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Form Nr: : SAF I IRF # 03
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FEHSE
ffisuorfirffi*rBelati*ns #lcsure Forr*
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Sat* Prepared : 29 I CI$ / SB
R*vision: CIZ {13 /i2l ?01Si
f,eedhaak $uhmlesi*n
th* relevant paraett*t*n:
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FIease spee ify (lf Otne r):
Target ilate
301c0/2il23
Reasons fsr sendlng the rep*rt late
iif
appEieablc)
*etails it a*y
{e.g. ffi"Report #, eta}
F!**t/$eetior':lArea
Amnionia
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NAST
083
AS Per NFPA-25 Testing regime of Deluge System to be Done on annually
ffiee*rs:mendati*rr
a. Operational Test
b. Maintenance
c. lnspection regime
Aetici'l s taken agai *ist rec*r'E*1*ndaticn
Testing regime has been established and Maintenance Instruction MNT-WI ll\liS-03$
(Procedure far Maintenance of Fire Hydrants, Fii'e Monitors and Deluge Systems) has been
rnade and maintenance frequency has been defined as bi-annuai complying with the frequency
a$ per recommendation. Action ta be considerecj as clcsed.
Status of Aetion ltcms
lf Nat
Not Completed
Cornpleted
completed, Revised Completion Date
tr
Being Responsible, I here by witness by signing thedocumentthat I have completed the marked responsibility.
CIv
Resp. Fcrson {Name / Desig}
t&
ffieing *onecrned, I hefe by urltness by signing the d
ae
krecwie#ge that aat!<*n status is eor"r:ptrete.
Aeknowledge ffiy {Name I Dcsig}
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{Name I Desig}
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L-eg*r'reis:
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IRR
IRRE
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fxecutive Health, $afety & f nvironment
Quarterly Emerg*ncy Driti
rlriA
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Process i-{azard Anaiysis
Flre-$tartup Safety Fi*view
lncideni Report Recommendaiion
Dqnf,
T VIET
Pr"occss Safety lilanag*meni
lncideni Repor"i Rectification Committee
DSe
Departmeni Safety C*mr:itl*e