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White Nile (5B) Petroleum Operating Company Ltd

Permit To Work Procedure

WNPOC/LII/HSE/019

Main Contents Page No


Document New /Amendment Request (DNAR) Document Change History (DCH) Distribution 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 Purpose Scope References Abbreviations Definitions Responsibilities Types of Permit and Usage Communication 8.1 8.2 8.3 9.0 9.1 9.2 9.3 10.0 Appendices Confined Space Entry Permit Excavation Permit Cold Work Permit Lifting Permit Electrical Permit Electrical Isolation Permit Hot Work Permit Radiation Permit Safety System Bypass Permit Display Board PTW Site Log Pre-job Discussion Job Preparation Job Execution Job Completion i ii iii 1 1 1 1 2 3 5 6 6 6 6 7 7 7 7 8

Procedure Details

Auditing

White Nile (5B) Petroleum Operating Company Ltd. Document New / Amendment Request (DNAR)

PAGE NUMBER:

i
DOCUMENT NUMBER:

WNPOC/LII/HSE/019

DNAR No.

WNPOC/DNAR/HSE/LII/0019

DNAR Date

31.03.06

Status of Document: New Reasons of Changes: New procedure establishment Revised Cancellation

Details of Changes PART WAS Page No Para/Clause None Description

CHANGE TO Page No Para/Clause New document Description

QA Check

Initial

Date

Prepared by

Reviewed by

Approved by

Section Head, HSE

HSE Manager

V.PRESIDENT

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Ltd. Document Change history (DCH)
Effective / Revision Date 31/03/06

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DOCUMENT NUMBER:

WNPOC/LII/HSE/019

Revision No 0

Status of Change (New / Revised / Cancellation) New procedure establishment

Details refer to Document New / Amendment Request (DNAR) Prepared Reviewed Approved by by by

Section Head, HSE

HSE Mgr.

V. President

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5b) Petroleum Operating Company Ltd. Distribution

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iii
DOCUMENT NUMBER:

WNPOC/LII/HSE/019

Copy No

Position Title

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

President, WNPOC Vice President, WNPOC GM, Exploration & Development GM, Finance & Planning GM, Human Resource & Admin GM, Production Sr. Manager, Exploration Sr. Manager, Operations Sr. Manager, Surface Development Manager, HSE Manager, Corporate Affair & Community Development Manager, Security Superintendent, Base Camp Company Man, Drilling Rig Company Man, Service Rig HSE Supervisor, Block 5A HSE Supervisor, Block 5B HSE Supervisor, Block 8 HSE Department Exploration Department Drilling Department Finance & Account Department Human Resource & Admin Department Contract, Procurement & Logistic Department

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Preliminary


1.0 Purpose

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1
DOCUMENT NUMBER:

WNPOC/LII/HSE/019

The purpose of the Permit To Work (PTW) procedure is to ensure that there is a formalized process in place to authorize and control hazardous work by ensuring that adequate precautions have been taken to safeguard people, property and the environment when the work is being carried out. It is also to ensure that an effective means of communication has been established about the hazardous nature of work to the supervisors, those who are carrying out the work and to those who are working around the hazardous work area. Although the PTW itself does not make the job safe, it ensures proper consideration is given to the risks prior to commencement of work. The PTW serves as a record of the authorization and completion of specific work.

2.0

Scope

The procedure shall be applicable to: All non-routine work that are classified as potentially hazardous or carried out in a hazardous area; Routine work that have been categorised by the line department management as potentially hazardous; All WNPOC employees and contractor employees working at operational locations; All WNPOC employees and contractor employees working at premises under WNPOC prevailing influences.

3.0

References

HSE UK publication titled Permit-To-Work Systems -ISBN 0 7176 1331 3. Industrial Accident Prevention Association of Canada publication on Work Permits. Alberta, Canada Workplace Health and Safety Bulletin SH 013 on Safe Work Permits. PETRONAS PTS 60.049 rev.2

4.0
AA PTW PA

Abbreviations
Approving Authority Permit To Work Permit Applicant Authorised Electrical Person / Senior Authorised Electrical Person Personal Protective Equipment Authorised Gas Tester Lower Explosive Limit Permissible Exposure Limit Job Safety Analysis Hydrogen Sulphide Person In Charge As Low As Reasonably Practicable
EFFECTIVE/REVISION DATE: REVISION NUMBER:

AEP/ SAEP PPE AGT LEL PEL JSA H2S PIC ALARP

PERMIT TO WORK

31 M A R C H 2006

White Nile (5B) Petroleum Operating Company Definitions


5.0 Definitions

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DOCUMENT NUMBER:

WNPOC/LII/HSE/019

Permit To Work

A formal written system that authorizes specific work, at a specific work location, for a specific time period. It is used to control and coordinate potentially hazardous work by ensuring that all foreseeable hazards have been considered and appropriate precautions have been defined. The person who applies for the permit e.g. the foreman/ supervisor responsible for planning and execution of the work. The WNPOC Person In-charge at the worksite who is authorised by management to sign the Permit To Work. The WNPOC Person In-charge is one of the following: - Field Production Manager, Production Superintendent, Operations Superintendent, Field Base Superintendent, Construction Supervisor, Drilling Supervisor, Facility Supervisor. In remote areas / facilities the Person In-charge may be delegated to following: - Production Supervisor, Maintenance Supervisor or Field Supervisor. A person, who is qualified, authorized and designated to test the function of approved gas test equipment and to test worksite and confined spaces for gas and oxygen levels. Work that is outside the regular operation of an operating facility. In this respect maintenance and construction activities are considered as non-routine. A competent person who has been trained and authorised by management to manage the operation, switching and isolation of electrical switchgear and systems except for HV & EHV. A competent person who has been trained and authorised by management to manage the operation, switching and isolation of HV / EHV electrical switchgear and systems. A list of control measures at the place of work execution to be taken before and during the work covered by the PTW. Equipment that has to be worn by individuals to protect themselves against exposure to hazards while carrying out their work. This applies to permits that have to be renewed daily for the certain jobs that take more than 1 day to complete. Revalidation is the process of checking that the precautions are still intact and the approving authority is satisfied that the job can be done safely.

Permit Applicant Approving Authority

Authorised Gas Tester Non-Routine Work

Authorised Electrical Person Senior Authorised Electrical Person Worksite Preparations / Precautions Personal Protective Equipment Revalidation

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Responsibilities


6.0 Responsibilities

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DOCUMENT NUMBER:

WNPOC/LII/HSE/019

It is the responsibility of each WNPOC employee and contractor to ensure that an appropriate PTW has been issued for any non-routine and / or hazardous activity undertaken. Permit Applicant Approving Authority Understand the hazards associated with the particular activity for which the PTW has been applied; Determine the correct people, PPE, tools, equipment and precautions that have to be in place for the job to be carried out safely; Prepare a JSA if required for the job; Fill in the appropriate PTW form stating all the precautions taken; Ensure that appropriate warning signs and barricades have been installed around the worksite; Visit the worksite with the AA to inspect the precautions that have been put in place; Ensure the PTW is approved by the AA before starting work; Brief the workers on the requirements of the PTW and JSA (if applicable); Ensure Copy no. 1 of the PTW is always kept at the worksite; Ensure that the workers adhere to all the PTW requirements throughout the period the work is being executed; Ensures that the PTW is revalidated daily when the job extends over the specified period; and Returns copy of the PTW on job completion or cancellation and informs the appropriate parties concerned. Ensure all hazards associated with the proposed job have been identified, assessed and controlled to ALARP; Ensure the work being authorised does not jeopardise other activities or ongoing operations of the facility; To inform the PA on all the nearby activities especially those that might interfere with his own activity; Check that all the necessary safety precautions have been identified in the PTW; Specifies other PTW that is additionally required for the job; Ensure that permits are cross referenced with other permits; Assign AGT and other required competent persons as required; Revalidate PTW as required; and Receive PTW on job completion or cancellation

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Responsibilities


Area Supervisor

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4
DOCUMENT NUMBER:

WNPOC/LII/HSE/019

Review that the necessary precautions have been filled the PTW by the applicant Go to the site to ensure that the safety precautions for the job have been implemented by the PA Visit the site the site to ensure the precautions are in place before requesting the AA to approve the PTW; Ensure that the PA has briefed all the workers on the PTW requirements; Ensure that the Gas Testing equipment is calibrated before use; Test for the level of Oxygen, combustible and toxic gases in confined space areas and in areas where hot work is carried out as specified by the AA in the PTW to determine whether it is safe to carry out work; Ensure that continuous gas monitoring is carried out in confined space areas; and Issue gas test certificates and attach them to the PTW. Ensure that they understand the requirements of the PTW; Be skilled, qualified trained and competent to perform the work, including the use of any personnel protective equipment or rescue equipment; Adhere to the PTW requirements'; Ensure the job is performed in a safe manner; Be aware of the hazards that could exist and have the necessary controls in place; Make equipment and area safe on completion of the task; Make the work area safe and seek immediate advice if a doubt or if circumstances or conditions change; and Ensure that all tags and signs are prominently displayed so that personnel are aware that the equipment etc. is isolated / not to be operated. To assist the PA in reviewing the PTW application; To assist the PIC/AA in reviewing the effectiveness of the safety precautions that have been implemented for the job requiring the PTW; To regularly monitor the effectiveness of the safety precautions during the course of the job; and To visit the site on completion of the job to ensure that proper housekeeping has been carried out and it is safe to resume normal operations.

Authorised Gas Tester

Workers performing the work

HSE Executive

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Types of Permit


7.0 Types of Permit and Usage

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DOCUMENT NUMBER:

WNPOC/LII/HSE/019

Hot Work

Cold Work Electrical Electrical Isolation

Lifting

Excavation

Work using or generating heat that is sufficient to ignite gases, vapours, dusts e.g. welding, burning, cutting, riveting, grinding, drilling; Work involving the use of pneumatic hammers and chippers, nonexplosion proof electrical equipment (lights, tools, and heaters), and internal combustion engines; Presence of flammable materials in the equipment being worked on; Presence of combustible materials that burn or give off flammable vapours when heated; Presence of flammable gases in the atmosphere, or gas entering from an adjacent area, such as sewers that have not been properly protected. All other hazardous non routine work that do not fall into other permit categories For specific work on electrical equipment and operations in power systems to be carried out under the direct supervision of an AEP or CEP Electrical power isolation by an AEP or CEP when electrically connected systems have to be worked for repair or maintenance work; and Confirmation that an AEP and CEP has electrically isolated the equipment to be worked on and suitable precautions have been taken to prevent inadvertent re-connection. Lifting over unprotected process or wellheads Wire sling is not used for overhead crane Wind velocity exceeding 30 knots Visibility less than 30 meters Load path not fully illuminated Multiple crane lifts Lifts exceeding 8 tones Lift inside confined space To ensure that excavation can be made without damage to existing buried facilities such as pipelines, drains and electric cables; To confirm that drawings and site has been checked and no potential damage is possible; and Used in conjunction with Confined Space Entry Permit when trenches or holes greater than 2metres in depth have to excavated for laying of pipes, cables and drain pipes For entry into tanks, vessels, large diameter pipes and working in trenches or holes greater than 2metres in depth Used in conjunction with other permits Covering the work on process or mechanical equipment Bypassing or overriding one or more process control, fire or gas alarm safety systems to prevent inadvertent facility shutdown. When radioactive sources are used to carry out radiographic examination of welding joints

Confined Space Entry Safety System Bypass Radiation

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Communication


8.0 Communication
8.1 Display Board

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WNPOC/LII/HSE/019

The AAs copy of the PTW shall be displayed on display board located in the operations control centre or at a central location in a remote area / facility; The original copy shall be made available at the work site on a temporary display board so that it can be checked from time to time to ensure that the safety precautions are being adhered to at all times. Work Permit site Log

8.2

A current and complete record of all permit to work / certificates shall be kept by each facility. This record will serve as an information source when issuing additional work permits / certificates. The following shall be logged in the work permit log: Types of permit to work Number Permit to work Date and time permit to work was issued Specific work location Date and time permit to work was closed off 8.3 Pre-job Discussion

Pre-job discussion shall be conducted prior to commencement of any work under a permit to work. The discussion is intended to ensure all the job crewmembers understand the content of the permit to work and safe work procedures. Pre-job discussion shall be documented.

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

White Nile (5B) Petroleum Operating Company Procedure Details


9.0 Procedure details
9.1 Job Preparation

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DOCUMENT NUMBER:

WNPOC/LII/HSE/019

The permit applicant shall fill up a permit to work form (in triplicate) with details of the job to be done, specifying the facility, location, equipment, time limits and tools to be used; The person in-charge shall specify other relevant permits required for the job and all relevant operational and additional precautions - isolation methods for equipment, safety precautions, PPE and other equipment - required for the job. Adjacent jobs that are carried out simultaneously shall be catered for. The PIC shall also specify other signatories required to validate the work permit. When the precautions have been detailed, the permit shall be returned to the permit applicant to retain until the preparations are complete. Permit applicant confirms this by signing the permit. After obtaining the required signatures, the permit applicant shall return the permit to the approving authority. The approving authority shall ensure the correctness and completeness of permit and certificates. When all the actions are complete, the approving authority shall sign the permit so that the job can be started. Job Execution Copy of work permit shall be retained in the office or control room of the facility and the permit applicant displays original copy at worksite. Person in-charge may delegate his subordinates to follow the job execution. He or his subordinate shall regularly check the worksite as the process and operational parameters / conditions may have changed. He has the power to stop the work at any time if the conditions have changed or the persons executing the works are not observing the precautions. The hand-over from one operational shift to the next shall include a review of all outstanding permits. Request for extension shall be done to the person in-charge. In case of emergency, a new work permit shall be issued for work continuation. Original permit to work can be used if the alarm happens to be false. Job Completion When the job is completed, the permit applicant shall sign off the permit and return to person in-charge. The person in-charge may delegate site supervisor on his behalf to sign for work completion and acceptance. The work permit is evidence, which may be required for claims, due to injury or compensation. The original shall, therefore be kept for as long as needed under local law. At a minimum, it shall be kept for 2 years.

9.2 9.3

PERMIT TO WORK

EFFECTIVE/REVISION DATE:

31 M A R C H 2006

REVISION NUMBER:

10.0 Auditing
The purpose of permit to work auditing is to ensure the permit to work system to function effectively; The Supervisor or Person In-charge shall inspect the permit to work log, Permit to work for proper authorization and validation; Facilities shall be inspected to ensure that all precautionary measures have been taken, pre-job discussion has been held; Management personnel may conduct the similar audit to ensure the above were done correctly; Audit findings shall be presented to the HSE department for further review; Any changes to be made if deem necessary are the responsibility of HSE department.

CONFINED SPACE ENTRYPERMIT


SECTION 1 REQUISITION
APPLICANTS NAME STAFF NO./ ID NO.

NO: CS 0001
Time:

Date:

DEPT./CO. LOCATION/FACILITY

WORK DESCRIPTION... ..

SECTION 2 CONFINED SPACE TYPE /HAZARDS/ WORK TO BE CONDUCTED Storage or Process vessel Gas & Fumes Blasting & painting Others Storage tank Hydrocarbon liquid Welding & grinding Lube Oil tank Loose earth walls Inspection Trenches Cleaning Pipe laying SECTION 3 SAFETY PRECAUTIONS TO BE TAKEN WHEN WORKING IN CONFINED SPACE Gas Test Results Gas Monitoring Fire Extinguisher Isolation by blinds Oxygen (19.5% to 22%)___ Continuous Fire Hose standby Valves isolated Combustible (<10%LEL)_____ Every ____hrs Continuous Ventilation Valves locked open/close Toxic (<PEL)______ Low Voltage lighting Space Cleaned Standby Watch Rescue equipment at site Pre job meeting Others. Name__________ Entry Status Board Escape route clear Trench shoring Personnel health check SECTION 4 PERSONAL PROTECTIVE EQUIPMENT Mandatory Others Welding apron Respirators Cotton gloves H2S meter Safety Helmet Welding shields Dust masks Leather gloves Safety Harness Safety shoes Face shields Ear Plugs/ muffs Chemical gloves Safety glasses Goggles SCBA Rubber gloves Coveralls B & P coveralls First aid kit Welding Gloves


SECTION 5 ASSOCIATED PERMITS / DOCIUMENTS Electrical Isolation Permit no.. Excavation Permit no. JSA required (Y/N) Electrical Permit no. Lifting Permit no Drawing no. Physical isolation Permit no Confined Space Entry Permit no Others.. Safety Bypass Permit no.. Radiation Permit no.. SECTION 6 JOINT SITE VISIT BEFORE WORK STARTS / APPROVAL I have personally checked the area and system to be worked on and am satisfied that work requested can be carried out safely. PERMIT APPLICANT Name. Designation.. Signature.. SECTION 7 REVALIDATION Date PERMIT APPLICANT AREA SUPERVISOR Name. Designation.. Signature.. AREA SUPERVISOR APPROVING AUTHORITY Name. Designation.. Signature.. APPROVING AUTHORITY

SECTION 8 PERMIT RETURN Work Completed

Housekeeping completed

Work incomplete due to APPROVING AUTHORITY Name. Date Signature.. Time

PERMIT APPLICANT Name... Date... Signature.


Copy No. 1 to be kept at site

AREA SUPERVISOR Name. Date Signature.. Time

Time...

Copy No. 2 Permit applicant

Copy No. 3 Approving Authority

EXCAVATION PERMIT
SECTION 1 REQUISITION APPLICANTS NAME STAFF NO./ ID NO. Date:

NO: EX 0001
Time:

DEPT./CO. LOCATION/FACILITY

WORK DESCRIPTION. SECTION 2 POSSIBLE HAZARDS Gas & Fumes Volatile Liquid under Pressure High Voltage cables Traffic Water pipelines H2S

Additional Precautions to be followed: . . . SECTION 3 SAFETY PRECAUTIONS /PERSONAL PROTECTIVE EQUIPMENT Warning signs Barricades Beacon Lights Traffic Guidance Safety Helmet Safety Shoes Gloves Safety glasses Where excavation depth is >1.5m Gas Test Shoring Ladders Standby watch SECTION 5 JOINT SITE VISIT BEFORE WORK STARTS / APPROVAL I have personally checked the area and system to be worked on and am satisfied that work requested can be carried out safely. PERMIT APPLICANT REVIEWED BY MECHANICAL REVIEWED BY ELECTRICAL SUPERVISOR SUPERVISOR Name Designation Signature AREA SUPERVISOR Name. Designation.. Signature.. Name Designation Signature Name Designation.. Signature..

APPROVING AUTHORITY Name. Designation.. Signature..

SECTION 6 REVALIDATION Date PERMIT APPLICANT

AREA SUPERVISOR

APPROVING AUTHORITY

SECTION 7 PERMIT RETURN Work Completed

Site Restored

Work incomplete due to

PERMIT APPLICANT Name Date.. Signature


Copy No. 1 to be kept at site

AREA SUPERVISOR Name Date Signature Time

APPROVING AUTHORITY Name. Date Signature.. Time.

Time.

Copy No. 2 Permit applicant

Copy No. 3 Approving Authority

COLD WORK PERMIT


SECTION 1 REQUISITION
APPLICANTS NAME STAFF NO./ ID NO.

NO: CW 0001
Date: Time:

DEPT./CO. LOCATION/FACILITY

WORK DESCRIPTION...

..
SECTION 2 HAZARDS/HAZARDOUS ACTIVITIES Working at height Scaffolding Gas & Fumes Electrical Excavation Liquid under pressure Hot Surface Radiography Chemical Dust Lifting H2S SECTION 3 WORKSITE PREPARATION/PRECAUTIONS (Y/N) Isolation by blinds (Y/N) System depressurised Valves isolated (Y/N) Safety system bypassed Area barricaded Warning signs installed (Y/N) (Y/N) (Y/N) Pressure Test Saw/Cold cut Hand tools Needle gun Others . . .

Scaffold safe to use

(Y/N)

Others.. .. .. .. Others

Fire extinguisher at site (Y/N) Escape ways clear Pre job meeting done (Y/N) (Y/N)

Valves locked open/close (Y/N) System drained/ flushed (Y/N)

SECTION 4 PERSONAL PROTECTIVE EQUIPMENT Mandatory Chemical suit Respirators Safety Helmet Chemical boots Dust masks Safety shoes Face shields Ear Plugs/ muffs Safety glasses Goggles Coveralls Disposable suit

Cotton gloves Leather gloves Chemical gloves Rubber gloves

H2S meter Safety Harness


(Y/N)

SECTION 5 ASSOCIATED PERMITS / DOCIUMENTS Excavation Permit no. Electrical Isolation Permit no.. Electrical Permit no. Physical isolation Permit no Safety Bypass Permit no.. Lifting Permit no Confined Space Entry Permit no Radiation Permit no..

JSA required

Drawing no. Others.

SECTION 6 JOINT SITE VISIT BEFORE WORK STARTS / APPROVAL I have personally checked the area and system to be worked on and am satisfied that work requested can be carried out safely. PERMIT APPLICANT Name. Designation.. Signature.. SECTION 7 REVALIDATION Date PERMIT APPLICANT AREA SUPERVISOR Name. Designation.. Signature.. AREA SUPERVISOR APPROVING AUTHORITY Name. Designation.. Signature.. APPROVING AUTHORITY

SECTION 8 PERMIT RETURN Work Completed

Housekeeping completed

PERMIT APPLICANT Name... Date... Signature.


Copy No. 1 to be kept at site

AREA SUPERVISOR Name. Date... Signature.. Time

Work incomplete due to APPROVING AUTHORITY Name. Date... Signature.. Time

Time ..

Copy No. 2 Permit applicant

Copy No. 3 Approving Authority

LIFTING PERMIT SECTION 1 REQUISITION APPLICANTS NAME Date:

NO: LP 0001 Time:

DEPT./CO.

STAFF NO./ ID NO.

LOCATION/FACILITY

WORK DESCRIPTION... SECTION 2 TYPE OF LIFT Major Lift (66%-88% of load chart) Heavy Lift (20tons or more) Lifts Over/Near live services

SECTION 3 CRANE INFORMATION TYPE OF CRANE BRAND NAME MODEL SECTION 5 ACTIVITY DETAILS LOCATION OF LIFT LENGTH OF BOOM RADIUS RIGGING WEIGHT BLOCK SLINGS/SHACKLES SPREADER BAR UPPER BOOM PT kg JIB kg BALL kg LOAD LINE kg PIN EXTRACTORS TOTAL RIGGING WEIGHT CHART CAPACITY AT RADIUS WEIGHT OF OBJECT TO BE LIFTED TOTAL WEIGHT (PLUS RIGGING WEIGHT SAFETY FACTOR OF CRANE PERCENTAGE OF SAFETY CHART NUMBER OF PARTS PER LINE RATED CAPACITY PER PART OF LINE ACTUAL LOAD PER PART LINE SECTION 4 APPROVAL CRANE SUPERVISOR Name Signature Date..
Copy No. 1 to be kept at site

Truck mounted / Crawler Crane

kg kg kg kg

kg kg kg kg kg each kg kg

LIFT SUPERVISOR Name Signature Date..


Copy No. 2 Permit applicant

APPROVING AUTHORITY Name Signature Date..


Copy No. 3 Approving Authority

ELECTRICAL PERMIT
SECTION 1 REQUISITION
APPLICANTS NAME

NO: E 0001
Date: Time:

DEPT./CO.

STAFF NO./ ID NO. LOCATION/FACILITY WORK DESCRIPTION... ..

SECTION 2 HAZARDS/EQUIPMENT EQUIPMENT TAG NO: HV Switchboard Lighting Others LV Cable Motor Generator Transformer Switchgear SECTION 3 WORKSITE PREPARATION/PRECAUTIONS Pre job meeting done Others.. Fire Extinguisher Equipment & locked Earthing installed Cable discharged Fuses withdrawn Fire Blanket Insulated tools available Lock out tags installed Cotton gloves Leather gloves Chemical gloves Rubber gloves Barricades installed Warning signs installed .. .. .. Others

SECTION 4 PERSONAL PROTECTIVE EQUIPMENT Mandatory Goggles Respirators Safety Helmet Electrically Dust masks Insulated boots Safety shoes Ear Plugs/ muffs Safety glasses Coveralls

H2S meter Safety Harness


(Y/N)

SECTION 5 ASSOCIATED PERMITS / DOCIUMENTS Electrical Isolation Certificate no. Confined Space Entry Permit no Safety Bypass Permit no.. Radiation Permit no..

JSA required

Drawing no. Others..

SECTION 6 JOINT SITE VISIT BEFORE WORK STARTS / APPROVAL I have personally checked the area and system to be worked on and am satisfied that work requested can be carried out safely. PERMIT APPLICANT REVIEWED BY AEP/ SAEP APPROVING AUTHORITY

Name. Designation.. Signature..

Name. Designation.. Signature..

Name. Designation.. Signature..

SECTION 7 WORK COMPLETION HOOK UP AFTER COMPLETION Motor Reinstalled Generator reinstalled Cables Connected Megger/ Continuity Test Completed Other works completed Ready to Energise SECTION 8 PERMIT RETURN Work Completed

DE-ISOLATION Earthing Removed Locks and tags removed Barricades and Warning signs removed Tools removed Open panels closed up

Housekeeping completed

Work incomplete due to APPROVING AUTHORITY Name. Date Signature.. Time

PERMIT APPLICANT Name... Date... Signature.


Copy No. 1 to be kept at site

AEP/SAEP Name. Date Signature.. Time

Time...

Copy No. 2 Permit applicant

Copy No. 3 Approving Authority

ELECTRICAL ISOLATION PERMIT


SECTION 1 REQUISITION APPLICANTS NAME STAFF NO./ ID NO. UNIT/AREA/FACILITY: START DATE: START TIME Date:

NO: EI 0001
Time:

DEPT./CO. LOCATION. EQUIPMENT TAG NO: CLOSE OUT DATE.. CLOSE OUT TIME

WORK DESCRIPTION... ..

SECTION 2 TYPE OF ISOLATION REQUIRED Switch Out Rack out SWITCHGEAR SWITCH BOARD PANEL LABEL/DESCRIPTION LOCKS A C

Record at log book NOTICES DANGER CAUTION

Lock Out Tag Out

EARTHED

INITIAL

I herby confirm that the equipment (stated above) has been deenergised, isolated from all electrical sources and safe to work on. COMPETENT ELECTRICAL PERSON (CEP)

CONFIRMED BY AUTHORISED ELECTRICAL PERSON (AEP)

Name. Designation.. Signature.. Date.

Name. Designation.. Signature.. Date..

SECTION 3 OTHER PERMITS ASSOCIATED WITH THIS ISOLATION PTW NO. ORIGINATING SECTION VALIDITY

SECTION 4 REQUEST FOR DE-ISOLATION I hereby confirm that the work for which electrical isolation was required has been completed, personnel withdrawn and request equipment to be re-energised. WORK SUPERVISOR

I have checked the work area and confirm that there are no personnel or tools around the work area and it is safe to reenergise the equipment. COMPETENT ELECTRICAL PERSON (CEP)

Name. Designation.. Signature.. Date.

Name. Designation.. Signature.. Date.

SECTION 4 NORMALISATION I hereby confirm that the electrical power to the equipment has been normalised and can be used as required. AUTHORISED ELECTRICAL PERSON (AEP)

Name
Copy No. 1 to be kept at site

Signature
Copy No. 2 Permit applicant

Date..

Copy No. 3 Approving Authority

HOT WORK PERMIT


SECTION 1 REQUISITION
APPLICANTS NAME STAFF NO./ ID NO.

NO: HW 0001
Date: Time:

DEPT./CO. LOCATION/FACILITY

WORK DESCRIPTION... ..

SECTION 2 HAZARDS/HAZARDOUS ACTIVITIES Welding Blasting & Painting Spark producing Others Flame Cutting Power brushing Self igniting material Open Flame Hot Tapping Gas & Fumes Grinding Photography Hydrocarbon liquid SECTION 3 WORKSITE PREPARATION/PRECAUTIONS Gas Monitoring Others.. Fire Extinguisher Pre job meeting done Continuous Fire Blanket .. Gas Test Results Every ____hrs Fire Retardant Screen Oxygen (19.5% to 22%) _____ .. Spark Arrestor on Engines Fire Watch Combustible (<10%LEL)_____ Cover for drain/ sump .. Name__________ Toxic (<PEL)______ Fire Hose standby SECTION 4 PERSONAL PROTECTIVE EQUIPMENT Mandatory Welding apron Respirators Safety Helmet Welding shields Dust masks Safety shoes Face shields Ear Plugs/ muffs Safety glasses Goggles Coveralls B & P coveralls

Cotton gloves Leather gloves Chemical gloves Rubber gloves Welding Gloves

H2S meter Safety Harness

Others


(Y/N)

SECTION 5 ASSOCIATED PERMITS / DOCIUMENTS Excavation Permit no. Electrical Isolation Permit no.. Electrical Permit no. Physical isolation Permit no Safety Bypass Permit no.. Lifting Permit no Confined Space Entry Permit no Radiation Permit no..

JSA required

Drawing no. Others..

SECTION 6 JOINT SITE VISIT BEFORE WORK STARTS / APPROVAL I have personally checked the area and system to be worked on and am satisfied that work requested can be carried out safely. PERMIT APPLICANT Name. Designation.. Signature.. SECTION 7 REVALIDATION Date PERMIT APPLICANT AREA SUPERVISOR Name. Designation.. Signature.. AREA SUPERVISOR APPROVING AUTHORITY Name. Designation.. Signature.. APPROVING AUTHORITY

SECTION 8 PERMIT RETURN Work Completed

Housekeeping completed

PERMIT APPLICANT Name... Date... Signature. Time...

AREA SUPERVISOR Name. Date Signature.. Time

Work incomplete due to APPROVING AUTHORITY Name. Date Signature.. Time

Copy No. 1 to be kept at site

Copy No. 2 Permit applicant

Copy No. 3 Approving Authority

RADIATION PERMIT
SECTION 1 REQUISITION Date:

NO: R 0001
Time:

APPLICANTS NAME STAFF NO./ ID NO. UNIT/AREA/FACILITY: START DATE: START TIME SECTION 2 WORK DESCRIPTION WELD SURVEY

DEPT./CO. LOCATION.

CLOSE OUT DATE.. CLOSE OUT TIME

CORROSION INSPECTION

ISOLATION/ COMMISSIONING OF SOURCE

SPECIAL INVESTIGATIONS . .

SECTION 4 RADIACTIVE SOURCE DETAILS 1. 2. 3. RADIOACTIVE SOURCE: (X-RAY/ISOTOPE).. MAXIMUM ACTIVITY (KV/Ci) TYPE OF RADIATION: ( X- RAY / ALPHA /BETA /GAMMA0

SECTION 5 PRECAUTIONS TO BE TAKEN BEFORE AND DURING ACTIVITY AREA TO BE BARRICADED WARNING SIGNS INSTALLED X-RAY DOSIMETERS USED BY TECHNICIANS SOURCED STORED IN APPROVED CONTAINER WHEN MOVING TO WORK SITE SECTION 6 VERIFICATION BY WNPOC SUPERVISOR

I hereby confirm that the site has been inspected, personnel removed and radiation technicians have taken all the necessary safety precautions to carry out the activity.
WORKS SUPERVISOR

Name. Designation.. Signature.. Date.


SECTION 7 APPROVAL I hereby authorise the Radiation activity to be carried out PERSON IN CHARGE

Name. Designation.. Signature.. Date.


SECTION 8 WORK COMPLETION I hereby confirm that radiation activity has been completed and the site has been restored for safe work AREA SUPERVISOR ACCEPTED

APPROVING AUTHORITY

Name. Designation.. Signature.. Date.


Copy No. 1 to be kept at site

Name. Designation.. Signature.. Date.


Copy No. 2 Permit applicant Copy No. 3 Approving Authority

SAFETY SYSTEM BYPASS PERMIT


SECTION 1 REQUISITION APPLICANTS NAME STAFF NO./ ID NO. UNIT/AREA/FACILITY: START DATE: START TIME SECTION 2 WORK DESCRIPTION REASON FOR SAFETY SYSTEM BYPASS Date:

NO: SSB 0001


Time:

DEPT./CO. LOCATION. EQUIPMENT TAG NO: CLOSE OUT DATE.. CLOSE OUT TIME

EFFECT ON SYSTEM DURING PERIOD OF BYPASS METHOD OF BYPASS Physical Isolation Temporary Removal of Instrument Hardwire jumper Temporary Setting Change

Others.

SECTION 3 ADDITIONAL PRECAUTIONS TO BE TAKEN PRECAUTIONS TO BE TAKEN Bypass notification notified to all at site Permit copy located in control room I shall implement all precautions as specified before work starts Additional Precautions / Instruction ..

Name. Designation.. Signature..


SECTION 4 APPROVAL I hereby authorise the applicant to proceed with Safety System Bypass as requested PERSON IN CHARGE

Name. Designation.. Signature.. Date.


SECTION 5 WORK COMPLETION I hereby confirm that the work for which Safety System Bypass was required has been completed and the system is back to normal operating mode AREA SUPERVISOR ACCEPTED

APPROVING AUTHORITY

Name. Designation.. Signature.. Date.

Name. Designation.. Signature.. Date.

Copy No. 1 to be kept at site

Copy No. 2 Permit applicant

Copy No. 3 Approving Authority