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X <br /> W.O.# NW1-2317502 <br /> ____ _ "anl�:rtology Inc <br /> ,5501 M.MoPse LAprassway.Suftr400 Au&tin t f `87r 9 B,gwl 964-0010 PoE3 Y 100-29-A <br /> 'F JCB CLEARANCE� CORM& " D <br /> SITE SAFETY <br /> dqqETY CM CLISf $toy¢sa:cE.8!€lait":Gb <br /> —OVF <br /> ,te Name Sk(t"c°t hrfCifAs;^.;r f <br /> Cit <br /> Arrival i3Y£r Departure Timel T€evel 7 irnw� w)ers on site: ate <br /> 01 scop of Weak nd I asKW flefforincid(J A's must b@ avails SE r al t z#gy <br /> Repairs�Eq.qmsntrl.k'tovrL�d: <br /> Follow-up actions required:oquipms nt Mated:commamw A,U CI 0 8 2014 <br /> PPE«PERSONAL PR ECTIVE�Gtt1Er� 1�T R�1QUtftE Gh �stems arseyti A k� a dre f ' � TM..... <br /> Sata4s Vest Satiety Glasses apCtti t [--10 <br /> ar ' a Cq r <s <br /> .___..,. Y.. .� .... �. <br /> Tne T3nct3 S;ash Goggras s.! <br /> f <br /> ERE-TEST LROCEDURES Check each Item com tend or m r# If not u dacaAte` <br /> 1. Ct SCUSS safety prop*durers with ssita personnel, Nearest hospit <br /> 2, �rP°a 'to fuel deliveries the UST system gust he placed bade infra working ordesc. <br /> 3. *� ecure entire work area with barricades Scones flags,and caknion tarps,pennant Ylaays ;r ca he?l stir It ev Gu aid'?. <br /> A. Peace Itis exprsur8tears and"No Srracskara 'signs in ti'ie woHt area <br /> 5. implement Lockovti'I•agout per API 1646('wham accessing product pipirig during tasks) <br /> A=1 applicable equipment disaa ed dung test(a}. 5 uu, the ircurt breaker w4h t ui davfreta and tags. <br /> Sovan,nomies with"Brit of Sanrzr4t"data and nylon ties, Ventya LOTV is r uutplet by tryin to A c'rcn"Pumps <br /> Curse bell valves or cheCA vatves An Prod urt prpirieP, QI$r inn rt ei +rioel"aayo et"❑ ne r from tiie S f P s). <br /> ,tom £,g�3 uatS�i9 i.ud r"Dena ism 9 ;%aturtt <br /> General saMy Checks. <br /> All site personnel have been informed, <br /> Fuel dolivery has been infOrsned_ �-a rvs��s r s� �� nGwiur s gr�siura <br /> 3a fuel delivery due Wddy7 <br /> 1 0TO prncedures have been discussed and agreed. <br /> Wosk.areass bstrric000d to protect work ,MIT&Public, <br /> €ieav€i die-;pu�sd` t7 r.Eaaraaica form vn2h techn.=an. <br /> RES Check eacta item ream tested car mark - Purest x ti attta <br /> 1, Rewe all'LockoutfTatgottt"devices. <br /> 2. Run all pumps and verify there ars no leaks; Impact Valve Test Ports under dispensers <br /> Leek Detector Threads on S f P`v <br /> Function*Elements&Relief Screws <br /> 3. Install lead wlrai:seal can all test plugs&teak detectors that were serviCed. 7-Eletver <br /> o €si LD threads: L1 „ L2 L3 L4_ LS— L6 <br /> 4. Check fo€lowing Components operational: ATG prestiFss,scare sr <br /> Ln <br /> Sall floats,d streaks&caps Cathodic protect's Pere nail <br /> dry <br /> u, Containment sumps are dry Dispensers&P �: d �a <br /> 'tea2 <br /> Dispenser panels are replaced Drop lutxas,trli a ,ors&Lia p5 <br /> Leak detectors&vent tubes Manhole covers zxap ktdt._, <br /> Monitoring system is cperatfcarael Seer deiv es are open <br /> Siphon lines and manifold valves &peon linss and rnaraiPfolU+,"z Nes <br /> STP tiPt'stscgs and bayonet connectors Vents!not Ca0ced,p11.100ed rd <br /> 5. Remove"barricades. <br /> SMOUT c V tki3ta Cif kYcsfK f ( s a,saa,oaiurs <br /> General BANty Checks: <br /> 'Pork area has been tett tidy 4 Wfkl. <br /> Site st2 @f err resit at'vtiarz s?etas including any remaining a�An �Y„n.,r:, i., a= 2 sin we sigrssc <br /> Changes W oquipr),jont ear, docwnented and ctsmmunr,aed. <br /> Ad incidents”near incidenis,and unsafe situaRisx'sreponed. <br /> _.. �3xras�n4�'Uv mrrtnniYs: en3Q'N rvL +} a� `,7^ ..„._m <br /> COMPANY C'ONFI JL'r't"5.1: 6 'ratfksit>BiV In'..'M 1.All Itighu Re+.rwd <br /> — ---— <br /> u'rerA��v rarer ss=€=a�dcx:eruncrsr an rancuirtralicd, Th'�aUm:rit 1'C,rcia s r svrklxhl a .3 a 1 ass::uulue,v Cars Lsaaa(].,xyann„t C tuatA?`�� t m <br /> � d VF <br /> AUG 2W <br />