<!-- TEMPLATE — Management of Change form for control-system modifications.
     Adapt severity thresholds and approval chain to your organization. -->

# Management of Change (MOC)

| MOC no. |  | Date raised |  |
|---|---|---|---|
| System / machine |  | Raised by |  |
| Priority |  | Target date |  |

## 1. Proposed Change

[What is changing — hardware, software, settings, documents. Attach marked-up
drawings or code diffs where possible.]

## 2. Reason for Change

[Problem being solved or improvement sought. Reference incidents, punch
items, or requests.]

## 3. Impact Screening

| Question | Yes/No | If yes: action |
|---|---|---|
| Does the change touch a safety function or safety-rated device? |  | Re-enter safety lifecycle at the affected stage |
| Does it change a PL/SIL calculation input (component, architecture, test interval)? |  | Recalculate and re-verify |
| Does it affect the hazardous-area classification or Ex equipment? |  | Area classification review |
| Does it change panel SCCR, OCPD coordination, or conductor loading? |  | Electrical review |
| Does it alter alarms, interlocks, or operator response? |  | Alarm rationalization update; operator training |
| Does it affect network architecture or cybersecurity posture? |  | Zone/conduit and access review |
| Are drawings, narratives, or O&M documents affected? |  | List documents to revise |

## 4. Classification

- [ ] **Replacement in kind** — verified equivalent; document and close
- [ ] **Minor change** — no safety function affected; engineering review only
- [ ] **Major change** — safety function or integrity affected; full re-verification

## 5. Verification and Validation

[What testing proves the change works and nothing else broke. Reference test
records.]

## 6. Approvals

| Role | Name | Signature | Date |
|---|---|---|---|
| Engineering |  |  |  |
| Operations |  |  |  |
| Safety (if screening triggered) |  |  |  |

## 7. Close-Out

- [ ] Change implemented and tested
- [ ] Documents updated (list):
- [ ] Training / notification completed
- [ ] MOC closed — date and by whom:
