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    SICIM Form # JAPL BLUE-Cold Work Permit Rev. 01

    Uploaded by

    Farrukh Ijaz
    This 3 sentence summary provides the key details from the work permit document: The document is a work permit for relocating the Jazan-Abha Refined Products Pipeline for SICIM Saudi Arabia. It outlines the work location, description, equipment to be used, potential hazards, and safety requirements that must be met before work can begin. The permit requires sign off from both the permit receiver and issuer once the work is authorized and closed to confirm the site has been returned to a safe condition.

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    SICIM Form # JAPL BLUE-Cold Work Permit Rev. 01

    Uploaded by

    Farrukh Ijaz
    68 views2 pages
    This 3 sentence summary provides the key details from the work permit document: The document is a work permit for relocating the Jazan-Abha Refined Products Pipeline for SICIM Saudi Arabia. It outlines the work location, description, equipment to be used, potential hazards, and safety requirements that must be met before work can begin. The permit requires sign off from both the permit receiver and issuer once the work is authorized and closed to confirm the site has been returned to a safe condition.

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    This 3 sentence summary provides the key details from the work permit document: The document is a work permit for relocating the Jazan-Abha Refined Products Pipeline for SICIM Saudi Arabia. It outlines the work location, description, equipment to be used, potential hazards, and safety requirements that must be met before work can begin. The permit requires sign off from both the permit receiver and issuer once the work is authorized and closed to confirm the site has been returned to a safe condition.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    68 views2 pages

    SICIM Form # JAPL BLUE-Cold Work Permit Rev. 01

    Uploaded by

    Farrukh Ijaz
    This 3 sentence summary provides the key details from the work permit document: The document is a work permit for relocating the Jazan-Abha Refined Products Pipeline for SICIM Saudi Arabia. It outlines the work location, description, equipment to be used, potential hazards, and safety requirements that must be met before work can begin. The permit requires sign off from both the permit receiver and issuer once the work is authorized and closed to confirm the site has been returned to a safe condition.

    Copyright:

    © All Rights Reserved
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    BI# 10-00875

    Relocate Jazan-Abha Refined Products Pipeline SICIM SAUDI ARABIA


    Contract # 6600045122
    COLD WORK
    WORK PERMIT NO #
    PERMIT

    Month Day Year Duration


    Section-1 – Work Description

    Identify Plant/Facility (where work will be carried out)

    Exact work location

    Work Description

    Equipment to be used at site

    STOP WORK if job site does not meet work permit conditions or any applicable Saudi Aramco Safety & Health requirements at any time

    Section 2 – Hazard Identification and Control


    A. Identify and attach any supplementary forms required to perform/control the work
     Method Statement  Critical Lift Plan  Pre-Excavation Checklist  Excavation Checklist  Job Safety Analysis
    B. Energy Types
     Electrical  Mechanical  Hydraulic/Pneumatic  Hydrocarbons  Others
    C. Potential Exposures
     High Noise  Temperature  Hydrogen Sulfide(H2S)  High Wind  Hazardous Material
     Radioactive Material  Flammable Liquids/gasses  Others
    D. Protective Equipment
     FRC  Fall Protection  Personal H2S Monitor  Goggles/Face shield  Hard Hat 
    Clothing
     Safety Shoes  Barricades  Respiratory Protection  Warning Signage’s  
     Standby Man  Firewatcher  Flagman  Confined Space Entry Supervisor
    Badge# Badge# Badge# Badge#
    E. List any additional safety requirements

    IN CASE OF EMERGENCY :

    Section 3 – HAZARD ANALYSIS CHECKLIST


    N/
    Y N Y N N/A
    A
    Is the correct type of permit issued for the work    Are slip trip and fall hazards controlled   
    Are weather conditions( wind speed , temperature) Have all the requirements of work at height
         
    acceptable to perform the work been applied
    Does the crew know what to do in case of emergency    Are all ignition sources eliminated or controlled   
    Does personnel have proper certifications to perform Is the scaffold tag completed correctly, signed
         
    activity/equipment/device and with a valid inspection date
    Is the equipment’s inspection sticker valid    Is the correct PPE available for the personnel   
    Does the work crew have the correct tools/equipment Does the fire watch have firefighting equipment
         
    for the job? are they in good condition available and know how to use the equipment

    Section 4 – Gas Testing/Monitoring


    LEL (%) H2S (ppm) O2 (%) GAS TESTER NAME CERTIFICATE No. SIGNATURE
    Initial Test

    Additional

    Section 5 – Permit Authorization & Closure


    PERMIT RECEIVER PERMIT ISSUER
    CERTIFICATE CERTIFICATE
    PERMIT BADGE No. SIGNATURE BADGE No. SIGNATURE
    No. No.
    OPEN
    HSE AUTHORIZATION & Name Signature Work shall not start without HSE authorization, Permit
    VERIFICATION shall be considered void without approval of HSE Dept.
    I have inspected the work site and confirm that it
    This permit has closed Date Time
    has been returned to a safe condition
    CLOSED

    JAPL-F-CWP-001 (Rev. 01)

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