General Work Permit - For Print From No. 7000
General Work Permit - For Print From No. 7000
General Work Permit - For Print From No. 7000
Description of Work:
B. PPEs required during work (Tick mark whichever is required & provided)
Safety Shoes Helmet Hi-Viz Jacket Goggles Gloves Mask Double lanyard full body harness
Specify any other PPEs required ______________________________________________________________________________________
C. Is Hazard & Risk Identified during LMRA including Co-laterals, captured in TBT form, and briefed to team. Yes
No
C1. Additional Safety Precautions: ____________________________________________________________________________________
D. I understand the hazard involved and have taken all necessary precautions for the job
Permit Authority
Requested by (Working agency) Issued by (SL authorized person)
Name
Signature
Designation
Date /Time
Mobile
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D1. Random Check (at least once per day by - Permit issuer / Site EHS / EHSMiP/ Site Manager/ Project Manager)
Observation/ Recommendation Name & Signature
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3 10
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6 13
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F. Extension of work permit (To be filled only for same day, job & team)
Permit Extension request by working agency
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