Information
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Document No.
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ONEOK Business Segment
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ONEOK Operation Site (i.e. OK Gathering, Medford Plant, etc.)
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Site Location
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Conducted on
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Prepared by
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Location
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Prime Contractor on site (if applicable)
1. Work Areas
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C1:1 - General Housekeeping?
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C1:2 - Walking - Working Surfaces?
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C1:3 - Unprotected Sides or Holes?
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C1:4 - Sanitary Facilities Acceptable?
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C1:5 - Water - Trash Receptacles?
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C1:6 Is the site location free from significant erosion and/ or soil channeling?
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C1:7 is the site location clear of vegetation?
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C 1.8 Is there active construction on-site?
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C1:9 - Impalement Hazards?
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C1:10 - Material Storage/Lay Down?
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C1:11 - Conex, Box 4 U, Gang Box, Roll Offs?
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Is the security of the site acceptable? (Fence in good condition, gates locked, lighting in working condition, building in good condition and locked)
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Other:
2. Job Site Posters/Signage
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C2:1 - Are job-site required posters posted? (i.e. DOL posters, OSHA 300 Log)
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C2:2 - Emergency Evacuations Plan including; GPS site location and Nearest Hospital Location?(if required)
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C2:3 - Emergency Contacts List?
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C2.4 - Is all DOT signage is place (Company Name, Phone number, PPE requirements, Authorized Personnel, No open flame/smoking, ESD, Exit signs)
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Other:
3. Heath/First Aid
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C3:1 - CPR/First Aid Training?
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C3:2 - First Aid Kit (No expired items)?
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C3:3 - Eye Wash Facilities in Field?
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C3:4 - Access to Eye Wash?
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C3:5 - Is AED functioning? (if on-site)
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C3:6 - Are AED pads expired? (if on-site)
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Other:
4. PPE
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Is there any personnel on-site?
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C4:1 - Hard Hats?
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C4:2 - Safety glasses with Side Shields?
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C4:3 - Face Shield/Goggles (if required)?
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C4:4 - Respiratory Protection (If required)?
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C4:5 - Hearing Protection (If required)?
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C4:6 - Clothing (FRC etc. if required)?
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C4:7 - Gloves on person?
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C4:8 - Foot Protection?
5. Fall Protection
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Is there any elevated work being performed?
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C5:1 - Trained Personnel (Competent Person)?
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C5:2 - Worn Properly?
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C5:3 - Suitable Anchorage Points?
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C5:4 - Inspected per manufacturer recommendation?
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C5:5 - Stored Properly?
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C5:6 - Emergency Rescue Plan?
6. Ladders
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Are there any ladders on-site?
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C6:1 - Base/Footing/Set Up/Proper secured?(i.e. proper tied off , 36 inches above landing surface)
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C6:2 - Inspections/Color Coded?
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C6:3 - Proper Type for Task?
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C6:4 - Are label attached and legible?
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C6:5 - Does ladder show any signs of UV damage?
7. Tools and Equipment
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Are tools on-site?
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C7:1 - In Good Condition?
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C7:2 - Inspected?
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C7:3 - Whip-Checks?
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C7.4 - Are all tools equipped with guards as required?
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Other
8. Excavations
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Are there any excavation on-site?
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C8:1 - Trained Personnel (Competent Person)?
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C8:2 - Access/Egress?(within 25 feet of working area)
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C8:3 - Soil Condition?
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C8:4 - Water Accumulating?
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C8:5 - Shoring/Shielding/Sloping?
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C8:6 - Barricades?
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C8:7 - Spoil Pile?(2 beyond the edge of the excavation)
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C8:8 - Air Monitoring?
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C8:9 - Emergency Rescue Plan?
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C8.10 - Has one-call been cleared?
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C8.11- Have utilities been marked?
9. Confined Space
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Are there any permit required confined spaces on-site?
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C9:1 - Trained Personnel (Competent Person)?
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C9:2 - Attendant Trained?
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C9:3 - Entrants Trained?
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C9:4 - Attendant Wearing Monitor?
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C9:5 - Attendant Sign In Sheet?
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C9:6 - Permit Required?
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C9:7 - Permit Followed?
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C9:8 - Air Monitoring?
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C9:9 - Emergency Rescue Plan?
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Are there any reclassified confined spaces?
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Have all the hazard been eliminated and properly documented on the permit?
10. Electrical
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C10:1 - GFCI's?
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C10:2 - Extension Cords?
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C10.3 - Any exposed electrical wiring?
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C10.4 - Are ARC Flash labels in place?
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C10.5 - Are electrical breakers and disconnects labeled?
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C10.6 - Are combustible materials stored 4 feet away from electrical equipment?
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C10.7 - Is equipment bonded or grounded adequately?
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Are any fire extinguishers used for electrical equipment CO2 extinguishers?
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Is Arc Flash Protection and signage a scope of this audit?
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Is the Arc Flash PPE in good condition?
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Is the inspection of the Arc Flash PPE up to date?
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Is the signs for proper use of Arc Flash PPE satisfactory?
11. Fire Safety
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Is Hot Work being performed?
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C11:1 - Hot Work Permit?
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C11:2 - Fire Watch Assigned (Competent Person)?
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C11:3 - Hot Work Barricade (if required)?
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C11:4 - Fire Extinguisher current with monthly and annual inspection?
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C11:5 - Combustibles Removed/Isolated?
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C11:6 - Is appropriate Flammable Gas Cans? (No plastic can)
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C11.7 - Are flammable properly stored? (in flammable cabinet)
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C11.8 - Is flammable cabinet in good condition? (if on-site)
12. Rigging and Hoisting
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Are there any Rigging and Hoisting equipment on-site?
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C12:1 - Capacity Tags attached and legible?
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C12:2 - Hooks and Latches?
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C12:3 - Chain Falls/Come-a-Longs?
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C12:4 - Tag Lines?
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C12:5 - Has the rigging equipment been inspected prior to use?
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C12.6 - Stored Properly?
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C12:7 - Designated Rigger?
13. Scaffold
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Is any scaffolding on-site?
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C13:1 - Trained Personnel (Competent Person)?
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C13:2 - Hand and Mid-Rails, Toeboards?
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C13:3 - Platform Decked/Secured?
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C13:4 - Level Footing/Set Up?
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C13:5 - Access/Egress?
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C13:6 - Away from Power lines?
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C13:7 - Barricades?(Fall Zone)
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C13:8 - Inspection/Tagged Correctly?
14. Crane Equipment
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Is a crane on-site?
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C14:1 - Crane Inspection?
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C14:2 - Operator Manual?
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C14:3 - Crane Setup?
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C14:4 - Crane Swing Radius?
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C14:5 - Flagman with Vest?
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C14:6 - Operator Qualified and Certified?
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C14:7 - Designated Qualified Signaler?
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C14:8 - Fall Zone Procedures?
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C14.9 - Critical Lift Plan?
15. Mobile Equipment
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Is there mobile equipment on-site?
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C15:1 - Equipment Inspections?
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C15:2 - Operator Qualified and Certified?
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C15:3 - Operator Manual?
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C15:4 - Flagman/Spotter?
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C15:5 - Proper Setup and Use?
16. Hazcom
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C16:1 - SDS For All Chemicals Onsite?
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C16:2 - Proper Storage of Chemicals?
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C16:3 - Proper PPE for Handling Chemicals?
17. Energy Control
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Is there an energy control in place?
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Energy Control Number:
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C17.1 - Has personnel verified all isolation of stored energy?
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C17.2 - Are all affected personnel on the lockbox? (if on-site including group lock)
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C17.3 - Does authorized employee demonstrate specific knowledge of the energy control procedure?
18. Process Equipment
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Is process equipment in the scope of this audit?
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C18.1 - Are valve indicators in place and functioning?
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C18.2 - Are all flange bolts flush with the nut or extend past the nut?
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C18.3 - Are all valves and pipe opening plugged?
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C18.4 - Does isolated piping, equipment and instruments in traffic areas have barricades and/or visible indicators?
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C18.5 - Does piping or equipment free from any signs of weak points or leaks?
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Are DOT regulated valves in the scope of this audit?
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C18.6 - Is explosion proof equipment properly sealed and all bolts in place?
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C18.7 - Are DOT valves marked with the valve ID number?
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C18.8 - Are over-pressure devices isolation sealed in open position (include thermal relief and isolation valves)?
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Are DOT regulated piping in the scope of this audit?
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C18.9 - Is conduit and small diameter pipe visibly stress-free?
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C18.10 - Is piping atmosphere-to-ground interface properly coated?
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Are DOT regulated Pig Launcher/Receiver in the scope of this audit?
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C18.11 - Do pig traps have containers for sediments?
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C18.12 - Are jumpers and bonding wires and grounding rods in place?
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C18.13 - Do all containers have lids to prevent rain collections and are secured from the wind?
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C18.14 - Are mainline valves on pig traps locked in normal position?
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C18.15 - Do trap and vessel enclosure have tattle-tail with chain connected to enclosure?
19. Inspection Conclusion
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C19.1 - Inspection Notes:
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C19.2 - Positive Observation:
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Prepared By: