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PERMIT TO WORK CERTIFICATE AUDIT AS OF 28 AUGUST 2010

Ite API, Date & API, Date &


Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
1 GAC Backwash Tank Foundation Works 22518 not Personnel Protective Equipment Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety shoes 24-May-10 24-May-10 Completio
n
2 - Wear safety goggles/faceshield 8:36 AM 8:36 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
2 GAC Backwash Tank Erection of 22791 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
Scaffolding required 1 - Wear helmet and safety gloves 8-Jun-10 8-Jun-10 Completio
n
2 - Wear safety goggles/faceshield 9:30 AM 9:30 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas

Page 1 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
10-Maintain housekeeping

Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
3 Chorine Contact Tank Erection of 22762 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
Scaffolding required 1 - Wear helmet and safety gloves 6-Jun-10 6-Jun-10 Completio
n
2 - Wear safety goggles/faceshield 5:05 PM 5:05 PM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines

Page 2 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures

4 Chlorine Contact Tank To construct the 17843 not Personnel Protective Equipment Shuaib Chalasa Tzoul Until Job
superstructure for required 1 - Wear helmet and safety gloves 14-Jul-10 14-Jul-10 Completio
Chlrine Contact Tank n
2 - Wear safety goggles/faceshield 9:50 AM 9:51 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not carryprecautions
out any hot work
74-Stop work if any imminent danger
5 Chlorination Building To construct the 38030 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Roger Agasen 28-Aug-10
superstructure of required near fuel gas skids/lines
1 - Wear helmet and safety gloves ahmed
28-Jul-10 28-Jul-10
the proposed
Chlorination Bldg.

Page 3 of 168
Ite API, Date & API, Date &
Proposed PTWC
m ToScope
construct the
of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. superstructure of Signatures Signatures
the proposed
2 - Wear safety goggles/faceshield 8:11 AM 9:35 AM
Chlorination Bldg.
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline

Working Areas
10-Maintain housekeeping
Lifting Equiptment
20-Use tested & certified crane/forklift
21-Use tested & certified lifting tackles
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
6 Main Electrical Bldg Removal of forms 38292 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:00 AM 7:00 AM Completio
n
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools

Page 4 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
24-Inspect before use
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder

Waste and Spills


71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
7 Tertiary Treatment To excavate for the 38308 not near fuel gas
Personnel skids/lines Equipment
Protective Minhaj Roger Agasen 23-Sep-10
Tank - 851, 852, 853 foundation required 1 - Wear helmet and safety gloves ahmed
23-Aug-10 23-Aug-10
2 - Wear safety goggles/faceshield 7:55 AM 8:50 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping

Page 5 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
8 Poly Preparation Bldg Removal of forms 38280 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:20 AM 7:50 AM Completio
n
4 - Wear appropriate handgloves 23-Aug-10 23-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
9 Recycling Sludge Erection of 38068 not occurs and without
Personnel personnel
Protective on or
Equipment Iqbal Chalasa Tzoul not
Tank Scaffolding near fuel gas skids/lines
required 1 - Wear helmet and safety gloves indicated
31-Jul-10 31-Jul-10
2-Wear safety goggles/faceshield 2:00 PM 2:10 PM
4 - Wear appropriate handgloves

Page 6 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger
10 New Biological Tank Soil Improvement 38151 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Roger Agasen 9-Sep-10
TK-832 near fuel gas skids/lines
required 1 - Wear helmet and safety gloves ahmed
8-Aug-10 8-Aug-10
2 - Wear safety goggles/faceshield 6:12 AM 6:50 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
11 Biological Sludge Superstructure 17619 not near fuel gas
Personnel skids/lines Equipment
Protective Shuaib Chalasa Tzoul Until Job
Holding Tank Construction of required 1 - Wear helmet and safety gloves 25-Jun-10 25-Jun-10 Completio
Biological Slidge n
Holding Tank

Page 7 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Superstructure
Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Construction of Signatures Signatures
Biological Slidge
2 - Wear safety goggles/faceshield 10:30 AM 10:30 AM
Holding Tank
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator

Waste and Spills


71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not carryprecautions
out any hot work
74-Stop work if any imminent danger
12 Biological Sludge Erection of 22823 not occurs and without
Personnel personnel
Protective on or
Equipment Iqbal Roger Agasen Until Job
Holding Tank Scaffolding near fuel gas skids/lines
required 1 - Wear helmet and safety gloves Completio
9-Jun-10 9-Jun-10
n
4 - Wear appropriate handgloves 7:30 AM 7:40 AM
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
13 Biological Sludge Exavation for the 38268 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Roger Agasen 15-Sep-10
Holding Tank foundation of BSHT near fuel gas skids/lines
required 1 - Wear helmet and safety gloves ahmed
28-Aug-10 28-Aug-10

Page 8 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Biological Sludge Exavation
Scope offor the
Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Holding Tank foundation of BSHT Signatures Signatures
2-Wear safety goggles/faceshield 6:21 AM 7:10 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7-Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable / Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
14 Proposed To excavate for the 38110 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Chalasa Tzoul 29-Aug-10
Construction of foundation required near fuel gas skids/lines
1 - Wear helmet and safety gloves ahmed
3-Aug-10 3-Aug-10
Equilization Tank
2 - Wear safety goggles/faceshield 9:55 AM 10:27 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas

Page 9 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines
15 Re-Aeration of Foundation Works 22522 not Personnel Protective Equipment Shuaib Roger Agasen Until Job
Electrical and Blowers required 1 - Wear helmet and safety gloves 25-May-10 25-May-10 Completio
Bldg n
2 - Wear safety goggles/faceshield 8:32 AM 8:35 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs

Page 10 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
16 Main Electrical Bldg Removal of forms 38292 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:00 AM 7:00 AM Completio
n
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
57-Inspect and tag scaffod before use
58-Use non conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
17 Poly Preparation Bldg Removal of forms 38282 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:20 AM 7:50 AM Completio
n

Page 11 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Removal of forms
Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
57-Inspect and tag scaffod before use
58-Use non conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
18 Coagulation House Erection of 17982 not near fuel gas
Personnel skids/lines Equipment
Protective Shuaib Chalasa Tzoul Until Job
Scaffolding required 1 - Wear helmet and safety gloves 24-Jul-10 24-Jul-10 Completio
n
2 - Wear safety goggles/faceshield 11:23 AM 11:25 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man

Page 12 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger
19 Inlet Work Electrical Superstructure 17822 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Chalasa Tzoul Until Job
Bldg required near fuel gas skids/lines
1 - Wear helmet and safety gloves ahmed
12-Jul-10 12-Jul-10 Completio
n
2 - Wear safety goggles/faceshield 7:15 AM 8:54 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not carryprecautions
out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines
20 Proposed To excavate for the 38312 not Personnel Protective Equipment Minhaj Chalasa Tzoul 29-Sep-10
Construction of foundation required 1 - Wear helmet and safety gloves ahmed
24-Aug-10 24-Aug-10
Primary Works beside
Inlet Work Electrical
Bldg
Page 13 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Proposed Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Construction of Signatures Signatures
Primary Works beside
2 - Wear safety goggles/faceshield 7:15 AM 8:15 AM
Inlet Work Electrical
Bldg 3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines

Page 14 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
PTWC Prepared/Audited by: Verified by: Checked by: Noted by:

ROGELIO AGASEN MARLON ORIARTE DAN DERRICK PADAGAS DENNIS ESCOLANO CHARALAMPOS GI
SETE Project Site Civil Eng'r/APR SETE Safety Assistant SETE Safety Officer SETE Safety Supervisor SETE Construction M

Page 15 of 168
Remarks

No activity at the
area waiting for the
materials.

Proper barricade
was provided at the
area

No activity at the
area still waiting for
the materials.

Proper barricade
was provided at the
area

Page 16 of 168
ProperRemarks
barricade
was provided at the
area

Safety precautions
are followed and
observed.

Workers are wearing


of appropriate
proper PPE

Scaffolding are
complete with Green
Scaff Tag signed by
Authorized Scaffold
Supervisor and
Inspector

Safety Warning
Signs are provided

Page 17 of 168
Remarks

Safety precautions
are followed and
observed.

Lifting operation
done with certified
rigger and crane
operator

Workers are wearing


of appropriate
proper PPE

Poor housekeeping -
On going removal of
rubbish/debris inside
the tank

Some of the panel


board stock up on
the walkway

Safety precautions
are followed and
observed.

Page 18 of 168
Remarks

Workers are wearing


of appropriate
proper PPE

Some woods and


rebars are scattered
on the area - On
going houskkeping

Some of the
previous safety
findings are rectified

Safety precautions
are followed and
observed.

Workers are wearing


of appropriate
proper PPE

Page 19 of 168
Remarks

Safety precautions
are followed and
observed.

Hard barricade &


good housekeeping
were observed

Workers are wearing


of appropriate
proper PPE

Page 20 of 168
Remarks

Safety precautions
are followed and
observed.

Safety precautions
are followed and
observed.

Page 21 of 168
Remarks

Safety precautions
are followed and
observed.

Heavy equiptment
operator as well as
the equiptment have
TUV.

Signal man in the


working area was
observed.

Safety precautions
are followed and
observed.

Page 22 of 168
Remarks

Scaffolder have TUV


Certificate and
wearing of proper
PPE such as full
body harness with
double lanyard while
working.

Safety precautions
are followed and
observed.

Page 23 of 168
Remarks

Hard barricade &


good housekeeping
were observed

Workers are wearing


of appropriate
proper PPE

Safety precautions
are followed and
observed.

Hard barricade &


good housekeeping
were observed

Page 24 of 168
Remarks

Workers are wearing


of appropriate
proper PPE

Safety precautions
are followed and
observed.

Page 25 of 168
Remarks

Safety precautions
are followed and
observed.

Safety precautions
are followed and
observed.

Page 26 of 168
SafetyRemarks
precautions
are followed and
observed.

Scaffolder have TUV


Certificate and
wearing of proper
PPE such as full
body harness with
double lanyard while
working.

Page 27 of 168
Remarks

Safety precautions
are followed and
observed.

Safety precautions
are followed and
observed.

Page 28 of 168
Remarks

Hard barricade,
good housekeeping,
edge sloping was
provided.

Page 29 of 168
Remarks

Noted by:

CHARALAMPOS GIDAS
SETE Construction Manager

Page 30 of 168
PERMIT TO WORK CERTIFICATE AUDIT AS OF 28 AUGUST 2010
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
1 GAC Backwash Tank Foundation Works 22518 not Personnel Protective Equipment Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety shoes 24-May-10 24-May-10 Completio
n
2 - Wear safety goggles/faceshield 8:36 AM 8:36 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
2 GAC Backwash Tank Erection of 22791 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
Scaffolding required 1 - Wear helmet and safety gloves 8-Jun-10 8-Jun-10 Completio
n
2 - Wear safety goggles/faceshield 9:30 AM 9:30 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas

Page 31 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
10-Maintain housekeeping

Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
3 Chorine Contact Tank Erection of 22762 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
Scaffolding required 1 - Wear helmet and safety gloves 6-Jun-10 6-Jun-10 Completio
n
2 - Wear safety goggles/faceshield 5:05 PM 5:05 PM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines

Page 32 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures

4 Chlorine Contact Tank To construct the 17843 not Personnel Protective Equipment Shuaib Chalasa Tzoul Until Job
superstructure for required 1 - Wear helmet and safety gloves 14-Jul-10 14-Jul-10 Completio
Chlrine Contact Tank n
2 - Wear safety goggles/faceshield 9:50 AM 9:51 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not carryprecautions
out any hot work
74-Stop work if any imminent danger
5 Chlorination Building To construct the 38030 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Roger Agasen 28-Aug-10
superstructure of required near fuel gas skids/lines
1 - Wear helmet and safety gloves ahmed
28-Jul-10 28-Jul-10
the proposed
Chlorination Bldg.

Page 33 of 168
Ite API, Date & API, Date &
Proposed PTWC
m ToScope
construct the
of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. superstructure of Signatures Signatures
the proposed
2 - Wear safety goggles/faceshield 8:11 AM 9:35 AM
Chlorination Bldg.
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline

Working Areas
10-Maintain housekeeping
Lifting Equiptment
20-Use tested & certified crane/forklift
21-Use tested & certified lifting tackles
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
6 Main Electrical Bldg Removal of forms 38292 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:00 AM 7:00 AM Completio
n
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools

Page 34 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
24-Inspect before use
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder

Waste and Spills


71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
7 Tertiary Treatment To excavate for the 38308 not near fuel gas
Personnel skids/lines Equipment
Protective Minhaj Roger Agasen 23-Sep-10
Tank - 851, 852, 853 foundation required 1 - Wear helmet and safety gloves ahmed
23-Aug-10 23-Aug-10
2 - Wear safety goggles/faceshield 7:55 AM 8:50 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping

Page 35 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
8 Poly Preparation Bldg Removal of forms 38280 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:20 AM 7:50 AM Completio
n
4 - Wear appropriate handgloves 23-Aug-10 23-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
9 Recycling Sludge Erection of 38068 not occurs and without
Personnel personnel
Protective on or
Equipment Iqbal Chalasa Tzoul not
Tank Scaffolding near fuel gas skids/lines
required 1 - Wear helmet and safety gloves indicated
31-Jul-10 31-Jul-10
2-Wear safety goggles/faceshield 2:00 PM 2:10 PM
4 - Wear appropriate handgloves

Page 36 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger
10 New Biological Tank Soil Improvement 38151 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Roger Agasen 9-Sep-10
TK-832 near fuel gas skids/lines
required 1 - Wear helmet and safety gloves ahmed
8-Aug-10 8-Aug-10
2 - Wear safety goggles/faceshield 6:12 AM 6:50 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
11 Biological Sludge Superstructure 17619 not near fuel gas
Personnel skids/lines Equipment
Protective Shuaib Chalasa Tzoul Until Job
Holding Tank Construction of required 1 - Wear helmet and safety gloves 25-Jun-10 25-Jun-10 Completio
Biological Slidge n
Holding Tank

Page 37 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Superstructure
Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Construction of Signatures Signatures
Biological Slidge
2 - Wear safety goggles/faceshield 10:30 AM 10:30 AM
Holding Tank
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator

Waste and Spills


71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not carryprecautions
out any hot work
74-Stop work if any imminent danger
12 Biological Sludge Erection of 22823 not occurs and without
Personnel personnel
Protective on or
Equipment Iqbal Roger Agasen Until Job
Holding Tank Scaffolding near fuel gas skids/lines
required 1 - Wear helmet and safety gloves Completio
9-Jun-10 9-Jun-10
n
4 - Wear appropriate handgloves 7:30 AM 7:40 AM
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
13 Biological Sludge Exavation for the 38268 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Roger Agasen 15-Sep-10
Holding Tank foundation of BSHT near fuel gas skids/lines
required 1 - Wear helmet and safety gloves ahmed
28-Aug-10 28-Aug-10

Page 38 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Biological Sludge Exavation
Scope offor the
Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Holding Tank foundation of BSHT Signatures Signatures
2-Wear safety goggles/faceshield 6:21 AM 7:10 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7-Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable / Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
14 Proposed To excavate for the 38110 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Chalasa Tzoul 29-Aug-10
Construction of foundation required near fuel gas skids/lines
1 - Wear helmet and safety gloves ahmed
3-Aug-10 3-Aug-10
Equilization Tank
2 - Wear safety goggles/faceshield 9:55 AM 10:27 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas

Page 39 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines
15 Re-Aeration of Foundation Works 22522 not Personnel Protective Equipment Shuaib Roger Agasen Until Job
Electrical and Blowers required 1 - Wear helmet and safety gloves 25-May-10 25-May-10 Completio
Bldg n
2 - Wear safety goggles/faceshield 8:32 AM 8:35 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs

Page 40 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
16 Main Electrical Bldg Removal of forms 38292 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:00 AM 7:00 AM Completio
n
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
57-Inspect and tag scaffod before use
58-Use non conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
17 Poly Preparation Bldg Removal of forms 38282 not near fuel gas
Personnel skids/lines Equipment
Protective Iqbal Roger Agasen Until Job
required 1 - Wear helmet and safety gloves 7:20 AM 7:50 AM Completio
n

Page 41 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Removal of forms
Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
57-Inspect and tag scaffod before use
58-Use non conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
18 Coagulation House Erection of 17982 not near fuel gas
Personnel skids/lines Equipment
Protective Shuaib Chalasa Tzoul Until Job
Scaffolding required 1 - Wear helmet and safety gloves 24-Jul-10 24-Jul-10 Completio
n
2 - Wear safety goggles/faceshield 11:23 AM 11:25 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man

Page 42 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger
19 Inlet Work Electrical Superstructure 17822 not occurs and without
Personnel personnel
Protective on or
Equipment Minhaj Chalasa Tzoul Until Job
Bldg required near fuel gas skids/lines
1 - Wear helmet and safety gloves ahmed
12-Jul-10 12-Jul-10 Completio
n
2 - Wear safety goggles/faceshield 7:15 AM 8:54 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not carryprecautions
out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines
20 Proposed To excavate for the 38312 not Personnel Protective Equipment Minhaj Chalasa Tzoul 29-Sep-10
Construction of foundation required 1 - Wear helmet and safety gloves ahmed
24-Aug-10 24-Aug-10
Primary Works beside
Inlet Work Electrical
Bldg
Page 43 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Proposed Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Construction of Signatures Signatures
Primary Works beside
2 - Wear safety goggles/faceshield 7:15 AM 8:15 AM
Inlet Work Electrical
Bldg 3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel
barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra
73-Do not precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or
near fuel gas skids/lines

Page 44 of 168
Ite API, Date & API, Date &
Proposed PTWC
m Scope of Works Isolation Safety Precautions time of time of Validity
Structures No.
No. Signatures Signatures
PTWC Prepared/Audited by: Verified by: Checked by: Noted by:

ROGELIO AGASEN MARLON ORIARTE DAN DERRICK PADAGAS DENNIS ESCOLANO CHARALAMPOS GI
SETE Project Site Civil Eng'r/APR SETE Safety Assistant SETE Safety Officer SETE Safety Supervisor SETE Construction M

Page 45 of 168
Remarks

No activity at the
area waiting for the
materials.

Proper barricade
was provided at the
area

No activity at the
area still waiting for
the materials.

Proper barricade
was provided at the
area

Page 46 of 168
ProperRemarks
barricade
was provided at the
area

Safety precautions
are followed and
observed.

Workers are wearing


of appropriate
proper PPE

Scaffolding are
complete with Green
Scaff Tag signed by
Authorized Scaffold
Supervisor and
Inspector

Safety Warning
Signs are provided

Page 47 of 168
Remarks

Safety precautions
are followed and
observed.

Lifting operation
done with certified
rigger and crane
operator

Workers are wearing


of appropriate
proper PPE

Poor housekeeping -
On going removal of
rubbish/debris inside
the tank

Some of the panel


board stock up on
the walkway

Safety precautions
are followed and
observed.

Page 48 of 168
Remarks

Workers are wearing


of appropriate
proper PPE

Some woods and


rebars are scattered
on the area - On
going houskkeping

Some of the
previous safety
findings are rectified

Safety precautions
are followed and
observed.

Workers are wearing


of appropriate
proper PPE

Page 49 of 168
Remarks

Safety precautions
are followed and
observed.

Hard barricade &


good housekeeping
were observed

Workers are wearing


of appropriate
proper PPE

Page 50 of 168
Remarks

Safety precautions
are followed and
observed.

Safety precautions
are followed and
observed.

Page 51 of 168
Remarks

Safety precautions
are followed and
observed.

Heavy equiptment
operator as well as
the equiptment have
TUV.

Signal man in the


working area was
observed.

Safety precautions
are followed and
observed.

Page 52 of 168
Remarks

Scaffolder have TUV


Certificate and
wearing of proper
PPE such as full
body harness with
double lanyard while
working.

Safety precautions
are followed and
observed.

Page 53 of 168
Remarks

Hard barricade &


good housekeeping
were observed

Workers are wearing


of appropriate
proper PPE

Safety precautions
are followed and
observed.

Hard barricade &


good housekeeping
were observed

Page 54 of 168
Remarks

Workers are wearing


of appropriate
proper PPE

Safety precautions
are followed and
observed.

Page 55 of 168
Remarks

Safety precautions
are followed and
observed.

Safety precautions
are followed and
observed.

Page 56 of 168
SafetyRemarks
precautions
are followed and
observed.

Scaffolder have TUV


Certificate and
wearing of proper
PPE such as full
body harness with
double lanyard while
working.

Page 57 of 168
Remarks

Safety precautions
are followed and
observed.

Safety precautions
are followed and
observed.

Page 58 of 168
Remarks

Hard barricade,
good housekeeping,
edge sloping was
provided.

Page 59 of 168
Remarks

Noted by:

CHARALAMPOS GIDAS
SETE Construction Manager

Page 60 of 168
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
1 GAC Backwash Tank Foundation Works 22518 not required Personnel Protective Equipment Iqbal Rogelio Agasen

1 - Wear helmet and safety shoes 24-May-10 24-May-10


2 - Wear safety goggles/faceshield 8:36 AM 8:36 AM
4 - Wear appropriate handgloves
Working Areas

10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
2 GAC Backwash Tank Erection of 22791 not required skids/lines
Personnel Protective Equipment Iqbal Rogeio Agasen
Scaffolding
1 - Wear helmet and safety gloves 8-Jun-10 8-Jun-10
2 - Wear safety goggles/faceshield 9:30 AM 9:30 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline

Working Areas
10-Maintain housekeeping
Working at Height
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
3 Chorine Contact Tank Erection of 22762 not required Personnel Protective Equipment Iqbal Rogelio Agasen
Scaffolding
1 - Wear helmet and safety gloves 6-Jun-10 6-Jun-10
2 - Wear safety goggles/faceshield 5:05 PM 5:05 PM
4 - Wear appropriate handgloves

6 - Wear full body harness & lifeline


Working Areas
10-Maintain housekeeping

Hand / Portable Power / Tools


24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills

71-Dispose waste on regular basis


72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines

4 Chlorine Contact Tank To construct the 17843 not required Personnel Protective Equipment Shuaib Chalasa Tzoul
superstructure for
Chlrine Contact Tank
1 - Wear helmet and safety gloves 14-Jul-10 14-Jul-10
2 - Wear safety goggles/faceshield 9:50 AM 9:51 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas

10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs

17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift

22-Appoint a signal man


23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
25-Use Non-sparking tools

Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
5 Chlorination Building To construct the 38360 not required and without Protective
Personnel personnel on or near fuel gas
Equipment Minhaj ahmed rogelio Agasen
superstructure of skids/lines
the proposed
Chlorination Bldg.
1 - Wear helmet and safety gloves 28-Aug-10 28-Aug-10
2 - Wear safety goggles/faceshield 7:45 AM 9:30 AM
4 - Wear appropriate handgloves

6 - Wear full body harness & lifeline


Working Areas
10-Maintain housekeeping

Lifting Equiptment
20-Use tested & certified crane/forklift
21-Use tested & certified lifting tackles
22-Appoint a signal man
23-Employ liscenced operator

Hand / Portable Power / Tools


24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
6 Main Electrical Bldg Removal of forms 38292 not required Personnel Protective Equipment Iqbal Rogelio Agasen

1 - Wear helmet and safety gloves 7:00 AM 7:00 AM


4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line

Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
10 Chlorination Building Masonry Works 135633 not required Personnel Protective Equipment Minhaj ahmed Rogelio Agasen

1 - Wear helmet and safety gloves 15-Sep-10 15-Sep-10


4 - Wear appropriate handgloves 8:15 AM 9:14 AM
6 - Wear full body harness & lifelines
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
26-Use insulated tools
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
Working at Heights
57-Inspect and tags scaffold before use
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment
7 Tertiary Treatment Tank To excavate for the 13690 not required Personnel Protective Equipment Minhaj ahmed Rogelio Agasen
- 851, 852, 853 foundation
1 - Wear helmet and safety gloves 25-09-10 25-09-10
2 - Wear safety goggles/faceshield 12:00 AM 10:20 AM
3-Wear ear protectors/muffs

4 - Wear appropriate handgloves


7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping

13-Barricade area with warning tape


14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
17 Poly Preparation Bldg Applying of 38440 not required skids/lines
Personnel Protective Equipment Minhaj ahmed Rogelio Agasen
Membrane Water
Proofing to
Foundation of Poly
Preparation Bldg
1 - Wear helmet and safety shoes 5-Sep-10 5-Sep-10
5 - Wear welding/chemical aprons 9:45 PM 10:05 PM
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Hot Work
55-Keep fire extinguisher ready
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment
10 New Biological Foundation Works 13553 not required Personnel Protective Equipment Minhaj ahmed Rogelio Agasen
Treatment TankTank
TK-832
1 - Wear helmet and safety gloves 14-Sep-10 14-Sep-10
2 - Wear safety goggles/faceshield 5:49 AM 9:08 AM
3 - Wear ear protectors/muffs
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
11 Biological Sludge Holding Superstructure 17619 not required and without Protective
Personnel personnel on or near fuel gas
Equipment Shuaib Chalasa Tzoul
Tank Construction of skids/lines
Biological Slidge
Holding Tank
1 - Wear helmet and safety gloves 25-Jun-10 25-Jun-10
2 - Wear safety goggles/faceshield 10:30 AM 10:30 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
12 Biological Sludge Holding Erection of 22823 not required Personnel Protective Equipment Iqbal Rogelio Agasen
Tank Scaffolding

1 - Wear helmet and safety gloves 9-Jun-10 9-Jun-10


4 - Wear appropriate handgloves 7:30 AM 7:40 AM
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
13 Biological Sludge Tank Exavation for the 13571 not required Personnel Protective Equipment Iqbal Rogelio Agasen
foundation of BSHT
1 - Wear helmet and safety gloves 16-Sep-10 16-Sep-10
2-Wear safety goggles/faceshield 7:30 AM 9:06 AM
3-Wear ear protectors/muffs

4 - Wear appropriate handgloves


7-Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
15-Provide flashing beacon lights

Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable / Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
10 Equalization Tank Foundation Works 38393 not required Personnel Protective Equipment Minhaj ahmed Rogelio Agasen

1 - Wear helmet and safety gloves 31-Aug-10 31-Aug-10


2 - Wear safety goggles/faceshield 7:45 AM 9:40 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
15 Re-Aeration of Electrical Foundation Works 22522 not required skids/lines
Personnel Protective Equipment Shuaib Rogelio Agasen
and Blowers Bldg
1 - Wear helmet and safety gloves 25-May-10 25-May-10
2 - Wear safety goggles/faceshield 8:32 AM 8:35 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
18 Coagulation House Erection of 17982 not required skids/lines
Personnel Protective Equipment Shuaib Chalasa Tzoul
Scaffolding

1 - Wear helmet and safety gloves 24-Jul-10 24-Jul-10


2 - Wear safety goggles/faceshield 11:23 AM 11:25 AM
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
19 Inlet Work Electrical Bldg Superstructure 17822 not required Personnel Protective Equipment Minhaj ahmed Chalasa Tzoul

1 - Wear helmet and safety gloves 12-Jul-10 12-Jul-10


2 - Wear safety goggles/faceshield 7:15 AM 8:54 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
24-Inspect before use
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
20 Proposed Construction of To excavate for the 38312 not required skids/lines
Personnel Protective Equipment Minhaj ahmed Chalasa Tzoul
Primary Works beside foundation
Inlet Work Electrical Bldg
1 - Wear helmet and safety gloves 24-Aug-10 24-Aug-10
2 - Wear safety goggles/faceshield 7:15 AM 8:15 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
21 Chlorination Building Removal of forms 13691 not required and without Protective
Personnel personnel on or near fuel gas
Equipment Minhaj ahmed Rogelio Agasen
skids/lines
1 - Wear helmet and safety gloves 25-Sep-10 25-Sep-10
others: 4 - Wear appropriate handgloves 9:05 AM 10:25 AM
Work at heights 6 - Wear full body harness & lifelines
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
26-Use insulated tools

Waste and Spills


71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
Working at Heights
57-Inspect and tags scaffold before use
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment
22 Warehouse Electrical wiring 13645 not required Personnel Protective Equipment Minhaj ahmed Noel Benitez

1 - Wear helmet and safety gloves 22-Sep-10 22-Sep-10


others: 2- Wear full body harness & lifeline 0715 am 0858 am
Work at heights Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
PERMIT TO WORK CERTIFICATE AUDIT AS OF 30 Sept 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
57-Inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment

PTWC Prepared/Audited by: Checked by: Noted by:

ROGELIO AGASEN MARLON ORIARTE RAUL GAMAYA NASSER AWALEH


SETE Project Site Civil Eng'r/APR SETE Safety Assistant SETE Safety Manager SETE Construction M
Validity Remarks

Until Job No activity at the area


Completion waiting for the
materials.

Proper barricade was


provided at the area

Until Job No activity at the area


Completion still waiting for the
materials.

Proper barricade was


provided at the area
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Workers are wearing of


appropriate proper PPE

Scaffolding are
complete with Green
Scaff Tag signed by
Authorized Scaffold
Supervisor and
Inspector

Safety Warning Signs


are provided
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Lifting operation done


with certified rigger and
crane operator

Workers are wearing of


appropriate proper PPE

Poor housekeeping - On
going removal of
rubbish/debris inside
the tank

Some of the panel


board stock up on the
walkway
Validity Remarks

28-Sep-10 Safety precautions are


followed and observed.

Workers are wearing of


appropriate proper PPE

Some woods and rebars


are scattered on the
area - On going
houskkeping

Some of the previous


safety findings are
rectified
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Workers are wearing of


appropriate proper PPE

15-Oct-10 Safety precautions are


followed and observed.
Validity Remarks

20 Oct. 10 Safety precautions are


followed and observed.

Hard barricade & good


housekeeping were
observed

Workers are wearing of


appropriate proper PPE
Validity Remarks

6-Oct-10

14-Oct-10 Safety precautions are


followed and observed.
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.
Validity Remarks

Until Job Scaffolder have TUV


Completion Certificate and wearing
of proper PPE such as
full body harness with
double lanyard while
working.

5-Oct-10 Safety precautions are


followed and observed.

Hard barricade & good


housekeeping were
observed
Validity Remarks

Workers are wearing of


appropriate proper PPE

september Safety precautions are


31, 2010 followed and observed.
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Until Job Scaffolder have TUV


Completion Certificate and wearing
of proper PPE such as
full body harness with
double lanyard while
working.
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.
Validity Remarks

29-Sep-10 Safety precautions are


followed and observed.
Validity Remarks

till job Safety precautions are


completion followed and observed.

till job Safety precautions are


completion followed and observed.
Validity Remarks

Noted by:

NASSER AWALEH
SETE Construction Manager
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
1 GAC Backwash Tank Foundation Works 22518 not required Personnel Protective Equipment Iqbal Rogelio Agasen
1 - Wear helmet and safety shoes 24-May-10 24-May-10
2 - Wear safety goggles/faceshield 8:36 AM 8:36 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
2 GAC Backwash Tank Erection of 22791 not required skids/lines
Personnel Protective Equipment Iqbal Rogeio Agasen
Scaffolding 1 - Wear helmet and safety gloves 8-Jun-10 8-Jun-10
2 - Wear safety goggles/faceshield 9:30 AM 9:30 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
3 Chorine Contact Tank Erection of 22762 not required Personnel Protective Equipment Iqbal Rogelio Agasen
Scaffolding 1 - Wear helmet and safety gloves 6-Jun-10 6-Jun-10
2 - Wear safety goggles/faceshield 5:05 PM 5:05 PM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
4 Chlorine Contact Tank To construct the 17843 not required Personnel Protective Equipment Shuaib Chalasa Tzoul
superstructure for 1 - Wear helmet and safety gloves 14-Jul-10 14-Jul-10
Chlrine Contact Tank
2 - Wear safety goggles/faceshield 9:50 AM 9:51 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
25-Use Non-sparking tools

Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
10 Main Electrical Bldg Masonry Works 13563 not required and without Protective
Personnel personnel on or near fuel gas
Equipment Minhaj ahmed Rogelio Agasen
skids/lines
(work at height) 1 - Wear helmet and safety gloves 15-Sep-10 15-Sep-10
4 - Wear appropriate handgloves 8:15 AM 9:14 AM
6 - Wear full body harness & lifelines
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
57-Inspect and tags scaffold before use
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and withdraw personnel
7 Tertiary Treatment Tank To excavate for the 13690 not required Personnel Protective Equipment Minhaj ahmed Rogelio Agasen
- 851, 852, 853 foundation 1 - Wear helmet and safety gloves 25-09-10 25-09-10
2 - Wear safety goggles/faceshield 12:00 AM 10:20 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
10 New Biological Foundation Works 13553 not required skids/lines
Personnel Protective Equipment Minhaj ahmed Rogelio Agasen
Treatment TankTank
1 - Wear helmet and safety gloves 14-Sep-10 14-Sep-10
TK-832
2 - Wear safety goggles/faceshield 5:49 AM 9:08 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
10 Poly-Preparation Bldg Sand Backfilling 13637 not required and without Protective
Personnel personnel on or near fuel gas
Equipment Minhaj ahmed Rogelio Agasen
skids/lines
1 - Wear helmet and safety gloves 21-Sep-10 21-Sep-10
6 - Wear full body harness & lifeline 6:10 AM 8:38 AM
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
16
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
76
10 Poly-Preparation Bldg Superstructure 13732 not required Personnel Protective Equipment Minhaj ahmed Rogelio Agasen

1 - Wear helmet and safety gloves 28-Sep-10 28-Sep-10


2 - Wear safety goggles/faceshield 6:22 AM 9:35 AM
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
Lifting Equiptment
20- Use tested & certified crane / forklift

54 Keep the hydrant hose ready


58 Use non conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
76Do not use battery
operated/electrical/electronics to o/s
11 Biological Sludge Holding Superstructure 17619 not required equipment
Personnel Protective Equipment Shuaib Chalasa Tzoul
Tank Construction of
Biological Slidge
Holding Tank
1 - Wear helmet and safety gloves 25-Jun-10 25-Jun-10
2 - Wear safety goggles/faceshield 10:30 AM 10:30 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
12 Biological Sludge Holding Erection of 22823 not required skids/lines
Personnel Protective Equipment Iqbal Rogelio Agasen
Tank Scaffolding

1 - Wear helmet and safety gloves 9-Jun-10 9-Jun-10


4 - Wear appropriate handgloves 7:30 AM 7:40 AM
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
15 Re-Aeration of Electrical Foundation Works 22522 not required Personnel Protective Equipment Shuaib Rogelio Agasen
and Blowers Bldg
1 - Wear helmet and safety gloves 25-May-10 25-May-10
2 - Wear safety goggles/faceshield 8:32 AM 8:35 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
18 Coagulation House Erection of 17982 not required skids/lines
Personnel Protective Equipment Shuaib Chalasa Tzoul
Scaffolding

1 - Wear helmet and safety gloves 24-Jul-10 24-Jul-10


2 - Wear safety goggles/faceshield 11:23 AM 11:25 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
skids/lines
19 Inlet Work Electrical Bldg Superstructure 17822 not required Personnel Protective Equipment Minhaj ahmed Chalasa Tzoul

1 - Wear helmet and safety gloves 12-Jul-10 12-Jul-10


2 - Wear safety goggles/faceshield 7:15 AM 8:54 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger occurs
and without personnel on or near fuel gas
21 Chlorination Building Removal of forms 13691 not required skids/lines
Personnel Protective Equipment Minhaj ahmed Rogelio Agasen

1 - Wear helmet and safety gloves 25-Sep-10 25-Sep-10


others: 4 - Wear appropriate handgloves 9:05 AM 10:25 AM
Work at heights 6 - Wear full body harness & lifelines
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
26-Use insulated tools

Waste and Spills


71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
Working at Heights
57-Inspect and tags scaffold before use
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment
22 Warehouse Electrical wiring 13645 not required Personnel Protective Equipment Minhaj ahmed Noel Benitez

1 - Wear helmet and safety gloves 22-Sep-10 22-Sep-10


others: 2- Wear full body harness & lifeline 0715 am 0858 am
Work at heights Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
26-Use insulated tools
PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures
Working at Heights
57-Inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment
23 Equalization tank Foundation of 39506 not required Personnel Protective Equipment Minhaj ahmed Noel Benitez
equalization tank
Supershed 1 - Wear helmet and safety gloves 30-Sep-10 30-Sep-10
PTWC
#38393
others: 2- Wear full body harness & lifeline 6:12 AM 8:00 AM
Foundation Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
26-Use insulated tools
Working at Heights
57-Inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
On or Near Fuel Gas Skids/Lines
76-do not use battery operated/electronics/
electronic to o/s equiptment

PTWC Prepared/Audited by: Checked by: Noted by:


PERMIT TO WORK CERTIFICATE AUDIT AS OF 07 October 2010
API, Date & API, Date &
Item PTWC
Proposed Structures Scope of Works Isolation Safety Precautions time of time of
No. No.
Signatures Signatures

ROGELIO AGASEN MARLON ORIARTE RAUL GAMAYA NASSER AWALEH


SETE Project Site Civil Eng'r/APR SETE Safety Assistant SETE Safety Manager SETE Construction Ma
Validity Remarks

Until Job No activity at the area


Completion waiting for the
materials.

Proper barricade was


provided at the area

Until Job No activity at the area


Completion still waiting for the
materials.

Proper barricade was


provided at the area
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Workers are wearing of


appropriate proper PPE

Scaffolding are
complete with Green
Scaff Tag signed by
Authorized Scaffold
Supervisor and
Inspector

Safety Warning Signs


are provided

Until Job Safety precautions are


Completion followed and observed.
Validity Remarks

Lifting operation done


with certified rigger and
crane operator

Workers are wearing of


appropriate proper PPE

Poor housekeeping - On
going removal of
rubbish/debris inside
the tank

Some of the panel


board stock up on the
walkway

15-Oct-10 Safety precautions are


followed and observed.
Validity Remarks

20 Oct. 10 Safety precautions are


followed and observed.

Hard barricade & good


housekeeping were
observed

Workers are wearing of


appropriate proper PPE
Validity Remarks

14-Oct-10 Safety precautions are


followed and observed.

Until Job Safety precautions are


Completion followed and observed.
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Until Job Safety precautions are


Completion followed and observed.
Validity Remarks

Until Job Scaffolder have TUV


Completion Certificate and wearing
of proper PPE such as
full body harness with
double lanyard while
working.
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Until Job Scaffolder have TUV


Completion Certificate and wearing
of proper PPE such as
full body harness with
double lanyard while
working.
Validity Remarks

Until Job Safety precautions are


Completion followed and observed.
Validity Remarks

till job Safety precautions are


completion followed and observed.

till job Safety precautions are


completion followed and observed.
Validity Remarks

30-Oct-10 Safety precautions are


followed and observed.

ted by:
Validity Remarks

NASSER AWALEH
SETE Construction Manager
PERMIT TO WORK CERTIFICATE AUDIT AS OF 25 Sept 2010
API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of
No. Structures No.
Signatures
1 GAC Backwash Tank Foundation Works 22518 not Personnel Protective Equipment Iqbal
required 1 - Wear helmet and safety shoes 24-May-10
2 - Wear safety goggles/faceshield 8:36 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
2 GAC Backwash Tank Erection of 22791 not Personnel Protective Equipment Iqbal
Scaffolding required
1 - Wear helmet and safety gloves 8-Jun-10
2 - Wear safety goggles/faceshield 9:30 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
3 Chorine Contact Tank Erection of 22762 not Personnel Protective Equipment Iqbal
Scaffolding required
1 - Wear helmet and safety gloves 6-Jun-10
2 - Wear safety goggles/faceshield 5:05 PM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines

4 Chlorine Contact Tank To construct the 17843 not Personnel Protective Equipment Shuaib
superstructure for required 1 - Wear helmet and safety gloves 14-Jul-10
Chlrine Contact Tank
2 - Wear safety goggles/faceshield 9:50 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
5 Chlorination Building To construct the 38360 not Personnel Protective Equipment Minhaj ahmed
superstructure of required 1 - Wear helmet and safety gloves 28-Aug-10
the proposed
2 - Wear safety goggles/faceshield 7:45 AM
Chlorination Bldg.
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Lifting Equiptment
20-Use tested & certified crane/forklift
21-Use tested & certified lifting tackles
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
6 Main Electrical Bldg Removal of forms 38292 not Personnel Protective Equipment Iqbal
required 1 - Wear helmet and safety gloves 7:00 AM
4 - Wear appropriate handgloves 21-Aug-10
Removal of forms

6-Wear full body harness/life line


Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
10 Chlorination Building Masonry Works 135633 not Personnel Protective Equipment Minhaj ahmed
required 1 - Wear helmet and safety gloves 15-Sep-10
4 - Wear appropriate handgloves 8:15 AM
6 - Wear full body harness & lifelines
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
26-Use insulated tools
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
Working at Heights
57-Inspect and tags scaffold before use
On or Near Fuel Gas Skids/Lines
76-do not use battery
operated/electronics/ electronic to o/s
7 Tertiary Treatment To excavate for the 13690 not equiptment
Personnel Protective Equipment Minhaj ahmed
Tank - 851, 852, 853 foundation required 1 - Wear helmet and safety gloves 25-09-10
2 - Wear safety goggles/faceshield 12:00 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
17 Poly Preparation Bldg Applying of 38440 not Personnel Protective Equipment Minhaj ahmed
Membrane Water required 1 - Wear helmet and safety shoes 5-Sep-10
Proofing to
5 - Wear welding/chemical aprons 9:45 PM
Foundation of Poly
Preparation Bldg Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Hot Work
55-Keep fire extinguisher ready
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
On or Near Fuel Gas Skids/Lines
76-do not use battery
operated/electronics/ electronic to o/s
10 New Biological Foundation Works 13553 not equiptment
Personnel Protective Equipment Minhaj ahmed
Treatment TankTank required 1 - Wear helmet and safety gloves 14-Sep-10
TK-832
2 - Wear safety goggles/faceshield 5:49 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
11 Biological Sludge Superstructure 17619 not Personnel Protective Equipment Shuaib
Holding Tank Construction of required 1 - Wear helmet and safety gloves 25-Jun-10
Biological Slidge
2 - Wear safety goggles/faceshield 10:30 AM
Holding Tank
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
12 Biological Sludge Erection of 22823 not Personnel Protective Equipment Iqbal
Holding Tank Scaffolding required
1 - Wear helmet and safety gloves 9-Jun-10
4 - Wear appropriate handgloves 7:30 AM
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
13 Biological Sludge Tank Exavation for the 13571 not Personnel Protective Equipment Iqbal
foundation of BSHT required 1 - Wear helmet and safety gloves 16-Sep-10
2-Wear safety goggles/faceshield 7:30 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7-Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable / Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
10 Equalization Tank Foundation Works 38393 not Personnel Protective Equipment Minhaj ahmed
required
1 - Wear helmet and safety gloves 31-Aug-10
2 - Wear safety goggles/faceshield 7:45 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
15 Re-Aeration of Foundation Works 22522 not Personnel Protective Equipment Shuaib
Electrical and Blowers required
Bldg 1 - Wear helmet and safety gloves 25-May-10
2 - Wear safety goggles/faceshield 8:32 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
18 Coagulation House Erection of 17982 not Personnel Protective Equipment Shuaib
Scaffolding required
1 - Wear helmet and safety gloves 24-Jul-10
2 - Wear safety goggles/faceshield 11:23 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
19 Inlet Work Electrical Superstructure 17822 not Personnel Protective Equipment Minhaj ahmed
Bldg required
1 - Wear helmet and safety gloves 12-Jul-10
2 - Wear safety goggles/faceshield 7:15 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
20 Proposed Construction To excavate for the 38312 not Personnel Protective Equipment Minhaj ahmed
of Primary Works foundation required
beside Inlet Work 1 - Wear helmet and safety gloves 24-Aug-10
Electrical Bldg
2 - Wear safety goggles/faceshield 7:15 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
PTWC Prepared/Audited by: Checked by:

ROGELIO AGASEN MARLON ORIARTE RAUL GAMAYA


SETE Project Site Civil Eng'r/APR SETE Safety Assistant SETE Safety Manager
ept 2010
API, Date &
time of Validity Remarks
Signatures
Roger Agasen Until Job No activity at the area
24-May-10 Completion waiting for the
materials.
8:36 AM

Proper barricade was


provided at the area

Roger Agasen Until Job No activity at the area


Completion still waiting for the
8-Jun-10 materials.
9:30 AM
Proper barricade was
provided at the area

Roger Agasen Until Job Safety precautions are


Completion followed and observed.
6-Jun-10
5:05 PM
Workers are wearing of
appropriate proper PPE

Scaffolding are
complete with Green
Scaff Tag signed by
Authorized Scaffold
Supervisor and
Inspector

Safety Warning Signs


are provided
Chalasa Tzoul Until Job Safety precautions are
14-Jul-10 Completion followed and observed.
9:51 AM

Lifting operation done


with certified rigger
and crane operator

Workers are wearing of


appropriate proper PPE

Poor housekeeping -
On going removal of
rubbish/debris inside
the tank

Some of the panel


board stock up on the
walkway
Roger Agasen 28-Sep-10 Safety precautions are
28-Aug-10 followed and observed.
9:30 AM
Workers are wearing of
appropriate proper PPE

Some woods and


rebars are scattered on
the area - On going
houskkeping

Some of the previous


safety findings are
rectified

Roger Agasen Until Job Safety precautions are


7:00 AM Completion followed and observed.
21-Aug-10
Workers are wearing of
appropriate proper PPE

Roger Agasen 15-Oct-10 Safety precautions are


15-Sep-10 followed and observed.
9:14 AM
Roger Agasen 20 Oct. 10 Safety precautions are
25-09-10 followed and observed.
10:20 AM
Hard barricade & good
housekeeping were
observed

Workers are wearing of


appropriate proper PPE
Roger Agasen 6-Oct-10
5-Sep-10
10:05 PM

Roger Agasen 14-Oct-10 Safety precautions are


14-Sep-10 followed and observed.
9:08 AM
Chalasa Tzoul Until Job Safety precautions are
25-Jun-10 Completion followed and observed.
10:30 AM

Roger Agasen Until Job Scaffolder have TUV


Completion Certificate and wearing
9-Jun-10 of proper PPE such as
full body harness with
7:40 AM
double lanyard while
working.
Roger Agasen 5-Oct-10 Safety precautions are
16-Sep-10 followed and observed.
9:06 AM
Hard barricade & good
housekeeping were
observed

Workers are wearing of


appropriate proper PPE
Roger Agasen september Safety precautions are
31, 2010 followed and observed.
31-Aug-10
9:40 AM

Roger Agasen Until Job Safety precautions are


Completion followed and observed.
25-May-10
8:35 AM
Chalasa Tzoul Until Job Scaffolder have TUV
Completion Certificate and wearing
24-Jul-10 of proper PPE such as
full body harness with
11:25 AM
double lanyard while
working.
Chalasa Tzoul Until Job Safety precautions are
Completion followed and observed.
12-Jul-10
8:54 AM
Chalasa Tzoul 29-Sep-10 Safety precautions are
followed and observed.
24-Aug-10
8:15 AM
Hard barricade, good
housekeeping, edge
sloping was provided.
Noted by:

NASSER AWALEH
SETE Construction Manager
PERMIT TO WORK CERTIFICATE AUDIT AS OF 18 Sept 2010
API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
1 GAC Backwash Tank Foundation Works 22518 not Personnel Protective Equipment Iqbal Roger Agasen
required 1 - Wear helmet and safety shoes 24-May-10 24-May-10
2 - Wear safety goggles/faceshield 8:36 AM 8:36 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
Extra Precautions
73-Do not carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
2 GAC Backwash Tank Erection of 22791 not fuel gas skids/lines
Personnel Protective Equipment Iqbal Roger Agasen
Scaffolding required 1 - Wear helmet and safety gloves 8-Jun-10 8-Jun-10
2 - Wear safety goggles/faceshield 9:30 AM 9:30 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas

Page 143 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
10-Maintain housekeeping
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
3 Chorine Contact Tank Erection of 22762 not fuel gas skids/lines
Personnel Protective Equipment Iqbal Roger Agasen
Scaffolding required 1 - Wear helmet and safety gloves 6-Jun-10 6-Jun-10
2 - Wear safety goggles/faceshield 5:05 PM 5:05 PM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines

Page 144 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures

4 Chlorine Contact Tank To construct the 17843 not Personnel Protective Equipment Shuaib Chalasa Tzoul
superstructure for required 1 - Wear helmet and safety gloves 14-Jul-10 14-Jul-10
Chlrine Contact Tank
2 - Wear safety goggles/faceshield 9:50 AM 9:51 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
5 Chlorination Building To construct the 38360 not occurs and without
Personnel personnel
Protective on or near
Equipment Minhaj ahmed Roger Agasen
superstructure of fuel gas skids/lines
required 1 - Wear helmet and safety gloves 28-Aug-10 28-Aug-10
the proposed
Chlorination Bldg.

Page 145 of 168


API, Date & API, Date &
Item Proposed PTWC
ToScope
construct the
of Works Isolation Safety Precautions time of time of
No. Structures No.
superstructure of Signatures Signatures
the proposed
2 - Wear safety goggles/faceshield 7:45 AM 9:30 AM
Chlorination Bldg.
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Lifting Equiptment
20-Use tested & certified crane/forklift
21-Use tested & certified lifting tackles
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable Power / Tools
24-Inspect before use
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
59-Use tested and certified manbasket
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
6 Main Electrical Bldg Removal of forms 38292 not fuel gas skids/lines
Personnel Protective Equipment Iqbal Roger Agasen
required 1 - Wear helmet and safety gloves 7:00 AM 7:00 AM
4 - Wear appropriate handgloves 21-Aug-10 21-Aug-10
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use

Page 146 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
26-Use insulated tools
Working at Height
57-inspect and tag scaffold before use
58-Use non-conductive ladder
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
10 Chlorination Building Masonry Works 135633 not fuel gas skids/lines
Personnel Protective Equipment Minhaj ahmed Roger Agasen
required 1 - Wear helmet and safety gloves 15-Sep-10 15-Sep-10
4 - Wear appropriate handgloves 8:15 AM 9:14 AM
6 - Wear full body harness & lifelines
Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
26-Use insulated tools
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
Working at Heights
57-Inspect and tags scaffold before use
On or Near Fuel Gas Skids/Lines
76-do not use battery
operated/electronics/ electronic to o/s
equiptment
7 Tertiary Treatment To excavate for the 38308 not Personnel Protective Equipment Minhaj ahmed Roger Agasen
Tank - 851, 852, 853 foundation required

Page 147 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Tertiary Treatment To excavate for the not Signatures Signatures
Tank - 851, 852, 853 foundation required 1 - Wear helmet and safety gloves 23-Aug-10 23-Aug-10
2 - Wear safety goggles/faceshield 7:55 AM 8:50 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
17 Poly Preparation Bldg Applying of 38440 not fuel gas skids/lines
Personnel Protective Equipment Minhaj ahmed Roger Agasen
Membrane Water required 1 - Wear helmet and safety shoes 5-Sep-10 5-Sep-10
Proofing to
5 - Wear welding/chemical aprons 9:45 PM 10:05 PM
Foundation of Poly
Preparation Bldg

Page 148 of 168


Applying of API, Date & API, Date &
Item Proposed Membrane PTWC
Scope ofWater
Works Isolation Safety Precautions time of time of
No. Structures Proofing to No.
Signatures Signatures
Foundation of Poly
Preparation Bldg Working Areas
10-Maintain housekeeping
Hand / Portable Power / Tools
24-Inspect before use
Hot Work
55-Keep fire extinguisher ready
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working extra precautions
On or Near Fuel Gas Skids/Lines
76-do not use battery
operated/electronics/ electronic to o/s
10 New Biological Foundation Works 13553 not equiptment
Personnel Protective Equipment Minhaj ahmed Roger Agasen
Treatment TankTank required 1 - Wear helmet and safety gloves 14-Sep-10 14-Sep-10
TK-832
2 - Wear safety goggles/faceshield 5:49 AM 9:08 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines

Page 149 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
11 Biological Sludge Superstructure 17619 not Personnel Protective Equipment Shuaib Chalasa Tzoul
Holding Tank Construction of required 1 - Wear helmet and safety gloves 25-Jun-10 25-Jun-10
Biological Slidge
2 - Wear safety goggles/faceshield 10:30 AM 10:30 AM
Holding Tank
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
12 Biological Sludge Erection of 22823 not occurs and without
Personnel personnel
Protective on or near
Equipment Iqbal Roger Agasen
Holding Tank Scaffolding required fuel gas skids/lines
1 - Wear helmet and safety gloves 9-Jun-10 9-Jun-10
4 - Wear appropriate handgloves 7:30 AM 7:40 AM
6 - Wear full body harness & lifeline
Working Areas
10-Maintain housekeeping
Hand Portable Power Tools
24-Inspect before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines

Page 150 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
13 Biological Sludge Tank Exavation for the 13571 not Personnel Protective Equipment Iqbal Roger Agasen
foundation of BSHT required 1 - Wear helmet and safety gloves 16-Sep-10 16-Sep-10
2-Wear safety goggles/faceshield 7:30 AM 9:06 AM
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7-Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Hand / Portable / Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
10 Equalization Tank Foundation Works 38393 not occurs and without
Personnel personnel
Protective on or near
Equipment Minhaj ahmed Roger Agasen
fuel gas skids/lines
required 1 - Wear helmet and safety gloves 31-Aug-10 31-Aug-10
2 - Wear safety goggles/faceshield 7:45 AM 9:40 AM
3 - Wear ear protectors/muffs

Page 151 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
Lifting Equiptment
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
15 Re-Aeration of Foundation Works 22522 not fuel gas skids/lines
Personnel Protective Equipment Shuaib Roger Agasen
Electrical and Blowers required 1 - Wear helmet and safety gloves 25-May-10 25-May-10
Bldg
2 - Wear safety goggles/faceshield 8:32 AM 8:35 AM
4 - Wear appropriate handgloves
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Mobile Vehicle/Tankers
33-Provide grounding while unloading
34-Provide reversing(back up) alarm
Waste and Spills
71-Dispose waste on regular basis

Page 152 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
18 Coagulation House Erection of 17982 not fuel gas skids/lines
Personnel Protective Equipment Shuaib Chalasa Tzoul
Scaffolding required 1 - Wear helmet and safety gloves 24-Jul-10 24-Jul-10
2 - Wear safety goggles/faceshield 11:23 AM 11:25 AM
3 - Wear ear protectors/muffs
4 - Wear appropriate handgloves
6-Wear full body harness/life line
Working Areas
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
17-Restrict/prohibit entry
Lifting Equiptment
20-Use tested & certified crane/forklift
22-Appoint a signal man
23-Employ liscenced operator
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do not carry out any hot work
74-Stop work if any imminent danger
19 Inlet Work Electrical Superstructure 17822 not occurs and without
Personnel personnel
Protective on or near
Equipment Minhaj ahmed Chalasa Tzoul
Bldg required fuel gas skids/lines
1 - Wear helmet and safety gloves 12-Jul-10 12-Jul-10
2 - Wear safety goggles/faceshield 7:15 AM 8:54 AM
4 - Wear appropriate handgloves
6 - Wear full body harness & lifeline
Working Areas

Page 153 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
10-Maintain housekeeping
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
16-Provide warning/caution signs
17-Restrict/prohibit entry
Lifting Equiptment
24-Inspect before use
25-Use Non-sparking tools
Working at Height
57-inspect and tag scaffold before use
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines
20 Proposed Construction To excavate for the 38312 not Personnel Protective Equipment Minhaj ahmed Chalasa Tzoul
of Primary Works foundation required 1 - Wear helmet and safety gloves 24-Aug-10 24-Aug-10
beside Inlet Work
2 - Wear safety goggles/faceshield 7:15 AM 8:15 AM
Electrical Bldg
3-Wear ear protectors/muffs
4 - Wear appropriate handgloves
7 - Wear appropriate respirator
Working Areas
10-Maintain housekeeping
13-Barricade area with warning tape
14-Barricade area with hard steel barrier
15-Provide flashing beacon lights
Lifting Equiptment
22-Appoint a signal man

Page 154 of 168


API, Date & API, Date &
Item Proposed PTWC
Scope of Works Isolation Safety Precautions time of time of
No. Structures No.
Signatures Signatures
23-Employ liscenced operator
Hand Portable Power Tools
24-Inspect before use
Excavation
61-Provide shoring, benching, sloping
63-Keep spoil 1 meter away from edge
65-use stop blocks for vehicles
Remove water or continue dewatering
Waste and Spills
71-Dispose waste on regular basis
72-Clean spills emediate if any while
working
73-Do notextra precautions
carry out any hot work
74-Stop work if any imminent danger
occurs and without personnel on or near
fuel gas skids/lines

PTWC Prepared/Audited by: Checked by: Noted by:

ROGELIO AGASEN MARLON ORIARTE RAUL GAMAYA NASSER AWALEH


SETE Project Site Civil Eng'r/APR SETE Safety Assistant SETE Safety Manager SETE Construction M

Page 155 of 168


Validity Remarks

Until Job No activity at the area


Completion waiting for the
materials.

Proper barricade was


provided at the area

Until Job No activity at the area


Completion still waiting for the
materials.

Proper barricade was


provided at the area

Page 156 of 168


Validity Proper Remarks
barricade was
provided at the area

Until Job Safety precautions are


Completion followed and observed.

Workers are wearing of


appropriate proper PPE

Scaffolding are
complete with Green
Scaff Tag signed by
Authorized Scaffold
Supervisor and
Inspector

Safety Warning Signs


are provided

Page 157 of 168


Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Lifting operation done


with certified rigger
and crane operator

Workers are wearing of


appropriate proper PPE

Poor housekeeping -
On going removal of
rubbish/debris inside
the tank

Some of the panel


board stock up on the
walkway

28-Sep-10 Safety precautions are


followed and observed.

Page 158 of 168


Validity Remarks

Workers are wearing of


appropriate proper PPE

Some woods and


rebars are scattered on
the area - On going
houskkeping

Some of the previous


safety findings are
rectified

Until Job Safety precautions are


Completion followed and observed.

Workers are wearing of


appropriate proper PPE

Page 159 of 168


Validity Remarks

15-Oct-10 Safety precautions are


followed and observed.

23-Sep-10 Safety precautions are


followed and observed.

Page 160 of 168


Validity Remarks
Safety precautions are
followed and observed.

Hard barricade & good


housekeeping were
observed

Workers are wearing of


appropriate proper PPE

6-Oct-10

Page 161 of 168


Validity Remarks

14-Oct-10 Safety precautions are


followed and observed.

Page 162 of 168


Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Until Job Scaffolder have TUV


Completion Certificate and wearing
of proper PPE such as
full body harness with
double lanyard while
working.

Page 163 of 168


Validity Remarks

5-Oct-10 Safety precautions are


followed and observed.

Hard barricade & good


housekeeping were
observed

Workers are wearing of


appropriate proper PPE

september Safety precautions are


31, 2010 followed and observed.

Page 164 of 168


Validity Remarks

Until Job Safety precautions are


Completion followed and observed.

Page 165 of 168


Validity Remarks

Until Job Scaffolder have TUV


Completion Certificate and wearing
of proper PPE such as
full body harness with
double lanyard while
working.

Until Job Safety precautions are


Completion followed and observed.

Page 166 of 168


Validity Remarks

29-Sep-10 Safety precautions are


followed and observed.

Hard barricade, good


housekeeping, edge
sloping was provided.

Page 167 of 168


Validity Remarks

Noted by:

NASSER AWALEH
SETE Construction Manager

Page 168 of 168

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