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088 - Work Permit Form

This work permit document outlines safety requirements for work being performed at different hazard levels. It requires identification of the work area, hazards present, isolation methods used, personal protective equipment needed, gas measurements that will be taken, approvals required from supervisors, and confirmation that isolation of safety systems and completion of work are properly conducted. The executor of the work must understand and fulfill all precautions before and during work.

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mashangh
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
454 views

088 - Work Permit Form

This work permit document outlines safety requirements for work being performed at different hazard levels. It requires identification of the work area, hazards present, isolation methods used, personal protective equipment needed, gas measurements that will be taken, approvals required from supervisors, and confirmation that isolation of safety systems and completion of work are properly conducted. The executor of the work must understand and fulfill all precautions before and during work.

Uploaded by

mashangh
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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WORK PERMIT

LEVEL 2 LEVEL 1

NO.:

Well operation Work on hydroExplosives carbon system Critical lifting operation Other/critical operation

Area (sketch/description)

Hot work A Hot work B Entry (confined space) Isolation of safety system

Pressure testing Work above sea Dangerous substances Radioactive materials

Work level 2 SAFE JOB ANALYSIS: NO: REQUIRES APPROVAL FROM ELECTRICAL DEPARTMENT
WORK ORDER NO.: OPERATION NO.: ISOLATION NO.:

Applicant name: Work description:

Discipline:

Phone:

Day
Equipment/tools: : Installation: Tag/line no.: Attachment:: Location/modul: Deck: Zone: Date:

Night
From hr:

Ongoing work To hr:


Sign: Sign: Sign:

Extended to hr: Area/Operations Supervisor CCR Technician Area Technician

OPERATIONS- AND SAFETY PREPARATIONS


Required Performed by area technician Depressurization Draining/emptying Cleaning/gasfreeing Isolation by singel valve/double block&bleed Isolation by blind/Isolation plan Safety tag/lock Venting/Extra ventilation Prevent release of oil/gas in the area Measures against radioactive radiation Inspection of the area every hour Other

A
Signature

B
Required Performed by executing skilled worker Portable gasdetector no. on the worksite Verify mechanical isolation Electrical isolation/locking Tag. No.: Fire Extinguisher/fire prevention Welding machine safely located and earthed Continuous guard/radio communication Drains blocked/covered Barrier/warning sign/PA-announcement Cooperate with CCR/Area technician Follow requirements for work above sea/at height Chemical data sheet known and available Procedures/cheklist for the operation known Ref. No. : Control of temporary lifting equipment Follow requirements for Entry (confined space) Special personal protective equipment

Signature

GASMEASUREMENTS PRIOR TO/DURING THE WORK Hydrocarbons every hour H2S every Oxygen every hour every ISOLATION SAFETY SYSTEM System:

hour hour

Locally

CCR

Measures to avoid work related deseases


Location/area: Compensating measures:

Other requirements/preparations

APPROVAL/AUTHORIZATION

Area/Operations Supervisor: Remarks/requirements:

Other position:

HSE Function:

Platform manager:

PRECAUTIONS PRIOR TO / DURING WORK EXECUTION


Safety system isolated/reactivated Isolated locally/CCR Reinstated locally/CCR Remark: Signature:

B
Gastest - value HC O2 H2S Time/sign.

4
Work site cleared according to requirements Area Technician time: Signature: The work is cleared with CCR CCR Technician time: Signature:

Precautions understood and are/will be fulfilled


Executing skilled worker

Name: (Block letters)

COMPLETION

A Yes No Yes No Signature:


Signature:

B Work completed Work not completed Work place cleaned and secured Executing skilled worker Signature: Original: Work site Copy:
GR0216803_01_eng

All locks/tags removed Equipment ready for operation Area Technician time: Work cleared by CCR CCR Technician time:

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