Title Page
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Audit Title
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Date of assurance:
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Completed by:
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Site:
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Work Description:
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Was the work well defined (description) in PTW?<br>(Review at least 50% of PTW issues in last 3 months)
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Was work completed by licensed/authorized person?<br>(In accordance with local/Shell requirements?)
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Was Job Hazard Analysis (JHA) submitted for the required work?<br>(JHA must identify all critical steps of the activity)
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Was competent person appointed to apply lock-out tag-out (LOTO) on the affected electrical system?<br>(Verify the license or permit)
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Was "as built" drawings and diagrams used for the application of permits and identification of isolation points for LOTO?<br>(Review drawings attached to PTW?)
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Was any test conducted at the working point for stored energy or hazard after LOTO?<br>(Review task sheet and interview the person)
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Was physical barrier and signage erected to prevent access to affected work area?
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Were electrical workers equipped with insulated tools including ladder?<br>(Physically examine the tools and equipment)
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Were electrical workers wearing PPE mentioned in PTW?
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Are affected parties informed of the plans to apply/remove the LOTO and restore the electrical system?
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Were PTW closed and all isolation points reinstated for operation?
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The inspection checklist for electrical work has been verified in accordance with the requirements listed.
