Impairment Submittal Form
Impairment Log | Impairment Submission Form | Operations Review & Database Editor



Fire Protection Impairment System O.O.S. Form

Date:                Unit 1         Unit 2

Clearance Permit No.:       

WO No.       

1.       Affected System          CO2     Halon     Water

2.       Building/ Area Affected  

3.       Date/Time - Out of Service          

4.       Expected Return To Service Date:     

5.      Reason for System O.O.S.    (Failure, DCP, WO, PMP, ___, etc.)
                    

6.      Compensatory Action             
:
7.      Valves Closed:    

8.       Panel De-energized      

9.       Name of Work Party Supervisor:     

10.     Fire Watch Provided:        Yes     No    
                    If Yes, type Fire Watch?                           Continuous       Hourly       N/A [Later]

11.     Was F.P.  Engineer Notified?            Yes    No

12.     Was NEIL Notified                               Yes    No  
                     If Yes, Notified By    
                    

13.      Compensatory Measures Taken?          Yes     No  
                    If Yes, Identify Measures:      
                   
 

     

OPERATION's REVIEW SECTION


14.     Signature of SM or US Authorizing Work                         
                                                                                                               SM/US                                                Date

      Approved by Operations           Yes   No