Ref: IX-HW-BBET-HSE-R9-001Rev0
Honeywell International ME- HBS- Duba
Site-Busi
WORK PERMIT No: Executive Tower
GENARAL WORK PER
Section A TYPE OF PERMIT
COLD HOT
Section B JOB PARTICULARS
Zone: Tower: Floor:
Job Description:
Name of Subcontractor: Supervisor Name:
ITEX
Section C NATURE OF WORK
WORK AT HEIGHT-SCAFFOLDING WORK AT HEIGHT-LADDER BELOW 1.8Mtr.
WORK ON HOT SURFACE MATERIAL LODING/UNLOADING
SPLICING/TERMINATION MANUAL MATERIAL HANDLING
TESTING/COMMISSIONING WORKING WITH ROTATING POWER TOOLS
Section D HAZARD CONSIDERATION
FIRE FALL FROM HEIGHT
NOISE & VIBRATION BIOLOGICAL HAZARDS
CUT ON BODY PARTS CRUSHING
ERGONOMIC DUST/FUMES
TOXIC / CORROSIVE MATERIAL WORKING WITH ELECTRICAL EQUIPMENT
SLIP, TRIP & FALL AT SAME LEVEL DROPPED TOOLS or OBJECT
DAMAGED TO THE PROPERTY POOR ACCESSIBILITY
EXCESS HOT ATMOSPHERE & HUMIDITY HAZARD FROM NEARBY ACTIVITY
SECTION E PREPARATION REQUIRED FOR SAFE EXECUTION
ENTRY RESTRICTED - BARRICADING WARNING BOARDS AT PLACED
ESCAPE ROUTES CHECKED AND CLEAR ADEQUATE SUPERVISION PROVIDED
DRAINAGE, MANHOLES COVERED LOTO ENSURED
NEARBY WORK HAZARD CONSIDERED INSPECTION TAG ON SCAFFOLD
JBR/ARK/HBS/FRM-0001 Rev.02
TBT CONDUCTED and RA DISCUSSED WORK AREA PHOTO TAKEN BEFORE START
MANDATORY PPEs PROVIDED AND USED JOB SPECIFIC PPEs AVAILABLE AND USED
SECTION F AUTHORISATION PERIOD
Permit is authorized from _________Hrs. On Date _______________ up to end of current da
per Section I (see overleaf)
SECTION G APPROVALS
Authority Level Name & Designation Sign
Issuer
Acceptor
SECTION H CLOSURE/ CANCELLATION
Select required box
Permit Closed - Job Completed. Snap taken, all equipment/tools used for job are removed & area clean.
Permit Closed - Job Incomplete. All equipment/tools used for job are removed & area clean.
Permit Cancelled / Rejected - Permit cancelled as present condition are not conducive for carrying the work
JBR/ARK/HBS/FRM-0001 Rev.02
SECTION I EXTENSION/ RENEWAL
DAY DATE VALID FROM VALID UP TO
JBR/ARK/HBS/FRM-0001 Rev.02
JBR/ARK/HBS/FRM-0001 Rev.02
nternational ME- HBS- Dubai
Site-Business Bay
wer
GENARAL WORK PERMIT
WORK ON ELECTRIC EQUIPMENT
Location:
Planned number of persons on the job:
HEIGHT-LADDER BELOW 1.8Mtr. WORK AT HEIGHT-LADDER ABOVE 1.8 Mtr.
L LODING/UNLOADING PAINTING
MATERIAL HANDLING GRINDING/DRILLING
G WITH ROTATING POWER TOOLS HACKSAW CUTTING
UNAUTHORIZED ENTRY
CAL HAZARDS ELECTRIC SHOCK
ELECTRIC ARC FLASH
STORED ENERGY
G WITH ELECTRICAL EQUIPMENT MOVING OBJECT
D TOOLS or OBJECT POOR VISIBILITY
CESSIBILITY WET & SLIPPERY SURFACE
FROM NEARBY ACTIVITY OTHER-
G BOARDS AT PLACED FALL PROTECTION PROVIDED
TE SUPERVISION PROVIDED PROPER LIGHTING PROVIDED
STANDBY PERSON PROVIDED
ON TAG ON SCAFFOLD INSPECTED LADDER. TAG NO-
JBR/ARK/HBS/FRM-0001 Rev.02
REA PHOTO TAKEN BEFORE START INSPECTED ELECTRICAL EQUIPMENT. TAG NO-
IFIC PPEs AVAILABLE AND USED OTHER PRECAUTIONS -
_______ up to end of current day (max up to 1700 Hrs.) Unless extended as
ection I (see overleaf)
Sign Date Time
Name & Sign Date & Time
used for job are removed & area clean. Acceptor
or job are removed & area clean. Acceptor
are not conducive for carrying the work.
JBR/ARK/HBS/FRM-0001 Rev.02
VALID UP TO ISSUER NAME & ID No. ACCEPTOR
JBR/ARK/HBS/FRM-0001 Rev.02
JBR/ARK/HBS/FRM-0001 Rev.02