Oxygen………..……………………% vol (21%), Time : –
Hydrocarbon………………………%LFL (less than 1%),
Toxic Gases(CO/H2S/Benzene)……..………………….ppm(less than 50 % TLV-TWA of the specific gas)
3* Have arrangements been made to repeat atmosphere testing of the space during occupancy and during breaks? 4* Are access and illumination adequate? 5* Have arrangements been made to continue ventilation of the space during occupancy and during breaks? 6* Is rescue and resuscitation equipment available for immediate use by the entrance to the space? 7* Has an attendant been designated to be in constant attendance at the entrance to the space ? 8* Has the Officer of the Watch (Bridge, ECR, CCR) been advised of the planned entry? 9* Has a system of communication between all parties been tested and emergency signals agreed? 10* Is a record maintained for the personnel entering/exiting the space? 11* Are Lock Out tags/notices in place where applicable? 12* Are Plant isolation referred to where applicable? 13* Are portable lights and other equipment available and an approved /certified type? 14* Are personnel entering the space equipped with personal monitors? ADDITIONAL CHECKS TO BE CONDUCTED FOR SPACES/TANKS OTHER THAN PUMPROOM 1. Has the space been cleaned, where necessary? 2 Has the space been tested at different levels and locations, using portable monitors? 3 Has the space been positively segregated by blanking off or isolating all connecting pipelines or valves and electrical power/equipment ?
Section 2 – PRE-ENTRY CHECKS
To be recorded by the person authorized as LEADER of team entering the space YES N/A 1. I have checked Section 1 of this permit and confirm it has been completed fully? 2. I am aware that the space must be vacated immediately in the event of ventilation failure or if atmosphere tests change from agreed safe criteria? 3. I have agreed upon the procedure for communication? 4. I have agreed upon a reporting interval of ……………..minutes 5. I have agreed and understood the emergency and evacuation procedures 6. I understand the work to be carried out. We have discussed and agreed the safety measures and I’m satisfied it is safe to commence work Name/Rank /Signature of team leader entering space SECTION 3 : AUTHORISATION I am satisfied that all appropriate safety measures are in place and that the work can be conducted safely. Chief Officer Work Authorised By: Master / Chief Engineer SECTION 4 : PERMIT CLOSURE/CANCELLATION Equipment /system has been de-isolated and returned to the “in-service condition” All notices and tags removed The work area and equipment is in a safe condition Work Completed Permit is time Expired Work suspended Permit Closed By:
