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LMRA
LMRA
All members of the work party who have participated in the LMRA Supervisor (Name, Signature):
and are familiar with the job scope and Hazard & Controls
Permit Number:
Name Initials Name Initials
Date & Time:
......................... ......................... ......................... .........................
What kind of work are you going to do?
......................... ......................... ......................... .........................
Has the Permit Issuer discussed the hazards & Does the work party know the emergency alarm
controls with the Permit Holder? Yes n/a and action required in event of an alarm or Yes n/a
accident?
Has the Permit Holder warned others that may be
affected by your work? Yes n/a Does the work party know the most effective Yes n/a
escape route and the location of the nearest
muster point?
Is there conflicting work that may affect you?
Yes n/a Yes n/a
Does the work party know the location of the
If yes describe hazards and controls below.
nearest eyewash station, emergency shower, first
aid kit and AED device?
Are there additional hazards that need to be controlled? If newly identified hazards are material changes to the permit, contact Permit Issuer!
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Pictograms of key hazards: Indicate (and discuss) which of the QatarEnergy Life Saving Rules are applicable:
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Altrad Babcock Last Minute Risk Assessment (LMRA) Template – Rev2 (31st July 2023)