17 - Pressure Testing Permit (A4)

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AL-DUR II IWPP PROJECT DATE:

PERMIT TO WORK PROCEDURE

Pressure Testing Permit PTW No: ______

JOB DETAILS

SECIAL TOOLS TO BE USED

JOB LOCATION/PLANT IDENTIFICATION


IS ANY OTHER WORK CURRENTLY BEING UNDERTAKEN THAT MAY INTERACT OR
AFFECT THIS PERMIT? (QUOTE PERMIT NUMBERS WHERE APPLICABLE)
The permit is only valid when all sections are complete. If you are in doubt or don’t understand then please ask. Remember all
accidents are preventable and it is people who get hurt and suffer pain. Please use this permit in the spirit intended to protect
yourself and others. Please ensure that you sign this permit-to-work.; Do not proceed with your work until your permit has been
authorized by the relevant member of staff.
HAZARDS AND PRECAUTIONS TO BE TAKEN
PRIMARY HAZARDS – fumes, electrics, gases, liquids, sludge, radiation, moving parts
HYDRAULIC TESTING-Are you qualified/ trained to undertake this work? YES NO
Is the vessel/pipe and its supports and foundations capable of withstanding the weight?
o o
Is the water temperature more than 7 C (45 F)?
Is there any danger of fire from flammable liquids?
Is there any likelihood of threatened failure?
Is there vessel/pipe totally filled with liquid and properly vented?
Have precautions been taken not to overstress the vessel/pipe?
Are remote viewing procedures necessary?
Do you have eye protection?
PNEUMATIC TESTING- Are you qualified/trained to undertake this work?
Has an assessment of the vessel/pipe been made/detailed inspection carried out?
Is it practicable to reduce to a minimum the internal volume?
Is there a possibility of condensation occurring?
Are methods for sealing openings in the vessel under test suitable?
Are pressure/testing gauges easily visible?
Are flexible pipes and their connections likely to reduce the risk of failure?
Are there adequate safety restraints?
Has the vessel been safely isolated?
Do you have eye protection?
Other precautions required:
Other safety equipment required:
I confirm that I will perform the above-mentioned work in compliance with relevant legal requirement, industrial
practice and site regulation and ensured that the necessary precautions have been taken.
It is safe to carry out the work as defined above and the permit information will be explained to all workers
involved. I accept responsibility for this work.

Person In charge: Company: Date:


Position Name Date
Construction Engineer
Approved By HSE Manager
Construction Manager
HAND BACK AND CANCELLATION
I confirm that the work has been completed / partially completed, checked by myself and the area left in a safe
and tidy condition.
I have inspected the completed/partially completed work and herby cancel this permit.
PERSON IN CHARGE DATE TIME
AUTHORISING SIGNTURE

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