SAFE WORK METHOD STATEMENT

Title & Description of Work: To carry out blinding and de-blinding works.

Work Executed by PEC Preparation Date

Work Location / Area Applied for PTW No.

1. Scope 1.1 To carry out blinding and de-blinding works.

 Work order
2. References 2.1  HOA-MS-MEC-0004_BLINDING AND DE-BLINDING WORK_RTN R2
 MD-04-MT-RSSTA-PD-025 Rev.01 Maintenance Procedure for Bolted Flange Joint Management

 NSRP HSSE PIC.

 NSRP Supervisor.
 PTW Requester.
3. Responsibilities 3.1
 PTW Issuer.
 Task Supervisor.
 Worker Crew.

4. Equipment / Tools 4.1 Hand tools, torque wrench, flange spreader

5. Materials 5.1 Gasket, RP7, rags

Resources
6. 6.1 PEC Resources (Supervisor, workers)
(Manpower & others)

7. Work Steps 7.1 1. Mobilization tools/equipment/material.

2. Identify Blinding Location
3. Unbolting to open the blinding flange
a. First, ease and loose the bolts and nuts at the 180° position as shown in the diagram below, check if any sound
or pressure or gas or liquid comes out from there. Ensure the work crew is not standing the line of fire i.e.

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 directly standing at the opposite direction of the loose bolt and nuts.

00

2700 900

1800
b. Stop work and tighten back the flanges immediately and report to Operation and NSRP supervisor if there is
liquid coming out from the flange joint
c. If no leak is found, continue to remove 270° and remove the remaining bolt and nuts.
d. Use flange breaker to create space between flanges to install the required blind
4. Cleaning flange gasket seating face.
5. Install of gasket.
6. Alignment check and Tightening bolt/nut by manual.
7. Housekeeping and Close out PTW/WO

 Pinch points.
 Propylene fluid
8. Safety 8.1
 Isolation
 Improper tools/equipment.

 First line break checklist.

9. Hold Point and Supervision required 9.1  Alignment check.
 Bolt torque value.

10. Attachment 10.1 WO, P&ID, plot plan, SDS.

Name Signature Date Position Company

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 Prepared by Work Execution PIC HOANG XUAN BAO 16/03/2022 LEAD TECHNICIAN PEC

Reviewed by Work Execution Manager DILIPKUMAR 16/03/2022 SITE MANAGER PEC

Reviewed by NSRP Responsible Discipline PIC NGUYEN VAN TUAN 16/03/2022 SUPERVISOR NSRP

Approved by NSRP Responsible Discipline Manager 16/03/2022 NSRP

JSA CHECKLISTS

Title & Description of Work To carry out blinding and de-blinding works.
Work Executed by PEC Preparation Date
Work Location / Area Applied for PTW No.
Equipment / Material & Tools to be used Hand tools, torque wrench, flange spreader
(A) Identify Potential Hazards for job
Hazard Prompt List (Review the job steps and identify if any of the following hazards are applicable) Potential Hazard Exposure Mechanisms

☐ Electricity
☐ Hot/Cold surface
☐ Rotating Equipment
Collision of vehicles,
☐ ☒
equipment
☐ Muscular Stress
☐ Mental Stress
☒ Repetitive Work
☐ Heights
☐ Underground facility
☒ Weather ☐ Excavations/Earthworks ☐ Struck – by, against boom truck & forklift.
☐ Insect/Animal Bites ☐ Fire/ explosion ☐ Contact with
☐ Lighting ☐ Pyrophoric material ☐ Contacted by
Driving Hazards ☐ Harm to Flora/Fauna ☐ Caught – in, on, under, between, against
☒ Falling Objects ☐ Pyrophoric deposit ☒ Exposure – temperature, chemicals, noise, dust
☐ Noise ☐ Inert atmosphere ☒ Slip, Trip or Fall – from heights, same level
☐ Radiation ☒ Spills/Leaks ☒ Complete Manual Handling Risk Assessment attached
☒ Hydrocarbon/Gas Release ☐ Other Mobile/Stationary/Equipment ☐ Overexertion/Excessive force – lifting, pushing, pulling,
☐ Open edge ☒ Pressure (Stored Energy) ☐ Escape of Material – oil spill, gas release, light spill

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 ☐ Vibration
☐ Depths
☐ Confined Spaces
☐ Asbestos
(B) Personal Protective Equipment
☒ Eye/Face protection
☒ Head protection
☒ Foot protection
☒ Body protection
☒ Tools/Equipment Failure ☐ Fumes/Vapour/Dust ☐ Human Factors
☒ Human Factors ☐ Catalyst ☐  Overload of lifting equipment
☐ Off Road ☐ Toxic gas ☐  Suspended load
☒ Chemicals ☐ Trip process ☐ Crane/ boom truck collapse
☒ Hearing protection ☒ Respiratory protection ☒ Weather conditions
☐ Safety/Rescue line ☐ Safety harness • hot/dry
• wet
☒ Hand protection ☒ Gas detector • windy
☐ Spill prevention and clean up ☐ Light shields • cold

☐ Other    

Title & Description of Work To carry out blinding and de-blinding works.

JOB SAFETY ANALYSIS

Title & Description of Work To carry out blinding and de-blinding works.

Work Executed by PEC Preparation Date

Work Location / Area Applied for PTW No.

Equipment / Material & Tools to be

Hand tools, torque wrench, flange spreader
used

Process fluid information Fluid: Propylene Pressure: Temperature: Toxicity: N/A Other: N/A

Type of JSA Level of Risk Activity

☒New ☐ Standardized ☐ High Risk ☒ Medium Risk ☐ Low Risk

JOB SAFETY ANALYSIS CONTENT

Base Risk Residual
(Before Risk (After
N Sequence of Basic Work provide Control Measures provide Action By
Potential Hazard Consequence
O Step control control
measures) measures)
L S R L S R

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 ▪ Property
1.1.1 Check and ensure the tools and equipment are in
damaged due
1.1 Defective Tools Equipment good condition.
to the tool C 1 1C C 0 0C
1.1.1 All tool and equipment to be inspected and apply valid
failure.
sticker
▪ People injury.
Mobilization 1.2 Engine spark (for boom truck and ▪ People injury. 1.2.1 Ensure the vehicle has equipped spark arrestor and
equipment/materials by forklift operation). ▪ Property allow to enter to plant area.
damaged due to Supervisor
D 2 2D D 1 1D
1. boom truck, forklift fire explosion or Workers
collision with Driver
adjacent objects
1.3 Ergonomic problems while handling ▪ Back injury. 1.3.1 Body posture is close to load to avoid back injury
the tools/ equipment to workplace. C 1C Do not manually lift up the load more than 40 kg. C 0 0C
▪
▪ People injury. 1.1.2 Suspend Work if Rains Heavily
1.4 Bad weather condition: windy, rainy,
C 1 1C Monitor weather condition and forecast continuously C 0 0C
typhoon led to unsafe condition.
▪
2.1 Wrong Blind location led to open ▪ People injury
pressurized line ▪ Community
impact due to 2.1.1 Follow marked up P&ID, WO, plot plan, ISO dwg.
effect on D 2 2D 2.1.2 Task supervisor and operation hang the blind tag D 1 1D
operation. 2.1.1 Perform point and call protocol.
▪ Property
damaged.
▪ People injury.
Identify Blinding Location ▪ Property 2.2.1 Scaffolding to be erect and inspect by qualified
2.2 Fall from height and falling objects. Supervisor
damaged. supervisor
5. Worker
2.2.2 Ensure to check scaffold tag and using safety harness
with 100% tie off in case work with yellow tag.
D 1 1D 2.2.3 Maintain 3 points contact while climb up/down on D 0 0D
ladder.
2.2.4 Secured all loosen items in blue tray and provide land
yards for all hand tools.
2.2.5 Barricade to avoid unauthorized people entry

2.3 Noise
▪ Deaf E 1 1E 7.1.1 All the time wear Ear Plug E 0 0E
Unbolting to open the 8.1.1 Identify the potential hazards and do not place fingers
8.
blinding flange 8.1 Pinch points in a pinch point
▪ Hand injury D 2 2D D 0 0D
8.1.2 Wearing hand gloves at all time.
8.1.3 Keep away from line of fire
9.1 splash or Leak (valve passing) ▪ Exposed to body D 2 2D 9.1.1 First line break check list shall be fulfill by related D 0 0D Supervisor

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 parties and sign off.
Worker
9.1.2 Strictly follow up LOTO procedure.
9.1.3 Wear Face shield, hand glove, haft face respirator and
others mandatory basic PPEs at all a time till breaking
flange finished according to first line break
requirement.
9.1.4 Ensure drip tray/empty drum are ready to contain
▪ Harm to people
residual liquid while opening flange.
▪ Impact to
9.1.5 Slowly loosen the bolt/nut from bottom side/back side
environment
of flange to avoid any residual energy in the system.
9.1.6 Away from line of fire.
9.1.7 Barricade working zone to avoid unauthorized people
entry.
9.1.8 Use of non-sparking spanner.
9.1.9 Equip 4 in 1 gas detector during working time
9.1.10 Stay up wind during opening flange.
10.1.1 Seek approval from managers and get signature on
line break checklist before opening flange in case
10.1 Hydrocarbon in the line or Leak ▪ Impact to
unable to confirm zero energy/pipe line empty or any
hydrocarbon (can’t confirm zero environment D 1 1D D 0 0D
items with answer is “No” on check list.
energy ) ▪ Harm to people
10.1.2 Additional risk assessment to be conduct by
issuer/SSV.
11.1.1 Ensure the tools and equipment are in good condition.
▪ Hand injury 11.1.2 All tool and equipment to be inspected and apply valid
11.1 Defective Tools Equipment. C 1 1C C 0 0C
▪ Violation sticker
11.1.3 Apply land yards for all hand tools
12.1.1 Provide tool land yard and ensure to holding while
hammering
▪ Body injury
12.1 Spanner flying C 1 1C 12.1.2 Barricade working zone to avoid unauthorized people C 0 0C
▪ Damage asset
entry.
12.1.3 Away from line of fire
13.1 Damaged flange spreader and ▪ Oil leakage C 1 1C 13.1.1 Ensure connection point is not loosen out while C 0 0C
hydraulic torque wrench. ▪ Hand/body injury pressurizing by apply whip arrestor and connect
▪ Harm to people properly
13.1.2 Ensure the tools and equipment are in good condition.
13.1.3 Inspect all Hand tools, torque wrench, flange spreader
daily before use to make sure no oily leak.
13.1.4 Assigned competent people only, who had training
prior to use hydraulic torque wrench.
13.1.5 Away from line of fire
13.1.6 Don’t put finger in between hydraulic torque wench
tool and flange bolts

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Open flange, cleaning flange
15.
gasket seating face.
14.1 Bad weather condition: hot,
14.1.1 Suspend Work if Rains Heavily, high temperature.
typhoon, rainy. ▪ Unsafe condition D 1 1D D 0 0D
14.1.2 Monitor weather condition and forecast continuously
15.1.1 Identify the potential hazards and do not place fingers Supervisor
in a pinch point Workers
15.1 Pinch points ▪ Hand injury D 2 2D D 0 0D
15.1.2 Wearing hand gloves at all time.
15.1.3 Keep away from line of fire
16.1.1 First line break check list shall be fulfill by related
parties and sign off.
16.1.2 Strictly follow up LOTO procedure.
16.1.3 Wear Face shield, hand glove, haft face respirator and
others mandatory basic PPEs at all a time till breaking
flange finished according to first line break
requirement.
▪ Exposed to body
16.1.4 Ensure drip tray/empty drum are ready to contain
16.1 Residual energy/fluid splash ▪ Harm to people
D 2 2D residual liquid while opening flange. D 0 0D
out(valve passing) ▪ Impact to
16.1.5 Slowly loosen the bolt/nut from bottom side/back side
environment
of flange to avoid any residual energy in the system.
16.1.6 Away from line of fire.
16.1.7 Barricade working zone to avoid unauthorized people
entry.
16.1.8 Use of non-sparking spanner.
16.1.9 Equip 4 in 1 gas detector during working time
16.1.10 Stay up wind during opening flange.
▪ Flammable
17.1.1 Ensure to use approved solvent like RP7/WD40
solvent.
only(refer SDS as required)
▪ Contaminated
17.1 Leak RP7 or splash out D 1 1D 17.1.2 Stay upwind while spraying. D 0 0D
wasted
17.1.3 Housekeeping and delivery contaminated cloths to
▪ Environment
hazardous storage.
issue
18.1 Damaged flange spreader and 18.1.1 Ensure connection point is not loosen out while
hydraulic torque wrench. pressurizing by apply whip arrestor and connect
properly
18.1.2 Ensure the tools and equipment are in good condition.
▪ Oil leakage 18.1.3 Inspect all Hand tools, torque wrench, flange spreader
▪ Hand/body injury C 1 1C daily before use to make sure no oily leak. C 0 0C
▪ Harm to people 18.1.4 Assigned competent people only, who had training
prior to use hydraulic torque wrench.
18.1.5 Away from line of fire
18.1.6 Don’t put finger in between hydraulic torque wench
tool and flange bolts
19.1 Unauthorized to utilize service ▪ Violation D 1 1D 19.1.1 Inform to Ops section 6 prior use service water/plant D 0 0D
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▪ Impact to
water/plant air. operation
▪ Damage to asset
20.1 Bad weather condition: hot,
▪ Unsafe condition D 1
typhoon, rainy.
21.1 Ergonomic Problems ▪ Back/hand Injury D 1
22.1 Pinch points ▪ Hand injury D 2
D 1
23.1 Gasket installed wrongly or damaged ▪ Leakage
gaskets ▪ Re-work
24.1 Damaged flange spreader and
Install of Gasket. hydraulic torque wrench.
22.
▪ Oil leakage
▪ Hand/body injury C 1
▪ Harm to people
▪ Back/hand Injury
25.1 Ergonomic Problems D 1
▪ Harm to people
Alignment check and
26.
▪ Gasket damaged
Tighten Bolt & Nut by torque
26.1 Flange miss-alignment ▪ Leakage D 1
wrench. ▪ Re-work
27.1 Ergonomic Problems. ▪ Back/hand Injury D 1
▪ Harm to people
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air.
19.1.2 Required Ops to standby for operate the valve of
steam/plant air at utility station.
19.1.3 Assigned competent people.
20.1.1 Suspend Work if Rains Heavily, high temperature.
1D D 0 0D
20.1.2 Monitor weather condition and forecast continuously
21.1.1 Always follow flange breaking procedure
21.1.2 Ensure the work area has not congested
1D D 0 0D
21.1.3 Follow safe manual handling procedures while carry
out blind rotation.
22.1.1 Identify the potential hazards and do not place fingers
in a pinch point
2D D 0 0D
22.1.2 Wearing hand gloves at all time.
22.1.3 Keep maintain the gap suitable to insert the gasket
1D 23.1.1 Select gasket based on P&ID , flange rating, size, D 0 0D
material.
23.1.2 Ensure to check gasket installed concentric to flange
ID.
23.1.3 Task SV to confirmed right gasket is selected
24.1.1 Ensure connection point is not loosen out while
pressurizing by apply whip arrestor and connect Supervisor
properly
Workers
24.1.2 Ensure the tools and equipment are in good condition.
24.1.3 Inspect all Hand tools, torque wrench, flange spreader
1C daily before use to make sure no oily leak. C 0 0C
24.1.4 Assigned competent people only, who had training
prior to use hydraulic torque wrench.
24.1.5 Away from line of fire
24.1.6 Don’t put finger in between hydraulic torque wench
tool and flange bolts
25.1.1 Always follow flange breaking procedure
1D 25.1.2 Ensure the work area has not congested D 0 0D
25.1.3 Follow safe manual handling procedures
26.1.1 Alignment check following bolted flange management Supervisor
procedure by task SV (04 parameters) Workers
1D 26.1.2 Assigned competent people. D 0 0D
26.1.3 Do not proceed tightening unless flange checked
done.
1D 27.1.1 Ensure the work area has not congested D 0 0D
27.1.2 Follow safe manual handling procedures.
27.1.3 Good communication between each other
 28.1.1 Identify the potential hazards and do not place fingers
in a pinch point
28.1 Pinch points ▪ Hand injury D 2 2D D 0 0D
28.1.2 Wearing hand gloves at all time.
28.1.3 Keep away from line of fire
29.1.1 Check and confirmed torque value based on flange
▪ Gasket damaged rating, bolt size and material of gasket
29.1 Over torque value setting - leak C 1 1C C 0 0C
▪ Bolt/nut broken 29.1.2 Follow up bolted flange management latest revision.
29.1.3 Assigned competent people to do tightening.
30.1.1 Ensure the tools and equipment are in good condition.
▪ Malfunction
30.1 Defective Tools Equipment. D 1 1D 30.1.2 All tool and equipment to be inspected and apply valid D 0 0D
▪ Body injury
sticker
31.1.1 Provide tool land yard and ensure to holding while
hammering
▪ Body injury
31.1 Spanner flying C 1 1C 31.1.2 Barricade working zone to avoid unauthorized people C 0 0C
▪ Harm to people
entry.
31.1.3 Away from line of fire
Housekeeping and close out 32.1 Scattered Material C 1 1C 32.1.1 Maintain Good House Keeping at work location. C 0 0C
PTW 32.2 Slip/ Trip / Fall 32.2.1 All materials to be stacked and arranged in well-
▪ Unsafe condition C 1 1C C 0 0C Supervisor
32. organized manner.
▪ Harm to people Workers
32.3 Excess material left on location. 32.3.1 Excess material to be returned back to designated
C 1 1C C 0 0C
area.

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Remark: “L” = Likely hood, “S” = Severity, “R” = Risk

Normally Work/Job shall be allowed to start if the Risk after applying control measures equal or smaller/less than “Moderate” as per “MD-04-HSE-HS-PD-022, Hazard Identification, Risk Management and
Control Procedure”

Name Signature Date Position Company

Prepared by Work Execution PIC HOANG XUAN BAO 16/03/2022 LEAD TECHNICIAN PEC

Reviewed by Work Execution Manager / His Delegate DILIPKUMAR 16/03/2022 SITE MANAGER PEC

Reviewed by NSRP Responsible Discipline Manager / His

NGUYEN VAN TUAN 16/03/2022 SUPERVISOR NSRP
delegate

Approved by Asset Owner / His delegate

Reviewed by NSRP Health and Safety SM

(High Risk Activity)

Reviewed and Approved by NSRP HSSE DM

(High Risk Activity)

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