0.0000.

PARTICULAR MANAGEMENT PROCEDURE LRT-QDVC-G3-PRC-HSE-

REF:
GEN00-010930
REV. B-
LUSAIL DEVELOPMENT CONFINED SPACE ENTRY PROCEDURE DATE:
LUSAIL TRANSIT SYSTEM PAGE:

8 ANNEXURE
8.1 PRCS CHECKLIST
S.NO CHECKLIST CHECK BOX

1 Is a PRCS Entry Permit, signed by the entry supervisor, provided prior to any Y N
permit required PRCS?
2 Are PRCS thoroughly emptied of any corrosive or hazardous substances (acids Y N
or caustics) before entry?
3 Are all lines to a PRCS containing inert, toxic, flammable or corrosive Y N
materials, shut off and blanked, disconnected or separated before entry?

4 Is it required that impellers, agitators or other moving equipment inside PRCS Y N

be locked-out and tagged before entry?
5 Is exhaust ventilation required before PRCS entry? Y N

6 Are gas tests performed for oxygen deficiency, toxic substances and Y N
explosive concentrations before PRCS entry?
7 Is there adequate illumination for PRCS work? Y N

8 Is the atmosphere inside the PRCS periodically tested or continuously Y N

monitored during the conduct of work?
9 Is there an assigned safety standby employee outside of the PRCS, when Y N
required, w h o s e s o l e r e s p o n s i b i l i t y i s t o w a t c h t h e w o r k i n
progress, sound an alarm and render assistance if necessary?
10 Is the standby employee trained and equipped to handle an emergency? Y N

11 Is t h e standby employee prohibited from entering the PRCS in an Y N

emergency unless relieved by a qualified safety standby and equipped with
lifelines and respiratory equipment?
12 Is communication provided between the standby employee and PRCS Y N
entrants, as well as emergency rescue personnel?
13 Is safety equipment and clothing provided when required? Y N

14 Is approved respiratory equipment required if the atmosphere inside the PRCS Y N

cannot is hazardous?
15 Before gas welding or cutting is started in a PRCS, are hoses checked for leaks, Y N
compressed gas cylinders forbidden in the PRCS, torches lighted outside the
PRCS, and is the confined area tested for toxic and combustible gases?

16 Is exhaust ventilation required when welding or hazardous materials are used Y N

in a PRCS?
17 Is self-rescue equipment provided? Y N
 PARTICULAR MANAGEMENT PROCEDURE LRT-QDVC-G3-PRC-HSE-
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REV. B-
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ADDITIONAL COMMENTS / REMARKS:

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 PARTICULAR MANAGEMENT PROCEDURE LRT-QDVC-G3-PRC-HSE-
REF:
GEN00-010930
REV. B-
LUSAIL DEVELOPMENT CONFINED SPACE ENTRY PROCEDURE DATE:
LUSAIL TRANSIT SYSTEM PAGE:

8.2 CONFINED SPACE PERMIT

Section 1
Date: Time:
Permit Duration:
Work Area:

PRCS Controller Employer PRCS Qualifications:

(CSC) Name Proof of Training/Competency

1.

Employee Names Employer PRCS Qualifications:

Proof of Training/Competency
1.
2.
3.

Section 2 Work Description

Description of work to be
undertaken:

WMS reference associated with the above work:

Section 3 Isolation of Services

Tick items below requiring isolation or to be made safe
Pipelines (Water, Steam, Gas Mechanical/Electrical drives
etc.) O
t
h
e
r

Sludges/Deposits/Waste Harmful materials

O
t
h
e
r

Electrical services Warning notices/tags/locks have been fixed to means of

isolation

Section 4 Atmospheric Test Requirements

 PARTICULAR MANAGEMENT PROCEDURE LRT-QDVC-G3-PRC-HSE-
REF:
GEN00-010930
REV. B-
LUSAIL DEVELOPMENT CONFINED SPACE ENTRY PROCEDURE DATE:
LUSAIL TRANSIT SYSTEM PAGE:

Test atmosphere and record levels – Note allowable limits below

Oxygen (19.5% - 23.5%) Flammable Gas (<10%
LEL)

Hydrogen Sulphide Carbon Monoxide

(<10ppm) (<35ppm)
Others: Contaminant Limit
Test time: am/pm Test Date: / /
Continued Atmospheric Monitoring is Mandatory
Entry is safe under the conditions checked below
With supplied-air respiratory Yes No
protection
With self-rescue respiratory protection Yes No

Section 5 Personal Protective Equipment

Personal Protective Equipment ticked below shall be worn:
Supplied-air respirators Safety Helmets
Air p u r i f y i n g r e s p i r a t o r y Safety belt, harness and/or safety line, life line or
p r o t e c t i v e devices rescue line
Eye protection Hearing protection
Hand/foot protection Protective clothing

Section 6 Substance Use

Use of chemical agents (supply
details):
Only the following substances may be taken into the PRCS:

1. 2.
3. 4.

Section 7 Hot Work

The precautions ticked shall be observed:
Area clean and free of combustible material for All drains within 15m covered with fireproof
15m blanket
Appropriate fire extinguishers on site near Water hose to job site and tested/left running
sources of ignition
Sparks completely contained/measures Welding unit//gas bottles located ( ) not
inspected prior to starting within 8m of any drain

Welding unit earthed directly to weld job, close Electrical l e a d s i s o l a t e d /free f r o m

as possible to arc m e t a l fixtures and kept dry
Electrical trace on pipes isolated Hot Work is not permissible inside space
 PARTICULAR MANAGEMENT PROCEDURE LRT-QDVC-G3-PRC-HSE-
REF:
GEN00-010930
REV. B-
LUSAIL DEVELOPMENT CONFINED SPACE ENTRY PROCEDURE DATE:
LUSAIL TRANSIT SYSTEM PAGE:

Section 8 Stand-By Personnel & Emergency Procedure

Number of Stand-By Personnel Required:

Stand-By Persons are (print names clearly):

1. 2.
Have emergency equipment and procedures been discussed, developed and Yes
understood by the work crew?
Ensure the emergency procedures are attached to the Entry Permit.

PRCS Controller (CSC) approval

to enter (signature):

Section 9 Signing Out

PRCS cleared of personnel. Further entry – new permit required
PRCS C o n t r o l l e r approval
(Signature):

Section 10 Work Completion/Suspension

All personnel/equipment has been withdrawn work has been completed.
Detail any faults or unsatisfactory aspects of this operation noted. Attach additional sheets if
necessary.

QDVC Recipient
(Print name):
 PARTICULAR MANAGEMENT PROCEDURE LRT-QDVC-G3-PRC-HSE-
REF:
GEN00-010930
REV. B-
LUSAIL DEVELOPMENT CONFINED SPACE ENTRY PROCEDURE DATE:
LUSAIL TRANSIT SYSTEM PAGE:

8.3 PRCS LOG SHEET

Location: Date: DD/MM/YY

Names LRT ID No. Time In Signature Time Out Signature