START UP INCIDENT IN AMMONIA PLANT

 Incident
A mixture of synthesis gas and ammonia was released from an ammonia plant during the start-up process following a shutdown for maintenance. The release occurred from a high vent after ammonia had been allowed to collect in the vent system through a valve left open as a result of failure to tag the valve as out of service.
During the start-up, operators failed to control levels in the process, resulting in a high level alarm in an ammonia catchpot which led to a release of synthesis gas (as designed) into the vent system. However, as the vent system already contained ammonia, the gas mixture was forced out of the high vent. The wind direction took the gas cloud over an adjacent construction area on the same site resulting in fourteen
contract employees experiencing irritation and discomfort and later seeking medical attention. Six of these contractors were physically affected as a result of the exposure but nobody suffered serious or long-term injuries. The ammonia release dispersed and was not detected at neighbouring premises.
Cause
The incident was caused by a combination of factors including a failure of the tagging system and the failure to adequately control the catchpot level during start-up.
Consequences
The tagging system for equipment which is out of service, has been reviewed to ensure during maintenance there is no unauthorised operation of equipment. Resource allocation has been reviewed to ensure that process control is secured and level indicators in the catchpot have been assessed to ensure accuracy for process control. Also, workers at the adjacent construction site will now carry gas respirators at all times and will be notified of any operating conditions, such as start-ups and shutdowns, with the potential to lead to releases of gas.

Source: Department of Minerals and Energy, Australia 

AMMONIA LEAK FROM REFRIGERATION SYSTEM

Incident
Approximately 56 kg of anhydrous ammonia was released to the atmosphere from
a 25-year-old refrigeration system. The emergency services stopped the leak by
closing an isolating valve. There was no injury. The site was not licensed for the
storage of anhydrous ammonia.
Causes
One valve failed to close and stop filling up the accumulator of the refrigerating
system. This resulted in flooding of the refrigeration compressor by liquefied
anhydrous ammonia, causing one of the compressor O-rings to fail, thereby causing
the release of anhydrous ammonia to the atmosphere. This points to an inadequate
maintenance program.
Consequences
The operator has been instructed to take appropriate measures so that the
refrigerating system complies with the relevant safety standard and the Dangerous
Goods Regulations. The operator was successfully prosecuted for failing to placard
the site and have a licence to store anhydrous ammonia.

Source: Department of Minerals and Energy, Australia

LOOSE BOLTS - CAUSES

 Www.smartbolts.com/insights/loose-bolts-causes-ways-prevent/

A pressurized bolted flange joint assembly begins to leak, creating a safety hazard. A rotor with its blades separates from the nacelle and spins off a wind turbine, crashing to the ground. Under constant vibration from the engine of an ocean freighter, loose bolts on a large piece of mining equipment work their way off the bolted joints and roll around the hull, inflicting further damage to the equipment.

AVOID GASKET SURPRISES

 https://www.chemicalprocessing.com/articles/2020/maintenance-avoid-gasket-surprises/

COMMON CAUSES OF FLANGE LEAKS AND THEIR SOLUTIONS

 https://www.sealxpert.com/common-causes-of-flange-leaks-and-their-solutions/

Classic Marmaduke: Marmy's First Lesson

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Is it Possible to Turnaround a Turnaround? - POWER Magazine

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Use Dry Fog to Control Coal Dust Hazards

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Coping with Coal Dust

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SMARTBOLTS.COM - LOOSE BOLTS - CAUSES

 http://www.smartbolts.com/insights/loose-bolts-causes-ways-prevent/

"A pressurized bolted flange joint assembly begins to leak, creating a safety hazard. A rotor with its blades separates from the nacelle and spins off a wind turbine, crashing to the ground. Under constant vibration from the engine of an ocean freighter, loose bolts on a large piece of mining equipment work their way off the bolted joints and roll around the hull, inflicting further damage to the equipment".

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The Urgency of Protecting the Electric Grid from Cyberattacks

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Practical guidelines for determining electrical area classification

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Safe Temporary Power and Lighting Strategies For Refinery Turn-around Activities

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IGNITION SOURCES - IDENTIFICATION AND CONTROL HSE UK

 Ignition sources may be:

Flames;
Direct fired space and process heating;
Use of cigarettes/matches etc;
Cutting and welding flames;
Hot surfaces;
Heated process vessels such as dryers and furnaces;
Hot process vessels;
Space heating equipment;
Mechanical machinery;
Electrical equipment and lights
Spontaneous heating;
Friction heating or sparks;
Impact sparks;
Sparks from electrical equipment;
Stray currents from electrical equipment
Electrostatic discharge sparks:
Lightning strikes.
Electromagnetic radiation of different wavelengths
Vehicles, unless specially designed or modified are likely to contain a range of potential ignition sources

Sources of ignition should be effectively controlled in all hazardous areas by a combination of design measures, and systems of work:
Using electrical equipment and instrumentation classified for the zone in which it is located. New mechanical equipment will need to be selected in the same way. (See above);
Earthing of all plant/ equipment (see Technical Measures Document on Earthing)
Elimination of surfaces above auto-ignition temperatures of flammable materials being handled/stored (see above);
Provision of lightning protection
Correct selection of vehicles/internal combustion engines that have to work in the zoned areas (see Technical Measures Document on Permit to Work Systems);
Correct selection of equipment to avoid high intensity electromagnetic radiation sources, e.g. limitations on the power input to fibre optic systems, avoidance of high intensity lasers or sources of infrared radiation
Prohibition of smoking/use of matches/lighters
Controls over the use of normal vehicles
Controls over activities that create intermittent hazardous areas, e.g. tanker loading/unloading
Control of maintenance activities that may cause sparks/hot surfaces/naked flames through a Permit to Work System
Precautions to control the risk from pyrophoric scale, usually associated with formation of ferrous sulphide inside process equipment
Direct Fired Heaters, Hot Oil Systems and Processes Operating Above Auto-Ignition Temperatures

SOURCE: https://www.hse.gov.uk/comah/sragtech/techmeasareaclas.htm

Explosion Relief Vents for Highly Effective and Economical Explosion Protection

 https://bulkinside.com/bulk-solids-handling/explosion-protection-process-safety/explosion-relief-vents-for-highly-effective-and-economical-explosion-protection/

Newson Gale - 5 Reasons why you should specify ATEX, IECEx and FM Approv...