Tasman Power Uncontrolled Release Of Energy CCC

• Site conducted

• Date & Time

  Date

• Task

• Work Area
  Address

• Prepared by

Guards, Barriers and Barricades

• Are all line of fire zones identified and clear of personnel?<br>

  Yes

  No

  N/A

• Is the work area and equipment demarcated and barricaded to prevent unauthorised access?

  Yes

  No

  N/A

• Is equipment guarding, barriers and barricading appropriate, in place and secure?<br>

  Yes

  No

  N/A

• Can you locate and easily access emergency stops, pull wires and dead man switches?<br>

  Yes

  No

  N/A

• Where guards, barriers and barricades have been removed, does the work plan include their reinstalment?<br>

  Yes

  No

  N/A

High Pressure Equipment Management

• Have you confirmed there is no alternative work method to eliminate use of high pressure equipment?<br>

  Yes

  No

  N/A

• Is there a requirement for the equipment to be used by a single operator?

  Yes

  No

  N/A

• Have you inspected the high pressure equipment and verified it is safe for use?<br>

  Yes

  No

  N/A

• Has a person been designated as the safety observer?<br>

  Yes

  No

  N/A

• Have you confirmed the pressure you are applying is within the operating limits of the equipment?<br>

  Yes

  No

  N/A

• Do you have the correct PPE for the task?<br>

  Yes

  No

  N/A

Isolation and Verification of Zero Energy

• Have you followed an approved isolation procedure?<br>

  Yes

  No

  N/A

• Have you placed your personal lock onto the correct isolation point?<br>

  Yes

  No

  N/A

• For unisolated work (including testing and fault finding), are you following an approved procedure?<br>

  Yes

  No

  N/A

• Have all energy sources been identified, isolated and checked for zero energy? E.g. process flows, mechanical, stored, residual, hydraulic, pneumatic, chemical, electrical.<br>

  Yes

  No

  N/A

Mechanical Integrity of Equipment

• Are there controls in place to stop high volume hoses/piping from uncontrolled movement? E.g. whip checks/lines, stop flow<br>valves, safety clips.<br>

  Yes

  No

  N/A

• Have you inspected piping, hoses and equipment to confirm their mechanical integrity and safe condition? E.g. walk the line, bolts, flanges, couplings<br>

  Yes

  No

  N/A

• Are piping, hoses and equipment under pressure correctly rated for the task?<br>

  Yes

  No

  N/A

• Is the measurement device (e.g. pressure gauge, load cells etc) used to confirm the pressure calibrated and in good working condition?<br>

  Yes

  No

  N/A

Relief Valves

• Have relief valves been inspected? E.g. check for safe and clear vent direction, integrity seal/tag<br>

  Yes

  No

  N/A

• Is the vessel pressure gauge indicating safe operating range?<br>

  Yes

  No

  N/A