╔═════════════════════════════════════════════════════════════════════╗ ║ COMMISSIONNING AND PRECOMMISSIONNING ACTIVITIES ║ ╠═════════════════════════════════════════════════════════════════════╣ ║ This form must be filled when a system, a circuit or an equipment ║ ║ must be started, energized, restarted or reenergized. ║ ║ Prior to any of these activities, this form must be signed by the ║ ║ supervisor who is directly responsible for the activity and must ║ ║ be transmitted to xxxxxxxxx Safety Department. ║ ║ ║ ╟─────────────────────────────────────────────────────────────────────╢ ║ ║ ║ ║ ║ DESCRIPTION OF ACTIVITY:________________________________________ ║ ║ ║ ║ ________________________________________________________________ ║ ║ ║ ║ ________________________________________________________________ ║ ║ ║ ║ ________________________________________________________________ ║ ║ ║ ║ ║ ║ EQUIPMENTS INVOLVED:____________________________________________ ║ ║ ║ ║ ____________________________________________ ║ ║ ║ ║ ____________________________________________ ║ ║ ║ ║ ____________________________________________ ║ ║ ║ ║ ____________________________________________ ║ ║ ║ ║ ____________________________________________ ║ ║ ║ ║ ║ ║ PRECAUTIONS: The contractors responsible for the construction, ║ ║ the installation or any other work done on the ║ ║ equipments involved have been notified. ║ ║ ║ ║ All the equipments involved have been visually ║ ║ inspected, from one end to the other and have been ║ ║ found completely safe, according to the "Testing & ║ ║ start-up procedure for mechanical equipment" and ║ ║ the "testing & start-up procedure of electrical ║ ║ equipments". ║ ║ ║ ║ All the barricades, signs, padlocks, tags or other ║ ║ protection devices required are in place. ║ ║ ║ ║ When applicable, watchmen are located at different ║ ║ strategic areas and keep radio contact with the ║ ║ supervisor of the activity. ║ ║ ║ ║ All the workers involved in the activity have been ║ ║ well informed about the procedure, they are aware ║ ║ of all the risks and they have been told all the ║ ║ precautions to be taken. ║ ║ ║ ║ ║ ║ ║ ║ SIGNATURE:___________________________________________ ║ ║ SUPERVISOR RESPONSIBLE FOR THE ACTIVITY ║ ║ ║ ╚═════════════════════════════════════════════════════════════════════╝
