Document 0J7d5ay8Qb9L4a1QxBmZ2pQBV

CHECKLIST (ATTACHMENT!) Applicable n/A JLS fL Consult piping and equipment specifications. Perform Reactive Chemicals testing. 2/15/94ln-Progres$? Add materials involved to Toxic Substanoe Control An (TSCA) inventory. Calculate impact on F&EI and CEI Comply with Engineering Practices. Comply with Technology Center guidelines. Comply with Dow LAD Environmental Project Checklist. Comply with Safety and Loss Prevention requirements. Consult maintenance. (Name) ... Consult instrument and electrical technician. (Name) __________________ Consult parts technician.(Name)_________ Evaluate and modify relief system.(Name) Contact Industrial Hygiene.(Namc)_______ Contact Process Engineering. (Name).. Complete required reviews. (Name them). Other ............ ..... ............ ................. Post-Modification Checklist: (Before startup) ------- Perform pr^-startup audit. Instrument loop drawings. Electrical drawings. Complete or update training program. Job procedures written and approved. P&ID's, process flow sheets and plot plans updated. Personnel trained on the change. Critical instrument checklist updated. Computer code and documentation changed. Checklist Follow-up Originator.. _______________ Date of Origination: Proposed Date of Change ._._..._.._.__________________ Area: Permanent Temporary From Description and Location of Change (Scope) Technical Basis for Change:,, To Safety Loss Prevention Environment | | Health (...."| Alarm [ Shutdown Point 1 1 Instrument [ 1 Process Computer Control | | Addition or Removal of Equipmer Piping Modification | [ Equipment/Material Modification 1 | Chemical | | Job Procedure} Expected Completion Follow-up__________________________________________________________________________ Date Complete Follow-up Follow-up Follow-up Follow-up Follow-up Follow-up Follow-up Approvals: Originator____ _____ __________ First Reviewer_________________ Department Head/Superintendent Name RETURN TO CHECKLIST Date DO ft 025850 CONFIDENTIAL