... Think safety!
Working with
Work permits
HSE in general
Environment
Health
Safety
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Working with
Work permits
Gasunie is one of the biggest gas infrastructure
companies in Europe. Within the company, we give
safety the highest priority; it forms the basis of our
license to operate. We abide by the strictest safety,
health and environmental standards, both for our
own employees and for our external contractors.
Gasunie’s safety policy is thus characterised by a
proactive approach which is designed to prevent
accidents, incidents and hazardous situations.
Gasunie uses work permits to perform work. These
permits contain the agreements that have been
concluded about how the work is to be carried out.
It is in everyone’s interests that all those involved
understand and comply with these agreements.
Remain alert at all times when you are working.
If in any doubt, always ask or suspend activities
where necessary.
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... Think safety!
WORK PERMITS
What is the purpose of work permits?
The purpose of the work permit is to ensure safe
working and hence prevent incidents, accidents and
hazardous situations by:
 promoting communication between parties
 identifying hazards and risks
 identifying precautionary measures
 recording the agreements made
How long does a written work permit last?
 A work permit is valid for one day and can be
extended up to 7 times.
Who is involved in a written work permit?
Applicant:
The person who applies to the operational department in respect of the work, for or on behalf of the
contractor. This is often the contractor’s work preparation officer or the construction supervisor acting
for the contractor(s).
Operational manager:
The direct (delegated) manager of the work
permit issuer.
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Working with
Work permits
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... Think safety!
Co-signatory:
The person who is partly responsible for deciding
that the work can be safely carried out. The co-signatory can if necessary also be the work supervisor.
Work permit drafter:
The person who carries out the preparatory
operational measures on behalf of the license issuer.
Work permit issuer:
The person in the operational department who is
authorised to issue work permits. The issuer can
where necessary also be the work supervisor.
Work permit holder:
The person who is responsible for supervising the
implementation of the work in accordance with the
agreements laid down in the work permit.
Work supervisor:
The person who ensures that the agreements
concluded between the contractor and the principal
are carried out. The work supervisor can extend a
work permit and if necessary issue it on site.
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Working with
Work permits
Minimum requirements
Applicant / Issuer / Co-signatory / Work supervisor /
Operational manager
VCA - VOL certificate
valid for 10 years
Training (Gasunie) Deltalinqs valid for 2 years
work permit
Holder
VCA – basic
valid for 10 years
preferably Training (Gasunie)
valid for 2 years
Deltalinqs work permit
Must have command of Dutch
and the language of the
contract workforce

At least two persons (roles) must be attached to
the work permit.
A work permit issuer can also be a work supervisor;
a work permit holder can also be the applicant.
When is a written work permit required?
The Gasunie work permit system applies to work at
Gasunie locations undertaken by persons who are
not part of the company’s own management organisation, for example during:
 non-operational work such as
- maintenance to installations
- repairs to installations
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 joint work by different disciplines, such as
- where work by one team could affect that
of another
- (too) many activities are taking place at the
same time in the same location
 high risk activities, such as
- work in confined spaces
- fire, explosion, electrocution, asphyxiation,
trapping and/or danger of falling
- risk of contact with hazardous substances
- lifting/hoisting activities near installation
components which are in operation or under
pressure
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Working with
Work permits
Elements of the written work permit
Column 1
Column 2
Work application
Measures taken by department
issuing the work permit
Werkvergunning
Aanvraag werkzaamheden
Maatregelen te nemen door verstrekkende afdeling
Maatregelen te nemen door de houder
B
(In te vullen door de aanvrager)
(In te vullen door verstrekker/vergunningvoorbereider)
(In te vullen door aanvrager)
Locatie / equipment nr.:......................................................................
Welk product bevat of heeft de apparatuur /leiding bevat?
Nodig
R
R
P
D
.........................................................
Afdeling / Firma:................................................................................
Werkordernummer:............................................................................
Te nemen voorzorgsmaatregelen:
putten, goten en/of riolen afdekken binnen
Invloed van naburige werkzaamheden:
meter
vonkafscherming plaatsen
“
A
...........................................................................................................................................
werkplek afzetten (zacht)
Nodig
Te nemen maatregelen
werkplek afzetten (hard) (t.w.........................................)
labelen
mangatwacht/brandwacht inzetten
T
D
systeem spoelen
communicatiemiddel (t.w.............................................)
T
systeem purgen
brandwaterslang gereed met straalpijp
O
systeem inertiseren
poederblussers (t.w.......................................................) N
overige brandblusmiddelen (t.w.....................................) D
Gereed
Omschrijving van het werk:
systeem controleren op LSA
geel/zwart
rood/wit
systeem airmoven
werkplek en/of werkstuk nat houden
V
systeem inblokken
werkplek beveiligen tegen valgevaar
(bloklijstnr./schakelplan:..................................)
(t.w.............................................................................)
M
N
systeem afsteken
geforceerde ventilatie
D
systeem afkoppelen
.................................................................................... N
.................................................................................... D
systeem drukvrij maken
systeem produktvrij maken
Werkwijze:
N
omgeving controleren op toxische stoffen
V
monteren demonteren
hakken/boren
ruimzicht/zuurbril
V
N
openen installaties
slijpen
omgeving controleren op brandbaar materiaal
gelaatsscherm
D
betreden besloten ruimte
hogedruk spuiten
apparatuur elektrisch blokkeren (bloklijstnr.:......................)
gehoorbescherming
H
branden/gutsen/lassen
vacuüm cleaning
apparatuur elektrisch vrijschakelen
valbeveiliging
z
röntgen/stralingswerk
gritstralen
(schakelbriefnr.:...............................................................)
hand / arm bescherming (t.w.........................................) A
en/of agressieve stoffen
Nodig
Aanvullende persoonlijke beschermingsmiddelen
hijsen
graven handmatig
apparatuur mechanisch blokkeren (bloklijstnr.:...................)
instrumentatie/elektrisch
graven machinaal
besloten ruimte conditierapport (nr.:.................................)
beschermende kleding (t.w............................................) V
N
vluchtmasker binnen handbereik
aanboren
graven zuigen
milieubeschermende maatregelen
persoonlijke gasalarmering (t.w.....................................) D
stoppelen
..........................
(t.w.................................................................................)
gebruik van adembescherming
verzamelplaats:.................................................................
A
filtermasker (t.w..............................................) v
Toegepaste gereedschappen:
verse luchtkap
H
N
persluchtmasker
Speciale operationele aandachtspunten:
.................................................................................... D
.................................................................................... H
N
D
Extra eisen (In te vullen door verstrekker):
D
Toegepaste voertuigen / equipment:
V
D
Mogelijke risico’s:
Planning:
Gepland aantal uitvoerenden :........................personen
Gasmetingen
Geplande begindatum
: __ /__ / 20__
Nodig Continu Datum
Geplande einddatum
: __ /__ / 20__
Werktijd
: van..................tot.........
meting
__/__/20__ __/__/20__ __/__/ 20__
Tijd
__/__/20__
__/__/20__
__/__/20__
__/__/20__
A
Zuurstof
(% O2)
Explosiviteit
(% LEL)
Toxische stoffen
Bijzondere werkzaamheden:
Besloten ruimte
: geen beperkingen
Meetwaarde (ppm/mg/m3)
Besloten ruimte
: beperkingen
Stof:
H
M
V
MAC/grenswaarde:
V
Paraaf:
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... Think safety!
Column 3
Column 4
Measures to be taken by
Confirmation
the work permit holder
NR.
Maatregelen te nemen door de houder
Bekrachtiging
(In te vullen door aanvrager)
Risico categorie:
hoog
laag
Risico analyse(TRA) nr.:..................................................................................
Procedure nr(‘s).:............................................................................................
De kolommen “Aanvraag werkzaamheden” en
Nodig
Te nemen voorzorgsmaatregelen:
putten, goten en/of riolen afdekken binnen
“Maatregelen te nemen door de houder” zijn juist ingevuld:
meter
vonkafscherming plaatsen
werkplek afzetten (zacht)
Aanvrager
geel/zwart
rood/wit
Naam:............................................. Firma:...................................................
werkplek afzetten (hard) (t.w.........................................)
mangatwacht/brandwacht inzetten
Telefoon :.........................................
Datum: __ /__ / 20__
Handtekening:......................................
communicatiemiddel (t.w.............................................)
Toestemming bijzondere werkzaamheden:
brandwaterslang gereed met straalpijp
n.v.t.
poederblussers (t.w.......................................................)
Operationeel beheerder
Naam:............................................. Afdeling:...............................................
overige brandblusmiddelen (t.w.....................................)
Datum: __ /__ / 20__
werkplek en/of werkstuk nat houden
Vergunning mede beoordeeld:
werkplek beveiligen tegen valgevaar
Mede ondertekenaar(s)
Naam:............................................. Afdeling:...............................................
(t.w.............................................................................)
Handtekening:......................................
n.v.t.
geforceerde ventilatie
Datum: __ /__ / 20__
....................................................................................
Naam:............................................. Afdeling:...............................................
Handtekening:......................................
Datum: __ /__ / 20__
....................................................................................
Handtekening:......................................
Vergunning is voorbereid:
Nodig
Aanvullende persoonlijke beschermingsmiddelen
n.v.t.
ruimzicht/zuurbril
Vergunningvoorbereider
Naam:.............................................
gelaatsscherm
Datum: __ /__ / 20__
Handtekening:......................................
Het werk kan veilig uitgevoerd worden en de beheersmaatregelen
gehoorbescherming
zijn doorgesproken met de vergunninghouder:
valbeveiliging
hand / arm bescherming (t.w.........................................)
Afsluiting vindt gezamenlijk plaats:
beschermende kleding (t.w............................................)
vluchtmasker binnen handbereik
Verstrekker
Naam:............................................. Telefoonnummer....................................
persoonlijke gasalarmering (t.w.....................................)
Datum: __ /__ / 20__
gebruik van adembescherming
A
Ja
Nee
Handtekening:......................................
Akkoord met opgelegde eisen en draagt zorg voor uitvoering
filtermasker (t.w..............................................)
volgens vergunningvoorwaarden:
verse luchtkap
Houder
Telefoonnummer....................................
Naam:............................................. Firma:...................................................
persluchtmasker
....................................................................................
Datum: __ /__ / 20__
....................................................................................
Houder na overdracht
Telefoonnummer....................................
Naam:............................................. Firma:...................................................
Handtekening:......................................
Datum: __ /__ / 20__
Extra eisen (In te vullen door verstrekker):
Handtekening:......................................
Dagelijkse vrijgave op de werkplek
Vrijgave geldig:
Datum
max. 1 week
Naam verstrekker
Paraaf
max.
uur
Naam houder
niet verlengen
Paraaf
Aantal Uitvoerenden
Afsluiten
Houder: de werkplek is opgeruimd en veilig achtergelaten
Naam:............................................. Handtekening:......................................
Mede ondertekenaar(s): gecontroleerd/specifieke maatregelen
veiligstellingen / overbruggingen ingetrokken
Naam:............................................. Handtekening:......................................
Vrijgever: maatregelen opgeheven en omgeving normaal
Naam:............................................. Handtekening:......................................
Verstrekker: Follow up en administratie
Naam:............................................. Handtekening:......................................
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Working with
Work permits
Task risk analysis
If an activity and its associated risks are not transparent or manageable enough (no procedures or
specific work instructions available) or if a risk inventory checklist (RBH) identifies them as high risk
activities, a task risk analysis must be carried out in
addition to the work permit. The work permit is then
classified as a “high risk work permit”.
Two types of risk can be identified:
 risks arising from the work which could affect the
process. The TRA is then compiled by the applicant
 risks arising from the process which could affect
the work. The TRA is then compiled/supplemented by the work permit issuer
Applicant– tasks and responsibilities
 Gives an accurate and clear description of the
work involved
 Indicates appropriate measures for the safe exe-
cution of the work, if necessary in consultation
with the work permit holder
 Determines the category of risk involved and en-
sures a task risk analysis, together with the work
permit issuer
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Operational manager – tasks and responsibilities
 Assesses the work permit (with others), based
on the proposed management measures if work
is proposed which might involve a high risk to
people, installations and/or the environment.
Co-signatory – tasks and responsibilities
 Confirms (with others) the work permit and
approves the securing of equipment and/or process
systems which fall under his responsibility (high
voltage installation, shared utilities, etc.)
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Working with
Work permits
License drafter – tasks and responsibilities
 Implements the appropriate operational
measures at the request of the work permit issuer.
 Implements the necessary gas and oxygen
measurements just before the start of the work
and signs them off on the work permit.
Work permit issuer – tasks and responsibilities
 Assesses the activities requested, proposed
measures that the holder must take and any
associated task risk analysis
 If necessary, compiles a supplementary task risk
analysis, together with the applicant and/or
work permit holder
 Confirms any extra requirements
 Determines the operational measures that must
be taken by the department to create a safe
workplace
 Decides whether gas measurements are needed
 Discusses the content of the work permit
 Issues product information (MSDS pages),
where necessary
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Work permit holder – tasks and responsibilities
 Familiarises self with the work permit, any task
risk analyses and agrees to the precautionary
measures required
 Discusses the permits with the contract team
 Puts in place the appropriate precautionary mea-
sures and checks them
 Implements the work and supervises its correct
implementation in accordance with the work
permit
 In the event of departures from the work
(work plan, alarm, doubts, incidents, accidents
or hazardous situation), stops the work and
contacts the work supervisor
 Signs off the work with the issuer of the
work permit
Work supervisor – tasks and responsibilities
 Acts as the point of contact for the issuer in the
event of work being carried out by a contractor
 Ensures good communication between the
contractor and the work permit issuer
 Ensures that the agreements concluded between
the contractor and the work permit issuer are
complied with
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Working with
Work permits
It is vital that the holder of the work permit and the
contractors implementing the work understand
how to execute the work safely. You should therefore
adopt a critical attitude towards the issuer and the
co-signatory of the work permit. This is in the interests of everyone’s safety.
Work safely or not at all!
Completing the work permit
 Write clearly and make sure everyone can read it
 Use as few abbreviations as possible
 (Unauthorised) amendments and changes made
subsequently will invalidate the work permit
 The original is intended for the holder
 The work permit must be kept at the workplace
unless otherwise agreed
 The copy is intended for the issuer
 There is important information on the reverse of
the work permit
If you have any questions or need more information,
please contact the issuer of the work permit.
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Working with
Work permits
Published by:
N.V. Nederlandse Gasunie
HSE Department
P.O. Box 19
9700 MA Groningen
gasunieveiligheid@gasunie.nl
© April 2012
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