APPENDIX 3.

2: EXAMPLE OF THE RECORDING OF PROOF

TEST RESULTS

The following example is included to illustrate a structured approach to the recording of results.
Attention is drawn to the following characteristics:
the specification of test equipment;
the requirement to record calibration and corrective actions (step 1) [consistent with
principle 4.2.1 (e)];
the specification of acceptable tolerances (heading panel and step 10);
instructions detailing the action to be taken on discovery of a fault (step 11);
the recording of the test result in the form of a code number allowing future analysis,
reporting and review [consistent with principle 4.5.1 (b)].

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 TRIP & ALARM TESTING
LOOP : (CLASS A)

SETTING LIMITS UNITS TEST INTERVAL :

PROCESS
INSTS

TEST METHOD

TITLE :

ACTION OF TRIP :

TEST EQUIPMENT :

LOOP NO :

DATE :

*** This Trip/Alarm protects against a SERIOUS hazard ***

Note : This test to be carried out during plant SHUT DOWN.

1. Ensure that there is a valid PERMIT to WORK for this test. Inform the
Panelman that testing is about to be carried out.

Check calibrate, note values in Comment box and correct as necessary.

Setting :

2. Panelman to open valves [1], [2], [3], [4], [5].

3. One man to remain in the Control Room, the other to carry out the outside
work.

4. Isolate the impulse lines. SLOWLY open the LP vent needle valve to allow
the pressure to fall SLOWLY, the high [process] alarm will be initiated but
continue to allow the pressure to fall until the Extra high [process] trip
annunciator is initiated.

5. When the annunciator is initiated, note the recorder/indicator reading in the

Comments box.

RESULTS

0 PASS 0 RETESTED OK
1 OPERATED EARLY 1 BLOCKAGE 1 INITIATOR 1 NO SPARES
2 OPERATED LATE 2 CALIBRATION ERROR 2 LOGIC 2 NO TIME/LAB
3 DID NOT OPERATE 3 BREAKAGE 3 SOLENOID VALVE 3 NOT KNOWN
4 FOUND DEFEATED 4 S/D MECHANISM 4 NEEDS S/D
5 WET/STUCK 5 DESIGN
9 NOT DONE 9 OTHER 9 OTHER 9 OTHER

1 PROCESS LIMITATION COMMENTS :

2 NO ACCESS
3 NO TEST EQUIPMENT
TEST RESULT 4 PLANT IS SHUTDOWN
5 UNABLE TO DEFEAT
6 NO I-E EFFORT
7 NO PROCESS EFFORT
8 PLANT SHUTDOWN REQD
9 OTHER

INSTRUMENT : ..............................................................

PROCESS:................................... ELECTRICAL:.......................................................... DATE ........./........../.........

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6. Check that valves [1], [2], [3], [4], [5] have tripped closed.

7. Recommission the D/P cell.

8. When conditions are stable, reset the trip using the Reset button.

9. Ask an authorised person to reset all conditions [1], [2], [3], [4], [5]. Check
that the associated data alarms have returned to normal.

10. Check and record the zero reading of the transmitter at process pressure. If it
is in error by more than 2.5% of full scale, then the test has FAILED.

11. If any part of the system failed to operate correctly or if the reading did not
correspond with the required trip or alarm setting within the prescribed limits
then the test has failed. Check each item of the loop. Repair where necessary
and re-test If extensive repairs have to be carried out, inform the Process
Supervisor.

12. Check that the [process] indication and annunciator(s) have returned to
normal. Ensure that valve(s) [1], [2], [3], [4], [5] have returned to normal.

13. Inform the Panelman that testing has been completed.

14. END of TEST.

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 APPENDIX 3.3: EXAMPLE OF PROOF TEST DOCUMENT
CONTROL

The following example is included to illustrate some of the principles of effective document
control.
Attention is drawn to the following characteristics:
reference to company, plant and unit;
unique document reference number [consistent with principle 4.3.1 (b)];
reference to the specific SIS;
revision history [consistent with principle 4.3.1 (b)];
specific reference to risk assessment [consistent with principle 4.7.1 (a)];
multiple approvals [consistent with principle 4.6.1 (c)];
definitions of the meanings of the different approvals [consistent with principle 4.6.1
(b)];
reference to a controlling procedure for the management of controlled documents
[consistent with principle 4.3.1 (b)].

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 Company Plant Unit

Procedure Number:

SIS Reference Number

DOCUMENT CONTROL SHEET

Document Issue A B C D E
Date
Risk Assessment No.

Responsibility Print Name Signature Date

Document Owner
Author of change or new procedure

Document Approver (Technical)

Procedure is correctly structured
and technically accurate

Document Approver (Process)

Procedure is correctly structured
and achieves purpose & scope
without adversely affecting process

Document Administrator
(Technology)
Procedure has been risk assessed
and will be filed as master copy

Refer to document number xx/xxx/002 Management of Controlled Documents for explanation

of individual responsibilities.

xxx/xxx/103 Issue A Page of

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