Purpose, Standard & Outcome

  • Performance Standard: Clearances are complete with no major non conformance

  • Major Non Conformance: Key element of clearance form omitted or not adequately completed which has the potential to lead to a major incident

  • Action on Non Compliance: Clearance authoriser to undergo additional training

Clearance Details

  • Clearance No

  • Clearance Type

  • Clearance Authoriser

  • Clearance Recipient

  • Clearance Date

1 Work Scope

  • 1.1 Is the task adequately described in the Job Description?

  • 1.2 Is the scope of the work clearly defined and adequately describes all the job steps?

  • 1.3 Does the authoriser have a complete understanding of the nature and scope of the work including all steps, equipment to be used, access requirements, etc ?

  • 1.4 Does the recipient have a complete understanding of the nature and scope of the work including all steps, equipment to be used, access requirements, etc?

2 Job Safety Analysis

  • 2.1 Have all the hazards associated with each of the job steps been identified on the JRA?

  • 2.2 Do each of the hazards have an appropriate control(s) specified?

  • 2.3 PPE
    Has all the PPE been specified correctly?
    Are the PPE requirements specific, ie type of gloves worn?
    Is it being worn as per the clearance?

  • 2.4 Has the JRA been signed by all parties involved?

    All recipients?

  • 2.5 Is the job copy of the clearance and signed JRA with the recipient?

  • 2.6 When breaking into ammonia lines has the correct respiratory requirements been specified?

    Ammonia gas service - canister mask?
    Ammonia liquid service - SCBA/LLB & chemical suit?

3 Permits

  • 3.1 Have any special clearances or permits been soecified?
    Confined space?
    Working at heights?
    Excavation/break in?
    Electrical live work etc ?

  • 3.2 If so, are they adequately cross referenced?

4 Isolations

  • 4.1 Has the SIS been adequately completed including the hazards and controls associated with preparing the isolations?

  • 4.2 Are all the isolations listed on the SIS with relevant
    line number ?
    Description?
    Isolation method ?
    Tag number ?

  • 4.3 Has a marked up ELD been attached, if appropriate

  • 4.4 Are the specified isolations correct? Do they meet the isolation standards?

  • 4.5 Are all the isolations listed on the SIS signed by the authorised person to indicate they are isolated?

  • 4.6 If a MIS or Confined Space Clearance was used, has it been adequately cross referenced?

  • 4.7 Have the authoriser and recipient inspected the equipment being isolated to ensure that all the necessary isolations are in place?

  • 4.8 Are the isolations locked?

  • 4.9 Are all isolations identified with a "Danger - Do No Operate" which is cross referenced to the clearance by stating the clearance number?

  • 4.10 Is electrical test running required?
    Has this requirement been identified on the JSA?
    Has the removal and replacement of isolations been managed by the SIS?
    Has a standby person (factory rep or authorised person) been in attendance?

  • 4.11 On completion of the job:
    Have the isolations been removed?
    Are they signed as removed in the standard isolation sheet?

5 Contractor Management

  • 5.1 Does the authorised person and recipients know who the Factory Representative is for the job and were they involved at clearance issue?

  • 5.2 Is the Factory Representative physically checking the contractor's job performance:
    Adherence to work scope?
    Observing conditions of clearance?
    Safe working practices?
    Equipment condition?

  • 5.3 Is the authorised person physically checking the contractor's job performance :
    Adherence to work scope?
    Observing conditions of clearance?
    Safe working practices?
    Equipment condition?

6 Authorisation

  • 6.1 Has the clearance been authorised with time, date and correct validity period?
    Was it issued at the job location?

  • 6.2 Has the JRA been signed on by all recipients with date and time?

  • 6.3 If the work being carried out is part of a plant modification, has the authoriser ensured the modification has been approved before signing the clearance certificate?

  • 6.4 Has the clearance been returned and signed by the recipient with the date, time and comments applicable?

  • 6.5 Has the clearance authoriser inspected the job to satisfy himself that the equipment has been left in a safe and workable state?

  • 6.6 If the work is confirmed to be physically complete, has the authorised person:

    De-isolated the equipment by removing the locks and tags and signing off the SIS?
    Signed off the clearance as complete by completing the clearance status section of the job copy?
    Signed and dated the clearance correctly?

  • 6.7 If the job was not completed, has the authorised person:
    Ensured that isolations remain correctly tagged and locked and that there are no open ends on process equioment?
    Signed off the clearance as incomplete by completing the clearance status section of the job copy?

7 General

  • 7.1 Has the clearance been properly completed and clearly presented?

  • 7.2 Have the incomplete and complete clearances been filed correctly?

  • 7.3 General comments?

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