OGIS – FM(6)-CDOP-F08 Date of issue : 01 Aug 2008

Page : 1 of 1 Revision : 1

HOT WORK CHECK LIST & PERMIT

熱工作業前檢查表及許可證
Ship's Name : Voyage :
船名 航次
Date of issue: Time of issue : Duration of validity (hours):
簽發日期 / / 簽發時間: 有效時間:___________小時
The validity duration of this permit is 24 hours or less 本表自簽發時間起算 24 小時內有效

Work location.
施工位置

No. Check Safety Check List

項次 檢查 安全檢查項目
1. 工作區及鄰接艙間是否已清除油氣? Have the work area and its adjacent areas been gas-freed?
2. 工作區通風是否充足? Dose work area have adequate ventilation?
3. 工作區內之可然物是否已移除? Has the flammable material in the sits been removed?
4. 工作區氣體是否經過測試? Has the air of work area been detected/tested?
易爆氣________LEL(碳氫氣含量<20LEL) Explosivegas_________LEL(HYDROCARBON<20LEL)
(如測出易爆氣時應採取相關防護措施以策安全) (take necessary actions if any explosive detected)
5. 消防裝備是否已取出備用? Does fire-fighting equipment laid out and ready for use?
滅火器________個: 水龍帶___________條 Fire extinguisher __________ pcs : Fire hose ___________
pcs
6. 沒有進行然油移轉作業. No bunker transfer in propose
7. 附近無易爆炸物品或危險貨物. No explosives or dangerous cargo in vicinity.
8. 是否已建立通信? Has the communication been established?
9. 是否已取得港務機關許可?(如有比要) Has Port Approved been obtained?(if applicable)
10. 若是蒸汽或高壓油, 水管路, 確認已釋壓? Has the pressure in the pipes been released?
11. 馬達電源及相關之閥(含液壓閥)是否均已關 Has the source of motor been turned off and the
閉? relating valves been shut off ?
12. 若使用電焊機, 確認已接地 ? Has the welding apparatus been grounded ?
13. 若使用瓦斯切焊裝置, 確認已正確選用器具? Has the proper gas cutting instrument been chosen ?
14. 是否已配置防火警戒? Has the fire watch posted ?
警戒人員性名: Name of the watchman:

All of the above listed items have been checked. It is considered safe to proceed with this work. 以上項目業經檢查,
確認施工安全無慮.

Person in charge 負責人 CO. / 1E. Master/CE

Remarks 備註: This form should retain on board for one year. 本表存船一年備查.