COLD WORK PERMIT

Permit Number: HSD-23/04072 Type: Cold Work

Status: Canceled Continuation of: `
SECTION 1: WORK REQUEST
Permit originator: Nguyen Ba Quan Date/Time: 28-Apr-23 16:13
CMMS Job Card: o Site: HSD
Heli o Main o Mezz o Cellar þ
Equipment ID/tag number: 02P-36202B Location:
Sub Cellar o Sea/Board Landing o
Equipment to be worked on: Demulsifier injection pump head

Task description: To repair demulsifier injection pump B due to leakage

Tools to be used: Hand tool, chemical PPE.

SECTION 2: HAZARD IDENTIFICATION AND CONTROL MEASURES
Area classification: H2S Classification: Isolation required:
o Zone 0 o H2S Red Zone þ Plant / Equipment
o Zone 1 o H2S Yellow Zone o Electrical
þ Zone 2 þ H2S Green Zone o Safety system
o Unclassified Zone o Non H2S Zone o Self isolation
Does the task involve hydrocarbon breaking containment? Yes o No þ (If YES, gas testing/ventilation requirement is MANDATORY)
Job Hazards and Standard Controls
Hazardous Substance (chemical,
Slips, Trips, and Falls Potential Spills Use of Equipment and Tools
hydrocarbon, toxic gas,...)

Follow MSDS controls and Maintain good Provide spill containment

Use protective guards
wear proper PPE housekeeping equipment/ spill pallet
Inspect & only use
Apply isolation -LO/TO Pay attention during moving Isolate when not in use equipment in good
condition
PPE (improper, lack of, poor Good arrangement of Clean up immediately any Competent persons to
quality) workplace spill use

Chemical Cartridge Clean up any liquids/spill Falling or Dropped Objects Incompetent Personnel

Maintain good Only competent persons

Manual Handling
housekeeping to involve the job

Protect/remove sharp edges

Avoid pinch points

Wear impact gloves

Hazards(Others) Chemical contact

Controls(Others) Chemical PPE must be wear.

TRA/JSA required? o Continuous attendance of PA at worksite ? þ

Supervisor Attendance: CAT A o CAT B þ CAT C o Not continuous attendance of PA at worksite ? o
SECTION 3: CROSS REFERENCED'S CERTIFICATES
PTW CSEC WRA/JSA

ICC HSD-23/04038a SSIC Toolbox Talk HSD TBT Mech repair DMO B due to
leaking on 29 Apr 2024.pdf
SECTION 4: ENDORSEMENT
The work described in Section 1 to be undertaken subject to compliance with the requirements stipulated in Section 2 & 3.
VSP Sup Name: Nguyen Ba Quan Designation: VSP Supervisor Date/Time: 28-Apr-23 16:18
AA Name: Hy Tac Sang Designation: TLJOC Production Sup Date/Time: 28-Apr-23 17:57

SECTION 5: AUTHORISATION
I hereby give my approval for the work described in Section 1 to issue in accordance with the validity period below
From: 07:00 Date: 29-Apr-23 To: 18:00 Date: 30-Apr-23

OIM Name: Nguyễn Ngọc Tân Designation: TLJOC OIM Date/Time: 29-Apr-23 06:54
SECTION 6: INITIAL SITE GAS TEST (When required)
Date/time of testing LEL% H2S O2 % CO Others Equipment No AGT Date/time input
ppm ppm
29-Apr-23 07:00 0 0 20.8 0 No.1 Nguyen Ba Quan 29-Apr-23 07:16

SECTION 7: ISSUE
I, Area Authority, declare that all hazards have been identified and all specified control measures are in place and it is now safe for the
work specified on the WP to be performed.
AA Name: Hy Tac Sang Designation: TLJOC Production Sup Date/Time: 29-Apr-23 07:19

I, VSP Supervisor, accept and assign my PA to perform properly the work in accordance with the conditions stipulated on this Permit.
VSP Sup Name: Nguyen Ba Quan Designation: VSP Supervisor Date/Time: 29-Apr-23 07:19
I, Performing Authority, have read and understand the above conditions and precautions. I accept responsibility for carrying out work as
specified. I will ensure the persons under my control read, understand and comply with these conditions and precautions. I will notify
the VSP Supervisor/Area Authority on completion or interruption of this work.
PA Name: Doan Thanh Mai Designation: VSP Mechnical Tech Date/Time: 29-Apr-23 07:19

SECTION 8: SANCTION TO TEST

I, Area Authority, declare that the proposed test is within the specified workscope and the isolations on the below ICC/SSIC have been
amended for test purposes.
ICC/SSIC No: AA confirmed: Name: Designation: Date/Time:
De-isolated þ Hy Tac Sang TLJOC Production Sup 29-Apr-23 15:12
HSD-23/04038a
Re-isolated o
De-isolated o
Re-isolated o
SECTION 9: REVALIDATION
PA returned OIM approved VSP Sup confirmed AA issued PA accepted

SECTION 10: CANCELLATION

I, Performing Authority, confirm that the status of the work / equipment as described in Section 1 is properly performed, all involved
persons have been withdrawn, the equipment and plant have been left in a safe, clean condition.
þ The work is COMPLETED o The work is INCOMPLETED
PA Name: Doan Thanh Mai Designation: VSP Mechnical Tech Date/Time: 29-Apr-23 16:26

I, VSP Supervisor, have checked at worksite and confirmed that the statement of PA above is accepted.
VSP Sup Name: Nguyen Ba Quan Designation: VSP Supervisor Date/Time: 29-Apr-23 16:27

I, Area Authority, agree that the work has been properly performed, all involved persons have been withdrawn, the equipment and plant
have been left in a safe condition and clean. This PTW can be cancelled.
AA Name: Hy Tac Sang Designation: TLJOC Production Sup Date/Time: 29-Apr-23 16:27

I, VSP Supervisor, have verified and confirmed that the revelant certificate processing as below:
þ ICC, SSIC, CSEC already removed þ The worksite/equipment is returned to normal service
o ICC, SSIC, CSEC still in place o The worksite/equipment can't returned to normal service
VSP Sup Name: Nguyen Ba Quan Designation: VSP Supervisor Date/Time: 29-Apr-23 17:00
I, OIM, satisfied that the Permit and related documentation complies with the requirements of the PTW System, and declare the PTW is
cancelled. Any lessons learned have been communicated to the workforce and the Process Owner.
OIM Name: Designation: Date/Time:

This form is auto-generated by system. No live signature is required

This print out copy is the only hard copy to be kept on site