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Integrated Management Procedure Framework[In line with requirement of ISO 9001:2015 QMS, ISO 14001:2015 EMS, OHSAS 18001:2007 OH&SMS]

GAIL GAS LIMITED

GAIL Gas Limited, Noida13th, 14th Floor, GAIL Jubilee Tower,Sector-1, Noida-201301Ph-0120-2446400Fax-0120-26185941

(c) 2016 Gail Gas Limited, have all rights reserved. This document may contain proprietary information and may only be released to third parties with approval of GAIL Gas Management. Document is uncontrolled unless otherwise marked; uncontrolled documents are not subject to update notification.

Gail Gas LimitedA wholly owned Subsidiary of GAIL (India) Limited

INTEGRATED MANAGEMENT SYSTEM PROCEDURE FRAMEWORK

DOCUMENT INFORMATION

Document Title Integrated Management System Procedure Framework (IMSPF)

Document Code GGL/IMSPF

Date of Initial Release (First Edition) -

System Effective Date 2nd Sep 2016

Current Document Revision No Revision “00”

Current Revision Date 1ST Sep 2016

Document Owner Management Representative

Document Author(s) Management Representative

Document / Document Change Reviewer Dy. General Manager

Document Approver COO

Document Status Approved

Document Revision Details Refer to Revision Record

T AUTHORIZATION

The Integrated Management System Procedure Framework 1st Issue, Rev “00” is approved and released for implementation and it comes in to effect from 15.Sep.2016.

Signature

Prepared by Reviewed by Approved by

Name Bidhan Mohanty R Choudhury Rajeev Garg

Designation Management Representative DGM Chief Operating officer

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TABLE OF CONTENTS

# Doc No Title Page no. No. of pages

1. - Contents 3 22. - Amendment Record Sheet 4 13. GGL-P-01 Management Review (9001, 14001 & 18001) 5 34. MR/F/01 Minutes of Management Review Meeting

5. GGL-P-02 Control of Documented Information (9001, 14001 & 18001)

8 8

6. MR/F/02 Master list of document7. MR/F/03 Master list of external document8. MR/F/04 Distribution record9. MR/F/05 Document change request10. GGL-P-03 Corrective Actions (9001, 14001) 16 311. MR/F/06 Corrective Actions12. GGL-P-04 Internal Audit (9001, 14001 & 18001) 19 713. MR/F/07 Annual Internal Audit Programme14. MR/F/08 Internal Audit Schedule15. MR/F/09 Internal Audit Observation Sheet16. MR/F/10 Internal Audit Non-Conformity Report

17. GGL-P-05 Identification of Aspects, impacts and OH&S risks (14001 & 18001)

269

18. MR/F/11 EHS Risk Assessment19. MR/F/12 EHS Risk Assessment Revision record

20. GGL-P-06 Identification and evaluation of Compliance Obligation ( 14001 & 18001)

352

21. MR/F/13 Compliance obligation

22. ---- Emergency Preparedness and response (14001 & 18001)

37 1

23. GGL-P-07 Risk Management Procedure (9001, 14001) 38 524. MR/F/14 Context of GAIL Gas Limited Assessment25. MR/F/15 Context of GAIL Gas Limited Revision Record26. GGL-P-08 IMS Communication (9001, 14001 & 18001) 43 327. MR/F/16 Communication matrix

28. GGL-P-09 Nonconformities, Corrective action & preventive action

463

29. MR/F/17 Corrective / Preventive Action Request

30. GGL-P-10 Handling of non-confirming Product & services(9001)

492

31. GGL-P-11 Analysis of data (9001, 14001 & 18001) 51 232. MR/F/18 Objective & Action plan33. MR/F/19 Analysis of data

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34. MR/F/20 Improvement program

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Amendment Record Sheet

# Rev. No.

Date of Revision

Procedure Revised

Page Ref. Revision Details

1 00 01.09.2016 All All Initial release IMS Procedure Manual

2

3

4

5

6

7

8

9

10

11

12

13

14

15

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MANAGEMENT REVIEW (GGL-P-01)

1. Purpose: To carry out management review of the IMS of GAIL Gas Limited at planned & defined intervals to ensure the continuing suitability, adequacy, and effectiveness of the management system.

2. Scope: All management reviews of integrated management system.

3. Responsibility: GM to conduct and MR to organise the Management Review Meeting

4. Activities:4.1 Management Review Meeting 4.1.1 GM (DGM in absence of GM) conducts a formal review of the Management System at least once

in six months, (Sep/Mar) along with HOD’s and MR to ensure continuing suitability, adequacy and effectiveness of the IMS. If felt necessary, the review is carried out more frequently.

4.1.2 Before each meeting, MR circulates the agenda for the meeting. All HOD’s & MR attend this meeting. Other persons can also be invited as per need assessed by MR. The following points will be discussed in the meeting:

Agenda for the management review shall be well structured and comprehensive to cover topics such as:

a) Review of the status of action(s) for the decisions taken during previous MRC meeting(s) (Presented by MR);

b) changes in :a. external and internal issues relevant to the (QMS & EMS) (Presented by MR);b. needs and expectations of interested parties, including, compliance obligations (EMS &

OHSMS) (Presented by MR)c. risk and opportunities (QMS & EMS) (Presented by MR)d. significant environmental aspects (EMS) and (Presented by OIC/SIC, MR)e. Unacceptable OH&S risks (OHSMS). (Presented by OIC/SIC, MR)

c) information on the performance and effectiveness of the IMS, including trends in:a) customer satisfaction, complaints and feedback from relevant interested parties; (QMS &

EMS) (Presented by Marketing, OIC/SIC)b) the extent to which objectives have been met (QMS, EMS & OHSMS); (Presented by

OIC/SIC, Respective Deptt Head, MR)c) process performance and conformity of products and services (QMS); (Presented by

OIC/SIC, Respective Deptt Head, MR) d) nonconformities and corrective actions (QMS, EMS & OHSMS); (Presented by OIC/SIC,

Respective Deptt Head, MR)e) monitoring and measurement results (QMS, EMS & OHSMS); (Presented by OIC/SIC,

Respective Deptt Head, MR)f) audit results (QMS, EMS & OHSMS); (Presented by MR)g) the performance of external providers; (QMS, EMS & OHSMS) (Presented by C&P head)h) fulfilment of its compliance obligations(EMS & OHSMS); (Presented by HR Head)

d) Participation and consultation on H&S Matter (OH&S). (Presented by HSE Head)e) Review of incident investigation, status of Corrective action & preventive actions to eliminate

potential causes of non-conformities (OHSMS); (Presented by HSE Head)f) relevant communication(s) from interested parties, including complaints (OH&S); (Presented by

OIC/SIC, Respective Deptt Head, MR) g) the effectiveness of actions taken to address risks and opportunities(QMS, EMS); (Presented by

MR) andh) Opportunities for improvement (QMS, EMS & OHSMS) (Presented by MR).i) Any other matter related to QMS, EMS & OHSMS (to be discussed).

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j) Review of resources and up-gradation of technology based on progressive needs of Customers, (EMS & OHSMS) requirements, if any. (the adequacy of resources;) (to be discussed)

k) Major changes in the system and documentation as a result of corrective actions and preventive actions. (to be discussed)

l) Adequacy of Company’s IMS Policy (once in a year). (to be discussed) m) Scheduling of next Management Review Meeting. (to be discussed)

4.1.3 MR organises the meeting. COO/DGM/OIC/SIC’s chairs the meeting.

4.1.4 After the meeting, MR prepares and circulates the minutes of the meeting to all concerned.

4.1.5 MR follows-up on the action points as decided in the meeting.

5. RecordsS

No Record Identification Location Retention Period In Years Disposition

5.1 MRM minutes GGL-MR-F-01 MR office Till revised Tearing

6. References6.1 Clause 9.3 ISO 9001, ISO 140016.2 Clause 4.6 OHSAS 18001

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Management Review Meeting Record GGL-MR-F-01

Gail Gas LimitedMINUTES OF MANAGEMENT REVIEW MEETING

Date of Report preparing:-Date of MRM – Report No.:-

Members Attended

1.2.3.

Agenda Point Discussion/ Minutes point Responsibility Target date

Members Present: Signature1.

2.

3.

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CONTROL OF DOCUMENTED INFORMATION (GGL-P-02)

1. Purpose: To control all documented information required for the IMS in GAIL Gas, with regard to approval before issue, review, revision and re-approval, issue of updated documents, identification and retrieval, to prevent unintended use of obsolete documents and to identify and control the distribution of documents of external origin.

2. Scope: All Management System Documented information of internal and external origin for GAIL Gas.

3. Responsibility: All Heads of Departments/Sections/in-charges and MR of GAIL Gas.

4. Activities:4.1 Documentation Structure4.1.1 The IMS documented information is in five tiers consisting of

a) Integrated management system framework,

b) Integrated management system procedure framework,

c) Process flow and Work instruction/Operational Control.

d) Risk Assessment(s), and

e) Formats/Record/Checklist(s)

4.1.2 The Integrated management system framework gives the description of the Integrated Management System of GAIL Gas, the basic policy with respect to the various clauses of ISO-9001, ISO 14001, OHSAS 18001, the scope of the management system, justification of all exclusions, references of the documented information and description of the sequence and interaction of the processes included in management system.

4.1.3a The Integrated management system procedure frameworks contains the procedures on the requirements of standards, other procedures required to ensure the effective planning, operation and control of processes in GAIL Gas i.e. “Department specific process flow are prepared by department core team members are maintain separately.”, and the forms.

4.1.3b The relevant process related work instruction are developed at micro level in Hindi/English for the operator and are maintained separately along with the department process flow, and the forms.

4.1.4 The list of procedures as given in the contents is also given in the Framework. There is a provision for including work instructions in Integrated Management Procedure Framework whenever required.

4.1.5 The controlled copies of the documented information are uploaded/hosted on the Intranet by MR in pdf (read only) format for reference of all employees as per the decision taken by the Top Management.

4.2 Numbering of documented information4.2.1 A unique document number identifies each Management system documents like Integrated

Management System Framework (IMSF), Integrated Management Procedure Framework (IMPF), Process flows (including WI wherever made and formats). This document/ format number is given in the top right side of page.

4.2.2 The numbering system and departmental codes used to identify the document are:

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4.2.3 The numbering system of Management System documented information is as below.

Document Identification number Explanation

IMSF GGL/IMSF/ZZGGL: GAIL Gas LimitedIMSF: Integrated Management System Framework.ZZ: running serial number starting with 01

IMPF (standard requirement) GGL/P/ZZ

GGL: GAIL Gas LimitedP : MR Procedure.ZZ: running serial number starting with 01

Departmental Process Flow/ Procedures

GGL/YY/PF/ZZGGL: GAIL Gas LimitedYY: Department abbreviationsPF: Process Flow/ ProcessZZ: Running serial number starting with 01

Standard Operating Procedure/ Work instruction / Operation control Procedure

GGL/YY/SOP/ZZGGL: GAIL Gas LimitedYY: Department abbreviationsSOP: Standard Operating procedureZZ: Running serial number starting with 01

Format GGL/YY/F-ZZGGL: GAIL Gas LimitedYY: Department abbreviationsF: FormatZZ: Running serial number starting with 01

Drawing Drawing numbers NR

Specification Description of the specification NR

Department abbreviation codeTM-Top ManagementHR-Human ResourcesO&M –Operation & MaintenanceMR – Management Representative

C&P-Contract & ProcurementProj – ProjectHSE – Health Safety & EnvironmentBIS- Business Information System

4.3 Approvals:

4.3.1 The Quality Management System documents are prepared, checked and approved as below:

Document Prepared by Reviewed by Approved by Issued by

IMSF

MR along with departmental representatives, site representatives & departmental/ site heads

DGM COO MR

IMPF

MR along with departmental representatives, site representatives & departmental/ site heads

DGM

COO

MR

Departmental Process Flow

Core Group Member nominated from Department

Another person from department

Head of the department MR

SOP/Work instruction Respective department Another person

from departmentHead of the department MR

4.3.3 MR along with IT uploads the documented information on the portal in pdf format and without signatures. MR retains the original master copy.

4.4 Issue & Control of documented information4.4.1 Issue of controlled copies of IMSF, IMPF as hard copies is restricted.

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4.4.2 In case it is required to be issued,: Make photo-copies of the original documents signed by all Stamp the title page and all contents pages as “controlled copy” in red Issue the controlled copy as per approval of Top Management Keeps records of issue. Destroy all old, superseded, obsolete, disfigured or inapplicable documents or mark boldly in red

as obsolete if they are retained. 4.4.3 MR reviews all controlled documents whenever ISO 9001, ISO14001, OHSAS 18001 standard is

revised to ensure their continued adequacy.

4.4.4 All HOD’s and controlled copyholders keep the documents in secure places and ensure that the documents are easily retrievable. They also train & make aware all personnel in the Department regarding the various procedures and objectives.

4.4.5 In case any un-controlled copies are issued, no records of issue are kept.

4.4.6 The controlled copy is distinguished from an uncontrolled copy by the red rubber stamp of “controlled copy” put on the title and contents pages of each controlled copy of the Manuals. The uncontrolled copy has no stamp marking.

4.4.7 In case of a controlled (hard) copy, each holder receives a copy of the section(s) revised whenever the revision is carried out.

4.4.6 The authority for uploading the controlled copies of documented information in pdf format is with MR only. They ensure that the without signature copy uploaded is identical to the signed and approved copy except for the signatures. All personnel can refer to and study the IMSF, IMPF by taking the copy from any copyholder or

viewing it on the intranet. The copies available with MR can also be used for reference by external and internal auditors.

4.5 Revision of documents

4.5.1 Revision of documents is done as follows: Core Group member of department receives request for a new document or a change to the

existing document from any person for IMSF, IMPF along with all details. It can be by mail also. Studies the request w.r.t. need for change, consequential changes, provisions of latest

management system standard, IMS Objectives, etc Decides along with HOD about changes to be made. Sends the changes to be made to MR Based on this request, MR takes the following actions:

Prepare the modified or new document. Incorporate appropriate revision status. Get master copy approved by approving authority and issuing authority. Update contents page Record the changes in the amendment record sheet for IMSF, and IMPF Stamp new contents pages as “controlled copy” in red. Issue the revisions as controlled copy to each controlled copyholder and upload the

revised version on the portal.

4.6 Control of other documents including external documents4.6.1 The concerned section, which receives or has these other documents or external documents other

than management system, controls all documents. e.g. contract, drawing, specifications, drawing, pictorials, acts, survey reports, etc. Keep record of all such documents.

4.6.2 In case copies are made and distributed, records of distribution are kept in soft or hard copy, especially in case of external origin documents like standards, external drawings, survey reports, engineering data, etc.

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4.7 Formats4.7.1 All formats given in documents are typical formats and generally these are made in soft and

communicated by mail. Each location can modify the format for use keeping the objective of the format in mind and also the applicability in each situation.

4.8 IMS Records4.8.1 All records required for the Management System are maintained to provide evidence of

conformance to requirements and effective operation of the Management System.

4.8.2 The records are identified, and given at the end of each procedure/Process flow. Each department keeps a consolidated list of records kept by them in a suitable format, preferably in soft. This is updated when new records are added or when the records are sent to Record Room or destroyed.

4.9 Storage, retention and disposition of records4.9.1 The records are retained at least for the retention period defined for each record.

4.9.2 All HOD’s/ site in-charges are responsible for the proper maintenance of the records as indicated.

4.9.3 These records are used for problem analysis and for corrective action and preventive actions. All concerned ensure that each record is legible/readable.

4.9.4 All records are kept in appropriate files and registers and stored in safe places (e.g. racks, cabinets) or in record room. The storage is done in such a way so that easy access to records is possible for quick retrieval. List of documents kept in Record Room is maintained.

4.9.5 All non-current permanent records and having historical value are sent to Record Room.

5. Records

S No Record Identification Location Retention Period

(yrs) Disposition

5.1 Master list of document GGL-MR-F-02

MR office Till the any update Tearing/ shredding

5.2 Master list of external document GGL-MR-F-03

5.3 Distribution record GGL-MR-F-04

5.4 Document change request GGL-MR-F-05

6. References

ISO 9001, ISO 14001 Clause 7.5

OHSAS 18001 Clause 4.4.5, 4.5.4

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Master list of GAIL Gas internal document GGL-MR-F-02

GAIL GAS LIMITED Date:

SN Name ofDocument

DocumentNumber

RevisionNo

Issue No Issue to(Department

Head)

Remarks

1 IMS Manual 00 012 IMS Procedure

Manual00 01

3 AI & HIRAAssessment

00 01

4 Risk Assessment 00 01Context of Gail Gas 00 01

5 O&M procedure 00 016 C&P procedure 00 017 Project Procedure 00 018 F&S procedure 00 019 CDA Rule 00 01

Note :- Documents are uploaded on Gail Gas Web portal.

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Master list of External document GGL-MR-F-03

GAIL GAS LIMITED

As on DateS External

DocYear of

PublicatioName of

DocumentDocument

NumberIssue No (if any)

Issue to(Department

Head)

Remarks

1 ISO 90012 ISO 140013 OHSAS

180014 PNGRB

(ERDMP)Regulation

5 PNGRB(T4S)Regulation

6 PNGRB(IMS)Regulation

7 PNGRB(TPI)Regulation

8 Gas CylinderRule 2004

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Document distribution list GGL-MR-F-04

GAIL GAS LIMITED

Date:- Maintained by: MR

SN DocumentNo.

Document Title(Short)

Issue/Revision No.

DISTRIBUTIONDate

DD/MM/YYDistribute

d ToNo. ofCopies

1

2

3

4

5

6

7

8

9

10

11

12

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DOCUMENT CHANGE REQUEST GGL-MR-F-05

GAIL GAS LIMITED

Date: Document Change Request:-Change Request Details

(new /obsolete/ correction)Potential consequence of

requested changes, (if any) and risk control

(new/obsolete /correction)Title of Change Request:

(filled by Requester)

Name of Person Making the Change Request:

Change Request ID #:(filled by MR)

Submitter's Title:

Description of the Proposed Change

Date of Completion

Reviewed by MR Approved by DGM

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CORRECTIVE ACTION (GGL-P-03)

1. Purpose: To ensure that actual non-conformities are identified, and actions taken to eliminate their

cause(s), so that the non-conformity does not occur at all as a part of preventive action and

that the non-conformity does not occur again as a part of corrective action.

2. Scope: All actual non-conformities requiring corrections, corrective actions.

3. Responsibility: Concerned HOD/ in-charges and MR

4. Activities:4.1 Correction4.1.1 Study the non-conformities detected (actual)- The information about non conformity is brought to the

notice of concerned head by an employee based on -:

In house non-conformances of process (also includes internal customer complaints, interested parties concern/issues)

External customer complaints Internal audits External audits Information about non conformities is also received through inspection reports of Checker etc at

any stage of procurement goods.4.1.2 Identify actions to be taken to eliminate the detected non-conformity.

4.1.3 Make immediate (without undue delay) corrections to set right the actual NC in the situation

observed and reported. e.g. in-process

4.1.5 Check and verify that the NC has been eliminated

4.1.6 Record the non-conformity including in case of internal audits also.

4.2 Corrective Actions4.2.1 Analyse detected non-conformity to determine the cause of the problem. Make separate analysis for

each NC. In case of a customer complaint, it is acknowledged either on phone or in writing within 03

working days. Studies the details of the complaint and analyses the problem for probable causes. If

required, discuss with the plant head other concerned person.

4.2.2 The common non-conformities in are -:

Product non-conformity during any process or inspection /checking Improper handling of. Improper or incomplete documentation leading to delays en-route. Any other which will depend upon case to case.

4.2.3 based on the cause analysed for each problem /NC, determine the specific actions to be taken to

Eliminate the cause of the problem Ensure that it does not occur again

4.2.4 Check that the action(s) identified is appropriate to the impact of the problem encountered viz

magnitude of the problem and likely risks and opportunities.

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4.2.5 Record the corrective action plan with person responsible and target date.

4.2.6 Assigned person takes the action and records it on the same form

4.2.7 After the action has been taken the HOD reviews and evaluates the effectiveness of the action

taken.(Output)

4.2.8 The actions taken may include

If re-training of personnel is needed, it is arranged in coordination with training head

If process needs to be modified or additional checks / controls need to be introduced, they are amended accordingly.

If stricter control on inputs. If damages occur due to negligence, the concerned persons are advised to be more vigilant in

future. If there is process delays like in handover / despatch. If there are any claims, action / help is given to settle them at the earliest. If the documentation is incomplete or inadequate, the system is reviewed to check and the

mistakes are erased.

5 Records

S No Record Identification Location Retention Period

(yrs) Disposition

5.1 Corrective Action Records GGL-MR-F-06 MR office Till the any update Torn

6 Reference : Procedure on Internal Audit GGL-P-04

Procedure on Management review GGL-P-01

ISO 9001, ISO 1400 Clause No 10.2

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GAIL GAS LIMITEDCORRECTIVE ACTIONS GGL/MR/F/06

Maintained by: HOD/ In-charges Preservation Period: 03 yearsDepartment:

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(Y/N

)Note: This format is to be made in landscape format for ease of use.

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INTERNAL AUDIT (GGL-P-04)

1. Purpose: To plan, organise and conduct internal audits in all departments of Gail Gas Ltd so as

to verify compliance to the IMS as per ISO 9001, ISO14001 and OHSAS 1800 and to

determine effectiveness of the implementation and maintenance of the system.

2. Scope : All internal Audits.

3. Responsibility: Management Representative.

4. Activities:

4.1 Plan and conduct Internal audit at least once in six months.

4.2 Prepare the internal Audit programme for the year. Depending upon the importance of the

activities of a particular department, finding of previous audit and the status of implementation of

the IMS in that department, the frequency of internal audit can be increased as decided by MR.

4.3 Prepare the audit schedule for each internal audit. Define the scope of the audit in the schedule

itself. Circulate it before the scheduled date of audit.

4.4 Assign the internal audit to trained auditors for conducting audits or to external contracted auditors.

MR maintains the list of such persons. The internal auditors assigned for an audit of any function

has appropriate education, training and experience, including training as internal auditors. The

auditors are deputed for audit functions, which are independent of the work they are performing.

4.5 All departments and employees are subject to audit.

4.6 Based on the schedule, each internal auditor carries out the audit.

4.7 In order to assist in the conduct of the audit each auditor prepares a “check list” for that

department before the audit.

4.8 During the audit, the auditor determines whether the integrated management system which has

been implemented:

conforms to the requirements of ISO 9001, 14001 and OHSAS 18001

Conforms to the IMS framework and the IM Procedure Framework.

Has been effectively implemented and maintained.

4.9 The methodology used during the audit includes:

Examination of documents and records.

Interviewing personnel.

Actually observing work being done.

Resources and facilities

4.10 During the audit, the internal auditor:

covers the entire scope of the audit.

Verifies the corrective actions taken by auditee on the non-conformities raised during earlier

audit and records it on the non-conformity report.

Uses the random sampling method. of 53



Crosschecks the information gathered and confirms from other sources to ensure that it is

correct (i.e. it is objective evidence).

Evaluates the findings objectively to determine which are to be reported as“non-conformity”.

Gives special emphasis on repetitive non-adherence.

Grades the reportable findings as major, minor or observation.

Intimate the auditee verbally on the spot.

Gets the audit non-conformity report signed by auditee and. hands over the original of the

report to the auditee and sends the copy to MR.

4.11 The auditor grades the non-conformities as Major, Minor or Observation. After all activities have

been audited, the audit team reviews the findings to determine which are to be reported as non-

conformities and which as observations. The non-conformities are graded as Major (Hold point), and

Minor (On going) and observations.

A major non-conformity is when an element of the standard is not complied with at all or there

are a significant number of minor non-conformities.

A minor non-conformity is when an activity or part of an activity is not carried out.

An observation is a situation, which may lead to non-conformity if not addressed in time

4.12 The auditee records the corrective action plan for non-conformity along with target date/ time

schedule on the audit report. The normal schedule for taking correction actions is 21 days.

4.13 The auditee takes corrective action, records it on the audit report, and sends one copy to MR.

4.14 On receipt of audit non-conformity report from auditor and corrective action completed report

from auditee, the MR assigning the verification of the corrective actions to the same auditor or

some other auditors. This is generally done during the next audit.

4.16 After the auditor has verified the corrective actions taken by the auditee, MR verifies audit non-

conformity report with respect to effectiveness of corrective actions taken and closes the audit

report by signing on it as evidence of an effective follow-up.

4.17 In case the auditee does not take the corrective action in time, MR follows up with the auditee/

HOD/ in-charges and may bring it to the notice of higher management as appropriate.

4.18 The salient features of the internal audit are reviewed in the Management Review Meeting

5. Records

Sl No Description Format

NumberMaintained

By Location RetentionPeriod

5.1 Annual Internal Audit Plan GGL-MR-F-07

Within deptt Office 3 years

5.2 Internal Audit Schedule GGL-MR-F-08

Within deptt Office 3 years

5.3 Internal Audit Non Conformity Report GGL-MR-F-09

Auditee Office 3 years

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5.4 Internal Audit Observation Sheet GGL-MR-F-10

MR Office 3 years

6. References : Procedure for corrective actions no GGL-P-03 Procedure for management review no GGL-P-01 Procedure on control of documented information GGL-P-02 ISO 9001, ISO 14001 clause No 9.2 OHSAS 18001 clause 4.5.5

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GAIL GAS LIMITED

ANNUAL INTERNAL AUDIT PROGRAMME GGL\MR\F\07Maintained by: MR Preservation Period: 2 yearsFinancial Year:

Function MonthJan Feb Mar Apr May Jun Jul

yAug Sep Oct Nov Dec

Top Management- HO

--# -- -- -- -- -- -- -- -- -- --

HSE-HO -- # -- -- -- -- -- -- -- -- -- --C&P-HO -- # -- -- -- -- -- -- -- -- -- --IT-HO -- # -- -- -- -- -- -- -- -- -- --O&M-HO -- # -- -- -- -- -- -- -- -- -- --Projects-HO -- # -- -- -- -- -- -- -- -- -- --Marketing -- # -- -- -- -- -- -- -- -- -- --Agra -- # -- -- -- -- -- -- -- -- -- --Meerut -- # -- -- -- -- -- -- -- -- -- --Devas -- # -- -- -- -- -- -- -- -- -- --Sonipat -- # -- -- -- -- -- -- -- -- -- --Site office-01 -- # -- -- -- -- -- -- -- -- -- --Site office-02 -- # -- -- -- -- -- -- -- -- -- --Site office-03 -- # -- -- -- -- -- -- -- -- -- --Site office-04 -- # -- -- -- -- -- -- -- -- -- --Site office-05 -- # -- -- -- -- -- -- -- -- -- --Site office-06 -- # -- -- -- -- -- -- -- -- -- --

# :- Planned, ## :- Rescheduling of Audit.

SignatureDate: (Management Representative)

Distribution: To all concerned.

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GAIL GAS LIMITED

INTERNAL AUDIT SCHEDULE GGL\MR\F\08

Maintained by: MR Preservation Period: 2 yearsScope of Internal Audit:-

S No Department Auditee Auditor Date and Time Remarks, if any

1 Top Management- HO2 HSE-HO3 C&P-HO4 IT-HO5 O&M-HO6 Projects-HO7 Marketing8 Agra9 Firozabad10 Meerut11 Dewas12 Sonipat13 KotaNote:

The auditors shall conduct the audit as per the above schedule. Auditor can do minor adjustments in date and time in consultation with Auditee.

The Auditor shall hand over the Audit Non-Conformity report duly signed by Auditee to the MR.

SignatureDate: (Management Representative)

Distribution: To all concerned

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GAIL GAS LimitedINTERNAL AUDIT NC/ OBSERVATION SHEET GGL\MR\F\09

Date of AuditDept/Division/SectionAuditee(s)Auditor (s)ScopeAudit No.

Audit FindingS. No.

Document Reviewed Reference

Findings/observation along with objective evidence

RemarksNC or

Observation (if any)

Signature of Auditee Date : Signature of Auditor

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GAIL GAS LimitedNON- CONFORMITY CLOSURE REPORT GGL\MR\FM\10

Audit No.Source Audits/Complaints/Observation by anyone in org/Interested Parties/Processes NCAudit Observation/Non-Conformance:What (what is the finding?)

Where (objective evidence/details)

What (what is requirement)

Correction Taken, if any,

Date: AuditeeRoot Cause Analysis (Use 5W technique):

Date: AuditeeCorrective Action TakenAction Responsibility Date:

Auditee

Corrective Action Taken

Audit Finding Closed :( mark ‘’) Yes: No:Verification of Corrective Actions for Effectiveness:

Date: Auditor/MRNon Conformity report reviewed for effectiveness and decision:

Date: MR

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IDENTIFICATION OF ASPECTS, IMPACTS & OH&S RISK (GGL-P-05)(Environmental Aspect & Impact and Hazard Identification & Risk Assessment)

1. PURPOSE To establish, implement and maintain a system for:- Identification and evaluation of Environmental Aspects and Impacts related to the operations and

activities - Identification and evaluation of Occupational Health & Safety Hazards and Risks related to the

operations and activities - Determining significant issues and initiating necessary control measures- Periodical updating of Initial Environmental Review and HIRA- Monitoring and measurement of Environmental, Health and Safety performance indicators

2. SCOPE This process applies to all activities, equipment, facilities, materials & product within GGL, whether carried out departmentally by GAIL Gas personnel, their (sub) contractor(s) and / or service provider(s) including the following: All routine and non-routine situations, activities, All processes, installations, machinery / equipment, repairs, maintenance, operating procedures

including their adaptation to human behaviour & capabilities

DEFINITION

IMSIntegrated Management System based on (ISO 9001, ISO 14001, and OHSAS 18001 standards )

MR Management Representative

Environment:Surroundings in which an organization operates, including air, water, land, natural resources, flora, humans, and their interrelations.

Environmental aspect

Element of an organization’s activities, products and services, which can interact with the environment.

significant environmental aspect Is an environmental aspect, which has or can have a significant environmental impactEnvironmental impact

Any change/ impact to the environment, whether adverse or beneficial, wholly or partially resulting from an organization’s activities, products or services.

Core Team The Group consisting of MR and members from operational areas/ other departments.

HazardsSource, situation or act with a potential for harm in terms of human injury or ill health or a combination of these.

Ill-Health:Identifiable, adverse physical or mental condition arising from and / or made worse by a work activity and / or work – related situation.

RiskCombination of likelihood of an occurrence of hazardous event or exposure and the severity of injury or ill health that can be caused by the event or exposure.

Incident:Work-related event(s) in which an injury or ill health (regardless of severity) or fatality occurred, or could have occurred.

GGL GAIL Gas Limited

3. RESPONSIBILITIES MR is overall responsible for implementing this procedure. Process owner ensure that all the activities under their department are addressed in EAI and HIRA. Core team members are responsible for co-ordination with concerned HOD’s for carrying out,

updation of EHS risk.

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4. PROCEDURE

SN Description of Activity Responsibility

Format / Reference document

1 Form a Core group including personnel from various disciplines / various departments / sites. HOD / MR Circular

2 Provide Training to the Core Group Members on the following:- Basics of Environmental Management System and ISO 14001- Basics of Occupational Health & Safety Management System

and OHSAS 18001- Basics of applicable Legal, Corporate and Other requirements- Documentation related to IMS- Method for Environmental Aspect Impact- Method for OHS Risk Assessment- Method of EHS Risk & Opportunities assessment- Method for review and updation of EHS risks- IMS Documentation

MR -

3 Carry out EAI and HIRA considering:- Site visit, study of various activities, products, services inside

company premises, services outside the company premises which may affect the company operation.

- Interview of concerned personnel, consultation of employees and workers

- Interaction with contractors/ service providers inside GAIL Gas premises, where GAIL Gas has influence

- Facilities at the workplace, provided by GAIL Gas, third party or others

- Routine and non-routine (such as start up, shut down, normal, abnormal and emergency) activities

- Potential emergency and accident situations- Review of legal & other environmental, and health & safety

requirements- Inspection of the company’s facilities, equipment, building,

infrastructure- Past accidents, incidents, near-misses, EHS Committee

findings, Site tours, Inspections and Audit findings, natural calamities

- Routine activities carried out (e.g. any activity which is done on a regular basis or where the frequency of the activity is defined with intervals)

- Non-routine activities and conditions (e.g. breakdown maintenance, sudden shut down, field trips, refurbishment of facilities, extreme weather conditions, temporary arrangements, potential emergency & accident situations)

- Base Line Data- Initial OHS Review / Safety Audit Reports- Reading equipment manual, discussion with supplier- Engaging supplier/Contractor representative while assessing

etc if required- Walk through in the entire work area and surroundings of the

company- Feedback from the personnel in the company performing the

processes- Review of previous accidents/ incidents records- As per the directions provided by the management.

Core group

GGL-MR-F-11

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- Suggestions.

Initial Environmental Aspect Impact Review:4 While identifying, consider the following for environmental aspect

identification

For each identified environmental aspect, the associated environmental impacts shall be determined. Aspect and Impact to the activities could be like.Operational conditions:Normal:

Under normal operations Activities during Start up, shutdown

Abnormal: Deviation from normal operating parameters Spillages, leakages

Emergency: Large overflow with severe impact Fire / explosion Failure of pollution control equipment Continuous non-compliance of legal limits for discharge /

emissions / quantities Large contamination to Storm water drain with potential for

public complaintsNote: Since preventive maintenance is carried out as a planned routine activity, it is treated as a normal activity.

Core group GGL-MR-F-11

5 Identify Environmental Aspects as follows:- Spillages, Leakages- Fire and Explosion- Discharges to water / land- Disposal of waste- Waste generation- Emissions, fumes, gases- Consumption of energy, water, fuel, natural resources- Noise generation- Reuse and recycle (Positive aspect)

Identify Environmental Impacts as follows:- Water Pollution- Air Pollution- Global warming and Climate change- Noise Pollution- Land Contamination- Depletion of Natural Resources- Waste Management (positive impact)

Core group, HODs, MR

GGL-MR-F-11

Evaluation of Aspects, Impacts and Determination of Significant Environmental Impact Level:6 For Environmental Aspects

Review and evaluate the aspects identified and shall determine their significance using the criteria given below. Where a new aspect is incorporated into the lists of aspects, it shall be reviewed and evaluated by the Core Team to determine significance. All the aspects in the format have to be evaluated and classified


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as Business concerns and Environmental concerns. Business concerns will include Legal Concerns (LC), Resource

Savings Potential (RSP) and Interested Parties’ Concern (IPC). The environmental concern will include evaluation of Severity of

Impact (S), and Probability of occurrence of the impact (P) and Detection (D).

The product of Severity of Impact (S) and Probability of occurrence of the impact (P) and Detection (D) shall be computed to obtain the Risk Score. i.e. Risk Score=SXPXD

CRITERIA FOR SIGNIFICANCEAny Aspect identified as Emergency category or legal concern or having resource saving potential (RSP) (in Rupees) orInterested Parties Concern (IPC) (If 50% of internal interested parties is a concern or if there is a complaint from an External Interested Party) is considered Significant.

An aspect with a score of 27 and above shall be considered Significant.

Hazard Identification and Risk Assessment:7 During the assessment with Team, For each identified OHS

hazards, the associated Harm consequence shall be determined. Following aspects are to be consider for hazard identification All routine (regular) activities performed in the company Non-routine activities (occasional e.g. construction,

maintenance, installation of machine/ equipment etc) Activities of all personnel having access to work place

(including contractors & visitors) Human behaviour capabilities and other human factors Identified hazards originating outside the work place capable of

affecting the health and safety of person under the control of the company

Hazard created in the vicinity of work place by work related activities

Infrastructure, equipment and material at the work place whether provided by the company and others

Changes or proposed changes in the organization, its activities, or materials

Modifications to the OH&S management system, including temporary changes, and their impacts on operations, processes, and activities;

Any legal obligation relating to risk assessment and implementation of necessary controls

The design of work area processes installation machinery/ equipment, operating procedures and work organization including their adaptation to human capabilities.

Enter the Hazard in assessment format.


8 Identify Occupational Health and Safety Hazards as follows:

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- Physical (operational, mechanical, heat, noise, electrical, slip and fall etc.)

- Chemical (fumes, gases, spills / leaks of chemicals, mist etc.)- Biological (Bacteria, Virus, fungi, Snake / Dog / Reptile / Insect

bites etc.)- Ergonomic (push & pull, lifting, posture etc.)

During Risk Assessment, consider the factors of Severity (ill-health, Injury) and Probability.


9 The identified OH&S hazards are documented and associated risks due to these hazards are evaluated considering the Likelihood of exposure to the hazard (L), Severity of Harm (S) criteria based on the RATING CRITERIA provided in GGL-MR- F-11


10 Determination of Significant OHS Risk Level:In addition to the L*S, legal requirements, interested parties concerns are also considered for risk evaluation.

The risk is identified as UNACCEPTABLE, when it falls in one or more of the following categories. If Risk score >= 11. When the Severity Ranking is equal to 4 When the Hazard or associated risk is covered under legal

requirements & violation may result in noncompliance to the legal requirements

More than 50% of the feedback obtained from interested parties has raised concern about the hazard.

Core group,HODs,

MR

GGL-MR-F-11

11 Control measures for Significant from EAI and HIRA, After that, consider the control options as per the following Hierarchy of Controls:

1. Terminate (Eliminate) the aspect / hazard through Objectives, Targets and Improvement Management Programmes (IMP’s)

2. Treat (Isolate, Substitution, Engineering Controls) the aspect / hazard through Objectives, Targets and Improvement Management Programmes (IMP’s)

3. Tolerate (Administrative Controls, Signages, Usage of Personal Protective Equipments etc.) the aspect / hazard through Work Instructions, Operational Control Procedures

4. Transfer the aspect / hazard through issue of Do’s & Don’ts to external agencies in Purchase / Work Orders, Work Permits, Letters, Supervision of job etc.

Mention the reference of the IMP, WI / OCP or control measures in the respective EAI and HIRA sheets.

Core group, HODs

GGL-MR-F-11

12 Risk and opportunities are assessed for the significant environmental aspects and unacceptable OHS risks.

Core group, HODs

GGL-MR-F-11

13 Preparation, Monitoring and Measurement of IMP’s:Improvement Management Programmes shall:

- Be SMART: Specific, Measureable (where possible), Achievable, Realistic, Time bound Objective

- Have Action plan to achieve the objective and target with individual steps, responsibility and time target.

Carry out review of achievement of Objectives, Targets and status of IMP’s department-wise once in 06 months and report to MR

HODs,MR

Objective and

Management Program

(EHS)

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section for discussion in the Management Review Meeting.14 Preparation, Monitoring and Measurement of WI’s / OCP’s:

Work Instructions / Operational Control Procedures shall include:- Method for the work / operation / activity- Control method for the significant aspect / hazard; i.e., how

to prevent occurrence- Main operating criteria to be followed- Any records to be maintained in Log books, Registers,

Files, Formats, Software etc.Carry out review of WI’s / OCP’s whenever the operation / activity is carried out and record the main operating criteria in Log Books, Registers, Formats, Software as mentioned in the WI.

Core Group,HoDs,

Concerned Departments

-

15 Management programmes or Operational Control Procedure are established and documented prepared as per the procedure for Establishing and Management of EHS Objectives & Targets.The actions to eliminate control the risks are prioritized in the following sequence

Eliminating the hazard Eliminating the risk Providing substitution Introducing the engineering (mechanical, electrical,

electronic. pneumatic) controls Providing signage, warning, system Providing personal protective equipment

Before implementation of the proposed actions as mentioned in the EHS Programme, new potential hazards associated with the actions are evaluated and where needed necessary controls are also determined in the action plans for EHS Programme.

Team Leader Management Program or OCP

16 The implementation of the EHS Programmes is monitored to ensure the timely completion and effectiveness.

Concern HOD

Management Program

Action to address EHS risk and Opportunities Assessment17 Identify the risks and opportunities in GGL-MR-F-11 for the

significant environmental aspects.Risk could be like

Failure of fulfil compliance obligations Fine Negative publicity leading to reduction in company value Clean up cost if spillage/leakage happen etc.

Opportunities could be like Reduce emission Reduce operating cost Use organic farming method Integrated pest management Reduce pesticide costs etc.

Core Group/MR

18 Decide planning to take action to mitigate or reduce or transfer risk and implement opportunities in the form by deciding objectives and action plan.

Core Group / MR

19 Review the risks & opportunities as per the action to address theseReview of EAI and HIRA assessment20 The team meets at least once in Six months to update the hazard

and risk evaluation.Core Group/ MR

GGL-MR-F-11

21 Whenever any of the following situations occur its information is Core GGL-MR-F- of 53





given to Head HR who in turn organizes to identify the hazards and associated risks.

Addition of new facilities, infrastructure, machines, equipment.

Changes in the organization, its activities, or materials Modification in the Safety Management procedures Addition of new product category Major accident / frequent incidents of similar nature after implementing the MP for the Significant aspect and

unacceptable risk Any other situation have the potential effect on health/

safetyUpdate the change log.

Group/MR 12

22 The AI and HIRA & risk re-evaluation is done following step no 06 onward.

Core Group/MR

GGL-MR-F-11

5. RecordsSl No Description Format

Number Maintained By Location RetentionPeriod

5.1 AI and HIRA sheet GGL-MR-F-11 Within deptt Office 3 years5.2 EAI & HIRA CHANGE LOG GGL-MR-F-12 Within deptt Office 3 years

6. REFERENCE DOCUMENTS ISO14001:2015 clause 6.1.2, 6.1 OHSAS 18001:2007 Clause 4.3.1 LIST OF OCP

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GAIL GAS LIMITEDAI and HIRA sheet GGL-MR-F-11

CORE TEAM MEMBER:- Department :- Doc No :- Rev No:-00 Eff Date:-

SN

Act

ivity

/ Pr

oduc

t / S

ervi

ce

HA

ZAR

D

RIS

K (C

onse

quen

ce)

Envi

ronm

enta

l Asp

ects

Envi

ronm

enta

l Im

pact

RO

UTI

NE,

NO

N R

OU

TIN

E (R

/NR

)

N/ A

B/ E

CONCERNS TO GGL(Y / N)

Exis

ting

Con

trol

mea

sure

s on

the

activ

ities

(C)

Evaluation for risk with

existing control

Evaluation for aspect & impact with existing

controls

Ref Doc’s

Risks and Opportunitie

s

App

licab

le In

dian

/ Sta

te A

ct/

Rul

eIn

tere

sted

Par

ty C

once

rn

Bus

ines

s C

once

rn

Like

lihoo

d of

exp

osur

e to

the

haza

rd (L

)S

ever

ity o

f Har

m (S

)

RIS

K L

EVEL

Scal

e S1

Seve

rity

S2

Prob

abili

ty P

Det

ectio

n D

Envi

ronm

enta

l im

pact

risk

LEG

AL

REG

ISTE

R

Ris

ks a

nd O

ppor

tuni

ties

that

ne

ed to

be

addr

esse

d

Plan

ning

to ta

ke a

ctio

n

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GAIL GAS LIMITEDEAI & HIRA CHANGE LOG GGL-MR-F-12

SN Activities revised/removed Rev. no. Rev. date MR remarks

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IDENTIFICAITON AND EVALUATION OF COMPLIANCE OBLIGATION (GGL-P-06)

1. Purpose: The purpose of this procedure is to establish a system to identify and update the

applicable EHS legal and other requirements

2. Scope: All areas, activities and operations carried out by GGL.

3. Responsibility: HR head is responsible for implementation of this procedure.

4. Activities: 4.1 Core team & MR Identify the legal & other requirements related to OH&S and environment.4.2 Core team & MR while identifying the legal and other requirements related to the environment and

OH&S applicable on the company’s processes, machinery, equipment, materials and products. The following sources are used for identification of the requirements: Knowledge of the person Legal Experts External consultants Legal documents (Factory act, Central/ state pollution control board rules & regulations, etc) Legal requirements published on the internet sites of various statutory / regulatory & legal

bodies Requirements communicated by the industries & commercial associations or volunteer

organizations4.3 The summary of the legal and other requirements applicable on the company are recorded in the

legal register.4.4 Necessary documentation (procedures, work instructions, formats) is established in conjunction with

concerned department heads to comply the legal requirements. 4.5 The information about the legal requirements is communicated to the concerned HR through

training or by circulating the established procedures.4.6 Necessary actions as specified in the relevant documents are implemented for achieving the

compliance to the legal requirements.4.7 Where needed the relevant information’s are submitted to the concerned legal / statutory bodies and

approval from these bodies is obtained. The records of the approval and associated data are maintained.

4.8 The designated member of the company is continually access the information relating to legal requirements.

4.9 Based on the information & discussion & review the new legal requirements are added in the legal register. The legal register is reviewed on quarterly basis.

4.10 A plan is prepared to verify the compliance to the legal requirements periodically. The responsibility and frequency of the verification is mentioned in the plan.

4.11 Appropriate verification of compliance is performed and information is communicated to the management during Management Review.

4.12 Accordingly the legal compliance plan and legal register are updated.4.13 Records of legal compliance are maintained.

5. RECORDS

Sl No Description Format

Number Maintained By Location RetentionPeriod

5.1 List and evaluation of compliance of legal and other requirement

GGL-MR-F-13Within deptt Office 3 years

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6. Reference: ISO 9001 clause 8.2 ISO 14001 clause 6.1.3

OHSAS 18001 clause 4.4.5

GAIL GAS LIMITED

COMPLIANCE OBLIGATION AND ITS EVALUATIONGGL-MR-F-13

Name of the Act/Rule

Relevant Section/Rul

eForm/Compliance Time -

Frame Authority Penalty

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EMERGENCY PREPAREDNESS AND RESPONSE (DISASTER MANAGEMENT)

Pls. refer ERDMP & INCIDENT REPORTING STRUCTURE of GAIL Gas.

1. Records.SLNo

Description Format No Maintained By Location RetentionPeriod

5.1 Near miss/ Hazard Reporting GGL/F&S/F-14 Respective site Office 3 Yrs5.2 First Information Report GGL/F&S/F-15 Respective site Office 3 Yrs5.3 Schedule-VI PNGRB (ERDMP)

Regulation-2010.GGL/F&S/F-16 Respective site Office 3 Yrs

5.4 Investigation Report GGL/F&S/F-17 Respective site Office 3 Yrs

2. Reference: ISO 14001:2004 clause 8.2 OHSAS 18001:2007 clause 4.4.7

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RISK & OPPORTUNITY MANAGMENT PROCEDRUE (GGL-P-07)

1. Purpose: To establish a system for identification of GAIL Gas issues interested parties’ needs & expectations and assessment of organization risks & opportunities.

2. Scope: Applicable to activities and operations carried out by GGL.

3. Responsibility: Management and MR are responsible for implementation of this procedure MR involve department head while identification & assessment of Context of Organization Preparation of Action plan responsibility lies with Concern Process Head and MR monitors the progress of action plan and update status to MR in MRM.

DEFINITIONS Risk: A negative effect of uncertainty. Opportunity: A positive effective of uncertainty. Uncertainty: A deficiency of information related to understanding or knowledge of an event, its

consequence, or likelihood. (Not to be confused with measurement uncertainty.) Risk Assessment: a systematic investigation and analysis of potential risks, combined with the

assignment of severities of probabilities and consequences. These are used to rate risks in order to prioritize the mitigation of high risks.

Risk Mitigation: a plan developed with the intent of addressing all known or possible risks and preventing their occurrence. Mitigation plan is also term as Action plan.

4. Procedure4.1. INTERESTED PARTIES

4.1.1. “Interested parties” are those stakeholders who receive our products or Services, who may be impacted by them, or those parties who may otherwise have a interest in our company. The interested parties applicable to GAIL Gas are listed in the Context of GAIL Gas, along with the reason for their inclusion. This includes both internal and external parties.

4.1.2. The identification of an interested party does not necessarily bring that party into the scope of the IMS; for example, labor union leadership may be identified as an interested party, but that does not mean IMS documents and policies must be developed related to them.

4.2. ISSUES OF CONCERN

4.2.1. For each interest party, the related issues of concern shall be identified in the Context of GAIL Gas. These issues may reflect direct concerns of the party (for example, customers are concerned about quality of products or services they purchase) or they may be indirect concerns. Such concerns may impact on the interested party, or may be concerns derived from the party that impact on the company.

4.2.2. Issues may be either internal or external, depending on whether the interested party is internal or external. In addition, a certain type of party may have both internal and external concerns.

4.2.3. When attempting to identify internal concerns, it may be useful to consider technological concerns, employee concerns, etc.

4.2.4. When attempting to identify external concerns, it may be useful to consider concerns arising from competition, society and culture, labor relations, statutory and regulatory issues, supply chain, economic issues, etc.

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4.3. Management along with department Heads identifies risks and opportunities related to the issues of concern within the Context of GAIL Gas.

4.4. Within the Context of GAIL Gas, each risk and opportunity will be noted, along with the primary process involved, priority, and a bias. The “bias” identifies if the issue is a risk, an opportunity, or some blending of the two.

4.5. Management will then determine a treatment method for each risk or opportunity. Risks are managed to reduce their likelihood and consequence, while opportunities are managed to increase their likelihood and consequence. Blended issues may require more complex treatment.

4.6. Where a risk is determined to be treated, these must then be entered into the Risk Register tag within the Context of GAIL Gas.

4.7. Risk treatment is deemed optimal, an entry shall be made in the Risk Register of the Context of GAIL Gas. When using the Risk Register, the following steps are to be followed:

4.7.1. Identify the risk

4.7.2. Identifying the process for which the risk most likely dominates.

4.7.3. Identify the opportunities if any.

4.7.4. Write existing controls for risks

4.7.5. Assigning a probability rating to the identified risk; this probability is comprised of two elements: likelihood and previous occurrences. Each element is given a score from 1 (lowest risk) to 5 (highest risk). The final probability rating is the average of the elements.

4.7.6. Assigning a consequence rating if the risk were to be encountered; this consequence is comprised of five elements: eventual loss of contract; negative impact on existing customers; inability to meet contract terms; any violation of statutory regulations or law; impact on organization reputation; and estimated cost of correction. Again, each element is given a score from low risk to high risk. The final consequence rating is the average of the elements.

4.7.7. Calculating a final Risk Factor based risk heat matrix and assign risk level i.e. Low risk, Medium risk or high risk

4.7.8. In next column, decide planning to take action for the risk coming as “high risk”. Allocate responsibilities.

4.7.9. Communicate actions to concern.

4.7.10. Risks with a medium are accepted but existing control parameter(s) are to be monitored on regularly and no mitigation plan is required unless otherwise directed by management.

4.7.11. A risk with a low risk doesn’t require any planning.

4.8. If a risk includes a potential positive aspect, those opportunities are managed via the Opportunity Register within the Context of GAIL Gas.

4.9. Analysis of any opportunity will generally result in one of the following possible determinations:

Pursue the opportunity

Explore the opportunity in greater detail before proceeding

Accept the opportunity, but under limited and controlled conditions

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Decline the opportunity, typically based on a high expected cost or low anticipated benefit

If an opportunity includes a negative aspect, management may elect to conduct a risk assessment on the negative aspect, as defined above.

4.10. This Context of GAIL Gas (issues, interested parties, risks & opportunities assessment) are reviewed in MRM and are amended if there is change in Product, interested parties, strategic direction, action plan for risk & opportunities are achieved etc.

STRATEGIC DIRECTION

4.11. From the information above, the Senior Management Team devises a “strategic direction” which is documented and reviewed during management review process.

5. Records.SLNo

Description Format No Maintained By

Location RetentionPeriod

5.1 Context of GAIL Gas ---- MR Office Continuous5.2 Action plan GGL-MR-F-14 MR Office 3 Yrs5.3 Change History GGL-MR-F-15 MR Office 3 Yrs

6. Reference: ISO 9001:2015, ISO 14001:2015 clause 4.1, 4.2, 6.1

IMS Policy

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GAIL GAS LIMITEDGGL-MR-F-14

ACTION PLANACTION PLAN \ MANAGEMENT PROGRAMME Action Plan No. GGL-AP-XX

Department / Section : Page No. 1

Objective/ Risk Reference :Target/ :Target date :Action PlanSl.No.

Description of activity Responsibility

Resources required

Expected date of

completion

Actual date of

completion

1234

Program/ Objective Monitoring Frequency : (before management Review meeting)

Records : MOM, WO, Execution certificate etc.

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REVISION HISTORY OF CONTEXT OF GAIL GAS GGL-MR-F-15

SN

Revision in Issues / interested parties/Risk& opportunities /

Action planDetail of description Rev No Approved by

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IMS COMMUNICATION (GGL-P-08)

1. Purpose: To provide a system and to assign responsibilities for internal and external communication regarding matters related to the IMS [Quality, Environmental and Occupational Health & Safety Management System] at GAIL Gas.

2. Scope: This procedure is applicable to all areas, activities and operations related to IMS in GGL.

3. Responsibility: MR and HODs/ in-charges

4. Activities4.1 Internal Communication Procedures: MR communicates information and instructions

regarding the following, to the various functional levels of the organization:

Sl. No Information Communication media

1 Policy Display of posters at prominent locations

2 IMS Manual and Procedure manual Hard copy/ soft coy/ intranet

3 Information about changes made to IMS Manual and Procedure manual E-mail / intranet

4 SOPs / Work instructions awareness Awareness / training programmes

5 Significant environmental aspects including applicable legal and other requirements Awareness / training programmes

6 Unacceptable risks including applicable legal and other requirements Awareness / training programmes

7 IMS management systems monitoring, audit and management reviews E-mail / intranet

8 IMS Objectives, targets and programmes Intranet / Awareness programmes

9 Marketing communication related to Contractors, Agreements

Email to customer or meeting with customer

10 Procurement related communications with external provider

Email to customer or personnel meetings with external providers

11 Context of organisation and Associated risks & Opportunities

Email to concern heads or risk & opportunities meeting or during MRM

12 Other Email or routine meeting

4.2 Complaints and suggestions from employees: Personnel at all levels and functions are encouraged to report problems and concerns about IMS, and offer suggestions on how to improve performance. They communicate those issues to their SIC/OIC. Concern must

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communicate the complaints and suggestions to MR without undue delay. MR evaluate them and initiate appropriate action and must maintain records of these.

4.3 External Communication Procedures: External communications include, To communicate information to external interested parties about the significant aspects, significant hazards and risks. Receiving, documenting and responding to the relevant communication from external interested parties

4.4 Communication from Regulatory Authority: GAIL Gas receives any communication from the regulatory authority (Pollution Control Board, MoEF, Electrical Inspectorate etc.). Legal must inform the top management to ensure that response as required by the Regulatory Authority is given without undue delay. In the event of the regulatory communication relates to new / changed regulatory compliance requirements, Legal must communicate the same to the top management. MR must ensure that the list of Legal and Other requirements are updated, and communicated to all the concerned. During emergency, external communication to the concerned statutory and regulatory will be done as per the Emergency Plans.

4.5 External Communication of Significant Aspects/Hazards: The MR must identify which of the significant aspects/hazards that needs to be communicated to specific external interested party. The top management through the management review procedure will deliberate and decide on the need to communicate the identified significant aspect to the interested party. The decision is recorded in the minutes of the management review. The decision on the significant aspect/ hazard communication may be reviewed at any subsequent management review on an as needed basis.

4.6 Each function prepare communication matrix and detail all the communication carried out within the GAIL Gas and outside the GAIL Gas.

5. Records.SLNo

Description Format No Maintained By

Location RetentionPeriod

5.1 Internal communication log FMS, Bill Watch System

- - Online

5.2 External communication log Central Dak - - Online5.3 Communication Matrix GGL-MR-F-16 MR Office 3 Yrs

6. Reference: ISO 9001:2015, ISO 14001:2015 clause 7.4

OHSAS 18001:2007 clause 4.4.3

IMS Policy

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COMMUNICATION MATRIX

DEPARTMENT: GGL-MR-F-16S. No.

Description of Communicatio

n

Mode of Communicatio

nResponsibilit

yFrequenc

yTo be Communicated

1234

Include all types of applicable Communications emerging from the department and communicated to other departments including Management Representative and Customer e.g. Objectives & Quality Policy, Progress on Continuous Improvement Projects, Non-conformances, Conformance Reports, Audit Results for effectiveness of Management Systems, Corrective and Preventive Actions, Supplier Performance, Customer & Statutory / Regulatory Requirements including SPCB / CPCB /interested parties requirements

Mode of communication may be either through meetings (MoM), Circulation of Hard Copy formats, e-mail.

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NONCONFORMITY, CORRECTIVE & PREVENTIVE ACTIONS (GGL-P-09)

1. Purpose: To establish a procedure for identification of nonconformities and implementing corrective & preventive actions.

2. Scope: The activities specified in this procedure are applied for all actual & potential nonconformities related to EHS management system. Note Preventive action is only applicable for OH&S nonconformity.

3. Process Owner: Management Representative is responsible to ensure the implementation of corrective &

preventive action on EHS Management System related nonconformities. Concerned Department Head’s/ site in-charges are responsible to implement corrective &

Preventive actions in their area of responsibility.

4. Abbreviations & Definitions:Corrective Actions – Actions taken to eliminate the causes of nonconformities & prevent their recurrence. Preventive Actions – Actions required eliminating the potential causes of nonconformities to prevent the occurrence of nonconformities.CAPA Team – One or more person assigned the responsibility for investing the causes of nonconformity and coordinating the implementation of corrective / preventive actions.

5. Procedure:Sr. No. Activity Responsibility References

A Corrective Action:5.1 EHS related nonconformities are detected / identified through,

Internal Audit External Audits Verification of compliance to legal and other requirements Performing EHS related Measurements & Monitoring Feedback from employees Review of Mock Drills results Incident investigation

MR/Concerned

Departmental heads/ in-charges

------

5.2 Where needed immediate actions are determined and implemented to correct the nonconformity and / or mitigate the effect of the nonconformity.

MRConcerned SIC

----

5.3 Concerned department heads review and identify the nonconformities for initiating the Corrective Action considering the seriousness and magnitude of the nonconformity. They direct the concerned persons in the department to float a Corrective & Preventive Action Request to deal with the nonconformity or problem. If required a departmental or cross-functional team is formed for taking the actions.

SIC ----

5.4 Investigate the causes of the nonconformity and record the details in the corrective action request.

MRConcerned SIC

----

5.5 The Team determines the corrective actions, responsibility & target dates for completion of the actions to eliminate the causes. The Corrective actions depend upon the magnitude & seriousness of the problem/ nonconformity.

MRConcerned SIC

----

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Sr. No. Activity Responsibility References5.6 The team evaluates new OH&S Hazards, associated Risks

and Environmental Aspects their Impact due to the proposed actions before implementation of the actions. If needed documents related to HIRA and EAIA are updated.

MRConcerned SIC

EHS risk Management

Procedure

5.7 Necessary actions are implemented as per the plan. MRConcerned SIC

5.8 The department heads tracks the progress in implementation of corrective actions through meeting or obtaining progress reports.

SIC

5.9 The department head ensures that the corrective actions are implemented within the target dates & verifies the effectiveness of the actions.

SIC

Preventive Actions (only for OH&S Nonconformities or Incidents)

5.10 Department Heads review the trends in internal / external non-conformities, processes performance to identify the potential causes / symptoms of potential problem.

SIC

5.11 They instruct the concerned personnel to generate a Corrective & Preventive Action Request for taking necessary preventive actions to avoid the occurrence of potential problem.

SIC GGL-MR-F-17

5.12 To determine & implement the preventive actions appropriate steps mentioned above at S No 5.1 to 5.11 are followed.

SIC

Standardization5.13 In case any document is affected as a result of corrective

preventive actions coordination with the concerned personnel is done for updating the affected documents.

MRConcerned SIC

Control of documented information Procedures

5.1.4 In case EMS nonconformity corrective action is having concern with EMS risk and opportunities, then updated risk & opportunities in Context of GAIL Gas.

MR Context of GAIL Gas

6. References: ISO 14001 clause No 10.2

OHSAS 18001 clause No 4.5.3

7. Records # Description Document No Maintained By Location Retention Period7.1 Corrective & Preventive

Action Request GGL-MR-F-23 MR office Office 3 years

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Corrective / Preventive Action Request GGL-MR-F-17

Area / Department: Date Opened Last Updated

Serial #

Description / Symptom(s) of Nonconformity: (Actual Nonconformity description or symptoms of potential nonconformity)

Immediate Action(s) Resp Target Date Actual Date

Team Members:Signature of Department Head

Investigation Done and Root Cause:

Corrective Actions Responsibility

Target Date

Actual Date

Risk Evaluation (To be completed before implementation of the proposed actions)Responsibility

Target Date

Actual Date

OH&S Hazards & Risk

Environmental Aspects & Impact Analysis

Effectiveness of the ActionsSituation after Completion of Actions Data before & After implementation of actions if

available

Standardization (Details of Documents Revised)Document Description Document No Description of Changes Done

Nonconformity Closed On : Sign of MR Signature of HOD/ Site in charges

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HANDLING NON-CONFORMING PRODUCT AND SERVICES (GGL-P-10)1. Purpose: To ensure that the product or service that does not conform to the customer, statutory &

regulatory or other requirements is identified and controlled to prevent its unintended

use and delivery.

2. Scope:All non-conforming Products and services.

3. Responsibility: departmental heads/ site in-charges are responsible for this procedure

4. Activities:4.1 The non-conforming products/ services are detected or identified based on:

Incoming/ receipt of material/inspection at external provider.

Inspection and verification carried out during O&M activities etc.

Verification of completeness and adequacy of documentation required including statutory and

regulatory requirements.

Monitoring of processes of unloading, handling, storage etc.

Inspection of purchased materials

Internal and External Audits

Feedback from customers including complaints.... etc

4.2 Identify the non-conforming product/service and mark (chalk/Paint etc) as such

4.3 If the non-conformity is in process, carry out re-processing/ re-work immediately, if feasible.

4.4 As soon as a non-conforming item is detected, immediately segregate it so that it does not get

mixed up with the conforming items.

4.5 If the non-conformity has been detected after the product/service has been delivered, trace the

background of it and identify the item correctly.

4.6 Evaluate the non-conformity and analyse the defects.

4.7 If the non-conformity can be rectified, reprocess and rework the item. After rectification, re-

inspect it before accepting it. In case it is still non-conforming, the rectification process is

repeated or the item is rejected or accepted under deviation from OIC or SIC or Respective Deptt

Head.

4.8 The COO/DGM take decision regarding deviation on critical parameter(s) variations and

accordingly concessions is requested to customer.

4.8 Maintain records of all non-conformities in the corrective action.

5 Records

# Record Identification Maintained By Retention Period

Disposition

5.1 Corrective Actions GGL/MR/F/06 All HOD/ SITE IN-CHARGES

3 Years Tearing

6. References Procedure on Internal Audits, Procedure on Corrective Action, Procedure for management

review

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CORRECTIVE ACTIONS GGL-MR-F-06

Maintained by: HOD Preservation Period: 3 yearsDepartment:

Dat

e

Det

ails

of d

etec

ted

non-

conf

orm

ity o

r pot

entia

l no

n-co

nfor

mity

Sour

ce re

fere

nces

&

deta

ils

Roo

t Cau

se a

naly

sed

Cor

rect

ion

to b

e m

ade

Whe

ther

cor

rect

ive

actio

n or

pre

vent

ive

actio

n

Action CorrectivePlan Action taken

Act

ion

to b

e ta

ken

By

who

m

By

whe

n

Sign

atur

e &

dat

e

Act

ion

take

n si

gnat

ure

& d

ate

Rev

iew

by

HO

D fo

r ef

fect

iven

ess.

Si

gnat

ure

& d

ate

Nee

d re

view

in R

isk

& o

ppor

tuni

ty

regi

ster

(Y/N

)

Note: This format is to be made in landscape format for ease of use.

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ANALYSIS OF DATA (GGL-P-11)

1 Purpose: To determine, collect and analyse data relating to the objectives, and all other parameters of the various measuring & monitoring data in processes to demonstrate the effectiveness of the IMS and to evaluate where continual improvement of the effectiveness of the management system can be made.

2. Scope: All data collected by each department.

3. Responsibility: Each HOD and MR.

4. Process 4.1 Process ActivitiesCollection of data4.1.1 Monthly or Quarterly, each HOD records the objectives/ targets for the month in form

GGL-MR-F-254.1.2 HOD determines the data to be collected in order to monitor achievement of each target & objective

on monthly basis. Data includes Conformity of services; the result of client satisfaction ; the performance and effectiveness of the IMS (refer Sr No 4.1.3) ; the effectiveness of actions taken to address risks and opportunities; the performance of external providers engaged in Projects; Need for improvements to the quality management system.

4.1.3 Collect data pertaining to progress of each project, performance of consultants, etc. (Appointment of survey consultant, milestones, Clearances, etc.)

4.1.4 Record actual data for the month.

Analysis of data4.1.5 Compile the actual data and analyse it against target as recorded4.1.6 Analyse if it is as per requirements and norms. Calculate variance.4.1.7 Based on the analysis, identify whether improvement actions are to be taken or not. If improvement

actions are required or justified, record them as corrective actions.4.1.8 Concern Risk Manager/MR reviews the corrective action outcome and amends respective risk &

opportunity register, if required

6. References Procedure on Management Review IMS Objectives

7 Records

S No Record Identification Location Maintained

ByRetention Period

In Years1 Objective and Action

planGGL-MR-F-18 Head office/

respective site in-charges

HOD/ in-charges

3

2 Analysis of data GGL-MR-F-19 Site in-charge/ HOD’s office

3

3 Improvement Plan GGL-MR-F-20 Site in-charge/ HOD’s office

3

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Objective and Action planDepartment- GGL-MR-F-18

Q, E, H&S OBJECTIVE (QMS/ EMS/OH&S)

Objective Parameter Category Last year figures

Target of next year

completion date

Review frequency

ANALYSIS OF DATAQuarterly GGL-MR-F-19

Maintained by: HOD/ in-charges Preservation Period: 3 yearsDepartment: Month:S N Objective /

ParameterTarget Actual

achievedVariance Improvement

Actions identifiedYes or no

Recorded in GGL-MR-F-06 (Yes or No)

IMS OBJECTIVES

Note: This sheet is to be used to monitor projects, objectives, targets for the month, legal and other requirements, process parameters, etc for each department on quarterly basis.

Improvement Program GGL-MR-F-20

SN Process Detail of IMS improvement program

Remarks

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