North America Business Unit (NABU) ENSCO SAFE SYSTEM OF WORK (SSOW) Permit to Work (PTW) Materials Re-Supply Catalogue

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1 North America Business Unit (NABU) ENSCO SAFE SYSTEM OF WORK (SSOW) Permit to Work (PTW) Materials Re-Supply Catalogue

2 Contents Page Permit to Work (PTW) Hardware () Permit to Work (PTW) Location Board.3 (2) Permit Rack..3 (3) Permit Rack Dividers - Authorized 4 (4) Permit Rack Dividers - Suspended...4 (5) Permit Rack Dividers - Cancelled. 4 (6) Permit Rack Dividers - Retained Isolations.4 (7) Magnetic Markers - Safety Systems Disabled..4 (8) Magnetic Markers - Pressure Testing in Progress...4 (9) Magnetic Markers - Operator / 3 rd Party Equipment. 4 (0) Magnetic Markers - Hot Work. 5 () Magnetic Markers - Cold Work..5 (2) Magnetic Markers - Entry...5 (3) Magnetic Markers - Isolations (temporary)..5 (4) Magnetic Markers - Isolations (retained)..5 (5) Magnetic Markers - Isolations (Idle)..5 (6) Isolation Tags...6 (7) Isolation Tie Wraps..6 (8) Isolation Chain..6 Permit to Work (PTW) Forms (9) Hot Work Permit 7 (20) Cold Work Permit.. 7 (2) Entry Permit....7 (22) Entry Log. 7 (23) Isolation Certificate....8 (24) Isolation Continuation Sheet 8 (25) Gas Testing Certificate (26) System Checklist... 8 (27) System Change Proposal.9 Custodian: NABU SHEM 2

3 PTW (PTW) Hardware ) Permit Location Board 8.PTWPLB 2) Permit Rack 8.PTWPR Custodian: NABU SHEM 3

4 3) Permit Rack Dividers Authorized 4) Permit Rack Dividers Suspended Authorized Suspended 8.PTWPRDA 8.PTWPRDS 5) Permit Rack Dividers - Cancelled Cancelled 6) Permit Rack Dividers - Retained Isolations Retained Isolations 8.PTWPRDC 7) Magnetic Markers - Safety System Disabled 8.PTWPRDRI 9) Magnetic Markers Operator / 3 rd Party Rental Equipment R 8.PTWMMSSD 8) Magnetic Markers Pressure Testing in Progress 8.PTWMMORE P 8.PTWMMPTP Custodian: NABU SHEM 4

5 0) Magnetic Markers Hot Work (Red) 8.PTWMMHW ) Magnetic Markers Cold Work (Blue) 8.PTWMMCW 2) Magnetic Markers Entry (Green) 8.PTWMME 3) Magnetic Markers Temporary Isolations (Yellow Black Numbers) 8.PTWMMTI 4) Magnetic Markers Retained Isolations (Yellow Red Numbers) 8.PTWMMTIYR 5) Magnetic Markers Rig Idle (Hot Stacked) Isolations (Yellow Letter I ) Custodian: NABU SHEM 5

6 I 8.PTWMMTIYRL 6) Isolation Tags 8.PTWIT 7) Tie Wraps for Isolation Tags 8.PTWTW0 8) Plastic Yellow Isolation Chain 8.PTWIC Custodian: NABU SHEM 6

7 Haz Zone 0 2 H2S Zone Y N Gas Test Y N Required? Other Area Hazards: In the event of a General Alarm, shutdown portable equipment, make the worksite safe and proceed to your muster / Emergency Station Certificate Types I certify that the work authorized by the Permit will not conflict with any work or operational activities under my control. Number I certify that the isolations and safety precautions shown on this Permit, associated certificates and JSA s attached are approved. Work may now start from the time shown. The work does not conflict with any other work underway No work may be done under this Permit after the Expiry / Work May Start Permit Expires I have read and understand the description of work and precautions to be taken. The appropriate controls from the JSA are in place. I will ensure safe conditions at the worksite are maintained and that all other persons in the work group are briefed at a pre-job safety meeting and adhere to the requirements. Worksite will be left SAFE & TIDY at work stop. Work Start Work Stop Work Start Work Start Work Stop I declare that the work has been properly performed and is complete/*not complete. The equipment is left safe and the area is SAFE & TIDY. * Complete and associated certificates signed off. * Not complete and continuing on Permit No... SECTION 3 - AUTHORIZATION & Validation I have inspected the worksite and certify that the isolations and safety precautions have been completed, I authorize entry for the period shown. Entry can be made when the above conditions are completed The work does not conflict with any other work underway I have read and understand the description of work, precautions to be taken. I will ensure safe conditions at the worksite are maintained and that all persons entering the space have been briefed at a pre job safety meeting and adhere to the requirements. Worksite will be left SAFE & TIDY at all times. Valid From Valid To Work Start Person in Charge Initial when safety requirements are in place : :.. Start Permit Issuer Person in Charge Stop Print ature Print Work Start Work Stop This certificate is now closed and has been deleted from cross-referenced work permits. Permit Issuer ature Work Stop : I have read and understand the description of work and precautions to be taken. The appropriate controls from the JSA are in place. I will ensure safe conditions at the worksite are maintained and that all other persons in the work group are briefed at a pre-job safety meeting and adhere to the requirements. Worksite will be left SAFE & TIDY at work stop. Permit to Work (PTW) Forms 9) Hot Work Permit 20) Cold Work Permit PERMIT TO WORK SYSTEM PERMIT TO WORK SYSTEM Rig HOT WORK PERMIT Serial No SECTION - WORK DESCRIPTION Worksite Work Order/JC. No... Contd. from Permit No Equipment Description.. Planned Duration: Work Description: SECTION 2 - AREA HAZARDS SECTION 3 - ASSOCIATED CERTIFICATES SECTION 4 - AUTHORIZATION & ISSUE A: COMPANY MAN (if required) B: PERMIT ISSUER C: PERSON IN CHARGE (st working period). SECTION 5 - RE-AUTHORIZATION atures in this section refer to the declarations made in Section 4 A: Permit Issuer B: Person in Charge Rig COLD WORK PERMIT Serial No SECTION - WORK DESCRIPTION Worksite Work Order/JC. No... Contd. from Permit No Equipment Description.. Planned Duration: Work Description: SECTION 2 - AREA HAZARDS SECTION 3 - ASSOCIATED CERTIFICATES H2S Zone Y N Gas Test Y N Required? SECTION 4 - AUTHORIZATION & ISSUE A: COMPANY MAN (if required) I certify that the work authorized by the Permit will not conflict with any work or operational activities under my control. B: PERMIT ISSUER I certify that the isolations and safety precautions shown on this Permit, associated certificates and JSA s attached are approved. Work may now start from the time shown. The work does not conflict with any other work underway No work may be done under this Permit after the Expiry / Work May Start Permit Expires C: PERSON IN CHARGE (st working period). Work Start Work Stop SECTION 5 - RE-AUTHORIZATION atures in this section refer to the declarations made in Section 4 A: Permit Issuer B: Person in Charge Work Start Work Start Work Stop SECTION 6 - PERMIT CANCELLATION A. PERSON IN CHARGE *delete as appropriate B. PERMIT ISSUER The job is accepted as :- *delete as appropriate Permit ready for archive SECTION 6 - PERMIT CANCELLATION A. PERSON IN CHARGE *delete as appropriate I declare that the work has been properly performed and is complete/*not complete. The equipment is left safe and the area is SAFE & TIDY. B. PERMIT ISSUER The job is accepted as :- *delete as appropriate * Complete and associated certificates signed off. * Not complete and continuing on Permit No... Permit ready for archive st.copy : Worksite 2nd.copy : PCP. Draft C Aug 0 st.copy : Worksite 2nd.copy : PCP. Draft C Aug 0 8.PTWFHW 8.PTWFCW 2) Entry Permit 22) Re-Entry Log PERMIT TO WORK SYSTEM ENTRY PERMIT Rig... Area / Equipment No.... SECTION Serial No : Worksite..... Contd. from Cert. No... Raised :... Associated work permits SECTION 2 SAFETY REQUIREMENTS FOR ENTRY:(Permit Issuer to delete and initial non-applicable items).. The area/equip has been isolated from all sources of dangerous liquids, gases and fumes by insertion of spades or by removing a section of pipework and blanking the open ends of the circuit, or by agreed alternative methods. 2. The area/equipment has been isolated from all sources of electrical and mechanical power on Isolation Cert. Number. 3. The area/ equipment has been freed of all dangerous materials. 4. The surrounding area has been examined and there are no hazards that shall arise from concurrent operations/work 5. Life lines, harnesses, breathing apparatus and resuscitation equipment are available 6. Adequate access and egress is provided. 7. The area/equip is sufficiently cool. 8. Air moving equipment has been installed (if equipment fails, vacate space). Air intakes to be protected from gas/fumes and airborne particles. 9. A rescue plan has been formulated and rescue team briefed 0. Competent standby personnel have been detailed. Maximum number of persons allowed in confined space Number 2. The area/equip has passed the Atmosphere Tests as detailed in Gas Test Cert. Number 3. Continuous monitoring for toxic gases and oxygen in place. A: Permit Issuer B: Person in Charge (st working period). SECTION 4 Re-Validation atures in this section refer to the declarations made in Section 3 (Persons entering to sign reverse side of sheet) SECTION 5 - WORK COMPLETION st.copy : Worksite 2nd.copy : PCP.3 rd Copy OIM Continued on Cert. No. :... Draft B Aug 0 8.PTWFE 8.PTWRL Custodian: NABU SHEM 7

8 23) Isolation Certificate 24) Continued Isolation Certificate 8.PTWFIC 8.PTWFCIC 25) Gas Testing Certificate 26 Permit Checklist 8.PTWFGTC 8.PTWFPC Custodian: NABU SHEM 8

9 27) System Change Proposal 28) Permit Rack Wallet 8.PTWFSCP 8.PTWPRW 29) Permit Worksite Wallet ENSCO OFFSHORE COMPANY PERMIT TO WORK 8.PTWENVELOPE Custodian: NABU SHEM 9

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