Appendix-2

Checklist for Shutdown Work

(Ref. FOM S 302 J R1)
1. Common confirmation items for every work
Confirmed by
Items to be confirmed
Client Chiyoda Subcon.
1. Has the work execution plan been approved/ permitted in accordance
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with Client’s procedure?
2. The contents of work have been explained to all workers including
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subcontractor, and did they understood?
3. Have all formalities related to Client’s procedures been completed?
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[When making list, the formalities needed must be put in the list.]
4. Have personnel in accordance with the work execution plan been
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allocated? (Including person in charge, banksman, etc.)
5. In case Client needs to witness, was the Client’s witness confirmed? -
6. Equipment and tools to be used, was it confirmed that they are safe by
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means of inspections?

2. Confirmation items for individual hazardous work

2.1 Blind Isolation Work
Confirmed by
Items to be confirmed
Client Chiyoda Subcon.
1. Are Tags with numbers attached to the points to be isolated?
2. Is there no mistake in the drawings/ list showing the points to be
isolated by blinds?
3. Were the locations to be isolated confirmed by checking the drawings
and tag number at the site?
4. Was it confirmed that residual pressure and residue do not exist in the
lines related to work?
5. Was it confirmed that drains were opened and the conditions of
connections to other facilities were safe?
[If harmful gases such as hydrogen sulfide had been flowing in the pipes
- - -
to be isolated by blinds, gas test shall be continued.]
6. Was the displacement of gas to the inside of pipe confirmed? (Such as
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steam blow or nitrogen gas purge, etc)
7. Were barricades for KEEP OUT around working place provided? -
8. Were airline masks (fan, filters, hoses, masks, etc) inspected? -
9. Was a spare airline mask for rescue prepared? -
10. Are workers to carry out work in the barricaded area wearing proper
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airline masks?
 2.2 Tanks and Columns/ Vessels Work
Confirmed by
Items to be confirmed
Client Chiyoda Subcon.
1. Have the pipes connecting to others outside been blocked off? (Closing
valves, inserting blinds, etc)
2. Was it confirmed that the residual pressure and the residue do not
exist in the system?
3. If there is a rotary machine inside, has the measure to protect start of
engine provided? (Such as power-cut and/or lock-out)
4. Was ventilation (Opening manholes, removing tank-vents, providing
fans, etc) provided in accordance with the execution plan?
5. Gas test has done, and was it confirmed that gas concentration was
under the each level of following?
¾ Flammable gas……………less than 20% of lower explosive limit
¾ Oxygen……………………..more than 18%, less than 21% (Japan)
More than 19.5%, less than 23.5% (OSHA)
¾ Harmful gas……………….less than threshold limit value
6. Is the entry control board posted at the entrance of tanks, columns or
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vessels?
7. Are all Personnel Protective Equipment in accordance with the
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execution plan prepared?
8. Was training for wearing PPE properly given to all workers involved?
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(Such as airline mask, etc)

2.3 Piping Work

Confirmed by
Items to be confirmed
Client Chiyoda Subcon.
1. Have all isolations such as inserting blinds been completed and
confirmed at the site?
2. Was it confirmed that purging in pipes, cleaning in pipes and gas tests
were done and that the inside of pipes are in safe condition?
3. When removing the existing pipes (cutting in/off), have Client, Chiyoda
and subcontractor been witnessed at all locations?
4. The exact locations and dimensions to be removed were marked with
color identifications, and then have their locations and dimensions -
been confirmed by the person to work directly before start of work?
 2.4 Hot Work
Confirmed by
Items to be confirmed
Client Chiyoda Subcon.
1. Has the fire wall been installed in accordance with the execution plan?
2. Measuring flammable gas concentration was carried out in accordance
with the execution plan, and was it confirmed that flammable gas does
not exist around working place?
3. Are any unauthorized tools or material for hot work brought in? -
4. Are tools permitted to bring in, been put at the designated locations? -
5. Are fire protection measures for hot work provided? -
6. Are suitable numbers of the fire extinguishers provided? -
7. Is there any flammable material such as oil, paint, etc left around at the
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working place?