019 - permit to work

White Nile (5B) Petroleum Operating Company Ltd

Permit To Work

Procedure

WNPOC/LII/HSE/019

Main Contents

Page No

Document – New /Amendment Request (DNAR) i

Document Change History (DCH) ii

Distribution iii

1.0 Purpose 1

2.0 Scope 1

3.0 References 1

4.0 Abbreviations 1

5.0 Definitions 2

6.0 Responsibilities 3

7.0 Types of Permit and Usage 5

8.0 Communication 6

8.1 Display Board 6

8.2 PTW Site Log 6

8.3 Pre-job Discussion 6

9.0 Procedure Details 7

9.1 Job Preparation 7

9.2 Job Execution 7

9.3 Job Completion 7

10.0 Auditing 8

Appendices

• Confined Space Entry Permit

• Excavation Permit

• Cold Work Permit

• Lifting Permit

• Electrical Permit

• Electrical Isolation Permit

• Hot Work Permit

• Radiation Permit

• Safety System Bypass Permit

White Nile (5B) Petroleum Operating Company Ltd.

P A G E N U M B E R :

i

Document – New /

Amendment Request (DNAR) D O C U M E N T N U M B E R :

WNPOC/LII/HSE/019

PE R M I T TO WO R K E F F E C T I V E / R E V I S I O N D A T E :

31 MA R C H 2006 R E V I S I O N N U M B E R :

0

DNAR No. WNPOC/DNAR/HSE/LII/0019 DNAR Date 31.03.06

Status of Document: � New Revised Cancellation Reasons of Changes:

New procedure establishment

Details of Changes

PART WAS Page No Para/Clause Description None

CHANGE TO Page No Para/Clause Description New document

Initial Date

QA Check

Prepared by Reviewed by Approved by

Section Head, HSE

HSE Manager

V.PRESIDENT

White Nile (5B) Petroleum Operating Company Ltd.


ii

Document – Change history

(DCH) D O C U M E N T N U M B E R :

WNPOC/LII/HSE/019



0

Details refer to Document New / Amendment Request (DNAR) Revision

No Status of Change

(New / Revised / Cancellation)

Effective / Revision

Date Prepared by

Reviewed by

Approved by

0 New procedure establishment 31/03/06 Section Head, HSE

HSE Mgr.

V. President

White Nile (5b) Petroleum Operating Company Ltd.


iii

Distribution

D O C U M E N T N U M B E R : WNPOC/LII/HSE/019



0

Copy No Position Title

1 President, WNPOC

2 Vice President, WNPOC

3 GM, Exploration & Development

4 GM, Finance & Planning

5 GM, Human Resource & Admin

6 GM, Production

7 Sr. Manager, Exploration

8 Sr. Manager, Operations

9 Sr. Manager, Surface Development

10 Manager, HSE

11 Manager, Corporate Affair & Community Development

12 Manager, Security

13 Superintendent, Base Camp

14 Company Man, Drilling Rig

15 Company Man, Service Rig

16 HSE Supervisor, Block 5A

17 HSE Supervisor, Block 5B

18 HSE Supervisor, Block 8

19 HSE Department

20 Exploration Department

21 Drilling Department

22 Finance & Account Department

23 Human Resource & Admin Department

24 Contract, Procurement & Logistic Department

25

26

White Nile (5B) Petroleum Operating Company


1

Preliminary




0

1.0 Purpose The purpose of the Permit To Work (PTW) procedure is to ensure that there is a formalized process in place to authorize and control hazardous work by ensuring that adequate precautions have been taken to safeguard people, property and the environment when the work is being carried out. It is also to ensure that an effective means of communication has been established about the hazardous nature of work to the supervisors, those who are carrying out the work and to those who are working around the hazardous work area. Although the PTW itself does not make the job safe, it ensures proper consideration is given to the risks prior to commencement of work. The PTW serves as a record of the authorization and completion of specific work. 2.0 Scope The procedure shall be applicable to: • All non-routine work that are classified as potentially hazardous or carried out in a

hazardous area; • Routine work that have been categorised by the line department management as

potentially hazardous; • All WNPOC employees and contractor employees working at operational locations; • All WNPOC employees and contractor employees working at premises under WNPOC

prevailing influences. 3.0 References • HSE UK publication titled “ Permit-To-Work Systems” -ISBN 0 7176 1331 3. • Industrial Accident Prevention Association of Canada publication on Work Permits. • Alberta, Canada Workplace Health and Safety Bulletin SH –013 on Safe Work Permits. • PETRONAS PTS 60.049 rev.2 4.0 Abbreviations AA Approving Authority

PTW Permit To Work

PA Permit Applicant

AEP/ SAEP Authorised Electrical Person / Senior Authorised Electrical Person

PPE Personal Protective Equipment

AGT Authorised Gas Tester

LEL Lower Explosive Limit

PEL Permissible Exposure Limit

JSA Job Safety Analysis

H2S Hydrogen Sulphide

PIC Person In Charge

ALARP As Low As Reasonably Practicable



2

Definitions




0

5.0 Definitions Permit To Work A formal written system that authorizes specific work, at a specific

work location, for a specific time period. It is used to control and coordinate potentially hazardous work by ensuring that all foreseeable hazards have been considered and appropriate precautions have been defined.

Permit Applicant The person who applies for the permit e.g. the foreman/ supervisor responsible for planning and execution of the work.

Approving Authority

The WNPOC Person In-charge at the worksite who is authorised by management to sign the Permit To Work. The WNPOC Person In-charge is one of the following: - Field Production Manager, Production Superintendent, Operations Superintendent, Field Base Superintendent, Construction Supervisor, Drilling Supervisor, Facility Supervisor. In remote areas / facilities the Person In-charge may be delegated to following: - Production Supervisor, Maintenance Supervisor or Field Supervisor.

Authorised Gas Tester

A person, who is qualified, authorized and designated to test the function of approved gas test equipment and to test worksite and confined spaces for gas and oxygen levels.

Non-Routine Work Work that is outside the regular operation of an operating facility. In this respect maintenance and construction activities are considered as non-routine.

Authorised Electrical Person

A competent person who has been trained and authorised by management to manage the operation, switching and isolation of electrical switchgear and systems except for HV & EHV.

Senior Authorised Electrical Person

A competent person who has been trained and authorised by management to manage the operation, switching and isolation of HV / EHV electrical switchgear and systems.

Worksite Preparations / Precautions

A list of control measures at the place of work execution to be taken before and during the work covered by the PTW.

Personal Protective Equipment

Equipment that has to be worn by individuals to protect themselves against exposure to hazards while carrying out their work.

Revalidation This applies to permits that have to be renewed daily for the certain jobs that take more than 1 day to complete. Revalidation is the process of checking that the precautions are still intact and the approving authority is satisfied that the job can be done safely.



3

Responsibilities


6.0 Responsibilities It is the responsibility of each WNPOC employee and contractor to ensure that an appropriate PTW has been issued for any non-routine and / or hazardous activity undertaken. Permit Applicant • Understand the hazards associated with the particular

activity for which the PTW has been applied; • Determine the correct people, PPE, tools, equipment and

precautions that have to be in place for the job to be carried out safely;

• Prepare a JSA if required for the job; • Fill in the appropriate PTW form stating all the precautions

taken; • Ensure that appropriate warning signs and barricades have

been installed around the worksite; • Visit the worksite with the AA to inspect the precautions

that have been put in place; • Ensure the PTW is approved by the AA before starting

work; • Brief the workers on the requirements of the PTW and JSA

(if applicable); • Ensure Copy no. 1 of the PTW is always kept at the

worksite; • Ensure that the workers adhere to all the PTW

requirements throughout the period the work is being executed;

• Ensures that the PTW is revalidated daily when the job extends over the specified period; and

• Returns copy of the PTW on job completion or cancellation and informs the appropriate parties concerned.

Approving Authority • Ensure all hazards associated with the proposed job have

been identified, assessed and controlled to ALARP; • Ensure the work being authorised does not jeopardise other

activities or ongoing operations of the facility; • To inform the PA on all the nearby activities especially

those that might interfere with his own activity; • Check that all the necessary safety precautions have been

identified in the PTW; • Specifies other PTW that is additionally required for the

job; • Ensure that permits are cross referenced with other

permits; • Assign AGT and other required competent persons as

required; • Revalidate PTW as required; and • Receive PTW on job completion or cancellation



0



4

Responsibilities


Area Supervisor • Review that the necessary precautions have been filled the

PTW by the applicant • Go to the site to ensure that the safety precautions for the

job have been implemented by the PA • Visit the site the site to ensure the precautions are in place

before requesting the AA to approve the PTW; • Ensure that the PA has briefed all the workers on the PTW

requirements;

Authorised Gas Tester

• Ensure that the Gas Testing equipment is calibrated before

use; • Test for the level of Oxygen, combustible and toxic gases in

confined space areas and in areas where hot work is carried out as specified by the AA in the PTW to determine whether it is safe to carry out work;

• Ensure that continuous gas monitoring is carried out in confined space areas; and

• Issue gas test certificates and attach them to the PTW.

Workers performing the work

• Ensure that they understand the requirements of the PTW; • Be skilled, qualified trained and competent to perform the

work, including the use of any personnel protective equipment or rescue equipment;

• Adhere to the PTW requirements'; • Ensure the job is performed in a safe manner; • Be aware of the hazards that could exist and have the

necessary controls in place; • Make equipment and area safe on completion of the task; • Make the work area safe and seek immediate advice if a

doubt or if circumstances or conditions change; and • Ensure that all tags and signs are prominently displayed so

that personnel are aware that the equipment etc. is isolated / not to be operated.

HSE Executive • To assist the PA in reviewing the PTW application;

• To assist the PIC/AA in reviewing the effectiveness of the safety precautions that have been implemented for the job requiring the PTW;

• To regularly monitor the effectiveness of the safety precautions during the course of the job; and

• To visit the site on completion of the job to ensure that proper housekeeping has been carried out and it is safe to resume normal operations.



0



5

Types of Permit




0

7.0 Types of Permit and Usage Hot Work • Work using or generating heat that is sufficient to ignite gases,

vapours, dusts e.g. welding, burning, cutting, riveting, grinding, drilling;

• Work involving the use of pneumatic hammers and chippers, non-explosion proof electrical equipment (lights, tools, and heaters), and internal combustion engines;

• Presence of flammable materials in the equipment being worked on;

• Presence of combustible materials that burn or give off flammable vapours when heated;

• Presence of flammable gases in the atmosphere, or gas entering from an adjacent area, such as sewers that have not been properly protected.

Cold Work All other hazardous non routine work that do not fall into other permit categories

Electrical For specific work on electrical equipment and operations in power systems to be carried out under the direct supervision of an AEP or CEP

Electrical Isolation

• Electrical power isolation by an AEP or CEP when electrically connected systems have to be worked for repair or maintenance work; and

• Confirmation that an AEP and CEP has electrically isolated the equipment to be worked on and suitable precautions have been taken to prevent inadvertent re-connection.

Lifting • Lifting over unprotected process or wellheads • Wire sling is not used for overhead crane • Wind velocity exceeding 30 knots • Visibility less than 30 meters • Load path not fully illuminated • Multiple crane lifts • Lifts exceeding 8 tones • Lift inside confined space

Excavation • To ensure that excavation can be made without damage to existing buried facilities such as pipelines, drains and electric cables;

• To confirm that drawings and site has been checked and no potential damage is possible; and

• Used in conjunction with Confined Space Entry Permit when trenches or holes greater than 2metres in depth have to excavated for laying of pipes, cables and drain pipes

Confined Space Entry

• For entry into tanks, vessels, large diameter pipes and working in trenches or holes greater than 2metres in depth

• Used in conjunction with other permits Safety System Bypass

• Covering the work on process or mechanical equipment • Bypassing or overriding one or more process control, fire or gas

alarm safety systems to prevent inadvertent facility shutdown. Radiation When radioactive sources are used to carry out radiographic

examination of welding joints



6

Communication




0

8.0 Communication

8.1 Display Board

• The AA’s copy of the PTW shall be displayed on display board located in the operations control centre or at a central location in a remote area / facility;

• The original copy shall be made available at the work site on a temporary display board so that it can be checked from time to time to ensure that the safety precautions are being adhered to at all times.

8.2 Work Permit site Log

A current and complete record of all permit to work / certificates shall be kept by each facility. This record will serve as an information source when issuing additional work permits / certificates. The following shall be logged in the work permit log: - • Types of permit to work • Number Permit to work • Date and time permit to work was issued • Specific work location • Date and time permit to work was closed off

8.3 Pre-job Discussion

Pre-job discussion shall be conducted prior to commencement of any work under a permit to work. The discussion is intended to ensure all the job crewmembers understand the content of the permit to work and safe work procedures. Pre-job discussion shall be documented.



7

Procedure Details




0

9.0 Procedure details

9.1 Job Preparation

• The permit applicant shall fill up a permit to work form (in triplicate) with details of the job to be done, specifying the facility, location, equipment, time limits and tools to be used;

• The person in-charge shall specify other relevant permits required for the job and all relevant operational and additional precautions - isolation methods for equipment, safety precautions, PPE and other equipment - required for the job.

• Adjacent jobs that are carried out simultaneously shall be catered for. • The PIC shall also specify other signatories required to validate the work permit. • When the precautions have been detailed, the permit shall be returned to the

permit applicant to retain until the preparations are complete. • Permit applicant confirms this by signing the permit. • After obtaining the required signatures, the permit applicant shall return the

permit to the approving authority. • The approving authority shall ensure the correctness and completeness of permit

and certificates. When all the actions are complete, the approving authority shall sign the permit so that the job can be started.

9.2 Job Execution

• Copy of work permit shall be retained in the office or control room of the facility

and the permit applicant displays original copy at worksite. • Person in-charge may delegate his subordinates to follow the job execution. • He or his subordinate shall regularly check the worksite as the process and

operational parameters / conditions may have changed. • He has the power to stop the work at any time if the conditions have changed or

the persons executing the works are not observing the precautions. • The hand-over from one operational shift to the next shall include a review of all

outstanding permits. • Request for extension shall be done to the person in-charge. • In case of emergency, a new work permit shall be issued for work continuation. • Original permit to work can be used if the alarm happens to be false.

9.3 Job Completion

• When the job is completed, the permit applicant shall sign off the permit and return to person in-charge. The person in-charge may delegate site supervisor on his behalf to sign for work completion and acceptance.

• The work permit is evidence, which may be required for claims, due to injury or compensation. The original shall, therefore be kept for as long as needed under local law. At a minimum, it shall be kept for 2 years.

10.0 Auditing • The purpose of permit to work auditing is to ensure the permit to work system to

function effectively; • The Supervisor or Person In-charge shall inspect the permit to work log, Permit to work

for proper authorization and validation; • Facilities shall be inspected to ensure that all precautionary measures have been taken,

pre-job discussion has been held; • Management personnel may conduct the similar audit to ensure the above were done

correctly; • Audit findings shall be presented to the HSE department for further review; • Any changes to be made if deem necessary are the responsibility of HSE department.

SECTION 1 – REQUISITION APPLICANT’S NAME………………

STAFF NO./ ID NO………………… WORK DESCRIPTION………………………………………………………………………………………………SECTION 2 – CONFINED SPA

Storage or Process vessel Storage tank Lube Oil tank Trenches

SECTION 3 – SAFETY PRECA Gas Monitoring

Continuous Every ____hrs

Standby Watch Name__________

SECTION 4 – PERSONAL PROMandatory

Safety Helmet Safety shoes Safety glasses Coveralls

Welding a Welding s Face shie Goggles B & P cov

SECTION 5 – ASSOCIATED P Electrical Isolation Permit no… Electrical Permit no…………… Physical isolation Permit no…… Safety Bypass Permit no………

SECTION 6 – JOINT SITE VISI have personally checked the area

PERMIT APPLICANT Name………………………………Designation………………………Signature…………………………

SECTION 7 – REVALIDATIODate PERMIT APPLIC SECTION 8 – PERMIT RETUR

Work Completed

PERMIT APPLICANT Name…………………... Date…

Signature………………. Time

Copy No. 1 – to be kept at site

1
CONFINED SPACE ENTRYPERMIT
Date: …………………… DEPT./CO……………………………….……

………………. LOCATION/FACILITY………………………

……………………………………………………………….……………………………………………………………………………………………………………………………………………………………………………………………………CE TYPE /HAZARDS/ WORK TO BE CONDUCTED Gas & Fumes Hydrocarbon liquid Loose earth walls Cleaning

Blasting & painting Welding & grinding Inspection Pipe laying

Other………………

UTIONS TO BE TAKEN WHEN WORKING IN CONFINED SPA Fire Extinguisher Fire Hose standby Continuous Ventilation Low Voltage lighting Rescue equipment at site Entry Status Board Trench shoring

Isolation by blinds Valves isolated Valves locked open/close Space Cleaned Pre job meeting Escape route clear Personnel health check

Gas Test ROxygen (1CombustibToxic (<P

Others………………………………

TECTIVE EQUIPMENT pron hields

lds

eralls

Respirators Dust masks Ear Plugs/ muffs SCBA First aid kit

Cotton gloves Leather gloves Chemical gloves Rubber gloves Welding Gloves

H2S meter Safety Harness

ERMITS / DOCIUMENTS …….. ……. ……

…..

Excavation Permit no………………. Lifting Permit no…………………… Confined Space Entry Permit no……… Radiation Permit no………..

JSA required Drawing no…… Others…………

IT BEFORE WORK STARTS / APPROVAL and system to be worked on and am satisfied that work requested can be

…. ….. …..

AREA SUPERVISOR Name…………………………………. Designation………………………….. Signature……………………………..

APPROVING AUT Name………………Designation…………Signature……………

N ANT AREA SUPERVISOR APPROVING

N Housekeeping completed Work incomplete d

………………………………………………

AREA SUPERVISOR APPROVING…... Name…………………. Date……… Name………………

……... Signature…………….. Time …… Signature……………

Copy No. 3– ACopy No. 2– Permit applicant

NO: CS 000

Time: ………………… …………………

…………………….. ……………………… ……………………..

s…………………… ………………… …………………

CE esults 9.5% to 22%)___ le (<10%LEL)_____

EL)______

……………. …………… ……………

Others………………… ………………… …………………

(Y/N) …………. …………..

carried out safely.

HORITY

…………………. ……………….. ………………..

AUTHORITY

ue to …………………… ……………………

AUTHORITY …. Date………

.. Time………

pproving Authority

SECTION 1 – REQUISITION

APPLICANT’S NAME………………………

STAFF NO./ ID NO…………………………

WORK DESCRIPTION……………………………………………………………………………………………………………………………………………………………………SECTION 2 – POSSIBLE HAZARDS

Gas & Fumes Traffic

Additional Precautions to be followed: ………………………………………………………………………………………………………………………………………………SECTION 3 – SAFETY PRECAUTIONS

Warning signs Safety Helmet

Barricade Safety Sh

Where excavation depth is >1.5m Gas Test Shoring

SECTION 5 – JOINT SITE VISIT BEFOI have personally checked the area and systePERMIT APPLICANT Name……………………………… Designation……………………… Signature…………………………

RS NDS

AREA SUPERVISOR Name…………………………………. Designation………………………….. Signature……………………………..

SECTION 6 – REVALIDATION Date PERMIT APPLICANT SECTION 7 – PERMIT RETURN

Work Completed

PERMIT APPLICANT Name……………… Date…….. N

Signature…………… Time……. S


EXCAVATION PERMIT

Date: T

…………

DEPT./CO……………………….…………

………. LOCATION/FACILITY……………………

………………………………………………………….…… ……………………………………………………………… ………………………………………………………………… …………………………………………………………………

Volatile Liquid under Pressure Water pipelines

High Voltage cable H2S

………………………………………………………………………………………………………………………………………………………………………………………………………………

/PERSONAL PROTECTIVE EQUIPMENT s oes

Beacon Lights Gloves

Traffic Gu Safety gla

Ladders Standby wRE WORK STARTS / APPROVAL m to be worked on and am satisfied that work requested can be cEVIEWED BY MECHANICAL UPERVISOR

ame……………………………… esignation……………………… ignature…………………………

REVIEWED BY ELESUPERVISOR Name…………………Designation……………Signature………………

APPROVING AUTHORITY Name…………………………………. Designation………………………….. Signature……………………………..

AREA SUPERVISOR APPROVING A

Site Restored Work incomplete du………………………………………………

AREA SUPERVISOR APPROVING Aame……………… Date…… Name…………………

ignature…………… Time …… Signature…………….

Copy No. 2– Permit applicant

NO: EX 0001

ime:

……………

……………

s

……. ……. …….

idance sses

atch

arried out safely. CTRICAL

……………… …………….. ……………..

UTHORITY

e to ……………… ………………

UTHORITY . Date………

. Time…….

Copy No. 3– Approving Authority

SECTION 1 – REQUISITION APPLICANT’S NAME………………………………

STAFF NO./ ID NO…………………………………

WORK DESCRIPTION………………………………………………………………………………………………… …………………………………………………SECTION 2 – HAZARDS/HAZARDOUS A

Gas & Fumes Liquid under

pressure Chemical H2S

Working at height Electrical Hot Surface Dust

SECTION 3 – WORKSITE PREPARATIOIsolation by blinds (Y/N)

Valves isolated (Y/N)

Valves locked open/close (Y/N)

System drained/ flushed (Y/N)

System dep

Safety syste

Area barric

Warning sig

SECTION 4 – PERSONAL PROTECTIVE Mandatory


Chemical suit Chemical boots Face shields Goggles Disposable suit

R D E

SECTION 5 – ASSOCIATED PERMITS / D Electrical Isolation Permit no………..

Electrical Permit no………………….

Physical isolation Permit no…………

Safety Bypass Permit no…………..

E

L

C

R

SECTION 6 – JOINT SITE VISIT BEFOREI have personally checked the area and system

PERMIT APPLICANT

Name…………………………………. Designation………………………….. Signature……………………………..

AR

NamDesSig


Work Completed H

PERMIT APPLICANT Name…………………... Date……... Nam

Signature………………. Time …….. Sig


COLD WORK PERMIT

Date: …… DEPT./CO……………………………….…

. LOCATION/FACILITY……………………

………………………………………………….……………………………………………………………………

………………………………………………………………CTIVITIES

Scaffolding Excavation Radiography Lifting

Pressure Test Saw/Cold cut Hand tools Needle gun

N/PRECAUTIONS ressurised (Y/N)

m bypassed (Y/N)

aded (Y/N)

ns installed (Y/N)

Scaffold safe to use (Y/N)

Fire extinguisher at site (Y/N)

Escape ways clear (Y/N)

Pre job meeting done (Y/N)

EQUIPMENT espirators ust masks ar Plugs/ muffs

Cotton gloves Leather gloves Chemical gloves Rubber gloves

H2S meter Safety Harnes

OCIUMENTS xcavation Permit no……………….

ifting Permit no……………………

onfined Space Entry Permit no………

adiation Permit no………..

JSA required

Drawing no…

Others………

WORK STARTS / APPROVAL to be worked on and am satisfied that work requested can

EA SUPERVISOR

e…………………………………. ignation………………………….. nature……………………………..

APPROVING AU

Name………………Designation………Signature…………

AREA SUPERVISOR APPROVIN

ousekeeping completed Work incomplete…………………………………………

AREA SUPERVISOR APPROVINe…………………. Date……... Name………………

nature…………….. Time …… Signature…………


NO: CW 0001

Time: …………………… …………………… ………………………..

……………………

………………………..

Others ………………………. ………………………. ……………………….

Others………………..

………………………..

………………………..

………………………..

s Others………………… …………………

(Y/N)

…………….

……….

be carried out safely.

THORITY

…………………. ………………….. …………………..

G AUTHORITY

due to ……………………… ……………………… G AUTHORITY

…. Date……...

….. Time ……


SECTION 1 – REQUISITION APPLICANT’S NAME……………………

STAFF NO./ ID NO………………………

WORK DESCRIPTION……………………

………………………………………………………

SECTION 2 – TYPE OF LIFT Major Lift (66%-88% of load chart) H

SECTION 3 – CRANE INFORMATION

TYPE OF CRANE

BRAND NAME

MODEL SECTION 5 – ACTIVITY DETAILS

LOCATION OF LIFT

LENGTH OF BOOM

RADIUS

BLOCK

SLINGS/SHACKLES

SPREADER BAR

UPPER BOOM PT

CHART CAPACITY AT RADIUS

WEIGHT OF OBJECT TO BE LIFTED

TOTAL WEIGHT (PLUS RIGGING WE

SAFETY FACTOR OF CRANE

PERCENTAGE OF SAFETY CHART

NUMBER OF PARTS PER LINE

RATED CAPACITY PER PART OF LIN

ACTUAL LOAD PER PART LINE SECTION 4 – APPROVAL

CRANE SUPERVISOR

Name……………………………… Signature…………………………… Date……………..

LI

NaSigDa


LIFTING PERMIT

Date:

……………

DEPT./CO…………………….……

………….

LOCATION/FACILITY…………

……………………………….……………………

……………………………………………………………………

eavy Lift (20tons or more) Lifts Over/N

Truck mounted / Crawler Crane

RIGGING WEIGHT

kg JIB

kg BALL

kg LOAD LINE

kg PIN EXTRACTORS

TOTAL RIGGING WE

IGHT

E

FT SUPERVISOR

me……………………………… nature…………………………… te……………..

APPROVING

Name…………Signature……Date…………


NO: LP 0001

Time:

…………………

………………………

……………………..

……………

ear live services

kg

kg

kg

kg

IGHT

kg

kg

kg

kg

kg

each

kg

kg

AUTHORITY

…………………… …………………… …..



STAFF NO./ ID NO…………………………………WORK DESCRIPTION……………………………

………………………………………………………

………………………………………………………

SECTION 2 – HAZARDS/EQUIPMENT HV LV

Switchboar Cable Generator Switchgear

SECTION 3 – WORKSITE PREPARATIO Equipment & locked

Earthing installed

Cable discharged

Fuses withdrawn

Fire Extingu

Fire Blanket

Insulated too

Lock out tag



Goggles Electrically

Insulated boots

R D E

SECTION 5 – ASSOCIATED PERMITS / D Electrical Isolation Certificate no…….


C

R


PERMIT APPLICANT


RE

NamDesSign

SECTION 7 – WORK COMPLETION HOOK UP AFTER COMPLETI

Motor Reinstalled Generator reinstalled Cables Connected Megger/ Continuity Test Completed Other works completed Ready to Energise

SECTION 8 – PERMIT RETURN

Work Completed H


Signature………………. Time……... Sign


ELECTRICAL PERMIT

Date: …… DEPT./CO……………………………….……

. LOCATION/FACILITY………………………………………………………………………….……………………

………………………………………………………………………

………………………………………………………………………

EQUIPMENT TAGd Lighting

Motor Transformer

Others………………

N/PRECAUTIONS isher

ls available

s installed

Pre job meeting done

Barricades installed

Warning signs installed

O

……

……

……


Cotton gloves Leather gloves Chemical gloves Rubber gloves


OCIUMENTS onfined Space Entry Permit no……


JSA required

Drawing no……

Others…………

WORK STARTS / APPROVAL to be worked on and am satisfied that work requested can be

VIEWED BY AEP/ SAEP

e…………………………………. ignation………………………….. ature……………………………..

APPROVING AUT Name………………Designation…………Signature……………

ON DE-ISOLATION Earthing Removed Locks and tags removed Barricades and Warning signs removed Tools removed Open panels closed up

ousekeeping completed Work incomplete d………………………………………………

AEP/SAEP APPROVINGe…………………. Date……… Name………………

ature…………….. Time …… Signature……………


NO: E 0001

Time: ………………… ………………… ……………………..

………………………

…………………….. NO: ……………………

………………… …………………

thers………………..

…………………..

…………………..

…………………..

Others……………………………………………………

(Y/N)

………….

…………..

carried out safely.

HORITY

…………………. ……………….. ………………..

ue to …………………… ……………………


.. Time………



APPLICANT’S NAME………………

STAFF NO./ ID NO…………………

UNIT/AREA/FACILITY:

START DATE:………………………START TIME…………………………

WORK DESCRIPTION……………………

……………………………………………

……………………………………………

SECTION 2 – TYPE OF ISOLATIO Switch Out Ra

SWITCHGEAR

SWITCH BOARD PANEL LABEL/D

I herby confirm that the equipment (stenergised, isolated from all electrical sCOMPETENT ELECTRICAL PER Name………………………………Designation………………………Signature…………………………Date…………. SECTION 3 – OTHER PERMITS A

PTW NO.

SECTION 4 – REQUEST FOR DE-I hereby confirm that the work for whwas required has been completed, persrequest equipment to be re-energised. WORK SUPERVISOR Name………………………………Designation………………………Signature…………………………Date…………. SECTION 4 – NORMALISATION I hereby confirm that the electrical pow

AUTHORISED ELECTRICAL PE

Name………………………………

T


ELECTRICAL ISOLATION PERMI

Date:

…………………… DEPT./CO……………………………

………………. LOCATION……………………………

EQUIPMENT TAG NO:

…… …

CLOSE OUT DATE…………………CLOSE OUT TIME……………………

………………………………………………………….…………………

………………………………………………………………………………

………………………………………………………………………………

N REQUIRED ck out Record at log book Lock

LOCKS NOTICES

ESCRIPTION A C DANGER CAUTION EA

ated above) has been de-ources and safe to work on. SON (CEP)

…. ….. …..

CONFIRMED BY AUTHORPERSON (AEP) Name………………………Designation…………………Signature……………………Date…………..

SSOCIATED WITH THIS ISOLATION

ORIGINATING SECTION VA

ISOLATION ich electrical isolation onnel withdrawn and

…. ….. …..

I have checked the work area and confpersonnel or tools around the work areenergise the equipment. COMPETENT ELECTRICAL PER Name………………………………Designation…………………………Signature……………………………Date………….

er to the equipment has been normalised and can be used as requ

RSON (AEP)

Signature……………………………

Date……………


NO: EI 0001

Time:

….……………………

…………….

……………….. …………

………………………..

…………………………

………………………..

Out Tag Out

RTHED INITIAL

ISED ELECTRICAL

…………. ……….. ………..

LIDITY

irm that there are no a and it is safe to re-

SON (CEP)

…. .. ..

ired.

..



STAFF NO./ ID NO…………………………………

WORK DESCRIPTION……………………………………………………………………………………………………………………………………………SECTION 2 – HAZARDS/HAZARDOUS A

Welding Flame Cutting Open Flame Grinding

Blasting & Power brus Hot Tappin Photograph

SECTION 3 – WORKSITE PREPARATIO Gas Monitoring

Continuous Every ____hrs

Fire Watch Name__________

Fire Extingu Fire Blanket Fire Retarda Spark Arres Cover for dr Fire Hose st



Welding apron Welding shields Face shields Goggles B & P coveralls

R D E

SECTION 5 – ASSOCIATED PERMITS / D Electrical Isolation Permit no………..

Electrical Permit no………………….

Physical isolation Permit no…………


E

L

C

R


PERMIT APPLICANT


AR

NamDesSign


Work Completed H


Signature………………. Time……... Sign


HOT WORK PERMIT

Date: …… DEPT./CO……………………………….……

. LOCATION/FACILITY………………………

………………………………………………….……………………………………………………………………………………………………………………………………………………………………CTIVITIES Painting hing g y

Spark producing Self igniting material Gas & Fumes Hydrocarbon liquid

Other………………

N/PRECAUTIONS isher nt Screen tor on Engines ain/ sump andby

Pre job meeting done Gas Test Results Oxygen (19.5% to 22%) _____ Combustible (<10%LEL)_____ Toxic (<PEL)______

O

……

……

……


Cotton gloves Leather gloves Chemical gloves Rubber gloves Welding Gloves


OCIUMENTS xcavation Permit no……………….

ifting Permit no……………………

onfined Space Entry Permit no………


JSA required

Drawing no……

Others…………

WORK STARTS / APPROVAL to be worked on and am satisfied that work requested can b

EA SUPERVISOR

e…………………………………. ignation………………………….. ature……………………………..

APPROVING AUT

Name………………Designation…………Signature……………

AREA SUPERVISOR APPROVING

ousekeeping completed Work incomplete ………………………………………………

AREA SUPERVISOR APPROVINGe…………………. Date……… Name………………

ature…………….. Time …… Signature……………


NO: HW 0001

Time: …………………

…………………

…………………….. ……………………… ……………………..

s…………………… ………………… …………………

thers………………..

…………………..

…………………..

…………………..

Others………………… ………………… ………………

(Y/N)

………….

…………..

e carried out safely.

HORITY

…………………. ……………….. ………………..

AUTHORITY

due to …………………… ……………………


.. Time………



APPLICANT’S NAME………………………

STAFF NO./ ID NO…………………………

UNIT/AREA/FACILITY:

START DATE:……………………………

START TIME……………………………

SECTION 2 – WORK DESCRIPTION WELD SURVEY

ISOLATION/ COMMISSIONING OF SOU

SECTION 4 – RADIACTIVE SOURCE D

1. RADIOACTIVE SOURCE: (X-RAY/IS

2. MAXIMUM ACTIVITY (KV/Ci)………

3. TYPE OF RADIATION: ( X- RAY / AL

SECTION 5 – PRECAUTIONS TO BE TA AREA TO BE BARRICADED

WARNING SIGNS INSTALLED

X-RAY DOSIMETERS USED BY TECHN

SOURCED STORED IN APPROVED CO

SECTION 6 – VERIFICATION BY WNPOI hereby confirm that the site has been insnecessary safety precautions to carry out WORKS SUPERVISOR

Name…………………………………. Designation………………………….. Signature…………………………….. Date………….

SECTION 7– APPROVAL I hereby authorise the Radiation activity to bePERSON IN CHARGE Name…………………………………. Designation………………………….. Signature…………………………….. Date…………. SECTION 8– WORK COMPLETION I hereby confirm that radiation activity has beand the site has been restored for safe work AREA SUPERVISOR

Name…………………………………. Designation………………………….. Signature…………………………….. Date………….


RADIATION PERMIT

Date:

……………

DEPT./CO………………………………

………. LOCATION……………………………

CLOSE OUT DATE……………………

CLOSE OUT TIME……………………

CORROSION INSPECTION

RCE SPECIAL INVESTIGATIONS

…………………………………………

…………………………………………

ETAILS

OTOPE)………………………………………………………

………………………………………………………………

PHA /BETA /GAMMA0

KEN BEFORE AND DURING ACTIVITY

ICIANS

NTAINER WHEN MOVING TO WORK SITE

C SUPERVISOR pected, personnel removed and radiation technicians hthe activity.

carried out

en completed ACCEPTED APPROVING AUTHORITY Name…………………………………Designation…………………………Signature……………………………Date………….


NO: R 0001

Time:

.……………………

…………….

……………..

…………

……………………….

……………………….

……..

………

ave taken all the

. .. ..



APPLICANT’S NAME………………

STAFF NO./ ID NO…………………

UNIT/AREA/FACILITY:

START DATE:………………………

START TIME…………………………

SECTION 2 – WORK DESCRIPTIREASON FOR SAFETY SYSTEM B

…………………………………………

…………………………………………

…………………………………………

EFFECT ON SYSTEM DURING PER

…………………………………………

…………………………………………

…………………………………………

METHOD OF BYPASS

Physical Isolation

Temporary Removal of Instrument

SECTION 3 – ADDITIONAL PREC

PRECAUTIONS TO BE TAKEN

Bypass notification notified to all at

Permit copy located in control room

I shall implement all precautions as sp Name………………………………Designation………………………Signature…………………………SECTION 4 – APPROVAL I hereby authorise the applicant to pro

PERSON IN CHARGE

Name………………………………Designation………………………Signature…………………………Date………….

SECTION 5– WORK COMPLETIOI hereby confirm that the work for whBypass was required has been compleback to normal operating mode AREA SUPERVISOR

Name………………………………Designation………………………Signature…………………………Date………….


1
SAFETY SYSTEM BYPASS PERMIT
Date:

…………………… DEPT./CO……………………………

………………. LOCATION……………………………

EQUIPMENT TAG NO:

……

…

CLOSE OUT DATE…………………

CLOSE OUT TIME……………………

ON YPASS

……………………………………………………………………

……………………………………………………………………

……………………………………………………………………

IOD OF BYPASS

……………………………………………………………………

……………………………………………………………………

……………………………………………………………………

Hardwire jumper Temporary Se

Others………………………………………………………

AUTIONS TO BE TAKEN

site

Additional Precautions / Instruction

…………………………………………

…………………………………………

…………………………………………

ecified before work starts

…. ….. …..

ceed with Safety System Bypass as requested

…. ….. …..

N ich Safety System ted and the system is

…. ….. …..

ACCEPTED APPROVING AUTHORITY Name………………………………Designation…………………………Signature……………………………Date………….


NO: SSB 000

Time:

….……………………

…………….

………………..

…………

………………………

………………………

………………………

………………………

………………………

………………………

tting Change

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019 - permit to work

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