POD/HAWIYAH GAS PLANT

ENERGIZATION FORM
(CERTIFICATE)

B.I. NO.

10-01256

SUBSTATION: PIB-03 H88-PIB-PP-001

LOCATION: PLANT HGP

EQUIPMENT: H88-MOV-3070
CIRCUIT:

FROM PIB-03 H88-PIB-PP-001 TO H88-MOV-3070, UTILITIES AREA.

( PC-4356 )
PROJECT ENGINEER:_____________________________________________ DATE:_______________
PROJECT INSPECTION REP._______________________________________ DATE:_______________
FOREMAN, OPERATION UNIT_____________________________________

DATE:_____________________

FOREMAN, POWER SERVICES UNIT_______________________________ DATE:_____________________

FOREMAN, POWER RELAY UNIT__________________________________DATE:_____________________
FOREMAN, POWER LINE/CABLE UNIT_____________________________

DATE:_____________________

SUPERVISOR, MAINT PLNG UNIT__________________________________

DATE:_____________________

POD ENGINEER__________________________________________________

DATE:_____________________

APOD DIV HEAD:

NAME:_____________________________

SIGNATURE_________________

DATE:_____________________

SENIOR OPERATIONS REP. _______________________________________DATE:_____________________

APOE/TSU ENGINEER/SUPERVISOR_______________________________

DATE:_____________________

ESO REP./POWER PLANTS FOREMAN______________________________

DATE:_____________________

AREA MAINTENANCE FOREMAN_________________________________

DATE:_____________________

AREA OPERATIONS FOREMAN____________________________________

DATE:_____________________

AREA MAINTENANCE SUPERINTENDENT__________________________

DATE:_____________________

AREA OPERATIONS SUPERINTENDENT:

NAME:_____________________________
DATE ENERGIZED:_____________________
TIME ENERGIZED: _____________________

SIGNATURE_________________

DATE:____________________