HOT WORK PERMIT
Permit Number
Permit Valid From:
26/11/2022
To: 02/12/2022
1. ACTIVITY:
3. PRECAUTIONS TO BE TAKEN
(Tick box)
DEPARTMENT:
Piping
Before
Starting:
COMPANY:DAESHIN PLANT
AREA:LAYDOWN
LOCATION: HDEC PIPING (AG WORKSHOP).
Toolbox talk to be conducted
TASK DESCRIPTION: Post weld heat treatment for pipes (PWHT).
Work to be provided with safe access and egress
Work area isolation barriers to be in place
EQUIPMENT TO BE USED: Generator, Welding Machine, PWHT Machine, Hand held Lifting equipment certified
induction, Heat Tracing, Temperature gauge.
All lifting devices to be visually examined before use
Discipline
Hoses and electrical extension cables to be protected/secure
Performing Party Issuing Authority
PTW Coordinator
Company/Department
DAESHIN PLANT
HDEC/Piping
Mobile #
07833224838
Signature
Y.H Lee
2. TASK QUESTIONS – Does your work; (tick box)
Generate heat or sparks (grinding, cutting, welding)
HDEC/HSE
YES
Require electrical or combustion engine equipment (ignition sources) within a
SIMOPS or Commissioning area?
Require excavation deeper than 300mm, but less than 1,200mm?
Require excavation deeper than 1,200mm?
Require entry into a space that is not designed for human occupancy and has
restricted access/egress?
Require using radiography equipment (e.g. soil density testing, NDT)
Require energization or de-energization of equipment, systems, or sub-systems?
Require work on electrical equipment, instrumentation, systems or sub-systems?
Require lifting of loads more than 40 t, over or near live lines, during night, by
tandem lift?
Require the removal of gratings or opening of floor decking?
Affected Discipline Managers Consulted
Discipline
Civil
Building Mech.
Piping
Instr.
Sign
Elec.
M.G
C.C.A
C.C.B
HDEC
PIPING
UG
Comm.
LAYDOWN
Others
Sign
Mobile #
2
Day or Shift
Date
Issuing Authority
Performing Party
3
27/11
Date
Site/local traffic to be routed away from the work area
Area to be free of flammable/combustible materials
During Work:
Access to work area to remain restricted
Equipment maintenance checks to be carried out
PPE to be worn at all times
Plant refueling procedure to be followed
Proper rest breaks to be observed
Plant/equipment operators to be certified
After Work:
Check work area to ensure barriers and lights are in place
All equipment to be removed and area made safe
De-watering pumps fueled and in place where needed
4. ACCEPTANCE AND AUTHORIZATION – (This counts as day one of the
permit)
PERFORMING PARTY
I am fully aware of the PTW requirements relevant to the
Name: Y.H Lee
work I am executing and confirm that I will ensure that all
Sign:
relevant safety control measures remain effectively in
Mobile: 07833224838
place throughout the validity of this permit.
ISSUING AUTHORITY
I have physically confirmed that each of the identified
Name:
control measures required by this permit have been put in
place. The performing party is authorized to commence
Sign:
the work under this permit within its validity period.
Mobile :
4
28/11
Date
NO
All equipment to be turned off when work site left unattended
Mobile #
Affected Area Construction Managers Consulted
AREA
YES
5
29/11
Date
6
30/11
Date
7
01/12
Date
Closed
02/12
Date
03/12/2022
Risk Assessment / JSA Form
Hot Work
Activity:
Project / Site location:
Date
Description of Work:
Review Date
20-OCT-2022
After 6 Months
Post weld heat treatment for pipes (PWHT).
Ref No.
Localized Shutdown:
IBRUP-BASRA REFINERY
LAYDOWN – UG WORKSHOP, HDEC PIPING
□ Required
□
Not Required
Piping
Contractor Department
Rev No.
HSE-JSA-2021-
Localized Shutdown:
□ Required
□
0
Not Required
Supervisor
Y.J KIM
07835769787
Supervisor
Lee H.S
07833224838
HSE supervisor
Abdullah
0781 474 2880
DAESHIN PLANT
Subcontractor
IBRU HSE Plan and safety procedures are to be followed at all times.
Minimum PPE to be worn at all times.
General safety condition
requirements:
This JSA to be available at all points of work – operatives must be informed of this JSA and understand the risks involved in the works.
Tool box talk / pre-job brief to be given at the start of each work shift and before starting a new task or activity.
Summer and Ramadan working hour’s changes are to be observed and details posted at worksite.
Paramedical or ambulance facilities to be available.
Minimum PPE required:
Helmet, safety glasses or goggles, Hi-Viz jacket, overalls, gloves, safety shoes
Risk Rating: S = Severity, P = Probability, R = Rating
Impact: P – People,
E – Environment,
A – Asset R - Reputation
Impact
Risk
Activities/Hazards
(consequence)
Preparation for the job
Planning and Obtain
1st Risk
Assessment
P E A R L
C
R
P
B
B4
R
2
Control
Measures
PTW shall be signed by Hyundai prior start of works
Action by
Residual
(Due date)
risk
L
C
R
1
B
B2
HSE & SUP
L
2
C
C6
All Staff
M
is less than adequate
PTW
Plan the work involving personnel responsible for preparation
• Exposed to
potentially infective
respiratory droplets
Coronavirus risks in the work
area
2nd Risk
Assessment
P
E
R
4
D
D16
 Pre-shift Temperature check for all involved workers
 Respiratory/medical masks to be worn constantly during the
transportation from the places of accommodation to workplaces.
• Personnel illness
 Regular disinfection of shared workplaces / Containers / Vehicles.
Delay or shutdown of
 Maintain proper personal hygiene level, wash your hand with soap
operations
or use sanitizer.
 Avoid touching your eyes, nose, and mouth with unwashed hands.
 Do not share personal items like: PPE, mobile phones, drinking
bottles, crockery, etc.
 Shared work tools or equipment shall be regularly disinfected.
 Avoid close contact: like shaking hands, hugging or kissing as a
greeting.
 Avoid unauthorized meetings / gathering of people.
 Full PPE to be worn all time including masks.
 Physical distance to be respected when possible.
 Preventive measure to be discussed at daily TBT.
Work task to be planned and assigned with regards of above
COVID-19 preventive measures.
Mobilization equipment of
workers from camp to
work area.
Embarking and
disembarking of workers
on Buses/vehicles at
relevant designated
working areas
Access and Egress
1. Vehicle traffic accident
2. Injury to Employee.
3. Struck by
A
P
4
D
D16
2
C
C6
Operators & Sup &
Workers
M
2
C
C6
All Staff
M
1
B
• Check all the condition of the driving vehicles
• Slips and trips
P
A
3
C
C9
• Tool Box meeting before start work.
• Personal injury
• Exit route and safe area to be discussed as part of pre task briefing
• Property damage
• Carry out tool box meeting before start work.
• Provide first aid kit and designated first aider on site.
In case of emergency leave worksite and proceed to the nearest muster
point according to the Mustering procedure.
Panic
• Wrong Posture
• Improper Manual
Manual Handling & Using
Hand Tools
• Emphasize the training of competency of operator and vehicle driver
as per the traffic control procedure.
• All the personnel should embark on and disembark from bus in
designated area only.
• Availability of emergency response (Ambulance and Medical
personnel).
• Speed limit to followed 20KM/H
• Traffic System to be followed
Handling
• Pinch Points
• Manpower injury
Back pain
• Heavy load damage to
the material
• Direct injury to the
operators
P
A
3
B
B6
• Avoid manual handling if it can be carried out mechanically.
• Try lifting one corner, if it’s too heavy use second person or other
means (Mechanical) to lift item.
• Use of more than one person to lift longer tubes
• Consider dual lifting (general rule of thumb if above 25 kg).
• Loads that can easily be carried a short distance can often be a
problem when carrying long distances – take this into consideration
when assessing the weight of the load – (Even a load of less than 25
kg can pose a problem if it has to be carried a long distance or up
and down stairs).
• Check the route first before lifting.
• Correct lifting techniques to be used at all times e.g. lifting using
legs with load held close to your body, take a firm grip, maintain
straight back, turn body not twisting upper body and avoid
overreaching.
• All tools provided must be assessed to ensure that they are fit for
purpose; the fit for the environment in which they are to be used and
they are in good condition.
• Visual checks must be completed by operatives on tools prior to their
B2
Forman &
Workers
L
use.
• Tools are required to be suitable for the purpose for which they
will be used
Eye Damage
Hot Work
Cutting, Grinding
Cuts & Burns
Sparks
Hot Slag
Open Flame
Electricity
P
A
3
D
D12
Gas
Hot Surfaces
Hot work
Eye Damage
Welding
Hot Slag
Open Flame
Electricity
Gas
Hot Surfaces
P
A
4
D
D12
good working order prior to use
Contain your sparks as far as possible
Barricade area below when welding overhead
Remove / Protect all combustibles in the vicinity
Always have a fire extinguisher at hand
Inspect all cords and plugs for damage before use
Put all hot off cuts from cutting work out
of harm’s way
During welding operations, proper welding gloves and full-face, UV-ray
protective shield shall be worn to prevent injuries to the operator
All small tools shall be inspected prior to use and found to be in
good working order prior to use
Contain your sparks as far as possible
Barricade area below when welding overhead
Remove / Protect all combustibles in the vicinity
Always have a fire extinguisher at hand
Inspect all cords and plugs for damage before use
Put all hot off cuts from cutting work out
of harm’s way
HSE Site Supervisor
2
D
D8
Workers &
M
Techinichin
HSE Site Supervisor
1
D
D4
Workers & welder
L
- Injury or possible
P
A
4
D
D16 -All equipment must be visually inspected before use for signs of damage to
fatality
cables (worn or frayed), casings, plugs, etc.,
-Electric Shock
-Trip devices (must be tested before use. Never stand on a damp or wet
2
D
D8
Forman &
Worker
M
Operators &
HSE
M
surface when using electrical equipment and keep equipment clean and dry
Operating Portable Electrical
-Trip hazards
tools (chipping & wood
cutter,grinder,drill)
-Appropriate guards / covers must be fitted to avoid contact with moving
parts.
- Wear correct PPE for tool and task
-Injury by contact
- Use tools only on the correct power supply as instructed on the maker’s
label
-Electrical Overload...
- Before using check to see it is properly earthed, unless it is
• Fire/explosion.
an approved type that does not require earthing
• Burns.
-, Generator fitted with overload trip switches.
• Electrocution
• shall wear appropriate PPE – face shield, earmuff, goggles
adequate to their job
Ground condition
Soft soil
Failure of equipment
Hand injury
Collapsing of out Riggers


P
A
3
D
D12 Use of adequate PPE

Lack of competency:
Selection of craftsman to do Personal injury & worker
injury -Equipment damage P
the job
- Damage to the facilities
A
2
C
C6



Mix chemical material

Works too close
to persons
within the same
working area
Heat stroke
serious
suffering from
thirst, inhalation
of sand dust
Machine strikes
another vehicle
or person in the




P
A
4
D
Stacking area should be compacted
Equipment must be checked daily
D16
Designated responsible person shall -Ensure that the personnel
are competent and all work activities is carried out in a safe
manner and any other statutory regulation requirement are
complied with before any work activities commence. -Conduct
Toolbox meeting, -Review the Method statement and Job hazard
analysis to all craftsmen involve in the work activities -Ensure
personnel clearly understand about the specific work activities.
BASRAH UPGRADING
Responsible person will conduct inspection and monitor the work
activities. -Responsible person must ensure safety standard and
work procedure is strictly adhering to. -IITS (Instruction,
Information, Training, Supervision)
Ensure that all equipment is having valid QP certificate to work in
the vicinity.
Make sure all operators know safe limitations of their equipment.
Assigned a competent banksman when equipment is moving at
the working area.
Heat stress management program when working during extreme
high temperature

Follow mid-day break rules

Providing sunshade shelter

Providing enough cold drinking water

Periodic resting system for workers

Applying of rotation of workforce / shift working
2
C
C6
1
C
C3
Operators &
HSE
M
Construction manager
M
- HSE Supervisor
- Site Supervisor
1
D
D4
- Foreman
- Permit H




vicinity
Inhalation of
harmful dust
and fumes and
skin.
Chemical burns
and skin
irritation.
Chemical
spillage to the
ground











Rigging by using chain
block and tackles





Non-Fixed
lifting points.
Cuts, bruises,
trapped
fingers.
Dropping of
loads
Surpass the
SWL.
Raise to the
point of the
hook.
Clutter the
hook and the
fittings.
Allow the load
to swing out of
reach.
Leave
unattended
suspended
loads.
Collapse, fall
the load.
Uncertified
tackles







P
A
R 3 D D12





Ensure strict control measure to separate mechanical plant and
enforce swing radius area as a no go area for any person of
vehicle in order to avoid collision.
Wearing appropriate of dust mask
Paramedical / ambulance support available.
Ensure to wear suitable respiratory protective equipment such as
a P, N, R and N95 respirator when fumes from dust can’t be
avoided.
Remove person to fresh air if discomfort of appropriate PPE
(Safety googles, Safety rubber shoe, Rubber gloves, Dust mask,
etc.)
Immediate removal of chemical spillage from ground if any
Use your experience, knowledge, and training to assess risks and
follow procedures.
Before operating an overhead manual chain hoist, read the
manual and understand how to safely and properly use the
overhead manual chain hoist.
Inspect the overhead manual chain hoist before use.
Do not operate an overhead manual chain hoist that is damaged
or has any actual or suspected malfunction.
Do not attempt to lengthen or repair the lifting chain.
Do not wrap the lifting chain around the load.
Do not use an overhead manual chain hoist to lift or support
people.
Do not operate if the overhead manual chain hoist, its lifting chain,
and its hooks are restricted from forming a straight line from hook
to hook in the direction of loading.
Do not use an overhead manual chain hoist in a way that causes
its hooks to be side loaded.
Do not use the lifting chain, or the hooks, or any other part of the
overhead manual chain hoist as a ground for welding.
Do not allow a welding electrode to be touched to the lifting chain,
or the hooks, or any other part of the overhead manual chain hoist.
Do not remove or obscure any warning labels on the overhead
manual chain hoist.
Do not allow anyone under a suspended load.

Protective gear to be worn at all times, this includes
goggles/glasses, ear defenders, and steel toe capped shoes and
face masks, correct clothing to be worn at all times.

Using certified overhead manual chain hoist and all other
accessories.

Protect accessories when attach with load.
1
C C3
All
workers
L





Burn Pipes (PWHT)


Fire
Explosion.
Presence of
flammable
gas.
Sparks from
faulty
equipment.
Leak of
electric
cables.









P
A
R 3 D D12










Keep flammable materials away from the work area.
Prepare a fire extinguisher.
Fire watch must be kept at the workplace during wok (PWHT) is
performed.
Make sure gas source have been closed.
Put barricade/signage.
Changing the damaged equipment.
Make checks on all used equipment.
Change the damaged electric cable.
Always check the cable before use.
Only competent person are authorized to do the work.
Wear Proper PPE.
Ensure the equipment / tool to be used for Heat Treatment (such
as Heat Tracings, Cables, terminals, switches and panel etc.) are
free from defect and suitable for the temperature ratings of the
system.
Ensure proper insulation of heat tracing coil and terminals.
Keep the area dry ensuring no water spillage.
Do not bring any flammable liquid or gas at the location where
heat treatment is under progress.
Do not touch the pipe segment which is being heat treated.
Do not leave the tool or equipment in energized condition when
the heat treatment is in progress.
Isolate power to the equipment when not in use.
Do not change (exceed / decrease) the Temperature or duration of
heat treatment without permission from Inspection Engineer.
Monitor the temperature in the heat treatment panel.
Do not apply rapid heating or cooling of the pipe segment.
Refer Heat Treatment Procedure or Contact Inspection Engineer
in case of doubt.
2
D
D8
All
workers
L
• Manual handling
Work Completion &
• Incorrect tools
Housekeeping
• Ensure continued housekeeping conducted
P
E
A
R
3
B
B6
1
B
B2
• Use correct and safe tools
• Slip, trip, fall
Prepared by:
Subcon Manager:
Reviewed by:
HSE Manager:
Approved by:
Discipline
Name:
Name:
Manager:
Signature:
Signature:
Name:
Signature:
All staff
L
STARRT Form
(STEP 1) GREETING (Checking In) Hi, how are you, how are you doing?
Tick box once completed
LINK PROGRESS AND QUALITY TO HSSE THROUGHOUT
(STEP 2) TASK PLANNING (THE TASK IDENTIFICATION AND DETAILS)
Work
Post weld heat treatment for pipes (PWHT).
Description
Supervisor
Name &
Contact No
J.B Kim
07833224771
Work Area
Location
Company
DAESHIN
PLANT
Method
Statement/JSA
number
Number of men
in work party
10
Permit to Work
number
Work duration
6:00 am – 5:00 pm
Date
UG WORKSHOP, HDEC PIPING
From
To
26-NOV-2022
02-DEC-2022
(STEP 3) TASK PLANNING (COMPETENT PERSONS, TOOLS AND EQUIPMENT
NECESSARY TO DO THE TASK)
Competent Persons
Tools Required
Equipment Required
Additional PPE
Required
EX: Radios,
Ex: Manlift, compressor,
Required
Ex Equipment operators,
Special testing
crane, forklift, truck etc
Ex: Fire retardant
AMP, VAMP, Vendors etc
meters, electric
coverall, Safety
tools, special tools,
harness, Chemical
SCBA etc
splash goggles etc
Generator
Grinding machine
Face shield
Grinder
Leather gloves
Full PPE
Welding Face shield
Welder
PWHT Machine
Welding machine
Welder Apron
Leather gloves
Mask
Hand tools
(STEP 4) AREA RISK MANAGEMENT (AREA HAZARDS) - LIST ANY NEARBY ACTIVITIES
THAT MAY IMPACT THE WORK, (INCLUD ELEVATED AREAS)
N/A
(STEP 5) RISK IDENTIFICATION AND RISK MANAGEMENT
What is the task?
List task steps
List potential hazards (write
List controls (write words
words or codes from step 6
or codes from step 6
below)
below)
H3,H4,H5,H8,H10,H11,H12,H13,H14,H1 C3,C4,C5,
PWHT Activity
5,H18,H19,H25,H31
C8,C10,C11,C12,C13,C14,C15,C18,
,C19,C25,C31
H3,H4,H5,H8,H10,H11,H12,H13,H15,
C3,C4,C5,C8,C10,C11,C12,C13,C15
Lamination Activity
H17,H18,H23
,C17,C18,C23
H3,H10,H11,H12
C3,C10,C11,C12
House keeping
LINK PROGRESS AND QUALITY TO HSSE THROUGHOUT
1
2
(STEP 6) TASK RISK MANAGEMENT (TASK HAZARD AWARENESS, RECOGNITION AND
CONTROLS)
1
3
HAZARDS OF THE TASK (H)
tick if applicable to task ()
HOW TO CONTROL THE TASK HAZARDS
(C)
Tick if applicable to task ()
100% tie-up. Green tag on scaffold and
lifeline. Awareness of working overhead.
Work at Height training
Green tag on scaffold. Work at Height
training
Good housekeeping. Access free from
obstructions
Tools in good condition. Tool inspected.
Right tool for the job
Electrical tools in good condition.
Inspected and colour coded
Barricade. Colour code on rigging gear.
Qualified rigger in work team
Confined Space Permit. Hole
Watchman. Gas Test
Artificial lighting. High visibility vest
H1
Working at Height
C1
H2
Scaffolding
C2
H3
Slips Trips and Fall Potential
H4
Injury from use of defective or
invalid hand tools
H5
Electricity
H6
Lifting operations
C6
H7
Confined Space
C7
H8
Poor Lighting / Low Visibility
C8
H9
Falling Objects
C9
Hard-hat. Good housekeeping. Tied off
tools. Awareness of overhead work
H10
High Ambient temperature /
Physical conditions
C10
Water available. Heat stroke flag.
Regular breaks. Proper acclimation.
√
C11
Managed work breaks. Look out for your
buddy
C12
Eye protection. Dust masks
√
√
√
√
√
H11 Fatigue / Physical tiredness
H12 Dust
H13 Hot Work / Fire
H14 Grinding
H15 Manual handling of heavy loads
√
√
√
√
√
√
√
√
√
H16 Rotating Equipment
C3
C4
C5
C13
C14
Area free of combustible materials. Fire
watchman. Fire extinguisher / blankets
Correct PPE (Eye protection, face
shields, gloves, other)
C15
Assess manual lift before starting work.
Mechanical lifting
C16
Machinery Guarding.
Lock Out / Tag Out
H17 Hot Surfaces
√
C17
PPE (gloves, coveralls). Guarding.
Barricades and warning sign
H18 Sharp and Jagged Objects
√
C18
PPE (gloves, coveralls).
bar caps in place
H19 Nearby work
√
C19
Foreman to co-ordinate, assess and
communicate to workers
H20 Hydro testing
C20
Barricades. Hydro test Permit.
shields
H21 Pressurized systems
C21
Certified equipment. Barricades.
Warning signs. Awareness
Exposed man-holes & incomplete
structures
Guarding. Re-
Oxygen deficient atmosphere &
inert gases
C26
H27 Radiation and X-Ray emissions
C27
H28 Work near water / drowning
C28
Barricades. Life vests
Working with Chemicals /
Possibility of Fumes/ Spills
Vibrating equipment - impact
hammers and compactors
H23
H24
H25 Noise
H26
C22
√
C23
C24
√
C25
1
4
√
√
√
Face
Hard barricades, signage and covers,
grating removal permit
Safety Data Sheet, Gloves, Coveralls,
Aprons, Chemical Suits, material correctly
Rotate Operators, Metatarsal protection,
Hearing Protection
Hearing Protection. Visible Evacuation
Alarm
Isolations, Confined space permit.
Purging barricades
Barricades, warning signs, NDE permit
H22
√
√
√
√
√
H29 Working inside Client fenced area
H30
Proximity to other commissioning
activities
H33
C30
√
H31 Work in Client area
H32
C29
Work on blinded systems and
pipes
Work in SIMOPS/ Live Line / Red
Blind area
C31
Client training, respect signs and line
labels, when in doubt assume system is
LIVE, use Client PTW.
Supervisor to communicate with his
Front-Line Supervisor (FLS) prior to work
and agree work plan and priorities. Use
MOPA matrix.
Use Client PTW, Read Tags, do not alter
Tags. Respect barricades.
C32
Spade removal certificate plus Client
PTW to be used.
C33
SIMOPS PTW to be used
H34
Work on or near (With potential of
contact with) live electric systems
C34
AEP to be present on site. Client PTW.
CEP’s to perform the task. Risk
Assessment to be conducted.
H35
Work on or near live steam
systems
C35
RA to be conducted. Where practicable
LOTO applied and Client PTW
√
(STEP 6) TASK RISK MANAGEMENT (TASK HAZARD AWARENESS, RECOGNITION AND
CONTROLS)
HAZARDS OF THE TASK (H) tick if
HOW TO CONTROL THE TASK HAZARDS (C)
applicable to task ()
Tick if applicable to task ()
H36
Work on or near live gas systems
C36
RA to be conducted. Where practicable
LOTO applied and Client PTW
H37
Work on or near live Nitrogen
system
C37
RA to be conducted. Where practicable
LOTO applied and Client PTW
H38
Work on or near live compressed
air system
C38
RA to be conducted. Where practicable
LOTO applied and Client PTW
H39
Work on or near live hydraulic
system
C39
RA to be conducted. Where practicable
LOTO applied and Client PTW
C40
SDS available and briefed to workers.
secondary containment arranged. spill kit
and training. PPE including chemical suit
if needed (Tyvek Tychem coveralls)
C41
Only intrinsically safe radios
C42
Communication (Inform to another team)
H40
Potential loss of containment
H41
Hazardous Area Communication
H42
Work in Close/ Proximity to others
√
1
5
√
(STEP 7) UNPLANNED EVENTS (If any of the following occurs, stop work and talk to your
supervisor)
Nearby work
Chemical
Excessive
Fires and
Unusual odors Heat stress
hazards
spills or
noise
explosions
releases
Evacuation
Extreme
Significant
Change in the following work conditions:
alarm
weather / high near miss
winds
LINK PROGRESS & QUALITY TO HSSE THROUGHOUT
Step (8) INCIDENT (EMERGENCY) PLAN AND ACTIONS Project Emergency
Number……………….
Emergency telephone number HDEC:
07716220428-07803857788
Nearest Muster point/safety shelter location
Alarm code(for communication period)
Evacuation Route(supervisor to explain to works)
Safety shower/eye washer location
Nearest first aid station location:
STEP (9) STEP BACK 5 X 5 (ADD FEEDBACK RECEIVED FROM CREWS
Project Emergency Number
1
6
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
1
7
Time
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
1
8
Time
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
1
9
Time
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
2
0
Time
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
2
1
Time
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
2
2
Time
Location:
TBT
Date:
I acknowledge receiving and understanding these instructions. I will fully comply with the assigned task
requirements.
Name
Position
Badge No.
Sign
Name
1.
14.
2.
15.
3.
16.
4.
17.
5.
18.
6.
19.
7.
20.
8.
21.
9.
22.
10.
23.
11.
24.
12.
25.
13.
26.
Position
Badge
No
Sign
I have Briefed my Workers on the Safety Requirements of this Task
Supervisor:
Signature:
Time:
:
(AM / PM)
FIELD AUDIT OF THE STARRT BY MANAGERS/SUPERVISORS
Name
Signature
Contractor
EPCC Contractor
2
3
Time