A-110

Authorization to Work Procedure

Section A — General and Personnel Revision 2 4 pages

Original Document

Scanned document (image-only PDF)

Extracted Text

Searchable text extracted from PDF

IGNLABS Change Control Request Form 
 
 Form: C-403-F1 CCRNo. CC-22-0477 Revision: 8 
 
 CCR No CC-24-0518 Rev 0 Due Date 12/04/24 
 
 Customer Notification Required: L] Yes M] No Date of Notification: N/A (attach evidence)
 
 SECTION 3 — Approvals [Reviewed/Approved (Y) Yes or (N) No-Initials/Date. If No, provide explanation
 ag First Routing Second Routing 
 ih sciiioied Prue Y/N Initials Date Y/N Initials Date 
 
 EHS&S, Rebecca Ste, wart Y pis? ii/o7] ayY WAF 
 
 Production Matt Keib rd naa\ (1/09/14 / 
 QA Paula Christensen y VOC. 22a) op 
 
 ‘ op) —| i= al 
 A 
 
 SECTION 4 — Change Control Implementation (DC) 
 Document Effective 
 Date orl\s{ 23 By \j BS Date orlia{ 2-4 
 
 | SECTION 5 — Change Control Closure (DC) 
 af‘All requirements included in the change control verified as complete 
 and closed my N (4 vate OWA 25 
 
 Comments 
 
 oe 
 
 

[SOP 

 Standard Operating Procedure SOP Revision 
 lon Number 2 
 o~ Labs uthorization to Wor 
 | Effective P 
 a DCC business Procedure Date age 
 m\istZ 5 Page 1 of3 
 Li. by/ Date Reviewed by/ Date Approved by/ Date 
 Y. leore hae 7 ufo7 /Zi Ml Ad 1/09/24 Hc. iz|zaey 
 2s G — 
 Title: EHS&S Director Title: COO Title: QA Director 
 
 1.0 Purpose 
 
 The purpose of this procedure is to ensure that all safety measures have been taken to protect
 
 employees from injury or illness caused by changes to the work area. Because changes to the
 workplace can create new hazards, we will not expose our employees to these potential hazards
 
 until a thorough inspection can be made. “Nothing we do is so important that it cannot be done
 safely—every time.” 
 
 2.0 Scope 
 
 This procedure applies to all changes to a work area including, but not limited to, modifications
 
 or installation of new equipment, changes in the work area, or changes in policies or
 
 procedures. “Managers and Directors bear a particular responsibility to provide clear
 leadership on health and safety issues.” 
 
 3.0 Responsibility 
 
 3.1 It is the responsibility of the Sr. Facility and Maintenance Manager to inform the
 
 EHS&S department of changes in the work area that could affect employee safety. The
 Sr. Facility and Maintenance Manager is also responsible for completing the
 
 Authorization to Work form when needed. 
 
 3.2 ‘It is the responsibility of the Sr. Facility and Maintenance Manager to inform the
 
 EHS&S department of changes or modifications to equipment and the installation of
 new equipment that could affect employee safety. The Sr. Facility and Maintenance
 
 Manager is also responsible for completing the Authorization to Work form when
 
 needed. 
 
 aus It is the responsibility of the COO to inform the EHS&S department of changes in
 
 
 

[SOP 

 Standard Operating Procedure SOPNo | Rev 
 Authorization to Work Procedure A-110 2 | Page 2 of3 
 
 production policies and/or procedures that could affect employee safety and health.
 The COO is also responsible for completing the Authorization to Work form when
 
 needed. 
 
 3.4 It is the responsibility of the EHS&S department to make an inspection of the changes,
 
 modifications, and/or installations of new equipment before employees are allowed to
 
 enter the work area. When the EHS&S department determines that the work area is
 safe for employees to enter, the EHS&S department will sign the Authorization to Work
 
 form. 
 
 4.0 Definitions 
 
 4.1 Mechanical Hazard — a hazard created as a result of either powered or manual use of
 tools, equipment, or machinery (e.g. contact, entrapment, and/or entanglement with
 
 unguarded moving parts on a machine) 
 
 4.2 Environmental Hazard — a hazard that can harm an employee without necessarily
 touching them, including noise or working at heights (e.g. exposed wires or a
 
 wet/slippery surface that may result in a trip or fall hazard) 
 
 4.3. Chemical Hazard — the introduction of a new or different chemical into the work area
 
 where employees have not been trained in the potential hazards associate with the
 chemical 
 
 4.4 Policy or Procedural Changes — changes to a standard operating procedure or working
 policy to which the affected employees have not been properly trained.
 
 5.0 References 
 
 5.1 OSHA Act 1970 Part 5(a)(1): Each employer shall furnish to each of his employees
 employment and a place of employment which are free from recognized hazards that
 
 are causing or are likely to cause death or serious physical harm to his employees.
 
 = A-110-F1, Form, Authorization to Work Form 
 
 

[SOP 

 Standard Operating Procedure SOP No Rev 
 A-110 Page 3 of 3 
 Authorization to Work Procedure 
 
 5.3 C-502, SOP, Record Storage, Retention, and Destruction 
 
 5.4 DCC Code of Conduct 
 
 6.0 Procedure 
 
 6.1 The Sr. Facility and Maintenance, Facility Manager and/or Maintenance Manager will
 
 inform the EHS&S department of proposed changes before work begins.
 
 6.2 Upon completion of the changes, Form A-110-F1 will be completed by the change
 owner and submitted to the EHS&S department for approval. 
 
 6.3 The EHS&S department will be informed of changes to policies or procedures that
 affect employee safety. These changes will be reviewed by the EHS&S before being
 
 implemented. 
 
 6.4 The EHS&S department will inspect the changes to the work area, equipment, and/or
 
 machinery before employees are permitted to enter. 
 
 6.4.1 If the new equipment or procedure inspection reveals issues that require
 
 corrective actions, the inspection form will be returned to the initiator. Upon
 completion of the required corrective action, the EHS&S department will re-
 
 inspect the changes. If no safety issues are uncovered, the EHS&S department
 will approve Form A-110-F1 Authorization to Work Form. 
 
 7.0 The EHS&S department will maintain all completed Authorization to Work forms following
 
 SOP C-502 Record Storage, Retention, and Destruction. 
 
 8.0 Revision History 

| Rev | Date | Description of Changes | CCR # | By |
|-----|----------|------------------------|-------|----|
| 0 | 04/28/21 | New procedure. N/A B. Almand l 02/21/22 Updated/added responsibilities and titles. Changed logo. CC-22-0082 B.Almand | - | - |
| 5 | 09/18/24 | ee SOP responsibilities, duties, titles, logo and company CC- | 24-0518 | R. Stewart |