ptw system procedure

0 A c

Permit to Work System Procedure

Document Revision and Approval

Revision Date Description

00 30 Nov 2011 First Issue

Proc. No: NC/PTW/SP-001

Proc Title: Permit to Work System Procedure

Developer Mohsin Abbas Awan GM (Quality) 22 Nov 2011

Reviewer I Haroon Tabani Manager (HSE) 23 Nov 2011 1UJ .1~ . ___. VI y)(\.4'~V Reviewer II Kamal Sid coo 30 Nov 2011

Approver Julio Torre Gutierrez CEO 30Nov2011 ~~~ Name Title Date ~ Signature

Uncontrolled, if printed *Refer latest version in the server I SAP *If required, print both the sides•


Uncontrolled, if printed * Refer latest version in the server / SAP * If required, print both the sides *

Proc. No: NC/PTW/SP-001 Rev: 00 of 59

Table of Contents

1. Purpose ...................................................................................................................................................... 3 2. Scope.......................................................................................................................................................... 3 3. Roles and Responsibilities ......................................................................................................................... 3 4. Equipment/Software ................................................................................................................................. 6 5. Terminology ............................................................................................................................................... 6 6. Procedure .................................................................................................................................................. 7 7. Records .................................................................................................................................................... 22 8. Legal Requirements and References ....................................................................................................... 23




1. Purpose

To define NOMAC Permit to Work System (NPTW SYSTEM) which is a formal documented system and recorded process used to control work in a safe manner.

2. Scope

All personnel and activities on operational facilities under NOMAC’s control including but not limited to:

Non-production work (maintenance, repair, inspection, testing, alteration, construction, dismantling, adaptation, modification, cleaning etc).

Non-routine operations.

Works where two or more individuals or groups need to co-ordinate activities to complete the job safely;

Jobs where there is a transfer of work and responsibilities from one group to another.

3. Roles and Responsibilities

Roles Responsibilities

Plant Manager (PM/PGM)

Accountable for ensuring the full implementation of the PTW system and ensuring compliance. (Output: Certificate of PTWS Implementation, NC/PTW/SP-001/FM-026).

Providing, or delegating authority to a senior manager to provide, resources and training (technical and awareness) to effectively implement and maintain the PTW system.(Output: Authority to train & resource PTWS, NC/PTW/SP-001/FM-027).

Appointing, or delegating authority to a committee of senior managers to appoint, a team of competent personnel to assure and authorize all necessary competent personnel to manage and operate the PTW system. (Output: Formation of PTWS CAC, NC/PTW/SP-001/FM-028).

Monitoring or delegating authority to a senior manager to monitor, the functionality and effectiveness of PTW system to deliver safe systems of work meeting industry good practices. (Output: Compulsion to Monitor PTWS, NC/PTW/SP-001/FM-029).

Quarterly Auditing the PTW system. (Output: PTWS Quarterly Audit Report, NC/PTW/SP-001/RP-001).

Setup a PTWS Office nearby CCR, with arrangements to manage LOTO kits, key safe, documents etc. OM will be responsible to manage PTWS office.





PTWS Competence and Authorizing Committee

To nominate competent employees to perform 9 roles of PTW System. The selection should be based on competency only, keeping in view plant systems knowhow, experience, PTWS training and proven technical & personal capabilities.

To define SWS (Standard Work Statement) for routine tasks. (NC/PTW/SP-001/FM-020)

To define SWBS (Standard Work Breakdown Structure ) for SWS. (NC/PTW/SP-001/FM-022)

To define WC(Work Center) exhaustively. (NC/PTW/SP-001/FM-021)

To nominate RA team & supervise RA activity.( NC/PTW/SP-001/FM-025)

To edit Hazard and control sheet (NC/PTW/SP-001/FM-024) as per requirement.

To define TBT (Tool Box Talk) for SWS. (NC/PTW/SP-001/FM-023)

To define a relationship of one to many between PTWS Roles and Site Roles.

To issue a list of Certified staffers for PTWS Roles. (Output: Certified PTWS Roles, NC/PTW/SP-001/FM-030).

Permit Authorizer PA

Ensures that PTW contains clear, simple, precise and complete descriptions and limitations of works, details of location and start/end timing.

Reviews and certifies the list of activities interacting with the PTW.

Define control measures for the activities of PTW which are interacting or affecting with other site activities being done with or without using PTW System.

Certify that all other works that would create hazards if undertaken at the same time are either suspended or made safe.

Define pre-determined actions in the event of emergencies at site or plant.

Identify competent persons engaged in preparation of permits.

Identify the competent persons responsible for supervision.

Permit Issuer PI

Ensure that all hazards associated with job have been identified and suitably addressed.

Ensure that all steps necessary to ensure the safety have been taken.

Ensure that all the required PTW system certificates and permits are identified, prepared and attached to the PTW.

Ensure that work activities that may interact or affect one another are clearly identified and either conflict avoided or precaution included in PTW.

Ensure that all precautions and isolations are withdrawn at the end of the job unless they are cross referenced to other permit based activity.

Permit Originator PO

Identify the work requiring PTW System’s activation.

Clearly and completely describe the works and tasks, the location, the scheduled start and end times

Conduct preliminary RA.

List of other ongoing activities under live permits or otherwise which may affect job or may be affected by undertaking job.

Define limitation on timings from PO perspective.

Define precisely the boundaries of proposed work w.r.t Plant Functions and Plant Technical Objects.





Isolation Authority IA

Ensure that baseline isolation standard is determined and applied.

All precautions and safety measures stated on permit are strictly followed.

Ensure Isolation is fully implemented and documented.

Issue Isolation Certificate.

Conduct RA for Isolation and De-isolation scheme.

Identify & maintain register for extended isolations.

Identify & manage cross referenced isolations with other PTWs or activities.

Prepare isolation and de-isolation sequence scheme.

Permit Acceptor PC

Lead, supervise and monitor the team undertaking the works.

Accept the permit on behalf of Permit User (PU) who carries out the work.

Ensure the work being done comply with all PTW and safety requirements.

Fully understands the PTW system and is fully competent to supervise/undertake the proposed work.

Permit User PU

Undertake the works in full compliance with the PTWS and all HSE requirements.

Be aware of and manage the works’ risks, scope, limits, nature and location related issues.

Be competent and trained to undertake the works and work within the PTW system.

Stop work when in doubt and seek advice and support.

Stop work if conditions change or become hazardous, make the area safe and immediately seek advice or follow predetermined action list for such kind of happenings.

Area Authority AA

Custodian of the location of work.

Ensure all hazards associated with the work are identified and risk controls are applied.

Monitor the works, location and permit user(s) to ensure that all precautions and safe systems of work have been effectively implemented and are understood by the permit user (undertaking the works).

Ensure Interaction is controlled and known.

Copies of PTW, Permits and Certificates applicable to job are available and displayed.

Accept and acknowledge the return of plant or equipment into his full control on completion of the works, reinstatement of good housekeeping practices and cancellation of the PTW.

Site Checker SK

Have certified competency to check all site conditions associated with Plant functions & processes.

Competent to understand, implement and monitor compliance with the PTW system

Only permit to start/continue works when/if necessary permits authorized, available and understood

Stop work when in doubt and seek advice and support.

Responsible for checking the conditions at site before start of any activity.

Remain conscious of possible degradation of site condition during the job & document it.

Let & verify AA and PU know about the limitations of site conditions.

Stop work if conditions change or become hazardous, make the area safe and immediately seek advice or follow predetermined action list for such kind of happenings.





Supervision Authority SA

Ensure understanding and competence of all employees using or complying with PTW system.

Ensure that the conditions and precautions specified in permits are fully understood, implemented and effectively monitored.

Ensure the arrangements that PA and PI will be timely informed when a job has been completed, suspended, conditions altered, task need to alter and/or any emergency exists.

Document Controller, DC

PTWS data , copies of permits, or records of their issue, are kept for a specified period to enable auditing or incident investigation.

4. Equipment/Software

SAP ERP, ECC 6.0 + systems including PM, PP, QA, PS Modules. Share point file server.

5. Terminology: Site Roles PM/PGM : Plant Manager / Plant General Manager OM : Operation Manager MM : Maintenance Manager TM : Technical Manager SC : Shift In-charge SS : Shift Supervisor LO : Local Operator CO : CCR Operator ME : Maintenance Engineer SB : Switch Board Operator MS : Maintenance Supervisor MT : Maintenance Technician SL : Skilled Laborer HO : HSE Officer PE : Planning Engineer PR : Process Engineer PM : Performance Manager LC : Lab Chemist HS : HR Supervisor DC : Document Controller CS : Contractor’s Staff CAC : Competence and Authorization Committee COO : Chief Operations Officer CEO : Chief Executive Officer. PTWS Roles: Supervision Authority (SA) Employee supervising the effectiveness of PTW Permit Authorizer (PA) Highest Authority ordering issuance of permit Permit Issuer (PI) Employee issuing the permit Permit Originator (PO) Requestor of job




Isolation Authority (IA) Employee responsible for installing Isolations Permit Acceptor (PC) Highest Authority (team leader) accepting the permit Permit User (PU) Personnel complying with and working under the terms of Permits Area Authority (AA) Employee in Control of location of work Site Checker (SK) Employee carrying out site checks/tests

6. PTWS Procedure (Concept)

NOMAC PTW system is not designed to simply issue permission to carry out a dangerous job, It is a process safety risk management system which determines how that job may be safely carried out under predetermined conditions and communicates these requirements to those doing and supervising the job. It should not be regarded as an easy way to eliminate hazard or reduce risk. The issue of a permit does not, by itself, make a job safe, that can only be achieved by dedication & competency of those preparing for the work, those supervising the work and those carrying out the work. The aim of the PTW system is to ensure that Authorized and competent people have thought about foreseeable risks associated with the job. Associated risks are avoidable by using suitable precautions and measures. Those carrying out the job will think about and understand what they are doing to carry out their work safely, and take the necessary precautions for which they have been trained and made responsible. An initial appraisal and risk assessment will be carried out to identify the nature of a task and its associated hazards before it is started. Precautions and controls to mitigate the risks will be defined and the PTW system will be implemented to control the following types of tasks and situations:

Non-production work (eg maintenance, repair, inspection, testing, alteration, construction, dismantling, adaptation, modification, cleaning );

Non-routine operations;

Jobs where two or more individuals or groups need to co-ordinate activities to complete the job safely;

Jobs where there is a transfer of work and responsibilities from one group to another. NOMAC’s PTW system consists of a set of procedures and forms. The PTW system clearly defines roles, responsibilities, nature and extent of works to control all activities in a predetermined safe manner. The system consists of:

PTW System Procedure, to drive the entire system.

PTWS sub-procedures with defined roles and processes which come in force at certain predefined instant.

PTW Permits and Certificates (mandatory to proceed with the job, as determined in RA).

PTW Form, containing essential elements of PTW System.

Standard lists of categorized Works, Work breakdown structures, Tool Box Talks, Work Centers and Risks (with details of scope and limits).

The PTW System is an integral part of an overall safe system of work and is designed to properly manage a wide range of routine and non-routine activities. This PTW System has taken into deep consideration “The human factors” & its possible failure to understand the job, its extent, its limits and nature. The failures may in turn be attributable to root causes such as a lack of training, instruction, communication or understanding of either the purpose or practical application of PTWs.




This PTWS Procedure should be subjected to test implementation in parallel with existing PTWS for certain amount of time till understanding is developed & procedural documents are generated in a proper sequence with requisite data quality. Process flow: 1. SAP Maintenance Order will be raised in 3 cases by PO either through Malfunction (Operation)

Notification, Predictive Notification or Preventive Notification. 2. There are other possibility of EPC requirement which will be taken care by PO using Activity

Notification, Engg requirement taken care by Plant Modification Notification and other requirements taken care by General Notification.

3. If a decision is made to conduct any of the aforesaid jobs in para 1 and 2, PO will raise permit request by filling first part of the PTW form viz NC/PTW/SP-001/FM-001.

4. The category of job activity will be assessed by PO among A ( Access Required), B(Permit required), C(permit with work pack required), D (New activity).

5. If activity falls in category A (based on RA), PO will fill first part of NC/PTW/SP-001/FM-001 , mentioning that it is now used as Access Permit & inform Operation about the activity, obtain signatures of PI/PA and conduct work. When Job is completed it is the responsibility of PO to inform PI/PA by closing the Access Permit. If activity falls in category B (based on RA), 4 documents are required to be raised, PTW form (NC/PTW/SP-001/FM-001), RA Form (NC/PTW/SP-001/FM-025), Isolation Certificate(NC/PTW/SP-001/FM-010) and Tool Box talk(NC/PTW/SP-001/FM-023). If activity falls in category C (based on RA), Work pack which consists of all necessary documents including work instructions, drawings etc will also be required. If it is a new activity for which there is no RA available, RA team already nominated by Plant will conduct RA and ascertain the category of activity.

6. PM/PGM will nominate an RA team consisting of 6 competent and experienced professionals. At least 2 members are required to conduct RA depending on complexity & severity of activity.

Supplementary Work Permits: Hot Work Permit: NC/PTW/SP-001/FM-002

1. PO will obtain Hot Work permit Form from PTWS Office. This should be done on every occasion that Hot Work is required to be carried out. PO will fill the required sections of the form and submit to SC.

2. PI will check the significance of any other permit to work going on in the vicinity which may involve the use of flammable liquids or gases.

3. PI will only issue Hot Work Permit for a specific task undertaken in a clearly identified area.

4. PI shall not issue Hot Work Permit for protracted periods. 5. If PI is not satisfied with the preparation as mentioned in check list and precautions

(section 2 and 3) PI may ask for more precautions which are to be entered in “Others” box.

6. Hot Work Permit will be completed in duplicate with top copy for PC and second copy for PI.

7. Completed form will remain with PI for record and future reference. Working at height Permit: NC/PTW/SP-001/FM-003

1. PO will obtain Permit Form from PTWS Office. This should be done on every occasion that this type of job is required to be carried out. PO will fill the section 1-3 of the form and submit to SC.




2. PI will check the significance of any other permit to work going on in the vicinity which may interact.

3. PI will only issue the Permit for a specific task undertaken in a clearly identified area. 4. PI shall not issue Permit for protracted periods. 5. If PI is not satisfied with the preparation as mentioned in check list and precautions


6. The Permit will be completed in duplicate with top copy for PC and second copy for PI. 7. Completed form will be returned to PTWS Office for record and future reference.

Confined Space Entry Permit: NC/PTW/SP-001/FM-004






Confined Space Working Permit: NC/PTW/SP-001/FM-005






Ground Disturbance Permit: NC/PTW/SP-001/FM-006









Diving Permit: NC/PTW/SP-001/FM-007






Disjoint Permit: NC/PTW/SP-001/FM-008






Containment Break Permit: NC/PTW/SP-001/FM-009









Certificates: Isolation Certificate: NC/PTW/SP-001/FM-010

1. PO will obtain Certificate Form from PTWS Office. This should be done on every occasion that this type of job is required to be carried out. PO will fill the section 1-3 of the form and submit to SC.

2. PI will check the significance of any other work going on in the vicinity which may interact.

3. PI will only issue the Certificate for a specific task undertaken in a clearly identified area. 4. PI shall not issue Certificate for protracted periods. 5. If PI is not satisfied with the preparation as mentioned in check list and precautions


6. The Certificate will be completed in duplicate with top copy for PC and second copy for PI.

7. Completed form will be returned to PTWS Office for record and future reference.

Logic Isolation Certificate: NC/PTW/SP-001/FM-011






7. Completed form will be returned to PTWS Office for record and future reference. Access Barrier Isolation Certificate: NC/PTW/SP-001/FM-012










HV Environment Isolation Certificate: NC/PTW/SP-001/FM-013






7. Completed form will be returned to PTWS Office for record and future reference. PD Containment Isolation Certificate: NC/PTW/SP-001/FM-014






7. Completed form will be returned to PTWS Office for record and future reference. Allowed to Test Certificate: NC/PTW/SP-001/FM-015






7. Completed form will be returned to PTWS Office for record and future reference. Test Certificate: NC/PTW/SP-001/FM-016









7. Completed form will be returned to PTWS Office for record and future reference. Interaction Certificate: NC/PTW/SP-001/FM-017







Machinery Certificate: NC/PTW/SP-001/FM-018






7. Completed form will be returned to PTWS Office for record and future reference. Radiation Certificate: NC/PTW/SP-001/FM-019





6.1 Process Map:

Operator

Notification Inspection

Planning SAP Maint. Order

Preventive

Notification Task List

Predictive

Notification

Work Request

Engineering

Construction

Validate Existing RA

Category A,

Only access

required

Identify Hazards

Conduct Risk Assessment

Design Process and Task Controls

Evaluate Residential Risks

Agreement to Proceed

Implement Controls & Prepare Draft PTWF

Isolation Certificates Prepared

PTW, RA, IC, TBT signed & accepted by

PA/PI & PO/PC

Undertake Task

in compliance with PTW requirements

PTW,RA,IC,TBT printed

Others

Define Parameters of Task and

required competencies

Implement Isolation

Prepare required Certificates, as per RA

PI authorizes and issues (signs) PTWF

Task completed

Hand-back procedure,

Job hand over procedureOpr. Shift Change over

Task suspended Job suspension Procedure

Job supervision Procedure

Permits Display Procedure

Define Isolation Standard

NOMAC PTW SYSTEM

N

N

Y

N

N

N

Y

CM

BD

Extended Isolation RequiredExtended Isolations

Management Procedure

Y

N

Undertake Risk Assessment with

competent team

Y

Changes to scope

of works or risks

N

Standard RA

Y

Permits Interaction ProcedurePermit/Task Interaction

N

N

LOTO Required LOTO ProcedureY

YY

Emergency/

Urgent Work

Emergency Tasks Procedure

STOP

STOP

Any Plant

Emergency

Scope change managable

Change Management

Procedure

Y

N

Routine work

Y

Standard WBS

Standard TBT

Finalize & Approve RA To PTWS Repository

PTW Form first part filled by PO

Standard IC

PTWS

Repository

To PTWS Repository

ManagableY N

Standard IC

available

Y

N




Task Risk Analysis Isolation CertificteS.Permits/

CertificatesPTW

Approved (PA)

Prepared (Any)

Schema Approved Approved (PA) Approved(PA)

Schema

Prepared (IA)

Awareness

Authorize

Surrundered

WithdrawnLong Term

De-Isolating

Proceed (IA)

Proceed (AA)

Available Issued

Raised (Any)Raised (Any)Raised (Any)Raised (Any)

Schema

Approved (IA)

Available

Prepare

Cancelled

Not RequiredCancelled Not Required Not Issued

Cancelled

Cleared

Prepare

Available

Cancelled

TRA, Permits, Certificate and PTW document Cycle




6.2 Procedure Flow:

Issue Timing Description of activities Responsible

(doing it) Accountable (ensure

it is done) Procedure/ SAP module

Outcome and Records

Forms and Templates

Competency Assessment

Pre-planning Check availability of personal with required competency for the scope of work

PO MM, PM 1. NC/HSE/SP-001/FM-032.

2. NC/HSE/SP-001/FM-033.

Confirmation of availability of personnel

SAP-PM-MO

Initial Risk Assessment

Pre-planning Complete initial risk assessment and assemble competent team to undertake full RA

PO MM,PM NC/HSE/SP-001 Initial risk assessment

FM-0025

Initiate the Maintenance Order

Planning Complete planning part of Maintenance Order by precisely dividing the maintenance activities into autonomous tasks mentioning duration, resources and material for each task.

PO MM SAP-PM-MO SAP Maintenance order

SAP-PM-MO

Work Request Planning Raise the work request by presenting maintenance order & filling part 1 of PTW Form

PO MM SAP-PM-MO. 1. NC/HSE/SP-

001/FM-001.

Work request Printed SAP-PM-MO

Scope of works Planning Determine exactly what the task will involve, The need for any special safety studies or assessments. whether it is obvious that the task cannot be carried out safely, and should be immediately discarded or delayed until other operations due to take place at the same time have been completed. If the likely hazards cannot be reconciled at this stage through task or other risk assessment, then the task should be rejected or redefined.

PO, PA OM,SC, ME, MM, SS SAP-PM-MO NC/HSE/SP-001

Detailed description of scope of works and required safe systems Agreement to proceed

SAP-PM-MO NC/HSE/SP-001/FM-001

Full Risk Assessment

Planning A full RA is undertaken for tasks that do not have a completed and available risk assessment. PA with supporting HSE team and PO will identify hazards associated with job and conduct RA and suggest controls in a predetermined formal way

PA, PO,PI HO, SC, ME NC/HSE/SP-001 RA, controls and safe work requirement

NC/HSE/SP-001/FM-001







Outcome and Records

Forms and Templates

Interaction with other works

Planning Define the control required to manage new planned works that could interact or impact with ongoing and on existing works and operations & vice versa.

PO, PA,PI, AA,IA

SC, ME,SS, LO,CO

PTW System Procedure. Permits Interaction Proc NC/PTW/SP-003

PI-Interaction jobs list. PO-Interaction Jobs list. Interaction Certificate

NC/PTW/SP-003/FM-001 NC/PTW/SP-003/FM-002 NC/PTW/SP-001/FM-003

Permits and Certificates

Planning Define Residual risks associated with the proposed job and determine the required PTW System supplementary permits and certificates.

PO, PA,SK,PI SS,HO,SC, ME NC/PTW/SP-001 NC/PTW/SP-002 NC/HSE/SP-001

Machinery Certificate

NC/PTW/SP-002/FM-001. NC/PTW/SP-001/FM-018..

Draft PTW Planning With all the information at hand the decision to proceed with the job (or not) is taken. At this point in time the PTW procedure will come in force. and the draft PTW Form, with all required RA controls, required Permits, required Certificates is prepared

PO , PA, PI, SK

ME, HO, SC PTW module NC/PTW/SP-001

Draft PTW NC/PTW/SP-001/FM-001

Define isolations

Make safe Determine isolation and LOTO base line standards for the proposed job. Prepare Isolation scheme. Prepare Isolation De-isolation sequence sheet. Determine common Isolation scenarios. Determine extended Isolation possibility.

PI,IA, AA SC,SS, LO Isolation Procedure NC/PTW/SP-002 LOTO procedure NC/PTW/SP-012

Isolation Scheme NC/PTW/SP-002/FM-001.







Outcome and Records

Forms and Templates

Effect Isolations Making Safe Implement the isolations and issue Isolation Certificate(s) as relevant. Verify Isolation Implementation.

IA, PI

SS,SC,LO Isolation Procedure NC/PTW/SP-002. PTW System Procedure NC/PTW/SP-001.

Isolation Certificate. Logic Isolation Certificate. HV Isolation Certificate. PD Containment Isolation Certificate. Access Barrier Isolation Certificate.

NC/PTW/SP-001/FM -010. NC/PTW/SP-001/FM -011. NC/PTW/SP-001/FM -013. NC/PTW/SP-001/FM -014. NC/PTW/SP-001/FM -012.

Making safe

Access Barrier Isolation Certificate

NC/PTW/SP-001/FM -011. NC/PTW/SP-001/FM -013. NC/PTW/SP-001/FM -014.

High Voltage Environment Isolation Certificate

Logic Isolation Certificate

Effect safe technical environment

PD containment Isolation Certificate AA

LO,SS NC/HSE/SP-001 Access Barrier Isolation Cert

Allowed to Test Certificate PI

SB NC/PTW/SP-002 HV Isolation Cert

NC/PTW/SP-001/FM -001.

Test Certificate PI,AA LO,SS NC/PTW/SP-002 PD Cont Isol Cert Interaction Certificate PA,PI PI, NC/PTW/SP-001 Allow to Test Cert Machinery Certificate SK, HO NC/PTW/SP-003 Test Certificate PO,PI SC,SS NC/PTW/SP-002 Interaction Cert PA,PO PI NC/PTW/SP-001 Machinery Cert Radiation Certificate PO,SK HO NC/PTW/SP-001 Radiation Cert







Outcome and Records

Forms and Templates

Supplementary Make safe Issue supplementary permits after making assessment of job and determining the requirement of Permits and Certificates.

PA,PI,PO ME,SC,SS NC/PTW/SP-001 Working at height Permit

NC/PTW/SP-001/FM -003

permits Working at height Permit SK,PI HO,SC,SS Hot work Permit

Hot work Permit PA,PI

SC,SS

Confined Space Entry Permit

NC/PTW/SP-001/FM -004. NC/PTW/SP-001/FM -005. NC/PTW/SP-001/FM -006

Confined Space Entry Permit PA,SK,PI

HO,SC,SS Confined Space Working Permit

Confined Space Working Permit PA,SK,PI

SC,SS,HO Ground Disturbance Permit

Ground Disturbance Permit PI,PA SC,SS Diving Permit Diving Permit PI,PA SC,SS Disjoint Permit

Disjoint Permit PI,IA,PA SC,SS,LO Containment

Break Permit

Containment Break Permit PI,PA SC,SS

PTW issued Made safe PTW Form issued with additional permits and/or certificates prepared and issued

PI, PA, IA SS,SC,LO NC/PTW/SP-001 Signed PTW , Required Certificates and Permits.

NC/PTW/SP-001/FM-001

PTW Acceptance

Accepted as safe

Check and accept the PTW form and supporting documents

PC, PU,PI, IA behalf of PU

MT,MS,ME,SS,SC Permit to work NC/PTW/SP-001

Signed and accepted Permit to work


Undertake works

Safe Works in progress

Undertake job in compliance with all precautions and instructions as per the PTW documentation

PU, PC, AA, PI,

MT,MS,ME,LO,SC,SS, Permits and Certificates Display Procedure NC/PTW/SP-013

PTW displayed at work location, Permits and Certificates displayed

NC/PTW/SP-001/FM-001 To NC/PTW/SP-001/FM-019.

Confined Space Safe Works in progress

Ensure that additional personnel for confined space entry are available

PO,SC,PC PC NC/PTW/SP-001 Confined space entry permit. Confined space working permit

NC/PTW/SP-001/FM-004. NC/PTW/SP-001/FM-005.

Supervision Ensure Safe Works in progress

The Job will be carried out under mandatory supervision

SA HO,PO,PA Permit Supervision Proc NC/PTW/SP-007

Records of supervision








Outcome and Records

Forms and Templates

Change of scope Works change management

During the job if any change in scope is required PU will inform PC, PO, AA and PI

PU, PC, AA PU, MS,MT,ME Scope of Work Change NC/PTW/SP-011

RA review, NC/PTW/SP-011/FM-001

Unplanned situation

Works in progress

During the job if any unplanned situation occurs the job will be stopped and a revised RA may be undertaken and implemented under Job suspension procedure.

PU, PC,AA,IA,PI

PU, PC, PI, MT, MS,SL,LO,SS, SC

Job suspension procedure NC/PTW/SP-006

Reassessment, Revalidation of controls and permits and certificates


Shift Change Works in progress

If Operation Shift changed over during job, job handover procedure will come in force. If Maintenance team change over during the job this procedure will become effective

PI,AA,PU,PC PI, PC,LO,SC,SS,MT,MS,SL

Job Handover Procedure NC/PTW/SP-004

SAP PM-MO-with marking on the operation list showing current status of job

NC/PTW/SP-004/FM-004. SAP-PM-MO

Extended Isolations

Works in progress

When extended isolations are required a formal procedure will be followed leaving no room for any mistaken activity.

IA, AA, PI, PO

ME, LO, Extended Isolations Proc NC/PTW/SP-014

Extended Isolation Register. Extended Isolation List.

NC/PTW/SP-014/PS-001. NC/PTW/SP-014/FM-001.

Monitoring Works in progress

Continuous checking of controls in place during the pendency of permit controlled job

AA, PI, IA, PA LO, SS,SC,MO,ME PTW Monitoring Proc NC/PTW/SP-008

PTWS Monitoring Report

NC/PTW/SP-008/RP-001, RP-002,

PTW Compliance

Works in progress

Periodic verification of compliance with PTW system and procedures

PI, PA, PO OM,MM,PM,GMQ Permits Review Proc NC/PTW/SP-010

PTWS compliance Report

NC/PTW/SP-010/RP-001

Suspension of Works

Works in progress

If task is suspended due to any reason then compliance with suspension procedure is required

PU,AA,PI, MS, MT,SL,LO,SS, SC Job suspension and Re-start Procedure NC/PTW/SP-006

Reassessment, Revalidation of permits, MO with scope change

NC/PTW/SP-006/FM-001 and RP-001

Completion of Works

Works completed

When task is completed as per plan then job hand back procedure come into effect

PU,AA,IA,PI, LO,SC,SS, Job Hand-back Proc NC/PTW/SP-005

List of Cancelled permits, Cancelled Certificates, General Permit to work

NC/PTW/SP-005/RP-001.

Compliance Audit

After completion

Periodic audits of compliance with the PTW system should be undertaken

PA OM,MM,PM,GMQ PTWS Audit Proc NC/PTW/SP-009

Audit Report NC/PTW/SP-009/RP-001




7. Records:

Procedure Reference Document No.

Permit-to-Work System Procedure NC/PTW/SP-001

PTWS - Isolation Procedure NC/PTW/SP-002

PTWS - Permits Interaction Procedure NC/PTW/SP-003

PTWS - Job Handover Procedure NC/PTW/SP-004

PTWS - Hand-back Procedure NC/PTW/SP-005

PTWS - Job suspension and Re-start Procedure NC/PTW/SP-006

PTWS - Supervision Procedure NC/PTW/SP-007

PTWS - Monitoring Procedure NC/PTW/SP-008

PTWS - Audit Procedure NC/PTW/SP-009

PTWS - Permits Review Procedure NC/PTW/SP-010

PTWS - Scope of Work Change Procedure NC/PTW/SP-011

PTWS - Lock out Tag out procedure NC/PTW/SP-012

PTWS - Permits and Certificates Display Procedure NC/PTW/SP-013

PTWS - Extended Isolation Procedure NC/PTW/SP-014

Record Number Record Title Responsibility Retention

Period

NC/PTW/SP-001/FM-001 Permit to Work PI 5 years

NC/PTW/SP-001/FM-002 Hot work Permit PI 5 years

NC/PTW/SP-001/FM-003 Working at height Permit PA 5 years

NC/PTW/SP-001/FM-004 Confined Space Entry Permit PA 5 years

NC/PTW/SP-001/FM-005 Confined Space Working Permit PA 5 years

NC/PTW/SP-001/FM-006 Ground Disturbance Permit PA 5 years

NC/PTW/SP-001/FM-007 Diving Permit PA 5 years

NC/PTW/SP-001/FM-008 Disjoint Permit PA 5 years

NC/PTW/SP-001/FM-009 Containment Break Permit PA 5 years

NC/PTW/SP-001/FM-010 Isolation Certificate IA, PI 5 years

NC/PTW/SP-001/FM-011 Logic Isolation Certificate IA, PI 5 years

NC/PTW/SP-001/FM-012 Access Barrier Isolation Certificate AA,PI 5 years

NC/PTW/SP-001/FM-013 High Voltage Environment Isolation Certificate

PA, PI 5 years

NC/PTW/SP-001/FM-014 PD containment Isolation Certificate IA, PI 5 years

NC/PTW/SP-001/FM-015 Allowed to Test Certificate IA, PI 5 years

NC/PTW/SP-001/FM-016 Test Certificate SC, PI, PO 5 years




Record Number Record Title Responsibility Retention

Period

NC/PTW/SP-001/FM-017 Interaction Certificate PI 5 years

NC/PTW/SP-001/FM-018 Machinery Certificate PI 5 years

NC/PTW/SP-001/FM-019 Radiation Certificate PI 5 years

NC/PTW/SP-001/FM-020 Standard Work Statement Sheet PM 20 years

NC/PTW/SP-001/FM-021 Standard Work Centers Sheet PM 20 years

NC/PTW/SP-001/FM-022 Standard Work Breakdown Structure Sheet

PO 20 years

NC/PTW/SP-001/FM-023 Standard Tool Box Talk Sheet PO 20 years

NC/PTW/SP-001/FM-024 Standard Hazard Control Sheet PM 20 years

NC/PTW/SP-001/FM-025 Task Risk Analysis Form PO 20 years

NC/PTW/SP-001/FM-026 PTWS Implementation Certificate PM 5 years

NC/PTW/SP-001/FM-027 PTWS Resourcing PM 5 years

NC/PTW/SP-001/FM-028 Formation of CAC PM 5 years

NC/PTW/SP-001/FM-029 PTWS Monitoring PM 5 years

NC/PTW/SP-001/FM-030 PTW Supplementary activity Sheet PO 5 years

8. Legal Requirements and References: 8.1 HCIS 8.2 ACWA Power O&M Standards & Guidelines 8.3 ISO-9001-2008 Clause 7.5.1 8.4 ISO 14001-2004 Clause 4.4.6 8.5 OHSAS 18001-2007 Clause 4.4.6




PERMIT TO WORK PTW-000000

Any Alarm, Alert, Gas Release, Evacuation or other Emergency Suspends / Cancels this permit. To Restart Contact PA

Activity Category: ( A:Access Controlled; B:Permit Controlled; C:Permit with Work Pack.; D New activity RA req.) PLANT

Activity Reference: RA Available RA No.: Date:

Valid From: RA Required RA No.: MO NO.

Valid To: Special Tools: Base Document Ref:

Maintenace Sections: Lead Sec. Work limitations:

Mechanical Functional Limits:

Electrical Object Limits:

I&C / Civil / / SWS ID: SWS:

1. WORK ACTIVITY F.L: Equipment:

Maintenance Order activities: CC by (ID) Duration(h) Work Center No. / ID RA Done/Ref

Supplimentary Work Activity Sheet Required Permit Originator (PO): Name & Signature & Date:

2. ADDITIONAL PERMITS / CERTIFICATES

Permits Permit No. YES NO Certifcates Certificate No. YES NO

. Hot Work Permit . Isolation Certificate.

. Confined Space Entry Permit . Logic Isolation Certificate.

.Confined Space Working Permit . Access Barrier Isolation Certificate.

. Working at Height Permit . HV Environment Isolation Certificate.

. Ground Disturbance Permit . PD Containment Isolation Certificate.

. Diving Permit . Allowed to test Certificate.

. Disjoint Permit. . Test Certificate.

. Containment Break Permit. . Interaction Certificate.

LOTO Key: Key: Key: . Machinery Certificate.

Key Safe No. Key: Key: Key: . Radiation Certificate.

3. APPROVAL & ACCEPTANCE:

. Permit Authorizer(PA): I certify that work is well defined with work limitations , RA done & controls mentioned therein are applied.

Name: Signature Date & Time:

. Area Authority(AA): I hereby certify that all the safety requirements of task are fulfilled and that the tasks as mentioned in para 1 can be performed safely.


. Permit Acceptor(PC): I accept this permit & declare that I am aware of all requirements & all safety measures taken to make this job as mentioned in para 1, safe.


. Permit Originator(PO): I accept this permit & declare that I am aware of all requirements & all safety measures taken to make this job as mentioned in para 1, safe.


. Permit Issuer(PI): I hereby confirm that all the Permit requirements are identified, met, precautions taken and safety is not compromised.


4. APPROVAL FOR HIGH HAZARD WORK:

. Permit Authorizer: I hereby further certify that all the safety requirements of this high hazard task are fulfilled and task can be performed safely.

Name: Signature Date Time:

5. PERMIT CONTROL:

Visit From date/time Role-Name-signature Observation

6. PERMIT USER/S CHANGE:

. Relieving Permit Accpeter / Permit User: I/We hereby certify that the status and all safety requirements of task are fully explained to incoming PC/PU.



. Incoming Permit Accpeter / Permit User: I/We hereby certify that we are made fully aware of the status and precautions of this job.



. Permit Issuer: I hereby certify that the plant will remain safe to be worked upon . NEW EXPIRY DATE & TIME:


7. OPERATION SHIFT CHANGE:

. Relieving Permit Issuer, Area Authority: We hereby certify that the status and all safety requirements of task are fully explained to incoming PI and AA.

Name: Signature Date Time: PI

Name: Signature Date Time: AA

. Incoming Permit Issuer / Area Authority: We hereby certify that we are made fully aware of the status and precautions of this job.

Name: Signature Date Time: PI

Name: Signature Date Time: AA

8. PERMIT CLOSURE & CANCELLATION

. Permit Acceptor: I hereby certify that all tasks as mentioned in para 1 are completed & work area is clear.


. Area Authority: I hereby certify that all the tasks as mentioned in para 1 has been checked & plant is ready for testing/recommissioning.


. Permit Authorizer: I hereby certify that tests have been completed and plant satisfactorily recommissioned. This permit stands cancelled.


NOMAC PTW System NC/PTW/SP-001/FM-001

Y

B C D

N

A

Y N

Y N




HOT WORK PERMIT HWP-000000


This Hot Work Permit is issued subject to the following conditions

VALID FROM (Date/Time): VALID TO: PLANT

REVISED VALIDITY , FROM(Date/Time): VALID TO: PTW NO.

2nd REVISED VALIDITY , FROM (Date/Time): VALID TO: MO NO.

1. HOT WORK PROPOSAL: ( To be Filled by PO)

Plant / Unit : Functional Location: Equipment:

Brief work description:

. Permit Originator: Above Location has been examined & Check list in section 3 is completed to the best of my knowledge.


2. HOT WORK CHECK LIST (To be Checked by PO, PI)

YES NO YES NO

. Jobs performed by contractors or temporary workers . Within 35 m, foolrs are free of oil, grease, solvent

. Adjacent equipments and area safe . Within 35 m, any covering with fire materials required.

. Potential flammable / explosive atmosphere . Within 35 m, flammable materials removed

. Potential high temperature . Within 35 m, combustable surfaces are wetted down

. Ventilation is acceptable . Fire watch required. Name: Signature

. Welding & Cutting Equipments in safe condition . Suspended work, beneath area covered.

. Confined space work . Lead is present in the objects being cut oe welded.

. Bypassing or removing/altering safety devices and equipment . Fire / smoke alram / Sprinkler system needs isolation.

. Indoor, smoke detectors in service . Multi purpose Fire extinguishers required. / Available

. In sprinklered area, Spriklers in service . Walkways protected beneath hot work.

. Welding curtain / shield required . All Wall and floors openings covered within 35 m.

. Electrical troubleshooting or repair on live circuits . Combustibles required to be moved away from other side of wall / Moved.

. Others (state):

3. SAFETY PRECAUTIONS

YES NO YES NO YES NO

. Depressurising . Fresh air ventilation . Elevated work

. Physical Isolation . Atmosphere analysis : . Contractors trained

. Electrical Isolation . Oxygen . Eliminate ignition sources

. Safety tags and locks . Flammable . Fire hose

. Flushing with water/solvent . Toxic . Fire screen

. Steaming out . Other . Wet surrounding area

. Purging with inert gas/air . Area marked off . Audible/visible warnings

. Temperature normalisation . Warning notices . Clear area of combustibles

Others (state): . Fire extinguishers

Type :

Type :

4. PERSONNEL PROTECTION YES NO YES NO YES NO YES NO Required Tools:

. Head . Ears Escape Set Harness 1

. Face . Hands SCBA Life Jacket 2

. Eyes . Feet Coverall Elsting Hood 3

. Body . Breathing Leather Apron Rubber Boots 4

State Special Requirements : 5

6


. Site Checker: This certifies that work area and all adjacent areas to which spark and heat might have spread have been inspected and found to be free of fire during and

following the completion of work. as detailed in Section 1.


. Permit Acceptor: I hereby accept this permit & declare that I am aware of all requirements & all safety measures taken to make this job as mentioned in para 1, safe.


. Permit Issuer: This Hot Work Permit Is issued subject to the conditioned as mentioned above.

Name : Signature : Date Time:


. Site Checker / Fire Watch: This certifies that work area and all adjacent areas to which spark and heat might have spread have been inspected and found to be

free of fire following the completion of work. as detailed in Section 1. (To be signed within 1 hour of completion of job)




. Permit Authorizer: I hereby certify that tests have been completed and plant satisfactorily recommissioned. This permit stands cancelled.






WORKING AT HEIGHT PERMIT WHP-000000


ONLY TRAINED AND COMPETENT PERSONS SHALL WORK AT HEIGHT




1. ELEVATED WORK PROPOSAL: ( To be Filled by PO)


Description of work

. Permit Originator: Above Location and task has been examined & Check list in section 2 & precautions in section 3 are completed to the best of my knowledge.


2. ELEVATED WORK CHECK LIST (To be Checked by PO, PI)

YES NO YES NO

. Jobs performed at Roof Surface: Roof pitch angle: . Method of access to Work Area

. Job is near exposed edge .Portable extension Ladder

. Work Area near open hole .Fixed Ladder

. On heavy plant and machinery .EWP

. Erecting Scafolding .SWP

. Job on steel structure .Man cage via crane

. On a Crane. .Climbing technique

. Others (state):



. Travel Restraint System . Full body harness .Cable fall-arrest device available

. Work positioning System . Using Retractable lanyard : . Adjustable lanyard available

. Fall arrest System . Seat belt type . Fallen worker retrieval plan

. Using Lanyard (adjustable length) . Cable type with winch . Pre-rigged retrieval kit available

. Using double Lanyard (twin-tail) . Cable type . ERT to be notified

. Using Lanyard (fixed length) . Other . Rescue plan annexed

. Purging with inert gas/air . Rope & rope grab/clamp . Standby persons available

. Person to foot ladder available . Warning notices .Name:

Others (state): .Name:

.Name:

.Name:

4. PERSONNEL PROTECTION Required Tools:

YES NO YES NO YES NO YES NO 1






6


. Permit User: I agreed to work within the conditions indicated on this permit and accept the responsibility. I declare that all the work at height will be acrried out in


PU Name: Signature Date Time:




. Permit Acceptor: I herby declare that the persons identified on this permit are competent and authorize to carry out the work at height subject to the terms and

conditions of this permit.

PC Name: Signature Date Time:

. Permit Issuer: I hereby declare that I am satisfied with all the arrangements of this work & allow to proceed.

PI Name: Signature Date Time:


. Permit Acceptor: All work associated with this permit is completed . All equipments associated with this permithas been returned in serviceable condition and the job

site is clear of any hazards associated with this work.




. Permit Issuer: I hereby declare that I am satisfied with completion requirements & cancel this permit.






CONFINED SPACE ENTRY PERMIT CSP-000000


SAFETY STANDBY IS REQUIRED FOR ALL CONFINED SPACE WORK




1. CONFINED SPACE ENTRY WORK PROPOSAL: ( To be Filled by PO)


Work Description:

TYPE OF CREW Alternate Entry: Communication Type: Test Instrument Sr. No.



2. CONFINED SPACE WORK CHECK LIST (To be Checked by PO, PI)

YES NO NA(Not Applied) YES NO NA

. LOTO requirement completed: . Check after Isolation & Ventilation: Time - % Time-% Time-% Limit

. De-energization requirement completed .Oxygen 19.50%

. Rescue Plan ready .Explosive <10%

. Purge-Flush-Vent requirements completed .Toxic <10ppm

. Ventilation requirement completed .Combustible gas 10%

. Secure area (post and flag) .CO <25 ppm

. Lighting exlosive proof .Others

. Others (state):

3. SAFETY PRECAUTIONS NA: Not Applied

YES NO NA(Not Applied) YES NO YES NO NA

. Fire extingusher . Full body harness .Atmospheric testing during work

. Supplied air respirator . Using Retractable lanyard : . Ist

. Respirators (air purifiers) . Seat belt type . 2nd

. Protecting Clothing . Cable type with winch . 3rd

. Emergency scape retrieval equipment . Cable type . 4th

. Life lines . Other . 5th

. Purging with inert gas/air . Hoisting Equipment Stand by persons:

. Resuscitator Inhalator . Warning notices .Name:


.Name:

.Name:








6


. Permit User: I agreed to work within the conditions indicated on this permit and accept the responsibility. I checked that the confined space entry is safe .






. Permit Acceptor: I herby declare that the persons identified on this permit are competent and authorize to enter the confined space & all safety measures are taken.














Y N SPRV




CONFINED SPACE WORK PERMIT CWP-000000


SAFETY STANDBY IS REQUIRED FOR ALL CONFINED SPACE WORK




1. CONFINED SPACE ENTRY WORK PROPOSAL: ( To be Filled by PO)


Brief Job Description:




2. CONFINED SPACE WORK CHECK LIST (To be Checked by PO, PI)









. Others (state):












.Name:

.Name:








6


. Permit User: I agreed to work within the conditions indicated on this permit and accept the responsibility. I checked that the confined space entry is safe .






. Permit Acceptor: I herby declare that the persons identified on this permit are competent and authorize to enter the confined space & all safety measures are taken.














Y N SPRV




GROUND DISTURBANCE PERMIT GDP-000000


ATTACH A SKETCH OR DRAWING WITH THIS PERMIT




1. GROUND DISTURBANCE WORK PROPOSAL: ( To be Filled by PO)

Plant / Unit : Functional Location: Location:

EXCAVATION WORK DETAILS: Start End Duration No. of Workers RA Done/Ref

EXCAVATION PURPOSE:

Sub Contractor: Estimated volume of Excavated material, m3:

MAX. DIMENSIONS: LENGTH: WIDTH: DEPTH:

. Protective System submitted: . AS-buit updare required

TYPE OF CREW Soil reuse for backfill . Excavation competent person



2. GROUND DISTURBANCE WORK CHECK LIST (To be Checked by PO, PI)


. Depth of excavation > 2 m: . Protective system is planned:

. Person entering .Slopping

. Sub contractor posses a valid permit .Benching

. Depth of excavation > 6 m .Shorting

. Protective system designed by professional Engr. . Soil Compaction testing required :

. Protected System submitted prior to excavation .Nuclear guage method

. Soil compaction required. .Sand cone test method

. Bore is near a housing . Excavation involve a well

. Others: . Excavation involve a soil boring



. Fire extingusher . Full body harness .Is the excavation within 7 lateral m

. Supplied air respirator . Excavation is within controlled area: of an under ground beam line housing.

. Respirators (air purifiers) . Contamination area . 2nd

. Protecting Clothing . Radiation area. . 3rd

. Environment Review:

. Waste classification of excavated material:

. Other requirements:

. Excavated Waste disposal arrangement:

. Utility Drawing review: Electrical Natural Gas Storm Drain Compressed air

Process Piping Telephone Control Cables Others

Groung water well Sewer Electrical Cable Water








6


. HSE Engineer: I hereby reviewed this permit and work may proceed. the conditions indicated on this permit and accept the responsibility.


. Permit Users: we hereby declare that jwe are competent and authorize to excavate.



. Permit Acceptor: I herby declare that the persons identified on this permit are competent and authorize to excavate.







site is clear of any hazards associated with this work. .As-built drwaings updated:


. Site Checker: I hereby certify that all the tasks as mentioned in para 1 has been checked & plant is ready for testing/recommissioning.





Y

NY NY




DIVING PERMIT DVP-000000


SAFETY STANDBY IS REQUIRED FOR ALL DIVING WORK



1. DIVING WORK PROPOSAL: ( To be Filled by PO)


Brief description of Diving activity: Start: End Duration Name of Divers RA Done/Ref

TYPE OF CREW Alternate Entry: Communication Type:



2. DIVING CHECK LIST (To be Checked by PO, PI)


. Divers medical Certificate produced . Insurance certificate produced

. Diver's log book produced .HSE Registration Certificate produced

. Rescue Plan ready .Diver's competence certificate produced

. Four Divers minimum per team . Diver's training certificate produced.

. Diving contractor's log book produced .Diver's medical fitness certificate produced

. First aid qualifications produced for atleast 2 divers . Emergency assisstance available

.Additional Isolation certificate required . Stated limit of place.

. Others (state): From:

To:



. Fire extingusher . Full body harness .Stated limit of time

. Supplied air respirator . Using Retractable lanyard : From:

. Respirators (air purifiers) . Seat belt type To:








6

5. TEMPORARY SUSPENSION:

. Permit Acceptor: I declare that all diving operations are ceased & diving team is clear of water.


. Permit Issuer: I hereby declare that diving permit is hereby suspended From: To:


. Permit Issuer: I hereby declare that diving permit is hereby resumed. From: To:


. Permit Acceptor: I declare that all diving operations are ceased & diving team is clear of water.


. Permit Issuer: I hereby declare that diving permit is hereby suspended From: To:


. Permit Issuer: I hereby declare that diving permit is hereby resumed. From: To:



. Permit User: I agreed to work within the conditions indicated on this permit and accept the responsibility. I checked that the & found safe .














Y N SPRV




DISJOINTING PERMIT DJP-000000


SAFETY STANDBY IS REQUIRED FOR ALL DIVING WORK



1. DISJOINTING WORK PROPOSAL: ( To be Filled by PO)


Work description: Start End Duration Name of Diver RA Done/Ref




2. DISJOINTING WORK CHECK LIST (To be Checked by PO, PI)









. Others (state):












.Name:

.Name:








6


. Permit User: I agreed to work within the conditions indicated on this permit and accept the responsibility. I checked that the disjointing is safe .






. Permit Acceptor: I herby declare that the persons identified on this permit are competent and authorize to do disjointing work & all safety measures are taken.














Y N SPRV




CONTAINMENT BREAK PERMIT CBP-000000


SAFETY STANDBY IS REQUIRED FOR ALL CONTAINMENT BREAKING WORK



1. CONTAINMENT BREAKING WORK PROPOSAL: ( To be Filled by PO)


Work brief description: Start End Duration Name of Diver RA Done/Ref




2. CONTAINMENT BREAKING WORK CHECK LIST (To be Checked by PO, PI)









. Others (state):












.Name:

.Name:








6


. Permit User: I agreed to work within the conditions indicated on this permit and accept the responsibility. I checked that the containment breaking is safe .






. Permit Acceptor: I herby declare that the persons identified on this permit are competent and authorize to do disjointing work & all safety measures are taken.














Y N SPRV




ISOLATION CERTIFICATE ISC-000000

Any Alarm, Alert, Gas Release, Evacuation or other Emergency Suspends / Cancels this Certificate. To Restart Contact PA.

SWS-ID: SWBS-ID: SRA-ID: SIC-ID:

VALID FROM (Date/Time): VALID TO: PLANT:/MO:


1. WORK PROPOSAL: ( To be Filled by PO)

SWS:

PURPOSE OF ISOLATION:



2.ISOLATIONS CHECK LIST BEFORE JOB START (To be Checked by PO, PI)


. Separate Isolation Scheme Required. . Check requird by PI after Isolation & Ventilation:

. Separate Isolation scheme prepared. . More than one person impelenting isolations.

. Isolation scheme span to multiple responsibilities area. . Sequencing of isolation / de-isolation is critical.

. Testing requirements during job. . More than one Isolation certificates for this job.

. Control Loop diagram assessed & annexed .Work pack prepared & annexed.

. Check on overall plant integrity required. .RA done & annexed for Isolation De-isolation activities.

. All the effects of isolation scheme listed and annexed .Initial Isolation is required for final isolation.

. Others (state):

2. PRECAUTIONS NA: Not Applied

YES NO NA(Not Applied) . Loss of Isolation Contingency plan YES NO . Isolation point mistake assessed: YES NO NA

. Potential for human failure assessed . Containment planned .Identification

. Comptency of work centers assessed . Upstream isolation identified .Proving/monitoring

. Check list requird during job: . Safe escape planned .Securing / Maintaining

3. DETERMINATION OF BASE LINE ISOLATION STANDARD Level of Security: (Tag) T

1. Determine Substance Category: Tag+Lock T+L

.Category1 . Very Toxic (T+) . Toxic (T) .Carcinigenic .Mutagenic .Toxic for Reproduction .Sensitising Tag+Lock+Key T+L+K

.Category2 . Extremely flammable(F+) . Flammable(F) .Steam .Asphyxiants .Oxidising .Explosive .Flashing Fluids .Pressurized gas

.Category3 . Corrosive(C) . Harmful (Xn) .Irretant(Xi)

.Category4 . Flammable liquids stored below flash point (R10) . Below flash point following release (R10) Isolation Method Standard

.Category5 . Not Classified . Not Stored in harmful state Spade(S) POSITIVE

2. Determine Release Factor (RF): Line Size Pressure > 50 barg 10 to 50 < 10 barg Single Block Bleed Spade POSITIVE

.Factor H > 20 cm H H M Double Block Bleed Spade POSITIVE

.Factor M 5-20 cm H M L DBB, SB, SBB PROVED

.Factor L <5 cm M L L DB, SB Non-Proved

3. Determine Location Factor (LF):

.Factor H . Human at risk > 10 . Congested equipment .Potential for escalation .Large Fires .Multiple fatalities .Extensive damage

.Factor M . Human at risk 3-10 . Uncongested equipment .Storage area .Minor Fires .Damage

.Factor L . Human at risk 1-2 . Remot single equipment .Easily Contined .Contained minor Fires .Minor Damage

4. Determine Outcome Factor (OF): 5. Determine Base line Isolation Standard: ISOLATION STANDARDS:

.LF / RF H M L OF / Substance Category 1 2 3 4 5 R: Reduce Risk (Further)

H A B B A R R I II II I: Positive Isolation Standard

M B B C B I I II II III II: Proved Isolation Standard

L B C C C I II II II III III: Non-Proved Isolation Standard

4. ISOLATION SCHEME: (For more Isolation points use supplementary Isolation Points sheet)

Isolation Point Isolation Method Isolation. Seq Status 1 Time 1 T / L / K Deisol seq Status 2 Time 2


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to effect Isloations. Isolations are iplemented as per scheme.

Isolations are secured, will be monitored and maintained through out the work.

IA Name: Signature Date Time:

. Permit Acceptor: I herby declare that all the isolation arrangements are adequate & all safety measures are taken.


. Permit Issuer: I hereby declare that I am satisfied with all the arrangements of this certificate & allow to proceed.


6. CERTIFICATE CLOSURE & CANCELLATION

. Permit Acceptor: All work associated with this permit is completed . All equipments associated with this permit has been returned in serviceable condition and the job



. Isolation Authority: I hereby certify that De-isolation has been implementd as per de-isolation plan.


. Permit Issuer: I hereby declare that I am satisfied with completion requirements & cancel this Certificate.






LOGIC ISOLATION CERTIFICATE LIC-000000


THIS CERTIFICATE CAN ONLY BE ISSUED WHEN THERE IS NO REASONABLE PRACTICAL ALTERNATIVE





Brief Description of logic requiring isolation Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

PURPOSE OF LOGIC ISOLATION:



2.LOGIC ISOLATIONS CHECK LIST BEFORE JOB START (To be Checked by PO, PI)


. Isolation Scheme prepared. . Check requird by PI after Isolation & Ventilation:

. Isolation scheme cross checked by PI/PC/PA/PO. . More than one person impelenting isolations.

. Isolation scheme span to multiple responsibilities area. . Sequencing of isolation / de-isolation is critical.

. Testing requirements during job. . More than one Logic Isolation certificates for this job.

. Loop diagram annexed .Work pack prepared & annexed.

. Check on overall logic integrity required. .RA done & annexed for Isolation De-isolation activities.

. All the effects of isolation scheme listed and annexed .Initial logic Isolation is required for finallogic isolation.

. Others (state):

2.LOGIC ISOLATIONS CHECK LIST DURING JOB. (To be Checked by PO, PI)


. Controlling Changes. . Check requird by PI after logic Isolation

.Changes imposed by condition of plant . More than one person impelenting logic isolations.

.Changes imposed by changing scope of work . Sequencing of isolation / de-isolation is critical.

.Changes imposed due to incoplete job. <10ppm

3. PRECAUTIONS


. Potential for human failure assessed . Loss of Isolation Contingency plan . Isolation point mistake assessed:

. Containment planned .Identification

. Upstream isolation identified .Proving/monitoring

. Safe escape planned .Securing / Maintaining

4. ISOLATION POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Isolation Point Isolation Method Isol /De seq. Time By T / L / K Status1 Status 2 (After job ) Time 2

1

2

3

4

5

6

7

8

9

10

11

12





















ACCESS BARRIER ISOLATION CERTIFICATE AIC-000000







Details of Access Barrier requirement & Job description Start End Duration WC RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF ACCESS BARRIER ISOLATION:



2. ACCESS BARRIER ISOLATION CHECK LIST (To be Checked by PO, PI)


. AB Isolation Scheme prepared. . Check requird by PI after AB Isolation :

. AB Isolation scheme cross checked by PI/PC/PA/PO. . More than one person impelenting AB isolations.

. AB Isolation scheme span to multiple responsibilities area. . Sequencing of AB isolation / de-isolation is critical.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed . Loss of AB Isolation Contingency plan . AB Isolation point mistake assessed:


4. ACCESS BARRIER ISOLATION POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Access Barrier Isolation Point AB Isolation Method IA PA / PI Time T / L / K Status AB Isolation sequence Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to effect AB Isloations. AB Isolations are iplemented as scheme.



















HIGH VOLTAGE ENVIRONMENT ISOLATION CERTIFICATE HVC-000000







Brief Description of Work requiring HV environment isolation: Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF HV ISOLATION:



2. HV ENVIRONMENT ISOLATIONS CHECK LIST BEFORE JOB START (To be Checked by PO, PI)


. HV Isolation Scheme prepared. . Check requird by PI after HV Isolation :

. HV Isolation scheme cross checked by PI/PC/PA/PO. . More than one person impelenting HV isolations.

. HV Isolation scheme span to multiple responsibilities area. . Sequencing of HV isolation / de-isolation is critical.

. Testing requirements during job. . More than one HV Isolation certificates for this job.

. Loop diagram annexed .Work pack prepared & annexed.

. Check on overall Plant integrity required. .RA done & annexed for HV Isolation De-isolation activities.

. All the effects of HV isolation scheme listed and annexed .Initial HV Isolation is required for final HVisolation.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed . Loss of HV Isolation Contingency plan . HV Isolation point mistake assessed:


. Upstream isolation identified .Proving/monitoring

. Safe escape planned .Securing / Maintaining

4. HV ISOLATION POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Isolation Point Isolation Method IA PA / PI Time T / L / K Status Isolation sequence Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12





















PD CONTAMINATION ISOLATION CERTIFICATE PDC-000000







Brief description of job requiring PD containment Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF PD CONTAMINATION ISOLATION:



2. PD CONTAMINATION ISOLATION CHECK LIST BEFORE JOB START (To be Checked by PO, PI)


. PD Isolation Scheme prepared. . Check requird by PI after HV Isolation :

. PD Isolation scheme cross checked by PI/PC/PA/PO. . More than one person impelenting HV isolations.

. PD Isolation scheme span to multiple responsibilities area. . Sequencing of HV isolation / de-isolation is critical.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed . Loss of PD Isolation Contingency plan . PD Isolation point mistake assessed:


4. PD CONTAMINATION ISOLATION POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Isolation Point Isolation Method IA PA / PI Time T / L / K Status Isolation sequence Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to effect PD Isloations. PD Isolations are iplemented as scheme.



















ALLOWED TO TEST CERTIFICATE ATC-000000







Brief description of jobs requiring test Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF TEST:



SANCTION TO TEST Check list


. Test Scheme prepared. . Check requird by PI after Testing :

. Test scheme cross checked by PI/PC/PA/PO. . More than one person impelenting TEST scheme.

. Test scheme span to multiple responsibilities area. . Sequencing of TEST is critical.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed .Contingency plan . TESTING point mistake assessed:


4. TEST / TEST POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Test / Test points Testing Method IA PA / PI Time T / L / K Status Testing sequence Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to sanction testings.


















TEST CERTIFICATE TTC-0000000


THIS CERTIFICATE CAN ONLY BE ISSUED WHEN TEST DEVICES ARE APPROVED





Brief Description of Jobs requiring tests Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF TEST:



SANCTION TO TEST Check list


. Test Scheme prepared. . Check requird by PI after Testing :

. Test scheme cross checked by PI/PC/PA/PO. . More than one person impelenting TEST scheme.

. Test scheme span to multiple responsibilities area. . Sequencing of TEST is critical.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed .Contingency plan . TESTING point mistake assessed:


4. TEST / TEST POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Test / Test points Testing Method IA PA / PI Time T / L / K Status Test Result Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to sanction testings.


















Interaction Certificate: PTW Ref: NC/PTW/SP-001/FM-001/

NC/PTW/SP-001/FM-017 Ref.No: NC/PTW/SP-001/FM-017/ PI-Name: Date:

Sr. Interacting Jobs

Nature

(PTWS/Opr

/Other)

LOTO Reqd. Start Time End Time Ref. POPermits

/Crtificates

Common

Isolation

(Y/N)

Responsible Controlling Scheme

1

2

3

4

5

I hereby Certi fy that a l l Interaction activi ties are known, veri fied, control scheme prepared & appl ied. PI-Signature:

NC/PTW/SP-003/FM-001, Ref:

NC/PTW/SP-003/FM-002, Ref:




MACHINERY CERTIFICATE MCC-000000


THIS CERTIFICATE CAN ONLY BE ISSUED TO WORK ON A LARGE & COMPLEX ITEMS OF MACHINERY





Brief Description of Jobs requiring workon Heavy Machinery Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF WORK:



2. MACHINERY CERTIFICATE Check list


. Isolation Scheme prepared. . Check requird by PI after IsolationsTesting :

. Isolation scheme cross checked by PI/PC/PA/PO. . More than one person impelenting Isolation scheme.

. Isolation scheme span to multiple responsibilities area. . Sequencing of Isolation / De-Isolation is critical.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed .Contingency plan . Isolation point mistake assessed:


4. MACHINERY ISOLATION POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Machinery Isolation points Isolation Method IA PA / PI Time T / L / K Status Isolation sequence Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to Implement Isolation / De-Isolation of very larg MAchinery.


















RADIATION CERTIFICATE RDC-000000


THIS CERTIFICATE CAN ONLY BE ISSUED TO AVOID EXPOSURE TO RAIDIATION





Brief desription of job being planned in the radiation area Start End Duration Name of Worker RA Done/Ref

1

2

3

4

5

6

7

8

9

10

PURPOSE OF WORK:



2. RADIATION CERTIFICATE Check list


. Site Inspection done. . Check requird by PI after IsolationsTesting :

. Isolation scheme cross checked by PI/PC/PA/PO. . More than one person impelenting Isolation scheme.

. Isolation scheme span to multiple responsibilities area. . Sequencing of Isolation / De-Isolation is critical.

. Others (state):

3. PRECAUTIONS


. Potential for human failure assessed .Contingency plan . Isolation point mistake assessed:


4. RADIATION POINT LIST: (For more Isolation points use supplementary Isolation Points sheet)

Radiation points Isolation Method IA PA / PI Time T / L / K Status Remarks Drawing Ref

1

2

3

4

5

6

7

8

9

10

11

12


. Isolating Authority: I declare that my name is mentiomned in the competent person's register, authorized to Issue Radiation Certificate.


















PTW SYSTEM; STANDARD WORK STATEMENT NC/PTW/SP-001/FM-020

VALIDITY: 12 months Or Plant modification date (Whichever happens first) PLANT:

1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Sr. Authority Designation Ref. Abbreviations:

1 Responsibility to develop SWS (Standard Work Statement). OM FM-028 WBS-ID: Work Break down Strucrure ID Q: SQIWPP A: Access

2 Responsibility to develop WBS (Work Breakdown Structure) for SWS. MM FM-029 SRA-ID: Standrad Risk Analysis ID E: SIWEP B: Permit

3 Responsibility to develop Standard IC(Isolation Certificate) for SWS. OM FM-010 SIC-ID: Standard Isolation Certificate ID S: SIWPP C: Permit+WP

4 Responsibility to Conduct RA for SWS. MM-HO FM-010 SIC-ID: Standard Isolation Certificate ID B: BARGES D: Unknow n

5 Responsibility to develop Standard Tool Box Talk for SWS. MM-HO FM-032 SWP-ID: Standard Work Pack ID R: IPPR

. PM/PGM: I hereby certify that above mentioned senior managers are competent & authrized to develop Master data for PTWS.AC: Activity Category. (A; B; C; D)-P:Preventive, N:Non-prev.

Name: Signature Date Maint Section: Lead Section to be placed first.

2. SWS ( Standard Work Statement):ID. SWS (Standard Work Statement) WBS ID Maint.

Section

SRA ID SIC ID STB ID AC SWP ID

MM-EM-IC





PTW SYSTEM; WORK CENTERS NC/PTW/SP-001/FM-021

VALIDITY: 12 months Or Change management date (Whichever happens first) PLANT:

1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Authority Designation Ref. Abbreviations:

Responsibility to develop SWS (Standard Work Statement). OM FM-021 WBS-ID: Work Break down Strucrure ID P:Preventive,

Responsibility to develop WBS (Work Breakdown Structure) for SWS. MM FM-028 SRA-ID: Standrad Risk Analysis ID N:Non-prev.

Responsibility to develop Standard IC(Isolation Certificate) for SWS. OM FM-010 SIC-ID: Standard Isolation Certificate ID CC:Completion-

Responsibility to Conduct RA for SWS. MM-HO FM-027 SWP-ID: Standard Work Pack ID Confirmation

. PM/PGM: I hereby certify that above mentioned senior managers are competent & authrized to develop Master data for PTWS. AC: Activity Category. (A; B; C; D)-P:Preventive


2. SWBS ( Standard Work Break Down Structure):

WC-ID Plant

Section

Sub-

SectionWC Description

Week

hrs

Daily

HrsWC-Type EMP-ID

Compet

ency/McI

d

Expert

ise/K

H

Rate/

hr

OT/

hrReports to

KnowHow Rating: E: Expert P: Professional N: Novice T: Trainee

Experience Category: H: Highly Experienced E: Experienced >5Y L: Little Experience <5 Y

Competency Level:

C-1: Welding Certif icate C-7: Working Safely Certificate C-13: Internal Audit Certificate C-19: Graduate Engineer

C-2: FF Certif icate C-8: Managing Safely Certificate C-14: Lead Auditor Certificate C-20: Diploma of Associate Engineer

C-3: Heavy Driving Certif icate C-9: BLS Certificate C-15: Corrosion Certificate C-21: Working Safely Certificate

C-4: Fork lif t driving certif icate C-10: H&S Certificate C-16: Working Safely Certificate C-22: Working Safely Certificate

C-5: Crane operator Certif icate C-11: SAP Certificate C-17: Working Safely Certificate C-23: Working Safely Certificate

C-6: Vibration Analysis Certif icate C-12: Defensive Driving Certificate C-18: Working Safely Certificate C-24: Working Safely Certificate

NOMAC PTW System NC/PTW/SP-001/FM-021 WC Types: Man; Group; Machine




PTW SYSTEM; STANDARD WBS NC/PTW/SP-001/FM-022


1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Authority Designation Ref. Abbreviations:

Responsibility to assign WC. MM FM-021 WBS-ID: Work Break down Strucrure ID

Responsibility to develop WBS (Work Breakdown Structure) for SWS. MM FM-020 SWS-ID: Standrad Work Statement ID

Responsibility to develop Standard IC(Isolation Certificate) for SWS. OM FM-010 WC: Work Centers , Man,Machine,Group CC:Completion-

Responsibility to Conduct RA for SWS. MM-HO FM-025 Confirmation

. PM/PGM: I hereby certify that above mentioned senior managers are competent & authrized to develop Master data for PTWS.


2. SWBS ( Standard Work Break Down Structure):

SWS ID. WBS-IDWBS-

Element-IDWBS Element Description WC WC WC. WC

Maint.

Section

Dur.

hrsLead WC WC CC WC

MM-EM-IC





PTW SYSTEM; STANDARD TOOL BOX TALK NC/PTW/SP-001/FM-023


1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Authority Designation Ref.

Responsibility to deveolp TBT for each Standard permit controlled Operation Job . OM SWS-ID:

Responsibility to deveolp TBT for each Standard permit controlled Maint. Job . MM SRA-ID:

Responsibility to deveolp TBT for each Standard permit controlled other Job . OM SIC-ID:

Responsibility to Conduct RA for SWS. MM-HO SWBS-ID:

. PM/PGM: I hereby certify that above mentioned senior managers are competent & authrized to develop Master data for PTWS.

Name: Signature Date

2. Tool Box Talk Mandatory Topics:

Sr. Topic Discussion





PTWS HAZARD CONTROL SHEET NC/PTW/SP-001/FM-024 HG-ID

Harzard Group

Hazard_ID Hazard Control ID Control

1

Work Area Related Hazards

10 Potential oxygen deficiency

61

62

63

64

11 Potential flammable, exposive atmosphre

65

66

67

12 Potential high temperature / Pressure

68

69

70

13 Confined space entry

71

72

73

14 Elevated work

74

75

76

15 Area or line or equipment containing hazardous conditions

77

78

79

31 Exposure to traffic

125

126

127

32 Exposure to moving / rotating machinery

128

129

130

33 Lack of fimiliarity with location

131

132

34 Slips or trips

21 Make arrangements to periodically clean floor

22 Trip hazard to be removed physically

23 Trip hazard to be marked or bridged

24 Good house keeping all the time

133

134

135

35 Poor lighting

10 Temporary lighting to ne provided at work place

11 Temporary lighting to ne provided at escape route

136

137

138

36 Adjacent operation

139

140

141

37 Hot or cold surface

142

143

144

38 Dropped objects

145

146

147




39 Obstackle at work site

148

149

150

40 Poor communication

151

152

153

41 Lone working

154

155

156

42 Extreme working conditions

157

158

159

43 Radiations

160

161

162

47 Long Working

172

173

174

56 Poor access

12 Ensure good house keeping

13 Clear access and scape routes

14 Erect barriers , signs & screens

199

200

201

65 Laser

226

227

228

78 High noise level

265

266

267

85 Negative biouncy

287

288

289

102 Electrocution

15 Make insulation material available for workers to stand upon

16 Related Equipments to be isolated and earthed

17 All non certified electrical tools and equipments to be tagged

18 Make portable fire extinusher available

338

339

340

2

Equipment being worked on, related Hazards

1 Lack of Equipment fimiliarity

25

26

27

28

2 Pressurized System

29

30

31

32

3 Presence of Static Charge

33

34

35

36




4 Presence of PD

37

38

39

40

5 Electrical hazard

41

42

43

44

6 Moving Machinery

1 Mechanically Isolate Equipment

2 Electrically Isolate Equipment

3 Apply Earthing to Equipment

4 Isolate System

5 Depressurize System

6 Erect Barriers

7 Place Sign

8 To be viewed when started

9 To be Isolated when unattended

45

46

47

48

7 Hot surface

49

50

51

52

8 Cold surface

53

54

55

56

9 Stored Energy

57

58

59

60

57 Inadvertant motion

202

203

204

58 Impact

205

206

207

59 Fragments

208

209

210

61 Mechanical

214

215

216

63 Vibration

220

221

222

66 Laser

229

230

231

87 Container rupture

293

294

295

94 Inadequate design

314

315

316

95 Sharp edges

317




318

319

3

Exposure to surface or material related Hazards

16 Area or line or equipment containing hazardous conditions

80

81

82

17 Potential flammable, exposive atmosphre

83

84

85

18 Area or line or equipment containing hazardous chemicals (toxic, reactive )

86

87

88

19 Area or line or equipment containing hazardous substances

89

90

91

60 Fragments

211

212

213

67 Using Flammable substance

232

233

234

103 Using hazardous substance

19 Not be used within 1m of hot surface

20 Substance to be stored seperately

341

342

343

4

Tools or Equipments being used, related Hazards

20 Use of mobile cranes

92

93

94

21 Use of fork lifts

95

96

97

22 Use of adopters

98

99

100

62 Mechanical

217

218

219

64 Vibration

223

224

225

68 Non certified electrical tools

235

236

237

91 Compressed air tools

305

306

307




5

Task specific Hazards

23 Job performed by contractor / temporary staff

101

102

103

24 By passing or removing or altering safety devices

104

105

106

25 Introduction of ignition source where not permanently allowed

107

108

109

26 Repair on live circuit

110

111

112

27 Electrical trouble shooting

113

114

115

28 Manual or powered excavation

116

117

118

29 Insulation handling

119

120

121

30 Catalyst handling

122

123

124

55 Product conversion in vessel

196

197

198

69 Little know how

238

239

240

6

Personnel related hazard

44 Lack of familiarity

163

164

165

45 Lack of extpertise

166

167

168

46 Lone Working

169

170

171

48 Long working

175

176

177

49 Competency

178

179

180

50 Fear

181

182

183

70 Lack of fitness

241




242

243

7

Control documents deficiency related hazards

51 Lack of drawings

184

185

186

52 Lack of work instructions

187

188

189

53 Lack of procedures

190

191

192

54 Permits

193

194

195

71 Lack of technical data

244

245

246

8

Loss or impairement of safety system related hazards

72 Loss of FF system

247

248

249 9 Others

73 Involve transfer of work

250

251

252

74 Contamination

253

254

255

75 Lubricity

256

257

258

76 Violent odor

259

260

261

77 Structural failure

262

263

264

79 High intensity visible light

268

269

270

80 Infrared radiation

271

272

273

274

81 Microwave radiation

275

276

277

82 Laser

278




279

280

83 Corrosive

281

282

283

84 Negative pressure effect

284

285

286

86 Pressure differential

290

291

292

88 Hydraulic hammer

296

297

298

89 Blown objects

299

300

301

90 Accidental release

302

303

304

92 Stored energy (Spring, weight, flywheel etc)

308

309

310

93 Weight to be lifted

311

312

313

96 Thermal stress

320

321

322

97 Thermal limits unknown

323

324

325

98 Source of non electrical heat

326

327

328

99 Presence of fuel (any kind)

329

330

331

100 Electrical storage (capcitors, coils, magnets etc)

332

333

334

101 Batteries

335

336

337

10

Weather related hazards




TASK RISK ANALYSIS TRA000000SWS-ID: SWBS-ID: SRA-ID:

RA Team: 1 3 5

(Name with WC No.) 2 4 6

Activity Reference: Previous RA Available RA No.: Date:

Valid From: MO NO.

Valid To: Base Document Ref:

1. WORK ACTIVITY F.L: Equipment:

Maintenance Order activities: Duration(h) Work Center No. / ID RA Done/Ref

Supplimentary Work Activity Sheet Required Permit Originator (PO): Name & Signature & Date:

2. ADDITIONAL PERMITS / CERTIFICATES

Permits Permit No. YES NO Certifcates Certificate No. YES NO

. Hot Work Permit . Isolation Certificate.

. Confined Space Entry Permit . Logic Isolation Certificate.

.Confined Space Working Permit . Access Barrier Isolation Certificate.

. Working at Height Permit . HV Environment Isolation Certificate.

. Ground Disturbance Permit . PD Containment Isolation Certificate.

. Diving Permit . Allowed to test Certificate.

. Disjoint Permit. . Test Certificate.

. Containment Break Permit. . Interaction Certificate.

. LOTO Required:. . Machinery Certificate.

. Radiation Certificate.

2. POTENTIAL HAZARDS & HAZARDOUS JOBS YES NO YES NO

. Jobs performed by contractors or temporary workers . Maintenance or repairs in areas, or to equipment or lines,

. Potential oxygen deficiency or enrichment containing or supposed to contain hazardous materials or conditions

. Potential flammable / explosive atmosphere . Manual or powered excavations

. Potential high temperature / pressure . Use of mobile cranes

. Potential exposure to hazardous chemicals (toxic, reactive, . Insulation or catalyst handling

acid, caustic….) . Use of adapters

. Confined space entry . Product conversion of stationary or mobile or portable vessels

. Bypassing or removing/altering safety devices and equipment and containers

. Elevated work . Temporary or permanent changes, alterations, modifications of

. Introduction of ignition sources where not permanently equipment or processes

allowed (fire permit) . Exposure to traffic (road, mail)

. Electrical troubleshooting or repair on live circuits . Exposure to moving / rotating machinery

. Others (state):



. Draining . Remove hazardous materials . Standby man

. Depressurising . Fresh air ventilation . Elevated work

. Physical Isolation . Atmosphere analysis : . Contractors trained

. Electrical Isolation . Oxygen . Eliminate ignition sources

. Safety tags and locks . Flammable . Fire hose

. Flushing with water/solvent . Toxic . Fire screen

. Steaming out . Other . Wet surrounding area

. Purging with inert gas/air . Area marked off . Audible/visible warnings

. Temperature normalisation . Warning notices . Clear area of combustibles

Others (state): . Fire extinguishers

Type :

Type :








7

5. CONTROL MEASURES ( Use Standard Hazards and Controls Sheet NC/PTW/SP-001/FM-024)

HazardGroup-Hazard-Control HazardGroup-Hazard-Control HazardGroup-Hazard-Control Evaluated Initial Risk before applying controls: Severity/LiklyhoodA B C D E 1 2 3 4 5 Evaluated Final Risk after applying controls: Severity/LiklyhoodA B C D E 1 2 3 4

Initial Risk (L/M/H): Final Risk (L/M/H): 5

RA Team: This certifies that we have consulted all relevant departments/personnel, discussed the scope of work, inspected the preparatory work,

,the work area covered by this RA, listed all possible hazards and suggested controls to reduce the risk ALARP. we therefore confirm that the work,

as detailed in Section 1, can be carried out provided all the control measures as mentioned in section 5 are taken & verified.

Name : Signature : Name : Signature :

Name : Signature : Name : Signature :

Name : Signature : Name: Signature :

Activity Category Declared as: A:Access Controlled; B:Permit Controlled; C:Permit with Work Pack.


Y N

Y N

B CA




PTW SYSTEM IMPLEMENTATION CERTIFICATE NC/PTW/SP-001/FM-026

VALID FROM (Date/Time): VALID TO: PLANT:

1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Sr. Task Site Role Date Name of Resource Done

1 Responsibility to train PTWS Users given.

2 CAC (Competence and Authorizing Committee) formed

3 Authority to arrange resources given

4 Responsibility to Monitor PTWS given

5 PTW Roles assigned & certificates issued

2. PTWS PROCEDURES Check list:Sr. Procedure Ref. Date Name of Resource Done

1 PTW System Procedure

2 Isolation Procedure

3 Permits Interaction Procedure

4 Job hand over procedure

5 Job hand back procedure

6 Job suspension and restart procedure

7 Supervision procedure

8 Audit procedure

9 Review Procedure

10 Scope of work change procedure

11 LOTO procedure

12 PTW display procedure

13 Extended Isolations procedure

3. PTWS PERMITS AND CERTIFICATES IMPLEMENTATION CHECK LIST:Sr. Permits / Certificates Ref. Date Name of Resource Done

1 PTW

2 Working at height Permit

3 Hot work permit

4 Confined Space entry permit

5 Confined space working permit

6 Ground Disturbance permit

7 Diving Permit

8 Disjoint permit

9 Containment Break permit

10 Isolation Certificate

11 Logic Isolation Certificate

12 Access Barrier Isolation Certificate

13 HV environment isolation certificate

14 PD containment Isolation Certificate

15 Allowed to test certificate

16 Test Certificate

17 Interaction Certificate

18 Machinery Certificate

19 Radiation Certificate

4. CERTIFICATE

. PM/PGM: All work associated PTWS is completed . I hereby certify that PTWS is implemented.






PTW SYSTEM; RESOURCING NC/PTW/SP-001/FM-027


1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Sr. Authority Designation Ref. Date Name of Resource Done

1 Responsibility to train PTWS Users given. OM

2 Responsibility to Resource PTWS Users given. OM

3 Responsibility to Resource PTWS Users given. MM

. PM/PGM: I hereby certify that above mentioned senior managers are authrized to resouce PTWS.


2. PTWS AUTHRIZED USERS:

Sr. Role Site Role Name Desig. Emp. No. Emp. Sig. Authority Sig. Remarks

1 PO (Permit Originator)

2 PA (Permit Authorizer)

3 PI (Permit Issuer)

4 IA (Isolation Authority)

5 AA (Area Authority)

6 PC (Permit Acceptor)

7 PU (Permit User)

8 SK (Site Checker)

9 SA (Supervising Authority)

4. CERTIFICATE

. PM/PGM: All PTWS Roles are assigned to competent site staff & certificates issued






PTW SYSTEM; FORMATION OF CAC NC/PTW/SP-001/FM-028


1. PTWS FOUNDATION CHECK LIST: ( To be Filled by PGM)Sr. Authority Designation Ref. Date Name of Resource Done

1 Responsibility to train PTWS Users given. OM

2 Responsibility to Resource PTWS Users given. OM

3 Responsibility to Resource PTWS Users given. MM

. PM/PGM: I hereby certify that above mentioned senior managers are authrized to resouce PTWS.


2. PTWS CAC Members

Sr. Role Site Role Name Desig. Emp. No. Emp. Sig. Authority Sig. Remarks

CAC Members

4. CERTIFICATE

. PM/PGM: CAC members are appointed on the basis of competnecy and proven track record






PTWS: CHECK LIST TO MONITOR PTW SYSTEM NC/PTW/SP-001/FM-029

Date: Time: Active: Complete:

Permit Type: Name of Monitor: Position:

Permit No.

Annexed Certificates:

Sr. Monitor check list OK Not OK

1 Is the scope of work clearly specified

2 Are the necessary Risk assessment avaiable to review

3 Are the Identified hazards listed on RA/PTW

4 Are the appropriate precautions listed on the PTW

5 Are Isolations clearly specified

6 Is the operational time limit of permit is clearly mentioned

7 Are extensions properly authorized

8 Are the certificates properly completed

9 Are the certificates appended to the PTW

10 Are othe area activities cross referenced correctly

11 Are the system activities cross referenced correctly

12 Are the copies of permit, certificates & attachments ligible

13 Are the signatures and initials traceable & legible

14 Are the copies of certificates & permits posted at correct locations

15 Is the record of live permit & suspended permits maintained at the point of issue

16 Are the attachments , drawings kept at correct positions

17 Are the permit users briefed as tool box talk

18 Do the permits clearly specifies whome they are issued to

19 Do the permits clearly specifies the equipment or plant area the job is limited to

20 Are the recipients actually read and understood the hazards of job

21 Are the Permit users have the understanding of requirements

22 Are the staff using PTW system is specifically trained for

23 Do the permit users know what to do in emergency

24 Are the isolations appropriate & clearly specified & correctly implemented

25 Are common isolations cross referenced

26 Are the right people aware of isolated equipments

27 Is the area Authority aware of the work

28 Is the work being carried out on the terms of permit

29 Does the permit contains the clear rules to be folloewed in case of emergency.

30 Are all the precautions mentioned on permit taken

31 Is there any provision of contingency plan within PTW if required

32 Are the control measures as mentioned in PTW taken

33 Are the tools & equipment suitable

34 Are the tools in good condition

35 Are the house keeping standard satisfactory

Auditor






PTW: Supplimentary Work Activity Sheet PTW-000000

1. WORK ACTIVITY S. Work Activity Sheet No.

F.L.: Equip.: MO No;

Maintenance Order activities: CC by (ID) Dur. Hr Work Center No. / ID RA Done/Ref

Permit Originator (PO): Name & Signature & Date:



ptw system procedure

Documents