PRESSURE TESTING PERMIT
Permit No:
Date
Requesting Contractor Name
PERMIT ISSUANCE DETAILS
Work Description
Location
Permit Validity Time (from): Time (to): Date:
Design Pressure of Pipeline Operating Pressure
Pressure Time
Testing Pressure
PRESSURE TESTING DETAILS
CHECKS Y / N/ NA CHECKS Y / N / NA
Is the segment of pipeline under testing Risk assessment/ method statement
isolated from service by closing nearest developed, approved, and
valves? communicated?
Is the Liquid/Gas vented/removed from the Testing & monitoring of the environment
pipeline? prior to entry?
Emergency response procedure and
Test Head and End plug/end point are
rescue plan are developed &
properly sealed/secured/tighten.
communicated?
Is Air vented completely by pumping and
filling the water in the testing segment Operatives are trained and competent?
pipeline without pressurizing?
Pressure testing equipment in good condition
Provision of vigilance supervision?
with available safe guards
Flexible pipe/hose are in good condition and Proper barricade and signage are
connections are safely clamped posted?
Pressure testing gauge have valid Safe means of access/egress
calibration. provided?
Pressure testing gauge/ valve are in safe &
accessible place outside restricted/isolated Means of communication available?
area
Is the testing pipeline/vessel/tank are Electrical equipment & connections
properly isolated safe?
Is confined space PTW required & obtained? Other(s
Acknowledgement by Receiver (Foreman / Supervisor / Engineer – Contactor):
Acknowledge that all above precautions have been taken. These have also been fully explained to the operatives, and I consider
them competent to do it safely.
Permit Receiver – Name (Foreman / Supervisor) Designation
Signature Date / Time
Acknowledgement by Issuer (CNCEC Engineer In-charge):
Acknowledge that I have checked above control measures and consider the work area safe to carry out the activity.
Permit Issuer – Name (Engineer In-charge) Designation
Signature Date / Time
Comments (if any):
Closeout / Cancel: Name: Signature:
Permit Issuer / Authorized Person
