12 LIST OF APPENDICES

Appendix –A Appointment Request Form For Selection And Appointment Of Permit to Work “Issuing Authority”

Appendix –B Appointment Request Form For Selection And Appointment Of Permit to work “Performing
Authority”

Appendix –C Appointment Request Form For Selection And Appointment Of Certificates “Issuing Authority”

Appendix –D List Of Area Authority For Non-Process

13 APPENDIX-2 INSTRUCTIONS FOR SELECTION AND APPOINTMENT OF PERMIT
TO WORK “ISSUING AUTHORITY”
The Head of the Deparment shall nominate personnel as permit to work “Issuing Authority” by
completing Part-A of the “Appointment Request Form”.
Separate form for each nomination shall be raised. Nomination shall be discussed with Site Manager
prior to submitting it to the Site HSE (Coordinator / Officer / Supervisor).
Issuing Authorities shall attend a Permit to Work training course approved by Company, which is to be
provided by Site HSE (Coordinator / Officer / Supervisor).
Site HSE (Coordinator / Officer / Supervisor) shall arrange arrange test of nominee for validation in the
“Eni Pakistan Permit to Work System” procedure.
Site HSE (Coordinator / Officer / Supervisor) shall recommend a nominee based on the score achieved
by him, in the written validation test. The minimum score required for qualifying the test is 96%. He
shall complete Part-B of the form and forward it to the Head of the Department.
The Head of the Department shall:
 Carry out Competence Assessment of the candidate in consultation with the Site Manager.
 After satisfying that the nominee possesses adequate competence, Head of the Department
shall;
 Obtain approval by the Site Manager to appoint the recommended nominee as Issuing
Authority, and attach the record of validation and testing in Part C.
 Obtain written acceptance of the appointment from the recommended nominee in Part-D of
the Appointment Request Form.
 Update Appendix-7 of this procedure: List of Permit to Work Issuing Authorities;
 Inform the unsuccessful nominee that the Site HSE (Coordinator / Officer / Supervisor) has
not recommended him which is based on the score achieved.
 Where the Head of the Department shall feel that an unsuccessful nominee should be
nominated again, he shall satisfy himself that significant enhancement in the unsuccessful
nominees’ knowledge and understanding of the documents and systems stated in Section-3 has
taken place.
 The nomination process may be reinitiated for unsuccessful nominees after a lapse of one
month.
Site HSE (Coordinator / Officer / Supervisor) shall be responsible for the preparation of test material
and the integrity of the testing and validation process.
Site HSE (Coordinator / Officer / Supervisor) shall maintain the record of each appointment comprising
of completed Appointment Request Form and the validation questionnaire.
Appendix-6 Appoint Request Form for Selection and Appointment of Permit to Work “Issuing
Authorities”
PART-A : Nomination by Head of the Department (HOD);

1. Mr. : Employee No:

2. Qualification :

3. Experience at Eni Pakistan (nature & duration) _____________________________________________

4. Nominated for Appointment as Permit to Work “Issuing Authority"for the Areas_____________________________

5. I certify that the nominated person is working as (designation)

 Has adequate knowledge of the Permit to work Application Procedure (Eni Pakistan Permit to Work System – pro hse 052 eni
pak hse-cr r01) and other site specific procedures i.e. ..................................................................................................................
 Has acquired additional trainings in ......................................................................................................................... as required
according to the roles and level of responsibility of appointment holders.

z
Signature of HOD/ Employee No. __________________________________ Date: __________________
PART-B :Recommendation by Site HSE (Coordinator / Officer / Supervisor)

6. Mr. Employee No: _____________ has successfully completed training in:

 Permit to work Application Procedure (Eni Pakistan Permit to Work System – pro hse 052 eni pak hse-cr r01)

He Scored % in Validation test.

Recommended for Appointment Yes / No Signature: Date:

PART-C Recommendation by Site Manager

I recommend Mr. Employee No __________________ as “Issuing Authority” for following work

permits and certificates;

Work Permits/ Certificates Yes / No Work Permits/ Certificates Yes / No

Cold Work Permit Hot Work Permit
Safety Defeat Certificate (SDC) Excavation Clearance Certificate (EEC)
Confined Space Entry Certificate Radiography Certificate (RC)
Vehicle / Equipment Entry Certificate Medium Voltage Certificate (MVC)
Energy Isolation Certificate (EIC)

for the Areas:.....................................................................................................................................................................................................

The Individual has successfully undergone competent assessment.

Signature: Employee No: Date:

PART-D Authorization by Eni Pakistan Managing Director

I authorize Mr. Employee No as Issuing Authority as recommended by

Site Manager in Part-C.

Signature: Employee No: Date:

PART-E Accepted by Appointee

I accept the Appointment. Signature: Employee No: Date:

Appendix-4 Lsit of Permit to Work Issuing Authorities

S. # Employment Number Name Area

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

____________________________________
____________________________________
Nominated by Site Manager Approved by Eni Pakistan Managing Director