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McKee Refinery DATE:

Energy Isolation List _______________

Unit: LOCK BOX:


Equip: _______________
Equip. #: LOCK BOX SEAL #
P&ID: _______________
INSTALLATION & REMOVAL VERIFICATION

Deviation
EIL Type: Page
Locks/Tags Installed/Removed Initialed By Blinds ______ of ______
Seal
ENERGY Ops. M&C Elec. Mech. Inst. Contr. Contr. Other Initialed by
Lock / Blind ISOLATION POINT LOCK 0 Verified
Tag Size/ Location / ID # 0 BLIND Installed
No. Rating (line-out unused isolation points)
Type Magnitude
Y/N Complete
Ops. Maint.
Exists
COMMENTS
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Installed
Removed
Completed forms shall be submitted to Supervision for Isolation Procedure Document Retention
CONFINED SPACE ENTRY (isolation complete including streamers)
Entry Supervisor _________________________ Date _______________ Operations _________________________ Date _______________
Handwritten / unvalidated isolation points on this EIL have been: P&ID Verified Field Verified Operations Sup Approved (required) (save for super-user)

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