Guidelines for the Management of Change for Process Safety
by Center for Chemical Process Safety
Copyright 2008 American Institute of Chemical Engineers, Inc
APPENDIX C:
EXAMPLES OF MOC SYSTEM
PROCEDURE WORK FLOW CHARTS
AND MOC REVIEW DOCUMENTATION
FORMS
The following figures provide examples of MOC system procedure work flow
charts and MOC review documentation forms. These charts and forms should
be considered advisory; they should not be used directly without going
through the proper MOC system design and development activities discussed
in Chapters 3 and 4.
Figure C. 1.
Figure C.2.
Figure C.3.
Figure C.4.
Example of an MOC system procedure work flow chart.
Example of a simple MOC review documentation form.
Example of a moderate MOC review documentation form.
Example of a complex MOC review documentation form
(including checklists).
123
Yes
Initial Review
Classification
Review
Hazard Review
Figure C.l Example of an MOC System Procedure Work Flow Chart
125
126
GUIDELINES FOR MANAGEMENT OF CHANGE
Complete tasks
identified as
required before
implementation
Authorization
Review
Close-out
Review
Figure C.l Example of an MOC System Procedure Work Flow Chart (cont 'd)
APPENDIX
127
Change description and rationale:
If the change is temporary, list the
pertinent dates. Dates valid:
Originator
This change has met the appropriate review requirements and has been
approved. Safety, health, and environmental concerns have been addressed,
procedures have been revised, the appropriate training and/or communication
activities have occurred, and all affected process safety information is being
updated.
RFC Authorizer
FIGURE C.2. Simple MOC Review Documentation Form
128
GUIDELINES FOR MANAGEMENT OF CHANGE
Unit or Area:
RFC No.:
Description and reason for change:
Date:
Orignator
Temporary Change
Removal Date:
Environmental, health, and safety reviews are complete and all concerns have been addressed.
EH&S Review Team Leader
Operating maintenance, and emergency procedures have been reviewed
Area Procedures Coordinator
All affected personnel have been informed of the change. The appropriate trailing has taken place.
Are a Tr aining C or dinator
All affected process safety inform edi on is scheduled for revision.
Unit Engneer
PSSR Required
PSSR No.:
This change has met the appropnate review requirements and has been approved.
Area Manager
FIGURE C.3. Moderate MOC Review Documentation Form
129
APPENDIX
REQUEST FOR CHANGE FORM
Standard Change
Emergency Change
Temporary Change
RFC No. .
Date Requested,
Date Required,
Unit
System or Equipment
Description (include technical basis for change):
Originator
I. TensOrary Changes (slap for permanent changes). This inicematian maybe provided in a temporary procedure (attach copy)
Whyis this designated a tempztraiy change?
Additionalpiecaxticns required:
Contingency plan
Dates valid:
Feisonresponsiblefbrtemoving the change:
II. Safety, HealtH and Environmental Reviews
Process S afcty (specify rnetliod)
Ocoipatianal Safe tyJlndustiul Hygiene
Enviraunenta] Review (s)
Reqd' Responsible
(Y/N) Party
Y
Target
Date
Date
Complete Initials
* Complete = Actianitems with immediate iripact are resclved and planis inplace to address long range items.
III. FfrcceduresRevised
Reqd' Responsible
(/) Party
Y
StaitupfthitdaviVErnejgeiry Shitdcwn
Normal Operation
Maintenance
Emeigency Response
Other (e.g., administrative)
** Complete = Revised procedures issued ;ary obsolete proaeduies discaidel.
Target
Date
Date
Complete
FIGURE C.4. Complex MOC Review Documentation Form (including
checklists)
Initials
130
GUIDELINES FOR MANAGEMENT OF CHANGE
I.
Training
W4
Operations
Mainterustce
Cortactor
Other
(Y/N)
Y
Individuals or Responsible
Groups to be trained ftrty
Taiget
Date
Date
Complete Initials
' Complete = AU specified peEcemel lave teceived and undeistood training. Responsibility fcf Any changetopermanent training
(e.g., learning blocks) is assigned and scheduled.
II. Process Safety IrfomiionRevised
WD
Access Flow Diagram
Electrical System Dooimentation
Reliefs ystemDooimentatkn
Spare Parts List
MSES
Documented Operating Limits
Other
* Ccetffeteif the are aiy Yes responses:
Folow-up Responsib ility
PS S R Responsibility
PSSR No.
Reqd' Responsible Date Target
(YiN) Party Coxtflete" Date
Y
Initials
III. Authorization
This change has net the appropriate leviewrequiietnenband has been appioved.
Aiea Operations Manager
Area Engineering Manager
IV. Close-out Review
All of the indicated process sa&ty infce-rraticffi revisions (S action V) hac^e been completed. This MOC action is complete.
FIGURE C.4. Complex MOC Review Documentation Form (including
checklists) (cont'd)
131
APPENDIX
G Off-hours review
MOC initiation dale
R e quire d implem e ntati on date
P lant modifi c ation tracking no.:
Modification title:
Permanent G
TemporaxyG
Expires
Date:
Requestor:
Unit:
FCCU
F-Alky
G Crude
G Quality Control
H
G Reformer
G Terminal
G Maintenance
G Other
Estimated costs of modification: Parts, material, equipment
Labor
Total
Description of change
D oes a sketch accompany this form? G Y es G
Purpose (technical basis)
otential impact on safety, health and the environment (including the public)
Reviews
G Approved
Area Manager
Dete
G Denied
C omments, conditions, or reasons for denial
azdreview required Q Yes Q No
Technique: MOC
G WhaUif
HAZOP Q Other
Initials
G Approved
Area Engineer
Dcte
D eti e d
C omments, conditions, or reasons for denial
Deagnresponsibility assigiedto
Design review required DYes D No
FIGURE C.4. Complex MOC Review Documentation Form (including
checklists) (cont fd)
