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W.O.# NW1-2335977 Cust Ref# : 383672
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<br /> PPE-PERSONAL PROTECTIVE EQUIPMENT REQUIRED CCheok ✓Itamr uxr�d ar rrrr"k'"fI n<yt appBi aDlat
<br /> 11 Safety Vont —Safely 0laasss
<br /> 1 olovos n;u,n,l I'nd ui
<br /> ! Steel Toe Boots I f3,lash(log las I lard lint Uthal
<br /> ✓ PRE TEST PROCEDURES (Ch6ck
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<br /> I,—i I Discuss safety procedures will)elle personnel. Noarosl hospllal.
<br /> 2. J Prior to fuel deliveries the UST system must he placorl hark 11110 working ardor.
<br /> 3. Imo-Secure entire work area with barricades(cones,flags,and bxtonsion bars,oautlon taps,,pennant flags,to„U„ r'r„„++ala'grlarrl).
<br /> 4. 1 11 Place fire extinguishers and"No Smoking”algae in tho work area.
<br /> 5. I Implement Lockout/Tagout per API 1040(when acrasaing product plphtg during tasks)
<br /> La Secure nozzles with"Out of Service"bags and nylon lies. I I 90aure Iha clfxnlll breakar(s)will)lw trout davlaas and Wig!
<br /> 17 Close ball valves or check vafves or,product piping, I I Discnnnoot olocUlr:al"bayonet"conna+•IuI hem(ha PP(!b
<br /> I l All applirable equlpmnnl disaMod dnring lest(a). I I Verify LOTO Is complslo by trying to oporala pulntw•
<br /> SIGN IN ntit .+,matin tin,a us,, a,um+.u+,•,w,.,wv
<br /> General Safety Checks:
<br /> All site personnel have been Informed. 1
<br /> Fuel delivery has been Informed. ^iia Ri,p,„rauedlva N,m,a S i,>Rw•,vrontaGva s,a,•.++
<br /> Is a fuel delivery due today?
<br /> LOTO procedures have been discussed and agrood.
<br /> Work areas barricaded to protect workers,staff R P013110 JI h,m,dlscussn
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<br /> 1. I Remove all"Lockoutri-rout”devices.
<br /> 2. 1 I Run all pumps and verify there are no Io4w 11 Impact Valve test Poll):under dispensers
<br /> I I Leak Detector Threads on STP'. 1 1 Functional klemontn`ItOW Screws
<br /> 3. 1 I Install lead wire seal on all test plugs&leak detectors that were serviced.
<br /> Count LD threads: L1 1-2 1-3 1.4 L.5 l G
<br /> 4 Check following components operational; I 1 AT(3 probes,suflsofs,&caps
<br /> I_I Ball floats,dry breaks&caps 1 I Cathodic pfotactlon operational
<br /> rI Containment sumps are dry `L ('J I 11 Dispensers&1101;operational
<br /> I I Dispenser panels are replaced 1 1 Drop lubes,fill adapters&caps,
<br /> I I Leak detectors&vent tubes `�s I ll�I I I Manhole covers and mimp lids
<br /> I I Monitoring system Is operational r" 11 F I I Shear Volvos are upon
<br /> 1 I Siphon lines and manifold valves .) I I Spill containers&drain valves
<br /> I I STP fittings and bayonet connectors r� 1 1 Vents(not capped,plugged oT isolated)
<br /> 5 1 I Remove barrlcados,
<br /> _ SIGN OUT&Operator Verification of Work(OVF) "a` Ttnlmlc An ,""e `
<br /> Gonaral Safely Checks: ( _ �-
<br /> Wolk neon this boon left tidy&sale.
<br /> ,'A081011'81011'are aware of work status Including any remaining(solation -M1--11-o iaa.n a vn N
<br /> Changes to equipment are documented and communicated.
<br /> All Incidents,near Incidents,and unsafe situations reported, ,1, , .
<br /> COMPANY CONFIDENTIAI, n, md,�.•"� la, , ',IIS 111�t3n•t<;.
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<br /> OVf RECEIVED BY EHD:
<br /> 7/27/2021
<br /> (received via Crompco Vault Portal)
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