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Process:

Date of checking:

Checked by:

Sr. No. Recommendations Observations as checked Complied or Remark from


in plant not Safety
Yes/ No

Whether the HAZOP recommendations are complied in totality: - Yes / No

Checked by: - Verified by :-

Name: - Name :-

Signature: - Signature :-

Signature Date
Prepared By: HOD 04.08.2009
Approved By: Location Head 04.08.2009

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