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Work Permit

Permit

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Sandeep Tiwari
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11 views

Work Permit

Permit

Uploaded by

Sandeep Tiwari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Design, Supply, Installation, Testing and Commissioning of Ballastless Track from

Sarthana to Dream City in Elevated and Underground Sections Including Connecting


Lines to Depot along with Ballasted I Ballastless I Embedded Standard Gauge Track for
Corridor - I,Surat Metro Rail Project, Phase 1
RVNL-ISC(JV)-GMRC/Track-1/Surat/Ph-1/2022 GENERAL WORK PERMIT

Permit Valid From (Date & Time)

Name of the Contractor/company

Precise location of General Work:

General work activity:

Safe System: A suitable and sufficient safe system of work must be available for this activity. Essential checkpoints are as below:
Check Point. Yes No NA
Risk Assessment available
Operator/driver third party competency availability
Equipment/vehicle third party availability
Medical fitness done
Safety Induction conducted
Tool box talk performed; attendance recorded
Area cordoned off and precautionary sign board displayed prominently
Experienced banks man /signal man available on the job
Traffic marshal availability
Workman has been informed about the methodology of work and safety aspect.
Only competent person allows to perform work.
Sufficient area lights are available when working during night shift (Min. 50 lux)
Proper means of escape / exit available
Fire extinguishers available in location of work
Rail trolley properly inspected before movement on track.
Ensure competent person allow to handle rail trolley.
No combustible material is stored below / adjacent structures

PERMIT TO WORK - INSPECTION & DECLARATION [SECTION IN-CHARGE / SUPERVISOR]


COMPLANCE BY SECTION IN CHARGE / SUPERVISOR: As the In-Charge / Supervisor, I am familiar with the scope of work and safe systems to
be implemented and shall ensure it during execution of work. A briefing has been delivered to the workforce on this safe system of work.
Name and designation of Section In-Charge / Supervisor
Sign and date of Section In-Charge / Supervisor

PERMIT TO WORK AUTHORIZATION [ACTIVITY IN-CHARGE]


Name and designation of Activity In charge
Sign and date of Activity In charge

VERIFICATION OF COMPLIANCE TO PERMIT CONDITIONS BY HSE MANAGER / ENGINEER


Observed that the permit conditions are complied. All permit conditions are not complied and advised
to go ahead after compliance.
Name Sign Date & Time

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