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Management of Change

Information

Change Initiator

Discription of proposed change

Area of Change

Proposed Date and Time to implement Change?
Engineering

Will the change bring about alterations to the original design of machine/equipment?

Will the change bring about a change to maintenance, equipment operating methods, or safety devices?

Will the change result in a negative impact on pressures, temperatures, lubrication, emissions, vibration or ergonomics?

Will the change initiate any new construction, modification of existing facilities, or decommissioning activities?

Will the change requie or involve any excavation, soil contamination or contamination of ground water?

Will the change involve, result in or generate radioactive,hazardous or mixed waste such as any new or altered carcinogenic, corrosive, biological ,radioactive, or infectious chemical or agents?

Will the change requier the use of large quantities of flammable liquids?

Will the change require that combustable liquids are heated above or close to their flashpoints?

Does the change require the use of storage tanks or the storage of large quantities of hazardous, radioactive, flammable or combustible materials?

Does the change involve any High -energy sources( e.g. Radiation, electromagnetic, laser, compressed gasses, propellants and/or explosives?

Will the change alter any pre-start inspection schedule?

Does the change alter the validity of of any certification, exemptions, or permissions?

Operating and Design

Will the change alter existing hardware and/or control software?

Will this alter emergency response used on site?

Quality

Will the change have an impact on the quality of the product or service?

Will the change have an impact on the quality of maintenance?

Operating Personnel

Have personnel changed?

Has a person's area of responsibility changed?

Do people require additional training to accomodate the change?

External Personnel on the site

Does the change require additional contractor personnel to be employed outside the current contract?

Will the change require a change in scope of work conducted by contractor personnel?

Will the change require a change in contractor company performing the work?

Regulations, Standards, or Code of Practice

Is the change as a result of a significant change in regulations, standard operating procedures, or any code of practice?

Is the change as a result of a client requirement, standard?

Is there a change required to procedures and/or training material?

Not covered in procedures or code of practices?

Organisational Structures

Will the change require significant alterations to the organisational structure?

Suppliers, Community and/or Client/User

Are there any added health, safety, and environmental risk to the suppliers, clients, users or the community?

Is there any added financial risk to the shareholders?

Are there any legal implications between the suppliers, clients, users and or community?

Other

Is there any added risk to personnel with regards to health & safety

Is there any added risk to the environment such as altering existing environmental status by generating any new or altered airborne emissions, liquid effluents, or solid debris, or affect the approved environmental management system?

Will the change require new or additional PPE?

Is there any negative impact on any of the fatal risks?

Completion

Is the change Permanent or Temporary

Comments

Name and signature

Management of Change (MOC) Procedure Template Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 52

Management of change procedure template helps safety officers identify and control occupational health and safety risks brought by organizational changes. Use this MOC template to review operational procedures and determine changes where risks may occur. Help the organization comply with legal and industry standards for workplace health and safety using iAuditor.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

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Management of Change

Information

Change Initiator

Discription of proposed change

Area of Change

Proposed Date and Time to implement Change?
Engineering

Will the change bring about alterations to the original design of machine/equipment?

Will the change bring about a change to maintenance, equipment operating methods, or safety devices?

Will the change result in a negative impact on pressures, temperatures, lubrication, emissions, vibration or ergonomics?

Will the change initiate any new construction, modification of existing facilities, or decommissioning activities?

Will the change requie or involve any excavation, soil contamination or contamination of ground water?

Will the change involve, result in or generate radioactive,hazardous or mixed waste such as any new or altered carcinogenic, corrosive, biological ,radioactive, or infectious chemical or agents?

Will the change requier the use of large quantities of flammable liquids?

Will the change require that combustable liquids are heated above or close to their flashpoints?

Does the change require the use of storage tanks or the storage of large quantities of hazardous, radioactive, flammable or combustible materials?

Does the change involve any High -energy sources( e.g. Radiation, electromagnetic, laser, compressed gasses, propellants and/or explosives?

Will the change alter any pre-start inspection schedule?

Does the change alter the validity of of any certification, exemptions, or permissions?

Operating and Design

Will the change alter existing hardware and/or control software?

Will this alter emergency response used on site?

Quality

Will the change have an impact on the quality of the product or service?

Will the change have an impact on the quality of maintenance?

Operating Personnel

Have personnel changed?

Has a person's area of responsibility changed?

Do people require additional training to accomodate the change?

External Personnel on the site

Does the change require additional contractor personnel to be employed outside the current contract?

Will the change require a change in scope of work conducted by contractor personnel?

Will the change require a change in contractor company performing the work?

Regulations, Standards, or Code of Practice

Is the change as a result of a significant change in regulations, standard operating procedures, or any code of practice?

Is the change as a result of a client requirement, standard?

Is there a change required to procedures and/or training material?

Not covered in procedures or code of practices?

Organisational Structures

Will the change require significant alterations to the organisational structure?

Suppliers, Community and/or Client/User

Are there any added health, safety, and environmental risk to the suppliers, clients, users or the community?

Is there any added financial risk to the shareholders?

Are there any legal implications between the suppliers, clients, users and or community?

Other

Is there any added risk to personnel with regards to health & safety

Is there any added risk to the environment such as altering existing environmental status by generating any new or altered airborne emissions, liquid effluents, or solid debris, or affect the approved environmental management system?

Will the change require new or additional PPE?

Is there any negative impact on any of the fatal risks?

Completion

Is the change Permanent or Temporary

Comments

Name and signature