Doc. No. 900-PRC-HS-1008 Rev.

6A
TANGGUH LNG Project TLNG Author’s Org. KJP
BPMIGAS KJP Doc. No. S-900-1242-022 Date 15FEB05
BP Berau Ltd. KJP Job Code J-3400-20-0000 Sheet 1 of 2

CONFINED SPACE ENTRY PERMIT

Issued on: Expiry Date/Time: / Location: Permit #:

GENERAL INFORMATION Craft/Department: ___________________________________________________________

Space to be entered: _________________________________________________________

__________________________________________________________________________ Superintendent: _____________________________________________________________

Location/Building: __________________________________________________________

_________________________________________________________________________

PURPOSE OF ENTRY: ______________________________________________________

PERMIT SPACE HAZARDS (INDICATE SPECIFIC HAZARDS WITH INITIALS)

_______ Oxygen (less than 19.5% or greater than 23.5%) ______ Materials harmful to skin
_______ Flammable gases or vapors (greater than 10% of LEL) ______ High temperature
_______ Toxic gases or vapors (greater than PEL/TLV) ______ OTHER: Complete TSTI/ JHA form & attach
_______ Mechanical hazards

EQUIPMENT REQUIRED FOR ENTRY AND WORK PREPARATION FOR ENTRY

Check after steps have been taken.
Specify as required:
Isolation Methods:
Personal Protective Equipment:
‰ Blind ‰ Purge/Clean ‰ Meter Calibration
‰ Lockout/Tagout ‰ Ventilate ‰ Atmosphere Test
‰ Faceshield ‰ Goggles
‰ ‰
‰ Barriers Inert Other
‰ Boots ‰ Chemical Resistant/Acid Suit
‰ Air Line ‰ Full Encapsulated Suit
‰ SCBA ‰ Chemical/Dust Respirator Personal Awareness:
‰ Gloves ‰ Pre-entry briefing on specific hazards and control methods.
‰ Notify contractors of permit and hazard conditions.
Atmosphere Testing/Monitoring: Emergency Notification: ____________________________________________________
_______________________________________________________________________
‰ 02 Monitor ‰ LEL Monitor _______________________________________________________________________
‰ Sample Tube (s): ___________________________________________
Additional Permits: (required and/or attached)
Communication: __________________________________________________
‰ Hot Work ‰ Blinding/Lockout/Tagout
Rescue Equipment:
‰ Vehicle Entry ‰ Cold Work
‰ Full Body Harness ‰ Lifeline
‰ Mechanical Hoist ‰ Other _____________________________________________________________
Other: _________________________________________________________

Record monitoring results every _____ hours for LEL/02 **List Pre-entry Temperature
Acceptable Conditions Result Result Result Result Result Result Result
TESTING Time hrs hrs hrs hrs hrs hrs hrs

Oxygen - mi 19.5
Flammability 0%
Benzene 1 PPM
CO 25 PPM
H2S 10 PPM
SO2 5 PPM
Temp**
Other
Entry prep O.K.
Equip Chkd O.K.

AUTHORIZATION FOR ENTRY: I certify that all required precautions have been taken and necessary equipment is provided for safe entry and work in confined space.

ENTRY SUPERVISOR PRINT: ________________________________________ SIGN: ___________________________________________________ DATE: ___________________

HOLE WATCH: APPROVED FOR ENTRY UNAPPROVED

PRINT: ____________ ________ SIGN: ___________________________________
ALTERNATE FOR HOLEWATCH: SAFETY DEPT. SIGN: _______________________________________________________

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PRINT: ____________________ SIGN: ___________________________________

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16-FE
B -2005
PT. Brown & Root Indonesia
 Doc. No. 900-PRC-HS-1008 Rev. 1C
TANGGUH LNG Project TLNG Author’s Org. KJP
BPMIGAS KJP Doc. No. S-900-1242-022 Date 30 Sept. 04
BP Berau Ltd. KJP Job Code J-3400-20-0000 Sheet 2 of 2

CONFINED SPACE ENTRY PERMIT

Issued on: Expiry Date/Time: / Location: Permit #:

STANDBY HOLEWATCH INSTRUCTIONS

You should be thoroughly familiar with the following duties when you assume the responsibilities of standby for a person(s)
working inside a vessel or confined space.
YOUR PRIMARY RESPONSIBILITIES ARE:
1. The safety of personnel working in the vessel or confined space.
2. Maintaining the conditions and requirements listed on the work permit.
3. Evacuating the vessel if you observe any condition any condition which you considered hazardous.
4. Getting help if an emergency develops. NEVER ATTEMPT TO ENTER THE VESSEL OR CONFINED SPACE, EVEN IN
AN EMERGENCY.
THE CIRCUMSTANCES AND CONDITIONS OF THE JOB WILL DETERMINE THE SAFETY REQUIREMENTS AND WHAT
YOUR STANDBY DUTIES ARE. HOWEVER, THE FOLLOWING DUTIES ARE BASIC TO ALL JOBS:
1. Do not leave your assignment while personnel are inside the vessel or confined space.
(The only exception is to get help in an emergency.) If other duties require you to leave your standby post, have all
personnel evacuate the enclosure.
2. If you have any questions regarding your job, check with your foreman.
3. BE ALERT, and try to anticipate and/or prevent any conditions that could be hazardous.
4. Prevent interference of air lines and/or lifelines.
5. If you are required to have respiratory equipment and lifelines, be sure you know how to use this equipment.
6. Upon completion of the job, clean and return all special equipment to its original location.

ENTRY/EXIT LOG

DATE: ______________ LOCATION: ________________________________ ELEVATION: _______________

HOLEWATCH NAME: _____________________________________ PERMIT NO.: _______________________

Name Badge Company TIME TIME TIME TIME TIME TIME TIME TIME TIME TIME
IN OUT IN OUT IN OUT IN OUT IN OUT

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16-FE
B -2005
PT. Brown & Root Indonesia