Part A
Version: 1
This form must be completed by the Person in Charge (PIC) before any helicopter fuel transfer to a bulk fuel tank system onboard Fieldwood Energy platforms.
Platform: / Date Issued: / Time Issued:PIC or Senior Operator supervising/authorizing transfer:
(Minimum A Operator) / (Please Print)
Person(s) authorized to perform transfer:
(Must be adequately trained in fuel transfer procedures) / (Please Print)
(Please Print)
Item to be completed/verified: / PICInitials
1. Job Safety Analysis (JSA) completed and signed by thePIC. JSA shall accompany this authorization.
2. Verify person(s) conducting transfer is/are adequately trained and experienced in this operation.
3. Insure all fuel totes are stored in designated, segregated area, properly marked with DOT placardand JET “A” FUEL stickers on all sides and top.
4. Physically identify totes to be downloaded.
*Record Serial Number(s):______, ______, ______.
5. Insure tote is equipped with slotted cam-lock fitted valve and the seal is on top of the vented lid. (Note: Make sure the seal has not been compromised)
*If tote is not equipped with slotted cam-lock fitted valve, do not proceed with operation. Notify fuel provider to return tote.
6. Verify the fuel tote tank have been properly sumped before commencing transfer by:Draining a minimum of 1 gallon of fuel from the tote tank into a clean container and visually observe for water or other contaminants. If a clear and bright fuel sample free of water or other contaminants cannot be achieved within 15 gallons of sumped fuel, do not transfer the fuel into the main tank. Quarantine the transporter and notify your supervisor.
7. Insure dedicated fuel hose is clean, marked (Helicopter Fuel Only), and connections match fuel tote connection.
8. Make certain all valves are open, tote top is vented, commence with fuel transfer, and continuously monitor operations for possible spills.
9. Once transfer is complete, disconnect and properly store hoses, close tote top vent, install tote drain plug, and properly store tote tank for return to shore.
(Do not utilize helicopter fuel transport tank for any other product.)
File the completed form in your platform file system.
Fieldwood Energy LLC Safe Work PracticesD-24-1A