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    Pressure Test Work Permit

    Uploaded by

    Md Abdul Raja
    This document is a request for a permit to conduct pressure testing. It requires information about the contract, permit number, location and details of the system to be tested, nature of the test, risk assessment, checklist of safety requirements that must be met, acknowledgement by the permit recipient, authorization by the approved permit issuer, confirmation from the supervisor that safety measures are in place, listing of authorized workers, stopping of activity, and cancellation of the permit once completed. It provides a standardized form and process to safely conduct and authorize pressure testing work.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Pressure Test Work Permit

    Uploaded by

    Md Abdul Raja
    1K views2 pages
    This document is a request for a permit to conduct pressure testing. It requires information about the contract, permit number, location and details of the system to be tested, nature of the test, risk assessment, checklist of safety requirements that must be met, acknowledgement by the permit recipient, authorization by the approved permit issuer, confirmation from the supervisor that safety measures are in place, listing of authorized workers, stopping of activity, and cancellation of the permit once completed. It provides a standardized form and process to safely conduct and authorize pressure testing work.

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    Pressure test work permit

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    This document is a request for a permit to conduct pressure testing. It requires information about the contract, permit number, location and details of the system to be tested, nature of the test, risk assessment, checklist of safety requirements that must be met, acknowledgement by the permit recipient, authorization by the approved permit issuer, confirmation from the supervisor that safety measures are in place, listing of authorized workers, stopping of activity, and cancellation of the permit once completed. It provides a standardized form and process to safely conduct and authorize pressure testing work.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    1K views2 pages

    Pressure Test Work Permit

    Uploaded by

    Md Abdul Raja
    This document is a request for a permit to conduct pressure testing. It requires information about the contract, permit number, location and details of the system to be tested, nature of the test, risk assessment, checklist of safety requirements that must be met, acknowledgement by the permit recipient, authorization by the approved permit issuer, confirmation from the supervisor that safety measures are in place, listing of authorized workers, stopping of activity, and cancellation of the permit once completed. It provides a standardized form and process to safely conduct and authorize pressure testing work.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Section 1- The Request for a Permit (Completed by or sub-contractors supervisor & submitted to Approved Permit Issuer)

    Contract Date of Permit Valid from:

    Senior Project Manager:


    Permit No Valid up to . (time)

    Description / location & details of plant/systems to be pressure tested:

    Nature of test (state whether hydrostatic, gas or air, state gas type & pressure involved:

    Additional comments arising from approved risk assessment and method statement:

    CHECKLIST FOR PRESSURE TEST PERMIT REQUIRED


    YES NO
    Hydraulic Test
    Approved risk assessment/method statement is attached
    Is a competent person designated?
    Are those involved trained and briefed?
    Blank/Plug/seal off all open ends
    Remove/blank off vulnerable items/meters,etc
    All valves closed at limits of test section
    All high point vents closed
    Calibration certificates (supplied)
    Adequate drain cocks
    Test area adequately identified with signs and cleared of personnel
    Other control measures
    Pneumatic Testing
    Approved risk assessment/method statement is attached
    Blank/Plug/seal off all open ends
    Remove/blank off vulnerable items/meters,etc
    All high point vents closed
    Calibration certificates (supplied)
    Air supply controlled outside test area
    Reducing valve required
    All flexible connections secured at both ends
    Safety valve set connected to pipe work
    Test area clearly demarcated and cleared of all personnel
    All valves closed at limits of test section
    Acknowledgement: I understand the hazards of this work and the precautions to be taken. I have ensured that these have been fully explained
    to the operatives carrying out this work, and consider them to be competent to do it safely. I will closely supervise these works to ensure that they
    are carried out in accordance with the terms of this permit and I will return my copy of this permit to the Approved Permit Issuer when this work
    has been safely completed.

    Permit Recipient: (Print Signature: Date: Time:


    Name)
    (To be signed by the or Subcontractors Supervisor in Direct control of the Work)
    Section 2- The Authorisation for Work to Proceed (to be completed by the Approved Permit Issuer)

    Validation: I confirm that I have checked that the control measures detailed in section 1 above are in place and therefore within the limitation below,
    work described above in section 1 is authorised to proceed.
    Permit Valid From: (hrs) on: (date) To (hrs) on: (Date)

    It is accepted by: (Name, Initials & Pass No.) Position: Contact:

    Authorised By (Approved Permit Issuer)


    HSE Manager

    Time Extension from: (hrs) on: (date) To (hrs) on: (Date)

    Authorised By: (Approved Permit Issuer)

    Section:3 to be completed by the Supervisor/Entry leader


    I confirm that a safe system of work is in place, which includes the control measures detailed in Part 1 of the permit, and that a full
    risk assessment and method statement has been completed for this activity and that this has been the subject of a briefing to the
    persons involved in this task prior to the commencement of the activity.
    Print Name Date of signature

    Signature Time of signature

    Persons authorised to work

    Name Name

    Name Name

    Name Name

    Name Name

    Section: 4 Stopping of Activity


    I confirm that work in the enclosed space has been completed / stopped and the persons in my control have been withdrawn along
    with all tools and equipment used during the activity.

    Print Name Date of Signature

    Signature Time of Signature

    Section 5: Cancellation of Permit to be completed by the person in charge of the works


    This permit is now cancelled; all additional or continuing works in this area will require a new permit to be issued

    Print Name Date of signature

    Signature Time of signature

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