Nomination Training Form – Authorised Roles in the PTW System

Form S###
Ver. 1 (10 July 10)
Complete S### - Nomination Training Form to nominate, as the Supervisor, an employee to undertake training to ascertain an Authorised Role to
allow them to undertake specific activities under PTW on site. Refer to CS-PTW-SOP-02 for further information.
Section1 – What Role/s is Employee to undertake?

Select relevant boxes to indicate the role that will be required of the person on site. The appropriate training will be arranged from this selection
Please indicate by selecting the relevant boxes:
Is this Nomination:
New/Trainee
Renewal
Core PTW Role Additional Requirement

Officer in Charge of Work (OIC)
Manage Confined Space
High Voltage OIC

Permit to Work Officer (PTWO)
Isolation Officer

Senior Permit to Work Officer (SPTWO)
Template Officer
Authorised Site Role
Confined Spaces Electrical Other
2

Work in a Confined Space
Safety Observer General
Bonded Asbestos Removal <10m
2

Standby Person for a Confined Space
Safety Observer Electrical
Bonded Asbestos Removal >10m

Air Quality Testing
Electrical worker
Cooling Tower Access

Operate Breathing Apparatus
Switching Officers Assistant
Working at Heights

Switching Officer

High Voltage Working Party Member

Working near Electrical Equipment

Instructed Person in Switchyard
Section2 – Employee/Contractor Details?
Surname: .........................................................................................................................................................................................................................
Given Name/s: ................................................................................................................................................................................................................
Company Name: ............................................................................................................................................................................................................
Occupation/Trade: .........................................................................................................................................................................................................
Phone: ............................................................................................... Mobile: .........................................................................................................
E-Mail: ............................................................................................... Fax: ................................................................................................................
Section 3 – Previous Experience
Have you worked in a Power Station before?
Yes
No If Yes, Which Location/s
If yes, which Location/s: ...............................................................................................................................................................................................
Have you held any similar Authorised Roles (see above)?
Yes
No
If yes, please list: ............................................................................................................................................................................................................
Time Period held: ...........................................................................................................................................................................................................
Note: If seeking training nomination for the first time, attach a list of previous experience and/or qualifications on Power Station
sites or relevant industrial plant to support your nomination and demonstrated knowledge of the plant.

Contractors Only:
What are the plant will you be working on: ....................................................Station , Unit .............................................. (e.g. Callide B1)
What plant area will you be working on (e.g. Boiler, Mills, Fans): .........................................................................................................................
Cost Centre: .............................................. CSE Contact: .......................................................................... Period on Site: ............................................
Section 4 – Site Approval
Employee/Contractor Declaration: I understand that I am required to undertake and satisfactorily complete the necessary training
and competency assessment to be authorized to perform any role listed above. Before undertaking activities relating to these
Authorised Roles I must receive a formal authorization memorandum from Site Management.
Signature of Nominated Employee/Contractor: .................................................................................................... Date: ...../...../.....
Name of Supervisor: ....................................................................... Signature:....................................................................... Date: ...../...../.....
PTW Administrator Approval: ....................................................... Signature:....................................................................... Date: ...../...../.....
Work Centre Created: .................................................................... Signature:....................................................................... Date: ...../...../.....
Note: Extension of Authorisation expiry dates will only granted on extreme circumstances i.e. in the interest of safety or crisis
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Nomination Training Form – Authorised Roles in the PTW System
Form S###
Ver. 1 (10 July 10)

The Procedure for Obtaining an Authorised Role working under a PTW

Step 1 – Complete Nomination Form

CS Energy Employees:
1. Complete Nomination Training Form – Authorised Roles in the PTW System
Ensure Section 4 is completed
(Supervisor’s endorsement is completed).
2. It is the Supervisor’s responsibility to tick  the relevant roles the need the Employee to attain
this will indicate to
the L&D Administrator the courses that need to be booked for that individual.
Contractors:
1. Complete Nomination Training Form – Authorised Roles in the PTW System
Ensure Section 4 is completed
(Supervisor’s endorsement is completed by the CS Energy Contact/Contract Administrator).
2. It is the CS Energy Contact/Contract Administrator’s responsibility to tick  the relevant roles the need the
Contractor to attain
this will indicate to the L&D Administrator the courses that need to be booked for that
individual.

Step 2 – Current Training Completed

3. Attach previous attained records of completion or demonstrate evidence of competence.
To Print Current training (CEDS)
• From the Intranet click SAP Portal link

• Select
• Select Reports – Current Plant Completed or OIC Status
Contractors:
3. The Site PTW Administrator will then contact the Contractor direct to review their competency.
Employees & Contractors:
4. Send to Site PTW Administrator (Site Superintendent or step up) for approval.
5. If unsuccessful, you will be asked to meet with the Site PTW Administrator to discuss the reasons.

Step 3 – Complete Further Training Required

6. L&D Administrator will book the next available courses that are needed for that individual to gain authorisation to
perform that role – refer to CS-PTW-02 Training and Authorisation in the PTW System.
7. These courses will all need to be completed before competency status is issued in SAP. You may have a period to
complete a competency after the completion of the training course in order to be authorised in that role (e.g.
Switching Officer).

Step 4 – Authorised by Site PTW Administrator

8. When authorised for a role, an expiry period will be issued in which it is the responsibility of the
Employee/Contractor to complete this form again to book a training or refresher course.