SA-924-2 Red Print

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HOT WORK PERMIT

Saudi Aramco 924-2 (08/14) Front No. B



Complete this form in English and write clearly. Use ink pen, not pencil.

Section 1 – Work Description


Month ..................................... Day ........................................ Year ....................................... Duration .................................
A. Identify plant/facility area: ………………...............................….............................................................................................................
B. Exact work location: ………………...............................….........................................................................................................................
C. Work to be done: ………………...............................…..............................................................................................................................
D. Equipment to be used at the site: ………………...............................…................................................................................................

STOP WORK if job site does not meet work permit conditions and any applicable Saudi Aramco safety and health requirements at any time.

Section 2 – Hazard Identification & Control


A. Identify and attach any supplementary forms required to perform/control the work:
Job Safety Analysis Gas test records Isolation plan Blind list Critical Lift Plan
Excavation Checklist Hydrotest procedure(s) Other ……………….…..…… Other ……….….….…………
B. Energy Types:
Hydrocarbon/gas/steam/chemicals Mechanical Electrical Hydraulic/pneumatic
Potential energy (spring loaded, gravity) Automated extinguishing systems Other ……………………………
C. Isolation Method(s):
Locked switch/breaker Mechanical block Block valve Single block & bleed
Double block & bleed Blinding Disconnect
D. Potential Exposures:
High noise level Hydrogen Sulfide (H2S) Flammable liquids/gases Hazardous/toxic materials
Radioactive materials Temperature Other …………………………… Other ……………………………
E. Protective Equipment:
Personal H2S monitor FRC Goggles/face shield Chemical suit/coveralls Fall protection
Barricades/warning signs Respiratory protection (Explain further in Additional Safety Precautions below)
F. Fire Protection Methods:
Fire extinguisher Fire monitor/hose Area wetted Fire barriers/shields
G. Cover/water seal all sewers within 23 m (75 ft) of the Hot Work area
H. Standby Man needed Badge No. ……………..…............ Fire Watch needed Badge No. ……………..…............
I. List any Additional Safety Precautions: …………………………………………....………………………………….……………….
…………………………………………....………..................................................................………………………….……………….

IN AN EMERGENCY:

Section 3 – Gas Testing/Monitoring


Periodic monitoring required: Yes No If yes, attach a supplemental form. Gas testing frequency: ...........................................
ONLY CERTIFIED GAS TESTERS PERFORM GAS TESTS

LEL (%) H2S (ppm) O2 (%) Other gases (name/value) Badge No. Signature

Initial Test

Renewed

Section 4 – Permit Authorization & Closure


Additional approvals per GI 2.100 or local instructions:
Signature: ............................................... Position: ................................................ Date: ........................... Time: ...........................

Receiver Org.: Issuer Org.: Countersignature(s) if applicable

PERMIT Badge No. Cert. No. Signature Badge No. Cert. No. Signature Org. Signature

Open

This permit is renewed Date: Duration:


Countersigner(s) notified of permit renewal
Renewed

This permit is closed Date: Time:

I HAVE INSPECTED THE WORK SITE AND CONFIRM THAT IT HAS BEEN RETURNED TO A SAFE CONDITION.

Closed
HOT WORK PERMIT
Saudi Aramco 924-2 (08/14) Reverse

PERMIT INFORMATION

HAZARD ANALYSIS CHECKLIST

Y N N/A Y N N/A

Is the system/equipment properly isolated and locked


Is the correct type of permit(s) issued for the work?
out? Did all workers apply their personal locks?
Have the Job Safety Analysis (JSA) and other applicable
Has the system/equipment been depressurized, drained
supplementary forms been communicated to the work
and/or purged before opening it?
crew?
Are weather conditions (e.g., wind speed) acceptable Has the potential for releasing flammable liquids and
to perform the work? gases been controlled?
Are slip and trip hazards controlled? Are all ignition sources eliminated or controlled?
Does the work crew have the correct tools/equipment Does the fire watch have firefighting equipment readily
for the job? Are they in good condition? available and know how to use the equipment?
Has the potential for exposure to high noise levels, H2S,
Do personnel have the proper certifications to perform
hydrocarbons, asbestos, hazardous chemicals or
the activity and/or operate the equipment?
radioactive materials been controlled?
Is the correct personal protective equipment (PPE)
Is the equipment’s inspection sticker valid?
available for use by personnel?
If the work may impact others nearby, or vice versa,
Have all requirements for working at heights (i.e., fall
have the work crews discussed their activities with each
protection) been applied?
other (i.e., simultaneous operations [SIMOPS])?
Is the scaffold tag completed correctly, signed and with Is there an emergency contingency plan in place to
a valid inspection date? respond to the work being performed?
Does the work crew know what to do in the event of
Has the potential for contact with sharp objects,
an emergency, such as evacuation routes, location of
rotating equipment, hot/cold surfaces or live electricity
emergency equipment and where assembly areas are
been eliminated?
located?

Any ‘N’ (NO) answers above shall initiate a “STOP” point where the Issuer and Receiver are to analyze the hazard(s) and develop
methods to adequately control the hazard(s) and list the additional precautions on the permit.

Signatures:

Issuer or Designated Representative ………………………..……………….… Receiver ………………………..……………….…

GAS TEST INFORMATION TABLE

Any reading above 0% LEL No hot work allowed


Combustible Gases/Vapors 5% LEL – 10% LEL Breathing apparatus must be used
10% LEL or above No work (or confined space entry) allowed
10 ppm or above Breathing apparatus must be used
Hydrogen Sulfide (H2S) 10 ppm – 100 ppm Division Head must sign the permit
100 ppm or above No work (or confined space entry) allowed
Less than 20.0% Breathing apparatus must be used and Division Head must sign the permit
Oxygen (O2)
Above 23.5% No work allowed
35 ppm – 1,000 ppm Breathing apparatus must be used
Carbon Monoxide (CO)
1,000 ppm or above No confined space entry allowed

PERMIT AUTHORIZATION & CLOSURE

Signatures: The Issuer and Receiver complete and sign the front of the permit (Section 4) once the Hazard Analysis has been completed and
all specified hazard controls are in place, required gas tests recorded, and supplemental forms attached. Additional signatures are required for
extended permits or when gas tests are at levels indicated in the Gas Test Information Table.

Countersignatures: The Issuer must obtain the approval and signature of other organizations whose operations will be affected by the work.

Renewed Permit: Requires signatures of the Issuer and Receiver coming on shift, and notification to all countersigning organizations.

Extended Permit: Requires signatures of the Division Head (or above) of both the issuing and receiving organizations.

Closed Permit: The Issuer and Receiver must sign the work permit after completion of the work or when the permit duration has expired.

For additional information on the Saudi Aramco Work Permit System, refer to GI 2.100

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