Guidelines for the Management of Change for Process Safety

by Center for Chemical Process Safety

Copyright 2008 American Institute of Chemical Engineers, Inc

APPENDIX C:
EXAMPLES OF MOC SYSTEM
PROCEDURE WORK FLOW CHARTS
AND MOC REVIEW DOCUMENTATION
FORMS

The following figures provide examples of MOC system procedure work flow
charts and MOC review documentation forms. These charts and forms should
be considered advisory; they should not be used directly without going
through the proper MOC system design and development activities discussed
in Chapters 3 and 4.
Figure C. 1.
Figure C.2.
Figure C.3.
Figure C.4.

Example of an MOC system procedure work flow chart.

Example of a simple MOC review documentation form.
Example of a moderate MOC review documentation form.
Example of a complex MOC review documentation form
(including checklists).

123

Yes

Initial Review

Classification
Review

Hazard Review

Figure C.l Example of an MOC System Procedure Work Flow Chart

125

126

GUIDELINES FOR MANAGEMENT OF CHANGE

Complete tasks
identified as
required before
implementation

Authorization
Review

Close-out
Review

Figure C.l Example of an MOC System Procedure Work Flow Chart (cont 'd)

APPENDIX

127

Change description and rationale:

If the change is temporary, list the

pertinent dates. Dates valid:

Originator
This change has met the appropriate review requirements and has been
approved. Safety, health, and environmental concerns have been addressed,
procedures have been revised, the appropriate training and/or communication
activities have occurred, and all affected process safety information is being
updated.

RFC Authorizer

FIGURE C.2. Simple MOC Review Documentation Form

128

GUIDELINES FOR MANAGEMENT OF CHANGE

Unit or Area:

RFC No.:

Description and reason for change:

Date:

Orignator
Temporary Change
Removal Date:
Environmental, health, and safety reviews are complete and all concerns have been addressed.

EH&S Review Team Leader

Operating maintenance, and emergency procedures have been reviewed

Area Procedures Coordinator

All affected personnel have been informed of the change. The appropriate trailing has taken place.

Are a Tr aining C or dinator

All affected process safety inform edi on is scheduled for revision.

Unit Engneer

PSSR Required

PSSR No.:

This change has met the appropnate review requirements and has been approved.

Area Manager

FIGURE C.3. Moderate MOC Review Documentation Form

129

APPENDIX
REQUEST FOR CHANGE FORM
Standard Change
Emergency Change
Temporary Change

RFC No. .
Date Requested,
Date Required,

Unit

System or Equipment

Description (include technical basis for change):

Originator

I. TensOrary Changes (slap for permanent changes). This inicematian maybe provided in a temporary procedure (attach copy)
Whyis this designated a tempztraiy change?
Additionalpiecaxticns required:
Contingency plan
Dates valid:
Feisonresponsiblefbrtemoving the change:
II. Safety, HealtH and Environmental Reviews
Process S afcty (specify rnetliod)
Ocoipatianal Safe tyJlndustiul Hygiene
Enviraunenta] Review (s)

Reqd' Responsible
(Y/N) Party
Y

Target
Date

Date
Complete Initials

* Complete = Actianitems with immediate iripact are resclved and planis inplace to address long range items.
III. FfrcceduresRevised
Reqd' Responsible
(/) Party
Y
StaitupfthitdaviVErnejgeiry Shitdcwn
Normal Operation
Maintenance
Emeigency Response
Other (e.g., administrative)
** Complete = Revised procedures issued ;ary obsolete proaeduies discaidel.

Target
Date

Date
Complete

FIGURE C.4. Complex MOC Review Documentation Form (including

checklists)

Initials

130

GUIDELINES FOR MANAGEMENT OF CHANGE

I.

Training

W4

Operations
Mainterustce
Cortactor
Other

(Y/N)
Y

Individuals or Responsible
Groups to be trained ftrty

Taiget
Date

Date
Complete Initials

' Complete = AU specified peEcemel lave teceived and undeistood training. Responsibility fcf Any changetopermanent training
(e.g., learning blocks) is assigned and scheduled.
II. Process Safety IrfomiionRevised
WD
Access Flow Diagram
Electrical System Dooimentation
Reliefs ystemDooimentatkn
Spare Parts List
MSES
Documented Operating Limits
Other
* Ccetffeteif the are aiy Yes responses:
Folow-up Responsib ility
PS S R Responsibility
PSSR No.

Reqd' Responsible Date Target

(YiN) Party Coxtflete" Date
Y

Initials

III. Authorization
This change has net the appropriate leviewrequiietnenband has been appioved.
Aiea Operations Manager

Area Engineering Manager

IV. Close-out Review

All of the indicated process sa&ty infce-rraticffi revisions (S action V) hac^e been completed. This MOC action is complete.
FIGURE C.4. Complex MOC Review Documentation Form (including
checklists) (cont'd)

131

APPENDIX

G Off-hours review
MOC initiation dale
R e quire d implem e ntati on date

P lant modifi c ation tracking no.:

Modification title:

Permanent G
TemporaxyG
Expires
Date:
Requestor:
Unit:
FCCU
F-Alky
G Crude
G Quality Control
H
G Reformer
G Terminal
G Maintenance
G Other
Estimated costs of modification: Parts, material, equipment
Labor
Total
Description of change
D oes a sketch accompany this form? G Y es G

Purpose (technical basis)

otential impact on safety, health and the environment (including the public)

Reviews
G Approved

Area Manager

Dete

G Denied

C omments, conditions, or reasons for denial

azdreview required Q Yes Q No

Technique: MOC

G WhaUif

HAZOP Q Other

Initials
G Approved

Area Engineer

Dcte

D eti e d

C omments, conditions, or reasons for denial

Deagnresponsibility assigiedto

Design review required DYes D No

FIGURE C.4. Complex MOC Review Documentation Form (including

checklists) (cont fd)