PETROKEMYA ENVIRONMENT, HEALTH, SAFETY, & SECURITY (EHSS)

MANAGEMENT SYSTEM
Description No. Date
Revision 06 November 2015
Work Permits
PK SHEMS-08.10 Amendment 0 -
Attachment (SHEM-08.10K)
Next Review - November 2020
Page 1 of 1

RESCUE PLAN
No. Requirement Details of arrangements

1 Confine space / high elevation work area / high risk area details
Means of access ( manhole open / channel head open / pit
2
cover open)
3 Lighting requirement
4 Internal obstructions
5 Height from ground
6 Pre-installed rescue equipment details
Supplied-air or self-contained
7
breathing apparatus
8 Communication tools
9 Safety harness requirement
10 Maximum number of men inside confine space
Air horn or any other type emergency horn with workers in
11
confine space
Mechanical device on-site for immediate use to retrieve
12 personnel from vertical type confined spaces more than 2
meters deep
13 Role of control room operator
14 Role of permit receiver
15 Who takes charge in emergency
16 How is emergency alarm raised
17 Who is to respond to emergency alarm
18 Define escape route or attach escape plan
Notification to (Fire Captain/Fire Prevention Manager) before
19
start the work

Person Name Authorized WP No. Signature Date Time

Fire Captain (Rescue Team
Leader)
Rescue Man
Permit Receiver
Permit Issuer

NOTE: Preparation should be done by all team members.