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🔧 OSHA 1910.147 | API RP 2016
Process Opening/Blinding Permit
Line Breaking & Pipe Opening Safety
📝 New Permit
✅ Close Out Permit
📋 Permit Information
Permit Initiator
*
Date
*
Company
*
Select...
A-C Electric
AKE-Line
Apache Corp.
Armstrong Oil & Gas
ASRC Energy Services
CCI-Industrial
Chosen Construction
CINGSA
Coho Enterprises
Conam Construction
ConocoPhillips
Five Star Oilfield Services
Fox Energy Services
G.A. West
GBR Equipment
GLM Energy Services
Graham Industrial Coatings
Harvest Midstream
Hilcorp Alaska
MagTec Alaska
Merkes Builders
Narwhal Exploration
Nordic-Calista
Parker TRS
Peninsula Paving
Pollard Wireline
Ridgeline Oilfield Services
Santos
Summit Excavation
Tesoro Refinery
Yellowjacket
Other
Location
*
Select...
Kenai
CIO
Beaver Creek
Swanson River
Ninilchik
Nikiski
Other Kenai Asset
Deadhorse
Prudhoe Bay
Kuparuk
Alpine
Willow
ENI
PIKKA
Point Thompson
North Star Island
Endicott
Badami
West Harrison Bay
Other North Slope
Phone/Radio
Work Area/Unit
*
Line/Equipment ID
*
Opening Type
*
Select...
Flange Break
Valve Removal
Pipe Cut
Equipment Opening
Filter/Strainer Service
Pump Seal Replacement
Instrument Removal
Vessel Entry
Other
Process Contents
*
Select...
Crude Oil
Natural Gas
Condensate
Produced Water
Glycol
Methanol
Diesel
Hydraulic Fluid
Lube Oil
Steam
Compressed Air
Nitrogen
Chemical
Other
Purpose of Opening
*
🌡️ Process Conditions
⚠️ Verify process conditions before initiating any line break. Pressure must be verified at ZERO before opening.
Normal Operating Pressure (PSI)
Normal Operating Temp (°F)
Current Pressure (PSI)
*
Current Temperature (°F)
*
Pressure Verified Zero?
*
Yes
No
Temperature Safe for Work?
*
Yes
No
☣️ Hazardous Materials Present
🚨 CRITICAL: Identify ALL hazardous materials. This determines required PPE and safety precautions.
🔥 Flammable Contents
☠️ Toxic Contents
⚗️ Corrosive Contents
💀 H2S Present
⚠️ Benzene Present
🏗️ Asbestos Present
☢️ NORM Present
💥 Pyrophoric Materials
🌫️ Inert Atmosphere
❓ Other Hazmat
🔒 Isolation Requirements
ℹ️ Proper isolation is critical for safe line breaking. Double block and bleed is preferred for hazardous contents.
LOTO Required?
*
Yes
No
Double Block and Bleed?
Yes
No
N/A
Single Block and Bleed?
Yes
No
N/A
Line Blinding Required?
Yes
No
Line Drained?
Yes
No
N/A
Line Depressurized?
Yes
No
N/A
Line Purged?
Yes
No
N/A
🌬️ Atmospheric Testing
Atmospheric Testing Required?
*
Yes
No
🦺 Required PPE
ℹ️ Select ALL required PPE based on identified hazards. PPE requirements are hazard-driven.
Face Shield
Chemical Splash Goggles
Hard Hat
Chemical Resistant Gloves
Leather Gloves
Chemical Suit
Tyvek Suit
FR Clothing
Steel Toe Boots
Rubber Boots
Hearing Protection
Fall Protection
Respiratory Protection Required?
Yes
No
🛡️ Additional Safeguards
Continuous Atmospheric Monitoring
Fire Watch Required
Spill Containment
Drain/Catch Basin
Absorbent Materials
Emergency Shower Nearby
Eyewash Available
Fire Extinguisher
Wind Direction Considered
Barricades/Signs Posted
Hot Work Permit Required?
Yes
No
Confined Space Entry Required?
Yes
No
✔️ Pre-Work Verification
⚠️ ALL items must be verified before initiating line break. Stop work if any item cannot be confirmed.
Pre-Job Briefing Conducted
Hazards Communicated to Crew
Emergency Procedures Reviewed
All Isolations Verified
Operator Notified
Control Room Notified
✍️ Authorization
Responsible Operator
*
Area Supervisor
*
Performing Supervisor
*
Start Time
*
Expiration Time
*
Submit Permit
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