Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Signature

JOB PLAN

  • Planner walk down checklist. Please refer to the Ivara work order for additional details.

  • Time and date of Job site visit.

  • Planner: Dan Courtemanche x.206 ch.1

Info

  • Work Order / Work Request

  • Work Order #

  • Work Request #

  • Asset number on work request verified against asset in field?

  • Asset #

  • Equipment model(s) in CMMS verified against model in field?

  • Enter equipment model(s)

  • Equipment Model

Location

  • Area

  • Floor

  • Control Room for Lock Out

  • Map

Details

  • Problem Description

  • Photos

  • Sketch

  • Job Scope

  • Enter task description(s)

  • Task
  • Task duration

  • If job scope changes, check with operator to see if lock out requirements have changed.

  • Prep work required?

  • Enter prep task description(s) and duration(s)

  • Prep Task
  • Prep work duration

  • Follow-up work required?

  • Enter follow-up tasks.

  • Task
  • Task duration.

  • Problems to resolve?

  • Enter problem details

  • Problem
  • Work acceptance criteria

  • Additional acceptance criteria.

  • Acceptance criteria
  • Rigging required?

  • A competent craftspersons must develop a sound rigging plan to be reviewed with his supervisor prior to starting the job.

  • Rigging options

  • Other rigging options.

  • Rigging option
  • Running condition

  • S/D?

  • Advanced details

  • Around-the-clock?

  • Complexity level

  • Exhaustion level

  • Contingency

  • Notes

  • Support documents required?

  • Other support documents required.

  • Document

Permits & Procedures

  • LOTO required?

  • No exposure to energy sources

  • Line / Process break?

  • Attach line breaking procedures to Ivara work order.

  • Hot work required?

  • Attach hot work permit to work order package.

  • Confined space entry?

  • Dräger masks

  • Bottles

  • Masks

  • Hose length

  • Operations is responsible for developing a CSE plan, arranging for breathing air, attendants, gas testing and continuous monitoring.

  • Gas test required?

  • Reason for gas test

  • Supervisor must arrange to have a gas test done.

  • Lifting over 25 tons?

  • Attach lifting permit to work order for all lifts over 25 tons.

  • TSSA?

  • Attach ITP (Inspect and Test Plan) to work order package. Please initial and date all applicable sections of the ITP.

  • Working on top of tank?

  • Attach completed permit for working on top of tanks to the work order package.

  • Work to be performed by a contractor?

  • Submit contracting out notification to Local:

  • All services above $25,000 require competitive bidding or an exception form.

  • Working from heights?

  • Attach working from heights procedure to work order.

  • Is fall arrest required?

  • Inspect all components and tie-off point(s).

Resources

  • Skills required?

  • Other skills required.

  • Skill
  • Bill of Materials

  • Add item to BOM

  • Item
  • Special tools required?

  • Additional specialty tools required.

  • Tool
  • PPE required?

  • Additional PPE required.

  • Item
  • Rigging required?

  • Additional rigging items required.

  • Item
  • Scaffold required?

  • Scaffolding details.

  • Details
  • Mobile equipment required?

  • Other mobile equipment required.

  • Equipment
  • External services required?

  • Other external services required.

  • Service

EMERGENCY: Contact Security by Phone ext.316 or Radio ch.1

  • Advanced emergency info

  • Nearest eyewash / shower

  • Nearest phone

  • Nearest emergency door

JSA / JHA

  • Perform Job Safety / Hazard Analysis?

  • A Job Safety / Hazard Analysis has not been performed.

  • Line of fire

  • Add media

  • Slips / Trips

  • Fall to lower level

  • Struck by / Struck against

  • Caught / Crushed

  • Cut / Puncture / Abrasion

  • Pressurized system / Compressed gas

  • Hot / Cold environment

  • Thermal Contact

  • Chemical Contact

  • PSM Chemicals

  • Non-PSM Chemicals

  • Gas Area

  • Possible exposure to

  • May be required to carry an H2S monitor. Check with the operator.

  • Other gas?

  • Carry approved respirator at all times.

  • Designated Substances?

  • Possible exposure to

  • Radiation

  • Electrical

  • Vibration

  • Noise

  • Over 85 dB - Hearing protection required.

  • Confined Space Entry

  • Check that all requirements on the CSE have been met.

  • Entanglement

  • Obstruction

  • Fire / Explosion

  • Dust / Fumes / Vapour

  • Approved respirator and cartridges must be work during exposure.

  • Ergonomics

  • Visibility / Lighting

  • Addition lighting may be required.

  • Access / Egress

  • Working on Roof

  • Requires use of buddy system.
    Must not be closer than 6 feet from edge unless a physical barricade is erected.

  • Traffic

  • Traffic hazard

  • Working Alone

  • Use buddy system or maintain periodic radio contact.

  • Drop tool to lower level

  • Drop hazard

  • Biohazardous Material

  • Insect Bite

  • Weather

  • Environmental damage

General Instructions

  • Perform 10 foot safety circle.

  • Complete job safety check sheet.

  • Ensure controls are in place for all identified hazards.

  • Keep work area tidy for the entire duration of the job.

  • Dispose of all garbage properly.

  • Place all recyclables in proper bins.

  • Put away all tools and rigging.

  • Return all unused parts to mill stores return bin.

  • Leave the job site cleaner than you found it.

  • Report activity as "Complete" in Ivara and leave feedback.

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