Professional Documents
Culture Documents
Hot Work Permit
Hot Work Permit
PTW No : A3 -
NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
SECTION 1 – WORK DESCRIPTION (BY PERFORMING PARTY) HOT WORK CONFINED SPACE ENTRY
Mandatory Respiratory Protection Eye, Face & Body Protection Fall Protection ! Hand Protection ! Personal O2 Monitor
! Helmet ! Half Mask Respirator ! Goggles ! Full Body Harness ! Cotton Gloves ! Personal Dosimeter/Film HOT WORK APPROVAL CONFINED SPACE ENTRY APPROVAL
! Safety shoes ! Full Face Respirator ! Face Shield ! Fall Arrest ! Leather Gloves Badge/Survey Meter I have personally checked that all control measures to prevent hazardous conditions have I have personally checked that all control measures to prevent hazardous conditions have
! Safety glass ! SCBA ! Welding Mask ! Rubber Gloves Others been put in place. been put in place.
! Approved Coverall ! Airline Set ! Chemical Suit Hearing Protection ! Chemical Gloves ! Life jacket / vest Approving Authority Department Designation Date CSE Approving Authority Department Designation Date
! Dust mask ! Chemical Boot ! Ear Plug Personal Monitoring Equipment ! Seat belt
! Disposable Suit ! Ear Muff ! H2S Meter ........................................... Name :............................................... Name :...............................................
! Personal Distress Unit ...........................................
Signature :......................................... Signature :.........................................
...........................................
! ELECTRICAL ISOLATION - Cert. No....................................... ! RADIATION - Cert. No...................................................... ! SKETCHES DRAWING/P&ID DATE BY RECEIVING AUTHORITY BY APPROVING AUTHORITY
! LIMIT of ELECT. ACCESS - Cert. No........................................ ! ROAD OBSTRUCTION - Cert. No................................... ! LIFTING DATA
! PHYSICAL ISOLATION - Cert. No............................................ ! JHA – Doc. No. …………………………………………. ! TOOLS INSPECTION CHECKLIST Name :................................................................ Name :........................................................................
! SAFETY SYSTEM BYPASS - Cert. No...................................... ! RELATED PTW No. …………………………………….. ! JOB METHOD STATEMENT Signature :.......................................................... Signature :..................................................................
! LIFTING CERTIFICATE – Cert. No ………………………….. ! CERTIFICATE OF FITNESS FOR MACHINERY ! OTHER.......................................................................... Date :........................Time :................................ Date :..........................Time :.................................
............................................................................................
............................................................................................
SECTION 6 – PERMIT TO WORK ENDORSED & REVIEW SECTION 7 – PERMIT PROPOSAL SECTION 10 - HAND BACK
I have personally checked the area and equipment to be worked on and satisfied the work requested can be carried out
I ensure to carry out the work safely as per this PTW conditions ! Work Completed and all associated Permits closed.
safely
! Work continue
BY RECEIVING AUTHORITY BY HSE BY PERFORMING PARTY ! Incomplete hand-back (Equipment status, reason for hand-back, etc.) ....................................................................................................................................................................
................................................................................................................................................................... ................................................................................................................
Name :..................................................................................... ................................................................................................................................................................... ................................................................................................................
Name :................................................................................ Name :....................................................................................
................................................................................................................................................................... ................................................................................................................
Signature :........................................................................... Signature :...............................................................................
Signature :......................................................................... ................................................................................................................................................................... ................................................................................................................
Date :............................. Time :.......................................... Company / Dept. :...................................................................
Date :....................... Time :..............................................
Date :................................. Time :..........................................
I authorized the work to commence subject to the conditions on this PTW. RECEIVING AUTHORITY ACCEPTED BY APPROVING AUTHORITY
Name :......................................................................................
PTW Valid From D M Y TIME Signature :................................................................................ Name :....................................................................... Date :.............................. Name :........................................................................ Date :..............................
PTW Valid Until D M Y TIME Date :............................. Time :..............................................
Signature :................................................................. Time :............................. Signature :.................................................................. Time :.............................
Always follow ZeTo Rules no. 1. STOP WORK AND EVACUATE AREA ON HEARING OF EMERGENCY ALARM
Work with a valid work permit (PTW) required by the job.
Distribution - Original: Displayed at Worksite Copy No. 2: PTW Station Copy No. 2: Receiving Authority
Pre Job Checklist
Please&)ck&(")&where&applicable&/&Tandakan&(")&yang&berkenaan&
Area Classification
Toolbox&mee)ng&conducted/&Mesyuarat)“Toolbox“)telah)dijalankan)
Zone 0 That part of a hazardous area in which a flammable atmosphere is continuously present or present for a long period.
PTW)Joint)Site)Visit)conducted)/)‘PTW)Joint)Site)Visit”)telah)dibuat)
PTW&and&JHA&requirements&have&been&verified&and&communicated&to&all&and&understood&/&Segala)keperluan)di)dalam)PTW)dan)JHA)
Zone 1 That part of a hazardous area in which a flammable atmosphere is likely to occur in normal operation.
telah)disahkan)dan)diberitahu)kepada)semua)orang)yang)terlibat)dan)difahami&
Hazards&from&the&ac)vity&has&been&shared&and&understood&/&Segala)bahaya)yang)terdapat)di)dalam)akEviE)telah)diterangkan)dan) That part of a hazardous area in which a flammable atmosphere is not likely to occur in normal operation and if it occurs
difahami& Zone 2
will exist only for a short period.
Control&measures&required&to&address&the&hazards&have&been&briefed&and&understood&/&Segala)kawalan)keselamatan)yang)
diperlukan)untuk)mengawal)bahaya)telah)dikongsi)bersama)dan)difahami&
Basic&PPE&D&Safety&Helmet,&Safety&Glass,&Safety&Shoes,&FRC.&Check&Availability,&Condi3on,&Expiry&Date&/&Peralatan&Perlindungan&Diri&
(PPE)&Asas&–&Topi)Keselamatan,)Cermin)Mata)Keselamatan,)Kasut)Keselamatan,)FRC.)Mencukupi,*Keadaan,*Tarikh*Luput&
Double&Barricade&working&area&/&‘Double)Barricade’)tempat)kerja) SAMUR Plot Plan
What&to&do&during&emergency&have&been&brief&:&Fire&alarm,&Assembly&point,&ERP,&Rescue&Plan&/&Perkara)yang)sepatutnya)dilakukan)
semasa)kecemasan)telah)diterangkan:)Siren)Kebakaran,)Tempat)Berkumpul,)ERP,)Pelan)Menyelamat&
Loca)on&of&emergency&eye&wash,&safety&shower,&fire&ex)nguisher&and&manual&call&points&are&iden)fied&/&Lokasi)“eye)wash”,)“safety)
shower”)untuk)kecemasan,)alat)pemadam)api)dan)“manual)call)points”)telah)dikenalpasE.&
All&electrical&tools&/&equipment&has&been&inspected&/&Segala)peralatan)elektrik)dan)sebagainya)telah)diperiksa&
Housekeeping&&during&and&aTer&work&/&Melakukan)kekemasan)semasa)dan)selepas)kerja)siap))
Ensure&workers&are&fit&to&work&(physically&and&mentally)&/&MemasEkan)pekerja)sihat)untuk)bekerja)(fizikal)dan)mental)&
Poten)al&Hazard&at&surrounding&area&/&Mengenal)pasE)potensi)bahaya)yang)terdapat)di)sekeliling)
Energy&sources&at&surrounding&area&iden)fied&/&SumberXsumber)tenaga)di)sekeliling)kawasan)telah)dikenalpasE&
Note : If there is an emergency declared in the plant all permits /certificates are canceled.