COROMANDEL INTERNATIONAL LTD.

– VISAKHAPATNAM

FORM-A

PSMS/MOC/007/REV ‘3’ Rev Date:01.07.2012

Dept. - Maintenance Issue date : - 25-1-2019 Sl.No. ___________
PROCESS / EQUIPMENT CHANGE AUTHORISATION

A. DETAILS OF PROPOSAL
1. Description of Equipment/Building layout/ : GRS ALR SLIDE BLOWER (SPARE)
Instrument/Process/Piping/Raw Material

2 Is the change/modification, permanent or SPARE BLOWER

temporary?
3. Description of the present condition 4 Description of the post condition
.

5. Reason of Change/Modification? : SPARE BLOWER NOT AVALIBLE

6. Are P & I diagram and/or standard operating NA

parameters required to be changed?

7. Any process hazards or anticipated problems : NO

in the proposed change/modification?

8. Is HAZOP/HAZARD RISK ASSESSMENT : NO

(OHSAS 18001) required?
9. Does it require STATUTORY approval? : N.A
10 Drawings / sketches (Attach separate sheet) :
…

B.AUTHORISATION
COMMENTS

Plant Manager Area Maintenance. Date

In-Charge

HOD-Operations Date

Mech. Inst. Civil Electrical Date

HOD- Engineering Services Date

HOD-EHS In-Charge TSD Date

Unit Head Date

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 COROMANDEL INTERNATIONAL LTD. – VISAKHAPATNAM

FORM-A

PSMS/MOC/007/REV ‘3’ Rev Date:01.07.2012

C. COMPLETION REPORT

1. JOB COMPLETED

Dept. Inst Civil Electrical Date

head-
Maint.
2. EQUIPMENT/CHANGE
(COMMISSIONED)

Plant Manager Area Maintenance. Date

In-Charge
3. EQUIPMENT INSPECTED
(BEFORE COMMISSIONING)

In-Charge- Inspection Date

4 DRAWINGS/DEVELOPMENTS
UPDATED

In-Charge-Engineering designs Date

D. APPROVED FOR RECORDS

HOD-Operations Date

HOD- Engineering Services Date

Unit Head Date

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