L4 02.02 GTR PTW-JHA Training Material

CERTIFICATE VALIDITY

The maximum validity of any single certificate shall be as follows:-

Confined Space Daily (12 hours validity)

Normal Certificate 7 consecutive days

(other than Confined Space)

Special Certificate 3 months / 90 days with weekly revalidation
(EIC, PIC, SSBO)

During plant turnaround the weekly revalidation of the special certificate is not
required. The validity/life of the special certificates is valid throughout the
turnaround period.

Internal

CERTIFICATE - Confine Space Entry

CONFINED SPACE ENTRY

A certificate used for entry and/or working in a confined space. The Certificate AA
(CAA)will prescribes the conditions required to ensure safe work environment and
determine Gas test requirement for the AGT.

CONFINED SPACE ENTRY CERTIFICATE ( To be filled by CAA )

TYPE OF ENTRY ALLOWED B CONDITIONS TO BE IMPLEMENTED BY RA / WL

Respirable Atmosphere Life Line Personal Oxygen Monitoring Meter Locate Mobile Equipment Away From Manhole
[ O2 19.5 - 22% & LEL < 10% & Toxic < PEL ] Personal H2S Meter Rescue & Evacuation Plan Attached
Continuous Ventilation Barricade and Warning Signs Confined Space Entry Checklist Attached
Harmful Atmosphere Continuous Gas Monitoring Extra Low Voltage Lighting (max 50V)
[ O2 > 22% or LEL 10% or Toxic PEL ] Personal Distress Unit BA Escape Set First Entry Using SCBA or Airline set
Irrespirable Atmosphere Tripod N2 Hose Disconnected
[ O2 < 19.5% ] Breathing Apparatus to be Used :

C GAS TEST REQUIREMENT SCBA Half mask

Airline Full face mask

Safety Watch Name 1)........................................................................
2)..........................................................................

LEL Check Before Work Starts / After Break Every .......................... Hours Interval Continuous Gas Monitoring
H2S Test Before Work Starts / After Break Every .......................... Hours Interval Operator On Standby
Oxygen Test Before Work Starts / After Break Every .......................... Hours Interval No Venting or Draining of Hydrocarbon
within 10 metres Radius.

Special Precautions ...........................................................................................................................................................................................................................................................
...........................................................................................................................................................................................................................................................................................
............................................................................................................................................................................................................................................................................................

I have personnally checked that all control measures to prevent release of hazard have put in place and complied with those conditions under this certificates

D Certificate Approving Authority Signature Department Designation Date

Internal

CERTIFICATE - Confine Space Entry Checklist

CONFINED SPACE ENTRY CERTIFICATE POD / TOD / CUF CHECKLIST FOR CONFINED SPACE ENTRY

Confined Space Entry Certificate states that the Serial No. NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
work site has been checked, identified the hazards CPE000000
therein and prescribes the necessary controls to
ensure safe work environment. As part of the SECTION 1 - GENERAL INFORMATION Work Leader :
confined space entry certificate approval, the Permit Applicant :
requirement for Confine Space Entry Check List is
mandatory and precautions in the Checklist for Safety Watch Name : Company/Contractor :
Confined Space Entry to must be complied and
implemented Location : Facility/Unit :

Vessel/Tank Services : Date of Work :

Equipment No : Time: From : To :

SECTION 2 - WORK DESCRIPTION

Purpose for entry :

.................................................................................................................................................................................................................................................................

................................................................................................................................................................................................................................................................

SECTION 3 - CONDITIONS TO BE CHECK BY APPROVING AUTHORITY YN N/A
YN N/A
Are all connections to the confined space been isolated/removed? YN N/A
Are isolation certificates attached to the permit ? Certificate No : ........................................ YN N/A
Are all electrical/hydraulic connections inside and outside the confined space locked out and tagged ? YN N/A
Is the confined space gas free ? Check by: ........................ Date:..................................... Time: .................... YN N/A
Is the oxygen level satisfactory ? Check by: .......................... Date:.....................................Time: ..................... YN N/A
Has a gas test for flammable gases and toxic gases been done? Check by: ........................ Date:................... Time:.............. YN N/A
Has a continuous forced air ventilation been provided and tested in the confined space? YN N/A
Are there any other hot work nearby ? If yes, assess the risk and take necessary precautions. YN N/A
Are there radiation sources nearby ? If yes, assess the risk and take necessary precautions. YN N/A
Are there exhaust fume hazards nearby ? If yes, assess the risk and take necessary precautions. YN N/A
Are warning signs and barricades available ? YN N/A
Are lightings to be used of the low voltage type ? Is ELCB installed ? (Maximum allowable voltage is 50V) YY N/A
If the job requires scaffolding, has it been erected and inspected ?
Are all the necessary PPE available at site?
TO BE CHECKED JOINTLY IF BREATHING APPARATUS IS TO BE USED
Are the workers trained in the use of BA provided ?
Have you checked the availability of emergency air supply when working in inert atmospheres ?

YN N/A
YN N/A

SECTION 4 - APPROVAL

Special Precautions .........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................

I have personally checked that all control measures have been put in place and complied with by those working under this checklist.

Signature Designation Date Time

Receiving Authority / RA Representative Y N N/A
Y N N/A
Certificate Approving Authority Y N N/A
SECTION 5 - VERIFICATION Y N N/A
Y N N/A
Are your workers trained in confined space entry procedures ?
Do your workers fully understand the safety requirements and have been briefed on the JSA ?
Have your workers undergone medical fitness test ?
Are you satisfied with all the isolations and preparation made for a safe entry ?
Have your workers been briefed on the Rescue and Evacuation plan of your worksite?
Mode of communication to be used : .................................................................................

Signature Designation Date Time

Receiving Authority / Work Leader Original : Display at site Copy No 1 : Control Room
Distribution

STOP WORK AND EVACUATE AREA ON HEARING OF EMERGENCY ALARM / SIREN

Internal

CERTIFICATE - Excavation POD / TOD /CUF EXCAVATION CERTIFICATE
Serial No.
A certificate used for excavation work. It is used to NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
ensure that the relevant parties have checked the E 00001
site and studied layout drawings so that the
excavation activity will not cause any damage to SECTION 1 - REQUISITION ENDORSED BY RA
existing buried facilities such as pipelines, drains, Applicant Name :
and electric cables Dept. / Co. : Name :

 All excavations or penetration of the ground over Staff No. / I C No : Tel No : Signature :
150 mm in depth require a Permit to Work and Signature : Date : Date / Time :
Excavation Certificate. SECTION 2 - GENERAL INFORMATION
Location : Facility :
 For excavation of more than 1.5 meters depth, it
is categorized as confined space. Thus Area / Unit : Date Required From : To :
Others :
requirements under PTS 18.52.08 Entry to Drawing Attach :
Machinery
Confined Space and Hot Work Permit to Work Method: Manual digging
shall apply. If excavation is carried out in
classified hazardous location requirements under SECTION 3 - WORK DESCRIPTION

PTS 18.52.08 ignition source control shall Reason for Excavation :-
...............................................................................................................................................................................................................................................................
apply. ...............................................................................................................................................................................................................................................................
...............................................................................................................................................................................................................................................................
 CAA shall determine the underground conditions ...............................................................................................................................................................................................................................................................
and specify necessary precautions to be
implemented by WL/RA to ensure the activity will SECTION 4 - APPROVAL FROM TES / AREA OWNER (TOD)
not endanger the existing underground services
I/we hereby certified the above drawings and document are correct and will not endanger the underground utiliities.

Section Approving Authority Name Signature Designation Date

Civil

Mechanical

Electrical
Area Owner TOD
SECTION 5 - CONDITIONS TO BE IMPLEMENTED by RA / WL

Exact location as per drawing Barricade with hazard tape Notification to Local Authority
Rigid barricade Signage to be placed at : ............................................ TNB
Beacon light Others : ......................................................................... JKR
Trial hole Others ............................

SECTION 6 - APPROVAL

Special Precautions .........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
....................................................................................................................................................................................................................................
....................................................................................................................................................................................................................................
....................................................................................................................................................................................................................................
....................................................................................................................................................................................................................................
....................................................................................................................................................................................................................................

All required conditions shall be implemented as specified in Section 5
Others ..........................................................................................................................................................................................................................

Certificate Approving Authority Signature Department Designation Date

Certificate Distribution- Original ( White ) : Displayed at Work Site Copy No. 1 (Yellow ) : Contol Room / AA Office Copy No. 2 ( Pink ) : Receiving Authority March 2003 Rev : 0

STOP WORK AND EVACUATE AREA ON HEARING FIRE, H2S OR GAS ALARM

Internal

CERTIFICATE - Radiation

A certificate used for handling of Ionizing Radiation POD / TOD /CUF RADIATION CERTIFICATE To:
Sources for radiographic examination, such as testing
of weld, wall thickness measurement, etc. Serial No. NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
R 00001
 Radiation Protection Officer (RPO) is the Department / Company :
authorized work supervisor who possesses SECTION 1 - REQUISITION Tel No :
(memiliki) certificate by AELB. Applicants Name : Date :
Staff No. / I C No :
Signature : Facility :
Date Required From :
SECTION 2 - GENERAL INFORMATION
Work Location :
Equipment / Vessel No :

Work Description ..........................................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................................................................

 Radiographer is a person who attended and SECTION 3 - DETAIL OF RADIATION SOURCE / OPERATOR Tel No :
passed examination to use/operate Radiographic Company Name : Expiry Date :
equipment. Date of Leak test / Service :
LPTA License Class : LPTA No. : Date of Service :
 In performing any radiographic work at site the Activity : Calibration Date :
following must be followed; Radioactive Source Type : SR . No. :
• Radiation certificate is approved /endorsed. Safe Radius : ..............................metre Radiographer
• Boundaries shall be defined with hazard Projector Model :
tape/barricade Name :
• Warning light or any other visual warning Survey Meter Model : LPTA Card No :
equipment/signs shall be in Expiry Date :
operation/displayed. Assistant Radiographer Film Badge No :
• RPO shall contactable within 50KM radius
from the site. Name : Barricade to be set up
• Radiographer shall be at site during work LPTA Card No : Radiation monitor to be installed
execution. Expiry Date : Notify relevant parties ................................................
Film Badge No : Others : .........................................................................
SECTION 4 - CONDITION TO BE IMPLEMENTED AAR / RAR

Film Badge shall be worn
Reading at Barricades must not exceed...........................Curie
Warning sign / beacon light to be setup

I / We have personally checked the area and equipment to be worked on and satisfy the work requested can be carried out safely.

RA REPRESENTATIVE AA REPRESENTATIVE

Name / Designation :.................................................................................................. Name / Designation :..................................................................................................
Signature : ..............................................................Date :.......................................... Signature : ..............................................................Date :..........................................

SECTION 7 - APPROVAL Acceptance By CAA
Endorsed By Radiation Protection Officer (RPO)

Name : Date : Name : Date :
Signature : Time : Signature : Time :

Certificate Distribution - Original( White ) : Displayed at Work Site Copy No. 1 (Yellow) : Contol Room / AA Office Copy No. 2 ( Pink ) : Receiving Authority March 2003 Rev : 0

STOP WORK AND EVACUATE AREA ON HEARING FIRE, H 2S OR GAS ALARM

Internal

CERTIFICATE - Road Obstruction

A certificate used to specify closure of roads and to POD / TOD /CUF ROAD OBSTRUCTION CERTIFICATE
ensure the necessary passage for emergency
response vehicles have been identified and inform Serial No. NO WORK THAT IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFETY
the relevant parties RO 00000

 The road obstruction certificate is required SECTION 1 - REQUISITION Department / Company : To :
whenever a road/access required to be Applicants Name : Tel. No :
obstructed. Date :
Staff No. / I C No :
 Certificate is not required when a road is Facility :
temporary block such as, when equipment or Signature : Date Required From :
material are being unloaded, movement of heavy SECTION 2 - GENERAL INFORMATION Others :
equipment on/across the road, etc. Location :
Road Name / Number :
 Road Obstruction Certificate used to specify closure Drawing Attach :
of specific roads for the work and to ensure the SECTION 3 - WORK DESCRIPTION
alternative passage for emergency response
vehicles have been identified and inform the Reason for obstruction :-
relevant parties ...............................................................................................................................................................................................................................................................
...............................................................................................................................................................................................................................................................
...............................................................................................................................................................................................................................................................
...............................................................................................................................................................................................................................................................
................................................................................................................................................................................................................................................................

SECTION 4 - CONDITIONS TO BE IMPLEMENTED Barricade with hazard tape
Notification to PFSU
Exact location as per plot plan Signage to be placed at : ............................................
Alternative passage / road diversion Others : .........................................................................
Manpower controlling traffic
Rigid barricade

SECTION 5 - APPROVAL

Special Precautions...................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................................................

........................................................................................................................................................................................................................................................................

I have personally checked that all control measures to prevent release of hazard have been put in placed and complied with those working conditions under
this certificate.

Certificate Approving Authority Signature Department Designation Date

SECTION 6 - PLOT PLAN

Certificate Distribution- Original ( White ) : Displayed at Work Site Copy No. 1 ( Yellow ) : Contol Room / AAOffice Copy No. 2 ( Pink ) : Receiving Authority March 2003 Rev : 0

STOP WORK AND EVACUATE AREA ON HEARING FIRE, H2S OR GAS ALARM

Internal

CERTIFICATE - Vehicle Entry POD / TOD /CUF VEHICLE ENTRY CERTIFICATE

A Vehicle Entry Certificate is required as part Serial No. NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
of the Hot Work Permit for the vehicles entry V 00001
into the process area.
SECTION 1 - REQUISITION Department / Company :
 Visual inspection is to be carried out by Applicants Name : Tel. No :
Security/authorized PGB staff. Staff No. / I C No : Date :
I / C No :
 Heavy machinery/equipment shall be Signature : Driving License Expiry Date :
inspected/approved by authorized PGB Name of Driver : PSV / GDL Expiry Date :
staff. Driving License No :
PSV / GDL No : Facility :
 Upon completion of work, the vehicle/heavy Tel No :
machinery must be checked by SECTION 2 - GENERAL INFORMATION Date Required From :
security/PGB prior to leaving the site. Work Location : Type of Vehicle. :
Model :
PGB Contact Person: Vehicle Height :

Vehicle Owner / Company : To:
Diesel
Registration No. :

Road Tax Expiry Date : Petrol

Capacity BDM : BTM :

Goods Description (if applicable) :

SECTION 3 - VISUAL INSPECTION

Radiator Leakage Passed Failed Brake Light Passed Failed Vehicle Height Passed Failed
Oil Leakage Passed Failed Reverse Light Passed Failed Failed
Fuel Leakage Passed Failed Signal Light Passed Failed Horn / Reverse Alarm Passed Failed
Exhaust Passed Failed Head Lamp Passed Failed Failed
Spark Arrestor Tyre Condition Fire Extinguisher Passed
Passed Failed Passed Failed
First Aid Box Passed

Others ..............................................................................

SECTION 4 -TECHNICAL INSPECTION (additional Checklist for Heavy Vehicle)

ENGINE Passed Failed CHAIN (FOR HEAVY VEHICLE) Passed Failed
Engine Condition Passed Failed Chain System
Braking System Passed Failed Passed Failed
Battery Connection OTHERS Passed Failed
Passed Failed Electrical Wire Connection
HYDRAULIC (FOR HEAVY VEHICLE) Belting
Hydraulic System

Special Precaution / Remark. .................................................................................................................................................................................................................................
...................................................................................................................................................................................................................................................................................
...................................................................................................................................................................................................................................................................................
..................................................................................................................................................................................................................................................................................

SECTION 5 - APPROVAL
I / We have personally checked that this vehicle has complied with the entry requirement and satisfy that it can be used safely.

SIGNED BY VEHICLE DRIVER APPROVED BY CAA

Name : Date : Name : Date :
Time :
Signature : Time : Signature :

SECTION 6 - HAND- BACK TO SECURITY

Work completed Incomplete hand-back ( equipment status, reason for hand-back, etc.).

Remark ...................................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................................................

Name : Signed By Work Leader / Vehicle Driver Name : Acceptance By CAA/RA
Date : Date :

Signature : Time : Signature : Time :

Certificate Distribution - Origina ( White ) : Displayed at Vehicle Copy No. 1( Yellow ) : Contol Room / AA Office Copy No. 2 ( Pink ) Security / Receiving Authority March 2003 Rev : 0

STOP WORK AND EVACUATE AREA ON HEARING EMERGENCY ALARM / SIREN

Internal

CERTIFICATE - Lifting POD / TOD / CUF LIFTING CERTIFICATE

A certificate used for lifting activity by using Serial No. NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
mobile lifting machinery such as crane. It will L 00001
specify the hazards therein and prescribes the
necessary controls to ensure safe lifting SECTION 1 - REQUISITION
activities
Applicants Name : Department / Company :
 All mobile lifting machinery must possess
(memiliki) Vehicle Entry Certificate before Staff No. / I C No : Tel No :
entrance into PGB plants process area.
Signature : Date :
 Mobile lifting machinery shall be inspected
and endorsed by Rigging Supervisor and SECTION 2 - GENERAL INFORMATION Facility : To:
reviewed by Certificate AA. Work Location : Date Required From :

 Upon work completion lifting activities, Equipment No :
mobile lifting machinery must be checked Vehicle Entry Cert. No :
by security at guard house prior to leaving
the site. Work Description ..........................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................

SECTION 3 - LOAD AND CRANE DATA

Load Description : Load BTM Elev. (M) Load Est. Wt (Ton)
Load Dimension (L x W x H) : Load Max. lift (M)
Load Act. Wt (Ton) PMA No. :
Boom LE (M) : Crane Capacity :
Crane Model : Safety Factor : Boom Angle ( Deg) :
Work Rad (M) :
Boom HT (M) : ELEVATION = METER
SECTION 4 - GROUND INFORMATION
Access Road Condition : CGA2003 LOAD = TON METER
Setup Area Condition : WORKING RADIUS = METER METER
Setup Site Clear (M) : SYMETRICAL
SECTION 5 - RIGGING INFORMATION METER
Hitch Argmt :
Sling Type : METER
Sling Size (MM) :
Sling Length (M) :
Sling max load :

Shackle Size (MM) :

Shackle Capacity (Tons) :

Hitch Capacity (Tons) :
SECTION 6 - LIFTING CATEGORY

Over or near live services
Major lift ( 66 - 85 % load chart )
Critical lift ( 86 - 100 % load chart )
Heavy lift ( Above 2 tons )
Basic lift ( 2 tons & below )

General Remark ..........................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................

SECTION 7 - APPROVAL Acceptance By CAA
Endorsed By Rigging Supervisor

Name : Date : Name : Date :
Signature : Time : Signature : Time :

Certificate Distribution - Original( White) : Displayed at Work Site Copy No. 1 ( Yellow ) : Contol Room / AA Office Copy No. 2( Pink ) : Receiving Authority March 2003 Rev : 0

STOP WORK AND EVACUATE AREA ON HEARING FIRE, H 2S OR GAS ALARM

Internal

CERTIFICATE – Electrical Isolation

A certificate used for covering the
work on electrical equipment,
especially high tension systems and
stating that an authorized and
competent person has electrically
isolated the equipment to be worked
on and has taken suitable
precautions to prevent inadvertent
(tidak sengaja) reconnection.

Internal

CERTIFICATE – Limit of Electrical Access

POD / TOD / CUF LIMIT OF ELECTRICAL ACCESS CERTIFICATE

Serial No. NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY
LE 0000

SECTION 1 - REQUISITION ( TO Be Filled By WL/ RA/ AAR )

Applicants Name : Department / Company :
Staff No. / I C No : Tel No :
Signature : Date :
Equipment Tag No : Location :
Date Required From :
To:

A certificate used to control any work in Work Description ..........................................................................................................................................................................................................................................................
the vicinity (persekitaran) of electrical .........................................................................................................................................................................................................................................................................................
equipment/facilities such as switch gears, .........................................................................................................................................................................................................................................................................................
transformers and electrical bus bars. .........................................................................................................................................................................................................................................................................................

SECTION 2 - PERMISSION TO ACCESS ( To Be Filled ByAEP )

To ............................................................................................................................................................. ( WL / RA )

I hereby give permission to access the equipment / in stallation with the following conditions.....................................................................................................................
.........................................................................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................................................................

Name Signature Date Time

SECTION 3 - ACCEPTED & AGREED ( To Be Filled By WL / RA )
I have read and understood the instructions as given above. No attempt will be made by me, or anyone under my control, to carry out any works other
than that specified. I will take all neccessary safety measures.

Name Signature Date Time

SECTION 4 - CLEARED ( To Be Filled ByWL / RA )
The work for which this certificate was issued is now completed, all personnel under my control have been withdrawn and warned that no further access is permitted.

Tools and gears removed Housekeeping done Date Job completed
Name Signature Time

SECTION 5 - CANCELLATION ( To Be Filled By AEP )
This certificate is hearby cancelled.

Name Signature Date Time

Certificate Distribution - Original ( White) : Displayed at Work Site Copy No. 1 ( Yellow ) : Contol Room / AA Office Copy No. 2 ( Pink ) : Receiving Authority March 2003 Rev : 0

STOP WORK AND EVACUATE AREA ON HEARING FIRE, H2S OR GAS ALARM

Internal

PURPOSE:
To allow any bypassing/ overriding work
activity on the safety system such as PSV,
shutdown and alarm switches, fire
suppression and deluge system
OBJECTIVES:
To ensure that the work site has been
checked, identified the hazards therein and
prescribes the necessary controls to ensure
safe work environment
REQUIREMENT:
Division shall identify related type of
equipment's which are applicable

Internal

CERTIFICATE – Physical Isolation

A certificate used for covering the work on process lines and equipment which states that
they have been drained of liquid, depressurized of gas, isolated from other equipment in
the operating facility and suitable precautions have been taken to ensure they remain
isolated.

Internal

PURPOSE:

 To cover the work on process lines and equipment which states that they
have been drained of liquid, depressurized of gas, isolated from other
equipment in the operating facility and suitable precautions taken to ensure
they remain isolated

METHOD AS IN PTS 18.52.19:

 Physical Isolation
1) Positive Isolation
2) Double Block and Bleed
3) Single Valve Isolation

 Electrical Isolation

Internal

To establish the key standard for all portable electrical equipment and temporary
installation (PETI)

To ensure that:
 Proper selection of equipment and tool as per applicable rule and regulation
of this standard.
 Safety precaution is taken to avoid any electrical incident in the plant or
work site.
 Inspection/checking of electrical equipment before they are brought into the
existing Plant or construction area.
 Compliant with basic rule for good working practice and safety and to cope
with increase hazard which are present in temporary installation.
 All relevant procedures, instructions, checklist, flowchart, sticker and
certificates are available from PGB PETI procedure

Internal

Internal

Internal

Division: CUF  POD PLANT FIRE WATER USAGE Serial No. FW 00001
TFDD  TOD CERTIFICATE
Sub Please circle:
 GPP A  KSMF  RO………… NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY Complex- 1 / 2 / 3/ 4/ 5 / 6 / DPCU2 / DPCU3 / KCS
 CUFG ………………… Specific Others ………………………………..
Complex:  GPP B  CUFK  Others…….. Work Site
 ET …………………

SECTION 1 - REQUISITION Department / Company :
Applicant Name :

PURPOSE: Staff No. / I C No : Contact No :

To establish the control of fire water Signature : Date :
usage in the PGB Operating Facilities
(if applicable) other than its main SECTION 2 - GENERAL INFORMATION ( TO BE FILLED BY WL ) Facility : □ Process □ Utility □ KCS □ Non-Process
purpose such as drill, fitness test, Location :
BOMBA inspection and actual
emergency Equipment No. : Tag No. : Date Required From : To :

PTW No : .......................................... Drawing Attach...................................... Others..............................................

SECTION 3 - WORK DESCRIPTION ( TO BE FILLED BY RA ) REMINDER:
The fire water usage subject for plants situation or
Reason for water usage fire water tank level.

Effect on the System Category 1:
 Fire Water tank level low Failure of the safety system will case:
 Jokey pump running  Serious hazard to personnel and facility with major
 Diesel level low consequences.
 Sales gas and Ethane production loss and total
Remark : plant shutdown e.g Unit Shutdown (USD)

SECTION 4 - WORKSITE PREPARATION / PRECAUTION ( TO BE FILLED BY RA / AA ) Category 2:
Failure of the safety system will case:
 Minor injury to personnel or minor damage to plant
equipment. Shutdown of equipment without
production loss. Fire Suppression System (FM200,
CO2, pyrogen), fire water deluge system and PSV
are considered as category 3

Precaution to be done YES NO LEVEL (%) Additional Precautions / Instruction
....................................................................................................................................
1. Check fire water tank level ....................................................................................................................................
2. Check fire water tank status ....................................................................................................................................
3. Check diesel level ....................................................................................................................................
4. Check fire water pump status ....................................................................................................................................
I shall implement all precautions as specified above before work start.

Receiving Authority : Designation : Signature : Date :

SECTION 5 - APPROVAL (CAA/AA/AAR)

The certificate applicant is authorized to proceed with the Plant Fire Water Usage described above.

Name Signature Department Designation Date

SECTION 6 - WORK COMPLETION
The above Plant Fire Water Usage is no longer required.

Receiving Authority Acceptance By Certificate Approving Authority
Date :
Name : Date : Name :
Time : Signature : Time :
Signature :

Permit Distribution: Original ( White ) : Displayed at Work Site, Copy No. 1 ( Yellow ) : Control Room / AA Office & Copy No. 2 ( Pink ) : RA
Notes*: Eq. – Equipment, AA – Approving Authority, CAA – Certificate Approving Authority, Phyroporic – Release heat when in contact with air, SIL-Safety Integrity Level

DOCUMENT NO:HSE-WP-09/A03 REVISION NO : 1 DATE OF REVIEWED : 1 8 2008
PAGE NO Page 1 of 2 TITLE : PERMIT TO WORK- COLD

STOP WORK AND EVACUATE AREA ON HEARING EMERGENCY ALARM / SIREN

Internal

PERMIT & CERTIFICATES • 7 consecutive days with revalidation daily
• CSE – Daily (12 hours validity)
PTW Cold
PTW Hot Maximum validity/life period is seven (7) days
Confined Space Entry

Radiation
Excavation
Road Obstruction
Vehicle Entry
Limit Of Electrical Access
Lifting
Fire Water Usage
Portable Equipment Temporary Installation

Electrical Isolation Re-validated every 7 days. When the specified
Safety System Bypass/override work permit expires after seven (7) days, the
Physical Isolation certificate will continue to be valid until a
maximum period of three (3) month

Internal

EXERCISE 1:
Task: WL to fill-up
manual Hot Work and
Cold Work PTW.

Internal

END OF DAY 1
THANK YOU

Internal Presentation Title (acronym) ; ©Petroliam Nasional Berhad (PETRONAS) 2014 170
Division – Name/OPU/HCU/BU (acronym) ;
Name of Presenter

Internal

OBJECTIVES OF JHA TRAINING

PROVIDE THE REDUCE THE NUMBER ENHANCE THE TO ENSURE HAZARDS
GUIDELINE ON OF UNSAFE ACTS AND AWARENESS OF THE ASSOCIATED WITH THE
DEVELOPING THE JOB
HAZARD ANALYSIS SAFETY PERSONNEL ACTIVITIES ARE
INFRIGEMENTS IDENTIFIED AND

MITIGATED

Internal

DEFINITION

 JHA is a technique that focuses on JOB TASKS as a way to identify
hazards (i.e. sequence of activities) so that:
 precautions and control /recovery measures can be implemented
hence eliminate or minimize the hazards to an acceptable risk level
 to prevent injury, Illness, property damage, negative impact to
environment and/ or reputation.

Job Task Precautio
nary

measure

Job
Hazard

Internal

• Work that requires a Permit to Work (PTW) • JHA Team
• Work that have the potential injury to • Involved at least > 2 people
• Minimum JHA composition (Click here)
personnel or damage to property or

negative impact to environment.

When Who

• Section c:: JHA Tool Box Communication How • Prepare lists of all the routine tasks
Briefing Form
and non-routine tasks that requires

JHA
• Performed risk assessment for the

described task based on the risk

assessment matrix
• To use standard format as defined.

Use Template

• List of activities: 02.02 L3 Job Hazard Analysis (Attachment I)
• Cover page: PTS reference
• JHA Worksheet: 02.02 L3 Job Hazard Analysis (Attachment II)

Internal

Back (Home)

JHA leader

JHA preparer/scriber

Front line supervisors responsible (owner and/or contractor)

Area owner or representative of the work or project being carried out

Representatives (Owners and/or Contractor) from relevant discipline (e.g. operations, mechanical, instrument, electrical,
civil etc.) affected by the activities or individual work steps or tasks

HSE “personnel” ( Owner and/or contractor‟s personnel responsible for HSE)

Expert or Specialist (for high risk and highly specialized jobs e.g. diving, online leak sealing, hot tapping etc.)

Internal

Internally

Identify Scope & JHA Objectives

Select job/task to be analyzed

Break the job/task into logical steps

Identify all hazards associated with each steps

Consider all HSE hazards (6 hazards category)

Identify method of control for each hazards

What controls exists and Do the required controls Are controls reasonable
they adequate? pose an additional risk? and feasible?

Consequences Steps for Identification Action Party

Control/Precautionary
measures

Briefing for Implementation

Using Tool Box Briefing Form or during Kick off meetings or any platforms

REMINDER:
Any changes to surroundings, procedure, standards,
tools, incidents shall require job hold and revisit JHA

Internal

By Contractor
or Third party

JHA Preparation Briefing to 3rd Party on JHA requirements

JHA Prepared by Contractor/3rd Party

JHA review by all relevant disciplines (PGB & Contractors)

Identify all hazards associated with each steps

Consider all HSE hazards (6 hazards category)

Identify method of control for each hazards

What controls exists and Do the required controls Are controls reasonable
they adequate? pose an additional risk? and feasible?

Consequences Steps for Identification Action Party

Control/Precautionary
measures

Briefing for Implementation

Using Tool Box Briefing Form or during Kick off meetings or any platforms

REMINDER:
Any changes to surroundings, procedure, standards,
tools, incidents shall require job hold and revisit JHA

Internal

WHEN TO APPLY JHA?

JHA is appropriate for any task where the hazards and control measures
need to be formally assessed. The most common areas of application are:

•Routine tasks that have the potential for serious incidents.
•Job/tasks having a history of incidents, including near misses.
•New tasks or tasks introducing new work methods.
•Routine tasks being carried out in unusual circumstances.
•Non-routine or one-off tasks.
•Changes in job/task steps.
•Job/tasks that conflict with other activities in the same location.
•Commissioning of new operating procedure/system.
•Jobs that are new to your operation or have undergone changes in processes
and procedures.

Internal

WHEN TO APPLY JHA?… continued

Example Hot Work (Welding, Gas Tie-in etc)
of Cold Work (Installation, housekeeping, painting, scaffold erections)
works: Energy isolated (electric/pressure)

Confined space entry

Ground disturbance (excavation, pilling etc)

Maintenance on equipment in hazardous services

When working on live equipment including testing

Heavy lifting

Working at height

Others – as per defined in the sample list of activities requiring JHA (next slide).

Internal

SAMPLE OF LIST ACTIVITIES REQUIRED OF JHA

ACTIVITY ACTIVITY

• Welding and flame cutting • Demolition work

• Hot taps • Working at height

• Work with bottled gas • Spray painting

• Piping removal and replacement • Grit blasting Important
for both
• Piping installation • Scaffolding erection and dismantling staff &
contractor
• Rigging • Handling & working on scaffolding
•To provide
• Manual handling • Working on tower scaffolds Job
Method
• Working off step ladders Statement
• Operating pneumatic hand tools
• Grinding • To specify
associated
Refer to HNRA list (to incorporate admin• Hydro testing activities in
• Air line blowing Permit To
work
activities which applicable into HNRA list)• Hot oil flushing
• Excavation and back fill work
• Erection, construction and dismantling of false work

• Mechanical cleaning (formwork)

• High pressure water cleaning • Mobilization and demobilization of heavy equipment

• Hydro jetting • Grass and tree cutting

• Radiography • Operating heavy equipment (i.e. crane, forklift,

• Magnetic particles inspection excavator, compactor etc.)

• Pneumatic testing • Removal of floor grating

• Operating pipe cutting and threading machines • Fire proofing

• First entry to confined space (OPS) • Hot insulation works

• Working in confined space • Cold insulation work

• Installation or removal of equipment • Metal cladding work

• Spading work • Electrical testing

• Working in adverse environment condition • Electrical installation

• Mechanical isolation • Working with electrical equipment

• Line depressurised • Instrument installation and impulse piping

• Erection of structures • Cable pulling and banding

• Transportation of materials • Instruments calibrations (on-line)

• Handling/storage/disposal of radioactive sources • Leak repairs on flanges (furmanite)

• Handling/storage/disposal of flammable substances • Other non-standard repairs

• Handling/storage/disposal of corrosive substances • Work on roof

• Handling/storage/disposal of irritant substances • Weed spraying

• Chemical cleaning • Road work

• Tie in work (Piping, electrical and instrumentation • Draining of hydrocarbon to oily sewer and atmosphere

works) • Pig receivers entry and pigging operations

• Working near or over water • Delisting works

Internal

WHO PREPARES A JHA?

JHA is The person involved in leading the analysis should have a
normally a level of technical competence relevant to the job to be
TEAM analyzed and be a competent JHA Leader.
EXERCISE.
The composition of the team depends on the individual task
being analyzed and front line supervisors and each area of
skill should be represented.

For simpler tasks, a small team lead by the supervisor of the
activity should be sufficient.

Tasks of greater complexity may involve safety advisers and
area supervisors or the asset owner.

Larger teams or JHA exercises covering a number of tasks
may benefit from use of a facilitator (someone holding JHA
skills).

Internal

INTERFACES OF JHA

Interfaces The primary interface with JHA is the Hazard Effect
with Other Register (HER), Chemical Health Risk Assessment
Hazards and (CHRA), Environmental Aspect Impact (EAI), Process
Effects Hazard Analysis (PHA), Pre Activity Safety Review (PASR),
Management Audit Findings and recommendations, etc
Techniques

JHA Other Other interfaces that may indicate the need to apply JHA to
Sources a specific task include: analysis of accident statistics,

Tripod-Beta diagnostic profiles or recommendations

resulting from accident or incident investigations.

Internal

APPLICATION - Conducting JHA

JHA may be conducted Three principal ways
on an existing task or of conducting JHA:
prior to a task, during

the planning stage.

Direct observation. Group discussion. Recall and check.

Internal

1. To fill all relevant columns

Internal

1. To fill all relevant columns

Internal

1. To fill all relevant columns

Internal

1. To fill all relevant columns

Internal

STEPS #1 –
Select Job based on Job Steps for Analysis

 Identify the jobs/tasks that make up your occupation or
responsibilities

 Priorities and conduct JHA on jobs/tasks based on;
 Does the job/task have risks?
 uncertainty about the job/tasks and risks.
 uncertainty about needed controls to reduce/eliminate risks
 Has this job/tasks been performed in the past?
 Has a JHA been completed for this job/tasks in the past?
 Is this job/tasks done infrequently

Rule of Thumb: If there is uncertainties about the job/tasks:

Refer Job Method Statement or Method of Statement

Internal

STEPS #2 – Break the Task into Steps

 Each jobs/tasks will consist of a set of sequential steps. To determine
where a step begins or ends look for;
 A change of activity
 A change in direction
 A change in movement

 Ensure to list all steps needed to perform the job but note;
 steps should not be too detailed, or
 too general

Rule of Thumb:
Must understand the entire job/tasks before developing the JHA

Internal

STEPS #3 – Identify the Hazards

 For each of the steps listed, identify and list ALL the hazards will be exposed
 Consider the different types of hazards and categories of hazards;

Hazards Examples but not limited to

Physical noise, radiation, ventilation, thermal stress, lighting

Chemical Paintings, sealants, pesticide, solvents etc.

Biological Bacteria, virus, snake, bees etc

Psychosocial/ Peer stress, long hours, night shifts etc/Manual handling,
Ergonomics repetitive works, awkward postures

EleCcotrnicsaidl er to interfaceEthleectJrHocAutwioitnh, Hshaozrat rcdirscu&itE, dffeefcetcstRcaebgliisntge,r d(HefEeRct)p, ower
Environmental Aspectto&olsIm, epxapcot,seCdhecambilceasl & Health Risk Assessment, etc.

Adverse Condition Thunderstorm, Monsoon, Rainy, Lightning

Rule of Thumb:
Hazard must be identified based on site specific and location due to each
location and jobs may posed different threat.

Internal

STEPS #4 – Identify the Consequences

 WHAT IS THE CONSEQUENCE OF HAZARD RELEASE ?
 POTENTIAL ACCIDENTS OCCURING FROM THE WORK ACTIVITY

Rule of Thumb: Each group have greater knowledge of
their part than anyone else.

Internal

STEPS #5 – Identify Who or What might be
Harmed (PEAR)

 Identify impact to People, Environment, Asset and Reputation

Rule of Thumb: Refer to PETRONAS HSE Risk Matrix (HSERM)
dated on 26th March 2015

Internal

STEPS #6 – Precautionary/Control Measures

 Decide what actions or control are necessary to eliminate or
minimize the hazards.

 Utilize the hierarchy of control (and PPE is the last defend mechanism)

Hierarchy Of Control TYPE OF CONTROLS (Technical)
(ELIMINATION-SUBSTITUTION- ISOLATION - ENGINEERING CONTROL – ADMIN)
Elimination Remove/Clean area from any biological hazards (Bees, centipede etc)
Substitution
Isolation Use less hazardous chemical.
Engineering Controls
Administrative Controls Barrier for noise containment & Enclosure
PPE Engineering Control (Mechanical lifting ie pulley – Manual handling)

Procedure, PTW, Risk Assessment, Signboard, Competency

Wear specific chemical resistance glove & respirator (Chemical hazards)
Safety Harness: Working at height

 When describing controls, try begin with an action word and avoid
generic statement.

 List required PPE for the job.

Rule of Thumb: Establish prudent and reasonable controls to
protect workers. (ALARP)

Internal

STEPS #7 – Action/ Responsible Person(s)

Review written JHA with all impacted parties, distribute and conduct job/task per
written JHA

 Has the final JHA been discussed with all parties?
 Is the JHA attached to PTW?
 Will someone audit the job/task to ensure it is performed per JHA?
 JHA as been communicated
The responsible person at the work site
 Receiving Authority
 Work Leader

Rule of Thumb: The job/task does not proceed unless all parties agree!

Internal

1. Tool Box Talk (TBT) shall be conducted daily by Work Leader and verified by
Receiving Authority.

2. Work Leader to tick daily checklist

Internal

1. Work Leader and Receiving Authority shall verify that TBT is conducted daily.
2. All person involve in the activities shall fill up the name and sign daily.

Internal

1. Site specific hazard assessment to be performed daily.
2. In case any additional hazard encountered at site, Work Leader shall fill Section D with

approval (via any communication medium) from RA/RAR and AA/AAR.

Internal

1. Fill up Section A and Section B.
2. Then, signed at prepare by (WL), review by (RA, HSE, ME, others) and approve by

(AA) column at Section A.
3. Scan signed JHA worksheet and upload in Section 4 ePTW.
4. JHA worksheet shall be attached together with PTW.
5. Section C to be completed by Work Leader and verify by Receiving Authority before

daily work execution.
6. In Section C: Declaration Column, all workers shall sign after daily Tool Box Talk

(TBT).
7. Section D shall be filled up in case any additional hazard encountered at site, Work

Leader shall fill Section D with approval (via any communication medium) from
RA/RAR and AA/AAR.
8. Completed JHA worksheet shall be uploaded in ePTW system during PTW closure at
Section 8 or Section 4.

Internal

RESPONSIBILITY – JHA Approval

JHA APPROVAL –
Must be approved by respective area owner of the designated area.
Info:

JHA approval and verification could be done prior proceed with PTW approval

for work area > 1 km radius with appropriate risk assessment done.

Internal

DOCUMENTATION

 Completed JHA must be attached to PTW and available at
work site.

 Each JHA shall valid for specific PTW only. Any changes in
work activities process/areas required reviews.

 Attach JHA with Job pack prior uploading in OEXMS/ECM

Internal