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Att.15 Specification Deviation Request Form

1) A contractor submitted a Specification Deviation Request to deviate from a project specification for the WEST QURNA 1 - PRODUCED WATER 2 PROJECT. 2) The request was evaluated for impact, risk, and by relevant functions. It was determined that functional endorsement was not required but an MOC may be. 3) The Engineering Lead recommended the deviation be endorsed with exceptions and that the request be distributed to relevant parties for documentation and tracking of the approved deviation.

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544 views5 pages

Att.15 Specification Deviation Request Form

1) A contractor submitted a Specification Deviation Request to deviate from a project specification for the WEST QURNA 1 - PRODUCED WATER 2 PROJECT. 2) The request was evaluated for impact, risk, and by relevant functions. It was determined that functional endorsement was not required but an MOC may be. 3) The Engineering Lead recommended the deviation be endorsed with exceptions and that the request be distributed to relevant parties for documentation and tracking of the approved deviation.

Uploaded by

abdallah mohamed
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Specification Deviation Request Form

Project: Contract Number: Contractor/Supplier:


WEST QURNA 1 - AWQ0815 ENKA
PRODUCED WATER 2
PROJECT
SDR Number: SDR Title: Revision: Page 1 of 4

PART I
(Request, Response, and Verification)

SECTION 1 CONTRACTOR REQUEST FOR SPECIFICATION DEVIATION


Specification Number: Section: Paragraph:

Specification or Document Title:

Global Practice Number (Cross reference of specification number to GP)


-

Description of Requested Deviation (attach additional sheets if necessary):

Discipline: Equipment Type:

Reason for Requested Deviation (attach additional sheets if necessary):

Attach documents with all information required to evaluate the deviation (e.g., P&ID's, ISO's, Material Selection Worksheets, calculations).
Attachments provided? Yes (If yes, provide list here) No

Document List:

Reference any associated NCR, TQ, RFI Concession Request, CAR, etc., or enter N/A if none
N/A

One-time Deviation to Project Spec Requirement


Permanent Change to Project Spec.

If this is a one-time deviation, describe affected equipment/component (including tag number, if applicable) and location:

Date: Requester's Organization:

Requesting Organization Approver Position: Approval Signature and Date:

Document No: IQWQ-EN815-XXDEV-XX-XXXX Rev: X Page 1 of 5


Specification Deviation Request Form
SECTION 2 COMPANY RESPONSE TO DEVIATION REQUEST
(TO BE COMPLETED AFTER PART II IS COMPLETED)
Deviation is technically acceptable Deviation request rejected
Deviation is technically acceptable only if implemented with Implement alternative (see comments)
exceptions or conditions described below (see comments)
Note: One of these boxes must be selected for Company Response to be valid:
Change Proposal required. Contractor shall prepare and obtain Company approval of a Change Proposal prior to implementation of any
deviation associated with this request.
Change Proposal not required. Proceed with implementation.
Comments (Attach additional sheets if necessary):

Is Contractor verification of implementation required? Yes No

Document No: IQWQ-EN815-XXDEV-XX-XXXX Rev: X Page 2 of 5


Project team endorsements as required by Engineering Lead(initials and dates):
Process _____________ I&C____________ Structural ____________ Operations __________
Mech._____________ Electrical ____________ Materials ____________ Construction:__________
Mach._____________ Risk/LP____________ Sys. Compl____________ Sub/PL ______________
Other _____________

Responsible Engineer who prepared response: Signature and Date:

PT Engineering Lead or higher if required: Signature and Date (only after completion of Sect. 4-8 as required):

SECTION 3 CONTRACTOR VERIFICATION OF IMPLEMENTATION


Implementation Actions Completed by Contractor:

Have the Project Specifications been changed to reflect deviation? Yes Not Required

Contractor Site Lead Signature: Date:

PT Responsible Engineer Signature: Date:

Specification Deviation Request Form

PART II
(COMPANY EVALUATION AND APPROVALS)

SECTION 4 IMPACT OF CHANGE TO PROJECT


Check all that apply: None Positive Negative N/A
Safety/Health (1)
Environmental (1)
Regulatory
Cost (2)
Schedule (2)
Engineering/Construction
Corrosion Protection
Maintainability, Operability, Reliability (3)
Other
Positive impact is a reduction in cost or schedule. Negative impact is an increase in cost or schedule.
(1) Functional approval may be required (2) MOC may be necessary (3) Operations approval may be required

Document No: IQWQ-EN815-XXDEV-XX-XXXX Rev: X Page 3 of 5


SECTION 5 RISK AND SHE SCREENING
Mark boxes before change with 'X' and after change with 'O' or enter information here: ________________ _______________
Risk Before Change Risk After Change
Comments:
Risk/SHE Impact from this Change:
The PT may approve the deviation if the cost is within the PT DOAG and if :
 The change reduces risks from high to medium or medium to low, or
 The deviations remain within the Low or Medium risk areas

Functional Manager and Project Loss Prevention Engineer review/approvals are required
if:
 The change increases the risk from Lower to Moderate or Moderate to Higher, or
 The deviation remains within the Higher Risk area, or
 The change is related to an [S] Safety or [E] Environment paragraph

DOAG 4 approval is required if:


 The change increases the risk from Moderate to Higher, or
 The deviation remains within the Higher Risk area

Discipline Engineer Signature: Date:


Loss Prevention Engineer Signature: Date:

SECTION 6 ENGINEERING LEAD RECOMMENDATION FOR FURTHER ACTION/REVIEWS


Endorsement by Function Required? Yes No
MOC Required (consultation w/ Project Manager may be required)? Yes No

Recommend change to WQ1 Global Practice (consider changes to Yes No


requirements and/or Rationales)?

Proceed directly with returning response if (1) Functional endorsement is not required and (2) MOC is not required.

Comments:

Engineering Lead Signature: Date:


Project Lead Signature: Date:
Project Manager (only if functional endorsement, MOC, or DOAG 4 required) Date:

Specification Deviation Request Form

SECTION 7 WQ1 FUNCTIONAL EVALUATION OF DEVIATION REQUEST


Deviation endorsed Deviation endorsed with exceptions
Deviation not endorsed Proposed alternative
Discussion (propose alternatives or describe exceptions and record any input from the WQ1SME here):

Attach additional sheets, if necessary.


WQ1 Functional SME Signature: Date:

WQ1 Functional Manager Signature: Date:

SECTION 8 DISTRIBUTION

Document No: IQWQ-EN815-XXDEV-XX-XXXX Rev: X Page 4 of 5


Project Files: Originator (Name/Organization:

Evaluating Function (designate recipient): WQ1 Facilities Operations Interface Group - WQ1
Coordinator (all specification deviations)

Project Distribution (designate recipients):


Operations ___________________________________________ Procurement _______________________________
Construction __________________________________________ Doc Control________________________________
Risk/Loss Prevention ___________________________________ Engr. _____________________________________
SHE&S_______________________________________________
Commissioning _____________________________
QA/QC _______________________________________________
MOC Coordinator: ______________________________________ Other _____________________________________

Document No: IQWQ-EN815-XXDEV-XX-XXXX Rev: X Page 5 of 5

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