EXCAVATION WORK PERMIT

QAZISH ISHLARIGA RUXSAT

Company: Permit No: X –

Kompaniya: Ruxsatnoma raqami: X -
Date: Sana: From: Kimdan: To:Kimg
a:

Location: Manzil:

Time: (day/night Vaqt: (kun/tun)

)

Permit Receiver Name & Signature Ruxsatsi oluvchining nomi va imzo

Full description of Excavation: Qazishning to'liq tavsifi:

Soil Classification: Tuproq tasnifi:

Rock A B C

Depth: Chuqurlik: Width: Kengligi:

Yes No
Yes No
Method of excavation: Qazish usuli:
Machinery: (specify) Mashina: (belgilash)
Manual: Qo'llanma:

General Hazard:

Underground utilities: Er osti kommunal xizmatlari:

Yes No N/A
CablesKabellar

Pipe linesQuvur
lari

QuduqlarQuduqla
r

others (specify) boshqalar (aniqlash)

Yes No N/A Others Boshqalar

Cave-in Hazard: G'orga kirish xavfi:

Access and Egress: Kirish va chiqish:

Stored Material fall: Saqlangan material tushishi

Excavation debris falling: Qazish qoldiqlari tushishi

Falling inside excavation: Qazishning ichiga tushish:

Human:

Vehicles:
Equipments:Uskunalar:

General Precautions Umumiy ehtiyot choralari

 Underground utilities were identified. Er osti kommunal tarmoqlari aniqlandi.

 All precautions for underground utilities was taken Er osti kommunal xizmatlari uchun barcha ehtiyot choralari ko'rildi

Excavating process: Qazish jarayoni:

 If Manual excavation: all tools inspected before activity started Agar qo'lda qazish bo'lsa: faoliyat boshlanishidan oldin barcha asboblar tekshiriladi
 EXCAVATION WORK PERMIT
QAZISH ISHLARIGA RUXSAT

If Machinery: the swinging area barricaded or controlled by banksman Mashina bo'lsa: tebranish maydoni to'silgan yoki bank xodimi tomonidan

boshqariladi

Excavation edges protected properly to prevent Cave-in Hazard G'orga kirish xavfini oldini olish uchun qazish qirralari to'g'ri himoyalangan
 Sloping and Benching Nishab va egilish

 Timber Shoring for Trenches Xandaqlar uchun yog'ochni mustahkamlash

 Aluminum Hydraulic Shoring for Trenching Xandaq qazish uchun alyuminiy gidravlik paypoq

 E – Alternatives to Timber Shoring E - Yog'ochni kesish uchun muqobillar

 F – Selection of Protective Systems F - Himoya tizimlarini tanlash

 Distance from stored material was calculated • Saqlangan materialdan masofa hisoblangan

 Suitable access/Egress are available. • Saqlangan materialdan masofa hisoblangan

 STAIRWAY  Zinapoya  LADDER zinapoya  RAMP  RAMPA

 All PPE are available and suitable for use. • Barcha shaxsiy himoya vositalari mavjud va ulardan foydalanish mumkin.

 All material storage secured and prevented from falling inside the excavation • Barcha materiallarni saqlash joylari mahkamlangan va qazishning ichiga tushib ketishining oldini
oladi

 Excavation debris are one meter away from edge. • Qozuv qoldiqlari chetidan bir metr uzoqlikda.

 Suitable barricades around excavation • Qazish ishlari atrofida mos barrikadalar

 Warning sign in place • Ogohlantirish belgisi joyida

 Traffic flashing lights if recommended • Tavsiya etilganda miltillovchi svetoforlar

 other (specify): • boshqa (ko'rsating):

Specific Hazard Maxsus xavf

CHANGING GROUND CONDITIONS, PARTICULARLY AFTER RAINFALL. YER SHARTLARINI O'ZGARTIRISH, XUSUSIQ, YOMG'IRDAN KEYIN.

MONITOR FOR POSSIBLE OXYGENE DEFICIENCY OR GASEOUS CONDITIONS. MUMKIN KISILGEN TAMMASHISHI YOKI GAZ SHARTLARINI MONITOR.

ADEQUACY OF SHORING AND/OR SLOPING AS WORK PROGRESSES. ISHLAB CHIQARISH BO'YICHA BO'LGAN BO'LGAN VA/yoki nishab KELASHTIRISHNING MUVOFIQligi.

CHANGE IN VEHICULAR AND MACHINERY OPERATION PATTERNS AVTO MOSHINA VA MOSHINALARNI ISHLATISH NAZINLARINI O'ZGARTIRISH

WATER REMOVAL EQUIPMENT AND OPERATION

NOTE: SLOPING OR BENCHING FOR EXCAVATIONS GREATER THAN 20 FEET DEEP SHALL BE DESIGNED SUVNI TO'KIRISH USKUNALARI VA ISHLATISH
ESLATMA: 20 FUTDAN KURTDAGI QAZIMALAR UCHUN QAYTALIK YOKI DAKA OLISH LOYIHALANISH MUMKIN.

Position Lavozim Name Ism Date Sana

Civil Fuqarolik

Electrical Elektr

SEPCOIII Division In-charge Turbine Turbina

Boiler Qozon

MachineryMashinasozli
k
 EXCAVATION WORK PERMIT
QAZISH ISHLARIGA RUXSAT

I&C

SEPCOIII HSE In-charge SEPCOIII HSE uchun mas'ul

Issued By Kim tomonidan berilgan SEPCOIII Construction ManagerSEPCOIII qurilish menejeri

CONTINUATION, COMPLETION OR CANCELLATION. DAVOM ETISH, TUGLASH YOKI BEKOR QILISH.

Continuation:
Above mentioned work is not completed and will continue in another permit. New Permit No: Yuqoridagi ishlar tugallanmagan va boshqa ruxsatnomada davom etadi. Yangi ruxsatnoma raqami:
Davomi:

All controls/isolations/precautions have been removed. Work area neat and clean.

Barcha nazorat/izolyatsiya/ehtiyot choralari olib tashlandi. Ish joyi toza va

The job is completed. I request the closure of the permit Ish tugallandi. Men ruxsatnomani yopishni
so'rayman
Completion: toza.
Tugallash:
Signature of PTW Issuer with date & time
Signature of PTW Receiver with date & timeSana va vaqt bilan PTW qabul qiluvchisining imzosi Sana va vaqt bilan PTW emitentining imzosi

No further work is permitted. A new permit must be issued prior to continuation of any further work.

Cancellation (if required): Boshqa ishlarga ruxsat berilmaydi. Keyingi ishni davom ettirishdan oldin yangi ruxsatnoma berilishi kerak.
Bekor qilish (agar kerak
bo'lsa):
Name, Position, Signature, Date & Time: Ism, Lavozim, Imzo, Sana va Vaqt