Management of Change Proposal & Authorities QMS-TM-MOC Rev2

SECTION A: PROPOSAL (INITIATOR TO COMPLETE)

Project Name: NTI Register #:

Change Type: ☐Emergency ☐Temporary (<12 months) ☒Permanent
Business: PM Group Location: NTI CO TANJUNG KARANG
Raised by: ASYRAAF Planned date: 24th Feb 2023 Planned date: 7th July 2023
(name) (commencement) (completion)
What has to be done?
Provide a brief Tank sump pre-fit work could not be done before tank sinking activity
description of the
proposed changes
Why?
Why make the change? Due to overhead obstruction at site entrance. The overhead cable laid very loose
Why now? caused the clearance height not sufficient to deliver tank with pre-fit sump installed.

How?
Describe how the To omit the pre-fit sump work. This will reduce the total height of the tank on low
change should be made loader trailer to 4.6m. The current height of the overhead cables from the ground is
around 4.65m to 4.7m (refer photos attached).

Comments:
Provide any further Kindly Refer Attachment for References
comments to support
the change

Does this change have No

time/cost impact?

Has the time/cost impact

been finalized and N/A
agreed with Shell?

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Management of Change Proposal & Authorities QMS-TM-MOC Rev2

SECTION B: CHANGE CHECKLIST (INITIATOR TO COMPLETE)

Physical changes Procedural changes Management & Organisation

☐ Alterations to safeguarding ☒ Changed procedures, ☐ Changes in key or critical

Equipment, interlocks, critical installation methods required personnel
Alarms, etc.

☐ Forecourt asset / structural ☐ New standards or codes or ☐ Personnel manning levels

legislation changed

☒ Modification of equipment to ☐ Site commissioning / ☐ Supervisory role or business

be installed decommissioning structure changed

☐ New technology used for the ☐ New of changed policy to be ☐ Change in contractors being
first time implemented used

☐ New materials being used ☐ Traffic management plan ☐ Changes affecting other parts
modifications of the business

☐ Changes to neighbouring ☐ Changes supply arrangements ☐ Changed business service

property usage levels

☐ Human factors (noise, fatigue, ☐ Changed maintenance ☐ Changed staff competence

manual handling, odours, etc.) requirements requirements

☐ Organisational stress factors

☐ Other: ☐ Other: ☐ Other:

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 Management of Change Proposal & Authorities QMS-TM-MOC Rev2

SECTION C: REVIEW, ASSESSMENT, APPROVAL

The change has the potential to:

☐ Create or introduce new / modified hazards ☐ Impact Personal Safety

☐ Impact existing barriers and controls ☐ Introduce a new activity
☐ Impact Process Safety
☐ Impact on Quality
☐ Impact on Procurement
☐ Impact on Operation & Maintenance
☐ Impact on Construction

What formal assessment is required?

☐ Risk Assessment ☐ Investigation of legislative requirements

☐ HAZOP ☐ Investigation of Client standards and
☐ Heath Assessment / Human Factors Assessment requirements

What disciplines need to be involved?

☐ HSSE ☐ Fuel System

☐ Project Manager / Asst. Project Manager ☐ Electrical expert
☐ Programme Manager ☐ Structural expert
☐ Client ☐ Civil expert
☐ Other: ☐ Architectural Expert

Approval: Documentation to support:

☐ Approved ☐ Hazard & Control register update

☐ Not approved ☐ Technical document update:
☐ Conditional approval ☐ Statement of Fitness
☐ Project scope change
☐ Other:
Note: Client consent to be obtained for key changes

DESIGNATION NAME DATE SIGNATURE

Initiator Asyraaf 05/05/2023 Asyraaf

Meinhardt Project Manager Hadiron Kamal 5/5/2023 Hadi K
Meinhardt Program Manager

Client

Comments / conditions

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Management of Change Proposal & Authorities QMS-TM-MOC Rev2

DOCUMENT CONTROL PAGE (DCP)

DOCUMENT TITLE: MANAGEMENT OF CHANGE FORM

DOCUMENT NO.: DOCUMENT CONTROLLER:

AMENDED DCP /

ISSUE SECTION NO. / APPROVED

DATE PAGE NO. DETAILS OF CHANGE DCR NO. BY

DISTRIBUTION:

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Management of Change Proposal & Authorities QMS-TM-MOC Rev2

Attachment 1

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