAP REVIEW AND APPROVAL

Attachment A Contractor Requirements for Entering the Dow Institute Plant

Attachment B -- Risk Identification and Assessment

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1.0 GENERAL SITE INFORMATION

Client Name/Site US Methanol at the Dow Institute Site
Street Address Route 25 Institute, WV 25112
Plant Entrance Contractor East Gate
Dow Emergency Phone Number (from a plant phone) Ext. 5555
Dow Emergency Phone Number (from a non-plant phone) (304) 747-5555
Dow Security Phone Number (304) 747-4562
Dow Security Non-Emergency Phone Number (304) 747-4444
Dow Welcome Center Phone Number (304) 747-7718

2.0 SITE AND PROJECT DESCRIPTION

US Methanol LLC (USM) has acquired Methanol production facility and will relocate the unit to the existing Dow
Chemical site at Institute, WV. The plant will be located in a brownfield area of the existing plant site.
The project will include assembly of the methanol plant, construction of 2, one-million gallon storage tanks and 4
smaller tanks, modification to the existing truck loading area, construction of a building that will house the
warehouse, maintenance shop, control room and office.
Jacobs WV/KY has been contracted to develop an assessment of the Outside Battery Limits (OSBL)
requirements for the project. The scope includes various tie-in points to existing Dow utilities, final product
storage, product loading facilities and equipment unloading facilities.

3.0 PROJECT SCOPE AND SCHEDULE

3.1 Description of Work
The general work description for the WV/KY employees is as follows:
Take field measurements and conduct assessments primarily on piping systems
CSA work for layout
Possible tunnel inspection (confined space entry)
3.2 Work Schedule
The work schedule is 4.5 days per week up to 40 hours per week.
3.3 Project Manpower Construction Support
The Jacobs project resource level for personnel is expected to peak at approximately 5 employees.
4.0 HSE REQUIREMENTS
4.1 US Methanol, Dow and Jacobs Requirements
Specific HSE policies and procedures are identified in the following documents and/or through the following
regulatory agencies.
US Methanol HSE Policies and Procedures
Dow Chemicals Environment, Health and Safety (EH&S) Policies and Procedures
Jacobs Health, Safety and Environment (HSE) Policies and Procedures
Federal OSHA 1910 and 1926 standards
Environmental Protection Agency
State and Local requirements
4.2 HSE Roles and Responsibilities
Personnel at all levels have the responsibility to actively participate in the HSE process and stop, or bring to the
attention of management, any at risk behavior, unsafe condition and/or potentially harmful environmental
practice.
Additionally, specific HSE roles and responsibilities are provided below.
Immediately correct any imminent danger situations such as exposure to falls from elevations, electrical shock
hazards, exposure to improperly protected excavations, LOTO violations, etc.
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Notify supervision if you have an insufficient understanding of the task to be performed, of HSE procedures
and of assigned safety equipment.
Promptly report incidents involving personnel, equipment, property or the environment, no matter how minor.
Learn the approved HSE safe practices that apply to your work and practice them at all times.
Ask for assistance from the HSE Department when unsure of a work or safety practice.
Promptly report safety device malfunctions and tag the device to warn others of the hazard.
Never attempt to do a job alone when good judgment indicates assistance is needed.
Inspect, use and maintain personal protective equipment that has been provided.
Observe safe practices off the job as well as on the job.
5.0 KEY PROJECT CONTACTS
5.1 Jacobs Project Management
Name Title Email Phone
Mark Paddock Project Manager mark.paddock@jacobs.com 304-720-4134 (O)
Carrel Prince Project Engineer carrel.prince@jacobs.com 304-720-4103 (O)
5.2 Key Client Contacts
Name Title Email Phone
Cameron Gunn Project Manager Cameron.gunn@usmeoh.com 786-445-5123c
Roberto Bueno Project Manager roberto.bueno@usmeoh.com
5.3 Key Dow Chemical Contacts
Name Title Email Phone
Jon Putnam Responsible Care Leader jputnam@dow.com 304-747-1165 (O)
Mary Byrd Security byrdml@dow.com 304-747-4562 (O)
Andy Altman Project Manager altmanam@dow.com 304-747-1958 (O)
Kenny Rice Contract Administration 304-747-1632 (O)
6.0 SITE ACCESS REQUIREMENTS AND TRAINING
6.1 Site Access
At the present time, entry onto the methanol project will be controlled through Dow Security. The Dow Institute
Plant has established specific requirements for gaining access to the plant. These include a drug screen,
background check, verification of citizenship and legal authorization to work. Verification and validation of the
employees Social Security Number is also required.

See Attachment A for the Dow Institute documentation (the documents are currently under revision by Dow
Security and they may change without notice).
6.2 Drug Screens
All Jacobs employees are subject to the provisions of the Dow Institute, US Methanol and Jacobs Drug Screening
Policy. Drug screens are coordinated through Jacobs HR. The test must be conducted in advance of your site
visit. Additional screening may include random, post-incident and/or for cause testing.
6.3 Background Check
A background check is required for entry into the facility. Background checks may take up to 7 days or more to
complete, so adequate lead time is required. Jacobs HR will coordinate background checks.

6.4 Safety Training

Completion of Basic Plus training is required for unescorted entry into the Dow Institute site. The training is
rd
delivered at the Regulatory Training Center (RTC) on 120 3 Avenue in South Charleston, WV.

For first time entrants into the Dow Institute site, the 5-hour Basic Plus, instructor-led training course is offered on
Monday and Wednesday at 8:00 AM.

For Jacobs WV/KY engineers, three additional classes are required. The classes are computer based and each
class is approximately 45 minutes in length.
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Annual Basic Plus refresher training is one hour in length and offered Monday through Friday from 7:00 AM
3:30 PM.

All training at the RTC must be scheduled at least 48 hours in advance. Contact Christel Mize at 304-720-8524 or
by email to schedule this training. If you do not have the required training, you must be escorted by a Dow
representative at all times while at the site.

Additional training may be required depending on your job tasks and the hazards associated with your work.

6.5 Badging
Upon completion of the safety training, an ID card will be issued from the RTC. This card, along with the
completed verification form, is presented to the receptionist at the Dow Institute Welcome Center. A Dow Institute
Site badge will be issued and your Dow Host will be contacted to escort you to your work location on the first visit.

Your badge must be visible at all times while working at the Dow Institute Site.

7.0 HSE PROGRAM

7.1 HSE Program Implementation
Core HSE program elements shall be as follows:
Safe Plan of Action (SPA)
When driving to the site, a driving SPA will be completed.
All tasks conducted in the field require the development of a SPA at the location where the task is being
performed.
Safety Observation Reports (SOR)
Jacobs employees are encouraged to participate in the Jacobs SOR process and/or the clients
equivalent process. Observations related to the clients site should be brought to the attention of your
client representative.
7.2 Work Control
A Safe Work Permit is required for all hands on work within the process operating areas. The need for safe
work permits will be determined by the unit operators and will depend on the scope of work.
Safe Work Permits can be issued for up to 12 hours, but it will be terminated once you leave the unit or
discontinue work. Once the task is completed, return the permit to the operator that issued the permit for
termination.
Unit sign-in does not replace the requirement for a Safe Work Permit.
7.3 Hazard Communication
Safety Data Sheets (SDSs) are maintained and available through Dows electronic database.
Area-specific HAZCOM training is required for entry into each operating unit. It is preferred that arrangements are
made in advance before your visit to the unit. The training is conducted at the respective unit control room and it
is valid for one year.
7.4 Project PPE and Clothing Requirements
The following are PPE and clothing requirements.
Hardhats (ANSI Z89.1)
Hardhats will be worn with the bill forward to protect the face and eyes from dropped objects or debris.
Eye and Face Protection (ANSI Z87.1)
Safety glasses with rigid side shields are a requirement. This includes both prescription and non-prescription
eyewear.
Clear safety glasses will be worn inside all buildings.
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Mono goggles are required where posted and must be carried at all times.
Foot Protection (ANSI Z41 or ASTM F2412-05 & F2413-05)
Safety toe footwear made of non-porous leather or synthetic material that at a minimum, covers the ankle, is
required.
Hearing Protection
Hearing protection is required in all posted areas.
Hearing protection should also be worn in all areas where noise levels are such that one must raise their
voice to be heard when standing next to another employee.
Hand Protection
All employees are required to wear protective gloves, which are appropriate for the task, when out in the field
or inside a process unit.
Clothing and Attire
FRC (flame retardant clothing) is required in all production and process units, including electrical handling
facilities, loading racks/material handling facilities, etc.
7.6 Cell Phone and Camera Use
All process unit areas are Class I/Division II classified areas and all electronic equipment used in the process
areas must be certified as intrinsically safe. The use of cell phones is not allowed.
The use of a camera, including the cell phone camera, is strictly forbidden on Dow property. If pictures must be
taken, your Dow host will give you a camera use authorization form. The Dow WV Responsible Care Leader
must approve all camera requests. The approval is good for one calendar year and it must be renewed by
January 1.
All photographs must be approved and released by a Dow representative before leaving the site.
7.7 Smoking
Smoking is prohibited on the property.
8.0 RISK IDENTIFICATION AND ASSESSMENT
A risk assessment has been documented as part of this HASAP. See Attachment B.
The risk assessment is a living document and it should be periodically reviewed and updated to ensure it is
maintained current with the scope of the project and the hazards that exist on the site. Revisions to the risk
assessment resulting in changes to hazards and/or controls will be communicated to the project team as
appropriate.
9.0 INJURY MANAGEMENT
9.1 Non-Life Threatening Medical Emergencies
Ensure notifications have been made to Jacobs and Dow and transport the employee to the designated Jacobs
healthcare provider.
The following healthcare providers have been identified.
MedExpress Urgent Care Cross Lanes or Dr. Syam B. Stoll
5161 Washington Street West 1563 Sand Plant Road
Cross Lanes, WV 25313 South Charleston, WV 25309
304-755-5323 304-756-1550

9.1 Life Threatening Medical Emergencies

Dow will provide immediate medical care and attention in the event of a serious or life threatening medical
emergency. Care will be limited to stabilization of the injured employee until EMS arrives and transports the
employee to the hospital.

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10.0 GENERAL EMERGENCY RESONSE

10.1 General Response
Dow has an extensive emergency response and alarm system. The alarms may sound for a fire or explosion,
toxic gas release or weather alert.
In the event the emergency alarm sounds, all work must stop and employees are to report back to the control
room from where they signed in, unless the area is no longer safe. If you cant safety reach the control room, call
the Emergency Phone Number and explain your circumstance. Site security will assist you in finding an
acceptable shelter and they will record your location for head count purposes.
The plant is equipped with an emergency alarm pull box system. If at any time you witness or experience an
emergency (injury, illness, fire, spill, release), locate and pull the nearest emergency alarm box. The Dow
Emergency response Team is equipped to handle all emergency situations.
If the emergency alarm system is activated, an alarm will sound, alerting personal of an emergency. The alarm
sound will be followed by an automated voice that will report the exact location of the alarm. If you pull an
emergency alarm, remain at the alarm box until emergency responders arrive. If it is not safe to remain in the
area, leave and call the Emergency Phone Number to relay information to emergency responders.
11.0 DOCUMENT CHANGE HISTORY

Document Change History

Rev. No. Changed By Date Brief Description of Change

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12.0 HASAP REVIEW AND APPROVAL

Lynn Roncco August 8, 2016

HSE Manager Signature Date
317-313-7392

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 Attachment A

Union Carbide Corporation

A Subsidiary of The Dow Chemical Company
West Virginia Operations

ACCESS CARD
AUTHORIZATION
Fill in appropriate blank(s):
Dow Contractor
Tenant Company Name

Date: (mm/dd/yy)

Name:
Last First Middle

Birthday (mm/dd/yy)

Address (Bldg./Room) Phone

RTC Training Expiration Date

To Be Completed By Dow/Tenant Sponsor

Access to Area: South Charleston Institute Technology Park

Company: Dow South Charleston Tenant Institute Tenant

Specify areas if needed:

Specify times if needed:

Drive-in Access Required: Yes No

Contract Administration Approval:

(Tenant CA approval required for dedicated work)

Approved by:

For processing, use File/Send to/Mail Recipient (As Attachment) or save this form to a file and attach the file to a mail message
and send this form to: Mary Byrd (Byrdml@dow.com) or bring to the reception centers for processing.

All Access Badges will be issued at:

South Charleston Reception Center:
Building 307 Visitor Center Monday-Fridays 7:30 AM-4:00 PM
Institute Reception Center:
Building 8402 Visitor Center Monday-Fridays 7:30 AM-4:00 PM

DOW RESTRICTED
 CONTRACTOR/TENANT ACCESS
PLEASE PRINT CLEARLY

Employee Name: ___________________________________________________________________________

(Please Print) Last First Middle

Permanent Address: _________________________________________________________________________

Street Address City State

Date of Birth: ________________________

Birthplace: __________________________ Citizenship: _________________

Sex: ___________ Height: ________________ Weight: ___________ Hair Color: ____________________

Eye Color: ________________ Complexion: _________________ Build: ________________________

Identifying Scars/Marks:

_________________________________________________________________________________________

Drivers License: ________________ Class: __________ State: _________ Expiration Date: __________

Are you a former employee of a contractor company working on a Dow Site? __________________________

Have you worked in Dows Operations in West Virginia within the last 6 months? _______________________

What company? ____________________________________________________________________________

Have you ever been convicted for any law violation (other than minor traffic violations) in the last seven years?
______________

If yes, list them below:

Date City/State Charge/Conviction Final Disposition

I AGREE THAT IF IT IS FOUND THAT I HAVE FALSIFIED OR OMMITED INFORMATION FROM THIS
QUESTIONNAIRE, SUCH FALSIFICATION OR OMMISION SHALL BE CONSTRUED TO BE FRAUD AGAINST DOW
CHEMICAL, AND SHALL BE SUFFICIENT GROUNDS FOR MY REMOVAL FROM DOW PROPERTY AND MY
ACCESS PASS REVOKED.

DOW RESTRICTED
 CONTRACTOR/TENANT BACKGROUND SCREEN VERIFICATION FORM

Contractor:

__________________________________________________________________________________________
Last Name First Name Middle Initial

Contractor Company: ________________________________________________________________________

Hire Date by Contract Company: ______________________________________________________________

I verify that a criminal history check has been completed on the individual identified on this form, and certify that this
individual has had no conviction within the last 7 years for any crimes involving theft, destruction of property, violence or
drugs.

YES NO* (if no, see note below)

____________________________________________________________________________________
Authorized Signature

I further verify that a check of citizenship has been conducted and the citizenship of this individual has been verified

YES NO* (if no, see note below)

____________________________________________________________________________________
Authorized Signature

I further verify the Social Security number of the individual in question has been checked for accuracy.

YES NO* (if no, see note below)

____________________________________________________________________________________
Authorized Signature

NOTE: Any discrepancies found related to the individual identified in this document are listed on the next page of this
document. We are requesting a review by Dow ES&S.

YES NO

____________________________________________________________________________________
Authorized Signature Company Phone Date

______________________________________________________________________________
Printed Name of Authorized Company Representative

DOW RESTRICTED
 Attachment B
Risk Assessment Date July 29, 2016
Revision : 1
Page : 1 of 5

Project Number: Project: US Methanol at Dow Institute (Engineering) Location: Institute, WV

Prepared By: Lynn Roncco Date: July 29, 2016 Reviewed By: Project Team Date:

Ref. Preliminary Risk Final Risk

Activity or Element Hazard Asset Control Type Controls
Number Assessment Assessment

H M L H M L

01 Critical Risk Activity Motor vehicle accident due to: P F X A Documented inspection of vehicle prior to use X
Driving Distractions Driving SPA completed
Fatigue Plan route in advance
Contact by other vehicle Driver has current drivers license and is current on
Contact with animals defensive driving training
Debris striking car Adherence to all signs and speed limits (slower if
Vehicle break-in and theft necessary)
Practice defensive driving techniques
Stay safe distance when following, especially in
construction zones
Cell phone use prohibited
Take periodic breaks
Remove personal and company property from vehicle
when the vehicle is not in use
03 Parking at the plant Contact with vehicles or pedestrians P F X W A Back into parking spaces (use a spotter) X
parking lot and walking Same level falls Be aware of traffic, particularly during shift changes
to contractor entrance Stay on designated pathways when available
No talking or texting when walking
04 Pre-entrance Lack of familiarity with hazards and P X A Review HASAP and attachments X
requirements safety policies Attend required client orientation(s)
Learn plants ERP (alarms, evacuation routes,
assembly areas, shelter-in-place locations, etc.)
Ensure HAZCOM training is current
Know location of Safety Data Sheets (SDSs)
Ensure general knowledge of hazardous chemicals for
each area
05 Completing work tasks Contact with vehicles or mobile P X A Stay on designated walkways X
throughout the plant equipment Stop at street intersections
Make eye contact with equipment or vehicle operators
before crossing in front of them
Listen for backup alarms
Be aware of blind spots or corners
High noise levels P X S Use hearing protection in posted areas and when noise X
levels are such that you have to raise your voice during
conversation with another employee who is standing
next to you

Asset: P = Personnel F = Facilities and Equipment E = Environment

Control Type: D = Design E = Engineering Control S = Safety Device W = Warning Device A = Administrative Control
 Attachment B
Risk Assessment Date July 29, 2016
Revision : 1
Page : 2 of 5

Project Number: Project: US Methanol at Dow Institute (Engineering) Location: Institute, WV

Prepared By: Lynn Roncco Date: July 29, 2016 Reviewed By: Project Team Date:

Ref. Preliminary Risk Final Risk

Activity or Element Hazard Asset Control Type Controls
Number Assessment Assessment

H M L H M L

Uneven walking surfaces P X S A Stay on designated pathways whenever possible X

(slips, trips and falls, Ensure footwear is in good condition
abrasions/lacerations, etc.) Watch for wet conditions and walk around these areas
whenever possible
Step over and not on the rails of railroad tracks
Step over and not on hoses, cords, etc.
Wear gloves and all required PPE

Wear cut resistant gloves and additional arm protection X

Exposure to sharp objects, hot P X S A if needed
surfaces, etc.
07 Critical Risk Activity Exposure to hazardous materials P X S W A Ensure HAZCOM training is current X
Hazardous Materials (absorption, inhalation, ingestion) Review Safety Data Sheets (SDSs) of hazardous
Gases, vapors, mists materials that you may come in contact with or that are
Liquids present in the work area
Solids, residue Use the appropriate PPE
Identify location of nearest safety shower and eyewash
in each work location
Identify alarm boxes in each area
Locate evacuation route and assembly area

Lead and asbestos awareness training must be current

Exposure to asbestos or lead
Stay away from any area where lead or asbestos
abatement is taking place
Report to the client the location or area where
insulation has been disturbed
08 Critical Risk Activity Falls down stairs P X S A Ensure annual ladder and stair training is current X
Work at Elevation Use handrail when ascending and descending stairs
Walk up and down stairs, one step at a time
Be observant for tools, material, debris that may be on
stairs

Falls from ladders Select the proper ladder for the task (extension ladders
are only to be used to access one level to another)
Inspect ladder prior to use
Personal tie-off required when on the 6th step or higher
on a step ladder
Step ladders 6 ft. or taller must be tied off or held when
in use
Extension ladders are to be tied off at all times
Asset: P = Personnel F = Facilities and Equipment E = Environment
Control Type: D = Design E = Engineering Control S = Safety Device W = Warning Device A = Administrative Control
 Attachment B
Risk Assessment Date July 29, 2016
Revision : 1
Page : 3 of 5

Project Number: Project: US Methanol at Dow Institute (Engineering) Location: Institute, WV

Prepared By: Lynn Roncco Date: July 29, 2016 Reviewed By: Project Team Date:

Ref. Preliminary Risk Final Risk

Activity or Element Hazard Asset Control Type Controls
Number Assessment Assessment

H M L H M L

Falls from scaffold Ensure annual scaffold user training is current

Review safety requirements on the scaffold inspection
tag before accessing the scaffold
Scaffold is not to be used if it does not have a tag on it,
if it has not been inspected for the current shift and if
the tag is a red, danger tag

Unprotected fall exposures of 6 ft. or more from one

Falls from elevations of 6 ft. to next level to another requires 100% or continuous tie-off
lower level Annual fall prevention and protection training must be
current
Inspect fall protection equipment prior to use
Use the equipment properly

Complete a pre-task roof assessment prior to

Fall from roofs or through skylights
accessing a roof. Evaluate fall exposures and potential
exposures to hazardous chemicals, steam and
condensate. from roof vents, PSVs

Tie off is required in all aerial and scissor lifts

Falls from aerial and scissor lifts
Employees are not to stand on toe boards, mid or top
rails
Ladders, boxes or similar items are not to be used in a
lift

Dropped objects When working at elevation, ensure all tools and

equipment are secure
Do not carry unsecured tools or other items in pockets
Tools and/or equipment are not to be left on stairs or
the top or the steps of a step ladders
Tools or equipment are not to be thrown from one level
to another or intentionally dropped down to another
employee at a lower level
09 Working Outdoors Cold and hot temperatures P X S A Layer clothing during the winter months X
Ensure adequate work and rest breaks
Ensure adequate hydration in both hot and cold
weather

Inclement weather Check weather conditions before doing any elevated

Asset: P = Personnel F = Facilities and Equipment E = Environment
Control Type: D = Design E = Engineering Control S = Safety Device W = Warning Device A = Administrative Control
 Attachment B
Risk Assessment Date July 29, 2016
Revision : 1
Page : 4 of 5

Project Number: Project: US Methanol at Dow Institute (Engineering) Location: Institute, WV

Prepared By: Lynn Roncco Date: July 29, 2016 Reviewed By: Project Team Date:

Ref. Preliminary Risk Final Risk

Activity or Element Hazard Asset Control Type Controls
Number Assessment Assessment

H M L H M L

work
Adhere to severe weather alarms when they are
activated
Be aware of lightning strikes if storms are near

Icy and slippery conditions Utilize anti-slip devices for footwear

Stay on designated paths or walkways that have been
salted and/or sanded

Exposure to insects that sting Assess the work area for the presence of wasps or
(spiders, wasps, yellow jackets), yellow jackets
rodents and snakes Check the work area for nests
Follow the clients procedures when nests have been
identified in the work area
Assess area before reaching into places where
rodents, spiders or snakes may live
10 Working in areas Overhead hazards P X S A Increased awareness of suspended loads and/or X
adjacent to construction Barricaded areas overhead hazards
or maintenance Entry into areas with red, danger tape is prohibited
activities Entry into areas with yellow and magenta tape or signs
is prohibited (radiographs)
Identify hazard(s) before crossing yellow, caution tape

Welding flash Do not look at welding flash

Flying debris Stay away from areas where craft employees are using
grinders
11 Working long hours or Fatigue P X A Follow the clients or the Jacobs Fatigue Management X
extended shifts Policy
12 Critical Risk Activity N/A N/A
Energy Isolation
13 Critical Risk Activity N/A N/A
Confined Space Work
14 Critical Risk Activity N/A N/A
Electrical Work
15 Critical Risk Activity N/A N/A
Lifting Operations
16 Critical Risk Activity N/A N/A
Excavations
17 Critical Risk Activity N/A N/A

Asset: P = Personnel F = Facilities and Equipment E = Environment

Control Type: D = Design E = Engineering Control S = Safety Device W = Warning Device A = Administrative Control
 Attachment B
Risk Assessment Date July 29, 2016
Revision : 1
Page : 5 of 5

Project Number: Project: US Methanol at Dow Institute (Engineering) Location: Institute, WV

Prepared By: Lynn Roncco Date: July 29, 2016 Reviewed By: Project Team Date:

Ref. Preliminary Risk Final Risk

Activity or Element Hazard Asset Control Type Controls
Number Assessment Assessment

H M L H M L

Mobile Equipment
Operation

Asset: P = Personnel F = Facilities and Equipment E = Environment

Control Type: D = Design E = Engineering Control S = Safety Device W = Warning Device A = Administrative Control