This checklist must be completed prior to starting any ___________________________. If any of the listed conditions change, then this permit is invalid and a new permit shall be issued before work continues.
VESSEL
DATE & TIME
WORK TO START (TIME)
Location and description of work to be done:
ALL QUESTIONS MUST BE ANSWERED TO PROCEED
YES
NO
N/A
1. Is the location of the maintenance work an enclosed space? NOTE: If YES, the proper Enclosed Space Entry permit must also be completed, authorized and attached.
2. Does the maintenance work involve working aloft, outboard, or over the side? NOTE: if YES, the proper Working Aloft, Outboard and Over the Side Permit must also be completed, authorized and attached.
3. Does the maintenance work involve any form of hotwork? NOTE: If YES, the proper Hot Work Permit also be completed, authorized and attached.
4. Has the proper tagout/lockout procedure for the work detailed been carried out?
5. Can maintenance work be done safely IAW NFPA requirements?
6. Have all power supplies to the work area been isolated, fuses pulled, circuit breakers tripped and switches set to “OFF”?
7. Have confirmation checks been carried out at the work position while remote and local power-on switching is carried out?
8. Have ship’s drawings been referenced to ensure all power supply routes to the work area are isolated?
9. Have appropriate warning signs been placed on equipment switches and valves?
10. If working on or near live electrical equipment, is a second man present who is competent in the treatment of electrical shock and is trained in fighting electrical fires and proper medical response?
11. Have the tools and equipment been inspected prior to starting work and found to be in good condition?
12. Have the workers done a Job Hazard Analysis in which clear instructions have been given on how to minimize or circumvent these hazards?
13. Have the instructions and plans been discussed in case of an emergency?
IF ANY CHECK MARKS MUST BE PLACED IN THE SHADED AREAS ABOVE, THEN THIS ITEM MUST BE RECTIFIED BEFORE PROCEEDING.
I HAVE READ THE ABOVE PERMIT AND WILL CARRY OUT THE WORK REQUIRED IN A SAFE MANNER.
SIGNATURE OF WORKER . SIGNATURE OF WORKER . SIGNATURE OF WORKER . SIGNATURE OF WORKER . SIGNATURE OF WORKER . SIGNATURE OF WORKER .
I have inspected the area described on the top of this form and state that the work can be done safely and in compliance with rules of the US Coast Guard, ABS, and any other authority whose rules I am bound to enforce.
OFFICER IN CHARGE . MASTER .
OFFICE USE ONLY PERMIT REVIEWED BY: . DATE: .
Original:
Master’s File
Copy 1:
Posted
Copy 2:
Office Copy (Mail)
PERMIT TO WORK
WORKING ALOFT, OUTBOARD AND OVER THE SIDE PERMIT
Form: PTW_OTS
Date:
Prep’d by:
Apprv’d by:
Page 1 of 2
This checklist must be completed prior to starting any work aloft, outboard or over the side. If any of the listed conditions change, then this Permit is invalid and a new permit shall be issued before work continues.
VESSEL
DATE & TIME (MAX. 12 HRS)
WORK TO START (TIME)
Location and Description of Work to be Done:
ALL QUESTIONS MUST BE ANSWERED TO PROCEED
YES
NO
N/A
1. Does the work involve any form of hot work? NOTE: If YES, the proper Hot Work Permit must also be completed, authorized and attached.
2. Does the work involve any electrical maintenance work? NOTE: If YES, the proper Electrical Maintenance Work Permit also be completed, authorized and attached.
3. If work is to be done on electrical equipment or any other energy sources, is the source locked out and tagged out and have all other lockout/tagout requirements been satisfied? NOTE: If YES the proper Lockout/Tagout Permit must also be completed, authorized and attached
5. If a safety net is rigged, has it been inspected and found in good order?
6. If staging or ladders provided, have they been inspected and found in good order?
7. If the work is overside, is the vessel stopped?
8. If working near the ship’s whistle, radio/radar antennae or other potentially hazardous equipment, are warning notices in place, lockout/tagout procedures carried out and the crew informed of work in progress?
9. If working in the funnel area, has the Duty Engineer been notified to reduce the emission of steam, harmful gases and fumes as far as is practicable?
10. Have ship’s drawings been referenced to ensure the area is safe for working in?
11. Has a safety man been provided?
12. Have personnel been provided with the proper Personnel Protective Equipment (PPE)?
13. If working outboard of the railings or over the side, are life vests provided?
13a. Is a lifebuoy with sufficient line ready for immediate use?
14. Have the correct tools and equipment required been provided?
15. Have the tools and equipment been inspected prior to starting work and found to be in good condition?
16. Has a tool belt or other tool storage device been provided?
17. Are ropes available to raise/lower tools and equipment?
18. If the work involves using a bosun’s chair, are the workers trained in its use and has the equipment been tested prior to use?
19. Have the workers done a Job Hazard Analysis in which clear instructions have been given on how to minimize or circumvent these targets?
20. Have instructions and plans been discussed in case of an emergency?
I inspected the enclosed area described on the top of this form and state that the work can be done and in compliance with rules of the US Coast Guard, ABS, and other authority whose rules I am bound to enforce.
OFFICER IN CHARGE OF SAFETY
MASTER
OFFICE USE ONLY
PERMIT REVIEWED BY:
DATE:
Original:
Master’s File
Copy 1:
Posted
Copy 2:
Office Copy (Mail)
PERMIT TO WORK
INSPECTION/REPAIR PERMIT CONDENSER/SEAWATER SYSTEM
Form: PTW_SWS
Date:
Prep’d by:
Apprv’d by:
Page 1 of 1
This checklist must be completed before beginning inspections or repairs to condensers or sea water systems where dismantling of the system is required, and watertight integrity depends on a single sea valve. Work shall not begin if any of the following precautions cannot be met. If any conditions listed in this permit change, then this Permit is invalid and a new permit shall be issued based on the new conditions before work continues.
IMPORTANT: Once valves are closed and tagged, all lock-out/tag-out procedures shall be followed. Condenser to be tested for leaks and closed up ASAP. Report any problems or deviations from the work plan to the Master, Chief Engineer and the Fleet Manager.
o Conference held to review scope and technology aspects of the work. Emergency response plan made up
o Communication established between job site and bridge (cargo control room if in port).
o Emergency squad drill held using the damage control plan. All necessary emergency tools available
o Weather forecast and sea conditions checked for period of work.
o Fleet Manager notified of work plan and schedule as appropriate.
o Isolation plans and procedures reviewed with emergency squad leaders and persons involved with the work. Schematic diagrams used to pinpoint all valves.
o “Splash Zones” defined and electrical equipment protected as necessary. Electrical actuators including remote stations to be locked/tagged out.
o Water-tight integrity proven with drain valves, and/or carefully loosening flange bolts. Condensers and piping can be pumped down to expedite the work, but pups cannot be used to maintain low water level.
o All valves closed to isolate the system. Lock-out/tag-out procedures conducted as per Sec. 8. 10 of the Health & Safety Manual.
o Normal emergency bilge pumps and valves tested and strainers cleaned for immediate use
o Sufficient staff present on site for duration of work to immediately deal with any emergency situation.
o Safe access or suitable work platform provided.
o Only one door removed from each end of condenser at any time.
o All other waterbox door openings are to remain in position (may be loosely bolted).
o Responsible person (with walkie-talkie radio) in attendance at entrance of waterbox.
o Condenser waterbox ventilated and well lighted.
o Rags and debris removed from waterbox promptly
I HAVE READ THE ABOVE PERMIT AND WILL CARRY OUT THE WORK REQUIRED IN A SAFE MANNER.
SIGNATURE OF WORKER ___________________________ SIGNATURE OF WORKER__________________________
SIGNATURE OF WORKER ___________________________ SIGNATURE OF WORKER__________________________
Complete this permit before beginning diver operations. Work shall not begin if any of the following precautions cannot be met. If any conditions listed change, then this Permit is invalid and a new permit shall be issued before work continues.
__________________________
VESSEL
___________________________
DATE & TIME (MAX. 12 HRS)
_____________________
WORK TO START (TIME)
Work Location
Work Description
General Precautions (Always read and initial.)
Master’s
Initials
_____Master has determined that the diver assisted work plan/procedure is safe.
_____Precautions have been explained to all personnel involved.
_____Deck/engine watch have been notified when work is to begin and when expected to be completed.
_____Other vessels or bunker barges not alongside during diving operations.
_____No other operations such as cargo, ballast movement, storing, etc. while the diver is in the water.
_____Engine room notified not to start up or stop any machinery which would change the status of the overboard discharges and intakes.
_____Terminal, Port Authority and Government approvals obtained as necessary.
_____All personnel advised of “Tagged-out” or “Locked-out” valves and proper procedures followed.
To Be Confirmed By Master
To Be Confirmed By Chief Engineer
Fleet Manager required concurrence obtained
Emergency Response Plan discussed & agreed.
Safety Meeting held & job scope/technical aspects clarified.
