All Signatures are Required PRIOR to Hot Work Start. Time Start Time Expires Authorized Print NameSignatureDate Permit Holder Permit Issuer (Chief Operator) Unit Operator Fire Watch Hot Work Permit Permit Number: Information to be completed by Permit Requestor/HolderCompany:  Meraux Refinery Contractor Name  Area/UnitPermit Holder: Tools/Equipment to be used: Equipment # # Persons: Work Order #:  Hand tools  Lift trucks  Double Insulated Electric Other: Scope of Proposed Task: Please initial that the Scope of work is clear and understood. Permit Holder: Permit issuer: Information to be completed by Permit Issuer. (Must be Chief Operator) Previous Product in Equipment: MSDS Checked  Yes  N/A Additional PPE Required? All Signatures are Required PRIOR to EXTENDING permit into the following shift. Time Start Time Expires Authorized Print NameSignatureDate Permit Holder Permit Issuer (Chief Operator) Unit Operator Fire Watch Equipment Pre-Work Req’d Done Equipment Pre-Work Req’dDone Area Preparation Req’dDone LOTO Procedures FollowedY -- NLock Box Number:Y -- NTrained Fire-WatchY -- N Blinded/DisconnectedY -- NDecontaminationY -- N Orange VestY -- N Equipment Opened/DepressurizedY -- N Water WashedY -- N Signal HornY -- N Valves-Closed/Tagged/Chained/LockedY -- N N2 PurgedY -- N Fire ExtinguisherY -- N De-energized Electrical SystemsY -- N SteamedY -- NArea “Wet Down” Y -- N Electrically Locked/tagged outY -- N OtherY -- NSumps-drains coveredY -- N Field Test / Attempt to Energize-startY -- NRadioactive Sources SecureY -- NContained SparksY -- N Blinds Verified & Blind-List initialedY -- N120V Electrical equip GFCIY -- NClean-up Oil in AreaY -- N Additional Fire EquipmentY -- N Additional StandbyY -- N Test 1 Test 2 Test 3 Test 4 Date Time Oxygen LEL H2SH2S CO Benzene Other Serial # Calibrated? Initial -- Meraux Qualified Person Signing this Hot Work Permit signifies the job site has been inspected by the Permit Issuer and Permit Requester/ Holder, the area is prepared, and each individual has agreed to comply with the conditions of this permit. The Permit is valid through the end of the current work shift (start and end times below) and may be extended into the next shift if necessary. Job Hazards Y Standard Controls Job Hazards Y Standard Controls PPEReq’d Static ElectricityGrounding,Manual Handling / LiftingAssessment & lifting equipment Standard (SSP-0011) Y -- N Slips, Trips & FallsHousekeeping, & PPEMoving PartsCovers, Isolation, & Maintenance Full Face ShieldY -- N Chemical /Fuel ExposureMSDS Review, PPEOverhead HazardsLabelling, Isolation, & Barriers GogglesY -- N Vehicle Entry in the unit?Procedures, Barriers, & PermitSharp EdgesCovers, PPE, & Equipment Inspections Hearing ProtectionY -- N ElectricityIsolation, LOTO, GFCIActivities of OthersCommunications, Barriers, Permit Fall ProtectionY -- N Flammable Vapors / liquidGas Testing & IsolationAccess & EgressHousekeeping, Walkways, Stairs Leather GlovesY -- N Fumes & DustRespirator / Eye ProtectionTrapped PressureVenting, Draining, & PPE Rubber GlovesY -- N Hot SurfacesInsulation / Barriers / PPEVehicle TrafficHi-Vis Clothing, Speed Limit, & Signs Non Permeable SuitY -- N Toxic Vapors / LiquidsGas Testing & IsolationUnderground HazardsCAT Testing, Labelling, & Barriers Respirator ½ faceY -- N ExcavationExcavation ChecklistHot LiquidProcedures & PPE Respirator Full FaceY -- N Weather ExtremesSchedule, breaks.Working at HeightScaffolding & Fall Protection / Harness Filter Type: Spillage to GroundSecondary ContainmentWorking Over WaterLife Jacket, & Safety Boat, Supplied AirY -- N Spillage to WaterContainment / BoomsMechanical LiftingBarriers / Lift Procedures Personal H2S monitor Y -- N Welding Apparel Y -- N HF Alky -- LEVEL “A”: Totally encapsulated suit – positive pressure HF Alky -- LEVEL “B”: One piece coverall, gloves w/sealed cuffs, HF boots, positive flow hood w/ air line. HF Alky -- LEVEL “C” : One Piece Coverall, HF Boots, Gloves w/sealed Cuffs/ face shield Specific Hazards:Additional Controls and/or Special Instructions Permit End Work Complete Safe/Clean Job-Site? Exposed HF Acid HF PPE Cleaned?Print NameSignatureDateTime Permit Holder  Y  N Unit Operator  Y  N Permit Review By: Date:

Permit Number will be pre- printed on form The Permit Holder completes this section of the permit prior to meeting wit permit issuer. Check and indicate Contractor Name for contractor work Check if Meraux personnel doing work Indicate work order numbers Indicate product last in vessel so proper PPE can be assessed.. Person responsible for directly supervising the work. The Permit Issuer and Permit Holder work through this section to ensure that: 1 – all Equipment Pre-Work area are checked to indicate what is REQUIRED (Req’d) 2 – to ensure that all REQUIRED Pre-Work is actually DONE The permit issuer and Permit Holder also ensure area preparation is required and Done for Bottle Watch or Low Energy Work. The Permit Issuer and Permit Holder also inspect the area for Job Hazards. In this area if a Job Hazard exists the box should be checked. Standard Controls or other appropriate measures should be taken to ensure the area is safe for work. Also – potential Environmental impacts are noted below: Identify any additional or specific Hazards of explanations of certain above information. Clarify additional controls or special instructions for the work.. A Meraux employee (or designated contractor during turnaround events) who is qualified to do air testing must test the work area prior any HOT work and must take additional samples during the course of the work. A separate form for tracking confined space entry and other required will also be required. Based on the work and hazards – specific required PPE should be Identified for the permitted work. When the work is complete the Permit Holder and the Unit Operator should review the work and indicate whether it is complete and the site is in Safe condition – then print and sign their name, date and time on the form. These names, signatures and date must be complete and the Start and End time for the permit set (above) prior to work start. If, at the end of the shift, it is necessary to extend the permit, the on-coming Permit Holder and Issuer must review the area to ensure conditions have not changed and re sign the permit with start and end times. List tools & equipment to be used. How many will be involved performing work The Permit Holder should describe the scope of work to be completed in this area. << Indicate if the MSDS was checked for the previous product in the vessel and any additional PPE required. If HF Exposure– indicate and Ensure area Cleaned. If HF Alky involved indicate PPE Level