Plant Control of Change Form

• Site impacted by change

  Select

• Change Title

• Originated on

  Date

• CoC Owner

• Originator

• Change reference number

• Please select type of change request

  Permanent

  Temporary

  Emergency

• Reason change is an Emergency.

• Date that Temporary change will no longer be required.

  Date

This section to be completed by originator

• Date required

  Date

• Plant zone

  Select

• Description- please attached photos, sketches, marked-up drawings by clicking "Media" below this question

• Additional information

This section to be completed by Change Reviewer Committee

• Priority Driven by:

  Select Standard Priority Environmental Priority Safety Priority Operability Priority Financial Priority

  • Standard Priority
  • Environmental Priority
  • Safety Priority
  • Operability Priority
  • Financial Priority

• Job Summary:

• Change Request Form Approved or Refused

  Approved

  Refused

  On Hold

• Reason for refusal

Scale of Change

• Will this change impact ATEX/DSEAR Assessments?

  Yes

  No

• Will this change impact Pressure Systems (PSSR/PED)

  Yes

  No

• Will this change impact the Environmental Permit?

  Yes

  No

• Will this change require CDM?

  Yes

  No

• Will this change require a new HAZOP and/or LOPA?

  Yes

  No

• Will this change impact, or potentially require new, Safety Instrumented Functions (SIFs)

  Yes

  No

• Will this change alter the Basis of Safety or impact the assumptions in the plant ALARP?

  Yes

  No

• If the answer to one or more of the above questions is Yes, then this constitutes a MAJOR change

• Scale of Change- Approval

  Major

  Minor

• Operations Director Approval:

  Sign

• Engineering Director, Board Director or

  Sign

• HOPO/HOPE Approval:

  Sign

• Process Engineering Manager Approval:

  Sign

Site Safety Impact

• Will the Fire Risk Assessment need to be reviewed?

  Yes

  No

• Will the existing HAZOP/LOPA need to be reviewed?

  Yes

  No

• Will the change be subject to PUWER?

  Yes

  No

• Will this change effect Access to plant or equipment?

  Yes

  No

• Will the change be subject to LOLER?

  Yes

  No

• Do site safety Signs need to be updated as a result of this change?

  Yes

  No

WHICH OF THE FOLLOWING PLANT DOCUMENTATION IS IMPACTED BY THIS CHANGE?

• PFD/P&ID

  Yes

  No

• Which PFDs/P&IDs will be effected? Please list and raise a DCR for the affected drawings.

• Enter relevant DCR Number here

• Electrical Drawings

  Yes

  No

• Which Electrical Drawings will be effected? Please list and raise a DCR for the affected drawings.

• Enter relevant DCR Number here

• Drawings

  Yes

  No

• Which drawings will be effected? Please list and raise a DCR for the affected drawings.

• Enter relevant DCR Number here

• DSEAR Zone

  Yes

  No

• Risk Assessments

  Yes

  No

• Which Risk Assessments will be effected? Please List

• Safe Working Procedures

  Yes

  No

• Which Safe Working Procedures will be effected? Please List.

• CoSHH Assessments

  Yes

  No

• Which CoSHH Assessments will be effected by this change? Please List.

• O&M Manuals in CMMS

  Yes

  No

Environmental Impact

• ISCC

  Yes

  No

• Emissions

  Yes

  No

• Noise

  Yes

  No

Regulatory Considerations

• Other

  Yes

  No

Process Condition Change

• Changes to T, P, Flow, Level etc.

  Yes

  No

• New Materials

  Yes

  No

Personnel

• PPE

  Yes

  No

• Training

  Yes

  No

Engineering & Design

• Civils

  Yes

  No

• Equipment Testing

  Yes

  No

• Planned Maintenance

  Yes

  No

• Control System & Instrumentation

  Yes

  No

• Earthing

  Yes

  No

• Does this change involve the creation of new Assets?

  Yes

  No

• Which Asset Tag No.s have been created for this change? Please list below.

• Have Asset Tags been ordered/printed?

  Yes

  No

• Plant Labelling (tags etc.)

  Yes

  No

• Interlocks

  Yes

  No

Operating Procedure Changes

• New/Updated Procedure required

  Yes

  No

• Commissioning plan required

  Yes

  No

• Temporary Work Instruction required

  Yes

  No

• New/Updated Risk Assessment Required

  Yes

  No

Other

• Other

• Are change impacts correctly documented and actions raised to address? Have those actions been sufficiently progressed to allow implementation?

  Yes

  No

  N/A

• Scale of change

  Major

  Minor

• Operations Director- Approval for Implementation

  Sign

• Engineering Director- Approval for Implementation

  Sign

• Enter Work Order Number raised.

• HOPO/HOPE- Approval for Implementation

  Sign

• Process Engineering Manager- Approval for Implementation

  Sign

• Enter Work Order Number raised.

• Have all actions been completed?

  Yes

  No

  N/A

• Are any open actions intrinsic to the safe use of the modification?

  Yes

  No

• This CoC Cannot be signed off for use. THE MODIFICATION CANNOT BE USED

Physical Checks

• Have all plant Isolations been removed?

  Yes

  No

  N/A

• Have all drain/vent valves been closed?

  Yes

  No

  N/A

• Have all isolation valves been opened?

  Yes

  No

  N/A

• Has motor direction been confirmed?

  Yes

  No

  N/A

• Has the system been pressure/vacuum tested?

  Yes

  No

  N/A

• Has scaffolding been removed if no longer required?

  Yes

  No

  N/A

• Have all fixed and removeable guards been refitted?

  Yes

  No

  N/A

Plant Documentation

• Have all drawing changes been completed & uploaded to IMS ?

  Yes

  No

  N/A

• Have required procedure changes been made and revised procedures issued?

  Yes

  No

  N/A

• Has any new or changed asset details been updated in the CMMS?

  Yes

  No

  N/A

• Are all relevent staff aware of the modification and its purpose?

  Yes

  No

  N/A

• Have all HAZOP/LOPA actions been acceptably closed?

  Yes

  No

  N/A

• Have all required changes to the DCS/HEMA been made and tested?

  Yes

  No

  N/A

• Have relevent Preventative Maintenance activities been updated in the CMMS?

  Yes

  No

  N/A

Systems

• Have all required assets been created and detailed correctly in the CMMS?

  Yes

  No

  N/A

• Have Asset Tags been issued and correctly applied to the assets in the field?

  Yes

  No

  N/A

Other

• Has all installation debris & tools been removed?

  Yes

  No

  N/A

• Has training been delivered and training records updated?

  Yes

  No

  N/A

• Have Operations check sheet/log templates been updated?

  Yes

  No

  N/A

• Has a "Heads-Up" been raised to communicate the new system/procedures etc to Operations & Maintenance?

  Yes

  No

  N/A

• Is Modification safe/ready to use?

  Yes

  No

  N/A

• Scale of Change- Completion

  Major

  Minor

• HOPO Acceptance:

  Sign

• Operations Director Approval:

  Sign

• Engineering Director Approval

  Sign

• HOPO/HOPE Approval:

  Sign

• Process Engineering Manager Approval:

  Sign

Change Review

• Date of Review

  Date

• Is this change still required?

  Yes

  No

• Review the actions that were required in Part 3 - Impact Action Checklist to implement the change and create new actions to reverse those changes in each relevant section.

• Have all reversion actions been suitably completed?

  Yes

  No

  N/A

• Change Reviewers to complete Part 8 - Completion/Closure

• Should this be converted to a Permanent change?

  Yes

  No

• Date of next review (Can be no greater than 3 months from the date of this review)

  Date

• Are additional actions required to convert this change to Permanent?

  Yes

  No

• Have all actions associated with this Change been completed?

  Yes

  No

  N/A

• Change Reviewers to complete Part 8.

• Are all actions associated with this change complete?

  Yes

  No

  N/A

• Is the changed equipment, plant or process functioning correctly without issue? (N/A if this is a Temporary change that has been reversed.)

  Yes

  No

  N/A

• If the answer to all of the above is Yes or N/A, then the CoC can be closed. To Close the CoC click "Complete Inspection" below.