5887 On PR HM 013 (1) +Ptw+Procedure

Pearl GTL Project Revision 4
Ras Laffan, Qatar Page 1 of 59
PEARL GTL PROJECT
HSSE
5887-ON-PR-HM-013
PERMIT TO WORK PROCEDURE
CONSTRUCTION PHASE
Rev 1 Rev 2 Rev 3 Rev 4
Prepared By (Originator): J. Pile J. Pile J. Pile J. Pile
Checked By (Line Manager): T. MacFarlane T. MacFarlane T. MacFarlane T. MacFarlane
Reviewed By (PQM): S. Alkhedairy S. Alkhedairy S. Alkhedairy S. Alkhedairy

Approved By (Project Director):
S. P. Watson S. P. Watson S. P. Watson S. P. Watson
Date: 29 Sep 06 11 Oct. 06 23 Oct. 06 15 Jan 07
Issue Status: IFL IFL IFL IFL

Permit To Work Procedure - Construction Phase
Pearl GTL Project Revision: 4
TABLE OF CONTENTS
1.0 PURPOSE............................................................................................................................... 5
2.0 SCOPE.................................................................................................................................... 5
2.1 Supporting Procedures ................................................................................................. 6
3.0 RISKS ..................................................................................................................................... 7
4.0 REFERENCES........................................................................................................................ 8
4.1 Project Reference Documents ...................................................................................... 8
4.2 Reference Associated Procedures ............................................................................... 8
5.0 DEFINITIONS AND ABBREVIATIONS .................................................................................. 9
5.1 Definitions ....................................................................................................................... 9
5.2 Abbreviations ................................................................................................................. 9
6.0 PROCESS............................................................................................................................. 10
7.0 PROCEDURE ....................................................................................................................... 11
7.1 Risk Assessment.......................................................................................................... 11
7.2 Permit Planning ............................................................................................................ 12
7.3 PTW Coordination ........................................................................................................ 12
7.4 Permit to Work Forms .................................................................................................. 12
7.5 PTW Distribution .......................................................................................................... 13
7.6 Permit Authorisation .................................................................................................... 14
7.7 Validity Period and Revalidation................................................................................. 14
7.8 Shift Handover .............................................................................................................. 15
7.9 Changes and Emergency Conditions......................................................................... 15
7.10 Close-out and Return to Service................................................................................. 15
7.11 Records ......................................................................................................................... 15
7.12 Monitoring, Audit and Review ..................................................................................... 16
8.0 RESPONSIBILITIES ............................................................................................................. 16
8.1 Pearl GTL Project Manager / Asset Manager ............................................................. 16
8.2 Pearl GTL / PMC / IC / EPCM HSSE/SD Mangers ....................................................... 17
8.3 Permit Requestor ......................................................................................................... 17
8.4 Permit Coordinator....................................................................................................... 17
8.5 Issue Authority ............................................................................................................. 17
8.6 Supervisor..................................................................................................................... 18
8.7 Permit Holder ................................................................................................................ 18
8.8 Authorised Gas Tester ................................................................................................. 18
9.0 PERMIT TO WORK ACTIVITIES ......................................................................................... 19
9.1 Entry into Confined Spaces ........................................................................................ 19
9.2 Electrical Isolations and Work on Live Systems ....................................................... 19
9.3 NDE and Ionising Radiation Activities ....................................................................... 19
9.4 Excavations and Piles.................................................................................................. 19
9.5 Operating Equipment Near Energised Overhead Electrical Services ..................... 19
9.6 Grating and Handrail Removal .................................................................................... 20
9.7 Hot Work in the Vicinity of Flammables or Explosives............................................. 20
9.8 Storage and Handling of Chemical and Hazardous or Toxic Materials................... 20
9.9 Explosive Devices and Tools Utilising Explosive Charges...................................... 20
9.10 Lifting of Personnel by Mechanical Means ................................................................ 20
9.11 Diving Operations ........................................................................................................ 21
10.0 CONTROLLED PROCEDURE ACTIVITIES......................................................................... 21
5887-ON-PR-HM-013
10.1 Pneumatic Testing ....................................................................................................... 21

10.2 Scaffolding .................................................................................................................... 21
10.3 Non-Routine and Heavy Lift Operations .................................................................... 22
11.0 TSTI AND PERMITS............................................................................................................. 22
11.1 Total Safety Task Instruction (TSTI) ........................................................................... 22
12.0 APPENDICES....................................................................................................................... 23
Appendix A Permit Control Area Plot Plan

Appendix B Confined Space Entry Permit
Appendix C Gas Test Certificate
Appendix D Confined Space Entry / Exit Log
Appendix E Non Destructive Examination (NDE) Permit
Appendix F Radiological Material Storage Permit
Appendix G Excavation Permit
Appendix H Crane Suspended Work Platform Permit
Appendix I Crane Suspended Work Platform Daily Checklist
Appendix J Working within 6 meters of Energised Overhead Uninsulated
Electrical Lines Permit
Appendix K Grating / Flooring / Hand-Railing Removal Permit
Appendix L Hot Work Permit
Appendix M Hazardous Material Storage Permit
Appendix N Powder / Explosive Charge Activated Tools Permit
Appendix O Permit to Work Inspection Check List
Appendix P Permit to Work Register
Appendix Q Total Safety Task Instruction Form
Appendix R Deleted
Appendix S Diving Permit
Appendix T Safety System Override Permit
Appendix U Permit to Work Form
Appendix V Permit Revalidation Certificate
Appendix W PTW Issuing Authority Appointees
Appendix X Index of Permit Areas
Appendix Y Risk Assessment Matrix (RAM)
Appendix Z Risk Assessment Matrix – Definition of Terms
5887-ON-PR-HM-013
Rev Issue Date Revision Details

Status
0 ICC 27 May 06 Issued for Internal Discipline Check
1 IFL 29 Sep 06 Document title, Purpose and Scope Sections revised to
clarify document use for Construction Phase only.
Standard Permit to Work Form, PTW Register, TSTI
Form and RAM added. New Sections 2.1, 9.0, 10.0 &
11.0 added.
2 IFL 11 Oct. 06 Revised. Appendices B to S revised.
3 IFL 23 Oct. 06 Attachment Q (TSTI) form revised items (17 & 18)
4 IFL 15 Jan. 07 General text revised as indicated in right hand margin.
Appendices B to O and V revised. Appendix Y was
Appendix T. Appendix R deleted. Appendices T, U, V, W
and X added.
5887-ON-PR-HM-013
1.0 PURPOSE
The objective of this procedure is to describe for the ICs, EPCs, PMC and Early Works
Contractors how hazardous construction activities are controlled in the workplace, and to
identify the actions and responsibilities that are necessary to operate the Pearl GTL
Permit to Work (PTW) system for the construction phase.
This procedure has been prepared by PMC, henceforth referred to herein as COMPANY
acting for and on behalf of Qatar Shell GTL.
The IC, EPCM, Early Works Contractors and their Sub contractors shall henceforth be
referred to herein as CONTRACTOR.
A further amendment to this procedure is planned to include an enhanced permit to work
system to hazardous pre-commissioning and commissioning activities, start-up and early
operations. A PTW procedure for construction work close to equipment undergoing
commissioning will also be prepared.
A PTW will be applied during construction. Activities within RLC in an unfenced area are
subjected to the RLC PTW system. Activities on site that can have an affect outside of a
fenced off area are also subject to the RLC PTW system.
The construction PTW system will be used up until the commencement of commissioning
activities at which time a further set of pre-commissioning, commissioning, start-up and
operations PTW systems will be introduced.
This procedure does not address hazardous activities after the construction phase i.e. pre-
commissioning, commissioning, start-up and production operations.
This procedure identifies the standards and sets the ground rules required to ensure, as
far as is possible, that the PTW system is applied in a similar way.
2.0 SCOPE
This document describes the procedure for the onshore ICs, EPCs, PMC and Early Works
Contractors will use whilst implementing the PTW system where required during
construction activities.
It also describes the principles and essential features of the Pearl GTL PTW system.
Providing details of the way in which planning, control and administration of work that is
under permit control is achieved by Pearl GTL.
CONTRACTOR, ICs, EPCM's and Early Works Contractors, shall be governed by this
PTW system.
The procedure includes descriptions of the following essential elements of the Pearl GTL
PTW system:
• The methodology used to identify hazardous work, especially non-routine

activities, that will be controlled by the Pearl GTL PTW system.
• The activities and types of work that will be controlled through the PTW system.
• A description of the permits that will be issued for various types of work.
5887-ON-PR-HM-013
• The method for deciding which hazardous work requires additional control
measures, such as confined space or excavation permits.
• The method used to ensure that a Health Risk Assessment (HRA) has been
carried out and the results incorporated in the control measures for work under
permit control as per the JSA.
• The persons who are authorised to issue permits and to specify the necessary
controls on supporting certificates.
• The method used to assure the competence of permit signatories and others
playing an active role in the Pearl GTL PTW system.
• Actions necessary for work planning, isolations, supporting certificates, issuing

permits, precautions during work, revalidation, shift handover and close out of
permits.
• A method for monitoring, auditing and reviewing the effectiveness of the PTW
system, including the role of System Custodian.
• The geographical boundaries of permit control areas.
2.1 Supporting Procedures

This procedure is supported by the following procedures which specifically address the
controls to be followed for the respective hazardous construction activities:
Work Permit Activity Reference Procedure
• Entry into Confined Spaces. - See procedure reference in Section 4.2,

Ref. [1].
• Electrical Isolations and Work on - See Electrical Lock Out / Tag Out (LOTO)
Live Systems. Procedure in Section 4.2, Ref. [2].
• NDE and Ionising Radiation - See Radiation Control and NDE Procedure
Activities. Section 4.2, Ref. [3].
• Excavations. - See Excavations Procedure Section 4.2,

Ref. [4].
• Operating Equipment Near - See procedure references in Section 4.2,

Overhead Electrical Services. Ref. [5] and [13].
• Grating and Handrail Removal. - See Fall Prevention Procedure Section 4.2,
Ref. [6].
• Hot Work in the vicinity of - See Fire Prevention and Protection

flammables or explosives. Procedure Section 4.2, Ref. [7].
• Storage, Handling and Use of - See Management of Hazardous Chemicals

Chemicals and Hazardous or Toxic Procedure Section 4.2, Ref. [8].
Material.
• Explosive Devices and Tools Using - See Small Tools and Equipment –
Explosive Charges. Inspection and Safe Use Procedure
5887-ON-PR-HM-013
Section 4.2, Ref. [9].
• Lifting of Personnel by Mechanical - See procedure references in Section 4.2,

Means. Ref. [5], [10], [15] and [16].
• Diving Operations. - See Diving Procedure Section 4.2, Ref.

[11].
The following hazardous construction actives will be controlled by procedures following a

job specific JSA.
Activity Reference
• Pneumatic Testing - This activity will be carried out under a

Commissioning Permit to Work system.
• Scaffolding - See Ref. [12] in Section 4.2.
• Non-routine and Heavy Lift - See Ref. [13] in Section 4.2.

Operations
3.0 RISKS
Failure to adequately identify and control health, safety and environmental hazards in the
workplace through a robust PTW system may result in serious injury, death, severe
environmental pollution, damage to assets and loss of local and international reputation.
Failure to identify competent personnel to administer the PTW system may result in the
PTW system being incapable of controlling hazards in the work place.
Failure to monitor the effectiveness of the PTW system may result in inadequate control of
hazards in the work place.
5887-ON-PR-HM-013
4.0 REFERENCES
4.1 Project Reference Documents
No. Title Reference No.

1. Permit to Work EP95-0315
2. Pearl GTL HSSE/SD MS
3. Site Plan T-13.369.401
4. General Workplace Practices EP95 0270
5. Job Hazard Analysis EP95-0311
6. Emergency Response Procedure 50982721
7. Pearl GTL Permit to Work Procedure 51140025
8. Project Specification Part IV Procedures and Appendix 1 Detailed
Requirements Chapter 9 – HSE Premise for the HSES/SD Standards and
Implementation Phase Guidance Section 2.13 &
5.2.6
9. RLC Procedure for the use of the Consolidated Permit to QPR-RIE-010 Rev 3
Work for RLC Common Areas Dated 04-07-2006
10. Confined Space Entry Shell Advisers Panel
2003
11. Electrical Safety Shell Advisers Panel
2003
12. Electrical Engineering Guidelines DEP 33.64.10.10-Gen
13. Ionising Radiation Safety Guide Shell Safety and Health
Committee 1993
4.2 Reference Associated Procedures
No. Title Reference No.

1. Confined Space Entry Procedure 5887-ON-PR-HM-039
2. Electrical Safety Rules – Pearl GTL T-4.599.556
3. Radiation Control and NDE Procedure 5887-ON-PR-HM-040
4. Excavations Procedure 5887-ON-PR-HM-041
5. Power Operated Work Platforms 5887-ON-PR-HM-033
6. Fall Prevention and Protection Procedure 5887-ON-PR-HM-032
7. Fire Prevention and Protection Procedure 5887-ON-PR-HM-042
8. Management of Hazardous Chemicals Procedure 5887-ON-PR-HM-043
9. Small Tools and Equipment – Inspection and Safe Use 5887-ON-PR-HM-027
Procedure
10. Crane Suspended Work Platforms 5887-ON-PR-HM-032
11. Diving Operations 5887-ON-PR-HM-044
12. Scaffolding T.-13.377.451
13. Crane and Lifting Operating Procedure 5887-ON-PR-HM-024
14. Worksite Risk Management & TSTI 5887-ON-PR-HM-038
15. Inspection and Colour Coding of Plant, Equipment and 5887-ON-PR-HM-026
Tools Procedure
16. Plant, Vehicle and Heavy Equipment Inspection and 5887-ON-PR-HM-030
Maintenance Procedure
17. Emergency Response Procedure 5887-ON-PR-HM-011
5887-ON-PR-HM-013
5.0 DEFINITIONS AND ABBREVIATIONS
5.1 Definitions
Item Description
Permit Document issued by the PMC to a specific contractor for a specific task
in a specific area authorising high risk tasks.
See Section 8.0 Responsibilities.
5.2 Abbreviations
Item Description
ALARP As Low As Reasonable Practicable
EPCM Engineer Procurement and Construction Management
EPCI Engineering Procurement Construction Installation Contractor
G&P Shell Gas and Power
SGS Shell Global Solutions International
GTL Gas to Liquids
HRA Health Risk Assessment
HSE Health, Safety and Environment
HSSE/SD MS Health, Safety, Security, Environmental / Social Development
Management System
IA Issuing Authority
IC Implementation Contractor
JSA Job Safety Analysis
NDE Non Destructive Testing
PC Permit Co-ordinator
PEFS Process Engineering Flow Sheets
PMC Project Management Contractor
PPE Personal Protective Equipment
PTW Permit to Work
RLC Ras Laffan City
TSTI Total Safety Task Instruction
5887-ON-PR-HM-013
6.0 PROCESS
S Start
Authorised Discipline Engineer *

R Responsible for Activity
C Consulted
Authorised Gas Tester

Other Area Authorities
E End
PC / IA / Supervisor *
Activity Step I Informed
Permit Requestor
X Meeting
Permit Holder
* Not to be the same person.
Notes
1 Identify Work. S
2 Prepare work permit. R I Section 7.2
3 Identify hazards. C R C C C C Section 7.1
4 Identify precautions. C R C C C C
5 Identify interfaces. R C Section 7.3
Identify additional safety

6 C R C C C C
controls.
Prepare supporting safety

7 R Section 7.4
documents.
Complete safety preparations

8 and complete safety R C C
certificates.
9 Issue permit. R
10 Accepting permit R
Distribute post permits and

11 R Section 7.5
safety certificates.
5887-ON-PR-HM-013
12 Brief work party. R
Revalidate permit and

13 supporting certificates at start R C C C C Section 7.0
of each shift.
On completion of work close

14 R C C
supporting safety certificates.
15 Check work site. R C
16 Close permit. R
7.0 PROCEDURE
The PTW system ensures that for activities generating additional risk in the workplace,
additional controls are in place to reduce the risk to acceptable levels (ALARP).
7.1 Risk Assessment

The permit applicant shall confirm if there is an existing JSA prepared for the activity to be
performed. If so implement the requirements for the JSA and confirm with the
Construction HSSE department if further specific risk assessments are required. See
Section 4.2 Ref. [14] for the procedure Worksite Risk Management and TSTI.
If there are no records of an existing JSA a risk assessment should be carried out, before
putting a PTW into operation, to identify those activities and types of work where the:
• The inherent risks of the activity assessed as high or medium by the Risk
Assessment Matrix identified in the HSSE/SD MS, see Appendix W.
• High risk construction activities where controls are not detailed in other procedures
or work instructions.
The following personnel will carry out the process risk assessments:
• PMC and EPC Area Managers for the onshore construction. The boundaries of the
working areas will normally be designated by secure fencing and signage
• Pearl GTL Asset Manager for operations in all areas within the fence line of the
Pearl GTL Complex (see T-13.369.401) and specific external operated areas
including Pearl Platform A; Pearl Platform B, Beach Valve and within 3rd party
operated areas of responsibility where specific activities occur that may interfere
with Pearl GTL’s operability e.g. Jetty, Offsite Storage, and Pipetracks.
For each phase of the Pearl GTL project Permit Control Areas will be identified, Appendix
X, which define the extent of control needed for the activities and types of work that have
5887-ON-PR-HM-013
been assessed. A plot plan which identifies the control areas is shown at Appendix A.
Typically the types of control will be:
• TSTI - all tasks are subject to a TSTI, see Appendix Q.
• Permits will be issued as per Section 9.0.

An assessment of maintenance, inspection, repair, testing, construction, dismantling,
modification and cleaning activities may require the control of a PTW.
7.2 Permit Planning

Work which it is intended to be placed under permit control must be carefully planned so
that interaction with other work is minimised and controlled. The plan, which is made
weekly and updated daily by the Construction Supervisor, must take into account the time
required to identify the full extent of the work, conduct a hazard analysis and risk
assessment, obtain the necessary materials and resources required to complete the work
and make operational and engineering preparations. To this end a work permit application
should be made a minimum of 24 hours in advance. Urgently required permits will only be
issued for emergency work.
7.3 PTW Coordination

It is important to ensure that work activities, requiring a PTW, are coordinated with other
CONTRACTORS and neighbouring activities in order to avoid risks caused by
simultaneous activities. In Pearl GTL co-ordination will be achieved by nominating a single
focal point normally (Construction / Shift Supervisor) who is responsible for the co-
ordination of work activities within their own defined areas as defined for each phase of
the project and for informing similar focal points where the work may infringe on another
area. This role will be carried out in conjunction with the areas permit issuing authorities.
The co-ordination duties of these individuals will be to:
• Coordinate all permit to work activities within the area, including those permits
which are suspended, but where the work is not complete.
• Inform the relevant authority of any potentially hazardous situations arising from
permitted work.
• Ensure all staff involved have an overview of significant ongoing work.
• Operate the permit issue point to reflect the current state of work.
• Provide a quality check on the completion of permits.
7.4 Permit to Work Forms

For construction activities PTW forms shall be used for all activities described in Section
9.0. Permit Forms are provided in Appendices B to Z.
To provide effective control of hazards in the workplace it is necessary that the permit
form includes the following information:
• Clear precise description of the work, which includes the actual location of the
work, the designated equipment to be worked on, the actual tools and equipment
to be used and the planned work method. The description may require other
5887-ON-PR-HM-013
documents to be attached to the permit these may include job hazard analyses,
method statements, isolation lists, drawings or sketches.
• Identification of any interfaces with other work being carried out in the same area
or in another adjacent area.
• Confirmation that all necessary preparations that have been made. Commonly
these will be:
• Mechanical and electrical isolations.
• Clearance of process materials by draining, venting, flushing, purging or

ventilation.
• Gas and / or dust testing to confirm that the equipment is free of any
flammable, toxic or asphyxiate atmosphere.
• A description of any residual hazards that remain after preparations have been
made. The hazards may include residual construction, materials, pressure,
temperature and physical hazards arising from the location or work to be carried
out.
• A description of any additional precautions or controls which are necessary during

the work. Additional precautions or controls may include the use of specific
personal protective equipment (PPE) or the frequency of gas testing and
monitoring.
• Identification of the validity period.
• After discussing the details of the work, the preparations that have been completed
and the controls specified on the permit, the permit issuing authority, focal point
construction supervisor and Permit Holder sign the permit to authorise the
commencement work and issue the permit. The Permit Holder undertakes to
explain to the work party the details of the work, the hazards and the controls.
• Confirmation by the permit holder and the permit issue authority that the work has
been completed or suspended and that the site has been left in a clean and safe
condition.
7.5 PTW Distribution

Copies of the permit forms and certificates will be provided as follows:
• A signed working master copy to be held by the Permit Issuing Authority whilst the
permit is in operation. (When the work is completed and the permit is closed this
becomes the file copy).
• An updated copy shall be retained by the Permit Coordinator.
• An updated copy of the master for display at the worksite whenever work is under
way.
As well as the permit forms and certificates, additional precautions required for the work
can be provided by safety checklists, see Appendices. The checklists are useful for
providing instruction and guidance to the Permit Holder and the workforce. The permit will
5887-ON-PR-HM-013
always be prepared in English; however, the checklists may be prepared in several

language versions if English is not the first language of the workforce.
7.6 Permit Authorisation

For each permit control area identified in the risk assessment and assessed as requiring
permit control (see Appendices A and X), CONTRACTOR line management will identify
those personnel who will fulfil the following roles within the permit system:
• Permit Issuing Authority, who is responsible for ensuring that all preparations are
complete, and for authorising the work to proceed.
• Authorised Gas Tester, responsible for measuring flammable, toxic and asphyxiate
gas, and to interpreting the results.
• Permit Holder, responsible for carrying out the work in accordance with the
conditions on the permit.
It is important that the Permit Issuing Authority and the Permit Holder is not the same
person. This is to prevent the possibility of a person issuing a permit to himself.
The Pearl GTL Training Manager will identify the levels of competence required for each
role and will establish training requirements to maintain the competence. Records of PTW
training and authorisation will be kept by the Pearl GTL Training Manager and the Pearl
GTL HSSE Manager respectively to demonstrate competence and authorisation of permit
signatories.
Only personnel who have successfully completed appropriate PTW training will be
authorised to perform signatory roles. Authorisation will be subject to an expiry date no
greater than 3 years. The need for refresher training, reassessment and reauthorisation at
periods of less than 3 years will be subject to the results from PTW audits. An up-to date
list of authorised personnel will be displayed at each permit issue point;
PTW awareness and the use of standard workplace PPE will form a part of the site
induction training provided for the whole workforce.
7.7 Validity Period and Revalidation

Individual permits will have a validity period set by the Issuing Authority. The validity
period of an individual permit will be based on a proper assessment of the time that the
work will take. The maximum allowable period is 30 days after which time a new permit
will be prepared. Permits should not routinely be given the maximum allowable validity.
Permits will be re-validated at the start of each shift in order that the Issuing Authority can
be satisfied that the conditions under which the permit was originally issued remain
unchanged and the permit holder is in control of work at all times. To achieve this the
Issuing Authority ensures that:
• No other work is being carried out that could conflict with the work identified on the
permit.
• The preparations carried out to make the worksite safe for work remain in place
and are still valid.
• The precautions identified on the original permit are still valid.
5887-ON-PR-HM-013
When re-validating a permit it is mandatory that permit issuing authority and the permit
holder verify that the worksite remains safe by completing a worksite inspection before the
permit is re-validated.
A person authorised as issuing authority may revalidate, close, suspend or cancel any
permit.
7.8 Shift Handover

Shift handover increases the risk potential of all work due to the possibility of a failure to
pass on information or by passing on incorrect information. In order to reduce this risk the
issuing authority and permit holders from each shift must allow sufficient time for a
detailed review, revalidation and discussion of the status of all permits.
7.9 Changes and Emergency Conditions

It is the duty of everyone to suspend work should working conditions change or the
working environment became potentially hazardous. In the event of a necessary change
in the permit conditions caused by the unavailability or suitability of tools or equipment or a
need to change the work method or a change in weather conditions that add to the jobs’
risk or a significant change in the work team, the work will be suspended. The coordinator
/ issuing authority and permit holder will then reassess the work and conditions and issue
a new or revalidate the permit before allowing the work to restart.
In the event of an emergency alarm on the site personnel will take the action identified in
the Emergency Response Procedure Section 4.1 [Ref.6], this will often result in work
stopping for a period of time and all permits being void. Post-emergency, but before work
is restarted, work will be reassessed and permits revalidated / cancelled or suspended.
7.10 Close-out and Return to Service

When the work is complete all copies of the permit will be returned to the issuing authority.
The issuing authority and the permit holder will then inspect the work site and jointly
confirm that they are satisfied that the work has been completed and the worksite has
been left in a safe and clean condition.
The issuing authority and permit holder will also ensure that all isolations (Electrical and
Mechanical) been removed or are covered by another permit. They will then sign to
confirm that isolations remaining in place are referenced to the relevant isolation certificate
and work permit.
Where alarm systems or fire and gas detection / protection systems has been overridden
in order to allow work to proceed, these will normally be cancelled as part of the permit
method statement. However, the issuing authority must be satisfied that such overrides
are no longer in place and have been cancelled.
The issuing authority and the permit holder are then able to sign the permit close out
certificate to confirm that the work is complete.
7.11 Records
The master copy of completed permits, supporting documentation and certificates will be
retained by the PMC / Asset Holder until the end of the project.
5887-ON-PR-HM-013
The following records will be retained by the COMPANY, Pearl GTL PMC, Training
Departments until the end of the project:
• PTW signatories’ course records,
• Permit training,
• Refresher training,
• Periodic inspection reports and check sheets,
• Independent audit reports and the results from management reviews.
7.12 Monitoring, Audit and Review

The Permit Issuing Authority, Permit Holder and / or HSSE personnel will monitor work
under permit control on a daily basis. Monitoring will including spot checks to ensure that:
• Worksite safety precautions are adequate and controls are being implemented
• Permits have been completed correctly and being displayed at the worksite.
• The work party been briefed and have an understanding of what the work entails,
the safety precautions that must be taken and the controls that must be
implemented
Periodic inspections of the way the PTW system is being implemented will be carried out
at 3 month intervals by an HSSE Advisor using a permit picked at random and the check
list at Appendix O. The results from these inspections will be used to improve the
operation of the PTW system and the training of those who use it.
An independent audit of the operation of the PTW system across the whole site will be
carried out at 2 year intervals as required by the Pearl GTL HSSE Internal audit
programme. The frequency of the internal HSSE audits will be dependent on results from
the previous audits or the frequency of workplace incidents.
As part of the continuous improvement of HSSE Management that results from the
management review process detailed in Pearl GTL HSSE MS Management Review
Procedure, management will review the effectiveness of the PTW system annually and
modify it where necessary
8.0 RESPONSIBILITIES
8.1 Pearl GTL Project Manager / Asset Manager

The Pearl GTL Project Manager/Asset Manager has overall responsibility for HSSE
Management and is responsible for:
• Applying an appropriate PTW system and ensuring that it is implemented.
• Authorising personnel in PTW signatory roles on successful completion of

appropriate PTW training.
• Ensuring that the PTW system remains suitable and effective, through monitoring,
audit and periodic review.
5887-ON-PR-HM-013
8.2 Pearl GTL / PMC / IC / EPCM HSSE/SD Mangers

The Pearl GTL / PMC / IC / EPCM HSSE/SD Mangers are responsible for:
• Developing the PTW system and providing advice in its application.
• Establishing and maintaining a competence programme for permit signatories.
• Monitoring the performance of the PTW system.
• Receiving feedback from users of the PTW system.
• Reviewing learning from incidents and periodic inspections of work controlled by

permits.
• Organising audits of the PTW system.
• Conducting formal systematic reviews of effectiveness of the PTW system.
8.3 Permit Requestor

The Permit Originator is a representative of the department or contractor organisation that
will carry out the work and is responsible for:
• Detailing on the permit the work to be done, the equipment to be worked on, the
method to be used, the area, the tools and equipment to be used.
• Attaching to the permit any job hazard analyses, drawings or other details
developed during planning of the work and assessment of the risks.
8.4 Permit Coordinator

The permit coordinator works under the delegated authority of the Project Manager / Asset
Manager and is responsible for:
• Confirming that all hazards associated with the work have been identified and
authorised permit signatories and authorised discipline engineers have provided
their input and agree with the precautions.
• Identifying any conflicts between the proposed work and other activities in the
area.
• Informing all people who may be affected by the work.
8.5 Issue Authority
• Signing off and cancelling the permit when the work is complete or suspended.
• Ensuring that all necessary supporting certificates, job hazard analyses and
drawings are attached to the permit.
• Confirming that all operational preparations, including process clearance and

isolations, have been completed.
• Specifying on the permit any additional precautions that need to be taken during
the work, including use of safety equipment and PPE.
5887-ON-PR-HM-013
• Ensuring that the Permit Holder knows the exact location of the work, all the
hazards that may be present and all the precautions that must be taken during the
work.
• Signing and issuing the permit.
8.6 Supervisor
• Confirming that the work site is safe for the work to proceed.
• Knowing the status of the work at all times and communicating the status to the
oncoming shift at shift handover.
• Authorising the work to proceed on a shift-by-shift basis, after ensuring that no

change in hazard has occurred and that the necessary controls remain in place.
8.7 Permit Holder

The Permit Holder is responsible for:
• Discussing the job fully with the permit issue authority before signing to accept the
permit.
• Showing the work party the exact location and equipment to be worked on.
• Explaining to the work party the details of the work, any potential hazards and
precautions to be taken.
• Ensuring that the precautions are maintained throughout the work, and that the
work party and the work stays within the limits (area, types of work, time) specified
on the permit.
• Displaying the permit and attachments at the work-site.
• Stopping the work and seeking advice from the permit issue authority if conditions
at the worksite change.
• Ensuring that the work-site is left in a safe and tidy condition before handing back
the permit on completion or suspension of the work.
• Providing and maintaining a list of all personnel working under the permit. (Note a
record will be kept of those personnel who leave the permit control area).
8.8 Authorised Gas Tester

The Authorised Gas Tester is responsible for:
• Carrying out gas tests (oxygen, toxic and flammability) at the frequency specified
on the permit and supporting certificates, see Appendix C.
• Stopping the work and instructing personnel to withdraw from the area whenever a
gas test or change in conditions indicates that it is unsafe for the work to continue,
then reporting back to the permit holder and permit issue authority.
5887-ON-PR-HM-013
9.0 PERMIT TO WORK ACTIVITIES

The following construction work activities are considered to contain hazards that require
control by the use of a specific Permit to Work system.
This list is not exhaustive and additional categories of work may require PTW control
following a job specific Risk Assessment.
9.1 Entry into Confined Spaces

All confined space work shall be carried out under a PTW system described the Confined
Space Entry Procedure Ref. [1] Section 4.2. Appendices B and C are applicable to this
activity.
A confined space PTW confirms that isolations, precautions needed to eliminate
hazardous gases or dust to provide a breathable atmosphere and to ensure that the
space is safe for people to enter the confined space.
9.2 Electrical Isolations and Work on Live Systems

All electrical isolations and work on live systems shall be carried as described in the
Electrical Safety Rules – Pearl GTL Procedure Ref. [2] Section 4.2.
9.3 NDE and Ionising Radiation Activities

All Non-Destructive Examination (NDE) activities and activities involving the use and
storage of radioactive sources shall be carried out under PTW described in the Radiation
Control and Non Destructive Examination (NDE) Procedure Ref. [3] Section 4.2.
Two permits are required for this activity, one to carry out the NDE work and a second
permit for the storage of radio active materials. Appendices E and F are applicable to this
activity.
9.4 Excavations and Piles

All excavation work shall be carried out under PTW system described in the Excavations
Procedure Ref. [4] Section 4.2.
An excavation PTW specifies the precautions required to
• Identify buried cables and pipes during excavation work of greater than a spade depth
(300mm).
• Protect people working in excavations.

Appendix G is applicable to this activity.
9.5 Operating Equipment Near Energised Overhead Electrical Services

Crane, lifting operations, and the use of powered operated elevated work platforms within
six metres of an overhead electrical line shall be controlled by PTW system described in
the,
• Crane and Lifting Operations Procedure Ref. [13] Section 4.2.
• Power Operated Work Platforms Procedure Ref. [4] Section 4.2.
5887-ON-PR-HM-013
Appendix J is applicable to this activity.
9.6 Grating and Handrail Removal

Removal of edge protection, grating, stairs or ladders shall not be carried out without an
approved PTW described in the Fall Prevention Procedure Ref. [6] Section 4.2.
Appendix K is applicable to this activity.
9.7 Hot Work in the Vicinity of Flammables or Explosives

Hot working in the vicinity of flammables or explosives shall not be carried out without
control by a PTW system described in the Fire Prevention Procedure Ref. [7] Section 4.2.
It is expected that during the construction phase the storage of flammable and explosive
substances shall be such that they do not interact with any planned hot work activities,
therefore it is anticipated that during the construction phase that the risks and hazards
associated with hot work will not normally be sufficient to require PTW control.
The exceptions to this will include:
• Work within 15m of flammable material storage areas. Therefore the contractor shall
plan the flammable material storage locations in order to minimise the use of a Hot
Work PTW;
• Any other activity identified via a risk assessment.

Appendix L is applicable to this activity.
9.8 Storage and Handling of Chemical and Hazardous or Toxic Materials

The storage and handling of hazardous materials (hydrocarbons, chemicals, toxic
materials stored in tanks, drums and paint stores, etc) shall be controlled by a PTW
system described in the Management of Hazardous Chemicals Procedure before it is put
into use.
The PTW shall be renewed periodically as described Ref. [8] Section 4.2.
Appendix M is applicable to this activity.
9.9 Explosive Devices and Tools Utilising Explosive Charges

The use of construction tools that utilize an explosive charge shall be controlled by PTW
system described in the Small Tools and Equipment Inspection and Safe Use Procedure
Ref. [9] Section 4.2.
Appendix N is applicable to this activity.
9.10 Lifting of Personnel by Mechanical Means

The use of crane suspended work platforms shall be controlled by a PTW system
described in the Crane Suspended Work Platforms Procedure Ref. [10] Section 4.2.
Appendices H and I are applicable to this activity.
The Permit to Work system shall be initiated under strict compliance for employee safety.
5887-ON-PR-HM-013
Prior to use of any work platform suspended from cranes or derricks for hoisting
personnel, the highest level of Project Management (i.e. Construction Manager) shall
determine if the use of conventional means is more hazardous or not possible because of
structural design or worksite conditions.
CONTRACTOR shall submit a justification to the COMPANY Construction Manager for
approval prior to issuing a Crane Suspended Work Platform PTW.
9.11 Diving Operations

All diving operations shall be controlled by a PTW system as described in the Diving
Operations Procedure Ref. [11] Section 4.2.
Appendix S is applicable for this activity.
10.0 CONTROLLED PROCEDURE ACTIVITIES
10.1 Pneumatic Testing

Due to the potential of project wide impacts no pneumatic tests will be carried out without
written permission from PMC.
Pneumatic testing shall only be carried out if there is no practicable alternative available.
The contractor shall prepare a risk assessment for approval and consider as a minimum:
• Details of alternative leak test methods considered;
• Marked-up Process Engineering Flow Sheets and Plot Plan showing the work scope
and the isolations;
• Details of the fabrication, verification and operability of test manifolds;
• Sizing, calibration and certification of pressure safety valve, relief valve, temperature
and pressure recorders and test pressure gauges as required for individual tests
• Procedures for leak detection that minimises the potential for release of energy;
• Timing and duration of the test in order to minimise HSSE and schedule impacts at the
Worksite;
• Extent of exclusion zones required and potential impact on other neighbouring

contractor (IC, EPC and PMC Early Works contractors) work areas;
• Procedures for barricading of exclusion zones and also for the monitoring of the
exclusion zone to prevent unauthorised access.
10.2 Scaffolding
Scaffolding quality shall be controlled via a “Scaffold tag” system and the Project
Scaffolding Procedure T-13.377.451, Ref. [12] and further described in the Fall Prevention
Procedure Ref. [6].
5887-ON-PR-HM-013
10.3 Non-Routine and Heavy Lift Operations

Non-routine and heavy lift crane operations shall be controlled via the preparation and
approval of specific lifting plans as described in the Crane and Lifting Operations
Procedure Ref. [13] Section 4.2.
11.0 TSTI AND PERMITS
11.1 Total Safety Task Instruction (TSTI)

Total Safety Task Instruction remains one of the basic safety control measures and all
activities shall be subjected to a TSTI whether a permit is used for the activity or not. See
Appendix Q.
11.1.1 Permit to work:

A Work Permit is applied to control activities where:
• Inherent risks of the activity assessed are high or medium by the Risk Assessment
Matrix – See Appendix Y.
• High risk construction activities where controls are not detailed in other procedures
or work instructions.
11.1.2 Confined Space Permit:

A Confined Space Certificate confirms isolations of the confined space and specifies the
precautions needed to eliminate hazardous gases or dust, to provide a breathable
atmosphere and to ensure that the space is safe for people to enter. See Appendix B.
11.1.3 Excavation Permit:

An Excavation Certificate specifies the precautions required to
• Identify buried cables and pipes during excavation work of greater than a spade
depth (100mm).
• Protect people working in excavations. See Appendix G.
11.1.4 Override Permit:

A Safety System Override Permit (Appendix T) will allow work to proceed with control,
protection and safety systems isolated or overridden, the permit will be cancelled as part
of the permit completion arrangements identified in the method statement. Overrides
should be in place for the shortest practicable time and should not necessarily wait until
the work is completed.
11.1.5 Work Platform / Personnel Basket Permit:

Prior to use of any personnel platforms suspended from cranes or derricks for hoisting
personnel, the highest level of Project Management shall determine if the use of
conventional means is more hazardous or not possible because of structural design or
worksite conditions.
5887-ON-PR-HM-013
11.1.6 Grating Removal Permit

The removal of any floors or grating installed poses serious risk if not controlled properly.
The permit requires senior level approval, barricading and 100 % tie off to ensure the
safety of all involved in the activity.
12.0 APPENDICES
Attachment Description
A Permit Control Area Plot Plan
B Confined Space Entry Permit
C Gas Test Certificate
D Confined Space Entry / Exit Log
E Non Destructive Examination (NDE) Permit
F Radiological Material Storage Permit
G Excavation Permit
H Crane Suspended Work Platform Permit
I Crane Suspended Work Platform Daily Checklist
Working within 6 meters of Energised Overhead Uninsulated Electrical
J
Lines Permit
K Grating / Flooring / Hand-Railing Removal Permit
L Hot Work Permit
M Hazardous Material Storage Permit
N Powder / Explosive Charge Activated Tools Permit
O Permit to Work Inspection Check List
P Permit to Work Register
Q Total Safety Task Instruction Form
R Deleted
S Diving Permit
T Safety System Override Permit
U Permit to Work Form
V Permit Revalidation Certificate
W PTW Issuing Authority Appointees
X Index of Permit Areas
Y Risk Assessment Matrix (RAM)
Z Risk Assessment Matrix Risk Assessment Matrix – Definition of Terms
5887-ON-PR-HM-013
Appendix A
Permit Control Area Plot Plan
5887-ON-PR-HM-013
Appendix B – Confined Space Entry Permit

Permit No:
Emerg. No. 4748888
Date:
CONFINED SPACE ENTRY PERMIT
Pearl GTL Project
SECTION 1: Work request
CONTRACTOR: PTW Requestor:
Telephone number: Badge number:
Detailed work location: Purpose of entry:
SECTION 2: Hazards
Hot work Oxygen (less than 20.0% Flammable gases or vapours Toxic gases or vapours
or greater than 21.5%) (greater than 1% of LEL) (greater than PEL / TLV)
Work at height / Contact with hazardous High temperatures (hot Mechanical / electrical
scaffolding materials surfaces / heat stress) hazard
Nitrogen Other hazards JSA required
SECTION 4: PPE required
Face Shield Boots Gloves Goggles
Air Line Dust mask Chemical / Dust Respirator Chemical Resistant / Acid
Suit
SCBA Full Encapsulated Suit Other
SECTION 5: Isolation and preparation for entry complete
PEFS attached Lines blinded / broke Lock out / Tag out Purged / cleaned
Inert complete Ventilation in place Lights (low voltage with Access good
GFCI / handheld)
Hot Work Scaffold approved Barriers / warning signs Other
SECTION 6: Emergency
Rescue plan attached Requires full body harness Requires mechanical hoist / life line
Method of communication between Hole Method of communication
Watch and Entrants to Emergency rescue team
SECTION 7: Approvals
Name Badge number Signature Date
CONTRACTOR representative
Supporting Signatory (Mechanical)
Supporting Signatory (Electrical)
PTW Issuing Authority
Gas test requirements Gas test frequency
Permit start (time / date) Permit finish (time / date)
SECTION 8: PTW accepted by CONTRACTOR
Hole Watch Name Badge number Telephone number Date
Alternative Hole Watch

PTW Holder (Work supervisor)
No. of craft working on the PTW TSTI reference
PTW Issuing Authority Name Badge number Signature Date
SECTION 9: PTW CLOSED

PTW Issuing Authority Name Badge number Signature Date
5887-ON-PR-HM-013
Appendix C – Gas Test Certificate

Permit No:
Emerg. No. 4748888
GAS TEST CERTIFICATE Date:
The gas test records shall be attached to the Confined Space
PTW and held by the Hole Watch
Pearl GTL Project
Gas Test One Name Badge number Telephone number Date and time
Hole Watch
Atmospheric Hazard Tested Acceptable Range of Hazard Actual Reading (Record) Acceptable (Yes / No)
Oxygen Content 20.0% - 21.5% %
Combustible Gas (% LEL) 0% %
Other (specify): PEL = ppm ppm
Gas Test Two Name Badge number Telephone number Date and time
Hole Watch
Gas Test Three Name Badge number Telephone number Date and time
Hole Watch
Gas Test Four Name Badge number Telephone number Date and time
Hole Watch
Gas Test Five Name Badge number Telephone number Date and time
Hole Watch
5887-ON-PR-HM-013
Appendix D – Confined Space Entry / Exit Log

Permit No:
Emerg. No: 4748888
CONFINED SPACE ENTRY / EXIT LOG Date:

Keep with the confined space entry permit for a minimum of one year.
Pearl GTL Project
Location
HOLE WATCH INSTRUCTIONS

You should be thoroughly familiar with the following duties when you assume the responsibilities of standby for a person(s)
working inside a vessel or confined space.
YOUR PRIMARY RESPONSIBILITIES ARE:

• The safety of personnel working in the vessel or confined space.
• Maintaining the conditions and requirements listed on the work permit.
• Evacuating the vessel if you observe any condition which you considered hazardous.
• Getting help if an emergency develops.
NEVER ATTEMPT TO ENTER THE VESSEL OR CONFINED SPACE, EVEN IN AN EMERGENCY.
THE CIRCUMSTANCES AND CONDITIONS OF THE JOB WILL DETERMINE THE SAFETY REQUIREMENTS AND WHAT
YOUR STANDBY DUTIES ARE. HOWEVER, THE FOLLOWING DUTIES ARE BASIC TO ALL JOBS:
• Do not leave your assignment while personnel are inside the vessel or confined space.
• (The only exception is to get help in an emergency). If other duties require you to leave your standby post, have all
personnel evacuate the enclosure.
• If you have any questions regarding your job, check with your foreman.
• BE ALERT, and try to anticipate and / or prevent any conditions that could be hazardous.
• Prevent interference of air lines and / or lifelines.
5887-ON-PR-HM-013
• If you are required to have respiratory equipment and lifelines, be sure you know how to use this equipment.
• Upon completion of the job, clean and return all special equipment to its original location.
Hole Watch Name Badge number Telephone number Date
AUTHORISED ENTRANTS Location

Name Contractor Badge Date Time Time Time Time Time Time Time Time
number in out in out in out in out
5887-ON-PR-HM-013
Appendix E – Non Destructive Examination (NDE) Permit

Permit No:
Emerg. No: 4748888
Non Destructive Examination (NDE) Date:
PERMIT
Pearl GTL Project
SECTION 1: WORK REQUEST BY CONTRACTOR
CONTRACTOR PTW Requestor
Telephone number Badge number
Work location details Plot Plan attached show work location Yes No
(target 2.5 microSv / hour; absolute
maximum 7.5 microSv / hour)
List impacted roads and mark Barricaded area extends beyond
Yes No
on Plot Plan CONTRACTOR boundary
Start date requested Finish date requested
SECTION 2: SOURCE DETAILS
X-ray apparatus Make / type
Yes No Maximum tube voltage kV
Radioactive source Type Sealed Unsealed
Maximum activity Ci
Yes No Isotope
Type of radiation Alpha Beta Gamma
SECTION 4: RADIATION MONITORING
Film badge Yes No Area monitoring Yes No
Personal dosi meter Yes No Other
SECTION 5: EMERGENCY CONTACTS
If irregularities or disturbances occur one of the following two people shall be notified immediately
Name Badge number Telephone number
SECTION 6: APPROVALS
Worksite NDE coordinator informed of NDE activity Yes No
Permit start (time / date) Permit finish (time / date)
SECTION 7: PTW ACCPETED BY CONTRACTOR
PTW Holder (Work supervisor) Name Badge number Telephone number Date
Number of craft working on the PTW TSTI reference

5887-ON-PR-HM-013
Appendix F – Radiological Material Storage Permit

Permit No:
Emerg. No: 4748888
RADIOLOGICAL MATERIAL STORAGE Date:
PERMIT
Pearl GTL Project
SECTION 1: REQUEST BY CONTRACTOR
Storage location Plot Plan attached Yes No
Qatari Licence number RLC Licence number
Start date requested Finish date requested
SECTION 2: SOURCE DETAILS
X-ray apparatus Make / type
Yes No
Maximum tube voltage kV
Radioactive source Type Sealed Unsealed

Maximum activity Ci
Yes No Isotope
Type of radiation Alpha Beta Gamma
SECTION 3: EMERGECNY CONTACTS
If irregularities or disturbances occur one of the following two people shall be notified immediately
Name Badge number Telephone number
PMC / IC HSSE Manager
PMC / IC Construction Manager
Permit start date Permit finish date
SECTION 5: PTW ACCEPTED BY CONTRACTOR
PTW Holder (Storage supervisor) Name Badge number Telephone number Date

5887-ON-PR-HM-013
Appendix G – Excavation Permit

Permit No:
Emerg. No: 4748888
Date:
EXCAVATION PERMIT
Pearl GTL Project
Purpose of Excavation
Detailed Work location Plot Plan attached
Yes No
Size of excavation Width mm Length mm Depth mm
SECTION 2: UNDERGROUND SERVICE REVIEW
Drawings checked for underground facilities? Electrical Inst./ comm. Piping Civils Other
Temporary facilities (yes / no)

Permanent plant (yes / no)
List hazards and mark on drawing
Owner of facilities contacted (yes / no)
SECTION 3: CIVILS REVIEW
Obstructions identified Footings No Yes Clearance = mm
Pilings No Yes Clearance = mm
Other No Yes Clearance = mm
Description of soil type
Shoring / sloping requirements
Access (specify number / position / type)
SECTION 4: CONFINED SPACE
Toxic / flammable gas / O2 deficiency potential (gas testing required) Yes No
SECTION 5: PRECAUTIONS
Lines located by detector Hand excavate / probe De-energise lines
Insulate operator Ground tools Barricades
Banksman required Other precautions
SECTION 6: APPROVAL
Electrical / Instrument
Piping
HSSE Department
Permit Issuing Authority
Permit start date Permit valid until:
SECTION 7: PTW ACCEPTED BY CONSTRUCTION

5887-ON-PR-HM-013
Appendix H – Crane Suspended Work Platform Permit

Permit No:
Emerg. No. 4748888
CRANE SUSPENDED WORK PLATFORM Date:
PERMIT
Pearl GTL Project
The Permit to Work system is initiated for strict compliance and employee safety.
Prior to use of any work platform suspended from cranes or derricks for hoisting personnel, the highest
level of Project Management (i.e. Construction Manager) shall determine if the use of conventional
means is more hazardous or not possible because of structural design or worksite conditions.
CONTRACTOR shall submit justification below for Construction Manager approval.
Reason for use
Job Hazard Analysis (JSA) reference
Submitted by Name Badge number Signature Date

Sub-Contractor HSSE Manager
Sub-Contractor Construction Manager
Approved by Name Badge number Signature Date

Construction Manager
NOTE: This copy shall be used for each lift and a copy kept inside the crane cab or operator's station. The form shall be
filed in the HSSE Office files after use.
5887-ON-PR-HM-013
Appendix I – Crane Suspended Work Platform Daily Checklist

Permit No:
Emerg. No: 4748888
CRANE SUSPENDED WORK PLATFORM Date:
DAILY CHECKLIST
Pearl GTL Project
Documentation of lift capacity information is required before using work platform suspended from cranes
This Checklist to be filled out prior to using work platform and information shall be retained in project site files
SECTION 1: CRANE DETAILS
Location Project
Crane Identification No.: Contractor name
Model/Type: Inspection Date:
Length of Boom: Boom Angle:
Radius: Meters:
SECTION 2: OPERATORS
Crane operator (name / badge no.) Rigger (name / badge no.)
Person in basket #1 (name / badge Person in basket #2 (name /
no.) badge no.)
Person in basket #3 (name / badge Person in basket #4 (name /
no.) badge no.)
SECTION 3: LOAD
(1) Basket Equipment number
(2) Weight of Basket = Kg
(3) Total Weight of occupants, tools and equipment = kg
(4) Load Block weight = Kg
(5) Whip Line Ball weight = Kg
(6) Working load capacity (2) + (3) + (4) + (5) = Kg
(7) Chart rated capacity at Operating Radius Kg
(8) Maximum Load capacity = 50% of (7) = Kg
NOTE: Because of the required safety factor, the working load capacity (6) can not be greater than the maximum load capacity (8)
SECTION 4: SAFETY CHECK
(9) Is platform suspended from crane that has controlled (17) Tag lines provided to control basket?
lowering capability?
(10) Has basket and all rigging equipment been inspected and (18) Area below basket barricaded?
valid?
(11) Four (4) or less employees inside basket (19) Safety harness worn by employees inside basket and
secured?
(12) Is safety line provided for basket? (20) Weather conditions good?
(13) Has crane operator's inspection been performed (daily (21) Proof testing at 125% of rated capacity before lift witnesses
crane checklist as per Crane and Lifting Operations by Contractor Rigger and Contractor Equipment Inspector?
procedure completed and attached (Section 7.1 of EPCM (22) Crane has a valid JK GTL/Utilities Inspection sticker?
Construction HSSE Manual)?
(14) Crane set up on firm footing and level with outriggers fully (23) Anti two-blocking device or two block damage prevention
extended, if equipped? feature functional and verified?
(15) Is working area for the crane free of power lines? (24) Basket has a valid JK GTL/Utilities Inspection sticker?
(16) Radio communications provided if hand signals are not (25) (25) Written approval for lift from JK GTL/Utilities
feasible? Construction Manager attached (and valid)
Comments
SECTION 5: APPROVAL TO LIFT

5887-ON-PR-HM-013
Documentation of lift capacity information is required before using work platform suspended from cranes
This Checklist to be filled out prior to using work platform and information shall be retained in project site files
Sub-Contractor Operator / Crane
Supervisor
Sub-Contractor Work Supervisor
Sub-Contractor HSE Supervisor
Sub-Contractor Area Supervisor
Contractor HSSE Supervisor
Contractor Area Superintendent
5887-ON-PR-HM-013
Appendix J – Working Within 6 Meters of Energised Overhead Uninsulated Electrical

Lines Permit
Permit No:
Emerg. No. 4748888
WORKING WITHIN 6 Meters of
Date:
ENERGISED OVERHEAD UNINSULATED
Pearl GTL Project
ELECTRICAL LINES PERMIT
Contractor PTW Requestor
Work location details Plot Plan attached show work Yes No
location
Work description Distance work platform will be metres
from energized electrical lines
SECTION 2: CONTRACTOR REVIEW
Contractor Construction Badge number
Superintendent name
Telephone number Line voltage
Special precautions Permission to use lift
Yes / No
Lead Electrical Field Engineer /
Electrical Superintendent

SECTION 5: PTW Closed
5887-ON-PR-HM-013
Appendix K – Grating / Flooring / Hand-Railing Removal Permit

Permit No:
Emerg. No. 4748888
GRATING / FLOORING / HAND-RAILING Date:
REMOVAL PERMIT
Pearl GTL Project
Request date: Planned duration of Work
Area Specific work location
SECTION 2: HSE PRECAUTIONS VERIFIED AT WORK LOCATION (PRELIMINARY APPROVALS)
Yes No Details / type
Has primary barricade been installed?
Temporary cover with sign available at work location?
Is 100% fall protection available and in place?
Is warning sign at grade in place?
Is warning sign at location in place?
Is ownership tag in place?
Is adequate lighting in place?
Has a dedicated hole watch been identified?
Has a secondary barricade been installed?
Is a hole cover available at work location?
Is a hole cover design needed?
Are hole cover modifications required?
SECTION 3: PRELIMINARY APPROVALS
We have reviewed this request. We agree that removing the grating, floor covering, hand-rail is required to accomplish this
activity. We have filled in the actions below and will sign final approval after all the requirements have been met.
CONTRACTOR Civil / Structural
CONTRACTOR HSSE
SECTION 4: FINAL APPROVALS
CONTRACTOR HSSE Manager
(Construction Superintendent)
CONTRACTOR PTW
Coordinator (PTW Registered)
Name Badge number Telephone no. Date
No. of craft working on the PTW TSTI reference
SECTION 6: DAILY CHECK OF COMPLIANCE WITH PTW BY CONTRACTOR
Name Badge no. Date Name Badge no. Date
Day 1 Day 5
Day 2 Day 6
Day 3 Day 7
Day 4
5887-ON-PR-HM-013

5887-ON-PR-HM-013
Appendix L – Hot Work Permit

Permit No:
Emerg. No. 4748888
Date:
HOT WORK PERMIT
Pearl GTL Project
Location of work Plot plan attached Yes No
Work description
Welding Burning Grinding Other

SECTION 2: HAZARDS AND CONTROL
Distance from flammable material storage m Housekeeping good and combustible Yes No
materials removed
Fire blanket or tray to prevents falling Yes No Fire watch required Yes No
sparks
Fire extinguisher required Yes No Number and type of fire extinguisher
CONTRACTOR Fire safety Officer /
HSSE Manager
PTW Holder (Work supervisor) Name Badge number Telephone no. Date
Number of craft working on the TSTI reference

PTW
5887-ON-PR-HM-013
Appendix M – Hazardous Material Storage Permit

Permit No:
Emerg. No. 4748888
HAZARDOUS MATERIAL STORAGE Date:
PERMIT
Pearl GTL Project
Storage location Plot plan attached MSDS or Risk assessment
attached
Yes / No
Yes / No
Material to be stored Maximum quantities
SECTION 2: HAZARDS
Flammable Combustible Corrosive
Material hazardous properties
Yes No Yes No Yes No
Irritant Toxic Carcinogenic Dangerous to the Environment
Yes No Yes No Yes No Yes No
Distance from nearest building, fabrication
shop, etc
Distance from nearest occupied buildings
Fire fighting equipment required
Environmental spill prevention measures
Warning signs required
Description of security measures
Name Badge number Telephone No. Date
Electrical Engineer
Issuing Authority (HSSE Manager)
PTW Holder (Work supervisor) Name Badge number Telephone No. Date

PTW Issuing Authority (HSSE
Manager)
5887-ON-PR-HM-013
Appendix N – Powder / Explosive Charge Activated Tools Permit

Permit No:
Emerg. No. 4748888
POWDER / EXPLOSIVE CHARGE Date
ACTIVATED TOOLS PERMIT
Pearl GTL Project
Work location
SECTION 2: ACTIVITY SPECIFIC DETAILS
Type of tool Type of charge
Size of stud Hot work PTW Yes No
Description of work Special precautions
SECTION 3: OPERATORS
Name Badge number Name Badge number
OPERATOR #1 OPERATOR #2
OPERATOR #3 OPERATOR #4
SECTION 4: APPROVAL
PTW Holder (Work supervisor) Name Badge number Telephone no. Date
Number of craft working on the TSTI reference

PTW
5887-ON-PR-HM-013
Appendix O – Permit to Work Inspection Check List

Permit No:
Emerg. No. 4748888
PERMIT TO WORK INSPECTION CHECK Date:
LIST
Pearl GTL Project
Contract No. Contract Title: Contractor Name:
Area / Installation: Inspector: Date:
Area / Site Manager: Permit Issuing Authority: Permit Holder:
1) Permit No:
2) Date of Issue:
3) Type of Permit:
4) Description of work (inc. work location)
Issue time: Valid until:

5) Distribution and display:
a) Have permit copies been properly distributed, and where necessary is a permit prominently Yes / No
displayed?
6) Is the work description on the permit adequate, i.e. does it adequately describe the work location, the
Yes / No
equipment to be worked on, and the exact nature and scope of the work?
If not, explain deficiency:
7) Validity
a) The permit should clearly state the time and dates between which it is valid. Yes / No
b) Is permit revalidation being signed and dated by Issuing Authority? Yes / No
c) Are revalidations up to date? Yes / No
8) Hazards
a) Are hazards clearly identified? Yes / No
b) Are they directly applicable to job being undertaken? Yes / No
9) Precautions
a) Are appropriate precautions identified and specific enough? Yes / No
b) Have other affected personnel outside the permit area been notified of the permit work? Yes / No
If yes, have they appended their signature? Yes / No
c) Have all precautions been implemented at the worksite? Yes / No
If no, explain deficiency
10) Gas Tests

a) Have gas tests been undertaken? Yes / No
b) Are tests valid for this period? Yes / No
c) Are portable gas monitors fully operable at worksite and calibrated? Yes / No
d) Are on-site personnel knowledgeable on how to operate equipment? Yes / No
e) Have they been properly trained in its use? Yes / No
f) Has periodic testing been carried out as appropriate? Yes / No
11) Precautions Taken by Permit Holder

a) Has Permit Holder briefed everyone in the Work Party? Yes / No
b) Have all the persons in the Work Party read the permit? Yes / No
c) Do all persons fully understand the safety requirements and the precautions stated on the PTW? Yes / No
d) Are they in compliance, e.g. using safety clothing as specified, isolating equipment at breaks, etc? Yes / No
5887-ON-PR-HM-013
If not, specify
12) Isolation
a) Are isolation certificates attached to the permit? Yes / No
b) Are they cross-referenced? Yes / No
c) Do certificates or attachments detail specific isolation points? Yes / No
d) Are all isolations secure? Yes / No
e) Are all isolations tagged? Yes / No
f) If more than one task on same isolation, has multiple lock/key system or other suitable control
Yes / No
been used?
If so, give details
13) Precaution by Permit Issuing Authority

a) Has task been fully discussed with person carrying out the isolation? Yes / No
b) Has task been discussed with Permit Holder? Yes / No
c) If more than one Permit on equipment/system, have all appropriate cross-references been made
Yes / No
and all necessary personnel been made aware?
d) Where tasks may impinge on other responsible persons/areas, have affected persons signed to
Yes / No
acknowledge their awareness of the work?
14) Handover
a) Has handover of permit been done between Permit Issuing Authorities at shift change? Yes / No
b) How is this being documented? .....................................................................................
c) Has a handover of jobs between Permit Holder been done? Yes / No
d) How is this being documented? .....................................................................................
15) Work Suspended / On Hold / Completed
a) Has site been left in a safe and tidy condition? Yes / No
b) If work not complete, are isolations secure? Yes / No
c) Is Permit Issuing Authority aware of status? Yes / No
d) Is Control Room aware of status? Yes / No
16) Training
a) Have personnel who are currently associated with this permit received training in the Pearl GTL
Yes / No
PTW system?
b) Is the type and frequency of training in accordance with company policy? Yes / No
c) Is evidence of their training and appointment readily available Yes / No
Summarise Overall Inspection:
Inspector:
Name (Capitals): Signature: Time: Date:
5887-ON-PR-HM-013
Appendix P - Permit to Work Register
PERMIT TO WORK REGISTER

Pearl GTL Project
Permit No. Date Issued to – Company Valid Type of permit: Date Signature:
Issued: / Name: from / completed:
to:
5887-ON-PR-HM-013
Appendix Q – Total Safety Task Instruction Form
Total Safety Task Instruction (TSTI) Template

TSTI is a safety communication, task planning and risk management system.
(Complete each box before proceeding to the next box.)
Pearl GTL Project
(Box 1 and 2 by Front Line Supervisor) Task Planning (1)

Permit/Work Order Number: Contractor: Craft/Dept: Date: / /
Task Description:
Job Hazard Analysis / Method Statement Reference:

Recognized Hazards:
Unit/Area Specific Training:
Emergency Action Plan (Risk Management) (2)

Area / Unit: Alarm Code:
Emergency telephone number: Evacuation Route:
Nearest Safety Shelter Location:

Assembly Area: Safety shower / eye washer located Yes No
Communication - Task Planning - Risk Management (Job Safety Analysis, JSA)

Task Steps (3) Potential Hazards (4) Eliminate / Control Hazards (5)
Hazard Recognition / Considerations (Risk Management)
5887-ON-PR-HM-013
Physical (6) Physical (continued) (6) Health (continued) (7)

Arcing / sparking equipment Sharp / jagged objects Heat stress
Dust (weather created) Pressurized systems and equip. Fumes
Electricity, close proximity Slips / tripping potential Noise (excessive)
Electricity, loss of Structural - surface openings Oxygen deficient atmosphere
Engulfment Tight/close work quarters Temperature - extreme heat / cold
Entanglement Vibration (excessive) UV rays – eyes / skin
Falling objects Water - drowning / hypothermia
Fall potential Other:
Fire / explosion Other:
Flying debris
Heavy or bulky material Environmental – air, soil, water (8)
High voltage - 5KV + Health (7) Chemical spills / releases
Hot or cold surfaces Airborne particles (work created) Wastewater
Lighting – inadequate Chemical – liquid / vapour Trash and housekeeping
Moving hazards Contaminated soil or water Other:
Pinching and crushing Fatigue
Radiation – X-ray
Task Planning
Standard equipment required (9) Special equipment and tools (10) Support craft and third party (11)
Example: Excavator, manlift, compressor, Example: radios, special testing meters, Example: Equipment Vendor, laborers,
crane, forklift, truck special tools, SCBA special hole drilling, testing company
Risk Management
Safe Work Practices (12) Basic Safeguards (13) PPE Required (14)
Asbestos abatement Arc shields Arc suit
Confined space entry Barricades Chemical resistant clothing
Crane lift study Crane suspended work platform Eye protection
Electrical - close proximity Fire extinguishers located Fall protection
Excavations and shoring Fire watch Foot wear
Hot taps Hole covers Hand protection
Lead abatement Hole watch Head protection
Line breaking / equipment Housekeeping Hearing protection
opening Lighting - additional Respirator (RPE)
Lock-Out / Tag-Out Post warning signs Weather resistant clothing
MSDS and labeling Scaffolding Work breaks and shade for heat
Water for heat stress Tools and equipment in good stress
condition and colour coded
Other: Ventilation / exhaust systems Other:
Communication
Stop work conditions (reminders) (15)
Adjacent work hazards Chemical spills or releases Excessive noise Fires and explosions
Change in conditions Evacuation alarm Extreme weather Unusual odours
5887-ON-PR-HM-013
Supervisor and worker comments / change in conditions (16):
Acknowledgement
I acknowledge receiving and understanding these instructions, I will fully comply with the assigned task
requirements (17)
Initials and Surname (Print) Badge number Signature Date
FLS / Supervisor name: (Print) Date:

(Signature)
(Supervisor will ensure completed TSTI-JSA forms are forwarded to the appropriate Area Superintendent or Construction Manager)
Acknowledgement
To be completed at the end of each shift. (18)
I hereby declare that I have not been injured today.
Initials and Surname (Print) Badge number Signature Date
FLS / Supervisor name: (Signature) (Print) Date:

(Supervisor will ensure completed TSTI-JSA forms are forwarded to the appropriate Area Superintendent or Construction Manager)
5887-ON-PR-HM-013
Appendix R – Deleted
5887-ON-PR-HM-013
Appendix S – Diving Permit to Work

Permit No:
No.
Date
DIVING PERMIT to WORK
Pearl GTL Project
Permit Reference No.
HOLD
5887-ON-PR-HM-013
Appendix T – Safety System Override Permit

Permit No:
Emerg. No: 4748888
Date
SAFETY SYSTEM OVERRIDE PERMIT
Pearl GTL Project
Description of Override
Work Area Location.
Type of Safety Protection System

Fire Level
Smoke Temperature
Gas Detection Pressure
Other (Please Specify)
Reason for Override
Method to be used
Requested By Issuing Authority

Name (Capitals) Signature Time Date
Certificate Validity
This Certificate valid From Date Time
This Certificate Expires Date Time
This Certificate has been Date Time
extended to
Extension Approved by
Issuing Authority
Override Completed
Authorised Engineer
Name (Capitals) Position (Capitals) Signature Date Time
Re-instatement
5887-ON-PR-HM-013
Re-instatement Requested
Issuing authority
Comments and Observations
Override Cancellation
Safety System Override Re-instatement Complete and Tested
Authorised Engineer
White copy-Master/Issue Point Yellow copy-Work Site
5887-ON-PR-HM-013
Appendix U – Permit To Work Form

Permit No:
Emerg. No: 4748888
Date
PERMIT TO WORK FORM
Pearl GTL Project
Contract No.: Contract Title: Contractor Name:
Permit to Work Activity:

Method Statement/JSA:
SECTION 1: Work Request By Contractor
Contractor: PTW Requestor:
Telephone number: Badge number:

Work location:
SECTION 2: Activity Specific Details
SECTION 3: Approvals
Name: Badge no: Signature: Date:
PTW Issuing
Authority:
Permit start date: Permit finish date:
SECTION 4: PTW Accepted By Contractor

PTW Holder (Work Name: Badge no: Telephone no: Date:
supervisor)
Number of craft TSTI reference:

working on the PTW:
SECTION 5: PTW Closed
Name: Badge no: Signature: Date:
PTW Issuing
Authority:
5887-ON-PR-HM-013
Appendix V – Permit Revalidation Certificate

Permit No:
Emerg. No: 4748888
PERMIT REVALIDATION CERTIFICATE Date

(Gas test required for excavation entry > 1.5 m)
Pearl GTL Project
Days Date Time Issuing Authority - Signature Performing Party - Signature
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Day 8
Day 9
Day 10
Day 11
Day 12
Day 13
Day 14
Day 15
Day 16
Day 17
Day 18
Day 19
Day 20
Day 21
Day 22
Day 23
Day 24
Day 25
Day 26
Day 27
Day 28
Day 29
Day 30
5887-ON-PR-HM-013
Appendix W – PTW Issuing Authority Appointees
PTW - Issuing Authority Appointees

PEARL GTL Project
Initials and Authorized Issuing Autorisation Appointed by Initials and Date Signature of
Surname for Authority Valid from / Surname (Only project appointment person doing
Area/Project Signature to: Construction Director or made appointment:
his delegate can appoint)
C Wright MOF Dec 06 – 09
D Harmon MOF Dec 06 – 09
R Emanuel MOF Dec 06 – 09
R Gillie MOF Dec 06 – 09
J Martinez Site Prep Dec 06 – 09

R Womack Site Prep Dec 06 – 09
C Harley Site Prep Dec 06 – 09

M Morgan Site Prep Dec 06 – 09
C Lange Site Prep Dec 06 – 09
C Armando Site Prep Dec 06 – 09
D Hannerman Site Prep Dec 06 – 09
M Eduardo Site Prep Dec 06 – 09

N Hinman Camp/WWT Dec 06 – 09
B Lewis Camp/WWT Dec 06 – 09

M Graham Camp/WWT Dec 06 – 09
J Ferrill Camp/WWT Dec 06 – 09
M Asisco Camp/WWT Dec 06 – 09
B Pedar Camp/WWT Dec 06 – 09
D Austiste Camp/WWT Dec 06 – 09
C Armando Camp/WWT Dec 06 – 09
D Smith Engineering Dec 06 – 09
R Miller Engineering Dec 06 – 09

E Larga QA/QC Dec 06 – 09
L De San Juan QA/QC Dec 06 – 09

O Pescon QA/QC Dec 06 – 09
N Enriquez QA/QC Dec 06 – 09
PWA du Plessis HSSE Dec 06 – 09
J Morney HSSE Dec 06 – 09
A Calingasan HSSE Dec 06 – 09

G Pienaar HSSE Dec 06 – 09
S Jones HSSE Dec 06 – 09
A Venter HSSE Dec 06 – 09
5887-ON-PR-HM-013
Pearl GTL Project Revision 4
Appendix X – Index of Permit Areas
Index of Permit Areas
C1 Buildings C4 Feed Gas Processing (FGP) C6 GTL Facilities C7 Off-Plot & Jetty
C1-P Admin & CCR Area C4-H Receiving facilities C6-A GTL Facilities Ph 1 C7-V Loading Lines
C1-PA Admin & Control Bldgs. C4-HA Slug Catcher C6-AA 2nd Stage HPS C7-VZ General
C1-PB Storage / Warehousing C4-HB Cond. Stab. Common & Ph.1 C6-AB 1st Stage HPS C7-W LPG Storage
C1-PZ General C4-HC Cond. Stab. Ph.2 + Future C6-AC SGP C7-WZ General
C2 Air separation Units (ASU) C4-HD E-W Piperack C6-AD N-S Piperack C7-Z Loading Jetty
C2-F Units 1-4 Ph1 ASU's C4-HZ General C6-AZ General C7-ZZ General
C2-FA ASU-1 Ph 1 C4-J Processing Ph 1 C6-B GTL Facilities Ph 2 C8 Effluent Treatment Plant (ETP)
C2-FB ASU-2 Ph1 C4-JA AGR. & DMR C6-BA 2nd Stage HPS C8-N Effluent Treatment
C2-FC ASU-3 Ph 1 C4-JB NGL, LPG & Ethane C6-BB 1st Stage HPS C8-NA AOC, COC, etc.
C2-FD ASU-4 Ph1 C4-JC Chilled Water C6-BC SGP C8-NB Biotreater, etc. Ph. 1
C2-FE S/Stn & FAR's C4-JD E-W Piperack C6-BD N-S Piperack C8-NC Biotreater, etc. Ph. 2
C2-FF LIN & LOX C4-JZ General C6-BZ General C8-ND Effluent Water, RO, etc.
C2-FG N-S Piperack C4-K Processing Ph 2 C6-C GTL Power Generation C8-NE FAR
C2-FZ General C4-KA AGR. & DMR C6-CA Steam Turbine Generator C8-NF Future
C2-G Units 1-4 Ph2 ASU's C4-KB NGL, LPG & Ethane C6-CB Steam Generator & IA C8-NZ General
C2-GA ASU-1 Ph 2 C4-KC Chilled Water C6-CC Power Generation Buildings PMC PMC Office Complex
C2-GB ASU-2 Ph2 C4-KD E-W Piperack C6-CD Gas Turbine Generator
C2-GC ASU-3 Ph 2 C4-KZ General C6-CE BFW
C2-GD ASU-4 Ph2 C4-L SRU & SCOT C6-CF Condensate Recovery EPCM EPCM Office Complex
C2-GE S/Stn & FAR's C4-LA SRU & SCOT Ph. 1 C6-CJ E-W Piperack Ph. 1 (North)
C2-GG N-S Piperack C4-LB SRU & SCOT Ph. 2 C6-CK E-W Piperack Ph. 2 (South)
C2-GZ General C4-LC Common Storage Area C6-CZ General TSF Pioneer Office
C4-LZ General
5887-ON-PR-HM-013
C3 Tank Farm C5 Liquid Processing Units ( LPU ) C6-U GTL General Utilities C Camp Complex
C3-M Gas Oil C5-D Units Ph 1 C6-UA CW Ph 1 + Waste Disp. (North)
C3-MA Gas Oil Tanks North C5-DA LDF C6-UB CW Ph 2 (South) CEW Early Works Camp
C3-MB Gas oil Tanks South C5-DB Downstream Units C6-UC Water Treatment CSTF JK Staff Camp
C3-MZ General C5-DC HMU & SMR Units C6-UD Flare CC1 Buildings Contractor Camp
C3-Q Kero, Naptha & Slops C5-DZ Common C6-UE Future CC2 ASU Contractor Camp
C3-QA Kerosene C5-E Units Ph 2 C6-UZ General CC3 Tanks Contractor Camp
C3-QB Naptha C5-EA LDF C6-Z General & Infrastructure CC4 Feed Gas Preparation(FGP) Contr. Camp
C3-QC Hot Slops Ph 1 C5-EB Downstream Units C6-ZC Main Cable Routes CC5 LPU/HMU Contractor Camp
C3-QD Hot Slops Ph 2 C5-EC HMU & SMR Units CC6 EPCM GTL / Util / BDI / Add'l. Plant Bldgs.
C3-QZ General C5-EZ Common MOF Material Offloading Facility Contractor Camp
C3-R Base Oil & Misc. CC7 Jetty & Offplots Contractor Camp
C3-RA Base Oil & Misc. (North) LD Laydown Areas (cont'd) CC8 Effluent Treatment Plant Contractor Camp
C3-RB Base Oil & Misc. (South) LDC7 Jetty & Offplots Fab & Laydown Area HTK Harbour Tanks CCM2B Civil & Mechanical Contractor Camp
C3-RZ General LDC8 ETP Fab & Laydown Area CC11 Spare Contractor Camp
LD Laydown Areas LDJK JK Fab & Laydown Area CGB1 Camp Area Greenbelt-1
LDC2 ASU Fab & Laydown Area LDEQ Heavy Equipment Yard WWT Waste Water Treatment CGB2 Camp Area Greenbelt-2
LDC3 Tank Fab & Laydown Area LDMT MMT Laydown Area CGB3 Camp Area Greenbelt-3
LDC4 FGP Fab & Laydown Area LDFS Main Fuel Storage CGB4 Camp Area Greenbelt-4
LDC5 LPU/HMU Fab & Laydown Area BAT Batch Plant
LDC6 GTL Fab & Laydown Areas

LDC6-1 GTL Descon Fab & Laydown Areas RCR Rock Crusher
LDC6-2 GTL J Warehouse & Laydown Area
LDC6-3 GTL K Warehouse & Laydown / S/blast Yard
5887-ON-PR-HM-013
Appendix Y – Risk Assessment Matrix (RAM)
CONSEQUENCES INCREASING LIKEYHOOD
A B C D E
Environment
Reputation
Severity
People
Asset
Has happened in Has happened at Has happened
Never heard of in Heard of in the G&P or more than QSGTL or more more than once
the industry. industry. once per year in than once per year per year at
the industry. in G&P. QSGTL.
No injury or health
0 No damage. No effect. No impact. Low Low Low Low Low
affect.
3
Slight injury or Slight damage. Slight effect. <1m Slight impact. Local
1 Low Low Low Low Low
health effect FAC. <$10,000. contained. community.
3
Minor injury or Minor damage. Minor effect. >1m Minor impact. Local Low
2 Low Low Medium Medium
health effect MTC. >$10,000. no lasting effect. media.
Moderate effect
Major injury or Moderate damage. 3 Moderate impact.
3 >10m requires Low Low Medium Medium High
health effect LTD. $100,000 to $1m. Regional media.
clean-up.
Major effect.
PTD or up to 3 Major damage. $1m 3 Major impact.
4 >100m extensive Low Medium Medium High High
fatalities. to $10m. National media.
clean-up.
Massive effect
3
>100m extensive
More than 3 Massive damage. Massive impact.
5 clean-up and Medium Medium High High High
fatalities. >$10m. International media.
remediation
measures.
Low Notes PTD Permanent Total Disability
Medium Risk Assessment Matrix FAC First Aid Case MTC Medical Treatment Case
High (RAM) LTI Lost Time Incident LTD Long Term Disability
5887-ON-PR-HM-013
Appendix Z – Risk Assessment Matrix – Definition of Terms

Severity Harm to People Severity Asset Damage and Consequential Business Loss
Index Index
No. Consequence No. Consequence
0 No injury or health effect. 0 No damage.
1 Slight Injury or health effect - Not affecting work performance and not affecting daily life 1 Slight damage – Cost is less than $10,000. E.g.
activities. E.g.
• No disruption to the operation.
• First aid cases and medical treatment cases.
• Exposure to health hazards that give rise to noticeable discomfort, minor irritations or
transient effects reversible after exposure stops.
2 Minor Injury or health effect - Affecting work performance, such as restriction to work 2 Minor damage – Costs between $10,000 and $100,000. E.g.
activities or the need to take up to 5 days to fully recover. Or affecting daily life activities
for up to 5 days. Or reversible health effects. E.g. • Brief disruption to operations.
• Restricted workday cases or lost work day cases resulting in up to 5 calendar days
away from work.
• Illnesses such as skin irritation or food poisoning.
3 Major injury or health effect – Affecting work performance in the longer term, such as 3 Moderate damage - Costs between $100,000 and $1,000,000. E.g.
absence from work for more than 5 days. Or affecting daily life activities for more than 5
days. Or irreversible damage to health. E.g. • Partial shutdown.
• Long term disability (previously referred to as Permanent Partial Disabilities).
• Illnesses such as sensitisation, noise induced hearing loss, chronic back injury,
repetitive strain injury or stress.
4 Permanent Total Disability * (PTD) or one to three fatalities – Resulting from injuries 4 Major damage - Costs between 1 and $10,000,000. E.g.
or occupational illness. E.g.
• Up to two weeks shutdown.
• Illnesses such as corrosive burns, asbestosis, silicosis, cancer and serious work
related depression.
• Car accident resulting in 1, 2 or 3 fatalities.
5 More than three fatalities – Resulting from injuries or occupational illness. E.g. 5 Massive damage - Costs in excess of $10,000,000. E.g.
5887-ON-PR-HM-013
• Multiple asbestosis cases traces to a single exposure situation. • Substantial or total loss or operation.
• Cancer to a large exposed population.
• Major fire or explosion resulting in more than 3 fatalities.
Severity Environmental Effect Severity Impact on Reputation

Index Index
No. Consequence No. Consequence
0 No effect. 0 No impact.
1 Slight effect – Slight environmental damage – contained within the premises. E.g. 1 Slight effect.
• Small spill in process area or tank farm area that readily evaporates. • Local public awareness but no discernible concern.
• No media coverage.
2 Minor effect – Minor environmental damage but no lasting effect. E.g. 2 Minor impact.
• Small spill -off site that seeps into the ground. • Local public concern.
• On-site ground water contamination. • Local media coverage.
• Complaints from up to 10 individuals.
Single exceedance of a statutory or other prescribed limit.
3 Moderate effect - Limited environmental damage that will persist or will require cleaning 3 Moderate impact - Significant impact in region or county.
up. E.g.
• Regional public concern.
• Spill from a pipeline into soil/sand that requires removal and disposal of large
quantities of soil / sand. • Local stakeholders, e.g. community, NGO’s, industry and government are aware.
• Observed off-site affects or damage. E.g. fish killed, vegetation damaged. • Extensive attention in local media. Some regional or national media cover.
• Off-site ground water contamination.
• Complaints from community organisations (or more than 10 complaints from

individuals).
5887-ON-PR-HM-013
• Frequent exceedance of statutory or other prescribed limits with potential long term
effects.
4 Major effect - Severe environmental damage that will require extensive measures to 4 Major impact – Likely to escalate and affect group reputation.
restore beneficial uses of the environment. E.g.
• National public concern.
• Oil spill at a jetty during tanker loading or off-loading that ends up on local beaches
requiring clean up operations. • Impact on national stakeholder relations. National government and NGO
involvement with potential for international NGO action.
• Off-site ground water contamination over an extensive area.
• Extensive attention in national media. Some international coverage.
• Many complaints from community organisations or local authorities.
• Potential for regulatory action leading to restricted operations or impact on operating
• Extended exceedance of statutory or other prescribed limits with potential long term licences.
effects.
5 Massive effect – Persistent severe environmental damage that will lead to loss of 5 Massive impact – Severe impact on group reputation.
commercial, recreational use or loss of natural resources over a wide area. E.g.
• International public concern.
• Crude oil spillage resulting in pollution of a large part of a river estuary and extensive
clean- up and remedial measures. • High level of concern amongst governments and action by international NGO’s.
• International media attention.
• Significant potential for effect on national / international policies with impact on

access to new areas, grants of licences and/or tax legislation.
5887-ON-PR-HM-013

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Pearl GTL Project Revision 4

Ras Laffan, Qatar Page 1 of 59

PEARL GTL PROJECT

PERMIT TO WORK PROCEDURE

Rev 1 Rev 2 Rev 3 Rev 4

Prepared By (Originator): J. Pile J. Pile J. Pile J. Pile

Checked By (Line Manager): T. MacFarlane T. MacFarlane T. MacFarlane T. MacFarlane

Reviewed By (PQM): S. Alkhedairy S. Alkhedairy S. Alkhedairy S. Alkhedairy

Date: 29 Sep 06 11 Oct. 06 23 Oct. 06 15 Jan 07

Issue Status: IFL IFL IFL IFL

10.1 Pneumatic Testing ....................................................................................................... 21

Appendix A Permit Control Area Plot Plan

Rev Issue Date Revision Details

• The methodology used to identify hazardous work, especially non-routine

• Actions necessary for work planning, isolations, supporting certificates, issuing

• The geographical boundaries of permit control areas.

2.1 Supporting Procedures

Work Permit Activity Reference Procedure

• Entry into Confined Spaces. - See procedure reference in Section 4.2,

• Excavations. - See Excavations Procedure Section 4.2,

• Operating Equipment Near - See procedure references in Section 4.2,

• Hot Work in the vicinity of - See Fire Prevention and Protection

• Storage, Handling and Use of - See Management of Hazardous Chemicals

Section 4.2, Ref. [9].

• Lifting of Personnel by Mechanical - See procedure references in Section 4.2,

• Diving Operations. - See Diving Procedure Section 4.2, Ref.

The following hazardous construction actives will be controlled by procedures following a

• Pneumatic Testing - This activity will be carried out under a

• Scaffolding - See Ref. [12] in Section 4.2.

• Non-routine and Heavy Lift - See Ref. [13] in Section 4.2.

4.1 Project Reference Documents

No. Title Reference No.

4.2 Reference Associated Procedures

No. Title Reference No.

5.0 DEFINITIONS AND ABBREVIATIONS

Authorised Discipline Engineer *

Authorised Gas Tester

2 Prepare work permit. R I Section 7.2

3 Identify hazards. C R C C C C Section 7.1

5 Identify interfaces. R C Section 7.3

Identify additional safety

Prepare supporting safety

Complete safety preparations

Distribute post permits and

12 Brief work party. R

Revalidate permit and

On completion of work close

15 Check work site. R C

7.1 Risk Assessment

• TSTI - all tasks are subject to a TSTI, see Appendix Q.

• Permits will be issued as per Section 9.0.

7.2 Permit Planning

7.3 PTW Coordination

• Ensure all staff involved have an overview of significant ongoing work.

• Provide a quality check on the completion of permits.

7.4 Permit to Work Forms

• Mechanical and electrical isolations.

• Clearance of process materials by draining, venting, flushing, purging or

• A description of any additional precautions or controls which are necessary during

• Identification of the validity period.

7.5 PTW Distribution

• An updated copy shall be retained by the Permit Coordinator.

always be prepared in English; however, the checklists may be prepared in several