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π MASTER PERMIT
Unit Work Permit
Master Permit - Coordinating All Work Activities
π New Permit
β Close Out Permit
π Section 1: 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 Group Leader
*
Tools/Equipment
Work Description
*
Respiratory Protection Required?
Yes
No
Hot Tapping Operations?
Yes
No
Hydro Testing?
Yes
No
π§ Section 2: Area Operator Requirements
β οΈ Complete this section with the Area Operator. Systems bypassed must be documented in DSD log.
Fire/Halon System Bypassed?
Yes
No
N/A
Remote Shutdowns Disabled?
Yes
No
N/A
π¬οΈ Section 3: Atmospheric Testing
Atmospheric Testing Required?
*
Yes
No
β οΈ Section 4: Critical Hazard Categories
π¨ Check ALL applicable hazard categories. Each checked category requires specific controls and documentation.
πͺ Heights / Fall Protection
π Working Over Water
π¨ High Pressure Work
ποΈ Lifting Operations
π₯Ά Low Temp / High Wind
π¦ Manual Material Handling (>50lb)
π§ Excavation / Trenching
β Other High Hazard Work
π Section 5: Task/Hazard/Mitigation Analysis
Task
Hazard
Mitigation
Special Precautions / Additional Notes
β Section 6: General Verification
βΉοΈ All applicable items must be verified before work begins. Mark N/A if not applicable to this work.
V1: Work area/equipment compatible and safe for work
V2: ACWR/Pre-job safety review complete
V3: Correct tools and equipment for task
V4: Zero energy state verified (if applicable)
V5: Work may cause remote alarm or shutdown
V6: Work near halon/water mist discharge nozzle
V7: Hoses and cords properly secured
V8: All hazards discussed with workers
V9: Critical lift plan reviewed (if applicable)
V10: Flammable liquid transfer controls in place
β’οΈ X-Ray / Radiography Verification (if applicable)
XR1: Warning signs and lights posted
XR2: Boundary limits clearly delineated
XR3: UVs bypassed (if required)
π· Section 7: Crew Sign-In
βΉοΈ All crew members must acknowledge hazards before beginning work. Add each crew member below.
Select Company...
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
+ Add Crew Member
π Section 8: Related Permits
βΉοΈ Reference any related permits that apply to this work scope.
Hot Work Permit #
Confined Space Entry Permit #
Energy Isolation (LOTO) Permit #
Process Opening/Blinding Permit #
βοΈ Section 9: Authorization
Work Group Leader Signature
*
Supervisor Approval
*
Board Operator
Area Operator
*
Start Time
*
Expiration Time
*
Submit Permit
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