Confined Space Work Permit Meraux Refinery June 1

Confined Space Work Permit Meraux Refinery June 1, 2011 Contractor Name Permit Requestor Information: Company: Meraux Refinery Area/Unit Permit Holder: Equipment # # Persons: Date Work Order # (s) Description PPE Time Job Complet ed Initial s CR CR CR Job Hazards Subtitle 1 Task 2 Task Job Hazards 3 Y Task es Access and Egress CR Activities of Others Adverse Weather Standard (SSP-0011) Full Face Shield Goggles Hearing Protection Fall Protection Chemical Gloves Chemical Suit Respirator ½ face Respirator Full Face Air Supplied Hood/Air line SCBA Other -- References / Documents Yes Moving Parts 4 Req’d q Unit Safe Upper and Lower Limits Spreadsheet Noise Task Rail Movement Chemical Exposure Sharp Edges Electricity Slips, Trips, and Falls Fatigue Static Electricity Fire and Explosion Trip Injuries Ground Contamination Trapped Pressure Manual Handling Working at Height Special Instructions q Issue Environmental q Issue WARNI NG Quality Assurance Other: q Issue q Any applicable warning. CAUTION q Any applicable caution. q Procedure Completed Date: ________ Chief Operator Signature: __________________________ Y Y

Title of Procedure (continued) Time Complet ed Are a Unit Operating Procedure # Certified by Revision # Date Page 2 Crude OPS-CR Mark Binder / Jason Tolar 0 4/15/11 2 of 2 Subtitle Job / Initials CR CR CR 1 Task 2 Task 3 Task WARNING CR q Procedure Completed 4 Any applicable warning. Task Date: ________ Chief Operator Signature: __________________________