Safe Work Permits

Safe Work Permits

Cutting / WeldingPermit

Location: Job No.

Date: Job No.

Confined Space Entry Permit

Location and description of confined space:Reason for entry:Permit issued to:Supervisor’s Name:Attendant’s name:Permit issuer’s name:% oxygen: % lower explosive limit: ppm CO: H2S:

Requirements

Emergency Rescuer yes noContinuous Gas Monitor yes noBarrier for ground openings yes noWarning Signs yes no

Safe Work Permit Permit #

Type: (hot work, confined space, line break, etc..... location:

Valid __/___/___ ____ __/___/___ ____ Issued to: From: M D Y time to M D Y time

Work Description: ____________________________________________________________________________ Supervisor’s Signature Print name________________________________________________________________________________________ Work Order No.

Atm Combustible vapors or gases (<10%) Oxygen Concentration (>19.5% & <21%) Toxic Material ConcentrationTests

Precautions Always Required:

There are currently three documents which are called“safe work permits.”

Safe Work Permits

Cutting / WeldingPermit

Location: Job No.

Date: Job No.

Location & Building: Floor

Nature of Job:

Welder’s Name:

The above location has been examined. The precautions checkedon the reverse of this card have been taken to prevent fire.Permission is granted for this work.

Permit Date: Time:Expires AM

PM

The Hot Work Permit is a formof Safe Work Permit issued bythe Fire Marshal or other person responsible for fire safety.

This permit is required for allsituations which may result infires or explosions.

Safe Work Permits

CAUTIONOpening in Ground

Keep Out !

The “Confined Space EntryPermit” is another form ofsafe work permit regulating

entry into pits, tanks, and vessels.

Confined Space Entry Permit

Location and description of confined space:Reason for entry:Permit issued to:Supervisor’s Name:Attendant’s name:Permit issuer’s name:% oxygen: % lower explosive limit: ppm CO: H2S:

Requirements

Emergency Rescuer yes noContinuous Gas Monitor yes noBarrier for ground openings yes noWarning Signs yes noSafety Harness with life line yes noTripod / Hoist / Pulley yes no

Safe Work Permits

Cutting / WeldingPermit

Location: Job No.

Date: Job No.

Confined Space Entry Permit

Location and description of confined space:Reason for entry:Permit issued to:Supervisor’s Name:Attendant’s name:Permit issuer’s name:% oxygen: % lower explosive limit: ppm CO: H2S:

Requirements

Emergency Rescuer yes noContinuous Gas Monitor yes noBarrier for ground openings yes noWarning Signs yes no

Confined Space Entry Permits and Hot Work Permitswill be discussed in detail in other training sessions.

Safe Work Permits

Safe Work Permit Permit #

Type: (hot work, confined space, line break, etc.... location:

Valid __/___/___ ____ __/___/___ ____ Issued to: From: M D Y time to M D Y time

Work Description: ____________________________________________________________________________ Supervisor’s Signature Print name________________________________________________________________________________________ Work Order No.

Atm Combustible vapors or gases (<10%) Oxygen Concentration (>19.5% & <21%) Toxic Material ConcentrationTests

Precautions Always Required:

The objective of the Safe Work Permit system is toidentify hazards associated with a nonroutine job, andto develop precautions required to control each hazardidentified.

Safe Work Permits

Let’s begin with alook at the hazardsassociated withspecific jobs, andexamine how Safe Work Permits can help to preventthem from causingdamage or injury.

Safe Work Permits

Examples of jobs requiring permits are:

1. Hot Work - the use of open flame, oxyacetylene burning, tar kettles, etc...., and the use of portable spark or heat producing equipment in flammable storage or handling areas.2. Confined Space Entry3. Excavations4. Blasting5. Whenever required by existing company or contractor procedures or required in the contractor’s Project Safety Plan.6. Use of internal combustion engines, or vehicles with internal combustion engines inside company buildings.7. Use of company owned equipment, such as personnel lifts, fork trucks, vehicles, etc., by employees of a contractor

Safe Work Permits

Excavations can result in:

head Injuries from materialsfalling from overhead surfaces,

rupture of high pressure hydrauliclines used on backhoes, shovels,and drills.

excessive noise from concretebreaking and cutting equipment,

and collapse of excavation walls and piles due to poorly secured soil, suddenweather changes, or other factors.

Permits are written to ensure that necessary equipment is present and ingood working order.

Safe Work Permits

Blasting can cause damageto adjacent operations andpersonnel.

Permits are issued to ensureprocedures are followed thatprevent injury to neighboringfacilities, equipment and employees.

Safe Work PermitsInternal combustion engines produce poisonous gasessuch as carbon monoxide, and oxides of nitrogen.

Permits ensure that procedures are followed that will prevent equipment emissions from contaminating air inside buildings and confined spaces.

Safe Work Permits

Unauthorized use of companyequipment can result in lostproduction and injury to untrainedoperators.

Permits prevent company equipmentfrom being taken by contractorswithout the permission of areamanagement, and requireverification of equipment operatortraining.

Safe Work PermitsMovement oflarge pieces of equipment,especially while other personnelare working nearby, can resultin employee injury.

Permits may be issued to ensurethe use of procedures that willprevent employee injury from falling material, or being struck by rigging equipment.

Safe Work Permits

Abandoned tanks, pipe lines,drums, and vessels may containhazardous vapors and gases.

Permits may be issued to preventtoxic or corrosive exposures to workerswhen working on abandonedequipment, complementing hot workand confined space permits.

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Safe Work Permits

Many construction processescreate noise levels high enoughto cause hearing loss.

Permit requirements may be issuedto reduce noise to acceptable limits,or to provide both construction andother employees with requiredhearing protection.

Safe Work Permits

Boilers, high pressurevessels, tanks, and reactorscan undergo sudden failureresulting in disastrousconsequences.

Permits may be issued requiringprecautions and equipment toprevent system failures notcovered by safe job proceduresor project safety plans.

Safe Work Permits

Permits may be requiredwhere the consequenceof noncompliance withfall protection requirementsis severe, or where droppedmaterials may endangerother workers below.

Safe Work Permits

Permits are requiredbefore work begins nearenergized lines which cannotbe shut off if there is dangerof fire, shock or electrocution.

Safe Work Permits

CAUTION

Hazardous Materials!

“Safe Work Permit Required!”

Permits are mandatory where signs are posted which require them.

Safe Work Permits

Safe Work Permit Permit #

Type: (hot work, confined space, line break, etc.... location:

Valid __/___/___ ____ __/___/___ ____ Issued to: From: M D Y time to M D Y time

Work Description: ____________________________________________________________________________ Supervisor’s Signature Print name________________________________________________________________________________________ Work Order No.

Permits are issued:

- for a specific date and time range,- for a specific job,- and to specific individuals.

Safe Work Permits

Safe Work Permit Permit #

-------------------------------------------------------------------------------------------------------------------------------------------------------------------Work Description: ____________________________________________________________________________ Supervisor’s Signature Print name________________________________________________________________________________________ Work Order No.

Atm. Combustible Vapors or gases (<10%) Oxygen Concentration ( >19.5% & < 21%) Toxic Material ConcentrationTests

Permit Issued by: _________________________/____/___ Work Area Manager Approval _______________/___/__

Permits must be reviewed and signed by:

- the safety representative issuing the permit,- the workers’ supervisor,- affected workers,- and the work area manager.

Safe Work Permits

Safe Work Permit----------------------------------------------------------------------

Precautions Always required:

o Emergency procedures review by:o Emergency equipment & location review by:o Area inherent hazards review by:o Material Safety Data Sheet(s) review by:

Workers must be informed of required emergency procedures, locationand operation of emergency equipment,and area inherent hazards.

Material Safety Data Sheets must be supplied and specialprecautions reviewed with workers and their supervision.

Safe Work Permits

Safe Work Permit----------------------------------------------------------------------

Special Precautions Required:

o Buddy System o Sprinklers in Serviceo Cleaning of _________ o Purging of ________o Remove materials from ___________________o Piping o Drain o Disconnect o Blank off / Cappedo Clean o Ventilateo Remove combustibles from other side of wall.o Floor Swept Clean of Combustibleso Clean area within 35 feet. o Wet down floor.o Adjacent areas: __________________________o Cover floor with: __________________________o Non-combustible Tarpaulins or Metal Shields Over:o Electrical Switches or Valves off, locked-out, and Tagged:o Electrical Grounding of: ________________________o Atmosphere monitored during work for: ____________ periodically: __________ continuously: __________o Safety Monitor(s) present from _________ to _________o Fire Watch Present during work and for 30 minutes after...o Respirator to be worn____ or be readily available ___

Required special precautionsmust be clearly indicated andcommunicated to workers,and their supervision.

It is the safety representative’sresponsibility to determine ifand when special measuresare required.

Safe Work Permits

Safe Work Permit----------------------------------------------------------------------

Safety Equipment Required

o safety glasseso hard hato face shieldo safety shoeso fire extinguishers - type ___ #___ size ___o fire hoseo supplementary illuminationo warning signso barricadeso non-sparking toolso explosion proof equipmento safety harnesso life lineo tripod emergency escape unito 2-way radio or phoneo respiratorso impervious gloveso protective clothing _____________________o mechanical ventilationo shower & eyewasho self contained breathing apparatuso ground fault circuit interruptero ladder / lift / scaffoldo other________________________________

Personal protective equipmentand other safety equipment requiredis specified.

For each hazard present at the worksite, the safety representative mustspecify a hazard control.

Safe Work Permits

Safe Work Permit----------------------------------------------------------------------

EXCAVATION PRECAUTIONS REQUIRED:

o Underground / Underfloor Utility Hazard Reviewo Soil Excavation Reviewedo Underground Utility Stakeout Performedo Excavation cut back 1/1, or walls reinforcedo Means of exiting within 25 feet.

The safety representative must verifythat all underground utilities havebeen located and staked out.

Provisions must be made to barricade the open trench, preventcollapse of trench walls, provideemployees with a means of exit,reroute ground water, and all otherrequirements of excavating.

If soil is contaminated, the safetyrepresentative will ask for a writtensafety and health plan.