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Permit To Work Form Word

This document is a hot work permit for work taking place at National Container Terminals in King Abdullah City, KSA. It requires a pre-job safety meeting, isolation and securing of the work area, securing electrical sources, availability of breathing apparatus and escape kits, immediate cleanup of spills, a clearly identified evacuation plan, erected barriers around the work area, testing and certification of all tools and equipment, fire extinguishers on site, a fire watcher, and proper personal protective equipment for all workers. Workers must confirm there are no flammable materials near the work site and that the ground is clear of ignition sources. The permit must be signed by an operation superintendent to be valid.

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Mohamed Elnagdy
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313 views

Permit To Work Form Word

This document is a hot work permit for work taking place at National Container Terminals in King Abdullah City, KSA. It requires a pre-job safety meeting, isolation and securing of the work area, securing electrical sources, availability of breathing apparatus and escape kits, immediate cleanup of spills, a clearly identified evacuation plan, erected barriers around the work area, testing and certification of all tools and equipment, fire extinguishers on site, a fire watcher, and proper personal protective equipment for all workers. Workers must confirm there are no flammable materials near the work site and that the ground is clear of ignition sources. The permit must be signed by an operation superintendent to be valid.

Uploaded by

Mohamed Elnagdy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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National Container Terminals

King Abdullah City, KSA.


Hot Work Permit

Hot work ‫اعمال ساخنه‬


Confined space entry ‫دخول أماكن مغلقة‬
Excavation ‫حفر‬
Other ‫أخرى‬

Work descriptions ‫وصف العمل‬


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Precautions to be taken ‫االحتياطات التى يجب اتخا ذها‬

Item Yes No ‫العنصر‬


Pre-job safety meeting is required ‫يلزم عمل اجتماع سالمة قبل بدئ العمل‬
Isolate & Securing the work place ‫البد من تامين وعزل مكان العمل‬
Secure the electrical sources ‫البد من تامين مصادر الكهرباء‬
SCBA & escape Kit must be available ‫البد من وجود أجهزةالتنفس‬
Clean up any spillage of oil/chemical immediately ‫البد تنظيف آي تسريب في الحال‬
Evacuation Plan Clearly Identified ‫تم التعرف على خطة اإلخالء في حاالتالطوارئ‬
Ensure barriers are erected around work area ‫البد من وضع حواجز حول منطقة العمل‬
All tools and equipment to be used must be tested, certified in good ‫كل األدوات والمعدات المستخدمة سليمة وتم فحصها وصالحة لالستخدام‬
condition and the correct tools for the job
The cutting/welding equipment must be tested, in good condition ‫أدوات القطع اللحام تم اختبارها وهى في وضع آمن‬
All workers must wear correct PPE at all times ‫كل العمال البد من آن يرتدوا مهمات الوقاية كاملة في كل األوقات‬
Ensure good ventilation at the worksite ‫البد من وجود تهوية جيدة في مكان العمل‬
Safety harness must be wear / life jacket ‫ال بد من ارتداء حزام األمان \ سترة النجاة‬
Fire extinguishers must be in work place ‫ال بد من وجود طفايات حريق بمكان العمل‬
Fire watcher must be in work place ‫ال بد من وجود مراقب حريق‬
Is there any flammable material in or near to the site of work? ‫هل هنالك أي مواد قابلة لالشتعال قريبة من مكان العمل ؟‬

Is the ground is clean and clear from ignition sources? ‫هل أرضية العمل خالية من آي مواد قابلة لالشتعال ؟‬

Additional Instructions (AI) ‫تعليما ت اضا فية‬


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Performing Authority (PA) ‫المسؤل عن أداء‬


‫العمل‬ Name/ ‫االسم‬ ID/‫الرقم‬ Date/ ‫التاريخ‬ Valid from To Signature/ ‫التوقيع‬
am/pm am/pm

Operation Superintendent ‫مشرف العمليات‬


Name/ ‫االسم‬ ID/‫الرقم‬ Date/ ‫التاريخ‬ Valid from To Signature/ ‫التوقيع‬
am/pm am/pm

Name/ ‫االسم‬ ID/‫الرقم‬ Date/ ‫التاريخ‬ Signature/ ‫التوقيع‬

Issue #: issue date: 27/11/2013 Revision: Revision date:

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