Professional Documents
Culture Documents
FOR:
27/02/2004
WorkToBeDone:
1YEARLYAnnuallyElevatorInspection&
Certification)
Yes No
WK Permit No:
AssessorName:
WorkPeriod:1hour
1.Bagus WS
3.
Date&TimeStart
:27/02/2004
2.Shift Spv.
4.
Date&TimeFinish
:27/02/2004
Rangeofmethodsbywhichworkcouldbedone:
Method1. Test of Emergency power supply unit , stop and emergency exit contact , safety edge and
photo cell , alarm and intercom system , door drive contacts and switches , and certification
Method2.
SelectedMethod
Detailanyworktobeperformedoutsidetheworkarea/spacethatmaycreateariskto
personnelwhilsttheyarewithintheworkarea/spacee.g.vehicle/stationaryenginefumes,
maintenanceactivities.
Emergency procedures:
Station Emergency Procedures
Special Procedures as attached
HAZARDS IDENTIFIED
RISK
Hazardous Substances
Chemical Contaminant
Chlorine
Ammonia
Ozone
Carbon Monoxide
Carbon dioxide
Hydrogen Sulfide
Dust
Sulfur dioxide
YES
NO
YES
NO
HAZARDS
Flammable Contaminants
Coal
Hydrogen gas
Fuel Oil
Lube Oil
RISK
YES
NO
YES
NO
PAITON 7 & 8
HAZARD RISK ASSESMENT FOR ACCESS TO PLANT
FOR:
27/02/2004
HAZARDS IDENTIFIED
RISK
YES
NO
Other
Manual Handling
Environmental Impact
Entrapment
YES
NO
HAZARDS
Fire Risk
Class A
Class B
Class C
Work Environment
Lighting
Heat
Humidity
Cold
Slippery Surfaces
Traffic (Pedestrian)
Height/Falls
RISK
YES
NO
YES
NO
CONTROL MEASURES
Safety Helmet
Safety Shoes
Eye Protection
Hearing Protection (ear muff/ear plug)
Welding Mask
Leather apron/gauntlet
Leather gloves
Dust Mask
Rubber Gloves
Rubber apron
Safety boot for chemical
Safety Goggles
Safety harness
Self Contain Breathing Apparatus (SCBA)
VARIABLE ISOLATION
PAITON 7 & 8
HAZARD RISK ASSESMENT FOR ACCESS TO PLANT
FOR:
27/02/2004
The following tests are required to assess the atmospheric conditions within the nominated space:
Test For
Relative Vapor
density to air
Station Standard
Test Required
(thick selection)
Yes
No
Ammonia
0.59
Carbon Dioxide
1.53
Carbon Monoxide
0.97
Chlorine
2.47
Hydrogen Sulfide
1.19
Lessthan5%
LEL
Oxygen
1.1
Lessthan23.5%
Ozone
1.66
Sulfur dioxide
2.26
NOTE:
For clarification on the test required to be carried out refer PI-01-04-03 (Testing Of
Confined Spaces)
Signature:
( Bagus WS )
Applicant
Date :25/02/2004
) (
Shift Supervisor
Time :15.00
) (
PAITON 7 & 8
HAZARD RISK ASSESMENT FOR ACCESS TO PLANT
FOR:
27/02/2004