BP Wind Energy

Permit No:

Permit to Work
Permit is not valid for more than 12 hours without reauthorization

Request Section
Type of Work Requested:

Hot Work

Cold Work

Electrical

JSEA completed/attached

Additional Permits Required:

LOTO Permit #

Issue Date/Time

Confined Space Permit #

1 Expires Date/Time

Ground Dist. Permit #

Location

BP

Contractor Company Name

Description of Work

Contact
2

Completed by Performing Authority

Contact Person/Supervisor

Phone Number

Equipment Condition

Completed by Performing Authority and Verified by Issuing Authority

Out of Service
In Service
Deenergized/Isolated
Electrically Energized
Other Conditions:

Depressured
Pressurized
Locked out
Bleeders open

Work Hazards

Radio Frequency

Atmosphere checked for:

Drained
Not Drained

% Oxygen
% LEL
CO (carbon monoxide)
PPM for:

Completed by Performing Authority and Verified by Issuing Authority

SIMOPS

Oxygen deficiency

Pinch points

Hot environment

Power tools

Hydrocarbon vapor

Working at heights

Cold environment

Line of fire

Chemical exposure

Electrical

Heavy lifting

High pressure

Acids/Caustics

Overhead work

Falling objects

Severe Weather

Sources of ignition

Eye hazards

High noise

Mechanical lifting

Excavation

Hot/Cold surfaces

Sharp objects

Stored energy

Limited access/egress

Walking/Working surface

Repetitive motion
MSDS#

Other Hazards:

Controls

Completed by Issuing and Area Authority

Barricades
Flagman required
LOTO
Level 2 Risk Assessment
Competent person's name
Additional precautions

Fire watch
Standby fire extinguishers
Blanket to contain sparks
Use tag line

Additional access/egress
Tractel
Additional lighting
Tripod with retrieval device
Air mover required
GFCI
Continuous monitor required, Type

See site safety procedures for additional requirements

PPE

Completed by Performing Authority and Issuing Authority

Standard Required PPE: (safety toed boots, hardhat, safety glasses)

Rubber boots
Face shield/goggles
Hearing protection
Supplied air

Protective suit, Type

Respirator, Type
Gloves, Type
Electrical hot suit, Type
FRC
8 cal
20 cal
40 cal

Cooling vest
Relective vest
Lifeline
Safety harness/lanyard/ladsafe

Any additional PPE

Authorization

Permit is Not Valid Until Signed

Print

Sign

Performing Authority
Issuing Authority

7 Area Authority/Facility Manager

Affected Issuing Authority (SIMOPS)
Area Authority notified by phone and approves (for after hours work)

Date/Time

Return Permit to Area Authority when work is finished for the shift

Permit Sign Off

Completed by BP and Contractor Representative

Work Complete

Performing Authority

Work Incomplete (Please list reasons)

Issuing Authority

PERMIT IS VOID IF WORK IS NOT STARTED WITHIN 2 HOURS OF GAS TEST

Copy of Permit must be at Job Location
White-Performing Authority -- Canary-Issuing Authority -- Green-SIMOPS