Information

  • EQUIPMENT OUT OF SERVICE (EOS)

  • Document No.

  • Company completing works

  • Add media

  • Date completed

  • Location
  • Completed by

  • Contact Number Mobile

  • Contact Number Office

EOS

Site details

  • Site Name

  • Details of work being completed.

  • CMMS NUMBER:

  • Will the Equipment be non operational for more than 1 day and less than 28 days?

  • EOS Duration (days)

  • Will the Equipment be non operational for more than 28 days?

  • EOS Duration Months

  • Operational Impact of work on site (during)

  • Operational Impact of work off site (after)

  • BREAKDOWN

  • PLANNED WORK

Site Responsible Officer

  • Site responsible officer at site during work

  • Add signature

Required isolation

  • Please note functional and safety isolation procedures must be followed in accordance with safe systems of work.

  • Mechanical

  • Responsible Framework Contractor

  • Electrical

  • Responsible Framework Contractor

  • Instrumentation, Control, Automation

  • Responsible Framework Contractor

Notified

  • Site Operator

  • EMAIL

  • Select date

  • PHONE

  • Select date

  • FIELD TEAM LEADER

  • EMAIL

  • Select date

  • PHONE

  • Select date

  • Asset Owner or Site Responsible Officer

  • EMAIL

  • Select date

  • PHONE

  • Select date

  • M&E

  • EMAIL

  • Select date

  • PHONE

  • Select date

Telemetry Alarms

  • Are any alarms permanently disabled

  • Alarm type disabled

  • Alarm

Cancellation/ Recommission

  • Is the EOS Active?

  • Is the site fully recommissioned

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.