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Feb 21 03 10: 59a TRIT Environmental System (9161 858-1011 p. 16 <br /> BP/ARCO Work Permit <br /> Datc: <br /> I7! <br /> Company: B?WEST COAST PRODUCTS,LLC. Job%W.O.# O <br /> AL �?7ell <br /> 1 Facility No. Arco 095 Permit is not valid more,han 12 hours without reauthorization <br /> Description of Work: <br /> ! <br /> Type of Pe='t Safe Work ❑Hot Work []Confined Space Entry <br /> Safe Work Permit See BP/ARCO Code of Safe Practices for additional re uirerneats <br /> Personal Protective'Equipment <br /> rd Hat Fall Protection MSDS Availabie Haz,Waste Operation: <br /> 2 I ( afety Glasses Gloves: Respiratory Protection: ❑Level A <br /> ❑Goggles u ber ❑Dust Mask ❑Level B <br /> ❑Face shield ❑Leather ❑Hose Line ❑Level C <br /> ❑Chemical Resistant.Boots ❑ Other: ❑Cartridge Respirator ❑Disposable Coveralls <br /> S e 'atConcerns <br /> cnzene, cerris n ur Xylene ❑Acid/Caustic ❑Potential Orders ❑Excess Dust <br /> Man Made Mineral Fiber 17PCB Handling F1Asbestos ❑Excess Noise <br /> ❑Hazardous Waste Generation <br /> Safe Work Procedures <br /> Lockout/Tagout ❑Crane Operation ❑Scaffolding <br /> 4 ❑ Vacuum Truck ❑Work at Elevations ❑Excavating <br /> ❑Method Statement aOther Procedure <br /> Equipment condition <br /> 5Out of Service ❑Depressured ❑Nitrogen Purged ❑Drained <br /> In Service ❑Pressurized ❑Water Washed Neutralized <br /> Hot Work Permit <br /> F1 Fire Watch Provided ❑Oil and Combustibles Removed ❑Continuous Monitor Required <br /> 6 ❑Sewers Covered ❑Sparks contained ❑Fire extinguisher Required <br /> ❑ <br /> Are Shieided <br /> Confined Space Entry Permit <br /> ❑Harness/Lifelines Required ❑Davit'Tripod Required ❑Rescue Winch Required <br /> 7 I ❑Atteadant(s)Designated ❑Communication Equipment Required ❑Ventilation Equipment Required <br /> ❑ Sign in Roster initiated ❑Adjacent Areas Checked for Hazards ❑Nearby Workers Notifted <br /> ❑Continuous Monitorin required Warningsigns/Barricades Required —[]Access Ladders)Re ui:cd <br /> Vapor Test Results Vapor Tests are required for Hot Work,Confined Space Entry and Some Special Hazards <br /> Tested For: Tune and Date <br /> ❑Oxygen %Vol, <br /> ❑Flammable Vapors %LFL <br /> 8 ❑Other PPM <br /> ❑ Other PPM <br /> Supervisors Initials <br /> Authorization <br /> I Additional Restrictiors: -- <br /> 9 — <br /> Signature required for Hot Work and Contlned Space Entry: Time Date <br /> Safety Representative or Contractor Su ervisor <br /> Call 911 for Emergencies <br /> 1 <br />