Critical Work Oversight

• Prepared by

• CWO Title

• Dig #

• Location
  Address

• Division

  NOG

  SOG

  SETX

• System

  MPL

  WIPL

  WRPL

  APL

• Station

  Select Staples Little Falls Foley Zimmerman Albany NA

  • Staples
  • Little Falls
  • Foley
  • Zimmerman
  • Albany
  • NA

• Repair Method

  sleeve

  clock spring

  change out

  stopple

  NA

• One call ticket #

• One call ticket #

• One call ticket #

• Welding procedure

• Type of Hotwork

• Type of Hotwork

• Type of Hotwork

• Welder Name

• Inspector Name

• Conducted on

  Date

Excavation Preparation Checklist

• Hazards Identified and Marked?

  Yes

  No

  N/A

• Process used to identify utilities and pipeline

  Yes

  No

  N/A

• Dig packet?

  Yes

  No

  N/A

• Alignment sheets or station drawings?

  Yes

  No

  N/A

• PE plan? (20' or deeper)

  Yes

  No

  N/A

• Separate One Call Tickets?

  Yes

  No

  N/A

During Excavations Checklist

• Photo of dig site.

  Media

• Depth (in feet)

• Length (in feet)

• Width (In feet)

• Soil classification

  Default C

  A

  B

  C

• Slopes. B = 1:1 benching allowed. C = 1.5:1 benching not allowed

  Yes

  No

  N/A

• Protective Systems (shoring and shielding)

  Yes

  No

  N/A

• Spoil piles, materials, and equipment 2' clearance.

  Yes

  No

  N/A

• Using probe bars as required.

  Yes

  No

  N/A

• 1' clearance with bucket?

  Yes

  No

  N/A

• Inspector engaged?

  Yes

  No

  N/A

Permit

• Adequate description?

  Yes

  No

  N/A

• Adequate mitigation of hazards?

  Yes

  No

  N/A

• Everyone logged in the permit?

  Yes

  No

  N/A

• Permit being adhered to?

  Yes

  No

  N/A

• Daily Excavation Checklist complete?

  Yes

  No

  N/A

Closing

• Extra Comments

• Signature

  Sign

Hot Work Preparation Checklist

• KPL Operations (AE) notified?

  Yes

  No

  N/A

• Pipeline control center notified?

  Yes

  No

  N/A

• Pipeline pressure specified and communicated?

  Yes

  No

  N/A

• KPL TG1602.201 appendix A available.

  Yes

  No

  N/A

• Welders qualified?

  Yes

  No

  N/A

• Appropriate welding procedure selected?

  Yes

  No

  N/A

During Hot Work

• Atmospheric monitoring?

  Yes

  No

  N/A

• Equipment blinded & Gas freed? (KPL STD 220.100 Appendix A)

  Yes

  No

  N/A

• Guards in place on Grinders?

  Yes

  No

  N/A

• Tools & Equipment are in good condition?

  Yes

  No

  N/A

• Fire extinguisher available? (minimum 20 lb. ABC)

  Yes

  No

  N/A

• Fire watch understands 30 minute watch after work has ceased?

  Yes

  No

  N/A

• AE on site and engaged with activities?

  Yes

  No

  N/A

Permit

• Adequate description of Hot Work?

  Yes

  No

  N/A

• Adequate mitigation of hazards?

  Yes

  No

  N/A

• Everyone signed in on permit?

  Yes

  No

  N/A

• Fire watch assigned?

  Yes

  No

  N/A

• Assigned fire watch has no other duties?

  Yes

  No

  N/A

Closing

• Additional Comments or notes

• Evaluators signature

  Sign

Verification of Energy Control

• Energy sources identified/verified in correct position?

  Yes

  No

  N/A

• Blinds installed? (KPL STD220.100)

  Yes

  No

  N/A

• Isolation locks or tags applied?

  Yes

  No

  N/A

• Energy sources tried?

  Yes

  No

  N/A

Application of isolation locks

• All exposed personnel have personal locks applied?

  Yes

  No

  N/A

• Name on personal lock?

  Yes

  No

  N/A

• If NO the KPL isolation tag used?

  Yes

  No

  N/A

• Isolation locks labeled "Danger, Locked Out, Do Not Remove"?

  Yes

  No

  N/A

• If NO then KPL isolation tag used?

  Yes

  No

  N/A

• Personal locks removed at end of shift?

  Yes

  No

  N/A

Application of lock box

• Station (red) locks applied?

  Yes

  No

  N/A

• If NO. Isolation tags applied with required information?

  Yes

  No

  N/A

• Project lock (yellow) with project tag applied at end of shift?

  Yes

  No

  N/A

• Complex job procedure in use? (If YES. Explain condition in comments section.)

  Yes

  No

  N/A

Closing

• Additional comments

• Signature

  Sign

Classification/General requirements of Confined Space

• Classification consistent with Confined Space Decision Flow Chart?<br>STD 220.100<br><br>Complete section B for Non-Permit Required Confined Space<br>Complete section C for Permit Required Confined Space

  Yes

  No

  N/A

• Confined Space properly isolated?

  Yes

  No

  N/A

• Labeled with "Danger, Confined Space, Enter by Permit Only"?

  Yes

  No

  N/A

• Ventilation established?

  Yes

  No

  N/A

• EH&S Permit addresses hazards/entry conditions?

  Yes

  No

  N/A

• Entry conditions have been met and communicated?

  Yes

  No

  N/A

B Non-Permit Required Confined Space

• Periodic Air Monitoring completed and logged?

  Yes

  No

  N/A

C Permit Required Confined Space

• Attendant in position maintaining entry and atmospheric logs?

  Yes

  No

  N/A

• Attendant has not other duties?

  Yes

  No

  N/A

• Atmospheric monitoring is continuous and is being logged?

  Yes

  No

  N/A

• Zone management in place controlling ignition sources?

  Yes

  No

  N/A

• Communication established between entrant, attendant, and rescue services?

  Yes

  No

  N/A

• Rescue equipment and services on site and ready?

  Yes

  No

  N/A

• Rescue pre-plan approved?

  Yes

  No

  N/A

Closing

• Additional comments

• Signature

  Sign