25
AUTHORIZATION TO OPERATE IN POTENTIALLY EXPLOSIVE ATMOSPHERES
Fill in only the parts that concern you. Delete the parts that don’t concern you.
Authorization to carry out welding, drilling, polishing, hammering and chiselling, and any other
operation which can generate flames or sparks.
This document is necessary also in case of employment of not flameproof equipments.
A.
1.
Customer…………………………Building site address …………………………………….………………………………….
Tel. ……………………………….Person in charge with safety……….. ……………………………………………………………….
2.
Location and work type ………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………………………….
3.
Permit from …...…. to ……..….. (hours) for the period of time ………………………………………………
4.
For workshop / company …………………… …………………………………Address …………………………………….
Person in charge with safety ……………….………………………………………………………………………………………………..
B. Dangerous areas in the
surroundings
In the working place, in the
buildings, of the equipments, etc.
Person in
charge
Building site
address
Telephone
1
2
3
4
C. Necessary safety measures ………………………. taken by ………………………
□
1 Checking of the pipe and equipment seal used
□
2 Fire protections and other safety measures
□
a. Water supply and extinguisher to put out the fire
□
b. Fire hose
□
c. Block off the area.
□
Workers
□ Employees □ Supervisors □ Firemen
□
d.
Remove flammable matters, possible steam, gas or dust
□
e.
□
f.
3. Signals (road, track plant, etc)
□
a.
with red flags (20 m on both sides of the work site)
□
b.
by means of signs
□
c.
barriers for tracked vehicle, detours for tankers, etc…
4. Protection against welding sparks
□
a. Covering of close pipings
□
b. Use of protective walls, a protection for the covering surface (if necessary keep it wet)
□
c. Work Interruption in case of trains traffic
□
d. Keeping a minimum distance of ……... from tank trucks, tanks etc. at the hazard of fire
□
e. Covering of grids, channel pits and lighting
□
f. ………………………………………………………………………………………………………………………………………………….
