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Date: From !o
"ocation of work #ames/ranks carrying out work $escription of work to be done %as &ntry into &nclosed 'paces (ermit been issued)
SE TION ! 1.1 1.*
%as the work area been checked with combustible gas indicator for hydrocarbon vapours) !ime %as the surrounding area been made safe) !ime %as the work area been checked with combustible gas indicator for hydrocarbon vapours) %as the equipment or pipeline been purged) %as the equipment or pipeline been blanked) -s this equipment or pipeline free of liquid) -s the surrounding area safe) -s additional fire protection available) -s the equipment isolated electrically) 'pecial conditions/precautions
SE TION " *.1 *.* *.+ *., *.. *./ *.0 *.1
SE TION # +.1
!he work has been completed and all persons under supervision of undersigned, materials and equipment have been withdrawn. !ime $ate
2aster3s approval 4h.&ng./4h.5ff. (erson supervising the work (erson assigned to the work
&7planation GENERAL 8a9 'tarting/finishing time must not e7ceed the 6uthorised 'ignatories3 working hours. 8b9 'pecific location of work to be given. 8c9 $escription of work to include type of equipment to be used. SE TION ! 6pplies to all ha:ardous work not involving naked flame or continuous spark production and would include use of electrical equipment, use of air driven rotary equipment, lifting equipment/materials over operating plant.
SE TION " 6pplies to all hot work involving high temperatures, open flame, arc or continuous source of sparks. etc. !his type of works include but is not limited to ; <elding or burning ; =rinding ; 'and or grit blasting ; 2etal chipping !est for combustible gas should be carried out shortly before commencement of hot work and at frequent intervals as long as the work is in progress.