Opening piping, hoses and process equipment that has held hazardous material
Required before any line, hose, pump, vessel or flange that has held acid, caustic, steam, ammonia, flammable, combustible, oxidizer or toxic material (or anything above 140°F) is opened. No OSHA form exists for this task; the controls come from OSHA 1910.147 (lockout), 1910.1200 (hazard communication), 1910.146 (if the equipment is a confined space) and 1910.119 at process-safety-managed sites. Where the customer issues its own line-break or work permit, that permit governs and this form is attached to it.
Choose how the line was isolated. If none of these can be done, stop and get manager and safety approval before going on.
Assume the line is full and pressurized until it is opened and proven clear. A “No” means do not break the line.
Test lines holding flammable or respiratory hazards with a calibrated instrument before starting and again once the bolts are loose. Readings of 1% LEL or more turn amber (continuous monitoring and added controls); 10% LEL or more, or oxygen outside 19.5–23.5%, turn red (stop).
Wear full PPE until the system is open and proven clear. Any reduction needs the approver’s agreement and is recorded below.
Complete when the work is done. Open this record again in edit mode to add it; the original stays on file.