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DS EHS FM 009 Work Permit General

The document is a work permit for excavation and backfilling around an emergency pond from September 19-24, 2019. Wardah Al Susan company will perform the work using excavators, dump trucks, and boom trucks. Risks include falling, slips, cuts, and MSD injuries. PPE like safety helmets, goggles, shoes, and gloves will be provided. A risk assessment, method statement, and marked drawings are available. Risks will be addressed through checklists, toolbox talks, and trainings. The site manager approved the permit pending EHS manager verification.

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Imran Khuraishi
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82 views2 pages

DS EHS FM 009 Work Permit General

The document is a work permit for excavation and backfilling around an emergency pond from September 19-24, 2019. Wardah Al Susan company will perform the work using excavators, dump trucks, and boom trucks. Risks include falling, slips, cuts, and MSD injuries. PPE like safety helmets, goggles, shoes, and gloves will be provided. A risk assessment, method statement, and marked drawings are available. Risks will be addressed through checklists, toolbox talks, and trainings. The site manager approved the permit pending EHS manager verification.

Uploaded by

Imran Khuraishi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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WORK PERMIT (General)

Shoaiba RO Ph.4 Desalination Plant Project Permit No. DHI-SRO4-EHS___


Section Ⅰ. General Information
Company : Wardah Al Susan Manpower : Date : 19 / 09 / 2019 . ~ 24 / 09 / 2019 .
Period
Specific Location : Emergency Pond Time : 6 : 00 AM ~ 7 : 00 PM

Responsible person : Mizanur Rahman Contact No.(Mobile) : +966 572927530

Class of Work □ Holiday Work □ Night Work


[ ] Hot Work [ ] Confined Space Work [ ] Excavation (more than 1.2 m) [ ] Critical Lifting [ ] Scaffolding (4m↑)
[ ] Hazardous Work : □ Radiography □ Chemical handling □ Other hazardous work
■ Cold Work : □ Working at height more than 2m □ Moving and Lifting heavy material less than 10 ton □ Roofing & Siding
□ Install / Dismantle temporary structure(Less than 4 m supporting, scaffolding, etc.) □ Install machine or frame
nderwater □ Working above or near water □ Working nearby high voltage □ Others:
★ Removal of : □ Safety net, □ Grating, □ Handrail, □ life line, □ Opening cover, □ Others
Equipment: (Excavator : 1 ), (Dump Truck : 2 ), (Boom Truck : ), (Mobile Crane : ), (Trailer : ), (E/M Eqpt.s : )
Work Description: Excavation and Back Filling around the Emergency Pond

Risk Type
R Fall □ Falling □ Caught in □ Struck R Slip □ Cutting □ Electrical Shock □ Burn □ Explosion
□ MSD □ Env. Contamination □ Others

Personal Protective Equipment (PPE) are suitably provided for working as item below :
R Safety Helmet R Safety Goggle R Safety Shoes □ Safety Harness □ Dust / Chemical Mask
□ Ear Plugs / Muff □ Respirator □ Face Shield □ Rubber / Leather Gloves □ Rubber Boots □ Others :

Documents Available:
R Risk Asessment R Method Statement □ Certificates □ Plan Drawings / Sketch with mark up

Risk Comments in Addition to Risks in R.A.:


Misoperation, Human Error, Entry of Non-Authorized Personals

Risk Improvement Method


1 . Providing Check-list for the operators.
2. TBT before the work commences.
3. Provide trainings and refreshment trainings.

Section Ⅱ. Application of Permit


Site Manager WARDAH AL SUSAN Name : Mosharaf Hussain Signature :

Section Ⅲ. Approval of Permit (DHI)


DOOSAN Construction Manager Name : S. H. Lee Signature :

Section IV. Verified By (DHI)


EHS Manager Name : C. S. Lee Signature : Time/Date :
Comments
Section V. Review
Date
Reviewer Position Remarks

Section VI. Cancellation


DHI Responsible Person Name : Signature : Time/Date :

Comments
Shoaiba RO Ph.4 Desalination Plant Project DS-EHS-FM-009

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