SAFE WORK

PROCEDURE NUMBER: HES-204

 CPL HES 204 Safe Work

CONTENTS

SAFE WORK HES-204

Section Title Page

1.0 Purpose 3
2.0 Scope 3
3.0 Prerequisites 4
3.1 Qualified Third Party Person in Charge 4
3.2 Specific Safe Work Practice Training 5
3.3 Use of a Contractor PIC for work requiring only a safe work permit 5

4.0 Process Overview 6

5.0 Instructions 7
5.1 Permit Origination 7
5.2 Hazard Evaluation (Analysis) 7
5.3 PPE 7
5.4 Authorize Work to Begin 7
5.5 Permit Extension 7
5.6. Work Completion 7
6.0 Roles and Responsibilities 8
7.0 Reporting Requirements 8
8.0 Documentation and Records Retention 9
9.0 Document List 9
Appendices
A Glossary
B Safe Work Permit

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1.0 Purpose
The purpose of this procedure is to:

describe the written safe work permitting process; and

establish requirements to be followed when performing work.

2.0 Scope
2.1 Personnel and Activities Covered by this Procedure
This procedure applies to all maintenance and construction work performed by Chevron
Pipe Line Company (CPL) workforce including but not limited to:
a) New construction;
b) Any work that requires:
o Hot Work Permit;
o Excavation Permit;
o Isolation Lockout/Tagout (LOTO);
o Confined Space Permit;
o Electrical Safe Work Permit.

c) Pipeline repair;
d) Pipeline replacement;
e) Tank or vessel maintenance and/or repair;
f) Hot taps;
g) Overhauling of equipment (pumps, compressors);
h) Site remediation projects; and
i) Any other work that is hazardous or unusual such as:
o Working from heights where personal fall protection is required;
o Overhead activities involving rigging in a congested area or over piping or
equipment in service; Unbolting, disconnecting, opening, or removal of any line,
process piping, equipment, or system that has been in service;
o Un-flanging or removal of heads, isolating blinds, blind flanges, man ways, process
piping, or equipment that has been in service;
o Working on live electrical equipment over 50 Volts;
o Removal of process valves and relief valves; and
o Construction work (includes the installation of new equipment and the modification
of existing equipment).

2.2 Personnel and Activities Exempt by this Procedure

Normal operations performed by CPL Employees

Delivery services

Office machine repair service

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Pest control

Laundry service

Janitorial service

Utility service

Third party training personnel

Day to day loading and off loading at those facilities where it is part of their operation
ie. Terminal operations

3.0 Prerequisites
3.1 Qualified Third Party Person-in-Charge
Individual contractor hired by CPL as third party may assume the responsibility as a CPL
PIC, provided that the following apply:
Use of a PIC will be determined on a job-by-job basis.
Approval for using a Qualified Third Party Contractor as a PIC will be
determined based on work location and scope of work. Approval can be
authorized by either the Team Leader or Project Manager from CPL Projects
Management Group.
Qualified Third Party (PIC) Must be a Contractor separate and distinct from
the contractor performing the work (a third party who does not work for the
contractor, but works directly on behalf of CPL) who has been trained in CPL
applicable procedures, and understands the hazards, risks, exposures, and
associated impact to operations from the activities in the facility.
a) Team Leaders responsible for the assets and/or Project Manager, must approve the
individual to act as a PIC on behalf of CPL, and assure the Third Party PIC or PIC
Contractor is trained and qualified in the operations process.
b) The Third Party PIC must be trained on the applicable CPL Safe Work practices
permitting systems, by the Health Environment & Safety (HES) Training Group.
(See section 3.3 Specific Safe Work Practice Training for training requirements).
c) Upon completion of the Safe Work Practice Permit training, the individuals
knowledge must be validated (90% on test). All training must be attested to by the
Team Leader and/or Project Manager or designated CPL employee representative and
records maintained at the appropriate office.
d) The PIC qualification documentation must be in writing by the Team Leader and kept
on file. Qualified means trained in applicable procedures and understands the hazards,
risks, exposures, and associated impact to operations from the activities in that facility
or work location.
e) Certification for PIC is only valid for three (3) years from the day of training. Records
of the training shall be retained in the appropriate office for three (3) years.
f) Third Party PIC can sign any of the Safe Work Practice Permits (safe work, hot work,
confined space, and excavation). In no scenario will a Third Party PIC be allowed to
initiate or approve a Lockout/Tagout (LOTO.)

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g) Permit Origination and Extensions: the Third Party PIC must review the permit(s)
requirements and receive daily concurrence by phone from the Team Leader and/or
Project Manager or their designated CPL employee representative, prior to signing
the Safe Work Practice Permit(s), (safe work, hot work, confined space, and
excavation) acknowledging concurrence per telecom. The Third Party PIC must sign
the permit in the appropriate place and sign the Team Leader and/or Project Manager,
or designated CPL employee name, which provided concurrence per telecom next to
their signature.
h) If the Team Leader and/or Project Manager or their designated CPL representative
does not concur with the Third Party PIC, verification must not be given per telecom
and work must not commence.

3.2 Specific Safe Work Practice Training

Specific Safe Work Practice Permit Process Training
a) CPL Safe Work Procedure and Permit
b) CPL Hot Work Procedure and Permit
c) CPL Confined Space Procedure and Permit
d) CPL Excavation Procedure and Permit
e) Occupational Safety and Health Administration (OSHA) Competent Person
f) Lockout/Tagout, etc. (For general knowledge only. The Third Party PIC nor
Contractor PIC cannot perform Lock Out Tag Out.)
g) Job Safety Analysis (JSA) using Hazard Identification Tool
h) Job Site Safety Plan (JSSP)
i) Any specific training that may be required per job.

3.3 Use of a Contractor PIC for Work Requiring Only a Safe Work
Permit
The Team Leader (TL) can designate any Qualified Contractor to act as a PIC to initiate
and sign Safe Work permits only. After receiving verbal approval from the Team Leader
or designee the Qualified Contractor can sign the permit and begin work. The Contractor
PIC must be trained on the applicable CPL Safe Work practices permitting systems, by
the Health Environment & Safety(HES)TrainingGroup. (See section 3.2 Specific Safe
Work Practice Training for training requirements). Team Leaders or designated CPL
employee representatives must confirm (test) the Contractor PICs knowledge of the
specific work operation and CPL Safe Work Permit process.
Possible Examples of (but not limited to) safe work permits only activities that can be
initiated and signed by a Contractor PIC are:
o Right-of -Way Mowing,
o Line Locate,
o Weed Spraying,
o Surveying,
o Window Air Conditioner Maintenance,
o Telecommunication Maintenance,
o Sign Maintenance,
o And/or any other job at the Team Leaders discretion.

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4.0 Process Overview

Is a
Safe Work Permit No STOP
required?

Yes

Identify the PIC

for the job/work

Is the
Use SWA and complete
Job Scope No
the scope of work
complete?

Yes YES

Is a
Use SWA and complete
CPL JSA
the JSA
required?

Yes

Has the
No JSA been No
completed?

Yes

PIC fills in the general

section on the Safe Work
Permit

PIC and person(s)

conducting the work meet at
the job site

Complete the Hazard

Analysis (if there is no CPL
JSA) and the PPE section

Review the permit with the

PCW(s)

Are all of STOP!

the requirements and MAKE SURE THAT ALL
No
conditions met & REQUIREMENTS ARE MET
understood BEFORE PROCEEDING

Yes

PIC and Person conducting Are there

When complete return
the work sign and date the any other permits No Work Begins
permit to PIC
permit required?

Yes
PIC files permit in the
appropriate office
Complete other permits as
required

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5.0 Instructions
5.1 Permit Origination - General Section

The PIC initiates the safe work permit process by completing the general section of the
permit (See Appendix B, Safe Work Permit Form), and must specify:
a) the facility, job boundaries, and equipment being worked on;
b) date and time limits (schedule time);
c) description of the work;
d) tools/equipment to be used; and
e) person(s) conducting the work (PCW).

The PIC specifies the required CPL permits that will also need to be completed prior to
the beginning of work. These permits include LOTO (HES-203), Confined Space
(HES-201), Hot Work (HES-205), Excavation (HES-202), and other permits that
may apply. Some routine tasks may not require a permit. These tasks will be
determined by the Team Leader.

The PIC specifies and assures that a JSA is conducted on-site and remains on location
until the job is complete. If a CPL JSA is completed then Hazard Analysis section can be
skipped.

5.2 Hazard Evaluation (Analysis)

The PIC and the Person Conducting the Work (PCW) will conduct a hazard analysis
within the boundaries identified in the Safe Work Permit, in order to aid in the proper
selection of personal protective equipment. If there is a CPL JSA required as part of the
job, the hazard analysis is not needed as part of the Safe Work Permit.

5.3 PPE
The PIC specifies the required Personal Protective Equipment (PPE) that will need to be
used (see HES-501).

5.4 Authorize Work to Begin

Once the conditions of the permit are met and the PIC and PCW agree, the permit must be
signed and dated, and the work may begin.

When performing work alone, the same person cannot act as both the PIC (CPL PIC or
Contractor PIC) and PCW at the same time. For times when a single person is performing
the work alone, at a minimum, the single person must review the permits with, and attain
verbal approval from the Team Leader or Designee. This can be done per telecom or in
person. Once concurrence is received, the single person must note the name of the Team
Leader or Designee providing concurrence as the PIC, and sign the permit(s) as the PCW.

Any permit that does not contain the current date and required signatures and initials
is not valid and work cannot be performed.

5.5 Permit Extension

A permit may be extended beyond a shift change, if:

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conditions remain unchanged and it is safe to do the work; and

the PIC and the PCW confirm that conditions are safe and the permit restrictions
continue to be met then date and sign the permit.

A permit may be extended for four consecutive shifts, not to exceed 12 hours per
shift.

5.6 Work Completion

Once the job is completed, the PCW removes and gives the permit to the PIC or CPL
Representative.

6.0 Roles and Responsibilities

The following table outlines the roles and responsibilities associated with this process.

Role Responsibilities

Person in Charge (PIC) The PIC is responsible for:

initiating the safe work permit process;

the overall safety of personnel and equipment from

operating hazards until the job is complete;

specifying all required restrictions and assuring

necessary steps are taken to eliminate the possibility
of an incident;

assuring all required fire and safety equipment is in

place and in working order;

giving final approval of the permit; and

filing the permit (Third Party PIC or Contractor PIC

must turn in permits to local field team for filing).

Person Conducting the Work The PCW is responsible for:

(PCW)
complying with all conditions and requirements of
the safe work permit;

communicating restrictions and conditions to other

personnel in the job boundaries; and

safe execution of work being performed.

7.0 Reporting Requirements

None

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8.0 Documentation and Records Retention

8.1 Document Control Information
Document Control Information

Description

Approval Date 15 December 2011

Next Revision Due 15 Decem ber 2012
Control Number

Document History

Version Number Date Notes related to changes

1.0 20 July 2009 Third Party PIC responsibilities, Contractor as a

PIC
1.1 Not Available Not Available
1.2 August 2009 Not Available
1.3 15 December 2011 Reviewed for content (CPL and regulatory
requirements).

9.0 Document List

This is a complete list of the documents referenced in this process.
Document List

Documents Retention and

Storage

CPL 204 Safe Work Safe Work Permits must be kept 2 years at the appropriate
Permit is used to document office appropriate office.
this procedure.

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CPL HES 204 Safe Work

Appendix A Glossary
Person-in-Charge
Qualified Third Party PIC
Contractor
Requestor/Work Owner
Maintenance
Non-Routine Maintenance
Workforce
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Team Leader responsible for the assets, or their designated
CPL employee representative, or a qualified third party
contractor, that has overall responsibility for determining
acceptable conditions in the area are safe for the task to be
performed and for the safety of personnel and equipment until
the job is complete.
The PIC cannot be a contractor working for the same contract
company performing the work.
However, the Person-in- Charge can be a third party inspector
who is acting as the Company representative.
A Contractor separate and distinct from the contractor
performing the work (a third party who does not work for the
contractor, but works directly on behalf of CPL) who has
been trained in CPL applicable procedures, and understands
the hazards, risks, exposures, and associated impact to
operations from the activities in the facility.
A person who agrees to furnish materials or perform services
at a specified price for construction. The person performing
the work
The person who selects, hires, or oversees the work of a
contractor.
The act of maintaining or keeping something in proper
condition or upkeep. Any activity, such as tests,
measurements, replacements, adjustments, and repairs,
intended to restore or retain.
Any maintenance activities outside the realm of routine
maintenance.
Inclusion of: CPL Employees, contractors and sub-
contractors.
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 CPL HES 204 Safe Work

Appendix B Safe Work Permit Form (CPL-204)

Use link (CPL-204) to get full document example shown below:

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