TANK CLEANING, TANK ID. NO.

: _____
Ships name Reference no.
Permit require
!on"ne space
content
SAFETY CHECKLIST
1 Has enclosed space been thoroughly YNN
A
! Ha"ards YNN
A
.# Depressuri$e .# Noise
.% &enti'ate ()* natura'+mechanica' means, .% To-ic
.. Draine .. !hemica'
./ Iso'ate )* 0 )'an1in2 ./ !orrosi3e
.4 0 isconnectin2 .4 5-p'osi3e
.6 0 3a'3es .6 7'amma)'e
.8 Steame .8 5'ectrica'
.9 :ater ;ushe .9 Static e'ectricit*
.< Inert 2as pur2e .< 7a'' from hei2ht
.#= Tan1 app'iances e'ectrica''* Iso'ate an
'oc1e
.
#=
O3erhea ha$ars
.## Opene tan1 hatches 2uare .
##
Potentia' roppe o)>ects
# Tan$ pr%&e &o'er has been( (a''
stations, ?hee' house, en2ine room, etc.,
YNN
A
.
#%
5ntrapment
.# 5'ectrica''* iso'ate an 'oc1e .
#.
@i2h pressure >ettin2
.% Aechanica' moti3e po?er iso'ate an
'oc1e
.
#/
Suction
) Sh%p &ach%nery *&a%n eng%nes+
sha,ts+ generators+ etc-.( in a''
stations, ?hee' house, en2ine room, etc.
YNN
A
.
#4
Trip ha$ar, specif*:
.# A2ree iso'ation of ship machiner* .
#6
@ot surfaces
.% A2ree chan2e of status, start0up
proceure
.
#8
Other:
/ 0ther Cons%derat%ons( YNN
A
1 2rotect%'e e3u%p&ent *22E.( YNN
A
.# Aateria' Safet* Data Sheets (ASDS,
a3ai'a)'e
.# 5*e protection, specif*:
.% Ana'*sis sheet .% 7ace shie's
.. Suita)'e access or e2ress pro3ie .. Respirator
./ Stan)* personne' etai'e ./ P&! 2'o3es
.4 Bife'ine + safet* harnesses + rescue hoist .4 Safet* )oots
.6 Creathin2 apparatus .6 @i2h pressure >ettin2 )oots
.8 Aeans of communications teste OK .8 :et suit
.9 Area free of ;amma)'e materia's .9 7u'' chemica' protecti3e c'othin2
.< Area free of I2nition sources .< Creathin2 apparatus
.#= :or1 time + fati2ue .
#=
@ea protection
.## !'ear ?or1in2 area .
##
5ar protection
.#% I''uminations .
#%
Other:
.#. &isi)i'it* of hoses 4 E&ergency 2rocedures( YNN
A
.#/ Other ?or1 cou' cause ha$ar: .# Auster points ienti"e
5 Tool 6o7 Tal$ *T6T.( YNN
A
.% 5scape routes ienti"e
.# TCT conucte ?ith a'' app'ica)'e
personne'
.. A'arms unerstoo
.% Specia' trainin2 + )rie"n2 require ./ Bocation of "re0"2htin2 an "rst ai
equipment
.. Other: .4 !ontact no.:
8- 2lant 9e3u%red YNN
A
#. 5mer2enc* ser3ice:
.# !ompressor %. &esse's )ri2e:
.% Safet* )arriers + si2ns .. Case operator:
.. Pressure ?ashers /. Tan1 c'eanin2 contractor
./ Bi2htin2 1: 0ngo%ng gas &on%tor%ng YNN
A
.4 &acuum tan1ers .# Das etectors use are ca'i)rate an
satis"e
.6 Air ri3en pumps .% 7requenc* of 2as monitorin2: ______
minutes
.8 Eettin2 'ance )aFes 11 0ther re3u%re&ents l%&%tat%ons+
spec%,y(
YNN
A
.9 Others, specif*:
;eclarat%on( I<'e personally chec$ed abo'e cond%t%ons+ ,ound sa,e to enter pro'%ded that
cond%t%ons la%d do=n are adhered to
Tan1 c'eanin2 contractor (compan* G
PI! name,
Si2n: Date:
!'ient representati3e (compan* G PI!
name,
Si2n: Date:
On)oar Aaster Si2n: Date: