SAFE WORK

PROCEDURE NUMBER: HES-204

2 Specific Safe Work Practice Training 5 3.4 Authorize Work to Begin 7 5.0 Instructions 7 5.0 Prerequisites 4 3. Work Completion 7 6.0 Reporting Requirements 8 8.0 Scope 3 3.0 Documentation and Records Retention 9 9.0 Roles and Responsibilities 8 7.0 Purpose 3 2.1 Qualified Third Party Person in Charge 4 3.3 Use of a Contractor PIC for work requiring only a safe work permit 5 4.2 Hazard Evaluation (Analysis) 7 5.6.3 PPE 7 5. 2 CPL HES 204 Safe Work .0 Process Overview 6 5.5 Permit Extension 7 5.0 Document List 9 Appendices A Glossary B Safe Work Permit Revised & Printed January 2012.1 Permit Origination 7 5. Uncontrolled when printed. CPL – HES 204 Safe Work CONTENTS SAFE WORK HES-204 Section Title Page 1.

2. o Un-flanging or removal of heads. opening.0 Purpose The purpose of this procedure is to: • describe the written safe work permitting process. o Working on live electrical equipment over 50 Volts. or equipment that has been in service. process piping. o Excavation Permit. isolating blinds. or system that has been in service. c) Pipeline repair. disconnecting.1 Personnel and Activities Covered by this Procedure This procedure applies to all maintenance and construction work performed by Chevron Pipe Line Company (CPL) workforce including but not limited to: a) New construction. f) Hot taps. CPL – HES 204 Safe Work 1.0 Scope 2. and • establish requirements to be followed when performing work.2 Personnel and Activities Exempt by this Procedure • Normal operations performed by CPL Employees • Delivery services • Office machine repair service Revised & Printed January 2012. man ways. process piping. h) Site remediation projects. equipment. or removal of any line. blind flanges. Uncontrolled when printed. o Confined Space Permit. compressors). and i) Any other work that is hazardous or unusual such as: o Working from heights where personal fall protection is required. o Removal of process valves and relief valves. g) Overhauling of equipment (pumps. o Isolation Lockout/Tagout (LOTO). 2. b) Any work that requires: o Hot Work Permit. Unbolting. and o Construction work (includes the installation of new equipment and the modification of existing equipment). o Electrical Safe Work Permit. 3 CPL HES 204 Safe Work . d) Pipeline replacement. e) Tank or vessel maintenance and/or repair. o Overhead activities involving rigging in a congested area or over piping or equipment in service.

c) Upon completion of the Safe Work Practice Permit training.1 Qualified Third Party Person-in-Charge Individual contractor hired by CPL as third party may assume the responsibility as a CPL PIC. must approve the individual to act as a PIC on behalf of CPL.0 Prerequisites 3. • Qualified Third Party (PIC) Must be a Contractor separate and distinct from the contractor performing the work (a third party who does not work for the contractor. Records of the training shall be retained in the appropriate office for three (3) years. by the Health Environment & Safety (HES) Training Group. provided that the following apply: • Use of a PIC will be determined on a job-by-job basis. Qualified means trained in applicable procedures and understands the hazards. exposures. b) The Third Party PIC must be trained on the applicable CPL Safe Work practices permitting systems. and associated impact to operations from the activities in the facility. a) Team Leaders responsible for the assets and/or Project Manager. 4 CPL HES 204 Safe Work . risks. and excavation). Terminal operations 3. • Approval for using a Qualified Third Party Contractor as a PIC will be determined based on work location and scope of work. confined space. hot work. risks. the individual’s knowledge must be validated (90% on test). and assure the Third Party PIC or PIC Contractor is trained and qualified in the operations process. and understands the hazards.) Revised & Printed January 2012.3 Specific Safe Work Practice Training for training requirements). Approval can be authorized by either the Team Leader or Project Manager “from CPL Projects Management Group”. d) The PIC qualification documentation must be in writing by the Team Leader and kept on file. f) Third Party PIC can sign any of the Safe Work Practice Permits (safe work. (See section 3. e) Certification for PIC is only valid for three (3) years from the day of training. Uncontrolled when printed. CPL – HES 204 Safe Work • Pest control • Laundry service • Janitorial service • Utility service • Third party training personnel • Day to day loading and off loading at those facilities where it is part of their operation ie. exposures. In no scenario will a Third Party PIC be allowed to initiate or approve a Lockout/Tagout (LOTO. and associated impact to operations from the activities in that facility or work location. All training must be attested to by the Team Leader and/or Project Manager or designated CPL employee representative and records maintained at the appropriate office. but works directly on behalf of CPL) who has been trained in CPL applicable procedures.

3. (For general knowledge only. and excavation) acknowledging concurrence per telecom. hot work. Team Leaders or designated CPL employee representatives must confirm (test) the Contractor PIC’s knowledge of the specific work operation and CPL Safe Work Permit process. (See section 3. Uncontrolled when printed. or designated CPL employee name. Possible Examples of (but not limited to) safe work permits only activities that can be initiated and signed by a Contractor PIC are: o Right-of -Way Mowing. o Telecommunication Maintenance. Revised & Printed January 2012. o Sign Maintenance. The Third Party PIC nor Contractor PIC cannot perform Lock Out Tag Out. CPL – HES 204 Safe Work g) Permit Origination and Extensions: the Third Party PIC must review the permit(s) requirements and receive daily concurrence by phone from the Team Leader and/or Project Manager or their designated CPL employee representative. o Line Locate. The Contractor PIC must be trained on the applicable CPL Safe Work practices permitting systems. verification must not be given per telecom and work must not commence. which provided concurrence per telecom next to their signature. o And/or any other job at the Team Leader’s discretion.) g) Job Safety Analysis (JSA) using Hazard Identification Tool h) Job Site Safety Plan (JSSP) i) Any specific training that may be required per job.3 Use of a Contractor PIC for Work Requiring Only a Safe Work Permit The Team Leader (TL) can designate any Qualified Contractor to act as a PIC to initiate and sign Safe Work permits only. etc. h) If the Team Leader and/or Project Manager or their designated CPL representative does not concur with the Third Party PIC. o Surveying. o Window Air Conditioner Maintenance. 5 CPL HES 204 Safe Work .2 Specific Safe Work Practice Training for training requirements). 3. prior to signing the Safe Work Practice Permit(s).2 Specific Safe Work Practice Training Specific Safe Work Practice Permit Process Training a) CPL Safe Work Procedure and Permit b) CPL Hot Work Procedure and Permit c) CPL Confined Space Procedure and Permit d) CPL Excavation Procedure and Permit e) Occupational Safety and Health Administration (OSHA) Competent Person f) Lockout/Tagout. The Third Party PIC must sign the permit in the appropriate place and sign the Team Leader and/or Project Manager. o Weed Spraying. (safe work. confined space. After receiving verbal approval from the Team Leader or designee the Qualified Contractor can sign the permit and begin work. by the Health Environment & Safety(HES)TrainingGroup.

6 CPL HES 204 Safe Work .0 Process Overview Is a Safe Work Permit No STOP required? Yes Identify the PIC for the job/work Is the Use SWA and complete Job Scope No the scope of work complete? Yes YES Is a Use SWA and complete CPL JSA the JSA required? Yes Has the No JSA been No completed? Yes PIC fills in the general section on the Safe Work Permit PIC and person(s) conducting the work meet at the job site Complete the Hazard Analysis (if there is no CPL JSA) and the PPE section Review the permit with the PCW(s) Are all of STOP! the requirements and MAKE SURE THAT ALL No conditions met & REQUIREMENTS ARE MET understood BEFORE PROCEEDING Yes PIC and Person conducting Are there When complete return the work sign and date the any other permits No Work Begins permit to PIC permit required? Yes PIC files permit in the appropriate office Complete other permits as required Revised & Printed January 2012. Uncontrolled when printed. CPL – HES 204 Safe Work 4.

If a CPL JSA is completed then Hazard Analysis section can be skipped. and equipment being worked on. the permit must be signed and dated.4 Authorize Work to Begin Once the conditions of the permit are met and the PIC and PCW agree. Uncontrolled when printed. b) date and time limits (schedule time). the single person must review the permits with. d) tools/equipment to be used. 5. Once concurrence is received. This can be done per telecom or in person. Any permit that does not contain the current date and required signatures and initials is not valid and work cannot be performed. and sign the permit(s) as the PCW. at a minimum. in order to aid in the proper selection of personal protective equipment. c) description of the work. and must specify: a) the facility.1 Permit Origination .5 Permit Extension A permit may be extended beyond a shift change. If there is a CPL JSA required as part of the job. the hazard analysis is not needed as part of the Safe Work Permit. 5. and e) person(s) conducting the work (PCW). The PIC specifies the required CPL permits that will also need to be completed prior to the beginning of work. For times when a single person is performing the work alone. These permits include LOTO (HES-203). Hot Work (HES-205). the single person must note the name of the Team Leader or Designee providing concurrence as the PIC. When performing work alone. and the work may begin. if: Revised & Printed January 2012. 7 CPL HES 204 Safe Work . and other permits that may apply. 5.3 PPE The PIC specifies the required Personal Protective Equipment (PPE) that will need to be used (see HES-501). job boundaries. and attain verbal approval from the Team Leader or Designee.2 Hazard Evaluation (Analysis) The PIC and the Person Conducting the Work (PCW) will conduct a hazard analysis within the boundaries identified in the Safe Work Permit. Safe Work Permit Form). These tasks will be determined by the Team Leader. 5. Excavation (HES-202). The PIC specifies and assures that a JSA is conducted on-site and remains on location until the job is complete. Confined Space (HES-201). Some routine tasks may not require a permit.0 Instructions 5.General Section The PIC initiates the safe work permit process by completing the general section of the permit (See Appendix B. CPL – HES 204 Safe Work 5. the same person cannot act as both the PIC (CPL PIC or Contractor PIC) and PCW at the same time.

the PCW removes and gives the permit to the PIC or CPL Representative. Uncontrolled when printed. 5. Role Responsibilities Person in Charge (PIC) The PIC is responsible for: • initiating the safe work permit process. • communicating restrictions and conditions to other personnel in the job boundaries. 7. and • filing the permit (Third Party PIC or Contractor PIC must turn in permits to local field team for filing). 6. and • safe execution of work being performed. CPL – HES 204 Safe Work • conditions remain unchanged and it is safe to do the work. • the overall safety of personnel and equipment from operating hazards until the job is complete.0 Reporting Requirements None Revised & Printed January 2012. • assuring all required fire and safety equipment is in place and in working order.6 Work Completion Once the job is completed. and • the PIC and the PCW confirm that conditions are safe and the permit restrictions continue to be met then date and sign the permit. • specifying all required restrictions and assuring necessary steps are taken to eliminate the possibility of an incident. • giving final approval of the permit. • A permit may be extended for four consecutive shifts. not to exceed 12 hours per shift.0 Roles and Responsibilities The following table outlines the roles and responsibilities associated with this process. 8 CPL HES 204 Safe Work . Person Conducting the Work The PCW is responsible for: (PCW) • complying with all conditions and requirements of the safe work permit.

Revised & Printed January 2012. Document List Documents Retention and Storage CPL – 204 Safe Work Safe Work Permits must be kept 2 years at the appropriate Permit is used to document office appropriate office.0 Documentation and Records Retention 8. Uncontrolled when printed. this procedure.1 Document Control Information Document Control Information Description Approval Date 15 December 2011 Next Revision Due 15 Decem ber 2012 Control Number Document History Version Number Date Notes related to changes 1.3 15 December 2011 Reviewed for content (CPL and regulatory requirements).1 Not Available Not Available 1. CPL – HES 204 Safe Work 8. 9 CPL HES 204 Safe Work . Contractor as a PIC 1.0 20 July 2009 Third Party PIC responsibilities.0 Document List This is a complete list of the documents referenced in this process.2 August 2009 Not Available 1. 9.

or oversees the work of a contractor. adjustments. measurements. However. or a qualified third party contractor. risks. Non-Routine Maintenance Any maintenance activities outside the realm of routine maintenance. Inclusion of: CPL Employees. intended to restore or retain. contractors and sub- Workforce contractors. The person performing the work Requestor/Work Owner The person who selects. replacements. and repairs. A Contractor separate and distinct from the contractor Qualified Third Party PIC performing the work (a third party who does not work for the contractor. Contractor A person who agrees to furnish materials or perform services at a specified price for construction. The act of maintaining or keeping something in proper Maintenance condition or upkeep. exposures. but works directly on behalf of CPL) who has been trained in CPL applicable procedures. CPL – HES 204 Safe Work Appendix A – Glossary Team Leader responsible for the assets. Revised & Printed January 2012. that has overall responsibility for determining acceptable conditions in the area are safe for the task to be performed and for the safety of personnel and equipment until the job is complete. Any activity. and understands the hazards.Charge can be a third party inspector who is acting as the Company representative. the Person-in. 10 CPL HES 204 Safe Work . The PIC cannot be a contractor working for the same contract company performing the work. hires. Uncontrolled when printed. such as tests. and associated impact to operations from the activities in the facility. or their designated Person-in-Charge CPL employee representative.

CPL – HES 204 Safe Work Appendix B – Safe Work Permit Form (CPL-204) Use link (CPL-204) to get full document example shown below: Revised & Printed January 2012. 11 CPL HES 204 Safe Work . Uncontrolled when printed.