Khursaniyah Gas Plant Project

WORKSITE___________________ DETAILED DESCRIPTION OF WORK :

EXCAVATION WORK PERMIT

AREA________________

PERMIT No_______________
EQUIPMENT NO_________

TOOLS/EQUIPMENT REQUIRED:

SITE PREPARATION
DETAILED WORK PROCEDURE SEWERS/DRAINS TO BE CLOSED/PLUGGED WITHIN A RADIUS--- METERS ELIMINATE LEAKS/SPILLS DEPRESSURISE SCAFFOLD ERECTION BARRIER OFF PIPE /VESSEL/EQUIPMENT EMPTY AND PURGED INERT GAS/STEAM PURGED/FLUSHED WATER FLUSHING VALVE ISOLATION AND TAGGING KEEP FOLW IN THE LINE MECHANICAL/ ELECTRICAL ISOLATION

FIRE PRECAUTIONS
FIRE EXTINGUISHER

PERSONAL PROTECTION
PERSONAL H2 S DE TECTOR

REMOVE COMBUSTIBLE MATERIALS FIRE BLANKET FIREMAN NOTIFIED FIRE HOUSE AT WORKSITE PROVIDE FIREWATCH FIREMAN STANDBY CONTINUOUS LEL/UEL TEST H2S TEST-REGULAR INTERVAL OXYGEN TEST GAS TEST FOR

S.C.B.A

OR

C.A.L.B.A

EYE PROTECTION FACESHIELD SPECIAL WELDING PPE SPECIAL GRITBLASTING PPE CHEMICAL HANDLING PPE SAFETY HARNESS / BELT DUST MASK GAS MASK - FILTER FOR

PERFORMING AUTHORITY

ISSUING AUTHORITY

SAFETY

APPROVING AUTHORITY

..
LEL /UEL %
H2S.PPM

..
OXYGEN..%
TESTED BY..

LINK PERMITS/ CERTIFICATES

ELECTRICAL ISOLATION CERTIFICATE MECHANICAL ISOLATION CERTIFICATE WITH DRAWING GAS CLEARANCE CERTIFICATE PROTECTIVE SYSTEMS ISOLATION CERTIFICATE PERMIT TYPE PERMIT NO PERMITE TYPE PERMIT NO

WORKSITE CHECKS AT FIRST ISSUE .

PERFORMING AUTHORITY SIGNATURE:

AUTHORIZATION TO START WORK P.R.A.. FROM...HRS, TO HRS , DATE.

LIST OF PERSONNEL

(HAVE BEEN INSTRUCTED BY PERFOMING AUTHORITY )

TOOL BOX SAFETY MEETING

SIGNATURES FOR REISSUE - DAY SHIFT

SIGNATURES FOR REISSUE - NIGHT SHIFT TIME From To Perfoming Authority TIME Issuing Authority PRA From To

DATE

Performing Authority

Issuing Authority

PRA

WORK SUSPENSION
WORK HAS BEEN SUSPENDED BY: ..

WORK RESUMING
TEST REPEATED WORK CAN BE RESUMED . P.R.A SAFETY

WORK COMPLETED
AT..HRS, DATE..

..
AT.HRS, DATE. ATHRS,

..
DATE..

PERFORMING AUTHORITY

P.R.A