CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

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e

PERMIT TO WORK
PROCEDURE

Revision Date Description Return Code

B 12/11/2021 ISSUE FOR APPROVAL

A 28/09/2021 ISSUE FOR APPROVAL 2
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Table of Contents
1.0 PURPOSE AND SCOPE 3
2.0 REFERENCES 3
3.0 ACRONYM AND DEFINITIONS 3
4.0 RESPONSIBILITIES 6
5.0 PERMIT TO WORK OBJECTIVE 6
5.1 PERMIT TO WORK SYSTEM CESSATION 7
6.0 PERMIT TO WORK ROLES 7
6.1 PROJECT MANAGEMENT 7
6.2 CONTRACTOR HSSE 7
6.3 PERMIT REQUESTOR / APPLICANT (PA) 7
6.4 WORK LEADER 8
6.5 RECEIVING AUTHORITY (RA) 8
6.6 RECEIVING AUTHORITY REPRESENTATIVE (RAR) 8
6.7 APPROVING AUTHORITY (AA) 8
6.8 APPROVING AUTHORITY REPRESENTATIVE (AAR) 9
6.9 PERMIT TO WORK COORDINATOR (PTWC) 9
6.10AUTHORISED GAS TESTER (AGT) 9
6.11FLAGMAN 9
6.12FIRE WATCH 10
7.0 MANDATORY PERMITS 10
7.1 GENERAL 10
8.0 PTW PROCESS 11
8.1 PERMIT VALIDITY 11
8.2 USE OF PERMIT TO WORK COMBINED FORM 12
8.3 PTW OWNERSHIP 12
8.4 PTW RENEWAL 13
8.5 PTW CLOSURE 13
8.6 PTW BREACH OR NON-COMPLIANCE 13
8.7 PERMIT SUSPENSION DUE TO EMERGENCY 14
8.8 SIMULTANEOUS (SIMOPS) OR INCOMPATIBLE WORK 14
8.9 PTW CONTROL 14
9.0 PTW TRAINING 14
10.0 DOCUMENTATION MANAGEMENT 15
10.1LOST / DAMAGED PERMIT 15
11.0 PTW RECORD / RETENTION 16
12.0 APPENDICES 16
13.0 ATTACHMENTS 16
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1.0 PURPOSE AND SCOPE

The purpose of this document is to identify the requirements for Permit to Work
This procedure includes the following major sections:
 PTW Objective
 PTW Roles
 Mandatory Permits
 PTW Process
 Appointment and Training
 Documentation Management

This procedure applies to all work activities executed under the management of MIEI and meets the
requirements of Malaysian Government and related authorities for Project at Construction Sites.

Permitting requirements may be adjusted during commissioning and after Ready for Start Up stages
of the project.

This procedure shall be reviewed on an annual basis from date of approval or as required due to
lessons learned or changes in corporate requirements.

2.0 REFERENCES

2.1 ILO - DOSH 2001: GUIDELINES ON OCCUPATIONAL SAFETY AND HEALTH

MANAGEMENT SYSTEM

2.2 MS ISO 45001:2018; Clause 8: Support; 8.1 Operational Planning and Control

2.3 MIEI Management System; Work Instruction; Permit to Work; WI 8.1.1-04

2.4 F44SL PROJECT HSE PLAN: F44SL-PHASE1-IPMT-HSE-PLN-0001

2.5 F44SL PROJECT PERMIT TO WORK (PTW) PROCEDURE : F44SL-PHASE1-IPMT-HSE-

PRC-0001

3.0 ACRONYM AND DEFINITIONS

CONTRACTOR: MIE Industrial

MIEI: MIE Industrial Sdn Bhd

CLIENT: TOP GLOVE

LOWER TIER means any person or company of any tier, including but not limited to,
SUBCONTRACTOR: suppliers or vendors of MATERIALS, suppliers of SUBCONTRACTOR’s
EQUIPMENT and erection contractors, having a contract with
SUBCONTRACTOR or a LOWER TIER SUBCONTRACTOR for the
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performance of any part of the WORKS.

PACKAGE: means each package of works or supplies forming part or parts of the
PROJECT.

PACKAGE WORK: The works, services or supplies, or any or all of the foregoing, to be
undertaken by a PACKAGE CONTRACTOR or PACKAGE VENDOR, as
applicable.
"SCOPE OF WORK" may also be used instead of "PACKAGE WORK" to
facilitate the understanding of all the parties.

PROJECT: TSR F44SL Project Phase 1

PROJECT means mandatory documents comprising of specifications and Project

SPECIFICATION Procedures.

SUBCONTRACTOR means any company which CONTRACTOR has engaged or proposes to

engage (as the context may require) to undertake any part of the
CONTRACTOR Services

VENDOR Shall mean any person, form or company having a purchase order with
the CONTRACTOR for the performance of any item or work.

The acronyms used in this document have the meaning defined below:

AA: Approving Authority

ALARP: As low as reasonably possible
JHA: Job Hazard Analysis is a step-by-step task analysis of a job, its safety hazards
and how these hazards effect management and work process at that job level.
To ensure the hazards associated with the activities are identified and
mitigated so that the work can be carried out safely.
Note: All JHA’s shall be risk assessed by each step. Risk assessment will be a
2 steps system, prior to controls being implemented and after controls are
implemented.
JMS: Job Method Statement is a work procedure that describes the methodology of
a task to be completed. This is not required to be risk assessed; however,
each MS requires a risk assessment aligned with its specific method of work.
SIMOPs: Simultaneous Operations - The interface between two work groups in a work
zone or where any number of work groups work scope may affect each other
at any given time.
Competent Person: A person who has, through a combination of training, education and
experience, acquired knowledge and skills enabling that person to perform a
specified task correctly
PR: Permit Requestor / Applicant
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PTWC: Permit to Work Coordinator

P&ID: Piping and Instrumentation Drawings
CDS: Chemical Data Sheet
Confined Space: Confined Space means a space which:
 is not intended as a regular workplace (i.e. continuous employee
occupancy);
 has restricted means of entry or exit;
 is large enough and so configured that an employee can bodily enter and
perform assigned work; and
 is at atmospheric pressure during occupancy.
In addition, the space has at least one of the following:
 it contains or has a potential to contain a hazardous atmosphere;
 it contains material (solid or fluid) that has potential for engulfing an
entrant;
 it has an internal configuration such that an entrant could be trapped or
asphyxiated by inwardly converging walls or by a floor which slopes
downward and tapers to a smaller cross-section; or
 it contains any other recognised serious safety or health hazards, for
example exposed rotor blades, noise etc.

Standby Person: Person required to be in attendance at a confined space entry point when
persons are in the confined space.
Preservation: A process that protects the integrity of equipment, prior to its operation. E.g.
nitrogen gas filling, oil filling or the heating of equipment to eliminate moisture
entry.
RFSU: (Ready for Start Up) All commissioning activities and requirements have been
completed and achieved. The UNIT / SYSTEM is ready for initial Start-Up,
introduction of feedstock, operational adjustments and ramp up activities, all
min accordance with all applicable contractual requirements.
AGT: Authorised Gas Tester is a person who is trained and authorised to conduct
gas testing prior to hot work, confined space entry or other types of work
where gas testing may be required.
Note: AGT for confined space entry in Malaysia shall be certified and
registered with Department of Occupational Safety and Health (DOSH). AGT
for purposes other than confined space entry shall be trained and authorized in
writing by the MIEI.
Working at Height: Working at heights is defined as 1.8m (person’s feet). Any person working at
1.8m or more shall have a fall protection system and procedure in place, and
be trained in these requirements.
Note Working at Height permits are not required where a certified handrail or
tagged scaffold is in place.
Crane Lifts: Field Riggers are required to complete Green Lift Checklists for non-critical lifts
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Critical Crane Lifts: A non-routine crane lift requiring detailed planning and additional or unusual
precautions All critical crane lifts will require a Critical Lift permit
Hot Work: Hot work is any work which involves use or introduction of heat, sparks or
flame.
Examples of hot work are:
Welding, flame cutting, grinding, etc (positive ignition sources) and the use of
spark producing tools or equipment. Where flammable gas and condensates
are present an internal combustion engine would be classed as hot work.
Note: Hot Work Permits are not required for general construction works in a
greenfield work area that are not classed as high fire risk potential.
IMPORTANT: All hot works on the site regardless of risk level will require a
suitable fire extinguisher to be available at hand to the persons conducting the
hot works.

Fire: Where an actual flame is present.

Smoulder: To burn slowly and gently, usually with some smoke, but without a flame.

High Fire Risk: High Fire Risk potential is classed as Hot Works that have a residual risk level
of major or catastrophic and/or will create a fire that will cause the definite risk
of: -
Explosion, significant risk of serious injury to person/s, environment or
property.

Examples - High Fire Risk.

 Hot works in an environment where flammable gases, condensates or

hydrocarbons are present or have potential to be present.
 Hot Works in a confined space where insufficient ventilation is
achievable or gaseous build up will cause engulfment or explosion.
 Hot works in an area where a fire could not be controlled by safe work
processes of the person/s working. This fire would cause significant
injury to person/s, property or the environment.

4.0 RESPONSIBILITIES

CONTRACTOR Management is responsible for ensuring that work activities carried out by the
CONTRACTOR and their subcontractors, the Package Vendors and that activities performed are
conducted safely and that all personnel of above entities are not exposed to hazards and risks.

CONTRACTOR is responsible for performing their work activities safely and to comply with all the
HSSE Procedures.

In order to achieve this, all activities carried out by the CONTRACTOR shall be conducted as per the
requirements of this Procedure and its associated standards. CONTRACTOR will conduct audits and
surveillance to ensure conformance to this Procedure
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5.0 PERMIT TO WORK OBJECTIVE

CONTRACTOR Permit to Work (PTW) System constitutes a formal method of ensuring safe work
practices for a specific activity with identified hazards. The work permit granted through the PTW
System stipulates the safety and precautionary or risk control measures to be applied with reference
to this specific procedure.

The minimum requirement for any works on site will be a Method Statement and a Risk Assessed
JHA.

CONTRACTOR reserve the right to implement a permit process for any task, where they decide the
risks and hazards of the task require a Permit to Work.

This PTW system is intended to better control the construction high risk work activities and ensure all
identified control measures are implemented.

The PTW will assist in the identification and control of hazards, but will not by itself make the work
safe. It is an essential part of a system which determines how a job can be completed safely and
helps communicate this to those doing the job.

The PTW system will ensure the following:

 Proper authorization for the work, ensure person or authority responsible for the site is
aware of all work being carried out.

 Effective communication on the risks/hazard of the job and precautions to be taken.

 Documentation of the work method and safety precautions required for the job.

 Confirmation that site conditions and preparations have been checked and recorded by
an authorised person.

 Clear communication between the Approving Authority and Permit Requestor.

5.1 PERMIT TO WORK SYSTEM CESSATION

All the CONTRACTOR and SUBCONTRACTOR including visitors will obtain proper permits
prior to performing any work that requiring a permit. Activities within CONTRACTOR’s new
construction area shall follow the requirement of this procedure alongside with COMPANY’s
PTW Procedures.

6.0 PERMIT TO WORK ROLES

6.1 PROJECT MANAGEMENT

 CONTRACTOR will appoint Permit to Work Authorities.

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6.2 CONTRACTOR HSSE

 CONTRACTOR HSSE will ensure all personnel are trained to the Permit to Work
procedure as to the level they require.
 CONTRACTOR HSSE will audit contractors for compliance to the CONTRACTOR PTW
system.

6.3 PERMIT REQUESTOR / APPLICANT (PA)

 Prepare the PTW with clear and complete information, including any known hazards and
hazardous activities for the job to be carried out
 Prepare the PTW with Supporting documents, JMS, JHA, certificates, checklists
 Initiates the permit request 24 hrs prior to the actual start time of works
 Confirms with CONTRACTOR construction Superintendent or delegate they can
commence works in the area and have meet construction approval requirements
 Ensures they have the resources to carry out the works
 Ensures all equipment and mobile plant has been inspected by CONTRACTOR and
marked approved for site.
 Review the JMS, and JHA against the PTW requirements.
 Visits the work site and discuss their intended work scope with any other contractor that
they may interface or have SIMOPS with.
 Will leave the work area in a clean, tidy and safe condition prior to departure at the end of
each shift.
 Will leave the work area clean, tidy and in a safe condition for others on completion of
works and the closure of their permit.

6.4 WORK LEADER

Confirm understanding and acceptance of conditions of the PTW and acknowledged by

signing
 Handle number of PTW based on assessment criteria mentioned in “Permit Control”
 Explain the JHA content and PTW conditions to the workers
 Supervise the work and should not leave the worksite while the work is ongoing unless
the work is formally handed over to another WL, RA, or RAR
 Verify control measures are in place–e.g. area barricaded, designated PPE are used
 Ensure compliance to PTW conditions
 Return PTW to RA on completion of the work
 The WL may also be the RA if trained and appointed to do so

6.5 RECEIVING AUTHORITY (RA)

May perform the role of PA (Permit Applicant / Requestor)

 Discuss the work and highlight any special precautions with the AA
 Discuss the work with the WL or PA
 Co-lead the risk assessment or JHA with discipline supervisor/engineer.
 Supervise the work in the PTW
 Perform joint site visit with AAR before the PTW is issued
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 Acknowledge the details of the PTW/certificate including any potential hazards, and all
the required precautions and conditions specified by the PTW AA
 Communicate all the requirements to the WL or Permit Applicant/ Requestor and workers
for the job
 Ensure the workers comply with the requirements set in the PTW/certificate e.g. physical
boundaries, precautions, type of work and validity time
 Leave the site in a safe condition and inform the AA on completion or suspension of the
work.
 Hand back and sign-off the PTW when the job is completed

6.6 RECEIVING AUTHORITY REPRESENTATIVE (RAR)

 To join site visit before work, start as instructed by RA and to ensure all the area have
been checked and equipment are working.
 To assist the RA during PTW execution

6.7 APPROVING AUTHORITY (AA)

 Minimum engineer or discipline head or superintendent or manager level

 Ensure hazards associated with the job are identified and mitigated
 Specify the controls and precautions for safe execution of the work
 Ensure that the work being authorized does not jeopardize ongoing operations of the
facility
 Ensure that the work does not conflict with other ongoing permits(jobs) and are cross-
referenced to other permits for jobs that may interact with each other
 Ensure that PTW is counter signed by AA of affected areas where applicable
 Communicate all ongoing or suspended PTWs with the incoming PTW AA during shift
handover if any.
 Approve and revalidate PTWs

6.8 APPROVING AUTHORITY REPRESENTATIVE (AAR)

 Visit the worksite with the Receiving Authority (RA) /Work Leader (WL) /Permit Applicant
prior to authorization of the PTW by the AA
 Verify the equipment has been safely isolated for the PTW to be authorized
 Visit the site while work is ongoing.

6.9 PERMIT TO WORK COORDINATOR (PTWC)

 Receives work permit requests, reviews and analyses the task and the precautionary
measures to be carried out
 Ensures the attachments (job location layout, required drawings, P&ID, MSDS, MS, and
JHA) are accurate to the job to be performed
 List any additional safety precautions and inform the Permit Requestor
 Forward all the work permits to the Permit Authority for approval
 Arrange permit approval time and location with the Permit Authority and Permit
Requestor
 Maintain the PTW register on work permits issued.
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 Monitor closure and safe keeping of open and closed work permits
 Prompt the contractors to renew / return all permits at expiry dates
 Inspect the permit sites to ensure the work permit corresponds to the work area and
safety precautions are being followed.
 Retain the PTW records

6.10 AUTHORISED GAS TESTER (AGT)

A person who is authorised to conduct gas testing prior to hot work, confined space entry or
other types of work where gas testing is required.

Note: An AGT is not required to be stationed at a work location unless it is deemed a

confined space and that space has potential for asphyxiation or atmospheric change during
work that would not be detectable by a personal gas monitor.

6.11 FLAGMAN

 Be trained in Mobile Plant spotting for plant and personnel interface.

 Flagman will be assigned to watch and guide mobile plant where there is a potential of
interface with personnel and mobile plant in a work place and it is impractical to remove
people for the work area.

IMPORTANT: Flagman will not carry out any other duties when watching and guiding mobile
plant and personnel interface

7.0 MANDATORY PERMITS

7.1 GENERAL

The following works or activities will require a Permit to Work:

 All hot work
 Confined space entry
 Excavation deeper than 1.5 meters.
 Mechanical lifting using cranes or other lifting equipment or devices (except routine
lifting activities which are as part of a normal and repetitive job)
 Installing, servicing and modifying temporary electrical installations (e.g. generator
set/portable power supply system complete with cabling, plugs, socket, distribution
box, ELCB, etc.) which do not form part of the permanent or fixed electrical
installation of the facility.
 Work on fixed electrical installation for the purpose of modification or repair of the
system. If the work involves preparation of temporary power supply or lighting system
for the work area, such temporary installation shall be inspected by competent
electrical person and certified safe for use.
 Radiography work.
 High pressure water jetting except when the work is conducted inside a designated
water jetting area. This applies to all pressures up to ultra-high pressure of >20,000
psi.
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 In-situ grid/sand blasting of equipment in the plant unit area.

 Pressure testing (pneumatic testing and hydro testing) of equipment.
 Chemical cleaning of equipment.
 Installation/Dismantling of scaffold.
 Other high-risk activities based on risk assessment or as required by IPMT
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8.0 PTW PROCESS

All site works will be assessed by its specific work scope and risk level, prior to the request for any
form of permit to work.

Permit Requestor either from CONTRACTOR, Sub-contractor or vendors are responsible to assess
their specific work scope and risks against this CONTRACTOR PTW procedure.

They must then request the required PTW for the work to be conducted from the CONTRACTOR
PTW Coordinator.

CONTRACTOR PTWC will review the permit requests to assess the permit required and the
documentation is suitable, prior to registering the permit and submitting it to the CONTRACTOR
Permit Authority for site inspection and approval.

8.1 PERMIT VALIDITY

Varying permits have different validity timelines. The Permit Authority has complete authority
over the final validity timeline of any permit and may reduce or increase timelines as per risk
levels.

Standard Time lines area as follows:

 PTW is valid during daylight hours ONLY (0700 – 1900 hours). Work at night time will
require permit extension and revalidation.
 Except for Confined Space Entry, a single PTW form can be used for a maximum of
seven (7) consecutive days subject to revalidation at each shift or day.
 The maximum validity of PTW for Confined Space Entry is ONLY twelve (12) hours
with a provision of extension for another four (4) hours after revalidation. A new PTW
is required if the work is to continue after the sixteen (16) hours.

8.2 USE OF PERMIT TO WORK COMBINED FORM

The Permit to Work Combined form may be used for any general construction work that is
assessed to have a residual risk level of major or catastrophic or any work that
CONTRACTOR HSSE / Construction management teams deem the permit process is
required.

The Permit to Work Combined form is designed specifically for construction and can also be
used for multiple other project specific permitted tasks on the project. It may be used for
more than one permit for the same work scope. CONTRACTOR HSSE and the Permit
Authority will have ultimate approval over the use of the permit form and what work scopes
can be assigned under that permit.

Work Types can be used for:

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 Any form of general construction classified by CONTRACTOR HSSE / Construction

management
 Confined Space
 Hot Work - where “High Fire Risk” potential exists
 Road Obstruction or Closure
 Access to high voltage areas (such as substations and yards)
 Rock blasting
 Piling
 Radiography

Examples of multiple use of Permit:

 Permit to do Piling and if that job had High Fire Risk and complete the Hot Work
Permit on the same Permit form.
 Permit for Road Obstruction or Closure for culvert works and complete a Confined
Space permit on the same Permit form for sealing works in the culvert
 Permit for Road Obstruction or Closure for culvert works, with a Confined Space
permit on the same Permit form for sealing works in the culvert and a Hot Work
permit for rebar fabrication at a entry pit on the same culvert.

IMPORTANT:

The permit combined form cannot be used for more than one Confined Space.

All Radiography permit packs will include Emergency Operation requirements for radioactive
Sources

8.3 PTW OWNERSHIP

Permit Requestor / Applicant (PR)

A Permit Requestor/Applicant may hold multiple permits within a work area; however, each
permit will be assessed by a Permit Authority as to the Permit Requestor’s capability to
supervise the permitted works across the work area.

CONTRACTOR and/or Sub-Contractor will provide sufficient Permit Requestor to ensure

permits are held for their duration and safely supervised.

Note: CONTRACTOR PTWC will provide the Permit Authority with a register of each Permit
Requestor as required, to ensure the Permit Authority is aware of the current permits held by
any individual Permit Requestor.

Approving Authority (AA)

The Approving Authority may approve any number of permits. Approving Authority has the
authority to approve, audit, review, revise, renew, close or cancel any permit as per the
permits risk level and/or work scope.
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8.4 PTW RENEWAL

On expiry of a PTW the Permit Requestor will:

 Review the work scope for change

 Make any required changes to their documentation
 Resubmit all documentation to the PTW and Permit Authority as per an initial permit
request

8.5 PTW CLOSURE

Prior to the closure of a work permit the works must be confirmed as completed by:

 The PR will contact their relative CONTRACTOR Construction Superintendent or

delegate.
 The CONTRACTOR construction superintendent or delegate will confirm the works
are completed and the permit can be closed.

IMPORTANT Note: This confirmation is NOT an agreement the work is project approved,
only that the PTW can be closed.

8.6 PTW BREACH OR NON-COMPLIANCE

When a permit breaches, or serious non-compliance to the work permit system requirements
is identified. All activities under the control of the PTW in question must be suspended
immediately and made safe. A PA or CONTRACTOR HSSE Manager must be informed to
assess the situation prior to works recommencing. A PA will provide authorization to either
recommence under the existing permit and its precautions or cancelation of the existing
permit and a new permit issued.

Any permit breaches and non-compliances will be subject to CLIENT the CONTRACTOR
Disciplinary Process.

8.7 PERMIT SUSPENSION DUE TO EMERGENCY

In the event of an emergency situation all works will cease and permits will be suspended.
Permit Applicant or Work Leader or Receiving Authority will hand in all permits to the
Approving Authority (AA)

Only after consultation with CONTRACTOR project management, CONTRACTOR HSSE

and AA can re-authorize permitted works after an emergency situation.

All permits will be renewed.

8.8 SIMULTANEOUS (SIMOPS) OR INCOMPATIBLE WORK

Simultaneous and/or incompatible work/activity shall be managed so as to ensure:

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 Correct sequential start/stop

 Safe separation
 Identification of additional control measures
 Close supervision to prevent conflicting/incompatible work that could lead to a potential
incident.

The PTW for such work shall be authorised by the AA so the affected areas to ensure that a
job in one area will not cause a hazard in another.

8.9 PTW CONTROL

PTW must be prepared in 3 copies

 The original copy must be displayed at the work site by the RA
 The copy no.1 must keep at PTW office.
 The copy no.2 will be kept by RA.

A person shall NOT issue a PTW to himself/herself.

All PTW application for planned activities shall be submitted at least 12 hours before start of
the work.

Only ONE task is allowed per permit.

A PTW office shall be established to manage PTW issuance and return. All documentations
and records related to PTW shall be retained in the PTW Office.

9.0 PTW TRAINING

All personnel working under the CONTRACTOR scope of works will be required to be trained in
CONTRACTOR Permit to Work.

CONTRACTOR HSSE will conduct the training for CONTRACTOR Permit to Work

The PTW training is valid for up to 3 years only

RA and AA who are not involved in PTW activities for more than 12 months shall attend PTW
refresher training

10.0 DOCUMENTATION MANAGEMENT

The CONTRACTOR Permit to Work Coordinator will be responsible for control of permit to work
documentation.

Permit to Work Requester (PR) will be responsible for the control of the permits issued to them and
will maintain all documentation at the work front in the field.

The PTW Coordinator will:

 Ensure the permit request documentation meets permit requirements

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 Maintain a register of all permits

 Issue a daily register of operating permits to CONTRACTOR construction management
 Instruct the Permit Requester as to management of operating permits in the field, renewal of
permits and return of expired permits.
 Monitor Package Contractor and/or Package Vendors permits for expiry
 Inspect work locations for permit documentation and compliance to precautions
 Scan and file operating and completed permits

The PR will:

 Maintain their permit pack in the field at an accessible point at the work location
 Permit pack will consist of required drawings, P&ID’s, MSDS, MS, JHA and the approved
permit/s
 Ensure workforce is aware of permit location
 Maintain permit compliance

10.1 LOST / DAMAGED PERMIT

If a permit is lost or damaged the PR must immediately contact the PTWC.

 The PTWC will check register and scanned permit

 The PTWC informs the PA, The PA will decide if the works should cease or continue
 The PTWC provides a stamped “copy” of the original. Both the PTWC, PR and the PA will
initial and date the copy
 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 17 of 22

11.0 PTW RECORD / RETENTION

The original and both copies of the PTW shall be kept at the PTW office

The status of all PTWs and certificates shall be tracked and recorded on a daily basis until they are
closed.

The following documentation and records shall be retained according to the document management
requirements:

 Completed/cancelled PTWs and certificates shall be retained for at least 6 months.

 Completed PTWs and certificates for confined space entry retained for at least 1 year.
 The permit, certificate and all relevant documents related to any incident retained for the life
of the facility.

12.0 APPENDICES

Appendix 1 - PTW Flow Chart

Appendix 2 - Emergency Operation requirements for radioactive sources

13.0 ATTACHMENTS

 Permit to Work combined

 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 18 of 22

Appendix 1 - PTW Flowchart

PTW REQUESTOR (PR)
Visit work site, prepares, required drawing, P&ID, PTW AUTHORITY (PA)
JMS, JHA, SDS
Work Approved by MIE Engineer/Superintendent PTW COORDINATOR (PTWC)
Review PR’s documentation, discusses work
or delegate scope
Equipment ready and approved for site Review related PTW documents
Assesses SIMOPS discusses with other for required permits Visits site with PR
contractor/s
Assesses Permit requirement and precautions to Discusses SIMOPS & PTW Check mobile plant & equipment approved for
MIE PTW Procedure precautions site
Completes permit form
Contact PTWC, provides PTW documentation for Assesses task, documents, precautions,
review and registration List any additional precautions
SIMOPs
Note: The PR will complete the PTW Request Register permit/s scans and file
Discusses task, SIMOPs, confirms all
process 24hrs prior to works commencing precautions at site

PERMIT RENEWAL
PR reviews task and documentation for change PTW REQUESTOR (PR)
Updates documentation as required
Completes new Permit form/s as required Instructs Work crew in method PTW COORDINATOR (PTWC)
Presents to PWTC as per 1st request process statement, JHA
PTWC scans, files approved
PERMIT CLOSURE / HAND BACK Brief and Instruct work crew permit/s & documentation
PR Iinforms CONTRACTOR Superintendent work permit precautions, SIMOPs
is complete
Original Permit/s issued to
PR clears site, to be clean and safe Commences works as per
Provides permit to PTWC
permit/s & documentation
PTWC informs PA, PA and CONTRACTOR
construction inspect site and works
 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 19 of 22

APPENDIX 2: EMERGENCY GUIDELINES FOR RADIOACTIVE SOURCES

In the event of an emergency, which may involve a radiographic source, the following procedures
will be followed.

The radiographer-in-charge has total emergency action responsibility. This person will have
complete and absolute responsibility until such time as the CONTRACTOR Site Manager and
HSSE Manager arrive on the scene and have been fully apprised of the entire situation.
CONTRACTOR Area Manager and HSSE Manager may then relieve the radiographer-in-charge of
the emergency responsibility.

Potential emergencies include:

 Theft or loss
 Malfunction of equipment
 Fire
 Accidental damage
 Vehicular road accident
 Unauthorized or accidental entry to restricted area
 Human error

In the event of the occurrence of any accident, the radiographer-in-charge must first establish a
restricted area and then contact the CONTRACTOR Site Manager and HSSE Manager and obtain
instructions as to continuing procedures to be followed. The CLIENT/IPMT must be notified.

Keep the area under constant, visual surveillance to prevent access by anyone not properly
authorized to be there. As long as the restricted area is maintained, any possible overexposure will
be minimized or eliminated.

The following special precautions will be followed in any emergency or potential emergency:

 Always move quickly to and from the exposure device.

 Use survey meter before and after each exposure.
 Use any available shielding when approaching device.
 Lock unit and conduct survey after each exposure.
 Constantly check dosimeter for accumulation of radiation.
 Do not move device to other locations without locking device.
 Restricted area must be properly posted with warning signs.
 Do not conduct operations with inoperable survey instrument.
 Be alert at all times.

SPECIFIC PROCEDURES

A. Plant Emergency

In the event of a plant emergency (such as fire or accident involving plant personnel) that occurs in
an area adjacent to a radiographic device, immediately do the following:
 Return source to shielded position in device and lock. Do not move device to other locations
without locking.
 Perform physical survey of device to verify that the source is in the shielded position.
 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 20 of 22

 Remove source guide tube and insert safety plugs. Detach drive cable; lock cover plate into
position on back of projector.
 Remove device from danger area and, if possible, return to storage vault.
 Notify the CONTRACTOR /Site Manager and HSSE Manager.
 If a radiographic device cannot be removed from the danger area, set up a restricted area
under constant visual surveillance. The CONTRACTOR Site Manager and HSSE Manager
will determine the further course of action.
 In the event of an accident to the source or device, immediately do the following:
 Return the source to the device, if possible, and lock device.
 Notify the CONTRACTOR Site Manager and HSSE Manager.

B. Source Cannot be Returned to Device

In the event the source cannot be returned to the device, immediately do the following:
 Set up and post restricted area, using a survey instrument to determine the perimeter of the
area.
 Do not allow anyone to enter this area.
 Continue to restrict entry into this area.

C. Exposure to Non-Monitored Personnel

In the event of an accident involving the radiation exposure of non-monitored personnel,

immediately do the following:
 Set up restricted areas as specified in the procedures. Use a survey instrument to determine
the perimeter of the area. Record the names and phone numbers of non-monitored
personnel involved.
 Check the restricted area and prevent admittance to the area.
 Notify the CONTRACTOR Site Manager and HSSE Manager.

The CONTRACTOR Site and HSSE Manager will be responsible to obtain pertinent facts involving
the accident and will determine the future course of action.

D. Lost Source

In the event of a lost source, notify the CONTRACTOR Site Manager and HSSE Manager, and
appropriate regulatory agencies
.
The HSSE Manager or designee will perform the following steps:
 Obtain the information at the last known location of the source.
 Check area with survey meters and rope off restricted area.
 Locate the source using survey meters. Triangulate the exact position of the source. Do not
enter into the high-radiation area without extensive planning for retrieval.
 Devise a plan for recovery of the source and record significant points of the plan. The
primary concern must be minimum exposure to any personnel.
 Carefully retrieve source and replace in device or shielded container.

Never handle an unshielded device with bare hands.

 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 21 of 22

E. Vehicular Accident

In the event of a vehicular accident involving by-product material, a restricted area must be
established as specified in these procedures.

 Do not rely on a possibly damaged meter. Assume that the source is in the exposed position
inside the vehicle. In case of a minor accident where it can be visually determined that the
source is safely stored in its container, its proper position in the device must be checked with
a survey meter before the device is handled. If the survey is satisfactory, a restricted area
may not be needed.
 After a minor accident, an apparently operable meter may provide totally erroneous
information and need recalibration; a backup meter should be used to determine if a
radiation hazard exists or else a site survey team may be called before the device or vehicle
is moved.
 In any case, immediately after establishing the restricted areas, notify the CONTRACTOR
Manager and HSSE Manager

F. Possible Overexposure

In the event an incident occurs and causes or threatens to cause overexposure to personnel, the
CONTRACTOR HSSE Manager will be responsible to verify that the following is/was performed:

 Remove personnel involved from radiographic operations area immediately.

 Post area properly if hazard exists.
 The CONTRACTOR HSSE Manager then verifies that Thermoluminescent Dosimeters (TLD
badges) or film badges are sent to nearest testing laboratory for immediate processing. In
case unauthorized personnel are involved, get the name, address, and telephone number of
the person(s) suspected and gather all facts pertaining to the cause of the exposure.
 Have the person(s) complete a statement of facts on how the exposure occurred and send
the report to the CONTRACTOR /Site Manager.

Upon receipt of all facts and exposure results, the CONTRACTOR HSSE Manager will determine
what action must be taken before the person(s) can return to normal radiographic operations.

The HSSE Manager or designee compiles a complete and comprehensive written report of all
elements that have transpired. The report is to be presented to the CONTRACTOR Site Manager
within 24 hours of the incident.
 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 22 of 22

ATTACHMENT 1: MIE PTW Form

 CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 23 of 22

ATTACHMENT 1: IPMT PTW Form (*will implement after noticed by TG/IPMT)

CLIENT Project Name TSR F44SL Project Phase 1 CONTRACTOR

Document No. F44SL-PHASE1-MIE2-HSE-PRC-0005

Document Title PERMIT TO WORK PROCEDURE

Revision 0 Doc. Class Page 24 of 22