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    No.4 PERMIT TO DIG

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    Safety First TV Ph
    No.4 PERMIT TO DIG

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    No.4 PERMIT TO DIG

    Uploaded by

    Safety First TV Ph
    1 views3 pages
    No.4 PERMIT TO DIG

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    No.4 PERMIT TO DIG

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views3 pages

    No.4 PERMIT TO DIG

    Uploaded by

    Safety First TV Ph
    No.4 PERMIT TO DIG

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    PALM JUMEIRAH

    CENTRAL SAFETY TEAM 050-558-5135

    SSp15/F04 – Permit To Dig

    PERMIT TO DIG
    SSP15/F04

    Prepared and Issued by:

    Steve Storey, H&S Manager, Palm Jumeirah Central Safety Team

    Reviewed by:

    Robert Whent, H&S Manager, Palm Jumeirah Central Safety Team

    Authorised by:

    Mark Warrington, Assistant Manager, Al Nakheel Safety

    Revision History:
    Revision Date Description

    Palm Jumeirah Central Safety Team Revision: 0


    SSP15/F04 Date : 01/06/05
    Issue No: 01 Page : Page 1 of 3
    PALM JUMEIRAH
    CENTRAL SAFETY TEAM 050-558-5135

    SSp15/F04 – Permit To Dig

    PERMIT TO DIG
    SSP15/F04

    PERMIT TO DIG
    PROJECT/SITE: PERMIT NO:

    TO: (competent person) CONTRACTOR:


    LOCATION OF WORKS: DESCRIPTION OF WORKS:

    Approved Method Statement and Risk Assessment in place YES NO


    Risk Assessment ref.no:
    The competent person or his supervisor should tick as appropriate
    PRECAUTIONS: precautions which have been taken
    Have all services been located and proved to location GENERAL
    UNDERGROUND SERVICES: All necessary drawings/ sketches received

    Trial holes Suitable protection barriers available

    Records of location Are sufficient ladders on hand for access to & from
    Services protected excavation

    CAT survey Adequate lighting available

    Services isolated Is Supervisor fully experienced and competent in the support


    OVERHEAD SERVICES: of excavations

    Records of location Confined space work permit

    Services protected

    ADDITIONAL PRECAUTIONS/ COMMENTS:

    PERMIT VALIDITY:
    This permit is valid from: am/pm on / / Until: am/pm on / /

    ISSUE OF PERMIT- AUTHORISATION/ RECEIPT


    The responsible person: The competent person (Contractor)

    I have examined the area specified and permission is given for I have read and agree to the conditions of this permit.
    the work to start, subject to the conditions stated above.

    Name: Name:
    (print) (print)

    Signed: Date: Signed: Date:

    Palm Jumeirah Central Safety Team Revision: 0


    SSP15/F04 Date : 01/06/05
    Issue No: 01 Page : Page 2 of 3
    PALM JUMEIRAH
    CENTRAL SAFETY TEAM 050-558-5135

    SSp15/F04 – Permit To Dig

    PERMIT TO DIG
    SSP15/F04

    COMPLETION OF WORKS/ CLOSING OF PERMIT


    The competent person: The responsible person:

    Time work completed/ suspended: am/pm THIS PERMIT IS NOW CANCELLED

    Name: Name:
    (print) (print)

    Signature: Signature:
    Date: Time: am/pm
    This permit must be returned to the responsible person on completion or suspension of the hot work.
    A record of permits issued must be maintained.

    Palm Jumeirah Central Safety Team Revision: 0


    SSP15/F04 Date : 01/06/05
    Issue No: 01 Page : Page 3 of 3

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