Shell Retail Permit to Work System 5.

1 ver
Questionnaire & Qualifying T est for Permit Issuers and Permit Holders

1. FULL NAME *

Trivendram Imran

2. COMPANY NAME *

Janain al janah LLC

3. YOUR CURRENT POSITION *

Elect rical Engineer

4. Are you a current Shell Retail Permit Holder? *

Yes

No

5. Enter your PH/PI No:- *

Nill

6. How many years experience do you have in working in Fuel Retail? *

Less t han 2 Years

More t han 2 Years

 More t han 5 Years

7. Outline your experience in being a supervisor or in leading teams *

8. Outline your experience working in Fuel Retail, including working for Shell *

5 year

9. Are you competent in using a gas detector? Outline your experience or qualification (type
of detectors, calibrating, any formal qualifications) *

NO

10. Outline any other Safety courses you have attended *

ESR,AHA,HSE,SSR

11. The PTW system is designed to: (1 Point) *

Help keep workers safe

All of t he above

Help workers recognise t he risks t hey face on sit e

Help workers t ake act ion to prot ect t hemselves

12. The JHA must be reviewed prior to issuing a Permit by the:

(1 Point) *

Permit Issuer

FMC / PMC Engineer

 Sit e Represent at ive

Shell Field Engineer

13. A Work Clearance Form must be completed on site for:

(1 Point) *

Ot her Risk act ivit ies

All work

High Risk act ivit ies

Medium Risk act ivit ies

14. Who is responsible for enforcing compliance with the JHA and the Permit throughout the
work?
(1 Point) *

Permit Issuer

Permit Holder

Shell Field Engineer

FMC/PMC Engineer

15. The Permit Holder must suspend the work if the following changes occur:
(1 Point) *

T here is conflict ing work being undert aken by anot her PH or cont ractor

T he specified equipment or tools are not available

Weat her condit ions changed drast ically

 All of t he above

16. What is the maximum amount of time a Permit is valid for?

(1 Point) *

7 consecut ive calendar days

1 working day

3 working days

5 consecut ive calendar days

17. What type of work is a Permit absolutely required for?

(1 Point) *

All works

High risk act ivit ies

Low risk act ivit ies

Medium risk act ivit ies

18. Work requiring a Permit may continue if the Permit Holder leaves the site for less than 1
hour. (1 Point) *

True

False

19. It is not necessary for the PI to remain on site for the duration of the work as the Permit
Holder is responsible for verifying that the precautions are maintained throughout the work
(1 Point) *

False
 True

20. The contractor must discuss the Work Clearance Form with the Site Representative prior
to starting any work. (1 Point) *

True

False

21. The Permit Holder is responsible for explaining to the work crew the details of the work
and any potential hazards and controls. (1 Point) *

False

True

22. The Permit Holder is responsible for signing off on the Permit once the work is complete
and confirming the work area has been left in a clean and safe condition (1 Point) *

True

False

23. Blanket Permits covering multiple locations are permitted (1 Point)

True

False

24. High risk work can be performed without issuing a Permit provided a Permit Holder is on
site. (1 Point)

True

False
25. The Site Representative advises the Contractor if there are any site conditions that may
impact the Contractor safely performing the work (e.g. product delivery) (1 Point)

True

False

26. The following documents are required for the scenario: JHA + WCF for risk activity
_ _ _ _ _ _ _ _ _ _ _ _ _ (1 Point) *

Medium risk

27. The PTW system consists of 3 primary documents. These documents are the
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , and _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ * (3 Points) *

PT W,JHA,WCF

28. A JHA always consists of job steps, job step _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ and job step
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . * (2 Points) *

Hazards, cont rol

29. In order to control a hazard by Hierarchy of Control, a contractor must choose to

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , isolate or minimise the hazard. (1 Point) *

Element

30. The following documents are required for the scenario: Permit + JHA + WCF for
_ _ _ _ _ _ _ _ _ _ _ _ _ risk activity. (1 Point) *

High risk act ivit y

31. The _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ is responsible for being present personally at the work site at
all times during the Permit controlled work. (1 Point) *

Permit holder
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