HSE Department Réf:

PERMIT TO WORK PROCEDURE Date: 11/12

Rev: 01
1 / 24

Revision history

Rev Date Description of Change

Approval Authority:

Owner Developer Reviewer Approver

Summary

The Permit to Work system is used to control and manage specific hazards during the
course of the work. The purpose of such a system is to achieve a safe working
environment by providing management control over the various activities that may
have potential for hazard. The Permit To Work system requires the involvement of
competent and responsible persons as well as the application of safety measures in a
controlled sequence.

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 HSE Department Réf:

PERMIT TO WORK PROCEDURE Date: 11/12

Rev: 01
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1.0 PURPOSE

The Permit to Work (PTW) system is used to control and manage specific
hazards during the course of the work. The purpose of such a system is to
achieve a safe working environment by providing management control over
the various activities that may have potential for hazard.

The PTW system requires the involvement of competent and responsible

persons as well as the application of safety measures in a controlled
sequence. The Permit to Work System ensures that the responsibility and
accountability for safe working practice is passed in a logical sequence to
those responsible for the work being carried out and ensures that adequate
safeguards are provided.

The PTW System is used to minimize the risk of harm to people, environment
and assets. The permit identifies all hazards and safeguards to be in-place
prior to work commencing to manage the hazards. Training on the Permit to
Work System will be provided to all personnel as part of their HSE induction.

2.0 SCOPE OF WORK

The provisions of this document are applicable to all hazardous activities

associated with the Project scope of work and apply to all Project employees
and subcontractors.

3.0 INSTRUCTIONS

A Project specific Permit to Work shall be developed in accordance with client

requirements and site specific hazardous conditions. The Permit to Work,
shall address as a minimum all the requirements specified for PTW.

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PERMIT TO WORK PROCEDURE Date: 11/12

Rev: 01
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APPENDIX I - 1 PURPOSE
The Permit to Work system is used to communicate and record specific
hazards during the course of the work as identified in pre-task risk
assessments. PTW is used to document the risk assessment and
management process. The purpose of such a system is to achieve a safe
working environment by providing management control over the various
activities that may have potential for hazard.

The PTW system requires the involvement of competent and responsible

persons as well as the application of safety measures in a controlled
sequence. The Permit to Work System ensures that the responsibility and
accountability for safe working practice is passed in a logical sequence to
those responsible for the work being carried out and ensures that
adequate safeguards are provided. It also ensures that personnel carrying
out the work are informed of the potential hazards.

The PTW System is used to demonstrate that risk to people; environment

and assets have been minimized. The permit identifies all hazards and the
safeguards to be in-place prior to work commencing and implemented
during the work to manage the hazards. Training on the Permit to Work
System will be provided to all personnel as part of their HSE induction.
Specific Permit to Work training will be provided to Supervisors.

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PERMIT TO WORK PROCEDURE Date: 11/12

Rev: 01
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APPENDIX I - 2 DEFINITIONS

Method A written description detailing how the work / activity /

Statement task is to be carried out.
Confined Anywhere there is a possibility of inadequate ventilation
Space Entry to dispel injurious or flammable fumes, vapor or gas or to
provide sufficient oxygen. Also includes areas where
access / egress is restricted, along with excavations
deeper than 1.2 meters.
Hazard The potential to cause harm to people, the environment,
or to material assets or a combination of these.
Hazardous The potential effects in the event that a hazard is realized.
Consequence
Likelihood The probability of occurrence of an event.
Permit An authorizing document approved by a competent
person, specifying the required precautions and
conditions under which potentially hazardous or
interacting activities can take place and the allowed
duration of the activity.
Permit A register maintained in a central location identifying the
Register: status of all permits.
Risk A combination of the likelihood of a hazardous event
occurring and the severity of the possible consequences
of that hazardous event. Risk is also the exposure to
something with the potential to cause harm.
Risk The means by which potential hazards are assessed and
Assessment the risks evaluated.
Safeguards Measures taken to reduce either the likelihood or
consequences, or both of a particular risk.
Performing An individual who has been assigned responsibility of the
Authority work
(PA) to be performed. He is the foreman / supervisor who will
oversee the work being carried out. He is responsible for
raising / preparing the permit.
Area The Project Site Representative / Construction Manager /
Authority Superintendent who is responsible at the area where the
(AA) work is to be performed. The area authority gives
approval for the work to go ahead.
PTW Co- The PTW Co-coordinator maintains a list of all live permits,
coordinator co-ordinates and maintains the file of all closed permits
for a minimum of 1 year.

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APPENDIX I - 3 FUNCTION OF WORK PERMIT SYSTEM

Appendix I - 3.1 Intent

The work permit system authorizes specific construction, maintenance,

inspection or repair activities to be conducted in the work areas. The
system is intended to be applied to those jobs identified by a task specific
risk assessment which represent a potential hazard to personnel,
operations and/or daily activities.

Appendix I - 3.2 Work Permit Forms

Work permit forms must be issued as appropriate for specific work at a

specific site. The different work permit forms are for all types of work in all
areas. A copy of the Permit to Work and all supporting documentation
shall be displayed at the worksite. Work must be identified as one or
combination of the following and the proper permits issued:

Appendix I - 3.3 General Work Permit

Covers all aspects of work such as excavating, trenching, equipment

movement, pipe movement, welding, burning, grinding etc:, in areas
where there is no potential for a hazardous, flammable or combustible
atmosphere.

Example: Work with hand tools, portable electric tools, welding (in area
where no potential for hazardous atmosphere), excavating;
trenching, painting, working at height etc.

Appendix I - 3.4 Line Break/Hydro-Test Permit

The actual or possible release of liquids or injurious materials that could

create a hazard will require the use of the Line Break/Hydro Test permit
form. A Line Break/Hydro Test permit is intended to ensure that if there is
a potential for a release of pressure or injurious liquid, then the
appropriate precautions have been addressed.

 Line Break/Hydro Test procedures will include ensuring all points where
the possibility of pressure or liquids could be released are to be
barricaded with appropriate warning tape or guarded, so that no un-
authorized personnel could enter these areas. Pressure shall be vented
through a properly designed valve venting arrangement (High point
vents and/or low point drains). Breaking of lines is unacceptable.
Isolation and pressure reduction to zero shall be confirmed prior to
breaking containment. In the event that a high point vent / low point
drains are not available, the HSSE Department shall be contacted.

 All areas where the actual release of hydrostatic pressure or liquids are
to be released shall be barricaded with appropriate warning tape, to
ensure that un-authorized personnel are aware of a hazardous working
area and should not enter. Appropriate containment shall be in place

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for the recycling of hydro test liquids to ensure no contamination of

surrounding environment.

Example: Opening a line, draining a vessel, and hydro-testing (note: a hot

or cold work permit may also be required.

Appendix I - 3.5 Hot Work Permit

Any work that develops sparks, flames or heat sufficient to cause ignition
shall be done under control of a hot work permit. This will apply to the use
of spark or flame producing tools and equipment, including the use of
portable electric and pneumatic tools in an area where the potential for a
hazardous atmosphere exist or could exist or where flammable or
combustible material is stored or used.

 In all areas where the potential for a hazardous, flammable or

combustible atmosphere or flammable or combustible materials are
stored or used, a Hot Work Permit will be issued.

 Areas where hydrocarbons are introduced will be demarcated as a Hot

Work Permitted Area.

Example: Welding, burning, grinding, grit blasting, in areas where there is

a potential for a hazardous atmosphere to exist.

Appendix I - 3.6 Confined Space Entry Permit

The entry of personnel into any space or structure (tank, vessel, vault,
excavation when 1.2 meters or deeper, etc.) not normally intended for
human occupancy, in which entry, movement within or exit is restricted.

Example: Tank cleaning, tank inspection, or work in sewer or trenches 1.2

meters or deeper.

(Note: in most cases a hot or cold work permit is also required).

Appendix I - 3.7 Hazardous Energy Control Permit

This permit will be used for all work that requires Electrical De-energising,
Blind Flange, Slip Blind, Disconnected Line, Isolation Spool, Double Valve &
Vent, Open Flange, and Instrument Disconnect to control the hazardous
energy.

Opening: Exposing the interior of any processing equipment (including

piping and sewers) to the atmosphere. This includes removing covers,
breaking flanges, etc.

Blinding: Installation of blinds into piping or blind flanges onto equipment

to isolate or close mechanical work.

Lockout/Tag-out: The placement of a Lockout / Tag-out device on an

energy isolating device, to prevent the energy isolating device and the

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equipment being controlled from being operated until the Lockout / Tag-
out is removed.

Appendix I - 3.8 Radiography Permit

Activities involving all types of industrial radiography, both gamma and x-

ray shall only be performed by licensed, trained radiographers and
assistant radiographers.

In addition to Permit, work shall not proceed without detailed approved

operating instructions and emergency procedures.

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PERMIT TO WORK PROCEDURE Date: 11/12

Rev: 01
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APPENDIX I - 4 THE PERMIT TO WORK PROCESS

The sequence of compiling a typical Permit to Work form is summarised in
Table 4.1. Table 4.1 lists the means by which a Permit shall be raised by
the Performing Authority and reviewed and approved by the Area
Authority.

Table 4.1: Permit to Work System Sequence

Step Action by Action to be Taken

 Provides sufficient information for Area Authority to

assess the task and issue proper permit.
 Identifies the hazards in the task, work area and
adjacent or associated work.
Performing  Lists precautions to take to control hazards. Notes
1 Authority any protective or preventative measures required.
(PA)  Consults with others affected.
 Specifies the protective clothing to be worn and the
equipment to be utilized.
 Lists the precautions and/or methods that are to be
taken.
 Examines and determines the need for gas testing.
PA and Area
2  Satisfy them that the Risk Assessment has been
Authority (AA)
completed and risk mitigated.
 Gas tests equipment/work area where required. Logs
3 GAS TESTER
and signs the results.
 Formal hand over to PA, after specified work site
4 PTW Coordinator
inspection by PA and AA.
 Reviews permit with work group who performs task
covered by the permit. Each person signs back of
5 PA permit to confirm understanding.
 Acceptance of work site inspection. Signs and
acknowledges understanding of permit requirements
Area Authority
6  Approved PTW to begin work
(AA)

7 PA  Confirms isolations inspected with AA in step 4 still in

place
 Following completion of work, worksite made safe
8 PA and tidy.
PTW withdrawn
9 Isolating Authority  Isolations removed

10 PTW Coordinator  PTW and supporting documents filed by PTW

Coordinator

Details of Permit to Work re-validation, maximum lives and senior

signatories are shown in Table 4.2.

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Table 4.2: Permit to Work Validation Details

Confine Hazardous
General Hot Line Break Radiographi
d Space Energy
Work Work Hydro-Test c Permit
Entry Control
Colour of
White Blue Green Yellow Orange Red
Permit
Re-
At shift change of Performing Authority
validation

Max Life 7 days 24 hours 24 Hours 24 Hours 24 Hours 24 Hours

Safety
Check No Yes Yes Yes Yes
Yes
Required
Entry Area JV Area Area
Senior Superviso Supervis
Superviso Superintende Superintende Superintende
Signatory r or
r nt nt nt

Appendix I - 4.1 Managing Permits

A permit shall be raised by the Performing Authority and approved by the

Area Authority. It is not acceptable for the Area Authority to raise and
approve his own permits.

The objective of the Permit to Work process is to aid communication

between work teams. It is the responsibility of the Construction Manager
to ensure that ALL Permits to Work are communicated to first line
supervisors on a daily basis.

A Permit to Work Board shall be positioned at the Construction Site Office.

All Permits for the following days activities shall be raised by the
Performing Authority no later than 3pm on the previous work day. The
Area Authority shall approve all permits to work by 5pm and all permits for
the following day shall be posted on the Work Permit Board no later than
6pm.

Exceptions to the above timescale may be granted by the Superintendent.

All Permits to Work raised by exception shall be communicated to the first
line supervisors of all relevant work teams.

Working without a Permit to Work is considered a serious near miss and

shall be investigated accordingly.

The PTW Co-ordinator shall maintain a Permit Register. All permits shall be
returned to PTW Co-ordinators office on expiry date. It is the responsibility
of the PTW Co-ordinator to assist the Construction Manager in the control
and communication of PTW.

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APPENDIX I - 5 TRAINING REQUIREMENTS

All personnel will undergo basic induction training on the PTW System.

Area Authority and Performing Authority personnel shall be appointed and

confirmed in writing by the HSE Department as trained and competent to
compile, sign and issue permits to work. They will have undergone the
recognised internal training course, passed the written examination and
achieved a particular level of validation with certificate.

Area Authority and Performing Authority personnel must be competent and

have adequate technical knowledge to fully appreciate the hazards and
risk potential that is involved in any particular activity / task.

No personnel shall be able to issue or authorise a Permit to Work until they

have received the appropriate training.

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APPENDIX I - 6 RIGHT TO STOP WORK AND CANCEL PERMITS

All work must stop on Site General Alarm and permits will be cancelled and
returned to register when safe to do so.

The PA or AA shall stop a job and withdraw/cancel a work permit if he feels

that the safety requirements of the job do not meet the conditions on the
work permit.

Note: It is everyone’s responsibility to stop a job if they feel it is unsafe

to proceed.

When work is stopped the Area Authority must write on the permit the
reason for stopping the work, the time and any other relevant information.

When conditions have been corrected and are safe, the PA may request
and issue a new work permit.

The PA has the responsibility to stop work and advise the Area Authority of
his action any time he feels the safe conditions in the area do not meet the
conditions on the work permit. The Area Authority and the Performing
Authority shall take action to correct deficiencies before resuming the job.

All unnecessary personnel whose presence adversely affects the safety of

the job shall be removed and kept from the job site or work shall be
stopped and the permit cancelled.

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APPENDIX I - 7 FILING WORK PERMIT

The PTW Coordinator shall keep the original copy of the work permits and
supporting certificates/documents in a central location and available for
inspection for a minimum of twelve (12) months.

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APPENDIX I - 8 PERIODIC REVIEWS

All crafts are required to review their own operations to ensure compliance
with this permit to work procedure. In addition, the HSSE Department
and/or Site Supervision will conduct periodic reviews and audits of the
work permit system.

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APPENDIX I - EXAMPLE GENERAL WORK PERMIT

GENERAL WORK PERMIT

Area

Date Valid From Hours To

Permit requested

Description of work

Equipment to be used

Additional permits required:

Confined Line Break/Hydro-test Hot Work
Space Entry Blasting Radiation
Hazardous Energy Control

SITE PREPARATION
Tick if
Initial Person performing the work must initial in boxes at left
required
Equipment isolation
Depressurize, drain, purge equipment
Lockout/Tag out
Electrical disconnect/ fuse removal
Blinds and tags
Area barricades/road closures/Signage
Scaffolding
Rigging diagram prepared and approved by competent person
X-ray work
Mechanical ventilation
Fall protection
Underground and Overhead cables / services
Other.
Safety & protective equipment required:

Special safety measures required:

APPROVAL SIGNATURES Date

Performing Authority

Issuing Authority/Area Authority

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SUSPEND/REVALIDATE
Valid until end of shift
Suspend/ Performing
Area Authority Date and Time Unless otherwise
Revalidate Authority
validated

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APPENDIX I - EXAMPLE HOT WORK PERMIT

HOT WORK PERMIT

Area

Date Valid From Hours To Hours

Work location
Permit requested by
Description of work

Equipment to be used

SITE PREPARATION
Tick if
Initial Issuer must tick applicable boxes at left & Initial
required
Combustible gas tested initially and every_____________hrs.
Continuous Gas Monitoring
Fire extinguisher at job site
Flammables removed from immediate area (minimum 15m free
zone)
Cover nearby equipment with fireproof blankets
Equipment isolated, drained, blinded, gas freed
Fire Watch at job site
Communications provided
Area barricaded / Signate
Exact hot work location identified
Other restrictions or special approvals

Special protective equipment / clothing (specify)

COMBUSTIBLE GAS TEST RESULTS

Date / Time
Percent LFL (5% maximum allowable)
Percent LEL
Gas Tester (signature)

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APPROVAL SIGNATURES DATE AND TIME

(By signing below parties agree work is safe to begin)

Performing Authority
Issuing Authority/Area Authority

SUSPEND/REVALIDATE
Valid until end of shift
Suspend/ Performing
Area Authority Date and Time Unless otherwise
Revalidate Authority
validated

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APPENDIX I - EXAMPLE CONFINED SPACE ENTRY PERMIT

CONFINED SPACE ENTRY PERMIT

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APPENDIX I - EXAMPLE LINE BREAK / HYDROTEST ENTRY PERMIT

LINE BREAK / HYDROTEST PERMIT TO WORK

Area
Date Valid From Hours To Hours
Work location
Permit requested by
Description of work

Equipment to be used

SITE PREPARATION
Tick if
Initial Issuer must tick applicable boxes at left & Initial
required
Combustible gas tested initially and every_____________hrs.

Fire extinguisher at job site

Are additional Permits to Work Required
Equipment to be tested/opened positively identified
Equipment isolated, drained, blinded, gas free as applicable
Fire Watch at job site
Communications provided
Area barricaded-Only necessary workforce allowed inside
Isolation list checked and approved by Issuer
Other restrictions or special approvals

Special protective equipment / clothing (specify)

Sketch of Test/Equipment:

APPROVAL SIGNATURES
(By signing below parties agree work is safe to begin)

Performing Authority

Issuing Authority/Area Authority

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APPENDIX I - EXAMPLE HAZARDOUS ENERGY CONTROL PERMIT

HAZARDOUS ENERGY CONTROL PERMIT

Department: Area:
Date:

Crew Coordinator: _______________________ Hazardous Energy

_____________________
Supervisor-In-Charge Control Coordinator Site Representative

Equipment Description:

Purpose of Isolation:

Hazardous Energy
Volts Pressure Temperature Other
Source

Method Of Isolation

Electrical Isolation / Lockout  Blind Flange 

Isolation Spool  Double Valve and Vent 
Disconnect Line / Line Break  Instrument Disconnect / Isolation 

Isolation Device and

Lock Number Date Installed Date Removed
Location

Energy Isolation Approved: _________________________ Method ___________ __Date________

Isolating Authority
Energy Isolation Approved: _________________________ Method _____________ Date________
Isolating Authority
Zero Energy Verified By : __________________________ Method _____________ Date _______
Site Representative

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Employees Protected By Lockout/Tag-Out

Name Badge No. In Name Badge No. Out

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APPENDIX I - EXAMPLE RADIOGRAPHY PERMIT

RADIOGRAPHY PERMIT/REQUEST

SECTION 1: To be completed by the Contractor requesting the radiography

Contractor Requesting Permit : NDE Contractor :
Date Requested: Date Required :
Proposed Start Time : Proposed Finish Time :
Location of Radiography : Equipment/Line Number :
Print Name : Signature :
A PLOT PLAN IDENTIFYING THE PROPOSED WORK LOCATIONS MUST BE ATTACHED TO THE
PERMIT

SECTION 2 : To be completed by the NDE Contractor’s level II radiographer

Badge Alarm Dosimeter (0-200
Name (s) of Technician (s) NDE Level
No. No. mr/h)
Start Finish

Name of Level II Radiographer: Signature:

A MINIMUM OF TWO AUTHORIZED/CLASSIFIED OPERATIVES MUST BE IN ATTENDANCE
SECTION 3 : To be completed by Level II radiographer and verified by safety dept. prior to
start
Documentation Checklist Yes No Comments
Radiation Safety Certificate
Decay Chart
Radiation Safety Manual
Emergency Telephone Numbers
Survey Meter
Collimator
Radiation Warning Signs
Audible Warning
Devices
Warning Tape/Rope
Flagman & Body card
Extra Shielding
Camera Manufacturer: Serial Number:
Type of Isotope Intensity:
Total Exposure Start
Finish Time:
Time Time:

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APPROVAL
SubContractor: Signature:

Safety Department Signature:

Construction Manager Signature:

The perimeter of the ”radiation area” must be roped off and have “warning signs” placed at intervals along the
perimeter(+) and at each entrance into the area. The “radiation area” must be clear of all none classified
personnel prior to each exposure and must be under visual surveillance during each exposure. Prior to use all
equipment is to be inspected and after each exposure both the camera and guide tube are to be surveyed
ensuring the source in the shielded position. The radioactive source shall not be left unattended.
RADIOGRAPHY WILL NOT COMMENCE UNTIL ALL SAFETY REQUIREMENTS HAVE BEEN CONFIRMED
SUSPEND/REVALIDATE
Valid until end of shift
Suspend/ Performing
Area Authority Date and Time Unless otherwise
Revalidate Authority
validated

(+) Calculation to be done to determine safe barricade distance from source.

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